The S.L.E.E.P.ing Beauty: new Research Idea suggests sedation-led chemotherapy to avoid pain

Photo by National Cancer Institute (NIH, USA) on Unsplash.

Blog post by Dr. Marco Cirillo, Heart Failure Surgery Unit Director at the Cardiovascular Department in Poliambulanza Foundation Hospital (Brescia, Italy)

Good morning, madam,” said the doctor greeting the patient who was entering his office. 

Good morning, Doctor,” she replied. 

So, how are you?” he asked her, motioning for her to sit in one of the two chairs in front of his desk. 

Well, it’s not bad.” 

The doctor looked at her carefully. 

So, this first dose of chemo… Did you tolerate it well, right?” 

“Yes, Doctor. I passed it…” 

Troubles? Nausea? Vomiting? Other problems?” 

No, Doctor. Nothing,” she replied. 

The doctor continued to watch her carefully. After her last answer he got up and went to sit next to her in the other chair that was in front of his desk. He took her hand and asked her again: 

So, madam: how are you?

The patient shook his hand as if in silent thanks. 

Doctor, you are a good doctor.” 

I’m here to understand what you need, madam, what can I do for you.” 

The patient thought a little longer before speaking. 

So, Doctor: the chemo didn’t bother me much, maybe because it’s the first one. Except that… In short, what was difficult was waiting together with the others, all talking about their tumor, where they have it, what chemo they are at, what happened to them, then the hairless ones with the turban on their heads, and how much hemoglobin you have, and what your husband said, and if they recognized you without hair…” 

I understand, madam. But it’s also a way to exorcise it, isn’t it? A way to share this bad experience, to not feel alone…” 

She looked him directly in the eyes.

Doctor, we are not all the same. These things bother me. Seeing how I will be in a month scares me. It doesn’t solace me to know that someone is sicker than me. And knowing that someone is better terrifies me…” 

The doctor nodded his head. 

I don’t want to think about my illness and when I come here, I necessarily think about it. I have to think about it. At home I do many things, I see many people, I may not think about it. But when I come here… Then for days I see these scenes in front of me, as if I’ve never left… Believe me, I do not simply ignore the disease, I know what I have and what awaits me. But if I could, I would avoid everything in between, between me and my illness. Do you understand?

Of course, madam. I understand. For others it is the same thing.” 

They went silent for a while. 

Then, the doctor said: 

If you had a choice, ma’am, what would you want? What would make you bear it all better?” 

She answered immediately, as if she had the answer ready. 

If I could, I would like to fall asleep and wake up when it’s all over! Don’t see the others, don’t even see the hospital, don’t hear what the nurses say, don’t see the drip, don’t feel the needle entering, don’t see the drop of poison that I have to let into my body to try to survive… Don’t feel the time passing so slowly, as slow as the drop of the drip, a time ‘lost’ that is part of the little time I still have left… I am forced to hope that this time will pass quickly, but at the same time I know that it is not convenient for me to pass quickly, because even this time of treatment is taken away from my life. From what remains of it…

The doctor released her hand and leaned back in his chair. 

The lady asked him: 

Did I say something wrong?” 

No, madam, on the contrary,” said the doctor. “You told me something wonderful.” 

Ah, really? It sounds trivial to me…” 

No, what a patient says when he talks about himself and his illness is never trivial. You gave me a very good idea, madam.” 

Indeed?” 

Sure! What you ask can be done.” 

That is…” 

I can set up a study in which to administer chemo during sleep and analyze the results,” the doctor said, then corrected himself by translating his words into more direct language. “Sorry: I can make you sleep during the treatment, maybe set the treatment during night, so it doesn’t alter your days. And then you will wake up when it’s all over. That wouldn’t prevent some side effects…” 

…but it would prevent me from living consciously at the time of treatment,” the patient completed. 

Sure,” the doctor confirmed. 

Like the Sleeping Beauty…” the patient said. “You know the tale, don’t you?” 

Sure, who doesn’t know it.” 

The fairy godmothers cannot avoid the evil witch’s curse, so they make her fall asleep instead of die. Waiting for a solution,” the patient sighed deeply. “So, Doctor, if you can eliminate the evil that hangs over me, do it. Otherwise, let me sleep before the spinning wheel stings me.” 

The doctor looked at her with a grateful look. He had always felt that not only did he do something for the patients every day, but the patients also did something for him every day. 

Would you do this for me, Doctor?” 

The doctor smiled. 

Of course, ma’am. For you and for all the people who want it. Just give me some time to organize this.” 

Take your time” the lady said enthusiastically, but soon after she added with a wink: “No, on the contrary: hurry up, I wouldn’t want to waste any more time…” 

**

Every doctor’s job is to heal diseases. When it is not possible to heal them, the best cure is to relieve the suffering. In Oncology, this second option is still extremely important. The psychological aspect of dealing with something that is often not guaranteed to heal is crucial. 

This project aims to extend the concept of “care” by approaching the patient and his/her needs: it is not the patient who has to adapt to the hospital’s schemes, its timing, its protocols, but it is the hospital that must serve the patients, to “take care” after their problem in its multidimensionality.  

The disease derails the life of the patient in a decisive way. We must as far as possible try to “sew in” the disease element into their everyday life,  if we want them to experience it as something that is part of normal life. This can make them tolerate it better and perhaps improve the chances of overcoming it. 

Here, this is the concept behind my research idea.

The study could be initially applied to a selected series of patients, and then extended, if the results are promising. 

Certainly, there are some practical limitations related to this study. Arranging the administration during sleep requires many “beds”; it requires specialized nursing staff; if it is carried at home, it also needs allocating specialists for home visits.

It is true, however, that home care for cancer patients is already very common in advanced healthcare systems. Economic investment and funding of cancer research and treatment remain at the top, along with cardiovascular diseases, in all healthcare systems. 

Cancer Centers nowadays abound around the world and are increasing in numbers. Comprehensive Cancer Centers, which are the largest in America, carry out transdisciplinary research, recognizing the importance of integrating different knowledge together for more effective treatment. The assistance and therapeutic network, the shared protocols, the sector research in Oncology already boast a very high level today. The coordination between centers makes use of all that assistance know-how. If I have to think of a medical field in which research, assistance, network of knowledge and uniformity of treatment are the most coordinated and efficient, this field is undoubtedly the oncology one. 

I would gladly give my scientific contribution by collaborating with centers of Excellence and their teams, who would like to join me on this research project. I would also readily share some organizational ideas by integrating them with the specific knowledge of colleague oncologists. Let’s fight the curse and help people to bear it with the least physical and psychological suffering!

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Read the full Research Idea in Research Ideas and Outcomes (RIO Journal) at: https://doi.org/10.3897/rio.7.e71271

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Full citation:
Cirillo M (2021) Sedation-Led chEmotherapy Evades Pain (S.L.E.E.P.). Research Ideas and Outcomes 7: e71271. https://doi.org/10.3897/rio.7.e71271

Open Science RIO Journal invites early research outcomes for the free-to-publish collection “Observations, prevention and impact of COVID-19”

Looking at today’s ravaging COVID-19 (Coronavirus) pandemic, which, at the time of writing, has spread to over 220 countries; its continuously rising death toll and widespread fear, on the outside, it may feel like scientists and decision-makers are scratching their heads more than ever in the face of the unknown. In reality, however, we get to witness an unprecedented global community gradually waking up to the realisation of the only possible solution: collaboration. 

On one hand, we have nationwide collective actions, including cancelled travel plans and mass gatherings; social distancing; and lockdowns, that have already proved successful at changing what the World Health Organisation (WHO) has determined as “the course of a rapidly escalating and deadly epidemic” in Hong Kong, Singapore and China. On the other hand, we have the world’s best scientists and laboratories all steering their expertise and resources towards the better understanding of the virus and, ultimately, developing a vaccine for mass production as quickly as possible. 

While there is little doubt that the best specialists in the world will eventually invent an efficient vaccine – just like they did following the Western African Ebola virus epidemic (2013–2016) and on several other similar occasions in the years before – the question at hand is rather when this is going to happen and how many human lives it is going to cost?

Again, it all comes down to collective efforts. It only makes sense that if research teams and labs around the globe join their efforts and expertise, thereby avoiding duplicate work, their endeavours will bear fruit sooner rather than later. Similarly to employees from across the world, who have been demonstrating their ability to perform their day-to-day tasks and responsibilities from the safety of their homes just as efficiently as they would have done from their conventional offices, in today’s high-tech, online-friendly reality, no more should scientists be restricted by physical and geographical barriers either. 

“Observations, prevention and impact of COVID-19”: Special Collection in RIO Journal

To inspire and facilitate collaboration across the world, the SPARC-recognised Open Science innovator Research Ideas and Outcomes (RIO Journal) decided to bring together scientific findings in an easy to discover, read, cite and build on collection of publications. 

Furthermore, due to its revolutionary approach to publishing, where early and brief research outcomes (i.e. ideas, raw data, software descriptions, posters, presentations, case studies and many others) are all considered as precious scientific gems, hence deserving a formal publication in a renowned academic journal, RIO places a special focus on these contributions. 

Accepted manuscripts that shall deal with research relevant to the COVID-19 pandemic across disciplines, including medicine, ethics, politics, economics etc. at a local, regional, national or international scale; and also meant to encourage crucial discussions, will be published free of charge in recognition of the emergency of the current situation. Especially encouraged are submissions focused on the long-term effects of COVID-19.

Why publish in RIO Journal? 

Launched in 2015, RIO Journal has since proved its place at the forefront of Open Science, which resulted in the SPARC’s Innovator Award in 2016. Supported by a renowned advisory board and subject editors, today the journal stands as a leading Open Science proponent. 

Furthermore, thanks to the technologically advanced infrastructure and services it provides, in addition to a long list of indexers and databases where publications are registered, the manuscripts submitted to RIO Journal are not only rapidly processed and published, but once they get online, they immediately become easy to discover, cite and built on by any researcher, anywhere in the world. 

On top of that, Pensoft’s targeted and manually provided science communication services make sure that published research of social value reaches the wider audience, including key decision-makers and journalists, by means of press releases and social media promotion.

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More info about RIO’s globally unique features, visit the journal’s websiteFollow RIO Journal on Twitter and Facebook.

Research on bats and pangolins – potential vectors of zoonotic pandemics like COVID-19 – invited to a free-to-publish special issue in ZooKeys

Captively bred pangolins. 
Photo by Hua L. et al., taken from their study on the current status, problems and future prospects of captive breeding of pangolins, openly accessible in ZooKeys at: https://doi.org/10.3897/zookeys.507.6970

Accepted papers will be published free of charge in recognition of the emergency of the current global situation

Was it the horseshoe bat or could it rather be one of the most traded mammal in the world: the pangolin, at the root of the current devastating pandemic that followed the transmission of the zoonotic SARS-CoV-2 virus to a human host, arguably after infected animal products reached poorly regulated wet markets in Wuhan, China, last year? 

To make matters worse, the current situation is no precedent. Looking at the not so distant past, we notice that humanity has been repeatedly falling victim to viral deadly outbreaks, including Zika, Ebola, the Swine flu, the Spanish flu and the Plague, where all are linked to an animal host that at one point, under specific circumstances transferred the virus to people. 

Either way, here’s a lesson humanity gets to learn once again: getting too close to wildlife is capable of opening the gates to global disasters with horrific and irreversible damage on human lives, economics and ecosystems. What is left for us to understand is how exactly these transmission pathways look like and what are the factors making certain organisms like the bat and the pangolin particularly efficient vectors of diseases such as COVID-19 (Coronavirus). This crucial knowledge could’ve been easier for us to grasp had we only obtained the needed details about those species on time.

Aligning with the efforts of the biodiversity community, such as the recently announced DiSSCo and CETAF COVID-19 Task Force, who intend to create an efficient network of taxonomists, collection curators and other experts from around the globe and equip them with the tools and large datasets needed to combat the unceasing pandemic, the open-access peer-reviewed scholarly journal ZooKeys invites researchers from across the globe to submit their work on the biology of bats and pangolins to a free-to-publish special issue. 

The effort will be coordinated with the literature digitisation provider Plazi, who will extract and liberate data on potential hosts from various journals and publishers. In this way, these otherwise hardly accessible data will be re-used to support researchers in generation of new hypotheses and knowledge on this urgent topic.

By providing further knowledge on these sources and vectors of zoonotic diseases, this collection of publications could contribute with priceless insights to make the world better prepared for epidemics like the Coronavirus and even prevent such from happening in the future. 

Furthermore, by means of its technologically advanced infrastructure and services, including expedite peer review and publication processes, in addition to a long list of indexers and databases where publications are registered, ZooKeys will ensure the rapid publication of those crucial findings, and will also take care that once they get online, they will immediately become easy to discover, cite and built on by any researcher, anywhere in the world. 

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The upcoming “Biology of bats and pangolins” special issue is to add up to some excellent examples of previous research on the systematics, biology and distribution of pangolins and bats published in ZooKeys

In their review paper from 2015, Chinese scientists looked into the issues and prospects around captive breeding of pangolins. A year later, their colleagues at South China Normal University provided further insights into captive breeding, in addition to new data on the reproductive parameters of Chinese pangolins.

Back in 2013, a Micronesian-US research studied the taxonomy, distribution and natural history of flying fox bats inhabiting the Caroline Islands (Micronesia). A 2018 joint study on bat diversity in Sri Lanka focused on chiropteran conservation and management; while a more recent article on the cryptic diversity and range extension of the big-eyed bats in the genus Chiroderma

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For more information, visit ZooKeys website

Follow ZooKeys on Twitter and Facebook.

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References:

Buden D, Helgen K, Wiles G (2013) Taxonomy, distribution, and natural history of flying foxes (Chiroptera, Pteropodidae) in the Mortlock Islands and Chuuk State, Caroline Islands. ZooKeys 345: 97-135. https://doi.org/10.3897/zookeys.345.5840

Edirisinghe G, Surasinghe T, Gabadage D, Botejue M, Perera K, Madawala M, Weerakoon D, Karunarathna S (2018) Chiropteran diversity in the peripheral areas of the Maduru-Oya National Park in Sri Lanka: insights for conservation and management. ZooKeys 784: 139-162. https://doi.org/10.3897/zookeys.784.25562

Hua L, Gong S, Wang F, Li W, Ge Y, Li X, Hou F (2015) Captive breeding of pangolins: current status, problems and future prospects. ZooKeys 507: 99-114. https://doi.org/10.3897/zookeys.507.6970

Lim BK, Loureiro LO, Garbino GST (2020) Cryptic diversity and range extension in the big-eyed bat genus Chiroderma (Chiroptera, Phyllostomidae). ZooKeys 918: 41-63. https://doi.org/10.3897/zookeys.918.48786

Zhang F, Wu S, Zou C, Wang Q, Li S, Sun R (2016) A note on captive breeding and reproductive parameters of the Chinese pangolin, Manis pentadactyla Linnaeus, 1758. ZooKeys 618: 129-144. https://doi.org/10.3897/zookeys.618.8886

Bulgarian Pharmaceutical Scientific Society’s journal moves to high-tech ARPHA platform

Bulgarian Pharmaceutical Scientific Society’s journal join the high-tech ARPHA platform and the fast-expanding portfolio of scholarly titles by Pensoft.Bulgarian Pharmaceutical Scientific Society’s journal join the high-tech ARPHA platform and the fast-expanding portfolio of scholarly titles by Pensoft.

The established Pharmacia demonstrates a complete makeover in its new issue after signing with scientific publisher and technology provider Pensoft and its signature open-access platform

Launched by the Bulgarian Pharmaceutical Scientific Society in 1954, the open-access, peer-reviewed Pharmacia has been available online as full text since 2007. As of 2019, the journal moves to the fast-expanding portfolio of scholarly publisher and technology provider Pensoft. The journal’s 2019 inaugural issue and the first since the realisation of the new partnership is already live on the journal’s new website.

Homepage of Pharmacia‘s new website, https://pharmacia.pensoft.net

Thanks to the Pensoft’s signature open-access scholarly publishing platform ARPHA, Pharmacia demonstrates a complete makeover, including a modern and user-friendly interface in addition to a long list of high-tech perks, meant to ensure that published articles are easy to discover, access, cite and reuse by both humans and machines all over the world.

Furthermore, all users of the journal’s system: authors, editors and reviewers alike, are to greatly benefit of ARPHA’s integrated approach to the publication process. This means that once submitted each manuscript goes through the whole cycle: from review and copy/layout editing to publication, dissemination and archiving without leaving ARPHA’s collaboration-focused online environment.

One of the interesting features now available in Pharmacia is the article-level metrics available thanks to the partnership between ARPHA and the revolutionary discovery and analytics tools Dimensions and Altmetric. By searching through millions of research articles, grant applications, clinical trials, as well as policy documents, news stories, blogs and social media posts, they allow for each article’s references and citations in both the academic and the public sphere to be monitored in real time.

Continuing its tradition, the journal welcomes original research and review articles, preliminary and short communications (notes) on a wide range of topics within the pharmaceutical and related sciences. In addition, the journal also publishes conference reports, biographies and book reviews. Articles in Pharmacia are published in English and subjected to single-blind peer review.

Pharmacia‘s Editor-in-Chief Prof Plamen Peikov, comments:

“We have been looking forward to our collaboration with Pensoft and ARPHA, as it is certainly going to not only help modernise Pharmacia on the outside, but also make it more appealing to our authors and readers by building on the journal’s accessibility and global outreach. I believe that this nice step forward is already clearly evident in Pharmacia‘s latest issue.”

ARPHA’s and Pensoft’s founder and CEO Prof Lyubomir Penev says:

“I’m delighted to see this particular journal joining the Pensoft’s and ARPHA’s family,” says ARPHA’s and Pensoft’s founder and CEO Prof. Lyubomir Penev. “With our strong background in scholarly publishing, technology development and open science practices, I am certain that we are able to provide the right venue for a high-quality and enterprising journal like Pharmacia.”

What’s on in the new issue?

The creeping cinquefoil – a perennial plant from the Northern hemisphere – has its status as a traditional medicine for treating diarrhoea, haemorrhoids and bleeding gums confirmed in a collaborative ethnobotanical study by researchers at the Bulgarian Academy of Sciences and the Medical University of Sofia (Bulgaria). Further, the team, led by Irena Mincheva, seek to explore the suggested use of the plant against mastitis: a relatively common disease and a major cause for milk reduction in both people and dairy cows.

Another paper, authored by Dr Illya Podolsky and Sergiy Shtrygol from the National University of Pharmacy in Ukraine, adds new information about “the pharmacological nature” of a molecule already known as a promising antidepressant with a unique spectrum of additional properties. By conducting an experiment in rats, using the preferred Morris water maze assessment method, the scientists study the effects of Atristamine on spatial memory and learning.

Pharmacia‘s latest issue is available on the new website. Available in HTML, XML and PDF formats, the articles are easy to find, access, mine, reuse and cite by both humans and computers. Check out the issue at: https://pharmacia.pensoft.net/issue/1757/.

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Pharmacia is indexed byScopusAltmetricBiotechnobaseCAplusSM/Chemical AbstractsCNKICrossRefDimensionsEBSCOhostEmbase, ExtraMED, Google ScholarJ-GateMEDLINE/PubMedMendeleyMicrosoft AcademicNaviga (Softweco)OpenAIREPascalReadCubeToxcenterUnpaywall.

About the Bulgarian Pharmaceutical Scientific Society:

The Bulgarian Pharmaceutical Scientific Society was registered in 2003 with the aim to organise national and international science forums, support education and publish academic literature. Its main objectives are to organise and encourage pharmacological research and support collaboration between pharmacology professionals and related organisations on both national and global level.