Highlights of the BMC Series: April 2019

We have had a fantastic month for publications this April at the BMC Series with over 1400 publications across the Series Journals. Below are some of the highlights from articles published in various BMC Series Journals in April 2019.

BMC Chemical Engineering: Energy systems engineering – a guided tour

A recent news highlight reported the UK running on clean energy for over 100 hours is an example of one of many attempts to steer away from coal-based energy with potentially huge environmental impacts. Energy efficiency, reduction of carbon footprint and the impact on the environment has forced us to think of better ways to engineer systems that allow for more cost-effective and sustainable forms of energy. This emerging field of engineering is called energy engineering or energy systems engineering.

In a recent commentary published in BMC Chemical Engineering, authors from Texas A&M University, present the current state of engineered tools in energy generation. With an aim in the field to optimize energy production to be more cost-effective, environment-friendly and easily operational, the task ahead to design such mouldable systems is becoming increasingly challenging.

In breaking down what we know so far and the potential areas for growth in this sector, the authors of the commentary introduce some key methods of energy systems engineering that are potentially versatile enough to cater to the changing human and environmental needs and resourcefulness of its tools. They discuss the criteria for selection, methods of optimization of production, and flaws in the current system of energy production. In proposing potential new directions for the field, they propose industry-academia collaborations, the use of information technology, artificial intelligence and machine learning, with potentially tapping into interdisciplinary research allowing access of previously unused sources of energy, as the way forward towards cheap and clean energy.

BMC Medical Education: How does ‘banter’ influence trainee doctors’ choice of career? A qualitative study

Banter often comprises stereotypes and caricatures, but despite its biases and distortions, it may still aid career choice

Who does not enjoy a good banter? However, have you ever thought about these friendly exchanges having a deep-rooted impact on your decisions? Researchers from the University of Bath analyse the effect of banter in an interview-based qualitative study among 24 trainee doctors.

They first go on to define what ‘banter’ comprises and to what extent it serves to shape their career choices. The content of the banter seems to be diverse but the most common themes among these medics seems to be judgement of demand, work/life balance, workload and personality. Authors note that comments from senior doctors, coupled with their experiences as a trainee, forces them to judge how and where they would best fit within the system. They found that humorous and stereotypical accounts of specialties often led to rivalry, particularly from and about surgeons. Also, lack of expertise featured quite prominently in “friendly banter”.

Earlier studies tended to show that propaganda towards or against certain practices, influenced how junior doctors picked their practices. In line with this, the trainee doctors reported as “not being influenced” by negative banter but, authors do note that these are not just taken at face value but are rather assimilated and weighed against other perceived information and experiences to make an informed career choice. In line with the study, “Banter often comprises stereotypes and caricatures, but despite its biases and distortions, it may still aid career choice”.

BMC Geriatrics: Using an interactive digital calendar with mobile phone reminders by senior people – a focus group study

As new technologies emerge, more tools are invented with the aim of making life easier. However, training senior citizens to bring them up to speed with using this technology is certainly a challenge. A recent study published in BMC Geriatrics evaluates the learning and implementation of the smart phone and in particular, an interactive digital calendar app called ‘RemindMe’. This app was designed to be used by community-dwelling seniors with cognitive impairments, to be reminded timely to take their medications.

A total of 20 seniors who used RemindMe for six weeks took part in this study. RemindMe can be used for scheduling of activities/events, with individual reminders that require conformation of reminders sent by SMS and further more allows self-monitoring based on the interaction with the app. The usefulness and the use of the app was recorded in feedback given by these 20 participants divided into four groups, with questions on how useful they found the reminders and how easy it was to use the app as an integral part of their daily lives.

For some, RemindMe was a sign of modernity, symbolizing that the user was part of the rapid technologically developing society

While some embraced these new technology-driven reminders, others found it hard to incorporate this into their daily life and often had difficulty using the smartphone, as the app in itself seems to be rather easy to use. Some also found it hard to change from their own regular calendars. In the event that they did manage to use it, they found the reminders helpful, giving them a sense of independence and control over their own lives. While analyzing the symbolic value of this study. The authors point out that “For some, RemindMe was a sign of modernity, symbolizing that the user was part of the rapid technology developing society”. They conclude that in order to promote seniors to embrace digital technology, they should be motivated to use it by clearly showing them the importance and the change it can bring to their everyday life.

BMC Family Practice: Perspective of healthy asymptomatic patients requesting general blood tests from their physicians: a qualitative study

Quite often we see healthy individuals asking for referrals from their doctors to have blood tests without any obvious symptoms. While there are several studies looking at why doctors give in and do end up referring them for these blood tests, there is no study on the patients’ perspective as to why such tests are being requested in the first place. Researchers from Israel have presented a study where they interviewed 15 presumably healthy adults between the ages of 22 and 50 who have requested a prescription for blood tests with no apparent symptom of illness.

With in-depth interviews, the authors identified three main reasons as to why these tests were being requested – those who requested the tests seem to need external validation that all is “OK” within them, they seem to think that periodic blood tests are beneficial in “catching things early”, or they are prompted by someone else’s illness to check if they are safe.

They seem to be requesting the blood tests, almost like annual dental exams, adding the routine blood test to their healthy lifestyle’s to-do list, like a healthy diet, stress reduction and regular exercise.  While some of them seemed to think there can really be no harm in taking these regular tests, other seemed to think that this thought was reinforced by adverts on media driving the need for early diagnosis of any potentially life-threatening condition and this is often when they have lost relatives due to conditions like Cancer.

This study highlights the gap between what is known to doctors and what is perceived by “patients”. Blood tests have in fact not proven to aid the early diagnosis of several disorders and also do not affect progression of the disease in many cases. Doctors acknowledge that early diagnosis in certain cases is important but in most cases these tests often lead to the waste of time and money, often leading to patient anxiety and unnecessary procedures.

The study has substantial practical implications and highlights the fact that doctors should be more proactive in understanding the patients’ motivations, aiming to educate them about when these tests are really necessary, preventing both unnecessary financial burden and potential health risk arising from harmful over-exposure to diagnostic tools.

BMC Cancer: Drug resistance profiling of a new triple negative breast cancer patient-derived xenograft model

Triple-negative breast cancer is both very aggressive and compounded by limited treatment option availability. In order to further understand this form of breast cancer, and derive potential treatment plans, as in other cancers, researchers from Tulane University in New Orleans have turned to patient-derived xenografts, whereby in you inject breast cancer cells taken from a patient into the animal – mice in this case, giving the cells a more human tumour-like characteristic than those purely developed in the lab.

After verifying that the cells injected into mice did indeed recapitulate the original cancer, the authors went on to make 2D and 3D cultures from these cells to test if a certain drug combination would prove effective in this case or not, prior to treatment of the actual patient, and also see if the tumour develops resistance to the drug. They employed a simple dead or alive staining first to determine if after treatment with a standard drug set had any effect. This allows them to broadly classify the drugs as those that prevent further growth versus those that have no effect on the tumour.

They identify that these cells were more sensitive to certain classes of drugs such as those that affect physical constraints within and around the cells, but resistant to others. They note that there are differences in how 2D cultures (a single sheet of cells) respond to treatment as opposed to 3D cultures, that are more complex in structure and characteristic, more similar to what can be found in real tumors. While this system has been tested here with just one form of cancer, and to known drugs, the system and the rather simplistic screen procedure allows for potential expansion and pre-clinical testing across all cancer types and the entire gamut of drugs that are approved in the market. It could also be further expanded to identify efficient drugs against rare and more aggressive cancer types that have, in the past, proved rather difficult to halt, identify and treat.

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