4 results
Vickybot, a chatbot for anxiety-depressive symptoms and work-related burnout
- G. Anmella, M. Sanabra, M. Primé-tous, X. Segú, M. Cavero, R. Navinés, A. Mas, V. Olivé, L. Pujol, S. Quesada, C. Pio, M. Villegas, I. Grande, I. Morilla, A. Martínez-Aran, V. Ruiz, E. Vieta, D. Hidalgo-Mazzei
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S109-S110
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Introduction
A significant proportion of people attending Primary Care (PC) have anxiety-depressive symptoms and work-related burnout and there is a lack of resources to attend them. The COVID-19 pandemic has worsened this problem, particularly affecting healthcare workers, and digital tools have been proposed as a workaround.
ObjectivesWe present the development, feasibility and effectiveness studies of chatbot (Vickybot) aimed at screening, monitoring, and reducing anxiety-depressive symptoms and work-related burnout in PC patients and healthcare workers.
MethodsUser-centered development strategies were adopted. Main functions included self-assessments, psychological modules, and emergency alerts. (1) Simulation: HCs used Vickybot for 2 weeks to simulate different possible clinical situations and evaluated their experience. (3) Feasibility and effectiveness study: People consulting PC or healthcare workers with mental health problems were offered to use Vickybot for one month. Self-assessments for anxiety (GAD-7) and depression (PHQ-9) symptoms, and work-related burnout (based on the Maslach Burnout Inventory) were administered at baseline and every two weeks. Feasibility was determined based on the combination of both subjective and objective user-engagement Indicators (UEIs). Effectiveness was measured using paired t-tests as the change in self-assessment scores.
Results(1) Simulation: 17 HCs (73% female; mean age=36.5±9.7) simulated different clinical situations. 98.8% of the expected modules were recommended according to each simulation. Suicidal alerts were correctly activated and received by the research team. (2) Feasibility and effectiveness study: 34 patients (15 from PC and 19 healthcare workers; 77% female; mean age=35.3±10.1) completed the first self-assessments, with 34 (100%) presenting anxiety symptoms, 32 (94%) depressive symptoms, and 22 (64.7%) work-related burnout. Nine (26.5%) patients completed the second self-assessments after 2-weeks of use. No significant differences were found for anxiety [t(8) = 1.000, p = 0.347] or depressive [t(8) = 0.400, p = 0.700] symptoms, but work-related burnout was significantly reduced [t(8) = 2.874, p = 0.021] between the means of the first and second self-assessments. Vickybot showed high subjective-UEIs, but low objective-UEIs (completion, adherence, compliance, and engagement).
ConclusionsThe chatbot proved to be useful in screening the presence and severity of anxiety and depressive symptoms, in reducing work-related burnout, and in detecting suicidal risk. Subjective perceptions of use contrasted with low objective-use metrics. Our results are promising, but suggest the need to adapt and enhance the smartphone-based solution in order to improve engagement. Consensus on how to report UEIs and validate digital solutions, especially for chatbots, are required.
Disclosure of InterestNone Declared
On the bulk motion of the cerebrospinal fluid in the spinal canal
- A. L. Sánchez, C. Martínez-Bazán, C. Gutiérrez-Montes, E. Criado-Hidalgo, G. Pawlak, W. Bradley, V. Haughton, J. C. Lasheras
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- Journal:
- Journal of Fluid Mechanics / Volume 841 / 25 April 2018
- Published online by Cambridge University Press:
- 20 February 2018, pp. 203-227
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Radionuclide scanning images published in Nature by Di Chiro in 1964 showed a downward migration along the spinal canal of particle tracers injected in the brain ventricles while also showing an upward flow of tracers injected in the lumbar region of the canal. These observations, since then corroborated by many radiological measurements, have been the basis for the hypothesis that there must be an active circulation mechanism associated with the transport of cerebrospinal fluid (CSF) deep down into the spinal canal and subsequently returning a portion back to the cranial vault. However, to date, there has been no physical explanation for the mechanism responsible for the establishment of such a bulk recirculating motion. To investigate the origin and characteristics of this recirculating flow, we have analyzed the motion of the CSF in the subarachnoid space of the spinal canal. Our analysis accounts for the slender geometry of the spinal canal, the small compliance of the dura membrane enclosing the CSF in the canal, and the fact that the CSF is confined to a thin annular subarachnoid space surrounding the spinal cord. We apply this general formulation to study the characteristics of the flow generated in a simplified model of the spinal canal consisting of a slender compliant cylindrical pipe with a coaxial cylindrical inclusion, closed at its distal end, and subjected to small periodic pressure pulsations at its open entrance. We show that the balance between the local acceleration and viscous forces produces a leading-order flow consisting of pure oscillatory motion with axial velocities on the order of a few centimetres per second and amplitudes monotonically decreasing along the length of the canal. We then demonstrate that the nonlinear term associated with the convective acceleration contributes to a second-order correction consisting of a steady streaming that generates a bulk recirculating motion of the CSF along the length of the canal with characteristic velocities two orders of magnitude smaller than the leading-order oscillatory flow. The results of the analysis of this idealized geometry of the spinal canal are shown to be in good agreement not only with experimental measurements in an in-vitro model but also with radiological measurements conducted in human adults.
Dengue virus in Mexican bats
- Á. AGUILAR-SETIÉN, M. L. ROMERO-ALMARAZ, C. SÁNCHEZ-HERNÁNDEZ, R. FIGUEROA, L. P. JUÁREZ-PALMA, M. M. GARCÍA-FLORES, C. VÁZQUEZ-SALINAS, M. SALAS-ROJAS, A. C. HIDALGO-MARTÍNEZ, S. AGUILAR PIERLÉ, C. GARCÍA-ESTRADA, C. RAMOS
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- Journal:
- Epidemiology & Infection / Volume 136 / Issue 12 / December 2008
- Published online by Cambridge University Press:
- 06 March 2008, pp. 1678-1683
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Individuals belonging to five families, 12 genera, and 19 different species of bats from dengue endemic areas in the Gulf and Pacific coasts of Mexico were examined by ELISA, RT–PCR, and for the presence of dengue virus (DV) NS1 protein. Nine individuals from four species were seropositive by ELISA: three insectivorous, Myotis nigricans (four positives/12 examined), Pteronotus parnellii (3/19), and Natalus stramineus (1/4), and one frugivorous Artibeus jamaicensis (1/35) (12·86% seroprevalence in positive species). DV serotype 2 was detected by RT–PCR in four samples from three species (all from the Gulf coast – rainy season): two frugivorous, A. jamaicensis (2/9), and Carollia brevicauda (1/2), and one insectivorous, M. nigricans (1/11). The latter was simultaneously positive for NS1 protein. DV RT–PCR positive animals were all antibody seronegative. M. nigricans showed positive individuals for all three tests. This is the first evidence suggesting the presence of DV in bats from Mexico.
3 - Theory for Interactions between Particles in Monolayers
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- By Juan C. Fernández-Toledano, Arturo Moncho-Jordá, Francisco Martínez-López, Roque Hidalgo-Álvarez, Grupo de Fisica de Fluidos y Biocoloides, Departamento de Fisica Aplicada, Universidad de Granada, Campus de Fuente Nueva 18071, Granada, Spain
- Edited by Bernard P. Binks, University of Hull, Tommy S. Horozov, University of Hull
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- Book:
- Colloidal Particles at Liquid Interfaces
- Published online:
- 11 October 2009
- Print publication:
- 17 August 2006, pp 108-151
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Summary
Introduction
Particle monolayers are formed when small colloidal solid particles adsorb at liquid–vapour or liquid–liquid interfaces. Typical examples are latex monolayers at the air–aqueous salt solution and oil–water interfaces. The interaction between particles within the monolayer is dependent on both the properties of the fluids that make up the interface and on the nature of the adsorbed particles. Therefore, a detailed analysis of the interactions in colloidal monolayers is quite complex and distinctions must be made to take into account the different components of the monolayer.
The total interaction between particles in the monolayer determines their stability behaviour. Thus, examples of stable monolayer systems with particles that remain independent for a long time have been reported, in spite of the fact that in a thermodynamic sense, colloidal particles are not stable because of their great surface to volume ratio. Some monolayer systems showed a triangular structure suggesting the existence of long-ranged particle interactions. In other reported systems, however, it was found that particles are unstable and aggregate to form fractal structures or even became organized to form the so-called mesostructures. When fractal structures appear, the particle interaction potential is short ranged and has a minimum at very short distances.