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BACKGROUND: Global population aging has sparked research into frailty and falls given their impact on older adults. This study provides a bibliometric analysis of frailty and fall literature to identify publication trends, leading contributors, impactful works, and conceptual themes. METHODS: Frailty and fall publications were retrieved from Scopus and Web of Science databases without date restrictions. Data was analyzed using ScientoPy, and VOSviewer to generate statistics, visualizations, and maps based on temporality, productive countries, institutions, citations, subject categories, and keyword occurrences. RESULTS: After pre-processing, 345 publications remained (84.6% Web of Science, 15.4% Scopus). The literature has grown steadily since 1990, led by the United States, China, and Japan. Prolific institutions were identified, including Pittsburgh University. Highly cited impactful studies were published across journals like the Journal of the American Geriatrics Society. Geriatrics/gerontology was the dominant subject category. Keyword co-occurrence analysis revealed clusters focusing on geriatric physical health, cardiovascular health, cognition, interventions, and mortality. CONCLUSIONS: This bibliometric analysis synthesizes a comprehensive overview of frailty and fall research, identifying rising publication and citation trends, leading global contributors, impactful studies, and thematic focuses. The findings can inform resource allocation, international collaboration, impactful evidence utilization, and future research planning to advance frailty science and clinical care for older populations. Ongoing investigation is warranted into frailty mechanisms, assessment, management, and multidomain interventions. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease (PD) poses a significant social burden. Zhengan Xifeng Decoction has been widely used in the treatment of PD. Objective: The aim of this study was to evaluate the clinical efficacy and safety of Zhengan Xifeng Decoction combined with Western medicine in the treatment of PD. Methods: Five independent databases were searched for clinical randomized controlled trials on Zhengan Xifeng Decoction combined with Western medicine for the treatment of PD. The risk of bias and quality of the included studies were assessed, followed by a meta-analysis. Results: A total of 21 studies, including 1678 patients, were included in the meta-analysis. The results suggested that the combination of Zhengan Xifeng Decoction and Western medicine demonstrated clinical efficacy in the treatment of PD [OR = 6.36, 95% confidence interval [CI] (4.70, 8.60), Z = 11.99 (P < 0.00001)] and reduced Unified Parkinson's Disease Rating Scale (UPDRS) scores [mean difference (MD) = -5.50, 95% CI (-6.93, -4.08)]; UPDRS I, II, III scores [MD = -4.87, 95% CI (-7.27, -2.47)]; UPDRS II, III scores [MD = -7.18, 95% CI (-15.71, -1.35)]; UPDRS I scores [MD = -0.15, 95% CI (-0.27, -0.03)]; UPDRS II scores [MD = -1.62, 95% CI (-2.42, -0.82)]; UPDRS III scores [MD = -2.14, 95% CI (-3.91, 0.38)]; and UPDRS IV scores [MD = -0.40, 95% CI (-0.79, -0.01)]. The differences between the groups were statistically significant (P < 0.05). Conclusions: Zhengan Xifeng Decoction combined with Western medicine demonstrates improved clinical efficacy in the treatment of PD, and patients tolerate adverse events well. [ABSTRACT FROM AUTHOR]

There has been a renewed interest in the clinical applications of psychedelics, with increasing use for a variety of psychiatric conditions. Individuals often describe psychedelic sessions as among the most significant experiences in their lives, emphasising the sense of awe, connectedness, and spiritual transformation they undergo. They can also feel they are experiencing truth and becoming aware of reality in deeper ways than ever before. As elusive as it is inescapable, Wilfred Bion’s ‘O’ denotes contact with absolute truth, approachable through an intuitive awareness of reality that goes beyond cognitive strategies seeking to ‘know’. The state of mind cultivated to enter into such realms, to reach O, and indeed to achieve mystical experiences under psychedelics, is one of surrender and transcendence of a cognitively weighted, sensorially bound interfacing with reality. This paper outlines the neurophenomenology of psychedelic use, the concept of O, and their clinical significance vis-à-vis contemporary psychodynamic thinking. As our understanding deepens regarding the changes associated with use of psychedelics, we can draw parallels between acquisition of insight and subsequent reshaping of one’s templates and perspectives taking place through use of these drugs, and the process that occurs over the course of a psychoanalysis or psychodynamic therapy. [ABSTRACT FROM AUTHOR]

Field-effect transistor (FET)-based biosensors exhibit excellent performance characteristics such as small size, ease of mass production, high versatility, and comparably low cost. In recent years, numerous FET biosensors based on various nanomaterials including silicon nanowires, carbon nanotubes, graphene, and transition metal dichalcogenides have been developed to detect a wide range of biomarkers that play a crucial role in early disease diagnosis, therapeutic monitoring and prognostic assessment. This review provides an overview of the structure, working principle, functionalization strategies and detection factors associated with FET biosensors based on diverse nanomaterials. Additionally, this paper discusses the applications of these diagnostic devices for detecting clinically relevant biomarkers such as nucleic acids, metabolites, proteins, cancer biomarkers, and hormones among others. The concluding section provides a comprehensive overview of the numerous challenges encountered in the widespread implementation of nanomaterial-based FET biosensors for clinical detection, while also presenting the future prospects for these biosensors based on current research advancements. Field-effect transistor (FET)-based biosensors exhibit excellent performance characteristics such as small size, ease of mass production, high versatility, and comparably low cost. In recent years, numerous FET biosensors based on various nanomaterials have been developed to detect a wide range of biomarkers that play a crucial role in early disease diagnosis, therapeutic monitoring and prognostic assessment. This review provides an overview of the structure, working principle, functionalization strategies and detection factors associated with field-effect transistor biosensors based on diverse nanomaterials. Additionally, this article discusses the applications of these diagnostic devices for detecting clinically relevant biomarkers such as nucleic acids, metabolites, proteins, cancer biomarkers, hormones among others. [ABSTRACT FROM AUTHOR]

[Display omitted] Lung cancer is an exceedingly malignant tumor reported as having the highest morbidity and mortality of any cancer worldwide, thus posing a great threat to global health. Despite the growing demand for precision medicine, current methods for early clinical detection, treatment and prognosis monitoring in lung cancer are hampered by certain bottlenecks. Studies have found that during the formation and development of a tumor, molecular substances carrying tumor-related genetic information can be released into body fluids. Liquid biopsy (LB), a method for detecting these tumor-related markers in body fluids, maybe a way to make progress in these bottlenecks. In recent years, LB technology has undergone rapid advancements. Therefore, this review will provide information on technical updates to LB and its potential clinical applications, evaluate its effectiveness for specific applications, discuss the existing limitations of LB, and present a look forward to possible future clinical applications. Specifically, this paper will introduce technical updates from the prospectives of engineering breakthroughs in the detection of membrane-based LB biomarkers and other improvements in sequencing technology. Additionally, it will summarize the latest applications of liquid biopsy for the early detection, diagnosis, treatment, and prognosis of lung cancer. We will present the interconnectedness of clinical and laboratory issues and the interplay of technology and application in LB today. [ABSTRACT FROM AUTHOR]

Radiomics, the science of extracting quantifiable data from routine medical images, is a powerful tool that has many potential applications in oncology. The Response Evaluation Criteria in Solid Tumors Working Group (RWG) held a workshop in May 2022, which brought together various stakeholders to discuss the potential role of radiomics in oncology drug development and clinical trials, particularly with respect to response assessment. This article summarizes the results of that workshop, reviewing radiomics for the practicing oncologist and highlighting the work that needs to be done to move forward the incorporation of radiomics into clinical trials. This paper by the RECIST Working Group outlines a path to realize the potential of radiomics as a precision biomarker. [ABSTRACT FROM AUTHOR]

Tumor spheroids are now intensively investigated toward preclinical and clinical applications, necessitating the establishment of accessible and cost-effective methods for routine operations. Without losing the advantage of organ-chip technologies, we developed a rocking system for facile formation and culture of tumor spheroids in hydrogel microwells of a suspended membrane under microfluidic conditions. While the rocking is controlled with a step motor, the microfluidic device is made of two plastic plates, allowing plugging directly syringe tubes with Luer connectors. Upon injection of the culture medium into the tubes and subsequent rocking of the chip, the medium flows back and forth in the channel underneath the membrane, ensuring a diffusion-based culture. Our results showed that such a rocking- and diffusion-based culture method significantly improved the quality of the tumor spheroids when compared to the static culture, particularly in terms of growth rate, roundness, junction formation and compactness of the spheroids. Notably, dynamically cultured tumor spheroids showed increased drug resistance, suggesting alternative assay conditions. Overall, the present method is pumpless, connectionless, and user-friendly, thereby facilitating the advancement of tumor-spheroid-based applications. [ABSTRACT FROM AUTHOR]

This paper aims to examine the spatial attributes in the hospital ward environment and their impact on medical students' learning and experience of the clinical workplace. An ethnographic study was conducted in a Scottish teaching hospital, combining observations and interviews over a period of 10 months. Two teaching wards served as the field-sites where approximately 120 h of non-participant observations took place sequentially. In addition, 34 individual interviews were conducted with identified key informants that included medical students, junior doctors, postgraduate trainees, consultant supervisors, ward nurses and hospital pharmacist. A combination of Actor-network Theory (ANT) and Social cognitive theory (SCT) was applied to analyse data pertaining to spatial attributes and their relevance to clinical teaching and learning. Analysis of the observational and interview data led to generation of the following themes: spatial attributes in the clinical workplace can enable or constrain teaching and learning opportunities, inadequate spaces impact students' and junior doctors' sense of value, short clinical rotations influence a sense of ownership of doctors' spaces, and contested nature of space in the clinical environment. Several illustrations of the field-sites help to contextualise the themes and aid in understanding the participants' experiences and perceptions. Our findings suggest a complex entanglement of space with medical students learning and wellbeing in the clinical workplace. Provision of suitable spaces needs to be a core consideration to realise the full potential of work-based learning in medicine. [ABSTRACT FROM AUTHOR]

On July 19th, 2023, the National Institute of Allergy and Infectious Diseases co-organized a workshop with the Society of Mathematical Biology, with the authors of this paper as the organizing committee. The workshop, "Bridging multiscale modeling and practical clinical applications in infectious diseases" sought to create an environment for mathematical modelers, statisticians, and infectious disease researchers and clinicians to exchange ideas and perspectives. [ABSTRACT FROM AUTHOR]

Background: ChatGPT is a large language model designed to generate responses based on a contextual understanding of user queries and requests. This study utilised the entrance examination for the Master of Clinical Medicine in Traditional Chinese Medicine to assesses the reliability and practicality of ChatGPT within the domain of medical education. Methods: We selected 330 single and multiple-choice questions from the 2021 and 2022 Chinese Master of Clinical Medicine comprehensive examinations, which did not include any images or tables. To ensure the test's accuracy and authenticity, we preserved the original format of the query and alternative test texts, without any modifications or explanations. Results: Both ChatGPT3.5 and GPT-4 attained average scores surpassing the admission threshold. Noteworthy is that ChatGPT achieved the highest score in the Medical Humanities section, boasting a correct rate of 93.75%. However, it is worth noting that ChatGPT3.5 exhibited the lowest accuracy percentage of 37.5% in the Pathology division, while GPT-4 also displayed a relatively lower correctness percentage of 60.23% in the Biochemistry section. An analysis of sub-questions revealed that ChatGPT demonstrates superior performance in handling single-choice questions but performs poorly in multiple-choice questions. Conclusion: ChatGPT exhibits a degree of medical knowledge and the capacity to aid in diagnosing and treating diseases. Nevertheless, enhancements are warranted to address its accuracy and reliability limitations. Imperatively, rigorous evaluation and oversight must accompany its utilization, accompanied by proactive measures to surmount prevailing constraints. [ABSTRACT FROM AUTHOR]

This paper reviews the research progress of Guizhi Fuling Pill in the clinical application of gynecology, such as the treatment of uterine leiomyoma, ovarian cyst, infertility and dysmenorrhea, in order to provide further research ideas for clinical researchers. [ABSTRACT FROM AUTHOR]

Antiretroviral therapy (ART) has significantly enhanced the outlook for people with HIV(PWH), yet certain ART medications can adversely affect the renal function of these patients. Of particular concern is the nephrotoxicity associated with tenofovir disoproxil fumarate (TDF). Compared to TDF, tenofovir alafenamide (TAF), another prodrug of tenofovir (TFV), results in lower TFV plasma levels, thereby alleviating the TFV-associated mitochondrial toxicity on proximal renal tubular cells. Currently, numerous clinical trials and real-world studies have demonstrated the favorable renal safety profile of ART regimens incorporating TAF for PWH. This paper seeks to consolidate the available evidence regarding the renal safety of TAF-based regimens in PWH, encompassing both the general PWH and those with renal impairment or predisposing factors, in order to offer recommendations and insights for TAF clinical application. [ABSTRACT FROM AUTHOR]

The practice of clinical medicine is imbued with uncertainty. The ways in which clinicians and patients think about, communicate about, and act within situations of heightened uncertainty can have significant implications for the therapeutic alliance and for the trajectory and outcomes of clinical care. Despite this, there is limited guidance about the best methods for physicians to recognize, acknowledge, communicate about, and manage uncertainty in clinical settings. In this paper, we propose a structured approach for discussing and managing uncertainty within the context of a clinician-patient relationship. The approach involves four steps: Recognize, Acknowledge, Partner, and Seek Support (i.e., the RAPS framework). The approach is guided by existing literature on uncertainty as well as our own experience as clinicians working at different stages of career. We define each component of the approach and present sample language and actions for how to implement it in practice. Our aim is to empower clinicians to regard situations of high uncertainty as an opportunity to deepen the therapeutic alliance with the patient, and simultaneously to grow and learn as practitioners. [ABSTRACT FROM AUTHOR]

Background: Care for patients undergoing elective colectomy has become increasingly standardized using Enhanced Recovery Programs (ERP). ERP, encorporating minimally invasive surgery (MIS), decreased postoperative morbidity and length of stay (LOS). However, disruptive changes are needed to safely introduce colectomy in an ambulatory or same-day discharge (SDD) setting. Few research groups showed the feasibility of ambulatory colectomy. So far, no minimum standards for the quality of care of this procedure have been defined. This study aims to identify quality indicators (QIs) that assess the quality of care for ambulatory colectomy. Methods: A literature search was performed to identify recommendations for ambulatory colectomy. Based on that search, a set of QIs was identified and categorized into seven domains: preparation of the patient (pre-admission), anesthesia, surgery, in-hospital monitoring, home monitoring, feasibility, and clinical outcomes. This list was presented to a panel of international experts (surgeons and anesthesiologists) in a 1 round Delphi to assess the relevance of the proposed indicators. Results: Based on the literature search (2010–2021), 3841 results were screened on title and abstract for relevant information. Nine papers were withheld to identify the first set of QIs (n = 155). After excluding duplicates and outdated QIs, this longlist was narrowed down to 88 indicators. Afterward, consensus was reached in a 1 round Delphi on a final list of 32 QIs, aiming to be a comprehensive set to evaluate the quality of ambulatory colectomy care. Conclusion: We propose a list of 32 QI to guide and evaluate the implementation of ambulatory colectomy. [ABSTRACT FROM AUTHOR]

Interactions between the cardiac and respiratory systems play a pivotal role in physiological functioning. Nonetheless, the intricacies of cardio-respiratory couplings, such as cardio-respiratory phase synchronization (CRPS) and cardio-respiratory coordination (CRC), remain elusive, and an automated algorithm for CRC detection is lacking. This paper introduces an automated CRC detection algorithm, which allowed us to conduct a comprehensive comparison of CRPS and CRC during sleep for the first time using an extensive database. We found that CRPS is more sensitive to sleep-stage transitions, and intriguingly, there is a negative correlation between the degree of CRPS and CRC when fluctuations in breathing frequency are high. This comparative analysis holds promise in assisting researchers in gaining deeper insights into the mechanics of and distinctions between these two physiological phenomena. Additionally, the automated algorithms we devised have the potential to offer valuable insights into the clinical applications of CRC and CRPS. [ABSTRACT FROM AUTHOR]

Background: Education is, after gaming, the second largest sector embracing augmented reality (AR) at an accelerated pace, yet studies on AR's potential as an efficient learning environment had mixed results. Objectives: This study's primary objective is to test students' interaction with graphical 3D elements in AR and its impact on information retention. The second objective is to compare information retention from AR engagement with information retention from exposure to identical 3D content delivered via instructional video. Finally, the third objective explores students' perceptions of AR as a learning environment. Methods: Sixty‐five college students participated in a two‐arm experiment followed by semi‐structured interviews. Results and Conclusion: AR can efficiently deliver a meaningful learning experience and promotes information retention. Nevertheless, AR's interactive features and novelty may distract learners while they engage with the virtual environment. Objective data obtained through eye tracking and video monitoring showed similar levels of engagement with a 3D model for both environments. While both AR and video groups showed significant knowledge gain from pre to post‐intervention, the video format was overall significantly more effective than AR in increasing topic‐related information retention. However, participants preferred the AR learning environment significantly more than the video. Takeaways: Although effective, AR is still a distracting instructional environment. Designing learning experiences tailored explicitly for AR environments requires additional research to ensure its successful deployment as a learning tool. Lay Description: What is already known about this topic: Education is the second‐fastest growing sector to adopt and experiment with augmented reality (AR).Hardware and software tools to create AR environments have reached the consumer level.The advantage of immersing learners in dedicated virtual environments seems obvious.Research has had mixed results in validating AR as a proper learning environment. What this paper adds: AR is a viable environment which supports information retention.For many students, the medium's novelty promotes engagement with the content.Students prefer AR to video lectures, but it may distract them from learning.Regarding information retention, video lectures do better than AR. The implications of study findings for practitioners: Learning experiences in AR should be reserved for some specific topics and designed purposedly.Progressive exposure of learners to AR environments may produce habituation and decrease distraction. [ABSTRACT FROM AUTHOR]

Purpose: Differences in Indigenous worldviews, practices and values highlight the need for Indigenous‐specific health quality indicators, such as patient‐reported outcome measures (PROMs) and patient‐reported experience measures (PREMs). The purpose of this paper is to present our methodology, as part of a larger study that sought to develop a framework for creating Indigenous‐specific PROMs and PREMs. Methods: The research design was informed by Indigenous research methodology and a community‐based participatory approach. It had three core components: (1) a literature exploration of existing Indigenous‐specific PROMs and PREMs; (2) interviews with researchers with expertise in PROMs and PREMs developed for Indigenous populations and community leaders interested in using these Indigenous‐informed evaluation tools; and (3) conversations with Indigenous community members about their experiences with health surveys. Interviews were audio‐recorded and transcribed verbatim; transcripts were analyzed qualitatively using an inductive and deductive approach. Themes and sub‐themes were identified to build a framework that honours Indigenous knowledges and ways of knowing. Results were validated with select research participants and the Project Advisory Committee. Results: Findings demonstrate how relationship building is the necessary starting point for engagement when developing survey instruments with Indigenous peoples. Engagement requires respectful collaboration through all stages of the project from determining what questions are asked to how the information will be collected, interpreted, and managed. A relational stance requires responsibility to Indigenous communities and peoples that goes beyond research carried out using a western scientific lens. It means ensuring that the project is beneficial to the community and framing questions based on Indigenous knowledge, worldviews, and community involvement. Conclusions: This study employed a collaborative, participatory qualitative approach to develop a framework for creating PROMs and PREMs with Indigenous peoples. The methods described offer concrete examples of strategies that can be employed to support relationship‐building and collaboration when developing Indigenous‐specific survey instruments. [ABSTRACT FROM AUTHOR]

Background: Scientific research activities are crucial for the development of clinician-scientists. However, few people pay attention to the current situation of medical research in pediatric medical students in China. This study aims to assess the perceptions, practices and barriers toward medical research of pediatric undergraduates. Methods: This cross-sectional study was conducted among third-year, fourth-year and fifth-year pediatric students from Zhejiang University School of Medicine in China via an anonymous online questionnaire. The questionnaires were also received from fifth-year students majoring in other medicine programs [clinical medicine ("5 + 3") and clinical medicine (5-year)]. Results: The response rate of pediatric undergraduates was 88.3% (68/77). The total sample of students enrolled in the study was 124, including 36 students majoring in clinical medicine ("5 + 3") and 20 students majoring in clinical medicine (5-year). Most students from pediatrics ("5 + 3") recognized that research was important. Practices in scientific research activities are not satisfactory. A total of 51.5%, 35.3% and 36.8% of the pediatric students participated in research training, research projects and scientific article writing, respectively. Only 4.4% of the pediatric students contributed to publishing a scientific article, and 14.7% had attended medical congresses. None of them had given a presentation at a congress. When compared with fifth-year students in the other medicine program, the frequency of practices toward research projects and training was lower in the pediatric fifth-year students. Lack of time, lack of guidance and lack of training were perceived as the main barriers to scientific work. Limited English was another obvious barrier for pediatric undergraduates. Pediatric undergraduates preferred to participate in clinical research (80.9%) rather than basic research. Conclusions: Although pediatric undergraduates recognized the importance of medical research, interest and practices in research still require improvement. Lack of time, lack of guidance, lack of training and limited English were the common barriers to scientific work. Therefore, research training and English improvement were recommended for pediatric undergraduates. [ABSTRACT FROM AUTHOR]

Background: Social determinants of health (SDOH) are the non-medical factors that impact health. Although geographical measures of deprivation are used, individual measures of social risk could identify those most at risk and generate more personalised care and targeted referrals to community resources. We know SDOH are important to health care, but it is not yet known whether their collection via the electronic health record (EHR) is acceptable and useful from the patient perspective. Aim: To synthesise relevant literature to explore patient perspectives on integrating information about SDOH into primary care EHRs, and the opportunities and challenges of its implementation in a general practice setting. Design & setting: Systematic review of primary care-based qualitative and mixed-method studies using thematic framework analysis. Method: Key databases were searched for articles reporting patient perspectives of SDOH collection within the primary care EHR. Qualitative and mixed-methods studies written in English were included. A framework analysis was conducted to identify themes. Results: From 14 included studies, the following five main themes were identified: rationale for SDOH screening and the anticipated outcomes; impact of the provider-patient relationship on patient perceptions; data, which included privacy concerns; screening process and referral; and recommendations for future research. Conclusion: Integration of information on SDOH into the EHR appears acceptable to patients. This review has added to the discussion of whether and how to implement SDOH screening and referral programmes into UK primary care systems. [ABSTRACT FROM AUTHOR]

A tablet app, based on the Pain Assessment Checklist for Seniors with Limited Ability to Communicate-II (PACSLAC-II), has been shown to have clinical utility and unique advantages. We aimed to replicate and extend the previous validation of the app through the implementation and evaluation of a new community platform involving a quality indicator (QI) monitoring feature and a resource community portal (CP) that work in conjunction with an updated version of the app. We employed a mixed-methods multiple-baseline design across 11 long-term care (LTC) units. Units were randomly assigned to conditions which varied in number of app features available. Data included unit-level QIs as well as questionnaires and semi-structured interviews with health professionals. Following use of the app, we found improvements in unit-level QIs regardless of availability of the QI/CP features. During interviews, participants expressed a preference for the app over a paper version of the PACSLAC-II due to reasons such as the app's ability to summarize information. Utilization of the community portal websites was unrelated to staff questionnaire-assessed stress/burnout. Despite the positive effects on the care of residents, the COVID-19 pandemic presented challenges and interfered with the long-term maintenance of the QI results. [ABSTRACT FROM AUTHOR]

Background: Edentulous sites with limited horizontal tooth‐implant distance pose a challenge to clinicians. This case report describes root amputation of an adjacent compromised molar to maintain an optimal tooth‐implant distance Methods and Results: A 41‐year‐old female was referred for extraction and implant placement to replace her left, maxillary second premolar (#13), which had been diagnosed with a vertical root fracture. Extraction and ridge preservation of #13 was completed without complication. The 4‐month postsurgical clinical examination revealed a narrow mesial‐distal distance (5.69 mm) of the edentulous space (#13), which was influenced by the degree of divergence of the mesial buccal root of tooth #14. Cone‐beam computed tomography (CBCT) analysis verified a periapical lesion on the mesial‐buccal root of tooth #14. The amputation of the endodontically compromised mesial‐buccal root of #14 was treatment planned to provide space and facilitate placement of a standard diameter implant without compromising the implant or adjacent teeth. Crestal bone levels were verified and maintained at the 1 year postoperative follow‐up. Conclusion: The findings of the case report demonstrate how root amputation of a compromised molar is an alternative solution for managing spatial limitations in contemporary implant dentistry. More studies are required to assess the reliability and long‐term success of this approach. Key points: Why is this case new information?There is insufficient evidence on the long‐term efficacy of narrow‐diameter implants. Clinical treatment guidelines are not sufficiently available.This paper presents an alternative approach to managing a specific scenario where mesial‐distance distance is limited using root amputation of an adjacent compromised tooth. What are the keys to successful management of this case?Comprehensive diagnosis and stringent case selectionMultidisciplinary treatment planningEvidence‐based decision making What are the primary limitations to success in this case?Very specific clinical application; adjacent compromised toothLong‐term follow up is required [ABSTRACT FROM AUTHOR]

Mandibular incisive canal (MIC) and related mental foramen (MF) and anterior loop (AL) morphometrics are important landmarks in medical and dental clinical applications. The main aim of this retrospective study to determine the morphometry of the mandibular incisive canal (MIC) in a Jordanian population and to propose a new shape-pattern classification of the MIC. In addition, MF and AL morphometrics were determined. Carestream 3D imaging software was used on 100 Cone-Beam Computed Tomography (CBCT) of a Jordanian population to determine the MF, AL and MIC morphometrics. The detection prevalence of the MIC was 96 %. The right and left MIC showed four distinct line patterns, proposed for the first time in this paper. The line-patterns were angular (L-line), straight (I-line), curved (V-line) and wavy (W-line), with a prevalence of 41 %, 19 %, 25.5 %, and 10.5 %, respectively. MF was detected in all mandibles with a round shape in 58 % of the images. The most common horizontal and vertical positions of the MF were H4 and H3 (73.5 %) and V3 and V2 (95 %), respectively. An accessory MF was detected in 14.5 % of the samples and was more prevalent in males and on the right side. AL was detected in 92.5 % of the samples and exhibited a pattern prevalence of 25.5 %, 40 % and 27 % for types I, II and III, respectively. Results revealed that asymmetry and gender differences between right and left MIC, MF, AL and AMF was seen in patient's mandibles. In conclusion, this is the first study to propose and show that Mandibular incisive canal exhibits four potential line patterns (L, I, V and W lines patterns). Gender and ethnic variations of the mandibular canal landmarks morphometrics of both right and left hemi-mandible are important to be acknowledged in learning anatomy and when planning or performing dental and medical procedures. [ABSTRACT FROM AUTHOR]

With decades of pre‐clinical studies culminating in the recent clinical application of xenotransplantation, it would appear timely to provide recommendations for operationalizing oversight of xenotransplantation clinical trials. Ethical issues with clinical xenotransplantation have been described for decades, largely centering on animal welfare, the risks posed to the recipient, and public health risks posed by potential spread of xenozoonosis. Much less attention has been given to considerations relating to potentially elevated risks faced by those who may care for or otherwise have close contact with xenograft recipients. This paper examines the ethical and logistical issues raised by the potential exposure to xenozoonotic disease faced by close contacts of xenotransplant recipients—defined herein as including but not limited to caregivers, household contacts, and sexual partners—which warrants special attention given their increased risk of exposure to infection compared to the general public. We discuss implications of assent or consent by these close contacts to potentially undergo, along with the recipient, procedures for infection screening and possible quarantine. We then propose several options and recommendations for operationalizing oversight of xenotransplantation clinical trials that could account for and address close contacts' education on and agency regarding the risk of xenozoonosis. [ABSTRACT FROM AUTHOR]

As carbon monoxide has a broad spectrum of biological activities, its production by plasma is a significant advantage in medicine. This paper presents a comparative study of the CO production of two plasma jets: a MHz‐jet and a kHz‐jet. Both were fed with a helium gas with CO2 ${\text{CO}}_{2}$ admixture (0%–1%). CO was produced by CO2 ${\text{CO}}_{2}$ dissociation and its maximal concentration was hundreds of parts per million, which is safe for clinical applications. For the same specific energy input, the CO production was more efficient for the kHz‐jet than the MHz‐jet. Both had antibacterial properties on Escherichia coli, and the addition of CO2 ${\text{CO}}_{2}$ improved them for the MHz‐jet, while it reduced them for the kHz‐jet. [ABSTRACT FROM AUTHOR]

Objective. Following the database search, a total of 236 references were retrieved and managed using the reference manager. The screening of references was conducted according to the PRISMA 2020 screening process, and their quality was assessed using the JBI checklist. Ultimately, a total of eight publications of high quality were selected for inclusion in the scoping review. The results of the synthesis validate the importance of utilizing VR in the context of breathing exercise in rehabilitation. The effectiveness and rapid development of VR breathing exercises are primarily attributed to the engaging and immersive experience they provide. The use of biofeedback and self-regulation techniques into VR exercise systems was also seen to have a notable impact on the effectiveness of the breathing exercise system. [ABSTRACT FROM AUTHOR]

Earlier and more accurate diagnosis of ischemic stroke is crucial in enhancing the therapeutic outcome for patients. CT technology currently stands as the most rapid diagnostic modality in clinical medicine. Due to the diverse and complex shape of ischemic stroke lesions, accurate segmentation remains a challenging task for automated diagnosis systems. This paper, proposes an ischemic stroke lesion segmentation network, LiU-Net. It based on KiU-Net, which improves network performance and is more suitable for practical lesion segmentation applications. Firstly, KiU-Net combines the undercomplete network U-Net and the overcomplete network Kite-Net. It can simultaneously learn both image detail features and global structural features. Secondly, LiU-Net combines the axial self-attention module with KiU-Net. The introduction of attention can make the network achieve both segmentation accuracy and efficiency. In addition, to improve the flexibility of axial self-attention, a gate factor is introduced within the module to encode information about spatial structure of image. Finally, to address the issue of gradient vanishing, we incorporated residual connection into the network to bolster the feature maps at each depth level and facilitate effective cross depth feature integration. Since there are few publicly available datasets of CT images of ischemic stroke in medical images. We applied to Longcheng District People's Hospital, and processed the obtained images to form a dataset of ischemic stroke. The experimental results shown, LiU-Net is more accurate in segmenting different shapes of ischemic stroke lesions. Compared with KiU-Net, LiU-Net improves the Dice, Acc, and mIoU metrics by 2.44%, 3.4%, and 3.89% respectively. Therefore, LiU-Net is highly suitable for ischemic stroke lesion segmentation, and effectively assist computers in this task. [ABSTRACT FROM AUTHOR]

Summary: Multi‐organ segmentation is a critical prerequisite for many clinical applications. Deep learning‐based approaches have recently achieved promising results on this task. However, they heavily rely on massive data with multi‐organ annotated, which is labor‐ and expert‐intensive and thus difficult to obtain. In contrast, single‐organ datasets are easier to acquire, and many well‐annotated ones are publicly available. It leads to the partially labeled issue: How to learn a unified multi‐organ segmentation model from several single‐organ datasets? Pseudo‐label‐based methods and conditional information‐based methods make up the majority of existing solutions, where the former largely depends on the accuracy of pseudo‐labels, and the latter has a limited capacity for task‐related features. In this paper, we propose the Conditional Dynamic Attention Network (CDANet). Our approach is designed with two key components: (1) multisource parameter generator, fusing the conditional and multiscale information to better distinguish among different tasks, and (2) dynamic attention module, promoting more attention to task‐related features. We have conducted extensive experiments on seven partially labeled challenging datasets. The results show that our method achieved competitive results compared with the advanced approaches, with an average Dice score of 75.08%. Additionally, the Hausdorff Distance is 26.31, which is a competitive result. [ABSTRACT FROM AUTHOR]

Ultrasonography (USG) has become an invaluable tool in the assessment of neurocritical patients in the operating theaters and critical care units. Due to its easy availability, reliability, safety, and repeatability, neuro-intensivists and neuro-anesthesiologists utilize USG to make a diagnosis, assess prognosis, and decide upon treatment. In neurocritical care units, USG has myriad indications for use, both systemic and neurologic. The neurological indications include the assessment of stroke, vasospasm, traumatic brain injury, brain death, acute brain damage, optic nerve sheath diameter, and pupillary reflexes to name a few. The systemic indications range from assessment of cardio-pulmonary function and intravascular volume status to detection of deep venous thromboses, vocal cord assessment in intubated patients, placement of central venous catheters, and percutaneous tracheostomy. In this narrative review, we iterate the clinical applications of USG in neuroanesthesia and neurocritical care, which we penned after searching relevant databases in PubMed, Medline, Ovid, and Google Scholar by using terms such as 'applications of transcranial Doppler', 'optic nerve sheath diameter', 'USG applications in the critical care unit', and so on. Our search database includes several research papers, neurocritical care books, review articles, and scientific databases. This article reviews various applications of USG in neuroanesthesia, neurosurgery, and neurocritical care. [ABSTRACT FROM AUTHOR]

Mesenchymal stem cells (MSCs) are multipotent stem cells that are able to differentiate into multiple lineages including bone, cartilage, muscle and fat. They hold immunomodulatory properties and therapeutic ability to treat multiple diseases, including autoimmune and chronic degenerative diseases. In this article, we reviewed the different biological properties, applications and clinical trials of MSCs. Also, we discussed the basics of manufacturing conditions, quality control, and challenges facing MSCs in the clinical setting. Extensive review of the literature was conducted through the databases PubMed, Google Scholar, and Cochrane. Papers published since 2015 and covering the clinical applications and research of MSC therapy were considered. Furthermore, older papers were considered when referring to pioneering studies in the field. The most widely studied stem cells in cell therapy and tissue repair are bone marrow-derived mesenchymal stem cells. Adipose tissue-derived stem cells became more common and to a lesser extent other stem cell sources e.g., foreskin derived MSCs. MSCs therapy were also studied in the setting of COVID-19 infections, ischemic strokes, autoimmune diseases, tumor development and graft rejection. Multiple obstacles, still face the standardization and optimization of MSC therapy such as the survival and the immunophenotype and the efficiency of transplanted cells. MSCs used in clinical settings displayed heterogeneity in their function despite their extraction from healthy donors and expression of similar surface markers. Mesenchymal stem cells offer a rising therapeutic promise in various diseases. However, their potential use in clinical applications requires further investigation. [ABSTRACT FROM AUTHOR]

Desmopressin is a synthetic analogue of vasopressin and a selective vasopressin receptor 2 agonist. It was first synthesised in 1967 and utilised for its antidiuretic properties. It is also used in bleeding disorders to enhance clotting. Other potential uses of the drug have been reported. The present review aims to provide a broad overview of the literature on potential further uses of oral forms of desmopressin. Key therapeutic areas of interest were identified based on known physiological activities/targets of desmopressin or reports of an effect of desmopressin in the literature. The feasibility of adequate dosing with oral forms of the drug was also considered. Systematic literature searches were carried out using the silvi.ai software for the identified areas, and summaries of available papers were included in tables and discussed. The results of the searches showed that desmopressin has been investigated for its efficacy in a number of areas, including bleeding control, renal colic, the central nervous system and oncology. Evidence suggests that oral desmopressin may have the potential to be of clinical benefit for renal colic and bleeding control in particular. However, further research is needed to clarify its effect in these areas, including randomised controlled studies and studies specifically of oral formulations (and doses). Further research may also yield findings for cancer, cognition and overactive bladder. [ABSTRACT FROM AUTHOR]

In clinical medicine, due to some accidents will inevitably produce the situation of missing data, this study for its with missing and truncated data, the use of mathematical statistics methods for inference supplement. After classifying the types of incomplete data, the article utilizes the great likelihood and empirical likelihood to form a linear statistical model to infer such data. It verifies it through simulation experiments and example analysis. In the simulation experiment, for the case of the same missing probability, as the number of samples increases from 150 to 300, the bias, variance, and mean square error of this paper’s algorithm in parameter β1 are reduced to 0.0122, 0.1435, and 0.1441, respectively. In the actual statistical inference analysis of cardiac disease and heart transplantation, the standard error of this paper’s method reduces by 0.0576 compared with that of CAA, and the inference The results are by the reality. In clinical medicine, this study proposes a practical statistical extrapolation method and a realization path for objective interpretation when incomplete data is present.

Background: This collection focuses on Navigation Surgery, we aim to explore the intersection of cutting-edge technology and musculoskeletal surgery. It covers recent advancements, challenges, and future directions in navigational techniques. Navigation devices reconstruct 3D surgical information on monitors, aiding in safer and more accurate operations across orthopedic surgeons. While beneficial, there are risks like misplaced implants, necessitating careful navigation usage. The collection encourages discussions on clinical applications and the ongoing evolution of navigation surgeries. [ABSTRACT FROM AUTHOR]

As computer vision algorithms increase in capability, their applications in clinical systems will become more pervasive. These applications include: diagnostics, such as colonoscopy and bronchoscopy; guiding biopsies, minimally invasive interventions, and surgery; automating instrument motion; and providing image guidance using pre-operative scans. Many of these applications depend on the specific visual nature of medical scenes and require designing algorithms to perform in this environment. In this review, we provide an update to the field of camera-based tracking and scene mapping in surgery and diagnostics in medical computer vision. We begin with describing our review process, which results in a final list of 515 papers that we cover. We then give a high-level summary of the state of the art and provide relevant background for those who need tracking and mapping for their clinical applications. After which, we review datasets provided in the field and the clinical needs that motivate their design. Then, we delve into the algorithmic side, and summarize recent developments. This summary should be especially useful for algorithm designers and to those looking to understand the capability of off-the-shelf methods. We maintain focus on algorithms for deformable environments while also reviewing the essential building blocks in rigid tracking and mapping since there is a large amount of crossover in methods. With the field summarized, we discuss the current state of the tracking and mapping methods along with needs for future algorithms, needs for quantification, and the viability of clinical applications. We then provide some research directions and questions. We conclude that new methods need to be designed or combined to support clinical applications in deformable environments, and more focus needs to be put into collecting datasets for training and evaluation. [Display omitted] • We refresh tracking and mapping in medical computer vision, reviewing 515 papers. • We summarize limitations and future directions to enable growth in this field. • Machine learning is increasing in impact for tracking and mapping. • Having more publicly available datasets and robust models is essential. • Modern computer vision methods are frequently adapted to the specifics of medical scenes. [ABSTRACT FROM AUTHOR]

The aim of this paper is to discuss the significance of the intersectionality framework for addressing prejudices, racism and inequalities in nursing education and clinical learning environments. Discrimination and racism against nursing students and educators based on their gender, ethnicity, race and social identities is well-documented in the nursing literature. Despite documented discrimination and incivility based on intersectional factors, it is reported that often nurse educators show limited interest in the culture, diverse experiences and values of nursing students with culturally and linguistically diverse backgrounds. Discussion paper The discussion was based on contemporary literature about intersectionality, discrimination and racism in nursing. We completed a cursory search of literature in nursing education journal and selected nursing and health science databases. This was not a formal literature review. Using a fictional example, the application of intersectionality to address inequalities in educational settings is illustrated. Intersectionality is an invaluable tool for examining interwoven power relations and power struggles arising from racial, gender, ethnic, religious and sexuality and disability-related differences. Nurse educators, students and leaders should be more cognizant of their preconceived views, sociocultural stereotypes and varied forms of sociocultural oppression affecting their interactions with each other in clinical learning environments. Incorporating intersectionality can address prejudices, racism and inequalities arising due to sociocultural, ethnic, power-related and intergenerational issues among educators, students and other personnel involved in creating clinical learning environments. [ABSTRACT FROM AUTHOR]

In this paper, the pharmacological effects and molecular mechanisms of sarsasapogenin, such as anti-oxidant, anti-inflammatory and anti-diabetic effects, are reviewed in order to provide a theoretical basis for the subsequent development and clinical application of sarsasapogenin. [ABSTRACT FROM AUTHOR]

This paper comments on the role of the color Red in the assessment process with specific applications to the Rorschach, as outlined by Piotrowski (2023). Based on prior research findings, the central importance of the impact of color Red on cognitive and perceptual processes is noted. Future research should stress experimental findings as well as applications for clinical assessment. [ABSTRACT FROM AUTHOR]

High sensitivity and accuracy of heart failure biomarker, N-terminal prohormone brain natriuretic peptide (NT-proBNP), is critical for the early detection of heart failure. However, traditional chemiluminescent (CL) probe still face the challenges of poor solubility, in particular, significant disappointing bioavailability, which profoundly limit its clinical applications. In this paper, we demonstrate functional CL probe acridinium ester (AE-2) for the detection of NT-proBNP, through introducing a hydrophilic unit for ensuring high water dispersity and reactive group for promoting better bioavaiability with antibody. Compared to the traditional CL probe, the functional CL probe AE-2 exhibits extraordinary features, such as better biocompatibility, higher label rate with antibody, as well as significant chemiluminescence signal. In addition, this CL probe exhibits excellent linearity with the test data of Longhua Hospital, suggesting that AE-2 could be used as a clinical examination assay to detect NT-proBNP in real clinical samples. Thus, this functional CL probe AE-2 can be a powerful tool for elucidating the roles of NT-proBNP in clinical samples. • Enhancing antibody coupling efficiency with functionalized acridinate dye. • Accurate NT-proBNP concentrations with high correlation coefficient (0.9998). • Remarkable NT-proBNP detection in high concordance with clinical data. [ABSTRACT FROM AUTHOR]

Accurate histopathological subtype prediction is clinically significant for cancer diagnosis and tumor microenvironment analysis. However, achieving accurate histopathological subtype prediction is a challenging task due to (1) instance-level discrimination of histopathological images, (2) low inter-class and large intra-class variances among histopathological images in their shape and chromatin texture, and (3) heterogeneous feature distribution over different images. In this paper, we formulate subtype prediction as fine-grained representation learning and propose a novel multi-instance selective transformer (MIST) framework, effectively achieving accurate histopathological subtype prediction. The proposed MIST designs an effective selective self-attention mechanism with multi-instance learning (MIL) and vision transformer (ViT) to adaptive identify informative instances for fine-grained representation. Innovatively, the MIST entrusts each instance with different contributions to the bag representation based on its interactions with instances and bags. Specifically, a SiT module with selective multi-head self-attention (S-MSA) is well-designed to identify the representative instances by modeling the instance-to-instance interactions. On the contrary, a MIFD module with the information bottleneck is proposed to learn the discriminative fine-grained representation for histopathological images by modeling instance-to-bag interactions with the selected instances. Substantial experiments on five clinical benchmarks demonstrate that the MIST achieves accurate histopathological subtype prediction and obtains state-of-the-art performance with an accuracy of 0.936. The MIST shows great potential to handle fine-grained medical image analysis, such as histopathological subtype prediction in clinical applications. [Display omitted] • A novel multi-instance selective transformer is proposed for the first time to formulate histopathological subtype prediction as fine-grained representation learning. • A selective instance transformer (SiT) is proposed to learn the instance- level fine-grained representation in histopathological subtype prediction by selecting the representative instances with a self-attention learning paradigm. • A multiple instance feature decoupling (MIFD) is proposed to leverage information bottleneck into the fine-grained representation learning and conduct accurate histopathological subtype prediction. [ABSTRACT FROM AUTHOR]

Accurate 3D tracking of hand and fingers movements poses significant challenges in computer vision. The potential applications span across multiple domains, including human–computer interaction, virtual reality, industry, and medicine. While gesture recognition has achieved remarkable accuracy, quantifying fine movements remains a hurdle, particularly in clinical applications where the assessment of hand dysfunctions and rehabilitation training outcomes necessitate precise measurements. Several novel and lightweight frameworks based on Deep Learning have emerged to address this issue; however, their performance in accurately and reliably measuring finger movements requires validation against well-established gold standard systems. In this paper, the aim is to validate the hand-tracking framework implemented by Google MediaPipe Hand (GMH) and an innovative enhanced version, GMH-D, that exploits the depth estimation of an RGB-Depth camera to achieve more accurate tracking of 3D movements. Three dynamic exercises commonly administered by clinicians to assess hand dysfunctions, namely hand opening–closing, single finger tapping and multiple finger tapping are considered. Results demonstrate high temporal and spectral consistency of both frameworks with the gold standard. However, the enhanced GMH-D framework exhibits superior accuracy in spatial measurements compared to the baseline GMH, for both slow and fast movements. Overall, our study contributes to the advancement of hand tracking technology, and the establishment of a validation procedure as a good-practice to prove efficacy of deep-learning-based hand-tracking. Moreover, it proves that GMH-D is a reliable framework for assessing 3D hand movements in clinical applications. • Hands are vital for carrying out daily-life tasks without external aid. • Measuring objectively hand dexterity can support new digital health treatments. • Deep Learning allows for video-based hand tracking of fine motor tasks. • We validate accuracy of Google Mediapipe Hand and GMH-D against motion capture. • Both frameworks achieve good-to-high spatial and temporal hand tracking performance. [ABSTRACT FROM AUTHOR]