Search

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]

Background: E-learning is recognised as a useful educational tool and is becoming more common in undergraduate medical education. This review aims to examine the scope and impact of e-learning interventions on medical student learning in clinical medicine, in order to aid medical educators when implementing e-learning strategies in programme curricula. Methods: A systematic review compliant with PRISMA guidelines that appraises study design, setting and population, context and type of evaluations. Specific search terms were used to locate articles across nine databases: MEDLINE/PubMed, ScienceDirect, EMBASE, Cochrane Library, ERIC, Academic Search Complete, CINAHL, Scopus and Google Scholar. Only studies evaluating e-learning interventions in undergraduate clinical medical education between January 1990 and August 2021 were selected. Of the 4,829 papers identified by the search, 42 studies met the inclusion criteria. Results: The 42 studies included varied in scope, cognitive domain, subject matter, design, quality and evaluation. The most popular approaches involved multimedia platforms (33%) and case-based approaches (26%), were interactive (83%), asynchronous (71%) and accessible from home (83%). Twelve studies (29%) evaluated usability, all of which reported positive feedback. Competence in use of technology, high motivation and an open attitude were key characteristics of successful students and preceptors. Conclusions: Medical education is evolving consistently to accommodate rapid changes in therapies and procedures. In today's technologically adept world, e-learning is an effective and convenient pedagogical approach for the teaching of undergraduate clinical medicine. [ABSTRACT FROM AUTHOR]

Despite the increasing number of studies on nanomedicine-based cancer immunotherapy, the overall research trends in this field remain inadequately characterized. This study aims to evaluate the research trends and hotspots in nanomedicine-based cancer immunotherapy through a bibliometric analysis. As of March 31, 2024, relevant publications were retrieved from the Web of Science Core Collection. Analytical tools including VOSviewer, CiteSpace, and an online bibliometric analysis platform were employed. A total of 5,180 publications were analyzed. The study reveals geographical disparities in research output, with China and the United States being the leading contributors. Institutionally, the Chinese Academy of Sciences, University of Chinese Academy of Sciences, and Sichuan University are prominent contributors. Authorship analysis identifies key researchers, with Liu Zhuang being the most prolific author. "ACS Nano" and the "Journal of Controlled Release and Biomaterials" are identified as the leading journals in the field. Frequently occurring keywords include "cancer immunotherapy" and "drug delivery." Emerging frontiers in the field, such as "mRNA vaccine," "sonodynamic therapy," "oral squamous cell carcinoma," "STING pathway,"and "cGAS-STING pathway," are experiencing rapid growth. This study aims to provide new insights to advance scientific research and clinical applications in nanomedicine-based cancer immunotherapy. [ABSTRACT FROM AUTHOR]

[Display omitted] • The immune response and inflammation in pulmonary hypertension (PH) have been systematically summarized based on recent studies. • The relationship between CC chemokines and the pathogenesis of pH is summarized in clinical and animal models. • We found that although the immune response serves as an important potential factor in the pathogenesis of PH, less attention has been paid to CC chemokines and their receptors. • We believe that a greater understanding of the relationship between PH and CC chemokines and their receptors is a pressing issue. • We believe that we need to further clarify the pathogenesis of pH and provide basis for the clinical treatment of PH. Pulmonary hypertension (PH) represents a progressive condition characterized by the remodeling of pulmonary arteries, ultimately culminating in right heart failure and increased mortality rates. Substantial evidence has elucidated the pivotal role of perivascular inflammatory factors and immune dysregulation in the pathogenesis of PH. Chemokines, a class of small secreted proteins, exert precise control over immune cell recruitment and functionality, particularly with respect to their migration to sites of inflammation. Consequently, chemokines emerge as critical drivers facilitating immune cell infiltration into the pulmonary tissue during inflammatory responses. This review comprehensively examines the significant contributions of CC chemokines in the maintenance of immune cell homeostasis and their pivotal role in regulating inflammatory responses. The central focus of this discussion is directed towards elucidating the precise immunoregulatory actions of CC chemokines concerning various immune cell types, including neutrophils, monocytes, macrophages, lymphocytes, dendritic cells, mast cells, eosinophils, and basophils, particularly in the context of pH processes. Furthermore, this paper delves into an exploration of the underlying pathogenic mechanisms that underpin the development of PH. Specifically, it investigates processes such as cellular pyroptosis, examines the intricate crosstalk between bone morphogenetic protein receptor type 2 (BMPR2) mutations and the immune response, and sheds light on key signaling pathways involved in the inflammatory response. These aspects are deemed critical in enhancing our understanding of the complex pathophysiology of PH. Moreover, this review provides a comprehensive synthesis of findings from experimental investigations targeting immune cells and CC chemokines. Aim of review : In summary, the inquiry into the inflammatory responses mediated by CC chemokines and their corresponding receptors, and their potential in modulating immune reactions, holds promise as a prospective avenue for addressing PH. The potential inhibition of CC chemokines and their receptors stands as a viable strategy to attenuate the inflammatory cascade and ameliorate the pathological manifestations of PH. Nonetheless, it is essential to acknowledge the current state of clinical trials and the ensuing progress, which regrettably appears to be less than encouraging. Substantial hurdles exist in the successful translation of research findings into clinical applications. The intention is that such emphasis could potentially foster the advancement of potent therapeutic agents presently in the process of clinical evaluation. This, in turn, may further bolster the potential for effective management of PH. [ABSTRACT FROM AUTHOR]

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]

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]

Quality circles or peer review groups, and similar structured small groups of 6–12 health care professionals meet regularly across Europe to reflect on and improve their standard practice. There is debate over their effectiveness in primary health care, especially over their potential to change practitioners’ behaviour. Despite their popularity, we could not identify broad surveys of the literature on quality circles in a primary care context. Our scoping review was intended to identify possible definitions of quality circles, their origins, and reported effectiveness in primary health care, and to identify gaps in our knowledge. We searched appropriate databases and included any relevant paper on quality circles published until December 2017. We then compared information we found in the articles to that we found in books and on websites. Our search returned 7824 citations, from which we identified 82 background papers and 58 papers about quality circles. We found that they originated in manufacturing industry and that many countries adopted them for primary health care to continuously improve medical education, professional development, and quality of care. Quality circles are not standardized and their techniques are complex. We identified 19 papers that described individual studies, one paper that summarized 3 studies, and 1 systematic review that suggested that quality circles can effectively change behaviour, though effect sizes varied, depending on topic and context. Studies also suggested participation may affirm self-esteem and increase professional confidence. Because reports of the effect of quality circles on behaviour are variable, we recommend theory-driven research approaches to analyse and improve the effectiveness of this complex intervention. [ABSTRACT FROM AUTHOR]

The discovery of novel biomarkers is a crucial goal in translational biomedical research. A complete and accurate reporting of biomarker studies, including quantitative prediction models, is fundamental to improve research quality and facilitate their potential incorporation into clinical practice. This paper reviews key problems, guidelines, and challenges in reporting biomarker studies, with an emphasis on diagnostic and prognostic applications in cardiovascular research. Recent advances and recommendations for aiding in peer review, research quality assessment, and the reproducibility of findings, such as diagnostic biosignatures, are discussed. An examination of research recently published in the area of cardiovascular biomarkers was implemented. Such a survey, which was based on a sample of papers deposited in PubMed Central, suggests that there is a need to improve the documentation of biomarker studies in terms of information completeness and clarity, as well as the application of more rigorous quantitative evaluation techniques. There is also room for improving practices in reporting data analysis and research limitations. This survey also suggests that, in comparison with other research areas, the cardiovascular biomarker research domain may not be taking advantage of existing standards for reporting diagnostic accuracy. The review concludes with a discussion of the challenges and recommendations. [ABSTRACT FROM AUTHOR]

Plain English summary: Patient and Public Involvement (PPI) describes the active involvement of patients and the public in the research process. Through PPI, patients and members of the public are increasingly involved in the design and conduct of clinical trials. PPI has been shown to improve the quality and relevance of research. During the COVID-19 pandemic, clinical trials have been playing a vital role in helping us find ways to prevent and treat the infection and improve our understanding of the virus. It is important that patients and the public are actively involved in deciding how COVID-19 research is carried out. Unfortunately, Research Ethics Committees in the UK have seen far less PPI for COVID-19 research studies compared with research before the pandemic. A key reason for this is that research is being designed much faster than normal and researchers may feel they do not have time to properly involve patients and the public. In this paper, we share our experiences of PPI for a COVID-19 clinical trial. We show that it is possible to rapidly involve patients and the public in COVID-19 clinical trials. We also explain how the design of the clinical trial was changed in response to feedback from public contributors. Lastly, we discuss the wider learning from this process which might be useful for researchers planning PPI activities for COVID-19 clinical trials in the future. Background: Clinical trials are playing a critical role in the global public health response to the COVID-19 pandemic. Despite the increasing recognition of the value of PPI in clinical trials, just 22% of the COVID-19 research proposals reviewed by Research Ethics Committees in the UK at the start of the pandemic reported PPI. There is a perception that PPI might result in delays in delivering research and therefore delays in obtaining important results. In this paper, we report our experience of rapid PPI for a COVID-19 clinical trial. Methods: RAPID-19 is a COVID-19 clinical trial which was planned to be submitted for fast-track ethics review in the United Kingdom. During the development of the trial protocol, the PPI Panel at the London School of Hygiene & Tropical Medicine Clinical Trials Unit was involved in the design of the study. The meeting with the PPI Panel lasted just over 1 h and was conducted by teleconference. Results: Although we only had a short period of time to explore the study with the PPI Panel, we were able to gain valuable insight into how the trial would be perceived by potential trial participants. Substantive changes were made to the trial to improve the acceptability of the research without compromising the study timelines. Having access to public contributors with relevant lived experience is an important resource for a Clinical Trials Unit and is critical for rapid PPI. The move to remote working due to lockdown required virtual discussions which helped to overcome some of the barriers to organising face-to-face meetings at short notice. Conclusions: PPI for clinical trials can be conducted in a time-efficient manner within the pressured environment of a pandemic. Involving PPI contributors at an early stage in protocol development maximised the opportunity to shape and influence the trial as well as limited potential delays which could occur if changes to the protocol had to be made at a later stage. [ABSTRACT FROM AUTHOR]

In medical research and clinical applications, the utilization of MRI datasets from multiple centers has become increasingly prevalent. However, inherent variability between these centers presents challenges due to domain shift, which can impact the quality and reliability of the analysis. Regrettably, the absence of adequate tools for domain shift analysis hinders the development and validation of domain adaptation and harmonization techniques. To address this issue, this paper presents a novel Domain Shift analyzer for MRI (DSMRI) framework designed explicitly for domain shift analysis in multi-center MRI datasets. The proposed model assesses the degree of domain shift within an MRI dataset by leveraging various MRI-quality-related metrics derived from the spatial domain. DSMRI also incorporates features from the frequency domain to capture low- and high-frequency information about the image. It further includes the wavelet domain features by effectively measuring the sparsity and energy present in the wavelet coefficients. Furthermore, DSMRI introduces several texture features, thereby enhancing the robustness of the domain shift analysis process. The proposed framework includes visualization techniques such as t-SNE and UMAP to demonstrate that similar data are grouped closely while dissimilar data are in separate clusters. Additionally, quantitative analysis is used to measure the domain shift distance, domain classification accuracy, and the ranking of significant features. The effectiveness of the proposed approach is demonstrated using experimental evaluations on seven large-scale multi-site neuroimaging datasets. [ABSTRACT FROM AUTHOR]

Bernaldo de Quirós et al. [[4]] present a review of the setups for the measurement of movements of stroke patients under free-living conditions using wearable sensors, and for the evaluation of the relation between such sensor-based outcomes and the level of functioning, as assessed using existing clinical evaluation methods. Ferraris et al. [[12]] describe the REHOME project, whose main goal consists of meeting the needs of both clinicians and patients in ensuring continuity of treatment, from healthcare facilities to the patient's home. Ubl et al. [[11]] face the problem of the evaluation of controllers for insulin pumps to be used by patients with diabetes to correctly dose insulin; this is an extremely important task for safety reasons. Among them, we cite micro/nano/cyberphysical systems; AI and machine learning techniques; early pathology detection technologies; e-health, mHealth, telemedicine, and digital solutions; and augmented reality for remote healthcare treatments. [Extracted from the article]

Cancer is one of the leading causes of death worldwide. The burden of cancer on public health is becoming more widely acknowledged. Lung cancer has one of the highest incidence and mortality rates of all cancers. The prevalence of early screening, the emergence of targeted therapy, and the development of immunotherapy have all significantly improved the overall prognosis of lung cancer patients. The current state of affairs, however, is not encouraging, and there are issues like poor treatment outcomes for some patients and extremely poor prognoses for those with advanced lung cancer. Because of their potent immunomodulatory capabilities, thymosin drugs are frequently used in the treatment of tumors. The effectiveness of thymosin drugs in the treatment of lung cancer has been demonstrated in numerous studies, which amply demonstrates the potential and future of thymosin drugs for the treatment of lung cancer. The clinical research on thymosin peptide drugs in lung cancer and the basic research on the mechanism of thymosin drugs in anti-lung cancer are both systematically summarized and analyzed in this paper, along with future research directions. [ABSTRACT FROM AUTHOR]

Abdominal aortic aneurysm (AAA) is characterized by inflammatory cell infiltration, extracellular matrix (ECM) degradation, and vascular smooth muscle cell (SMC) dysfunction. The inflammatory cells involved in AAA mainly include immune cells including macrophages, neutrophils, T-lymphocytes and B lymphocytes and endothelial cells. As the blood vessel wall expands, more and more lymphocytes infiltrate into the outer membrane. It was found that more than 50% of lymphocytes in AAA tissues were CD3+ T cells, including CD4+, CD8+T cells, gd T cells and regulatory T cells (Tregs). Due to the important role of T cells in inflammatory response, an increasing number of researchers have paid attention to the role of T cells in AAA and dug into the relevant mechanism. Therefore, this paper focuses on reviewing the immunoregulatory role of T cells in AAA and their role in immunotherapy, seeking potential targets for immunotherapy and putting forward future research directions. [ABSTRACT FROM AUTHOR]

Suppressor of mother against decapentaplegic (SMAD) family proteins are central to one of the most versatile cytokine signalling pathways in metazoan biology, the transforming growth factor-β (TGF-β) pathway. The TGF-β pathway is widely known for its dual role in cancer progression as both an inhibitor of tumour cell growth and an inducer of tumour metastasis. This is mainly mediated through SMAD proteins and their cofactors or regulators. SMAD proteins act as transcription factors, regulating the transcription of a wide range of genes, and their rich post-translational modifications are influenced by a variety of regulators and cofactors. The complex role, mechanisms, and important functions of SMAD proteins in tumours are the hot topics in current oncology research. In this paper, we summarize the recent progress on the effects and mechanisms of SMAD proteins on tumour development, diagnosis, treatment and prognosis, and provide clues for subsequent research on SMAD proteins in tumours. [ABSTRACT FROM AUTHOR]

Chitosan (CTS), a biocompatible and multifunctional material derived from chitin, has caught researchers' attention in electrochemical detection due to its unique properties. This review paper provides a comprehensive overview of the recent progress and applications of CTS-based electrochemical sensors in the analysis of pharmaceutical products and other types of samples, with a particular focus on the detection of medicinal substances. The review covers studies and developments from 2003 to 2023, highlighting the remarkable properties of CTS, such as biocompatibility, chemical versatility, and large surface area, that make it an excellent candidate for sensor modification. Combining CTS with various nanomaterials significantly enhances the detection capabilities of electrochemical sensors. Various types of CTS-based sensors are analyzed, including those utilizing carbon nanomaterials, metallic nanoparticles, conducting polymers, and molecularly imprinted CTS. These sensors exhibit excellent sensitivity, selectivity, and stability, enabling the precise and reliable detection of medications. The manufacturing strategies used for the preparation of CTS-based sensors are described, the underlying detection mechanisms are elucidated, and the integration of CTS sensors with transducer systems is highlighted. The prospects of CTS-based electrochemical sensors are promising, with opportunities for miniaturization, simultaneous detection, and real-time monitoring applications. [ABSTRACT FROM AUTHOR]

Accurate identification of lesions and their use across different medical institutions are the foundation and key to the clinical application of automatic diabetic retinopathy (DR) detection. Existing detection or segmentation methods can achieve acceptable results in DR lesion identification, but they strongly rely on a large number of fine-grained annotations that are not easily accessible and suffer severe performance degradation in the cross-domain application. In this paper, we propose a cross-domain weakly supervised DR lesion identification method using only easily accessible coarse-grained lesion attribute labels. We first propose the novel lesion-patch multiple instance learning method (LpMIL), which leverages the lesion attribute label for patch-level supervision to complete weakly supervised lesion identification. Then, we design a semantic constraint adaptation method (LpSCA) that improves the lesion identification performance of our model in different domains with semantic constraint loss. Finally, we perform secondary annotation on the open-source dataset EyePACS, to obtain the largest fine-grained annotated dataset EyePACS-pixel, and validate the performance of our model on it. Extensive experimental results on the public dataset FGADR and our EyePACS-pixel demonstrate that compared with the existing detection and segmentation methods, the proposed method can identify lesions accurately and comprehensively, and obtain competitive results using only coarse-grained annotations. [ABSTRACT FROM AUTHOR]

In recent years, neuro-biomechanical enhancement techniques, such as transcranial direct current stimulation (tDCS), have been widely used to improve human physical performance, including foot biomechanical characteristics. This review aims to summarize research on the effects of tDCS on foot biomechanics and its clinical applications, and further analyze the underlying ergogenic mechanisms of tDCS. This review was performed for relevant papers until July 2023 in the following databases: Web of Science, PubMed, and EBSCO. The findings demonstrated that tDCS can improve foot biomechanical characteristics in healthy adults, including proprioception, muscle strength, reaction time, and joint range of motion. Additionally, tDCS can be effectively applied in the field of foot sports medicine; in particular, it can be combined with functional training to effectively improve foot biomechanical performance in individuals with chronic ankle instability (CAI). The possible mechanism is that tDCS may excite specific task-related neurons and regulate multiple neurons within the system, ultimately affecting foot biomechanical characteristics. However, the efficacy of tDCS applied to rehabilitate common musculoskeletal injuries (e.g., CAI and plantar fasciitis) still needs to be confirmed using a larger sample size. Future research should use multimodal neuroimaging technology to explore the intrinsic ergogenic mechanism of tDCS. [ABSTRACT FROM AUTHOR]

Unlike conventional glasses, corneal contact lenses (CLs) can directly contact the surface of the tear film through the application of biopolymer materials, to achieve therapeutic and cosmetic purposes. Since the advent of polymethylmethacrylate, a material that has gained widespread use and attention, statistically, there are now more than 150 × 106 people around the world who wear corneal contact lenses. However, the associated complications caused by the interaction of contact lenses with the ocular surface, tear film, endogenous and environmental microorganisms, and components of the solution affect nearly one-third of the wearer population. The application of corneal contact lenses in correcting vision and myopia control has been widely recognized. With the development of related materials, corneal contact lenses are applied to the treatment of ocular surface diseases, including corneal bandage lenses, drug-loaded corneal contact lenses, biosensors, and other new products, while minimizing the side effects associated with CL wear. This paper summarized the development history and material properties of CLs, focused on the current main clinical applications and mechanisms, as well as clarified the possible complications in wearing therapeutic contact lenses and the direction for improvement in the future. [ABSTRACT FROM AUTHOR]

This paper describes the integration and role of masters-prepared behavioral health consultants (BHCs) within a state-wide psychiatry consultation program for children, adolescents, and perinatal women. Data from the Michigan Clinical Consultation and Care (MC3) program are reviewed, with attention to the role that BHCs play in the consultation process, integrated care, screening, and their dual roles with Community Mental Health Services Programs (CMHSPs) in Michigan. Approximately 82% of MC3 services are provided by the BHCs and involve resources or integrated care. BHCs play a role in managing provider consultations and connecting patients and providers to resources in the MC3 program. [ABSTRACT FROM AUTHOR]

DNA nanoparticles hold great promise for a range of biological applications, including the development of cutting-edge treatments and diagnostic tests. Their subnanometer-level addressability enables precise, specific modifications with a variety of chemical and biological entities, making them ideal as diagnostic instruments and carriers for targeted delivery. This paper focuses on the potential of DNA nanomaterials, which offer scalability, programmability, and functionality. For example, they can be engineered to provide highly specific biosensing and bioimaging capabilities and show promise as a platform for disease diagnosis and treatment. Successful operation of various biomedical nanomaterials has been demonstrated both in vitro and in vivo. However, there are still significant challenges to overcome, including the need to improve the scalability and reliability of the technology, and to ensure safety in clinical applications. We discuss these challenges and opportunities in detail and highlight the progress and prospects of DNA nanotechnology for biomedical applications. [ABSTRACT FROM AUTHOR]

Chronic inflammation, in general, refers to systemic immune abnormalities most often caused by the environment or lifestyle, which is the basis for various skin diseases, autoimmune diseases, cardiovascular diseases, liver diseases, digestive diseases, cancer, and so on. Therapeutic strategies have focused on immunosuppression and anti-inflammation, but conventional approaches have been poor in enhancing the substantive therapeutic effect of drugs. Nanomaterials continue to attract attention for their high flexibility, durability and simplicity of preparation, as well as high profitability. Nanotechnology is used in various areas of clinical medicine, such as medical diagnosis, monitoring and treatment. However, some related problems cannot be ignored, including various cytotoxic and worsening inflammation caused by the nanomaterials themselves. This paper provides an overview of functional nanomaterial formulations for the prevention, diagnosis and treatment of chronic inflammation-related diseases, with the intention of providing some reference for the enhancement and optimization of existing therapeutic approaches. [ABSTRACT FROM AUTHOR]

A thyroid nodule, a common abnormal growth within the thyroid gland, is often identified through ultrasound imaging of the neck. These growths may be solid- or fluid-filled, and their treatment is influenced by factors such as size and location. The Thyroid Imaging Reporting and Data System (TI-RADS) is a classification method that categorizes thyroid nodules into risk levels based on features such as size, echogenicity, margin, shape, and calcification. It guides clinicians in deciding whether a biopsy or other further evaluation is needed. Machine learning (ML) can complement TI-RADS classification, thereby improving the detection of malignant tumors. When combined with expert rules (TI-RADS) and explanations, ML models may uncover elements that TI-RADS misses, especially when TI-RADS training data are scarce. In this paper, we present an automated system for classifying thyroid nodules according to TI-RADS and assessing malignancy effectively. We use ResNet-101 and DenseNet-201 models to classify thyroid nodules according to TI-RADS and malignancy. By analyzing the models' last layer using the Grad-CAM algorithm, we demonstrate that these models can identify risk areas and detect nodule features relevant to the TI-RADS score. By integrating Grad-CAM results with feature probability calculations, we provide a precise heat map, visualizing specific features within the nodule and potentially assisting doctors in their assessments. Our experiments show that the utilization of ResNet-101 and DenseNet-201 models, in conjunction with Grad-CAM visualization analysis, improves TI-RADS classification accuracy by up to 10%. This enhancement, achieved through iterative analysis and re-training, underscores the potential of machine learning in advancing thyroid nodule diagnosis, offering a promising direction for further exploration and clinical application. [ABSTRACT FROM AUTHOR]

Photoacoustic imaging is a promising medical imaging modality that enables the visualization of molecular functional and morphological information of biological tissues. Its clinical potential has been widely investigated for assessing and diagnosing various diseases. Currently, several research groups are developing photoacoustic imaging systems for translation from the laboratory to the clinic. In particular, the integration of photoacoustic imaging into existing diagnostic ultrasound applications, such as cancer diagnosis, has shown promising results. Additionally, recent research has explored the application of photoacoustic imaging for novel clinical uses. In this review paper, recent trials of photoacoustic imaging in both conventional and novel clinical applications are summarized and evaluated. Additionally, current limitations and future directions of photoacoustic imaging for successful translation into the clinical world are discussed. The aim of this review is to provide a comprehensive overview of the recent advancements in photoacoustic imaging and highlight its potential for clinical diagnosis and treatment. It is hoped that this review will contribute to the development of improved diagnostic and therapeutic approaches for a wide range of diseases using photoacoustic imaging. [ABSTRACT FROM AUTHOR]

Video Review (VR) is a well established educational tool for developing the practice of patient-centered care in family medicine residents. There are a number of behaviorally-based checklists that can be use in both live observation as well as VR of clinical encounters to identify and promote behaviors associated with patient-centered care, most of which also overlap with behaviors associated with Emotional Intelligence (EI). We propose a VR that is structured less on a seek-and-find of clinician behaviors and more as a self-reflective exercise of how the clinician presents in the room alongside how they were feeling during that encounter. We believe that this exercise promotes the first two skills of EI (self-awareness and self-management) and then provides a foundation on which to build the second pair of skills (social awareness and relationship management). This perspective paper offers guidance, including stepwise instruction, on how to facilitate such a VR curriculum. [ABSTRACT FROM AUTHOR]

Accurate diagnosis, prognosis, and subsequent rehabilitation care planning for persons with Disorders of Consciousness (DoC) has historically posed a challenge for neurological care professionals. Evidence suggests rates of misdiagnosis may be as high as 40% when informal beside evaluations are used to determine level of consciousness. The presence of myriad medical, neurological, functional (motor, sensory, cognitive) and environmental confounds germane to these conditions complicates behavioral assessment. Achieving diagnostic certainty is elusive but critical to inform care planning, clinical decision making, and prognostication. Standardized neurobehavioral rating scales has been shown to improve accuracy in distinguishing between coma, unresponsive wakefulness syndrome/vegetative state and minimally consciousness state as compared to informal assessment methods. Thus, these scales are currently recommended for use as the informal "gold standard" for diagnostic assessment in DoC. The following paper will present an evidence-based approach to neurobehavioral assessment for use in clinical practice. Strategies for optimizing assessment and aiding in identification and management of confounds that can limit diagnostic accuracy will be provided. Finally, clinical application of an interdisciplinary approach to identifying and managing confounds will be discussed and how assessment results can be used to identify trends in performance and guide prognostic counseling with families. [ABSTRACT FROM AUTHOR]

Procedure for Prolapse and Hemorrhoids (PPH), also known as circular stapled hemorrhoidectomy, is a common method of treating hemorrhoids due to its low risk of complications and minimal postoperative pain. Several complications have appeared alongside the rise of treated cases, however, and this has led to a progressive slowing of the clinical use of PPH in recent years. Anastomotic stenosis is one of the most common complications of PPH, but the greater amount of tissue removed and the speed with which it can heal make it the best choice for patients with severe prolapsed annular hemorrhoids or rectal mucosal prolapse. Therefore, academics continue to comprehensively study PPH to take advantage of annular resection and reduce complications. In this paper, we analyzed the causes, intraoperative warnings, and postoperative therapy of anastomotic stenosis induced by PPH, with an eye toward scientific application in the anorectal field, based on the experience of clinical applications. [ABSTRACT FROM AUTHOR]

Religiosity and spirituality (R/S) have been described extensively as being an integral part of subjective well-being and mental health, especially in Anglo-American regions. Accordingly, the Multidimensional Inventory for Religious/Spiritual Well-Being (MI-RSWB) was developed in the European context to be able to contribute to the further development of this research field by means of a validated measure. In this paper, after an introduction to basic considerations about the scale, more recent developments (from 2012 to 2022) regarding the use of the MI-RSWB are presented. Thus, it is intended to focus here on (1) the presentation of standard values for the MI-RSWB for the Austrian general population, (2) several scale translations into different languages, (3) more recent data on the relationship between RSWB, personality, and mental health, and (4) the potential clinical applications of the RSWB dimensions. As a conclusion, further potential applications of the RSWB concept are discussed. [ABSTRACT FROM AUTHOR]

Aloe vera is a kind of herb rich in polysaccharides. Acemannan (AC) is considered to be a natural polysaccharide with good biodegradability and biocompatibility extracted from Aloe vera and has a wide range of applications in the biomedical field due to excellent immunomodulatory, antiviral, antitumor, and tissue regeneration effects. In recent years, clinical case reports on the application of AC as a novel biomedical material in tissue regenerative medicine have emerged; it is mainly used in bone tissue engineering, pulp–dentin complex regeneration engineering, and soft tissue repair, among other operations. In addition, multiple studies have proved that the new composite products formed by the combination of AC and other compounds have excellent biological and physical properties and have broader research prospects. This paper introduces the preparation process, surface structure, and application forms of AC; summarizes the influence of acetyl functional group content in AC on its functions; and provides a detailed review of the functional properties, laboratory studies, clinical cutting-edge applications, and combined applications of AC. Finally, the current application status of AC from basic research to clinical treatment is analyzed and its prospects are discussed. [ABSTRACT FROM AUTHOR]

Background: Recently, target auto‐segmentation techniques based on deep learning (DL) have shown promising results. However, inaccurate target delineation will directly affect the treatment planning dose distribution and the effect of subsequent radiotherapy work. Evaluation based on geometric metrics alone may not be sufficient for target delineation accuracy assessment. The purpose of this paper is to validate the performance of automatic segmentation with dosimetric metrics and try to construct new evaluation geometric metrics to comprehensively understand the dose‐response relationship from the perspective of clinical application. Materials and Methods: A DL‐based target segmentation model was developed by using 186 manual delineation modified radical mastectomy breast cancer cases. The resulting DL model were used to generate alternative target contours in a new set of 48 patients. The Auto‐plan was reoptimized to ensure the same optimized parameters as the reference Manual‐plan. To assess the dosimetric impact of target auto‐segmentation, not only common geometric metrics but also new spatial parameters with distance and relative volume (RV${R}_V$) to target were used. Correlations were performed using Spearman's correlation between segmentation evaluation metrics and dosimetric changes. Results: Only strong (|R2| > 0.6, p < 0.01) or moderate (|R2| > 0.4, p < 0.01) Pearson correlation was established between the traditional geometric metric and three dosimetric evaluation indices to target (conformity index, homogeneity index, and mean dose). For organs at risk (OARs), inferior or no significant relationship was found between geometric parameters and dosimetric differences. Furthermore, we found that OARs dose distribution was affected by boundary error of target segmentation instead of distance and RV${R}_V$ to target. Conclusions: Current geometric metrics could reflect a certain degree of dose effect of target variation. To find target contour variations that do lead to OARs dosimetry changes, clinically oriented metrics that more accurately reflect how segmentation quality affects dosimetry should be constructed. [ABSTRACT FROM AUTHOR]

Highly precise micromanipulation tools that can manipulate and interrogate cell organelles and components must be developed to support the rapid development of new cell-based medical therapies, thereby facilitating in-depth understanding of cell dynamics, cell component functions, and disease mechanisms. This paper presents a literature review on micro/nanomanipulation tools and their control methods for single-cell surgery. Micromanipulation methods specifically based on laser, microneedle, and untethered micro/nanotools are presented in detail. The limitations of these techniques are also discussed. The biological significance and clinical applications of single-cell surgery are also addressed in this paper. [ABSTRACT FROM AUTHOR]

Big data analytics utilizes different techniques to transform large volumes of big datasets. The analytics techniques utilize various computational methods such as Machine Learning (ML) for converting raw data into valuable insights. The ML assists individuals in performing work activities intelligently, which empowers decision-makers. Since academics and industry practitioners have growing interests in ML, various existing review studies have explored different applications of ML for enhancing knowledge about specific problem domains. However, in most of the cases existing studies suffer from the limitations of employing a holistic, automated approach. While several researchers developed various techniques to automate the systematic literature review process, they also seemed to lack transparency and guidance for future researchers. This research aims to promote the utilization of intelligent literature reviews for researchers by introducing a step-by-step automated framework. We offer an intelligent literature review to obtain in-depth analytical insight of ML applications in the clinical domain to (a) develop the intelligent literature framework using traditional literature and Latent Dirichlet Allocation (LDA) topic modeling, (b) analyze research documents using traditional systematic literature review revealing ML applications, and (c) identify topics from documents using LDA topic modeling. We used a PRISMA framework for the review to harness samples sourced from four major databases (e.g., IEEE, PubMed, Scopus, and Google Scholar) published between 2016 and 2021 (September). The framework comprises two stages—(a) traditional systematic literature review consisting of three stages (planning, conducting, and reporting) and (b) LDA topic modeling that consists of three steps (pre-processing, topic modeling, and post-processing). The intelligent literature review framework transparently and reliably reviewed 305 sample documents. [ABSTRACT FROM AUTHOR]

In this paper, the safety of Tripterygium wilfordii polyglycoside (TW) preparation was evaluated by combining literature research and evidence-based evaluation research, so as to provide evidence-based safety information of Tripterygium wilfordii polyglycoside preparation (nephroptosis) for government decision making and clinical application. In this paper, we propose a network structure inspired by the LSTM gate mechanism. All the research methods of the included references are evaluated by internationally recognized evaluation tools or standards. Prevalence was analyzed according to the type of intervention (e.g., time of administration) and route of administration. The results of this experiment provide methods and suggestions for the evaluation of traditional Chinese medicine nephroptosis in the future. [ABSTRACT FROM AUTHOR]

Objective: Irrational use of antimicrobial agents for preventing postoperative SSIs is a common phenomenon in China, which results in more bacterial resistance, higher hospital infection rates, extra costs of antimicrobial agents. The aim of the study is to evaluate the effect of Drug Rational Usage Guidelines System (DRUGS) on the surgeon's prescription behavior of antimicrobial agents. Methods: 10 common surgical operations which included 1543 cases (where 778 cases using paper-based guidelines and 765 cases using DRUGS) were selected and their demographic and clinical data were collected. The selected operations include thyroid resection, breast mass resection, myomectomy, etc. The evaluation criteria were antibiotic administrative categories, the time of initial dose, duration of administration, length of stay, the costs of antibiotics, SSIs and drug adverse reactions(ADR). Results: The antimicrobial agents were mostly administrated within 0.5 h to 2 h before incision, 656 patients (85.75%) were intervened with DRUGS and 256 (32.90%) with paper-based guidelines according to the protocol. For the clean wounds incision, 547 patients (91.62%) were within 24 h of withdrawal antibiotics with using paper-based guidelines versus 91 (14.79%) with using DRUGS. A total of 19 kinds of antibiotics were used in the 1543 cases. The leading three on the list of frequency were piperacillin and sulbactam sodium, cefathiamidine and cefoperazone. While after the intervention, the list of frequency changed to cefazolin, cefathiamidine, cefoperazone. The average hospital stay was (7.00±4.31)d with paper-based guidelines and (2.54±1.57)d with DRUGS, respectively. The average cost of antibiotics was ¥(3481.36±2584.46) with paper-based guidelines and ¥(1693.39±1478.27) with DRUGS, respectively. However, there were no significant differences in the incidence of SSIs and ADR between two groups. Conclusion: In this study, the increased availability of antibiotic guidelines at the time of drug ordering, combined with DRUGS, was associated with an enhanced surgeon adherence to guidelines. [ABSTRACT FROM AUTHOR]

For decades, the advantages of rapid prototyping for clinical use have been recognized. However, demonstrations of potential solutions to treat spinal problems that cannot be solved otherwise are scarce. In this paper, we describe the development, regulatory process, and clinical application of two types of patient specific 3D-printed devices that were developed at an in-house 3D point-of-care facility. This 3D lab made it possible to elegantly treat patients with spinal problems that could not have been treated in a conventional manner. The first device, applied in three patients, is a printed nylon drill guide, with such accuracy that it can be used for insertion of cervical pedicle screws in very young children, which has been applied even in semi-acute settings. The other is a 3D-printed titanium spinal column prosthesis that was used to treat progressive and severe deformities due to lysis of the anterior column in three patients. The unique opportunity to control size, shape, and material characteristics allowed a relatively easy solution for these patients, who were developing paraplegia. In this paper, we discuss the pathway toward the design and final application, including technical file creation for dossier building and challenges within a point-of-care lab. [ABSTRACT FROM AUTHOR]

Over the past decade, there has been substantial progress towards integrating our understanding of social determinants of reproductive, maternal, newborn, child, and adolescent health (RMNCAH) into health planning and programs. For these programs, gender inequity remains one of the most harmful factors for women's access to healthcare. Designing RMNCAH programs to be gender-responsive through active engagement with and overcoming of gender-related barriers remains paramount to increasing women's access to and use of health programs. However, the integration of gender within RMNCAH programs and their evaluation is often non-existent or is limited in scope. Building on a prior framework for comprehensive gender analysis in RMNCAH, we discuss key steps used to incorporate a gender lens and analytical approach in the Real Accountability: Data Analysis for Results (RADAR) evaluation framework. In order to effectively address these key areas, gender must be integrated into all stages of the evaluation, including tool development and programmatic activities that are associated with each question. Our paper includes practical activities and tools that evaluators may use to integrate gender into their evaluation tools. [ABSTRACT FROM AUTHOR]

Objectives: This paper introduces the surgical procedure of "terminal ileum suspension" in the radical resection for low rectal cancer patients and evaluates the possibility of its clinical application. Methods: This paper retrospectively analyzed the data of patients with low rectal cancer who underwent "terminal ileum suspension" during radical resection of rectal cancer (Dixon) in our hospital, and introduces the specific surgical procedures and key points of "terminal ileum suspension". Observe the relevant conditions of patients during the operation, postoperative recovery and postoperative complications, and analyze the safety and feasibility of this operation ("terminal ileum suspension"). Results: The operation of all 8 patients went smoothly, and no anastomotic leakage, intestinal obstruction, and open diversion of suspended terminal ileum were found. The application of "terminal ileum suspension" in the operation of low rectal cancer has achieved ideal clinical effect, without increasing the rate of anastomotic leakage and rehospitalization, reducing the proportion of the secondary return operation, and reducing the pain of the patients. Conclusion: "Terminal ileum suspension" is a safe, effective and feasible surgical method for laparoscopic radical resection of low rectal cancer, which can be applied in clinical practice. [ABSTRACT FROM AUTHOR]

The relevance of this study is conditioned upon the prevalence of pulmonary oedema in cats and special approaches to their therapy. In this regard, this paper is aimed at identifying aetiological factors, breed predisposition, clinical manifestations, haematological parameters, and radiological signs. Leading in the study of this issue is an integrated approach, which includes consideration of the aetiology, pathogenesis, diagnosis of cardiogenic and non-cardiogenic pulmonary oedema and treatment of cats. It was found that in the conditions of the "Vet House" Veterinary Centre (Vinnytsia), cats of the British Shorthair, Sphinx, Maine Coon breeds and their hybrids were most often registered with this pathology. 68 cats were diagnosed with cardiogenic pulmonary oedema due to hypertrophic, restrictive, and unclassified cardiomyopathy. 42 animals were found to have non-cardiogenic pulmonary oedema due to traumatic brain injury, toxic substance poisoning, anaphylactic reaction, airway obstruction, and electric shock. It was found that the most informative during the differential diagnosis of pulmonary oedema in cats are the results of echocardiography and X-ray examination. It was established that for the differential diagnosis of cardiogenic and noncardiogenic pulmonary oedema, clinical indicators and results of haematological examination of animals are low in information. It was discovered that therapeutic measures for pulmonary oedema are effective in considering aetiological factors, although at the first stage, for both forms of pulmonary oedema, they are aimed at reducing and eliminating the manifestations of acute respiratory failure. The materials of this paper are of practical value for veterinary doctors of general practice and intensive care on differential diagnosis, prediction of the development of the disease and effective treatment of cats [ABSTRACT FROM AUTHOR]

Rehabilitation robots have been proven to be an effective tool for patient motor recovery in clinical medicine. Recently, few degrees of freedom (DOFs), especially 1-DOF, rehabilitation robots have drawn increasing attention as the complexity and cost of the control system would be significantly reduced. In this paper, the mechanism synthesis problem of 1-DOF rehabilitation robots is studied. Traditional synthesis methods usually aim at minimizing the trajectory error to generate a mathematically optimal solution, which may not be a practically feasible solution in terms of engineering constraints. Therefore, we propose a novel mechanism synthesis approach based on chord angle descriptor (CAD) and error tolerance expansion to generate a pool of mechanism solutions from which mathematically and practically optimal solutions can be selected. CAD is utilized for its capability to represent the same-shaped trajectories of different mechanisms in a unified way, and it is robust to the noise in the rehabilitation trajectory acquired by motion capture systems. Then a library of mechanism trajectories is established with compressed representations of CAD via an auto-encoder algorithm to speed up the matching between mechanism and rehabilitation trajectory where the matching error tolerance can be adjusted according to practical rehabilitation specifications. Finally, a design example of a 1-DOF rehabilitation robot for upper-limb training is provided to demonstrate the efficacy of our novel approach. [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]

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]

Primary care physicians (PCPs) play an indispensable role in providing comprehensive care and referring patients for specialty care and other medical services. As the COVID-19 outbreak disrupts patient access to care, understanding the quality of primary care is critical at this unprecedented moment to support patients with complex medical needs in the primary care setting and inform policymakers to redesign our primary care system. The traditional way of collecting information from patient surveys is time-consuming and costly, and novel data collection and analysis methods are needed. In this review paper, we describe the existing algorithms and metrics that use the real-world data to qualify and quantify primary care, including the identification of an individual's likely PCP (identification of plurality provider and major provider), assessment of process quality (for example, appropriate-care-model composite measures), and continuity and regularity of care index (including the interval index, variance index and relative variance index), and highlight the strength and limitation of real world data from electronic health records (EHRs) and claims data in determining the quality of PCP care. The EHR audits facilitate assessing the quality of the workflow process and clinical appropriateness of primary care practices. With extensive and diverse records, administrative claims data can provide reliable information as it assesses primary care quality through coded information from different providers or networks. The use of EHRs and administrative claims data may be a cost-effective analytic strategy for evaluating the quality of primary care. [ABSTRACT FROM AUTHOR]

The awareness of the existence of plant bioactive compounds, namely, phytochemicals (PHYs), with health properties is progressively expanding. Therefore, their massive introduction in the normal diet and in food supplements and their use as natural therapeutics to treat several diseases are increasingly emphasized by several sectors. In particular, most PHYs possessing antifungal, antiviral, anti-inflammatory, antibacterial, antiulcer, anti-cholesterol, hypoglycemic, immunomodulatory, and antioxidant properties have been isolated from plants. Additionally, their secondary modification with new functionalities to further improve their intrinsic beneficial effects has been extensively investigated. Unfortunately, although the idea of exploiting PHYs as therapeutics is amazing, its realization is far from simple, and the possibility of employing them as efficient clinically administrable drugs is almost utopic. Most PHYs are insoluble in water, and, especially when introduced orally, they hardly manage to pass through physiological barriers and scarcely reach the site of action in therapeutic concentrations. Their degradation by enzymatic and microbial digestion, as well as their rapid metabolism and excretion, strongly limits their in vivo activity. To overcome these drawbacks, several nanotechnological approaches have been used, and many nanosized PHY-loaded delivery systems have been developed. This paper, by reporting various case studies, reviews the foremost nanosuspension- and nanoemulsion-based techniques developed for formulating the most relevant PHYs into more bioavailable nanoparticles (NPs) that are suitable or promising for clinical application, mainly by oral administration. In addition, the acute and chronic toxic effects due to exposure to NPs reported so far, the possible nanotoxicity that could result from their massive employment, and ongoing actions to improve knowledge in this field are discussed. The state of the art concerning the actual clinical application of both PHYs and the nanotechnologically engineered PHYs is also reviewed. [ABSTRACT FROM AUTHOR]

CNS metastases are often terminal for cancer patients and occur at an approximately 10-fold higher rate than primary CNS tumors. The incidence of these tumors is approximately 70,000–400,000 cases annually in the US. Advances that have occurred over the past two decades have led to more personalized treatment approaches. Newer surgical and radiation techniques, as well as targeted and immune therapies, have enanled patient to live longer, thus increasing the risk for the development of CNS, brain, and leptomeningeal metastases (BM and LM). Patients who develop CNS metastases have often been heavily treated, and options for future treatment could best be addressed by multidisciplinary teams. Studies have indicated that patients with brain metastases have improved survival outcomes when cared for in high-volume academic institutions using multidisciplinary teams. This manuscript discusses a multidisciplinary approach for both parenchymal brain metastases as well as leptomeningeal metastases implemented in three academic institutions. Additionally, with the increasing development of healthcare systems, we discuss optimizing the management of CNS metastases across healthcare systems and integrating basic and translational science into our clinical care to further improve outcomes. This paper summarizes the existing therapeutic approaches to the treatment of BM and LM and discusses novel and emerging approaches to optimizing access to neuro-oncologic care while simultaneously integrating multidisciplinary teams in the care of patients with BM and LM. [ABSTRACT FROM AUTHOR]

The recent COVID-19 pandemic has hit humanity very hard in ways rarely observed before. In this digitally connected world, the health informatics and investigation domains (both public and private) lack a robust framework to enable rapid investigation and cures. Since the data in the healthcare domain are highly confidential, any framework in the healthcare domain must work on real data, be verifiable, and support reproducibility for evidence purposes. In this paper, we propose a health informatics framework that supports data acquisition from various sources in real-time, correlates these data from various sources among each other and to the domain-specific terminologies, and supports querying and analyses. Various sources include sensory data from wearable sensors, clinical investigation (for trials and devices) data from private/public agencies, personnel health records, academic publications in the healthcare domain, and semantic information such as clinical ontologies and the Medical Subject Heading ontology. The linking and correlation of various sources include mapping personnel wearable data to health records, clinical oncology terms to clinical trials, and so on. The framework is designed such that the data are Findable, Accessible, Interoperable, and Reusable with proper Identity and Access Mechanisms. This practically means to tracing and linking each step in the data management lifecycle through discovery, ease of access and exchange, and data reuse. We present a practical use case to correlate a variety of aspects of data relating to a certain medical subject heading from the Medical Subject Headings ontology and academic publications with clinical investigation data. The proposed architecture supports streaming data acquisition and servicing and processing changes throughout the lifecycle of the data management. This is necessary in certain events, such as when the status of a certain clinical or other health-related investigation needs to be updated. In such cases, it is required to track and view the outline of those events for the analysis and traceability of the clinical investigation and to define interventions if necessary. [ABSTRACT FROM AUTHOR]

Since the discovery of mesenchymal stem cells (MSCs) in the 1970s, they have been widely used in the treatment of a variety of diseases because of their wide sources, strong differentiation potential, rapid expansion in vitro, low immunogenicity, and so on. At present, most of the related research is on mesoderm-derived MSCs (M-MSCs) such as bone marrow MSCs and adipose-derived MSCs. As a type of MSC, ectoderm-derived MSCs (E-MSCs) have a stronger potential for self-renewal, multidirectional differentiation, and immunomodulation and have more advantages than M-MSCs in some specific conditions. This paper analyzes the relevant research development of E-MSCs compared with that of M-MSCs; summarizes the extraction, discrimination and culture, biological characteristics, and clinical application of E-MSCs; and discusses the application prospects of E-MSCs. This summary provides a theoretical basis for the better application of MSCs from both ectoderm and mesoderm in the future. [ABSTRACT FROM AUTHOR]

Ultrasound intelligent diagnosis is an emerging technology that combines artificial intelligence (AI) and medical ultrasonography. It has gained significant attention in recent years due to its potential to improve the accuracy and efficiency of medical diagnosis. The core elements of ultrasound artificial intelligence are the construction of data and algorithm models. Therefore, developing autonomous and controllable models, algorithms, and data platforms is extremely important. In this paper, we provide a comprehensive review of the current state-of-the-art in ultrasound intelligent diagnosis including the aspects of the construction of ultrasonic database, deep learning techniques in ultrasound intelligent diagnosis, and the clinical application of ultrasound-AI products. With continued advancements in AI and ultrasound imaging technology, we believe ultrasound intelligent diagnosis will be a valuable tool in the hands of healthcare professionals, providing them with more accurate and efficient diagnoses and treatment plans in the coming years. [ABSTRACT FROM AUTHOR]