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This classic methods paper () considers the assessment of agreement between measures, an often overlooked aspect of assessing measurements taken for use in research and practice and (re) introduces the ubiquitous ‘Bland Altman’ procedures for assessing agreement. The importance of these procedures is high and they address issues that are not always considered in research which uses measurement scales or describes the characteristics of scales developed for use in clinical practice. Many widely used approaches for reliability assessment can fail to consider the agreement between measures at all and can give an entirely misleading impression of an instrument's suitability for use in research or practice. [Copyright &y& Elsevier]

In Australia, numerous reviews and inquiries have documented concerns about inadequate access to, and the quality of, aged care. Despite those concerns, research is yet to appraise fully how care needs are assessed, prioritised, and met or left unmet. This paper asks two interrelated questions: (1) How should we conceptualise and measure unmet care need and care inequalities among older people? (2) What are the policy parameters for assessing needs, prioritising access to support and monitoring quality in aged care in Australia? Key insights from academic literature are used to critically review Australian policy documents describing rights, assessments, prioritisation, quality standards and performance indicators for the aged care sector. Using the concepts of care inequalities and care poverty, the paper develops a framework for understanding and measuring needs and unmet needs in aged care, and for encompassing fundamental and valued aspects of life for older people, their carers and their care network. The paper argues that the concept of care poverty opens the space to discuss what level of unmet need and inequality in access to aged care in any society may be considered intolerable. [ABSTRACT FROM AUTHOR]

Introduction: The threshold concept framework (TCF) was first described nearly 20 years ago, but its application in the field of medical education has recently seen a significant growth of interest with a diverse range of literature published on the subject. The transformative nature of threshold concepts (TCs) offers potential for the design of learning experiences and curricula across the medical education continuum. A scoping review was conducted to map the extent of the current literature regarding TCs in medical education—to describe the types of available evidence and its focus—and identify research gaps. Methods: The review followed the JBI Manual for Evidence Synthesis approach for scoping reviews. Four databases and two additional websites were searched for articles exploring TCs in medical education. Data were analysed using quantitative and qualitative thematic approaches. A framework of conceptual change was used to synthesise the TCs identified. Results: Thirty‐six papers, spanning undergraduate, postgraduate and continuing medical education, were included in the final analysis. The most frequent application of the TCF was in the identification of TCs, which related to basic scientific knowledge, ways of thinking and ways of practising in medicine. Uncertainty, patient care, clinical reasoning and professional identify formation were themes that emerged at multiple stages of training. Several papers evaluated the use of the TCF in teaching. Conclusion: The understanding and embodiment of TCs increases in complexity across the medical education continuum, with TCs recurring with changes in clinical environment and responsibilities. This lends support to a holistic approach to curriculum design spanning all stages of training. Further research is needed to develop a consistent approach for describing and applying the TCF in medical education and to address how the TCF can be used in teaching and how threshold crossing can be measured. Understanding and embodiment of threshold concepts across the medical education continuum is argued through this review to support a holistic approach to curriculum design. [ABSTRACT FROM AUTHOR]

Various guidelines for authors of research papers and the checklists that often accompany these statements play an important role in the creation of carefully written scientific papers - for authors, they serve as tools to ensure the correct structure and content of the manuscript, increasing the chances that a paper will be published in a journal with a high rejection rate. The aim of this editorial is to provide a concise outline of the checklists most frequently used to guide the structuring of papers published in Advances in Clinical and Experimental Medicine, and to support current and prospective authors of this journal in choosing a checklist for their manuscript. The EQUATOR website is presented as a useful tool in choosing a checklist: https://www.equator-network.org/. Then, 8 checklists that are most popular among authors who publish their work in Advances in Clinical and Experimental Medicine are outlined: STROBE - for observational studies; ARRIVE - for any area of bioscience research using laboratory animals; CASP - for qualitative studies; CONSORT - for parallel group randomized trials; PRISMA - for all reviews and meta-analyses; SQUIRE - for studies on quality improvement in healthcare; STARD - for diagnostic accuracy studies; REMARK - for tumor marker prognostic studies. Each of the 8 presented checklists is discussed in a following order: 1) the name of the checklist is explained; 2) the type of articles to which it is intended is pointed out; 3) the structure of the checklist is explained; 4) if there are any extensions of the presented checklist for specific subtypes of papers, they are listed; 5) the most important literature on the presented checklist is provided. As a take-home message, basic tips for choosing a checklist are formulated. Finally, examples of papers adhering to each discussed checklist are provided. [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]

The rapid advancement of informatization has opened up new possibilities for the development of auricular acupoint information devices. This paper starts with a discussion between diagnosis and treatment of auricular acupoint and auricular acupoint information devices. It also summarizes the current research and development status of auricular acupoint information devices that assist with precise acupoint localization, diagnosis, and treatment. Furthermore, it explores the impact of these devices on transforming the models of diagnosis and treatment, as well as facilitating telemedicine in auricular acupoint. The analysis highlights existing challenges faced by auricular acupoint information devices globally, such as limited clinical application and promotion, the urgent need for improved level of informatization, and insufficient cross-disciplinary integration. The paper also proposes corresponding measures that emphasize the importance of research, development, and transformation, enhancing the level of informatization, and fostering multidisciplinary exchanges and cooperation. The aim of this study is to provide valuable insights for the development of auricular acupoint information devices. [ABSTRACT FROM AUTHOR]

The article is dedicated to the 350 th anniversary of the death of the Dutch anatomist, physiologist, yatrochemist and the greatest physician of the XVII century, Franciscus Sylvius (Franz de le Boe) (1614-1672). His contribution to the study of the structure of the nervous system is characterized, as well as the main scientific discoveries and achievements in building a rational system of medical science and practice. It is stated that eponym «aquaeductus Sylvii» was coined by Lorenz Heister in 1717 in his paper «De admiranda cerebelli structura».

Zhu Zhenheng, the last generation and sole representative from Southern China among the four masters of Jin-Yuan medicine, synthesized the evolution of Chinese medicine from the Song to the Yuan dynasties, profoundly impacting East Asian medical history. Zhu, identified as a Neo-Confucian scholar, appears in the Scholarly Records of the Song-Yuan Dynasties and in ‘the Biographies of Confucians’ rather than ‘the Biographies of Experts’ in the Official History of the Yuan Dynasty. His close association with the Jinhua school of Daoxue is noteworthy. Zhu’s career, as well as his medical theory and practice, exemplify the influence of Zhu Xi’s Neo-Confucianism, which was a significant intellectual resource among the literati during the late Yuan period, on medicine. Zhu Zhenheng’s model of a Confucian physician later became a paradigm in East Asia, as Neo-Confucianism gained mainstream acceptance among the literati. This paper offers a detailed exploration of the specific contexts of Zhu’s social and intellectual networks as well as an examination of the characteristics of his medical theories and practices. It explores how Zhu’s career and identity as a Neo-Confucian physician were shaped through the local and empire-wide networks of the Jinhua school of Neo-Confucianism within the broader context of the Mongol empire, a global power in the late Yuan period. The paper also examines in depth how Zhu’s medical practices were influenced by Neo-Confucianism, and it investigates the real nature and significance of the integration of medicine and Neo-Confucianism, two distinctly different realms of knowledge. Zhu Zhenheng’s medical theories were formed through concerns about jufang medicine and the active presentation of alternatives. A notable aspect of his integration of medicine and Confucianism was the adoption of Neo-Confucian terminologies, concepts, and philosophical and ethical theses, while ensuring that the unique and independent domain of medicine was not subordinated to abstract philosophical theories. This is especially evident through his active and effective use of medical cases. Unlike previous studies, this paper demonstrates that Zhu Zhenheng’s integration of medicine and Neo-Confucianism was mostly a metalevel process, involving methodology and knowledge reproduction patterns, and was driven by a belief in the possibility of harmonizing with Daoxue’s ultimate principle without undermining the autonomy of medical knowledge.

According to the WHO, cancer is the second leading cause of death in the world. This is an important global problem and a major challenge for researchers who have been trying to find an effective anticancer therapy. A large number of newly discovered compounds do not exert selective cytotoxic activity against tumorigenic cells and have too many side effects. Therefore, research on muramyl dipeptide (MDP) analogs has attracted interest due to the urgency for finding more efficient and safe treatments for oncological patients. MDP is a ligand of the cytosolic nucleotide-binding oligomerization domain 2 receptor (NOD2). This molecule is basic structural unit that is responsible for the immune activity of peptidoglycans and exhibits many features that are important for modern medicine. NOD2 is a component of the innate immune system and represents a promising target for enhancing the innate immune response as well as the immune response against cancer cells. For this reason, MDP and its analogs have been widely used for many years not only in the treatment of immunodeficiency diseases but also as adjuvants to support improved vaccine delivery, including for cancer treatment. Unfortunately, in most cases, both the MDP molecule and its synthesized analogs prove to be too pyrogenic and cause serious side effects during their use, which consequently exclude them from direct clinical application. Therefore, intensive research is underway to find analogs of the MDP molecule that will have better biocompatibility and greater effectiveness as anticancer agents and for adjuvant therapy. In this paper, we review the MDP analogs discovered in the last 10 years that show promise for antitumor therapy. The first part of the paper compiles the achievements in the field of anticancer vaccine adjuvant research, which is followed by a description of MDP analogs that exhibit promising anticancer and antiproliferative activity and their structural changes compared to the original MDP molecule. [ABSTRACT FROM AUTHOR]

This paper introduces a complex novel concept and methodology for the creation of personalized biomedical appliances 3D-printed from certified biocompatible photopolymer resin Dental LT Clear (V2). The explained workflow includes intraoral and CT scanning, patient virtualization, digital appliance design, additive manufacturing, and clinical application with evaluation of the appliance intended for patients with cranio-facial syndromes. The presented concept defines virtual 3D fusion of intraoral optical scan and segmented CT as sufficient and accurate data defining the 3D surface of the face, intraoral and airway morphology necessary for the 3D design of complex personalized intraoral and extraoral parts of the orthopedic appliance. A central aspect of the concept is a feasible utilization of composite resin for biomedical prototyping of the sequence of marginally different appliances necessary to keep the pace with the patient rapid growth. Affordability, noninvasiveness, and practicality of the appliance update process shall be highlighted. The methodology is demonstrated on a particular case of two-year-old infant with Pierre Robin sequence. Materialization by additive manufacturing of this photopolymer provides a highly durable and resistant-to-fracture two-part appliance similar to a Tübingen palatal plate, for example. The paper concludes with the viability of the described method and material upon interdisciplinary clinical evaluation of experts from departments of orthodontics and cleft anomalies, pediatric pneumology and phthisiology, and pediatric otorhinolaryngology. [ABSTRACT FROM AUTHOR]

Background: Non-invasive prenatal testing (NIPT) has had an incomparable triumph in prenatal diagnostics in the last decade. Over 1400 research articles have been published, predominantly praising the advantages of this test. Methods: The present study identified among the 1400 papers 24 original and one review paper, which were suited to re-evaluate the efficacy of > 750,000 published NIPT-results. Special attention was given to false-positive and false-negative result-rates. Those were discussed under different aspects—mainly from a patient-perspective. Results: A 27: 1 rate of false-positive compared to false-negative NIPT results was found. Besides, according to all reported, real-positive, chromosomally aberrant NIPT cases, 90% of those would have been aborted spontaneously before birth. These findings are here discussed under aspects like (i) How efficient is NIPT compared to first trimester screening? (ii) What are the differences in expectations towards NIPT from specialists and the public? and (iii) There should also be children born suffering from not by NIPT tested chromosomal aberrations; why are those never reported in all available NIPT studies? Conclusions: Even though much research has been published on NIPT, unbiased figures concerning NIPT and first trimester screening efficacy are yet not available. While false positive rates of different NIPT tests maybe halfway accurate, reported false-negative rates are most likely too low. The latter is as NIPT-cases with negative results for tested conditions are yet not in detail followed up for cases with other genetic or teratogenic caused disorders. This promotes an image in public, that NIPT is suited to replace all invasive tests, and also to solve the problem of inborn errors in humans, if not now then in near future. Overall, it is worth discussing the usefulness of NIPT in practical clinical application. Particularly, asking for unbiased figures concerning the efficacy of first trimester-screening compared to NIPT, and for really comprehensive data on false-positive and false-negative NIPT results. [ABSTRACT FROM AUTHOR]

The performance of the current skin cancer diagnostic models cannot meet the requirements of clinical applications, and the diagnostic accuracy is not high for a few categories. To slove this problem, this paper proposed a SC-Net model based on transfer learing and data augmentation. Firstly, using the ECA attention module to fine tune the pre-training model of DenseNet-201 on the skin cancer dataset, and extract the implicit high-level features of the images. Then, joining the general statistical features, and using SMOTE oversampling technology to balance a few categories of data. Finally, putting the data into XGBoost model for training to obtain the final SC-Net classification model. The experimental results show that the accuracy, sensitivity and specificity of SC-Net model reach 99.25%, 99.25% and 99.88%, which is about 0.6% ～ 18.7% higher than the existing models. The proposed model has stronger classification ability for a few categories such as Dermato fibroma and Actinic keratoses and intraepithelial carcinoma. The performance of the current skin cancer diagnostic models cannot meet the requirements of clinical applications, and the diagnostic accuracy is not high for a few categories. To slove this problem, this paper proposed a SC-Net model based on transfer learing and data augmentation. Firstly, using the ECA attention module to fine tune the pre-training model of DenseNet-201 on the skin cancer dataset, and extract the implicit high-level features of the images. Then, joining the general statistical features, and using SMOTE oversampling technology to balance a few categories of data. Finally, putting the data into XGBoost model for training to obtain the final SC-Net classification model. The experimental results show that the accuracy, sensitivity and specificity of SC-Net model reach 99.25%, 99.25% and 99.88%, which is about 0.6% ～ 18.7% higher than the existing models. The proposed model has stronger classification ability for a few categories such as Dermato fibroma and Actinic keratoses and intraepithelial carcinoma. [ABSTRACT FROM AUTHOR]

The external and middle ear conditions are diagnosed using a digital otoscope. The clinical diagnosis of ear conditions is suffered from restricted accuracy due to the increased dependency on otolaryngologist expertise, patient complaint, blurring of the otoscopic images, and complexity of lesions definition. There is a high requirement for improved diagnosis algorithms based on otoscopic image processing. This paper presented an ear diagnosis approach based on a convolutional neural network (CNN) as feature extraction and long short-term memory (LSTM) as a classifier algorithm. However, the suggested LSTM model accuracy may be decreased by the omission of a hyperparameter tuning process. Therefore, Bayesian optimization is used for selecting the hyperparameters to improve the results of the LSTM network to obtain a good classification. This study is based on an ear imagery database that consists of four categories: normal, myringosclerosis, earwax plug, and chronic otitis media (COM). This study used 880 otoscopic images divided into 792 training images and 88 testing images to evaluate the approach performance. In this paper, the evaluation metrics of ear condition classification are based on a percentage of accuracy, sensitivity, specificity, and positive predictive value (PPV). The findings yielded a classification accuracy of 100%, a sensitivity of 100%, a specificity of 100%, and a PPV of 100% for the testing database. Finally, the proposed approach shows how to find the best hyperparameters concerning the Bayesian optimization for reliable diagnosis of ear conditions under the consideration of LSTM architecture. This approach demonstrates that CNN-LSTM has higher performance and lower training time than CNN, which has not been used in previous studies for classifying ear diseases. Consequently, the usefulness and reliability of the proposed approach will create an automatic tool for improving the classification and prediction of various ear pathologies. [ABSTRACT FROM AUTHOR]

Micro-expression automatic analysis method is one of the research directions of computer vision. Micro-expression analysis technology has important research and application value in criminal investigation, clinical medicine, business negotiation, public security and other scenarios. In order to sort out the research status and development direction in the field of automatic micro-expression analysis, this paper sorted out the commonly used micro-expression datasets and data preprocessing methods. Based on micro-expression features, various algorithms, this paper comprehensively sorted and compared experimental methods and verification indicators for micro-expression spotting and recognition tasks. It can help researchers more quickly and comprehensively understand the current research status, existing problems and future development directions in this field. [ABSTRACT FROM AUTHOR]

Purpose: This paper examines the historical background of accountingization, colonization and hybridization in the health services by exploring the relationship between hospital accounting and clinical medicine in Britain between the late 1960s and the early 2000s. Design/methodology/approach: The paper draws on an analysis of professional journals, government reports and other documentary sources relating to accounting and medical developments. It is informed by Abbott's sociology of professions and Eyal's sociology of expertise. Findings: The paper shows that not only accountants but also elements within the medical profession sought to make the practice of medicine more visible, calculable and standardized, and that accounting and medical attempts to make medicine calculable interacted in a mutually reinforcing manner. Consequently, it argues that a movement towards clinical forms of quantification within the medical profession made it more open to economic calculation, which underpinned hospital accounting reforms and the accountingization, colonization or hybridization of health services. Originality/value: The paper demonstrates that a fuller understanding of the relationship between accounting and public sector professions can be developed if we examine their mutual interactions rather than restricting ourselves to analyzing accounting's effects on public sector professions. The paper moreover illustrates instances of intraprofessional conflict and inter-professional cooperation, and draws on the sociology of expertise to suggests that while hospital accounting reforms have curbed the power of medical professionals, they have also enhanced the power of clinical expertise. [ABSTRACT FROM AUTHOR]

Purpose: Recently published papers have demonstrated that particularly in untreated individuals, clinical parameters more often associate with thyroid hormone, particularly free thyroxine (FT4), levels than with thyrotropin (TSH) levels. Clinical and research assessments of the thyroid state of peripheral tissues would therefore be more precise if they were based on FT4 levels rather than on TSH levels. In this paper we describe implications of, and opportunities provided by, this discovery., Conclusions: The FT4 level may be the best single test of thyroid function. The addition of free triiodothyronine (FT3) and TSH levels would further enhance test sensitivity and distinguish primary from secondary thyroid dysfunction respectively. There are opportunities to reconsider testing algorithms. Additional potential thyroidology research subjects include the peripheral differences between circulating FT4 and FT3 action, and outcomes in patients on thyroid replacement therapy in terms of thyroid hormone levels. Previously performed negative studies of therapy for subclinical thyroid dysfunction could be repeated using thyroid hormone levels rather than TSH levels for subject selection and the monitoring of treatment. Studies of outcomes in older individuals with treatment of high normal FT4 levels, and pregnant women with borderline high or low FT4 levels would appear to be the most likely to show positive results. There are fresh indications to critically re-analyse the physiological rationale for the current preference for TSH levels in the assessment of the thyroid state of the peripheral tissues. There may be opportunities to apply these research principles to analogous parameters in other endocrine systems., (© 2021. The Author(s).)

Setting:South Africa has the third highest tuberculosis (TB) burden in the world. Intensified case finding, recommended by WHO, is one way to control TB. Objective:To evaluate the effectiveness and acceptability of a paper slip method for TB contact tracing. Method:TB patients were offered paper slips to give to their contacts, inviting them for TB screening. The number of contacts screened and the proportion diagnosed with TB was calculated. Contacts that returned to the clinic after receiving the slips were interviewed. A focus group discussion (FGD) with TB patients was held to determine their acceptability. Results:From 718 paper slips issued, a 26% TB contact tracing rate was found, with a 12% case detection rate. The majority (68%) of contacts were screened within 2 weeks of receiving the slip. Age and gender were not significantly associated with time to screening. 16% of the contacts screened did not reside with the TB patients. 98% of the contacts said the method was acceptable. FGD findings show that this method is acceptable and may prevent stigma associated with TB/HIV. Conclusion:This simple, inexpensive method yields high contact tracing and case detection rates and potentially would yield additional benefits outside households. [ABSTRACT FROM AUTHOR]

Presents a clinical case which identified azo dyes as skin allergens in carbonless copy paper manufacturing. Presenting signs and symptoms; Results of diagnostic examinations; Therapeutic options.

The article offers information on the 2008 Journal of Orthodontics scientific paper of year prize sponsored by Maney Publishing. It mentions that the article "Evaluation of a quality of life measure for children with malocclusion," by C. O'Brien, P.E. Benson and Z. Marshman has been selected as the winner of the scientific paper prize. Moreover, it notes that the paper covers an area of interest within orthodontics and the potential for changing future clinical practice.

Comments on a series of three papers starting in "The Lancet" that will explore the gap between research and clinical practice. The topic of quality of care in a study by Richard Grol and Jeremy Grimshaw; The concept of evidence-based primary care medicine in the second paper; The study of problems in health-care policy in the third paper by Maynard.

Oral and maxillofacial diseases are one of the most prevalent diseases in the world, which not only seriously affect the health of patients' oral and maxillofacial tissues, but also bring serious economic and psychological burdens to patients. Therefore, oral and maxillofacial diseases require effective treatment. Traditional treatments have limited effects. In recent years, nature exosomes have attracted increasing attention due to their ability to diagnose and treat diseases. However, the application of nature exosomes is limited due to low yield, high impurities, lack of targeting, and high cost. Engineered exosomes can be endowed with better comprehensive therapeutic properties by modifying exosomes of parent cells or directly modifying exosomes, and biomaterial loading exosomes. Compared with natural exosomes, these engineered exosomes can achieve more effective diagnosis and treatment of oral and maxillary system diseases, and provide reference and guidance for clinical application. This paper reviews the engineering modification methods of exosomes and the application of engineered exosomes in oral and maxillofacial diseases and looks forward to future research directions. [ABSTRACT FROM AUTHOR]

Immunotherapy is a therapeutic approach that employs immunological principles and techniques to enhance and amplify the body's immune response, thereby eradicating tumor cells. Immunotherapy has demonstrated effective antitumor effects on a variety of malignant tumors. However, when applied to humans, many immunotherapy drugs fail to target lesions with precision, leading to an array of adverse immune-related reactions that profoundly limit the clinical application of immunotherapy. Nanodrug delivery systems enable the precise delivery of immunotherapeutic drugs to targeted tissues or specific immune cells, enhancing the immune antitumor effect while reducing the number of adverse reactions. A nanodrug delivery system provides a feasible strategy for activating the antitumor immune response by the following mechanisms: 1) increased targeting and uptake of vaccines by DCs, which enhances the efficacy of the immune response; 2) increased tumor cell immunogenicity; 3) regulation of TAMs and other cells by, for example, regulating the polarization of TAMs and interfering with TAN formation, and ECM remodeling by CAFs; and 4) interference with tumor immune escape signaling pathways, namely, the PD-1/PD-L1, FGL1/LAG-3 and IDO signaling pathways. This paper reviews the progress of nanodrug delivery system research with respect to tumor immunotherapy based on tumor immunomodulation over the last few years, discussing the promising future of these delivery systems under this domain. [ABSTRACT FROM AUTHOR]

Background: Existing research on health equity falls short of identifying a comprehensive set of indicators for measurement across health systems. Health systems in the ASEAN region, in particular, lack a standardised framework to assess health equity. This paper proposes a comprehensive framework to measure health equity in the ASEAN region and highlights current gaps in data availability according to its indicator components. Methods: A comprehensive literature review was undertaken to map out a core set of indicators to evaluate health equity at the health system level. Secondary data collection was subsequently conducted to assess current data availability for ASEAN states in key global health databases, national health accounts, and policy documents. Results: A robust framework to measure health equity was developed comprising 195 indicators across Health System Inputs and Processes, Outputs, Outcomes, and Contextual Factors. Total indicator data availability equated to 72.9% (1423/1950). Across the ASEAN region, the Inputs and Processes sub-component of Health Financing had complete data availability for all indicators (160/160, 100%), while Access to Essential Medicine had the least data available (6/30, 20%). Under Outputs and Outcomes, Coverage of Selected Interventions (161/270, 59.63%) and Population Health (350/350, 100%) respectively had the most data available, while other indicator sub-components had little to none (≤ 38%). 72.145% (384/530) of data is available for all Contextual Factors. Out of the 10 ASEAN countries, the Philippines had the highest data availability overall at 77.44% (151/195), while Brunei Darussalam and Vietnam had the lowest data availability at 67.18% (131/195). Conclusions: The data availability gaps highlighted in this study underscore the need for a standardised framework to guide data collection and benchmarking of health equity in ASEAN. There is a need to prioritise regular data collection for overlooked indicator areas and in countries with low levels of data availability. The application of this indicator framework and resulting data availability analysis could be conducted beyond ASEAN to enable cross-regional benchmarking of health equity. [ABSTRACT FROM AUTHOR]

Aim: Reports of patients with hepatitis B have highlighted associations between polymorphisms in the human leukocyte antigen (HLA)‐DPB1, CXCL13, and CXCR5 genes and disease pathology. Owing to its potential to contribute to the development of new diagnostic and therapeutic methods, we aimed to establish a reliable host genome analysis technique that can be used in countries with inadequate infrastructure. Method: We compared multiple commercially available kits for dried blood spot (DBS)‐based sample collection to develop a basic DBS‐based host genome analysis technique. We then collected blood samples from Cambodian patients with hepatitis B and performed single‐nucleotide polymorphism genotyping and HLA allele typing by the DBS system. Result: We were able to perform single‐nucleotide polymorphism genotyping and HLA allele typing with host DNA samples obtained using a combination of a HemaSpot™ filter paper‐based device and a SMITEST® EX‐R&D DNA extraction kit. The accuracy of genotyping using samples obtained by this method was not inferior to one using samples obtained by venipuncture. In the Cambodian population, significant associations of HLA‐DPB1*04:01 with protection against chronic hepatitis B virus (HBV) infection, and HLA‐DPB1*05:01 and HLA‐DPB1*13:01 with susceptibility to chronic HBV infection were identified. Conclusion: Based on the DBS system, we clarified the associations of HLA‐DPB1 alleles with chronic HBV infection in the Cambodian population for the first time. Because the DBS is a low‐cost, durable, transportable, and easy‐to‐handle modality, genetic analysis based on the DBS system is a feasible strategy for obtaining a deeper understanding of HBV epidemiology, especially in middle‐ or low‐income countries. [ABSTRACT FROM AUTHOR]

Background: Perforator flaps have become a popular option for soft tissue reconstruction due to their ability to provide pliable and durable coverage without the donor site morbidities of more traditional "workhorse" pedicled and free musculocutaneous flaps. Over the last several years, the medial sural artery perforator flap has been increasingly employed as a reconstructive option in both head and neck surgery and for coverage of extremity defects. The goal of this paper is to review the anatomy of the medial sural artery flap through cadaveric study and highlight the utility of this reconstructive option over other more traditional options including the anterolateral thigh flap and radial forearm free flap through the treatment of several extremity defects at our institution in both pedicled and free tissue transfer. Methods: Four cadaveric lower extremities were dissected and the pedicle of the medial sural artery flap evaluated. Three clinical cases involving lower extremity reconstruction with the medial sural artery perforator flap at our institution were reviewed. Results: Four cadaveric specimens with medial sural artery perforator (MSAP) flap dissected were evaluated for pedicle length (11–16.5 cm) and diameter (2–5 mm). Three clinical cases are described highlighting the utility of this reconstructive method. Conclusions: Through our clinical implementation and cadaveric dissection, the MSAP flap was demonstrated to be a thin and pliable perforator option for reconstruction of the lower extremity in both pedicled and free fashion without significant sacrifice of pedicle length or donor skin paddle diameter. Advantages over more traditional "workhorse" flaps are highlighted. Level of evidence: Level IV, therapeutic. [ABSTRACT FROM AUTHOR]

Background: According to the Chinese guidelines for lipid management (2023), evolocumab in combination with statins was recommended as secondary prevention of cardiovascular disease. However, because of the variation in the price of evolocumab and its different methods of confirming clinical efficacy, it was necessary to explore its economics and the impact of different methods of confirming efficacy on its economic studies. Objective: The purpose of this paper was to assess the cost-effectiveness of evolocumab with statins versus statins alone for patients with acute myocardial infarction(AMI) in China and to investigate the impact of different clinical effectiveness modeling approaches on economic outcomes. Methods: A Markov cohort state-transition model was used to estimate the incremental cost-effectiveness ratio (ICER) based on Chinese observational data on cardiovascular event rates, efficacy from the Asian subgroup of the FOURIER trial, cost and utility from the Chinese Yearbook of Health Statistics, health insurance data, and published studies conducted in China. This study conducted subgroup analyses for different populations and dosing regimens; sensitivity analyses for parameters such as cost, utility, and cardiovascular event rates; and scenario analyses on hospital hierarchy, time horizon, starting age, and price for statins. Results: ICERs ranged from 27423 to 214777 Chinese yuan(CNY) per QALY gained, all below the willingness-to-pay threshold of CNY 257094. Only when the time horizon became small, the ICERs were greater than the willingness-to-pay. The probabilities that adding evolocumab to statins was cost-effective ranged from 76 to 98%. When the time horizon became small, i.e. evolocumab was discontinued before the age of 75 (after conversion), the corresponding ICERs were almost always greater than the willingness-to-pay. ICERs for modelling approaches based on clinical endpoints were 1.34 to 1.95 times higher than ICERs for modelling approaches based on reduced LDL-C levels. Conclusions: From the Chinese healthcare and private payer perspectives, adding evolocumab to statin therapy in AMI patients is more likely to be a cost-effective treatment option at the current list price of CNY 283.8. However, evolocumab may not be cost-effective if used for shorter periods of time. The results based on different clinical effectiveness modeling approaches were significantly different. [ABSTRACT FROM AUTHOR]

Trib. Lorantheae is one of the important medicinal plants in traditional medicine. There are 41 genera. 6 genera of which are produced in China, mainly distributed in Southwest China. South China and Central South China. There ar«-many kinds of plants in this family, and 22 species can be used as Chinese medicinal materials in China. The branches and leaves of Trib. Lorantheae are rich in flavonoids, alkaloids, terpenoids. polysaccharides. organic acids and other functional substances. among which flavonoids are one of the important chemical components to exert pharmacological activity. and play an important role in hypoglycemic. lipid-lowering, anti-inflammatory. anti-tumor, anti-oxidation, anti-osteoporosis and so on. In this paper, the chemical composition, extraction method, component analysis and pharmacological action of flavonoids in Trib. Lorantheae plants were reviewed. in order to provide scientific reference for further development and clinical application of flavonoids in Trib. Lorantheae plants. [ABSTRACT FROM AUTHOR]

Wedelolide is a coumarin-like active substance extracted from Ecliptae Herba. It not only has pharmacological effects of anti-pulmo- nary fihosis, anti-arthritis, blood vessel protection and liver protection, but also effectively inhibits the poliferation of cancer cells and induces apoptosis of cancer cells, thereby delaying the further development of malignant tumors. In this paper, the pharmacological effects and mecha- nisms of wedelactone were reviewed to lay a foundation for further study and clinical application of wedelactone. [ABSTRACT FROM AUTHOR]

Mongolian medicine and traditional Chinese medicine have different interpretations of Bistortae Rhizoma, including its name, nature and taste, function and efficacy. This paper sorted out the related application of Chinese and Mongolian medicine from the records of Materia Medica. The chemical components and pharmacological effects of Bistortae Rhizoma were summarized to provide a reference for the clinical application of Bistortae Rhizoma in traditional Chinese medicine and Mongolian medicine, and for the better development and utilization of national medicines. [ABSTRACT FROM AUTHOR]

In this second part of a two‐part paper, we intend to demonstrate the impact of the previously proposed advanced quality control pipeline. To understand its benefit and challenge the proposed methodology in a real scenario, we chose to compare the outcome when applying it to the analysis of two patient populations with significant but highly different types of fatigue: COVID‐19 and multiple sclerosis (MS). 31P‐MRS was performed on a 3 T clinical MRI, in 19 COVID‐19 patients, 38 MS patients, and 40 matched healthy controls. Dynamic acquisitions using an MR‐compatible ergometer ran over a rest (40 s), exercise (2 min), and a recovery phase (6 min). Long and short TR acquisitions were also made at rest for T1 correction. The advanced data quality control pipeline presented in Part 1 is applied to the selected patient cohorts to investigate its impact on clinical outcomes. We first used power and sample size analysis to estimate objectively the impact of adding the quality control score (QCS). Then, comparisons between patients and healthy control groups using the validated QCS were performed using unpaired t tests or Mann–Whitney tests (p < 0.05). The application of the QCS resulted in increased statistical power, changed the values of several outcome measures, and reduced variability (standard deviation). A significant difference was found between the T1PCr and T1Pi values of MS patients and healthy controls. Furthermore, the use of a fixed correction factor led to systematically higher estimated concentrations of PCr and Pi than when using individually corrected factors. We observed significant differences between the two patient populations and healthy controls for resting [PCr]—MS only, [Pi], [ADP], [H2PO4−], and pH—COVID‐19 only, and post‐exercise [PCr], [Pi], and [H2PO4−]—MS only. The dynamic indicators τPCr, τPi, ViPCr, and Vmax were reduced for COVID‐19 and MS patients compared with controls. Our results show that QCS in dynamic 31P‐MRS studies results in smaller data variability and therefore impacts study sample size and power. Although QCS resulted in discarded data and therefore reduced the acceptable data and subject numbers, this rigorous and unbiased approach allowed for proper assessment of muscle metabolites and metabolism in patient populations. The outcomes include an increased metabolite T1, which directly affects the T1 correction factor applied to the amplitudes of the metabolite, and a prolonged τPCr, indicating reduced muscle oxidative capacity for patients with MS and COVID‐19. [ABSTRACT FROM AUTHOR]

Stroke clinical guidelines recommend care processes that optimize patient outcomes and minimize hospital‐acquired complications. However, audits and surveys illustrate that recommended care is not always consistently or thoroughly implemented. This paper outlines the methods for implementing and evaluating a new bundle of care. Screen‐Clean‐Hydrate bundles together recommendations from the Australian Clinical Guidelines for Stroke Management and supplements these with evidence‐informed best practice from the literature for: swallow screening within 4 h of presentation to hospital (Screen); oral health assessment and delivery of oral care (Clean); and hydration assessment and management (Hydrate). The study is a pre−post Type 2 hybrid effectiveness/implementation design with an embedded process evaluation, which will be conducted in two acute stroke units in a capital city of Australia. The integrated‐Promoting Action on Research Implementation in Health Services (iPARIHS) framework will be used to guide study design, conduct, and evaluation. Clinical effectiveness will be measured by rates of hospital‐acquired complications and proxy measures of cost (length of stay, procedure costs) for 60 patient participants pre‐ and postimplementation. Implementation outcomes will focus on acceptability, feasibility, uptake and fidelity, and identification of barriers and enablers to implementation through staff interviews, medical record audits, and researcher field notes. Due to its design as a hybrid effectiveness/implementation study, once completed, the study will provide information on both intervention and implementation effectiveness, including details of successful and unsuccessful multidisciplinary implementation strategies. This will inform a larger multisite effectiveness/implementation trial for future upscale, leading to improved compliance with stroke guidelines and therefore stroke outcomes. [ABSTRACT FROM AUTHOR]

Paclitaxel, a natural secondary metabolite isolated and purified from the bark of the Taxus tree, is considered one of the most successful natural anticancer drugs due to its low toxicity, high potency and broad-spectrum anticancer activity. Taxus trees are scarce and slow-growing, and with extremely low paclitaxel content, the contradiction between supply and demand in the market is becoming more and more intense. Therefore, researchers have tried to obtain paclitaxel by various methods such as chemical synthesis, artificial culture, microbial fermentation and tissue cell culture to meet the clinical demand for this drug. This paper provides a comprehensive overview of paclitaxel extraction, combination therapy, total synthesis, semi-synthesis and biosynthesis in recent years and provides an outlook, aiming to provide a theoretical basis and reference for further research on the production and application of paclitaxel in the future. [ABSTRACT FROM AUTHOR]

Background: Postgraduate supervision takes place within complex training environments, where experiences are shaped by the socio-cultural context and wider profession, and where tensions permeate. Bordin's working alliance-based model of supervision suggests that quality relationships encompass agreement on the goals and tasks of supervision, in the context of an emotional bond. However, as trainees and their supervisors navigate the demands of providing safe clinical care, alongside educational support, disagreement on expectations for supervision may emerge. By applying a critical lens, this research draws on positioning theory to explore General Practice trainees' experiences of supervision. Methods: In 2017–2019 a series of narrative interviews were undertaken with 13 General Practice trainees in the United Kingdom (UK). Participants were purposively sampled based on end-of-year performance, gender, training location and training status. Interviews were analysed using Brown and Gilligan's Listening Guide, which was adapted to incorporate an exploration of positioning, power and agency. Results: Trainees appeared to hold variable positions, such as 'insiders', 'outsiders', 'peers' and 'problem trainees'. Supervisors, through talk and the degree of access afforded, contributed to this positioning. Some trainees viewed their supervisors as brokers and guides as they navigated their training, whilst others were suspicious of the supervisor role. For trainees who raised concerns about their supervisor through formal channels, results were not often satisfactory. Others chose to navigate difficulty in supervision through informal means. This typically involved mastery of artefacts of training, such as the electronic appointment book or training portfolio. Conclusions: This paper builds on Bordin's model of supervision to encourage greater clarity in supervisory discussions, exploring assumptions, and recognising the influences of environment, power, positioning, and agency. We have developed a Model of the Supervisory Alliance in Postgraduate GP Training (MSA-GP) to serve as a springboard for discussion for trainees and their supervisors. [ABSTRACT FROM AUTHOR]

There is a lack of a safe and effective technology to monitor intracranial pressure accurately and non‐destructively. In this paper, the relationship between reduced scattering coefficient and intracranial pressure in clinical patients under different brain edema states was studied. First, the brain edema MC simulation model was constructed based on different types of brain edema. The results laid a foundation for clinical ICP detection. Second, the changes of ICP and reduced scattering coefficient caused by brain edema were studied in clinical application. It was found that when the patient developed brain edema, the reduced scattering coefficient and ICP showed corresponding changes. Finally, the mathematical model of invasive ICP and reduced scattering coefficient was established. It was found that the sensitivity of 834 nm light to brain tissue changes was higher than that of 692 nm light, which could be used to reflect the changes of brain tissue physiological state. [ABSTRACT FROM AUTHOR]

Huobahuagen tablet is a traditional Chinese medicine preparation made from the root of Tripterygium wilfordii Hook. f. Kunming Shanhaitang. Clinical application proves that it has anti-inflammatory and immunosuppressive effects. Huobahuagen tablet has the advantages of less adverse reactions and higher efficiency on the basis of hormone-like effects, which is mainly used in the clinical treatment of rheumatoid arthritis and lupus erythematosus. However, in recent years, literature have shown that the drug can also be applied to kidney disease, and achieved significant clinical efficacy. In this paper, the etiology and pathogenesis of chronic kidney disease, such as dampness, heat and stasis are discussed. Combined with clinical application and literature reports in the past two decades, the clinical application progress of Huobahuagen tablet in the treatment of chronic kidney disease is reviewed [ABSTRACT FROM AUTHOR]

Rhodiola rosea L. (RRL) is a popular plant in traditional medicine, and Rosavin, a characteristic ingredient of RRL, is considered one of the most important active ingredients in it. In recent years, with deepening research on its pharmacological actions, the clinical application value and demand for Rosavin have been steadily increasing. Various routes for the extraction and all-chemical or biological synthesis of Rosavin have been gradually developed for the large-scale production and broad application of Rosavin. Pharmacological studies have demonstrated that Rosavin has a variety of biological activities, including antioxidant, lipid-lowering, analgesic, antiradiation, antitumor and immunomodulation effects. Rosavin showed significant therapeutic effects on a range of chronic diseases, including neurological, digestive, respiratory and bone-related disorders during in vitro and vivo experiments, demonstrating the great potential of Rosavin as a therapeutic drug for diseases. This paper gives a comprehensive and insightful overview of Rosavin, focusing on its extraction and synthesis, pharmacological activities, progress in disease-treatment research and formulation studies, providing a reference for the production and preparation, further clinical research and applications of Rosavin in the future. [ABSTRACT FROM AUTHOR]

This paper describes an interprofessional clinical learning experience for students within two primary care safety-net sites. An interprofessional team of faculty at one university partnered with two safety-net systems to provide students opportunities to work in an interprofessional team providing care for socially and medically complex patients. Our evaluation outcomes are student-centered, focusing on students' perceptions of caring for medically underserved populations and satisfaction with the clinical experience. Students reported positive perceptions of the interprofessional team, clinical experience, primary care, and caring for underserved populations. Strategic development of partnerships between academic and safety-net systems to offer learning opportunities can increase future healthcare providers' exposure and appreciation for interprofessional care of underserved populations. [ABSTRACT FROM AUTHOR]

Background: In this paper, we are interested in interactions between a high-dimensional -omics dataset and clinical covariates. The goal is to evaluate the relationship between a phenotype of interest and a high-dimensional omics pathway, where the effect of the omics data depends on subjects' clinical covariates (age, sex, smoking status, etc.). For instance, metabolic pathways can vary greatly between sexes which may also change the relationship between certain metabolic pathways and a clinical phenotype of interest. We propose partitioning the clinical covariate space and performing a kernel association test within those partitions. To illustrate this idea, we focus on hierarchical partitions of the clinical covariate space and kernel tests on metabolic pathways. Results: We see that our proposed method outperforms competing methods in most simulation scenarios. It can identify different relationships among clinical groups with higher power in most scenarios while maintaining a proper Type I error rate. The simulation studies also show a robustness to the grouping structure within the clinical space. We also apply the method to the COPDGene study and find several clinically meaningful interactions between metabolic pathways, the clinical space, and lung function. Conclusion: TreeKernel provides a simple and interpretable process for testing for relationships between high-dimensional omics data and clinical outcomes in the presence of interactions within clinical cohorts. The method is broadly applicable to many studies. [ABSTRACT FROM AUTHOR]

Background: Small interference RNA (siRNA) has emerged as the most desired method for researchers and clinicians who wish to silence a specific gene of interest and has been extensively developed as a therapeutic agent. This review points to collecting all clinical trials on siRNA and understanding its benefits, pharmacokinetics and safety by reading articles published in the last 5 years. Materials and Methods: Searching in the PubMed database using 'siRNA' and 'in vivo' with limits to articles published in the previous 5 years, article type 'clinical trials' and language 'English' to acquire papers on in vivo studies on siRNA approaches. Features of siRNA clinical trials registered at https://clinicaltrials.gov/ were analysed. Results: So far, 55 clinical studies have been published on siRNA. Many published clinical trials on siRNA showed tolerability, safety and effectiveness in treating cancers like breast, lung, colon, and other organs and other diseases like viral infections and hereditary diseases. Many different routes of administration can silence many genes at the same time. Limitations and uncertainties associated with siRNA treatment include the effectiveness of cellular uptake, precise targeting of the intended tissue or cell and prompt elimination from the body. Conclusions: The siRNA or RNAi method will be one of the most critical and influential techniques to fight against many different diseases. Although the RNAi approach has certain advantages, it also has limitations concerning clinical applications. Overcoming these limitations remains a daunting challenge. [ABSTRACT FROM AUTHOR]

Prostate cancer (PC) is one of the most life-threatening diseases in men and causes numerous deaths worldwide. Early and on-time detection of PC could dramatically improve survival. Biomarkers are useful for detection and monitoring of PC due to their ease of sampling and abundancy. Biomarkers can also be used for designing reliable detection platforms. Various types of biosensors have provided simple, sensitive, specific, and cost-effective detection of PC biomarkers in patients' biological fluids, such as serum and urine. Recent advances in designing and application of biosensing platforms pave the way toward their application in clinical practice. Prostate cancer (PC) is one of the most common tumors and a leading cause of mortality among men, resulting in ~375 000 deaths annually worldwide. Various analytical methods have been designed for quantitative and rapid detection of PC biomarkers. Electrochemical (EC), optical, and magnetic biosensors have been developed to detect tumor biomarkers in clinical and point-of-care (POC) settings. Although POC biosensors have shown potential for detection of PC biomarkers, some limitations, such as the sample preparation, should be considered. To tackle such shortcomings, new technologies have been utilized for development of more practical biosensors. Here, biosensing platforms for the detection of PC biomarkers such as immunosensors, aptasensors, genosensors, paper-based devices, microfluidic systems, and multiplex high-throughput platforms, are discussed. [ABSTRACT FROM AUTHOR]

Non-invasive laser irradiation can induce photobiomodulation of cells and tissues. Photobiomodulation (PBM) is widely used, especially in antimicrobial infection and improving inflammation. However, studies have found that PBM has a bidirectional regulation of bacteria and inflammation. Antibacterial and pro-bacterial, anti-inflammatory and pro-inflammatory will change under different experimental conditions. In recent years, the clinical applications of PBM have received more and more attentions, especially in the field of antibacterial, because it is a noninvasive strategy with few contraindications. However, due to the bidirectional regulatory effect, researchers still have doubts about the application mode of PBM, and the parameters such as light wavelength and dose must be modified according to its clinical application. Therefore, this paper summarizes the bidirectional regulation effects of PBM on bacteria, and analyzes the influencing factors and molecular mechanism of this bidirectional regulation effect. The bidirectional regulation effect of PBM on bacteria is affected by light wavelength, dose, bacterial category and bacterial state. A better understanding of the degree of bidirectional dose-response in low-intensity laser therapy is necessary to optimize clinical treatment. It can also help explore the most reliable mechanism of PBM use and ultimately standardize the treatment of patients with various diseases. In addition, rational use of the bidirectional regulation mechanism of PBM can promote or inhibit the growth of bacteria, which has broad application prospects in the fields of microbial manufacturing, flora regulation, improvement and treatment of diseases. [ABSTRACT FROM AUTHOR]

Background: The anatomical basis of pituitary adenomas (PAs) with oculomotor cistern (OC) extension as a growth corridor is overlooked in the literature. In this paper, the authors use the technique of epoxy sheet plastination to study the membranous structure of the OC and validate the results by retrospective analysis of patients with OC extension. Methods: Eighteen specimens were used to study the membranous anatomy surrounding the OC using the epoxy sheet plastination technique. Thirty-four patients with OC extension were retrospectively reviewed. Results: The OC consisted of two thin membranous layers. The inner layer was extended by the arachnoid layer from the posterior fossa, and the lateral layer consisted of the dura mater sinking from the roof of the cavernous sinus. The oculomotor nerve is more likely to displace with a superolateral trajectory due to the weakness of the posterior dura and the relatively large space in the medial and posterior trajectories, which is consistent with the intraoperative observations. Among the anatomical factors that affect the PA by OC extension, we found that the relative position of the internal carotid artery (ICA) and posterior clinoid process may lead to the narrowing of the OC. Of 34 cases, 28 patients achieved total resection. Among 24 preoperative patients with oculomotor nerve palsy, 16 cases were relieved to varying degrees postoperatively. There was no ICA injury or severe intracranial infection found in any of the patients. Conclusions: Extension into the OC is influenced by two anatomical factors: a weak point in the dura in the posterior OC and a potential space beyond this region of the dura. Meticulous knowledge of the membranous anatomy in endoscopic endonasal surgery is required to safely and effectively resect PA with OC extension. [ABSTRACT FROM AUTHOR]

Breast cancer remains a significant public health issue, being a leading cause of cancer-related mortality among women globally. Timely diagnosis and efficient treatment are crucial for enhancing patient outcomes, reducing healthcare burdens and advancing community health. This systematic review, following the PRISMA guidelines, aims to comprehensively synthesize the recent advancements in computer-aided diagnosis and treatment for breast cancer. The study covers the latest developments in image analysis and processing, machine learning and deep learning algorithms, multimodal fusion techniques and radiation therapy planning and simulation. The results of the review suggest that machine learning, augmented and virtual reality and data mining are the three major research hotspots in breast cancer management. Moreover, this paper discusses the challenges and opportunities for future research in this field. The conclusion highlights the importance of computer-aided techniques in the management of breast cancer and summarizes the key findings of the review. [ABSTRACT FROM AUTHOR]

Age-Friendly Health Systems (AFHS) commit to providing evidence-based, low-risk, coordinated care centered on what matters most to older adults, their families, and caregivers. Nova Southeastern University's South Florida Geriatric Workforce Enhancement Program (NSU SFGWEP) has partnered with primary care clinics to provide AFHS training and support to promote AFHS transformation in Broward and Miami-Dade Counties. NSU SFGWEP provides face-to-face and virtual training for AFHS and Electronic Health Record (EHR) documentation as part of the initiative. This project focuses on a group of primary care clinics in Broward County, Florida. In this paper, we evaluate the progress of AFHS transformation through six e-clinical measures that collectively provide indicators of the 4 M framework of AFHS (What Matters, Medication, Mentation, and Mobility). We used provider feedback and e-clinical measures aligned with the Center for Medicare & Medicaid Services (CMS) Merit-based Incentive Payment System (MIPS) to measure clinic outcomes. From Jan 1– Dec 31, 2019, to Jan 1–Dec 31, 2020, the clinics improved high-risk medication management (0–3.71%), advanced care planning (6.79%–20.74%), and fall risk assessment (no data- 46.72%). Results demonstrate some success and ongoing opportunities to continue and expand AFHS interventions for sustainability. [ABSTRACT FROM AUTHOR]

Lithospermoside is a kind of alkaloid compound existing in Semiaquilegia adoxoides, with anticancer, anti-inflammatory, antibacterial, hypoglycemic, antioxidant and other pharmacological effects. This paper reviews the pharmacological action and molecular mechanism of lithospermoside, in order to provide a theoretical basis for clinical application of lithospermoside. [ABSTRACT FROM AUTHOR]