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Article ; Online: Virtual care and COVID-19: A survey study of adoption, satisfaction and continuing education preferences of healthcare providers in Newfoundland and Labrador, Canada.

Curran, Vernon R / Hollett, Ann / Peddle, Emily

Frontiers in digital health

2023 Volume 4, Page(s) 970112

Abstract: ... adaptation to virtual care provision (e.g., virtual examinations/assessments), as well as patient educational ...

Abstract	Introduction: Virtual care has expanded during COVID-19 and enabled continued access to healthcare services. For many healthcare providers, the adoption of virtual care has been a new experience in the provision of healthcare services. The purpose of this survey study was to explore healthcare providers' experiences with virtual care during COVID-19. Methods: A web-based survey-questionnaire was developed by applying Rogers' theory of diffusion of innovation and distributed to healthcare providers (physicians, nurses and allied health professionals) in Newfoundland and Labrador, Canada to explore virtual care experiences, satisfaction and continuing professional development (CPD) needs. Analyses included descriptive statistics and thematic analysis of survey responses. Results: Fifty-one percent of respondents ( Discussion: Beyond the COVID-19 pandemic, virtual care will have a continuing role in enhancing continuity of care through access that is more convenient. Survey findings reveal a number of opportunities for supporting healthcare providers in use of virtual care, including CPD, guidelines and resources to support adaptation to virtual care provision (e.g., virtual examinations/assessments), as well as patient educational support.
Language	English
Publishing date	2023-01-25
Publishing country	Switzerland
Document type	Journal Article
ISSN	2673-253X
ISSN (online)	2673-253X
DOI	10.3389/fdgth.2022.970112
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Article ; Online: Patient Experiences With Virtual Care During the COVID-19 Pandemic: Phenomenological Focus Group Study.

Curran, Vernon R / Hollett, Ann / Peddle, Emily

JMIR formative research

2023 Volume 7, Page(s) e42966

Abstract: Background: Virtual care has expanded during the COVID-19 pandemic and enabled greater access and continuity of care for many patients. From a patient-oriented research perspective, understanding the patient experience with virtual care appointments is ... ...

Abstract	Background: Virtual care has expanded during the COVID-19 pandemic and enabled greater access and continuity of care for many patients. From a patient-oriented research perspective, understanding the patient experience with virtual care appointments is an important first step in identifying ways to better support patient use and satisfaction. Objective: The purpose of this qualitative study was (1) to explore patients' experiences and perspectives with the adoption and use of virtual care during COVID-19 in Newfoundland and Labrador, Canada, and (2) identify the education and informational needs of patients to inform future strategies for supporting patient use of virtual care. Methods: Using a phenomenological approach, we conducted a focus group interview with a purposive sample of patient representatives representing a cross-section of the population of the province of Newfoundland and Labrador. Five patient representatives were recruited from the Newfoundland and Labrador Support Patient Advisory Council and participated in the focus group. The focus group was conducted in February 2022 via videoconferencing technology. Using thematic analysis, we identified several recurrent themes that described respondents' experiences with the use of virtual care during COVID-19, as well as their perceptions of education and informational needs to support more effective patient use of virtual care. Results: Respondents felt that virtual care is a beneficial addition to the health care system, enabling greater convenience and access to health care services. Key barriers and challenges in adopting and using virtual care appear to primarily arise from patients' lack of knowledge, understanding, and familiarity with respect to virtual care. Cost, technological access, connectivity, and low digital literacy were challenges for some patients, particularly in rural communities and among older patient population. Patient education and support were critical and needed to be inclusive, easy to understand, and include information regarding privacy, security, consent, and the technology itself. The types of patient education experiences regarded as most helpful included peer support and knowledge sharing among patients themselves. Conclusions: Beyond the COVID-19 pandemic, virtual care will have a continuing role in enhancing the continuity of care for patients through more convenient access. The education and informational needs of patients are important considerations in promoting the adoption and use of virtual care. Key education and informational needs and strategies were identified to enable and empower patients with the knowledge, digital literacy skills, and support to effectively use virtual care.
Language	English
Publishing date	2023-05-01
Publishing country	Canada
Document type	Journal Article
ISSN	2561-326X
ISSN (online)	2561-326X
DOI	10.2196/42966
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Article: Training for virtual care: What do the experts think?

Curran, Vernon / Hollett, Ann / Peddle, Emily

Digital health

2023 Volume 9, Page(s) 20552076231179028

Abstract: Introduction: Virtual care has expanded during COVID-19 and enabled continued access to healthcare services. As with the introduction of any new technology in healthcare delivery, the preparation of healthcare providers for adopting and using such ... ...

Abstract	Introduction: Virtual care has expanded during COVID-19 and enabled continued access to healthcare services. As with the introduction of any new technology in healthcare delivery, the preparation of healthcare providers for adopting and using such systems is imperative. The purpose of this qualitative study was to explore experts' ascribed opinions on healthcare providers' continuing professional development (CPD) needs in virtual care. Methods: Semistructured interviews were conducted with a purposive sample of key informants representing Canadian provincial and national organizations with expertise in virtual care delivery. Results: Three main areas of knowledge, skills, and abilities that would be most helpful for healthcare providers in preparing to adopt and use virtual care were identified. The use of technology necessitates knowledge of how to integrate technology and virtual care in the practice workflow. This includes knowing how to use the technology and the privacy and security of the technology. Providers need to be able to adapt their clinical skills to virtual care and build rapport through good communication with patients. Virtual care is not appropriate for all visits, therefore providers need to understand when an in-person visit is necessary with respect to the nature of the appointment, as well as contextual factors for individual patients. Finally, providers need to adapt their examination skills to virtual care. Discussion: Beyond the COVID-19 pandemic, virtual care will have a continuing role in enhancing continuity of care through access that is more convenient. Key informants identified barriers and challenges in adopting and using virtual care effectively, fundamental knowledge, skills and/or abilities required, and important topics and/or educational experiences to guide CPD program development on virtual care for healthcare providers.
Language	English
Publishing date	2023-05-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	2819396-9
ISSN	2055-2076
ISSN	2055-2076
DOI	10.1177/20552076231179028
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Article ; Online: Lysosomal lipid peroxidation regulates tumor immunity.

Bhardwaj, Monika / Lee, Jennifer J / Versace, Amanda M / Harper, Sandra L / Goldman, Aaron R / Crissey, Mary Ann S / Jain, Vaibhav / Singh, Mahendra Pal / Vernon, Megane / Aplin, Andrew E / Lee, Seokwoo / Morita, Masao / Winkler, Jeffrey D / Liu, Qin / Speicher, David W / Amaravadi, Ravi K

The Journal of clinical investigation

2023 Volume 133, Issue 8

Abstract: Lysosomal inhibition elicited by palmitoyl-protein thioesterase 1 (PPT1) inhibitors such as DC661 can produce cell death, but the mechanism for this is not completely understood. Programmed cell death pathways (autophagy, apoptosis, necroptosis, ... ...

Abstract	Lysosomal inhibition elicited by palmitoyl-protein thioesterase 1 (PPT1) inhibitors such as DC661 can produce cell death, but the mechanism for this is not completely understood. Programmed cell death pathways (autophagy, apoptosis, necroptosis, ferroptosis, and pyroptosis) were not required to achieve the cytotoxic effect of DC661. Inhibition of cathepsins, or iron or calcium chelation, did not rescue DC661-induced cytotoxicity. PPT1 inhibition induced lysosomal lipid peroxidation (LLP), which led to lysosomal membrane permeabilization and cell death that could be reversed by the antioxidant N-acetylcysteine (NAC) but not by other lipid peroxidation antioxidants. The lysosomal cysteine transporter MFSD12 was required for intralysosomal transport of NAC and rescue of LLP. PPT1 inhibition produced cell-intrinsic immunogenicity with surface expression of calreticulin that could only be reversed with NAC. DC661-treated cells primed naive T cells and enhanced T cell-mediated toxicity. Mice vaccinated with DC661-treated cells engendered adaptive immunity and tumor rejection in "immune hot" tumors but not in "immune cold" tumors. These findings demonstrate that LLP drives lysosomal cell death, a unique immunogenic form of cell death, pointing the way to rational combinations of immunotherapy and lysosomal inhibition that can be tested in clinical trials.
MeSH term(s)	Mice ; Animals ; Lipid Peroxidation ; Apoptosis ; Cell Death ; Neoplasms/pathology ; Antioxidants/pharmacology ; Lysosomes/metabolism
Chemical Substances	Antioxidants
Language	English
Publishing date	2023-04-17
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	3067-3
ISSN	1558-8238 ; 0021-9738
ISSN (online)	1558-8238
ISSN	0021-9738
DOI	10.1172/JCI164596
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Article ; Online: Lysosomal lipid peroxidation regulates tumor immunity

Monika Bhardwaj / Jennifer J. Lee / Amanda M. Versace / Sandra L. Harper / Aaron R. Goldman / Mary Ann S. Crissey / Vaibhav Jain / Mahendra Pal Singh / Megane Vernon / Andrew E. Aplin / Seokwoo Lee / Masao Morita / Jeffrey D. Winkler / Qin Liu / David W. Speicher / Ravi K. Amaravadi

The Journal of Clinical Investigation, Vol 133, Iss

2023 Volume 8

Abstract	Lysosomal inhibition elicited by palmitoyl-protein thioesterase 1 (PPT1) inhibitors such as DC661 can produce cell death, but the mechanism for this is not completely understood. Programmed cell death pathways (autophagy, apoptosis, necroptosis, ferroptosis, and pyroptosis) were not required to achieve the cytotoxic effect of DC661. Inhibition of cathepsins, or iron or calcium chelation, did not rescue DC661-induced cytotoxicity. PPT1 inhibition induced lysosomal lipid peroxidation (LLP), which led to lysosomal membrane permeabilization and cell death that could be reversed by the antioxidant N-acetylcysteine (NAC) but not by other lipid peroxidation antioxidants. The lysosomal cysteine transporter MFSD12 was required for intralysosomal transport of NAC and rescue of LLP. PPT1 inhibition produced cell-intrinsic immunogenicity with surface expression of calreticulin that could only be reversed with NAC. DC661-treated cells primed naive T cells and enhanced T cell–mediated toxicity. Mice vaccinated with DC661-treated cells engendered adaptive immunity and tumor rejection in “immune hot” tumors but not in “immune cold” tumors. These findings demonstrate that LLP drives lysosomal cell death, a unique immunogenic form of cell death, pointing the way to rational combinations of immunotherapy and lysosomal inhibition that can be tested in clinical trials.
Keywords	Oncology ; Medicine ; R
Subject code	572
Language	English
Publishing date	2023-04-01T00:00:00Z
Publisher	American Society for Clinical Investigation
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: [Corrigendum] Daily or weekly dosing with EGFR inhibitors, gefitinib and lapatinib, and AKT inhibitor MK2206 in mammary cancer models.

Lubet, Ronald A / Steele, Vernon E / Juliana, M M / Bode, Ann / Moeinpour, Fariba / Grubbs, Clinton J

Oncology reports

2018 Volume 41, Issue 1, Page(s) 718

Abstract: The AKT inhibitor employed in this article was identified as MK 2206 (8‑[4‑(1‑aminocyclobutyl) phenyl]‑9‑phenyl‑1,2,4‑ triazolo[3,4‑f][1,6]naphthyridin‑3(2H)‑one hydrochloride (1:2). However, another AKT inhibitor was actually used, which is typically ... ...

Abstract	The AKT inhibitor employed in this article was identified as MK 2206 (8‑[4‑(1‑aminocyclobutyl) phenyl]‑9‑phenyl‑1,2,4‑ triazolo[3,4‑f][1,6]naphthyridin‑3(2H)‑one hydrochloride (1:2). However, another AKT inhibitor was actually used, which is typically identified as Akt I‑1,2 (HC,I. IPA (2‑[4‑(3‑phenylquinoxalin‑2‑yl)phenyl]propan‑2‑amine hydrochloride isopropanol (1:1:1). Therefore, all references to MK 2206 in the paper should have been made to Akt I‑1.2. Based on the experience of the present authors with a range of targeted inhibitors, it is expected that both inhibitors would have given rise to similar results; therefore, the results obtained in the paper are not likely to have been greatly affected as a consequence of the use of the alternative inhibitor. The authors regret that this error was not identified sooner, prior to the publication of the article, and regret any inconvenience that has been caused. [the original article was published in Oncology Reports 40: 1545‑1553, 2018; DOI: 110.3892/or.2018.6313].
Language	English
Publishing date	2018-10-17
Publishing country	Greece
Document type	Journal Article ; Published Erratum
ZDB-ID	1222484-4
ISSN	1791-2431 ; 1021-335X
ISSN (online)	1791-2431
ISSN	1021-335X
DOI	10.3892/or.2018.6802
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Article ; Online: Daily or weekly dosing with EGFR inhibitors, gefitinib and lapatinib, and AKt inhibitor MK2206 in mammary cancer models.

Lubet, Ronald A / Steele, Vernon E / Juliana, M M / Bode, Ann / Moeinpour, Fariba / Grubbs, Clinton J

Oncology reports

2018 Volume 40, Issue 3, Page(s) 1545–1553

Abstract: Daily vs. weekly dosing with EGFR inhibitors (gefitinib and lapatinib) and an AKT inhibitor (MK2206) were compared in two rodent breast cancer models. Female Sprague-Dawley rats were administered methylnitrosourea (MNU) at 50 days of age, and gefitinib ( ... ...

Abstract	Daily vs. weekly dosing with EGFR inhibitors (gefitinib and lapatinib) and an AKT inhibitor (MK2206) were compared in two rodent breast cancer models. Female Sprague-Dawley rats were administered methylnitrosourea (MNU) at 50 days of age, and gefitinib (daily/weekly dosing at 10/70 mg/kg BW) or lapatinib (daily/weekly dosing at 75/525 mg/kg BW) were administered by gavage beginning 5 days after MNU. For the prevention studies, weekly or daily dosing with gefitinib or lapatinib reduced cancer multiplicity >75%, and all treatments reduced tumor weights by >90%. For the therapeutic studies, MNU-treated rats were followed until small palpable mammary cancers developed. The rats were then treated daily or weekly as above for 6 weeks. Either daily or weekly dosing with lapatinib or gefitinib caused regression in >50% of the tumors. Immunohistochemistry biomarker studies in palpable mammary cancers following a weekly dose of gefitinib showed that 1 day (but not 7 days) after treatment, the levels of phosphorylated EGFR1 were significantly decreased. In an ER-negative (ER-) Neu-overexpressing model employing MMTV-Neu/P53KO mice, daily (100 mg/kg BW/day, 5 days each week), or weekly dosing (500 or 250 mg/kg BW) with gefitinib reduced tumor multiplicity 65, 85 and 75%, respectively. In the MNU prevention model, daily dosing (100 mg/kg BW/day) with the allosteric AKT inhibitor MK2206 was ineffective, while weekly dosing (700 mg/kg BW) reduced the final tumor weight >70%. Combining weekly MK2206 with the aromatase inhibitor vorozole (0.12 mg/kg BW/day) showed that each compound alone reduced tumor multiplicity 40-50%. The combination reduced cancer multiplicity ~70%. These studies demonstrate the efficacy of weekly dosing with various protein kinase inhibitors; raising the possibility of employing these agents in a breast cancer preventive setting.
MeSH term(s)	Animals ; Disease Models, Animal ; Drug Administration Schedule ; ErbB Receptors/antagonists & inhibitors ; Female ; Gefitinib ; Heterocyclic Compounds, 3-Ring/administration & dosage ; Lapatinib ; Male ; Mammary Neoplasms, Experimental/drug therapy ; Mammary Neoplasms, Experimental/pathology ; Mice ; Mice, Knockout ; Protein Kinase Inhibitors/administration & dosage ; Quinazolines/administration & dosage ; Rats ; Rats, Sprague-Dawley ; Triazoles/administration & dosage
Chemical Substances	Heterocyclic Compounds, 3-Ring ; MK 2206 ; Protein Kinase Inhibitors ; Quinazolines ; Triazoles ; Lapatinib (0VUA21238F) ; vorozole (1E2S9YXV2A) ; EGFR protein, human (EC 2.7.10.1) ; ErbB Receptors (EC 2.7.10.1) ; Gefitinib (S65743JHBS)
Language	English
Publishing date	2018-03-14
Publishing country	Greece
Document type	Journal Article
ZDB-ID	1222484-4
ISSN	1791-2431 ; 1021-335X
ISSN (online)	1791-2431
ISSN	1021-335X
DOI	10.3892/or.2018.6313
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Article: A Phenomenological Study of Postgraduate Medical Trainees' Incidental Learning Experiences and Psychological Well-Being During the COVID-19 Pandemic.

Curran, Vernon R / Hollett, Ann / Simmons, Karla / Stuckless, Teri / Radu, Greg

Cureus

2024 Volume 16, Issue 2, Page(s) e54937

Abstract: ... with virtual care. Some also reported a perceived increase in elements of emotional intelligence (e.g., self ...

Abstract	Background: During the COVID-19 pandemic, postgraduate medical trainees contributed significantly to the healthcare workforce, as multiple vulnerabilities in the healthcare system and medical training were expounded. The burden of training, learning, and working at this time introduced unique psychological and emotional stressors within a context of generalized volatility and radically different ways to work and learn. This study explored postgraduate trainees' experiences with coping, managing, and learning during the COVID-19 pandemic. Methodology: Using a phenomenological approach, semistructured interviews were conducted with an intradisciplinary sample ( Results: The COVID-19 pandemic prompted the use of restrictive public health measures and an unprecedented shift from in-person to virtual learning. This affected trainees' exposure to normalized learning experiences, training rotations, and opportunities to learn from peers and staff. Certainly, trainees reported that virtual learning improved their educational experiences in unique ways, increased engagement and attendance, and enabled regular meetings and learning when in-person options were unavailable. Trainees also reported enhanced self-directed learning skills, greater ownership of and leadership in their education, and increased confidence and experience with virtual care. Some also reported a perceived increase in elements of emotional intelligence (e.g., self-awareness, empathy, and compassion). Conclusions: Trainees reported a variety of incidental learning experiences from working and training during COVID-19. Although some experiences were challenging, there was a perception that such experiences led to new learnings that were beneficial to one's professional development and future career, as well as implications for future training provided to trainees. While there was a reported shift in the culture surrounding postgraduate trainees' health and safety, respondents also described the need for additional support for postgraduate trainees' well-being during a pandemic.
Language	English
Publishing date	2024-02-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.54937
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Article ; Online: Patterns of metastasis from a multicenter cohort of metastatic basal cell carcinoma.

Groover, Morgan / Gupta, Neha / Granger, Emily / Forrester, Vernon J / Anstadt, Emily J / Su, William / Heusinkveld, Lauren / Lukens, John N / Silk, Ann W / Schoenfeld, Jonathan D / Koyfman, Shlomo A / Vidimos, Allison T / Ruiz, Emily S

Journal of the American Academy of Dermatology

2024

Language	English
Publishing date	2024-02-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	603641-7
ISSN	1097-6787 ; 0190-9622
ISSN (online)	1097-6787
ISSN	0190-9622
DOI	10.1016/j.jaad.2024.01.069
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Article ; Online: Neuropsychiatric symptoms in severe dementia: Associations with specific cognitive domains the Cache County Dementia Progression Study.

Rozum, William J / Cooley, Bryce / Vernon, Elizabeth / Matyi, Joshua / Tschanz, JoAnn T

International journal of geriatric psychiatry

2019 Volume 34, Issue 7, Page(s) 1087–1094

Abstract: Objectives: To examine the prevalence of neuropsychiatric symptoms (NPS) and cognitive correlates in severe dementia.: Methods: A population-based sample of 56 individuals with severe dementia (85.7% Alzheimer's type; 67.9% female) were assessed with ...

Abstract	Objectives: To examine the prevalence of neuropsychiatric symptoms (NPS) and cognitive correlates in severe dementia. Methods: A population-based sample of 56 individuals with severe dementia (85.7% Alzheimer's type; 67.9% female) were assessed with the Severe Cognitive Impairment Profile (SCIP) and the Neuropsychiatric Inventory (NPI). Descriptive statistics displayed the frequency of NPS and bivariate and multiple regression analyses examined the associations between cognitive domains on the SCIP and NPS total, domain, and cluster scores. Results: NPS were common in severe dementia with 98% of the sample exhibiting at least one symptom. Most common were delusions, apathy, agitation/aggression, and aberrant motor behavior, affecting 50% or more of participants. SCIP comportment was significantly associated with NPI total score and apathy (r = -.350 and -.292, respectively). All SCIP domains except for arithmetic, visuospatial, comportment, and motor behavior were significantly associated with agitation/aggression (r = -.285 to -.350). These associations remained in individual multiple regression models. Conclusion: In severe dementia, impairment in specific cognitive domains was associated with more severe NPS. Environmental manipulations to reduce processing demands in persons with severe dementia may be a useful strategy to target agitation and aggressive behaviors.
MeSH term(s)	Aged ; Aged, 80 and over ; Anxiety/epidemiology ; Apathy ; Cognitive Dysfunction/psychology ; Delusions/epidemiology ; Dementia/psychology ; Disease Progression ; Female ; Humans ; Male ; Mental Disorders/epidemiology ; Neuropsychological Tests ; Prevalence ; Regression Analysis ; Utah/epidemiology
Language	English
Publishing date	2019-04-25
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	806736-3
ISSN	1099-1166 ; 0885-6230
ISSN (online)	1099-1166
ISSN	0885-6230
DOI	10.1002/gps.5112
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