Search

Objective: To assess the current trends in the field of artificial intelligence in medicine by analysing 100 most cited original articles relevant to the field., Methods: The bibliometric analysis was conducted in September 2022, and comprised literature search on Scopus database for original articles only. Google and Medical Subject Headings databases were used as resources to extract key words. In order to cover a broad range of articles, original studies comprising human as well as non-human subjects, studies without abstract and studies in languages other than English were part of the inclusion criteria. There was no specific time period applied to the search and no specific selection was done regarding the journals in the database. The screening was done using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to extract the top 100 most cited articles in the field of artificial intelligence usage in medicine. Data was analysed using SPSS 23., Results: Of the 11,571 studies identified, 100(0.86%) were analysed in detail. The studies were published between 1986 and 2021, with a median of 43 citations (IQR 53) per article. The journal 'Artificial Intelligence in Medicine' accounted for the highest number 9(9%)) of articles, and the United States was the country of origin for most of the articles 36(36%)., Conclusion: The trends, development and shortcomings in field of artificial intelligence usage in medicine need to be understood to conduct an effective research in areas that still need attention, and to guide the authorities to direct their funding accordingly.

The sterile paper-plastic barrier system for packaging sterilized medical equipment is studied, the main factors affecting its breakdown are revealed, and the inhalation rate during the pressure sterilization is experimentally analyzed. The results offer a new window of opportunity for a stricter risk-analysis and a robust strategy for the pressure sterilization, and this paper can be served as an example of strict clinical applications. [ABSTRACT FROM AUTHOR]

An Adlerian view on some examples of pastoral care in a clinical setting and with people in old-age The final thesis for the Individual Psychological Counselor provides insights into the diverse application of individual psychological concepts in pastoral practice by looking at encounters in different contexts. The reflections show how individual psychology can help to understand and support people in different life situations by emphasizing the importance of a sense of community, feelings of inferiority and lifestyles. [ABSTRACT FROM AUTHOR]

Aim: The increase in the number of people with chronic obstructive pulmonary disease (COPD) and the disease burden, has prompted concerted efforts to improve healthcare, particularly outpatient services. In line with these attempts the Partnership-Based Nursing Practice Theoretical Framework for People with COPD was developed to guide outpatient nursing care. The principal approach of the framework is a ‘Dialogue’ with the patients, which has four components: ‘Establishing family involvement’, ‘Assisting living with symptoms’ and ‘Facilitating access to healthcare’, with the primary goal being ‘Enhancement of the health experience’. With new knowledge, research on the framework, and extensive experience in using it, a need arose to modify the framework to maximize its clinical utility. Design: Discursive paper. Methods: A narrative review and critical reflection was conducted to revise the nursing practice framework via selected literature search from 2012 to 2022, research on the framework, and the authors' reflections on the clinical experience of using the framework. Results: The nursing practice framework highlights capacities and possibilities that lie in the nurse–patient relationship. The overarching dialogue in the revised framework includes both patients and families. The action-related component ‘Assisting living with the disease’ was added to the framework to underscore the significance of attempting to understand what may lie ahead for patients and families. The other action-related components are as follows: ‘Assisting living with symptoms’ and ‘Facilitating access to healthcare’. The primary goal remains unchanged: enhancing the ‘Health experience’. Conclusion: Using the revised nursing practice framework in outpatient care may help to enhance the lives of people with COPD and their families, particularly at advanced stages of the disease. It may have transferability to other groups of people living with progressive diseases dealing with complicated health problems, and to reduce the usage of costly healthcare resources such as hospital care. Implications for the Profession and/or Patient Care: The partnership-based nursing practice framework assumes an extension of conventional specialized respiratory service and embraces a comprehensive account for that which may influence the patient's health problems. This guidance, which holistically attends to patient-family needs of living with complicated and progressive health predicaments, is fundamental. It contributes to strengthening the disciplinary focus of nursing, interdisciplinary collaboration, person-family-centred quality nursing care and inspires research initiatives. Critical reflections and updates on nursing practice frameworks, such as this revision, are essential to advance nursing and healthcare. [ABSTRACT FROM AUTHOR]

BACKGROUND: Data about performance measures (PM) in patients with ST segment Elevation Myocardial Infarction (STEMI) in low- and middle-income countries is really scarce. One of the reasons is the lack of appropriate measures for these scenarios where coronary intervention is not the standard treatment. OBJECTIVE: This study aimed to develop a set of PM and quality markers for patients with STEMI in these countries. METHODS: Two investigators systematically reviewed existing guidelines and scientific literature to identify potential PM by referring to documents searched through PubMed from 2010 through 2019, using terms "Myocardial Infarction", "STEMI", "quality indicator", and "performance measure". A modified Delphi technique, involving multidisciplinary panel interview, was used. A 15-member multidisciplinary expert panel individually rated each potential indicator on a scale of 1 (lowest) to 5 (highest) during three rounds. All indicators that received a median score ≥4.5, in final round without significant disagreement were included as PM. RESULTS: Through the consensus-building process, 84 potential indicators were found, of which 10 were proposed as performance measures and 2 as quality metrics, as follows: Pre-Hospital Electrocardiogram; Patients with reperfusion therapy; Pre-hospital Reperfusion; Ischemic time less than 120 minutes; System delay time less than 90 minutes; In-hospital Mortality; Complete in-hospital Treatment; Complete in-hospital Treatment in patients with Heart Failure; 30 day-Re-admissions; 30 day-mortality; Patients with in-hospital stress test performed; and, Patients included in rehabilitation programs. CONCLUSION: This document provides the official set of PM of attention in ST segment Elevation Myocardial Infarction of the Cuban Society of Cardiology and Cuban National Group of Cardiology. [ABSTRACT FROM AUTHOR]

Introduction: Over the last decade, the emergence and spread of personalized medicine (PM) have defined a substantial revolution in healthcare. In principle, healthcare system sustainability is challenged by the investments required for research and development, as well as the adoption of PM techniques in routine clinical care. The "Integrating China in the International Consortium for Personalized Medicine" (IC2PerMed) EU-funded project aims to integrate China into the "International Consortium for Personalized Medicine" (ICPerMed). IC2PerMed aims to align the EU and China's research agendas in this field to enable a swift development of approaches in the EU and China with strong leverage upon EU-Chinese collaborations. Methods: Within this project, we first mapped relevant policies on PM in both the EU and China, and then we involved European and Chinese experts in PM in workshops and Delphi surveys in order to identify relevant priorities for the implementation of PM in sustainable healthcare. Results: As a result of this process, we identified nine overarching priorities, each addressing specific aspects of the sustainability of healthcare systems and PM implementation, with the main goal of supporting policymakers in integrating PM approaches in the EU and China. Discussion/conclusion: The implementation of PM in health systems is appealing in terms of improved accuracy in diagnostics, treatment, and prevention of disease, as well as reduction of the side effects resulting from inefficient use of drugs. Research, development, and implementation of needed techniques require time and resources that can slow the adoption of PM in healthcare systems. The nine priorities we identified address some of the most critical points, trying to lay the foundations for a comprehensive approach. [ABSTRACT FROM AUTHOR]

Point-of-care testing (POCT) biosensors are rapidly developing in recent years because of the urgent needs for rapid test and home test. Among various types of POCT biosensors, paper-based biosensors have occupied large market share owing to the advantages of cost-effectiveness, portability and simplicity. To further meet the increasing requirement of POCT in various application scenes, the functionalization of paper is highly demanded. Metal-organic framework (MOF), a multifunctional porous material, is introduced in the design of paper-based biosensors, significantly improving the sensing property and application potential. This review provides a summary of the recent advances and emerging trends of MOF-functionalized paper-based biosensors (MOF@paper), including different types of substrates, fabrication methods, detection mechanisms and applications. On account of the multifunctionality and superior performance of MOF@paper biosensors, this field should possess promising prospect in scientific researches, translational medicine and clinical applications. • Multifunctional MOF endows paper-based biosensors with diverse detection properties. • The substrates and fabrication methods for MOF@paper biosensors are reviewed. • Various detection mechanisms are summarized and discussed. • MOF@paper biosensors are promising in diagnosis, food, environment and other related applications. [ABSTRACT FROM AUTHOR]

Background: Aesthetics medicine, a controversial branch of clinical medicine known for its high degree of commercialization, faces numerous conflicts, particularly in some developing countries. The global aesthetics medicine industry requires enhancements of its legal and supervision framework and risk management systems. Aims: This paper aimed to provide a comprehensive visual analysis of academic achievements related to regulatory and legal issues in the field of aesthetic medicine and to identify its development trends and research hotspots. Methods: The Web of Science Core Collection was employed to retrieve relevant studies, resulting in a total of 602 research articles after selection. Utilizing bibliometric methods and CiteSpace, this study analyzed the primary countries, institutions, authors, journals, hotspots, frontiers, and trends in this domain. Results: The findings indicated rapid increases in the number of published papers. The United States emerged as the leading contributor with 131 research papers and the highest intermediate centrality. Eleven keyword clusters were identified, with "adolescence" and "office‐based surgery" being the most recent topics. We also analyzed the trends and frontiers of legal research in medical aesthetics. Conclusion: The importance of informed consent has been increasingly emphasized, and research in the field of medical aesthetics has been gradually expanding beyond individual cosmetic procedures. The management system has become more comprehensive, moreover, guidelines and medical laws have been continually published, with research shifting toward a holistic perspective that encompasses patients, medical aesthetic providers, and regulatory authorities in the study of medical aesthetics regulation and legislation. This paper also proposes some innovative directions for future research and applications. [ABSTRACT FROM AUTHOR]

Digital health technologies (DHTs) at the intersection of health, medical informatics, and business aim to enhance patient care through personalised digital approaches. Ensuring the efficacy and reliability of these innovations demands rigorous clinical validation. A PubMed literature review (January 2006 to July 2023) identified 1250 papers, highlighting growing academic interest. A focused narrative review (January 2018 to July 2023) delved into challenges, highlighting issues such as diverse regulatory landscapes, adoption issues in complex healthcare systems, and a plethora of evaluation frameworks lacking pragmatic guidance. Existing frameworks often omit crucial criteria, neglect empirical evidence, and clinical effectiveness is rarely included as a criterion for DHT quality. The paper underscores the urgency of addressing challenges in accreditation, adoption, business models, and integration to safeguard the quality, efficacy, and safety of DHTs. A pivotal illustration of collaborative efforts to address these challenges is exemplified by the Digital Health Validation Center, dedicated to generating clinical evidence of innovative healthcare technologies and facilitating seamless technology transfer. In conclusion, it is necessary to harmonise evaluation approaches and frameworks, improve regulatory clarity, and commit to collaboration to integrate rigorous clinical validation and empirical evidence throughout the DHT life cycle. [ABSTRACT FROM AUTHOR]

Objective: This scoping review aims to map the available literature and provide an overview of the published articles discussing the impact of electronic prescribing on medication errors and pharmacy workflow. Methods: The literature search was conducted using PubMed®, Web of Science®, and the Cochrane Database of Systematic Reviews®, as well as grey literature reports, using the search terms and related components of "pharmacists", "electronic prescribing", "medication errors", and "efficiency". The search included all articles that were published from January 2011 to September 2023. Twenty-two relevant articles were identified and fully reviewed, ten of which were included in this review. Results: Electronic prescribing (e-prescribing) provides a solution for some of the challenges that are associated with handwritten and paper prescriptions. However, the implementation of e-prescribing systems has been recognized as a source of new unforeseen medication errors in all the reviewed articles. Productivity in community pharmacies has been affected with receiving electronic prescriptions (e-prescriptions) and having to deal with the issues that arise from them. The pharmacists' interventions were not eliminated with e-prescriptions compared to other prescription formats. The most frequently reported reason for intervention was related to incomplete instructions in the field of directions of use. Other common challenges with e-prescriptions were related to missing information, quantity, inappropriate dose, dosage form, and drug. Discussion: This review demonstrates the scarcity of research about the impact of electronic prescribing on medication error and efficiency in community pharmacies. In the literature, most of the studies had mainly focused on hospital pharmacies. The literature search demonstrated that there are still some barriers to overcome with e-prescribing systems and that medication errors were not fully eliminated with e-prescriptions. New errors have been identified with e-prescriptions, all of which caused delays in processing, which affected the productivity of the pharmacy staff, and could have negatively impacted patients' safety if not properly resolved. Conclusion: e-Prescribing solved some of the challenges associated with illegibility of handwritten prescriptions. However, more time is required to allow e-prescribing systems to mature. Further training for prescribers and pharmacists is also recommended before and after the implementation. [ABSTRACT FROM AUTHOR]

Analytical performance specifications (APS) are used for the quantitative assessment of assay analytical performance, with the aim of providing information appropriate for clinical care of patients. One of the major locations where APS are used is in the routine clinical laboratory. These may be used to assess and monitor assays in a range of settings including method selection, method verification or validation, external quality assurance, internal quality control and assessment of measurement uncertainty. The aspects of assays that may be assessed include imprecision, bias, selectivity, sample type, analyte stability and interferences. This paper reviews the practical use of APS in a routine clinical laboratory, using the laboratory I supervise as an example. [ABSTRACT FROM AUTHOR]

Objective: HealthPathways is a web-based platform designed for use during a consultation to offer health professionals locally agreed information to support clinical and referral decision making. This study aimed to investigate whether access to specific HealthPathways pages in the North Coast New South Wales (NSW) region increased during specific critical events. High pageviews is used as a proxy for platform usefulness, and/or trust as a source of up-to-date information. Methods: Data were extracted from Google Analytics from December 2015 to December 2021. Descriptive statistics were generated for the total number of pageviews for all pages by month and year (2015–2021); for the top 15 most viewed pages in 2019, February–March 2020 inclusive (early COVID-19 pandemic period), 10–24 March 2021 (North Coast NSW region local disaster declaration period) and 26 June–11 October 2021 (NSW COVID-19 lockdown period); and for monthly pageviews for the Influenza Immunisation pathway (2016–2021). Results: Access to specific pages in HealthPathways increased alongside the occurrence of critical events affecting the region. Spikes in access to specific pages were seen during COVID-19 lockdown periods, during natural disasters, as well as during the annual influenza season. Conclusions: HealthPathways is viewed as a useful and trusted source of information for health professionals in the North Coast NSW region. HealthPathways provides an opportunity for timely dissemination of information during critical events, including natural disasters and emergencies. What is known about the topic? Evidence from New Zealand suggests that HealthPathways is viewed as a useful and trusted source of information by health professionals during critical and emergency events, and when information needs are subject to frequent change. What does this paper add? This paper provides evidence in the Australian context that health professionals access specific pages in HealthPathways at higher rates during critical and emergency events. What are the implications for practitioners? HealthPathways has the capacity to provide timely and accurate information to health professionals during critical and emergency events, as well as to identify their emerging information needs. [ABSTRACT FROM AUTHOR]

Healthcare is a critical area where blockchain technology (BT) is being heralded as a potential game-changer for facilitating secure and efficient data sharing. The purpose of this review is to examine BT applications, performance challenges, and solutions in healthcare. To begin, This review paper explores popular blockchain networks for data exchange, encompassing both public and permissioned platforms, such as Ethereum and Hyperledger Fabric. This paper analyzes the potential applications of BT's decentralized, immutable, and smart contract capabilities in healthcare settings, including secure and interoperable health data exchange, patient consent management, drug supply chain oversight, and clinical trial management. The healthcare industry might greatly benefit from the increased privacy, transparency, and accessibility that these technologies provide. Despite BT's promising medical uses, the technology is not without its drawbacks. High energy consumption, throughput, and scalability are all concerns. We wrapped up by discussing the solutions that have been implemented, including consensus processes, scalability measures like sharding, and off-chain transactions that are designed to mitigate the drawbacks. [ABSTRACT FROM AUTHOR]

(1) Background: In digital-technology-assisted nasal defect reconstruction methods, a crucial step involves utilizing computer-aided design to virtually reconstruct the nasal defect's complete morphology. However, current digital methods for virtual nasal defect reconstruction have yet to achieve efficient, precise, and personalized outcomes. In this research paper, we propose a novel approach for reconstructing external nasal defects based on the Facial Mesh Generation Network (FMGen-Net), aiming to enhance the levels of automation and personalization in virtual reconstruction. (2) Methods: We collected data from 400 3D scans of faces with normal morphology and combined the structured 3D face template and the Meshmonk non-rigid registration algorithm to construct a structured 3D facial dataset for training FMGen-Net. Guided by defective facial data, the trained FMGen-Net automatically generated an intact 3D face that was similar to the defective face, and maintained a consistent spatial position. This intact 3D face served as the 3D target reference face (3D-TRF) for nasal defect reconstruction. The reconstructed nasal data were extracted from the 3D-TRF based on the defective area using reverse engineering software. The '3D surface deviation' between the reconstructed nose and the original nose was calculated to evaluate the effect of 3D morphological restoration of the nasal defects. (3) Results: In the simulation experiment of 20 cases involving full nasal defect reconstruction, the '3D surface deviation' between the reconstructed nasal data and the original nasal data was 1.45 ± 0.24 mm. The reconstructed nasal data, constructed from the personalized 3D-TRF, accurately reconstructed the anatomical morphology of nasal defects. (4) Conclusions: This paper proposes a novel method for the virtual reconstruction of external nasal defects based on the FMGen-Net model, achieving the automated and personalized construction of the 3D-TRF and preliminarily demonstrating promising clinical application potential. [ABSTRACT FROM AUTHOR]

This article aims to summarize performance indicators used in telephone triage services research, and make recommendations for the selection of valid indicators to measure the performance of telephone triage. We describe what kind of frameworks, performance indicators, or variables have been used for evaluating telephone triage performance by systematically mapping the telephone triage performance measurement. The objective was to find measures for each Triple Aim dimension. A scoping review method was used following Joanna Briggs Institute guidelines. Using this method, we defined indicators to measure the performance of telephone triage. We used the Triple Aim framework to identify indicators to measure the overall performance of telephone triage. The Triple Aim framework consists of improving the patient experience of care, improving the health of populations, and reducing cost per capita. The scoping review was performed using CINAHL, Medline, EBSCOhost, and PubMed electronic databases. The eligibility criterion was research published in English between 2015 and 2023. The inclusion focused on the use and performance of telephone triage services and system-focused studies. A total of 1098 papers were screened for inclusion, with 57 papers included in our review. We identified 13 performance indicators covering all Triple Aim dimensions: waiting times, access, patient satisfaction, the accuracy of triage decision, severity and urgency of the symptoms, triage response, patient compliance with the advice given, follow-up healthcare service use, and running costs of service. We didn't find any earlier framework covering all Triple Aim dimensions properly. Measuring the performance of telephone triage requires an extensive and comprehensive approach. We presented performance indicators that may be included in the framework for measuring the performance of telephone triage to support overall performance measurements of telephone triage. [ABSTRACT FROM AUTHOR]

In recent years, Artificial Intelligence (AI) has revolutionized people's lives.AI has long made breakthrough progress in the field of surgery. However, the research on the application of AI in orthopedics is still in the exploratory stage. The paper first introduces the background of AI and orthopedic diseases, addresses the shortcomings of traditional methods in the detection of fractures and orthopedic diseases, draws out the advantages of deep learning and machine learning in image detection, and reviews the latest results of deep learning and machine learning applied to orthopedic image detection in recent years, describing the contributions, strengths and weaknesses, and the direction of the future improvements that can bemade in each study. Next, the paper also introduces the difficulties of traditional orthopedic surgery and the roles played by AI in preoperative, intraoperative, and postoperative orthopedic surgery, scientifically discussing the advantages and prospects of AI in orthopedic surgery. Finally, the article discusses the limitations of current research and technology in clinical applications, proposes solutions to the problems, and summarizes and outlines possible future research directions. The main objective of this review is to inform future research and development of AI in orthopedics. [ABSTRACT FROM AUTHOR]

The tumor microenvironment (TME) constitutes a complex microenvironment comprising a diverse array of immune cells and stromal components. Within this intricate context, tumor-associated macrophages (TAMs) exhibit notable spatial heterogeneity. This heterogeneity contributes to various facets of tumor behavior, including immune response modulation, angiogenesis, tissue remodeling, and metastatic potential. This review summarizes the spatial distribution of macrophages in both the physiological environment and the TME. Moreover, this paper explores the intricate interactions between TAMs and diverse immune cell populations (T cells, dendritic cells, neutrophils, natural killer cells, and other immune cells) within the TME. These bidirectional exchanges form a complex network of immune interactions that influence tumor immune surveillance and evasion strategies. Investigating TAM heterogeneity and its intricate interactions with different immune cell populations offers potential avenues for therapeutic interventions. Additionally, this paper discusses therapeutic strategies targeting macrophages, aiming to uncover novel approaches for immunotherapy. EjPgUqH7NocL1u9xj7Aojm Video Abstract [ABSTRACT FROM AUTHOR]

This paper explores the available material regarding the potential use of a thermal imaging camera in the field of uroandrology and human sexuality research. Infrared thermography (IRT) constitutes a low-cost, effective and quick tool for the diagnosis and real-time monitoring of therapeutic effects. The presented paper focuses on the clinical aspects of the use of IRT in daily medical practice, the methodology of applying thermal imaging measurements and the physical properties of infrared radiation. IRT provides a precise, measurable and repeatable source of temperature data and its applications are constantly expanding into new medical fields complementing and developing conventional diagnostic methods. [ABSTRACT FROM AUTHOR]

Issue : For students in the preclinical years of medical school, it is easy to overlook the narrative component of medicine and become occupied with learning the vast sea of information about the human body. There are limited, if any, options to learn about historical figures in medicine and how they can inform our future in clinical medicine. Evidence : There is an apparent lack of education offered on pivotal figures in medicine across many institutions. The few instances that medical history has been incorporated into the curriculum are further discussed. Implications : In order to incorporate cultural competency in our delivery of care, it is important to consider the diversity of the population we will be serving and how we can prepare to help patients feel heard in their unique issues. In this paper, we propose learning about the true history of certain medical practices, rather than the "colonial" version often utilized in textbooks and lectures, as a means of diversifying students' perspectives of the origins of these practices as well as giving credit where it is due. The time period during which many of these medical practices were cultivated is referred to as the Islamic Golden Age, but scholars who made contributions belonged to many different faiths and cultural backgrounds. El-Zahrawi was a Muslim physician whose principal work, Kitab-at-Tasrif, contains topics on medicine, surgery, midwifery, pharmacology, therapeutics, diet, psychotherapy, and medical chemistry. He pioneered numerous techniques in surgery and invented surgical devices that are still used to this day.

Taxus, a rare and protected genus predominantly distributed across the Northern Hemisphere’s temperate regions, has garnered global attention due to its significant potential in medical research and pharmaceutical development, bolstered by advancements in cultivation techniques and medical technology. This review primarily focuses on the chemical constituents and pharmacological activities of Taxus, underscoring the progress and potential of these components in clinical applications. Recent studies have revealed that Taxus contains not only taxane active components but also flavonoids and polysaccharides with distinct activities. These compounds from Taxus exhibit potent antitumor, anti-inflammatory, immunomodulatory, antibacterial, and antidiabetic properties with evident mechanisms of action. Notably, the representative compound, paclitaxel, has demonstrated significant efficacy in treating various cancers, such as ovarian, breast, and lung cancer. This paper also reviews the basic situation of Taxus drug formulations, with extracts primarily administered orally and monomeric taxanes typically via injection, reflecting a mature development stage with ongoing research into oral formulations. Finally, this review summarizes the pharmacokinetic characteristics of crucial compounds in Taxus, including their absorption, distribution, metabolism, and excretion patterns in the human body. These pharmacokinetic profiles provide crucial guidance for evaluating the overall dosing regimen of Taxus and its components. The paper concludes with a forward-looking analysis of the potential applications of these compounds in disease treatment, envisioning their role in the future of medical and pharmaceutical advancements. [ABSTRACT FROM AUTHOR]

Diabetic retinopathy, a microvascular condition associated with an increased risk of cardiovascular disease, poses a substantial global healthcare challenge. The demand for timely diagnosis has prompted the development of automated solutions due to the scarcity of specialists. In this paper, we introduce a ground-breaking approach to diabetic retinopathy detection – the Diabetic Retinopathy Residual Network (DR-ResNet +). The proposed model leverages the power of deep learning to automatically extract features, achieving optimal results in just seven training epochs. The DR-ResNet + architecture is meticulously designed by incorporating a series of convolutional, pooling, and fully connected layers. Hyperparameter optimization is done using both grid and random search techniques to ensure peak performance. To validate the proposed model's robustness, simulated results are compared with well-established deep learning models, such as GoogleNet, VGG16, and AlexNet, using a comprehensive Kaggle dataset comprising over 35,000 retinal images. Moreover, the proposed model is also tested on external datasets like MESSIDOR and IDRiD for its validation. Simulation results reveal that the proposed DR-ResNet + model not only reduces training time by an impressive 95% but also exhibits outstanding performance metrics, including an accuracy of 0.9898, specificity of 0.9916, precision of 0.9670, sensitivity of 0.9829, and an F1-score of 0.9748. These findings position the proposed model as exceptionally well-suited for real-time clinical applications, offering a potential game-changer in diabetic retinopathy diagnosis. This paper presents DR-ResNet + as a pioneering advancement in diabetic retinopathy diagnosis. With its rapid training, superior accuracy, and significant real-world implications, the model holds promise for transforming the landscape of healthcare by providing timely and precise diagnoses for this critical condition. [ABSTRACT FROM AUTHOR]

Dissolving microneedles (DMNs) represent an innovative advancement in drug delivery and skincare technologies, offering significant advantages compared to traditional needles. This paper presents an overview of the historical evolution of microneedles and the rise of dissolving types, exploring their definition, concept, and diverse clinical applications such as vaccinations, drug delivery, and skincare treatments. Design and manufacturing considerations cover the materials employed, fabrication techniques, and methods for characterizing DMNs, focusing on aspects like mechanical strength, dissolution rate, and delivery efficiency. The mechanism of action section examines skin penetration mechanics, the process of microneedle dissolution, controlled release of active compounds, and considerations of biocompatibility and safety. Recent developments in DMNs encompass technological advancements, improved delivery systems, and updates on clinical trials and studies. Challenges and opportunities in scaling up production, overcoming market adoption barriers, and future research directions are discussed, aiming to address unmet medical needs and expand applications. In summary, DMNs have the potential to transform drug delivery and skincare treatments, with ongoing advancements aimed at tackling current challenges and unlocking new opportunities for enhanced healthcare outcomes. [ABSTRACT FROM AUTHOR]

Since three-dimensional (3D) bioprinting has emerged, it has continuously to evolved as a revolutionary technology in surgery, offering new paradigms for reconstructive and regenerative medical applications. This review highlights the integration of 3D printing, specifically bioprinting, across several surgical disciplines over the last five years. The methods employed encompass a review of recent literature focusing on innovations and applications of 3D-bioprinted tissues and/or organs. The findings reveal significant advances in the creation of complex, customized, multi-tissue constructs that mimic natural tissue characteristics, which are crucial for surgical interventions and patient-specific treatments. Despite the technological advances, the paper introduces and discusses several challenges that remain, such as the vascularization of bioprinted tissues, integration with the host tissue, and the long-term viability of bioprinted organs. The review concludes that while 3D bioprinting holds substantial promise for transforming surgical practices and enhancing patient outcomes, ongoing research, development, and a clear regulatory framework are essential to fully realize potential future clinical applications. [ABSTRACT FROM AUTHOR]

Motivated by a recent trend that advocates a reassessment of the aim of medical science and clinical practice, this paper investigates the epistemic aims of biomedical research. Drawing on contemporary discussions in epistemology and the philosophy of science, along with a recent study on scurvy, this paper (1) explores the concept of understanding as the aim of scientific inquiry and (2) establishes a framework that will guide the examination of its forms in biomedical research. Using the case of Tuberculosis (TB), (3) it is argued that grasping a mechanistic explanation is crucial for reaching a threshold of understanding at which we may speak of an objectual, biomedical understanding of TB. [ABSTRACT FROM AUTHOR]

Malignant tumor, one of the most threatening diseases to human health, has been comprehensively treated with surgery, radiotherapy, chemotherapy and targeted therapy, but the prognosis has not always been ideal. In the past decade, immunotherapy has shown increased efficacy in tumor treatment; however, for immunotherapy to achieve its fullest potential, obstacles are to be conquered, among which tumor microenvironment (TME) has been widely investigated. In remodeling the tumor immune microenvironment to inhibit tumor progression, macrophages, as the most abundant innate immune population, play an irreplaceable role in the immune response. Therefore, how to remodel TME and alter the recruitment and polarization status of tumor-associated macrophages (TAM) has been of wide interest. In this context, nanoparticles, photodynamic therapy and other therapeutic approaches capable of affecting macrophage polarization have emerged. In this paper, we categorize and organize the existing means and methods for reprogramming TAM to provide ideas for clinical application of novel tumor-related therapies. [ABSTRACT FROM AUTHOR]

This paper reviews the latest trends and applications of silicone in ophthalmology, especially related to intraocular lenses (IOLs). Silicone, or siloxane elastomer, as a synthetic polymer, has excellent biocompatibility, high chemical inertness, and hydrophobicity, enabling wide biomedical applications. The physicochemical properties of silicone are reviewed. A review of methods for mechanical and in vivo characterization of IOLs is presented as a prospective research area, since there are only a few available technologies, even though these properties are vital to ensure medical safety and suitability for clinical use, especially if long-term function is considered. IOLs represent permanent implants to replace the natural lens or for correcting vision, with the first commercial foldable lens made of silicone. Biological aspects of posterior capsular opacification have been reviewed, including the effects of the implanted silicone IOL. However, certain issues with silicone IOLs are still challenging and some conditions can prevent its application in all patients. The latest trends in nanotechnology solutions have been reviewed. Surface modifications of silicone IOLs are an efficient approach to further improve biocompatibility or to enable drug-eluting function. Different surface modifications, including coatings, can provide long-term treatments for various medical conditions or medical diagnoses through the incorporation of sensory functions. It is essential that IOL optical characteristics remain unchanged in case of drug incorporation and the application of nanoparticles can enable it. However, clinical trials related to these advanced technologies are still missing, thus preventing their clinical applications at this moment. [ABSTRACT FROM AUTHOR]

Platelets play a significant role in hemostasis, forming plugs at sites of vascular injury to limit blood loss. However, if platelet activation is not controlled, it can lead to thrombotic events, such as myocardial infarction and stroke. To prevent this, antiplatelet agents are used in clinical settings to limit platelet activation in patients at risk of arterial thrombotic events. However, their use can be associated with a significant risk of bleeding. An enhanced comprehension of platelet signaling mechanisms should facilitate the identification of safer targets for antiplatelet therapy. Over the past decade, our comprehension of the breadth and intricacy of signaling pathways that orchestrate platelet activation has expanded exponentially. Several recent studies have provided further insight into the regulation of platelet signaling events and identified novel targets against which to develop novel antiplatelet agents. Antiplatelet drugs are essential in managing atherothrombotic vascular disease. The current antiplatelet therapy in clinical practice is limited in terms of safety and efficacy. Novel compounds have been developed in response to patient variability and resistance to aspirin and/or clopidogrel. Recent studies based on randomized controlled trials and systematic reviews have definitively demonstrated the role of antiplatelet therapy in reducing the risk of cardiovascular events. Antiplatelet therapy is the recommended course of action for patients with established atherosclerosis. These studies compared monotherapy with a P2Y12 inhibitor versus aspirin for secondary prevention. However, in patients undergoing percutaneous coronary intervention, it is still unclear whether the efficacy of P2Y12 inhibitor monotherapy after a short course of dual antiplatelet therapy depends on the type of P2Y12 inhibitor. This paper focuses on the advanced-stage evaluation of several promising antiplatelet drugs. [ABSTRACT FROM AUTHOR]

Neurodegenerative diseases are a significant challenge to global healthcare, and oxidative stress plays a crucial role in their development. This paper presents a comprehensive analysis of the neuroprotective potential of olive oil, with a primary focus on its antioxidant properties. The chemical composition of olive oil, including key antioxidants, such as oleuropein, hydroxytyrosol, and oleocanthal, is systematically examined. The mechanisms by which these compounds provide neuroprotection, including counteracting oxidative damage and modulating neuroprotective pathways, are explored. The neuroprotective efficacy of olive oil is evaluated by synthesizing findings from various sources, including in vitro studies, animal models, and clinical trials. The integration of olive oil into dietary patterns, particularly its role in the Mediterranean diet, and its broader implications in neurodegenerative disease prevention are also discussed. The challenges in translating preclinical findings to clinical applications are acknowledged and future research directions are proposed to better understand the potential of olive oil in mitigating the risk of neurodegenerative conditions. This review highlights olive oil not only as a dietary component, but also as a promising candidate in preventive neurology, advocating for further investigation in the context of neurodegenerative diseases. [ABSTRACT FROM AUTHOR]

Universal health coverage has been proposed as a strategy to improve health in low- and middle-income countries, but this depends on a good provision of health services. Under-5 mortality (U5M) reflects the quality of health services, and its reduction has been a milestone in modern society, reducing global mortality rates by more than two-thirds between 1990 and 2020. However, despite these impressive achievements, they are still insufficient, and most deaths in children under 5 can be prevented with the provision of timely and high-quality health services. The aim of this paper is to conduct a literature review on amenable (treatable) mortality in children under 5. This indicator is based on the concept that deaths from certain causes should not occur in the presence of timely and effective medical care. A systematic and exhaustive review of available literature on amenable mortality in children under 5 was conducted using MEDLINE/PubMed, Cochrane CENTRAL, OVID medline, Scielo, Epistemonikos, ScienceDirect, and Google Scholar in both English and Spanish. Both primary sources, such as scientific articles, and secondary sources, such as bibliographic indices, websites, and databases, were used. Results: The main cause of amenable mortality in children under 5 was respiratory disease, and the highest proportion of deaths occurred in the perinatal period. Approximately 65% of avoidable deaths in children under 5 were due to amenable mortality, that is, due to insufficient quality in the provision of health services. Most deaths in all countries and around the world are preventable, primarily through effective and timely access to healthcare (amenable mortality) and the management of public health programs focused on mothers and children (preventable mortality). [ABSTRACT FROM AUTHOR]

Aim(s): To assess the effectiveness of sub‐epidermal moisture (SEM) assessment technology in the detection of early‐stage pressure damage in a critical care unit (CCU) and dark skin tone patients and its impact on hospital‐acquired pressure injury (HAPI) incidence. Design: Quality improvement study employing Kurt Lewin's change model emphasizing planning, implementation, evaluation and sustainable change. Methods: The study evaluated 140 adult patients admitted to the CCU over a 24‐week period, from July to December 2022. Retrospective analysis of standard PI care pathways was performed in 90 patients admitted during a 12‐week pre‐implementation period. Fifty patients were admitted through the subsequent 12‐week implementation period. SEM assessments were performed daily at the sacrum and heels and interventions were applied based on SEM assessments; SEM delta ≥0.6 indicating localized oedema or persistent focal oedema. Statistical analyses were performed on anonymized data. Results: Pre‐implementation HAPI incidence was 8.9% (N = 8/90). All eight patients were African American with varying skin tones. A 100% reduction in HAPI incidence was achieved in the implementation period which included 35 African American patients. The relative risk of HAPI incidence was 1.6 times higher in the pre‐implementation group. Conclusion: Implementing SEM assessment technology enabled equitable PI care for all population types and resulted in a 100% reduction of PIs in our CCU. Objective SEM assessments detected early‐stage PIs, regardless of skin tone and enabled providing interventions to specific anatomies developing tissue damage as opposed to universal preventive interventions. Implications: PI care pathways relying on visual and tactile skin assessments are inherently biased in providing equitable care for dark skin tone patients. Implementing SEM assessments empowers healthcare practitioners in driving objective clinical interventions, eliminates bias and enables positive PI health outcomes. Impact: Implementing SEM assessment technology had three main effects: it detected early tissue damage regardless of skin tone (detection effect), enabled anatomy‐specific interventions (treatment effect) and prevented PIs across all population types (prevention effect). The authors have adhered to the Standards for Quality Improvement Reporting Excellence (SQUIRE) 2.0 guidelines. Patient or Public Contribution: No patient or public contribution. What does this paper contribute to the wider global clinical community? Addressing health inequities in pressure injury prevention; Demonstrated effectiveness across patient populations; Resource optimization and enhanced patient safety. [ABSTRACT FROM AUTHOR]

The composition of the vaginal microbiota is linked to numerous reproductive health problems, including increased susceptibility to infection, pregnancy complications, and impaired vaginal tissue repair; however, the mechanisms contributing to these adverse outcomes are not yet fully defined. In this review, we highlight recent clinical advancements associating vaginal microbiome composition and function with health outcomes. Subsequently, we provide a summary of emerging models employed to identify microbe-microbe interactions contributing to vaginal health, including metagenomic sequencing, multi-omics approaches, and advances in vaginal microbiota cultivation. Last, we review new in vitro, ex vivo, and in vivo models, such as organoids and humanized microbiota murine models, used to define and mechanistically explore host-microbe interactions at the vaginal mucosa., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

A brain tumor magnetic resonance image processing algorithm can help doctors to diagnose and treat the patient's condition, which has important application significance in clinical medicine. This paper proposes a network model based on the combination of U-net and DenseNet to solve the problems of class imbalance in multi-modal brain tumor image segmentation and the loss of effective information features caused by the integration of features in the traditional U-net network. The standard convolution blocks of the coding path and decoding path on the original network are improved to dense blocks, which enhances the transmission of features. The mixed loss function composed of the Binary Cross Entropy Loss function and the Tversky coefficient is used to replace the original single cross-entropy loss, which restrains the influence of irrelevant features on segmentation accuracy. Compared with U-Net, U-Net++, and PA-Net the algorithm in this paper has significantly improved the segmentation accuracy, reaching 0.846, 0.861, and 0.782 respectively in the Dice coefficient index of WT, TC, and ET. The PPV coefficient index has reached 0.849, 0.883, and 0.786 respectively. Compared with the traditional U-net network, the Dice coefficient index of the proposed algorithm exceeds 0.8%, 4.0%, and 1.4%, respectively, and the PPV coefficient index in the tumor core area and tumor enhancement area increases by 3% and 1.2% respectively. The proposed algorithm has the best performance in tumor core area segmentation, and its Sensitivity index has reached 0.924, which has good research significance and application value., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Wu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Low-Dose computer tomography (LDCT) is an ideal alternative to reduce radiation risk in clinical applications. Although supervised-deep-learning-based reconstruction methods have demonstrated superior performance compared to conventional model-driven reconstruction algorithms, they require collecting massive pairs of low-dose and norm-dose CT images for neural network training, which limits their practical application in LDCT imaging. In this paper, we propose an unsupervised and training data-free learning reconstruction method for LDCT imaging that avoids the requirement for training data. The proposed method is a post-processing technique that aims to enhance the initial low-quality reconstruction results, and it reconstructs the high-quality images by neural work training that minimizes the ℓ1-norm distance between the CT measurements and their corresponding simulated sinogram data, as well as the total variation (TV) value of the reconstructed image. Moreover, the proposed method does not require to set the weights for both the data fidelity term and the plenty term. Experimental results on the AAPM challenge data and LoDoPab-CT data demonstrate that the proposed method is able to effectively suppress the noise and preserve the tiny structures. Also, these results demonstrate the rapid convergence and low computational cost of the proposed method. The source code is available at https://github.com/linfengyu77/IRLDCT. [ABSTRACT FROM AUTHOR]

Medical Visual Question Answering (Med-VQA) faces significant limitations in application development due to sparse and challenging data acquisition. Existing approaches focus on multi-modal learning to equip models with medical image inference and natural language understanding, but this worsens data scarcity in Med-VQA, hindering clinical application and advancement. This paper proposes the ITLTA framework for Med-VQA, designed based on field requirements. ITLTA combines multi-label learning of medical images with the language understanding and reasoning capabilities of large language models (LLMs) to achieve zero-shot learning, meeting natural language module needs without end-to-end training. This approach reduces deployment costs and training data requirements, allowing LLMs to function as flexible, plug-and-play modules. To enhance multi-label classification accuracy, the framework uses external medical image data for pretraining, integrated with a joint feature and label attention mechanism. This configuration ensures robust performance and applicability, even with limited data. Additionally, the framework clarifies the decision-making process for visual labels and question prompts, enhancing the interpretability of Med-VQA. Validated on the VQA-Med 2019 dataset, our method demonstrates superior effectiveness compared to existing methods, confirming its outstanding performance for enhanced clinical applications. [ABSTRACT FROM AUTHOR]

Introduction: Globally, healthcare organizations have transitioned from paper-based documentation to electronic health records (EHR), including in Saudi Arabia. However, the adoption of EHR at the national level in Saudi Arabia needs more attention. Thus, this study aimed to determine the workflow integration of EHR and associated factors. Objectives: The specific aims were to examine the level of EHR use and workflow integration among nurses, to determine the differences in EHR use and workflow integration based on nurses' demographic characteristics, and to determine the association between the predictive factors and EHR workflow integration. Methods: This is a cross-sectional, correlational descriptive study. The data were collected from 293 nurses using the convenience sampling method. The participating nurses completed a questionnaire that included two measures: the Information System Use Survey and the Workflow Integration Survey (WIS). The data were analyzed using descriptive and multivariate statistics with SPSS software. Results: The nurses had a positive perception of EHR use and workflow. The EHR use scores differed based on workplace (P <.01), education level (P <.05), and area of practice (P <.001). Similarly, the EHR workflow integration scores varied according to workplace (P <.05), education level (P <.05), and area of practice (P <.001). Education level and workplace significantly predicted information system use. Furthermore, education level and information system use significantly predicted the EHR integration into nurses' workflow. Conclusion: The nurses expressed a greater perceived use of EHR regarding the integrated health information system, which was a predictor of EHR integration into nurses' workflow. [ABSTRACT FROM AUTHOR]

Stepper motors are synchronous electric actuators with incremental displacement that can be controlled in open loop in position or speed. Unfortunately, the rotor oscillations that characterize stepper motors are a major handicap that limits the use of this type of actuator in precision industrial applications and especially in biomedical systems. Improving motor drive performance is challenging due to the presence of uncertainty in system parameters and large load variations. To overcome these problems and the shortcomings of conventional control approaches, a new control concept based on fuzzy logic is developed. To this purpose, this paper proposes a fuzzy logic concept (FLC) for damping rotor oscillations of stepper actuator devoted to an Electrical Syringe Pump application. The FLC membership functions and rules are designed with value normalization that allows the developed controller able to be flexible when applied to a wide range of applications. The proposed FLC is numerically validated. Critical testing scenarios are employed including motor inertia variation, supply voltage variation, fluid friction variation and for different loads. Moreover, thanks to its normalized design, the proposed FLC is not limited to the studied biomedical applications, but can be applied to other application systems. [ABSTRACT FROM AUTHOR]

Automatically segmenting polyps from colonoscopy videos is crucial for developing computer-assisted diagnostic systems for colorectal cancer. Existing automatic polyp segmentation methods often struggle to fulfill the real-time demands of clinical applications due to their substantial parameter count and computational load, especially those based on Transformer architectures. To tackle these challenges, a novel lightweight long-range context fusion network, named LightCF-Net, is proposed in this paper. This network attempts to model long-range spatial dependencies while maintaining real-time performance, to better distinguish polyps from background noise and thus improve segmentation accuracy. A novel Fusion Attention Encoder (FAEncoder) is designed in the proposed network, which integrates Large Kernel Attention (LKA) and channel attention mechanisms to extract deep representational features of polyps and unearth long-range dependencies. Furthermore, a newly designed Visual Attention Mamba module (VAM) is added to the skip connections, modeling long-range context dependencies in the encoder-extracted features and reducing background noise interference through the attention mechanism. Finally, a Pyramid Split Attention module (PSA) is used in the bottleneck layer to extract richer multi-scale contextual features. The proposed method was thoroughly evaluated on four renowned polyp segmentation datasets: Kvasir-SEG, CVC-ClinicDB, BKAI-IGH, and ETIS. Experimental findings demonstrate that the proposed method delivers higher segmentation accuracy in less time, consistently outperforming the most advanced lightweight polyp segmentation networks. [ABSTRACT FROM AUTHOR]

Objectives: Accreditation to standards developed by the Royal Australian College of General Practice provides assurance to the community of the quality and safety of general practices in Australia. The objective of this study was to conduct an empirical evaluation of the 5th edition standards. Minimal empirically driven evaluation of the standards has been conducted since their publication in 2020. Methods: Data encompass consecutive Australian general practice accreditation assessments between December 2020 and July 2022 recorded from a single accrediting agency. Met and not met compliance (binary) scores for 124 indicators evaluated at the site visit were recorded. A subset of indicators derived from a selection of existing and consistently non-conformant indicators within each criterion was generated. Concordance between the indicator subset and the criterion was assessed to determine the predictive ability of the indicator subset in distinguishing practices who are conformant to the entire criterion. Results: A total of 757 general practices were included in the analysis. On average, 113.69 (s.d. = 8.16) of 124 indicators were evaluated as conformant at the site visit. In total, 52 (42%) indicators were required to obtain a true positive conformity rate above 95% for all criterions of the standards. For criterion 1 (General Practice 1) conformity to the entire criterion (nine indicators; >95% true positive rate) could be obtained by including 2/9 indicators (C1-1a and C1-2a). Conclusion: Our results identified that indicator non-conformity was driven by a small proportion of indicators and identifying a subset of these consistently non-conformant indicators predicted a true positive rate above 95% at the criterion level. What is known about the topic? Minimal empirical evaluation of the 5th edition standards for accreditation have occurred since their implementation. What does this paper add? Our findings suggest that more than half of the indicators currently do not adequately distinguish practices at the site assessment. What are the implications for practitioners? These findings may suggest that a review of individual indicators and the standards structure is required. [ABSTRACT FROM AUTHOR]

Objective: There is a need to undertake more proactive and in-depth analyses of general practice accreditation processes. Two areas that have been highlighted as areas of potential inconsistency are the self-assessment and surveyor assessment of indicators. Methods: The data encompass 757 accreditation visits made between December 2020 and July 2022. A mixed-effect multilevel logistic regression model determined the association between attempt of the self-assessment and indicator conformity from the surveyor assessment. Furthermore, we present a contrast of the rate of indicator conformity between surveyors as an approximation of the inter-assessor consistency from the site visit. Results: Two hundred and seventy-seven (37%) practices did not attempt or accurately report conformity to any indicators at the self-assessment. Association between attempting the self-assessment and the rate of indicator non-conformity at the site visit failed to reach statistical significance (OR = 0.90 [95% CI = 1.14–0.72], P = 0.28). A small number of surveyors (N = 9/34) demonstrated statistically significant differences in the rate of indicator conformity compared to the mean of all surveyors. Conclusions: Attempt of the self-assessment did not predict indicator conformity at the site visit overall. Appropriate levels of consistency of indicator assessment between surveyors at the site visit were identified. What is known about the topic? There is a need to undertake more proactive and in-depth analyses of the general practice accreditation process and outcomes to improve the quality and safety within this healthcare sector. What does this paper add? Attempt of the self-assessment does not predict indicator conformity at the site visit overall, and appropriate levels of consistency of indicator assessment between surveyors at the site visit were identified. What are the implications for practitioners? We present empirical evidence as to the consistency of assessment with general practice accreditation to inform future standards and (re)accreditation assessments. [ABSTRACT FROM AUTHOR]

Ultrasound is a highly adaptable medical imaging modality that offers several applications and a wide range of uses, both for diagnostic and therapeutic purposes. The principles of sound wave propagation and reflection enable ultrasound imaging to function as a highly secure modality. This technique facilitates the production of real-time visual representations, thereby assisting in the evaluation of various medical conditions such as cardiac, gynecologic, and abdominal diseases, among others. The ultrasound modality encompasses a diverse range of modes and mechanisms that serve to enhance the methodology of pathology and physiology assessment. Doppler imaging and US elastography, in particular, are two such techniques that contribute to this expansion. Elastography-based imaging methods have attracted significant interest in recent years for the non-invasive evaluation of tissue mechanical characteristics. These techniques utilize the changes in soft tissue elasticity in various diseases to generate both qualitative and quantitative data for diagnostic purposes. Specialized imaging techniques collect data by identifying tissue stiffness under mechanical forces such as compression or shear waves. However, in this review paper, we provide a comprehensive examination of the fundamental concepts, underlying physics, and limitations associated with ultrasound elastography. Additionally, we present a concise overview of its present-day clinical utilization and ongoing advancements across many clinical domains. [ABSTRACT FROM AUTHOR]

Context: The COVID-19 pandemic has reignited a commitment from the health policy and health services research communities to rebuilding trust in healthcare and created a renewed appetite for measures of trust for system monitoring and evaluation. The aim of the present paper was to develop a multidimensional measure of trust in healthcare that: (1) Is responsive to the conceptual and methodological limitations of existing measures; (2) Can be used to identify systemic explanations for lower levels of trust in equity-deserving populations; (3) Can be used to design and evaluate interventions aiming to (re)build trust. Methods: We conducted a 2021 review of existing measures of trust in healthcare, 72 qualitative interviews (Aug-Dec 2021; oversampling for equity-deserving populations), an expert review consensus process (Oct 2021), and factor analyses and validation testing based on two waves of survey data (Nov 2021, n = 694; Jan-Feb 2022, n = 740 respectively). Findings: We present the Trust in Multidimensional Healthcare Systems Scale (TIMHSS); a 38-item correlated three-factor measure of trust in doctors, policies, and the system. Measurement of invariance tests suggest that the TIMHSS can also be reliably administered to diverse populations. Conclusions: This global measure of trust in healthcare can be used to measure trust over time at a population level, or used within specific subpopulations, to inform interventions to (re)build trust. It can also be used within a clinical setting to provide a stronger evidence base for associations between trust and therapeutic outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The significance of atraumatic electrode array (EA) insertion in cochlear implant (CI) surgery is widely acknowledged, with consensus that forces due to EA insertion are directly correlated with insertion trauma. Unfortunately, the manual perception of these forces through haptic feedback is inherently limited, and techniques for in vivo force measurements to monitor the insertion are not yet available. Addressing this gap, we developed of a force-sensitive insertion tool capable of capturing real-time insertion forces during standard CI surgery. Methods: This paper describes the tool and its pioneering application in a clinical setting and reports initial findings from an ongoing clinical study. Data and experiences from five patients have been evaluated so far, including force profiles of four patients. Results: The initial intraoperative experiences are promising, with successful integration into the conventional workflow. Feasibility of in vivo insertion force measurement and practicability of the tool's intraoperative use could be demonstrated. The recorded in vivo insertion forces show the expected rise with increasing insertion depth. Forces at the end of insertion range from 17.2 mN to 43.6 mN, while maximal peak forces were observed in the range from 44.8 mN to 102.4 mN. Conclusion: We hypothesize that this novel method holds the potential to assist surgeons in monitoring the insertion forces and, thus, minimizing insertion trauma and ensuring better preservation of residual hearing. Future data recording with this tool can form the basis of ongoing research into the causes of insertion trauma, paving the way for new and improved prevention strategies. [ABSTRACT FROM AUTHOR]

Medical image segmentation is crucial for clinical applications, but challenges persist due to noise and variability. In particular, accurate glottis segmentation from high-speed videos is vital for voice research and diagnostics. Manual searching for failed segmentations is labor-intensive, prompting interest in automated methods. This paper proposes the first deep learning approach for detecting faulty glottis segmentations. For this purpose, faulty segmentations are generated by applying both a poorly performing neural network and perturbation procedures to three public datasets. Heavy data augmentations are added to the input until the neural network's performance decreases to the desired mean intersection over union (IoU). Likewise, the perturbation procedure involves a series of image transformations to the original ground truth segmentations in a randomized manner. These data are then used to train a ResNet18 neural network with custom loss functions to predict the IoU scores of faulty segmentations. This value is then thresholded with a fixed IoU of 0.6 for classification, thereby achieving 88.27% classification accuracy with 91.54% specificity. Experimental results demonstrate the effectiveness of the presented approach. Contributions include: (i) a knowledge-driven perturbation procedure, (ii) a deep learning framework for scoring and detecting faulty glottis segmentations, and (iii) an evaluation of custom loss functions. [ABSTRACT FROM AUTHOR]

Precise medical image segmentation of regions of interest (ROIs) is crucial for accurate disease diagnosis and progression assessment. However, acquiring high-quality annotated data at the pixel level poses a significant challenge due to the resource-intensive nature of this process. This scarcity of high-quality annotated data results in few-shot scenarios, which are highly prevalent in clinical applications. To address this obstacle, this paper introduces Agent-Guided SAM (AGSAM), an innovative approach that transforms the Segment Anything Model (SAM) into a fully automated segmentation method by automating prompt generation. Capitalizing on the pre-trained feature extraction and decoding capabilities of SAM-Med2D, AGSAM circumvents the need for manual prompt engineering, ensuring adaptability across diverse segmentation methods. Furthermore, the proposed feature augmentation convolution module (FACM) enhances model accuracy by promoting stable feature representations. Experimental evaluations demonstrate AGSAM's consistent superiority over other methods across various metrics. These findings highlight AGSAM's efficacy in tackling the challenges associated with limited annotated data while achieving high-quality medical image segmentation. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have cast light on the relationship between the gastric microbiota and gastric carcinogenesis. In this study, we conducted a bibliometric analysis of the relevant literature in the field of gastric cancer and the gastric microbiota and clarified its research status, hotspots, and development trends. Materials and methods: Publications were retrieved from the Web of Science Core Collection on 18 July 2023. CiteSpace 6.2.R4, VOSviewer 1.6.19.0, and Biblioshiny were used for the co-occurrence and cooperation analyses of countries, institutions, authors, references, and keywords. A keyword cluster analysis and an emergence analysis were performed, and relevant knowledge maps were drawn. Results: The number of published papers in this field totaled 215 and showed an increasing trend. The analysis of funding suggested that the input in this field is increasing steadily. China had the highest number of publications, while the United States had the highest betweenness centrality. Baylor College of Medicine published the most articles cumulatively. Both Ferreira RM and Cooker OO had the highest citation frequency. The journal Helicobacter showed the most interest in this field, while Gut provided a substantial research foundation. A total of 280 keywords were obtained using CiteSpace, which were primarily focused on the eradication and pathogenic mechanisms of Helicobacter pylori, as well as the application of the gastric microbiota in the evaluation and treatment of gastric cancer. The burst analysis suggested that in the future, research may focus on the application of gastric microorganisms, particularly Fusobacterium nucleatum, in the diagnosis and treatment of gastric cancer, along with their pathogenic mechanisms. Conclusion: Current studies have been tracking the eradication of Helicobacter pylori and its pathogenic mechanisms, as well as changes in the gastric microbiota during gastric carcinogenesis. Future research may focus on the clinical application and pathogenesis of stomach microorganisms through bacteria such as Fusobacterium nucleatum. [ABSTRACT FROM AUTHOR]

Obacunone, a natural triterpenoid, is an active component of the herbs Dictamnus dasycarpus Turcz. and Phellodendron amurense Rupr, and an indicator of the herbs' quality. Owing to its multiple health benefits, several studies have investigated the multi-targeting potential action mechanisms of obacunone. To summarize recent developments on the pharmacological actions of obacunone and focus on the underlying molecular mechanisms and signaling networks, we searched PubMed, Europe PMC, Wiley Online Library, Web of Science, Google Scholar, Wanfang Medical Network, and China National Knowledge Infrastructure for articles published prior to March 2024. Existing research indicates obacunone has great potential to become a promising therapeutic option against tumors, fibrotic diseases, bone and cholesterol metabolism diseases, and infections of pathogenic microorganisms, among others. The paper contributes to providing up-to-date references for further research and clinical applications of obacunone. [ABSTRACT FROM AUTHOR]

Background: Whole-mount histopathology (WMH) has been a powerful tool to investigate the characteristics of prostate cancer. However, the latest advancement of WMH was yet under summarization. In this review, we offer a comprehensive exposition of current research utilizing WMH in diagnosing and treating prostate cancer (PCa), and summarize the clinical advantages of WMH and outlines potential on future prospects. Methods: An extensive PubMed search was conducted until February 26, 2023, with the search term "prostate", "whole-mount", "large format histology", which was limited to the last 4 years. Publications included were restricted to those in English. Other papers were also cited to contribute a better understanding. Results: WMH exhibits an enhanced legibility for pathologists, which improved the efficacy of pathologic examination and provide educational value. It simplifies the histopathological registration with medical images, which serves as a convincing reference standard for imaging indicator investigation and medical image-based artificial intelligence (AI). Additionally, WMH provides comprehensive histopathological information for tumor volume estimation, post-treatment evaluation, and provides direct pathological data for AI readers. It also offers complete spatial context for the location estimation of both intraprostatic and extraprostatic cancerous region. Conclusions: WMH provides unique benefits in several aspects of clinical diagnosis and treatment of PCa. The utilization of WMH technique facilitates the development and refinement of various clinical technologies. We believe that WMH will play an important role in future clinical applications. [ABSTRACT FROM AUTHOR]