Hasil untuk "Other systems of medicine"

Laura Caci, Emanuela Nyantakyi, Kathrin Blum et al.

Background Organizational readiness for change (ORC), referring to psychological and behavioral preparedness of organizational members for implementation, is often cited in healthcare implementation research. However, evidence about whether and under which conditions ORC is relevant for positive implementation results remains ambiguous, with past studies building on various theories and assessing ORC with different measures. To strengthen the ORC knowledge base, we therefore identified factors investigated in the empirical literature alongside ORC, or as mediators and/or moderators of ORC and implementation. Method We conducted a systematic review of experimental, observational, and hybrid studies in physical, mental, and public health care that included a quantitative assessment of ORC and at least one other factor (e.g., ORC correlate, predictor, moderator, or mediator). Studies were identified searching five online databases and bibliographies of included studies, employing dual abstract and full text screening. The study synthesis was guided by the Consolidated Framework for Implementation Research integrated with the Theory of ORC. Study quality was appraised using the Mixed Methods Appraisal Tool. Results Of 2,907 identified studies, 47 met inclusion criteria, investigating a broad range of factors alongside ORC, particularly contextual factors related to individuals and the innovation. Various ORC measures, both home-grown or theory-informed, were used, confirming a lack of conceptual clarity surrounding ORC. In most studies, ORC was measured only once. Conclusions This systematic review highlights the broad range of factors investigated in relation to ORC, suggesting that such investigation may enhance interpretation of implementation results. However, the observed diversity in ORC conceptualization and measurement supports previous calls for clearer conceptual definitions of ORC. Future efforts should integrate team-level perspectives, recognizing ORC as both an individual and team attribute. Prioritizing the use of rigorous, repeated ORC measures in longitudinal implementation research is essential for advancing the collective ORC knowledge base.

Camelia Corina Pescaru, Alexandru Florian Crișan, Adelina Marițescu et al.

<b>Background</b>: Cystic fibrosis (CF) is an autosomal recessive disease caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Modulator therapies have the ability to improve CFTR function in CF patients, but despite the clear evidence of benefits regarding CFTR modulator therapy, including improved lung function, the reduced rate of exacerbations, and an overall improved quality of life, studies focusing on the reduction rates of <i>P. aeruginosa</i> infections during modulator therapy expressed the need for future research on this topic. <b>Objective</b>: This study aimed to evaluate the impact of CFTR modulator therapies on the prevalence, density, and persistence of <i>P. aeruginosa</i> infection in CF patients and to explore the mechanisms involved. <b>Methods</b>: A systematic literature review was performed by searching five major databases (PubMed, Cochrane Library, Scopus, Google Scholar, and Web of Science), and 21 relevant articles investigating the link between CFTR therapy and <i>P. aeruginosa</i> infections were selected following the PRISMA guidelines. <b>Results</b>: The data indicated that Ivacaftor and the combination Elexacaftor/Tezacaftor/Ivacaftor (ETI) can reduce total bacterial load and markers of systemic inflammation. However, clonal lines of <i>P. aeruginosa</i> persist in most cases, and complete eradication is rare, mainly due to biofilm formation and antimicrobial resistance. <b>Conclusions</b>: Although CFTR-modulating therapies help to improve clinical condition and reduce inflammation, they do not consistently lead to the elimination of <i>P. aeruginosa</i>.

Aqeela Malik, Fatima Ali, Muhammad Tariq Saeed et al.

Introduction: Human parainfluenza viruses (HPIVs) are significant contributors to respiratory infections worldwide, with a lack of effective antiviral therapies. This study investigates the antiviral potential of bioactive saponins extracted from H. helix (常春藤) and V. thapsus (毛蕊花), two medicinal plants traditionally used for respiratory ailments. This study evaluates the antiviral potential of H. helix L. (ivy) and V. thapsus L. (mullein), two medicinal plants with traditional uses in herbal systems, including therapeutic parallels in Traditional Chinese Medicine (TCM), against HPIV using Vero cell lines. Methods: Plant extracts were prepared using ethanol extraction, followed by dilution and characterization via HPLC and HNMR to identify saponins. In vitro antiviral assays were conducted on Vero cell lines infected with HPIV, assessing pre-, post-, and simultaneous treatments. Hemagglutination assay quantified viral activity. Molecular docking of major saponins against HPIV’s HN protein was performed to predict interaction mechanisms. Results: HPLC identified hederacoside C, hederacoside D, and α-hederin in H. helix, and thapsuine A in V. thapsus. HNMR spectra supported the presence of complex saponin structures. Both extracts demonstrated dose-dependent antiviral activity, with H. helix exhibiting the most potent inhibition at 40 µg/mL, particularly when administered before infection. Molecular docking revealed strong binding affinities of hederacoside C and α-hederin with the HN protein, indicating a potential mechanism of action. Conclusion: The results suggest that H. helix and V. thapsus possess significant anti-HPIV activity, likely mediated by saponins disrupting viral replication. This study highlights the promise of H. helix and V. thapsus as natural antiviral agents within an integrative TCM framework, paving the way for future research into their clinical applications against respiratory viral infections.

Liza I Ibrahim, Abeer M. ElDeeb, Hamed M. Elkozamy et al.

Abstract Background Idiopathic scoliosis is a common musculoskeletal disorder that affects spinal and pelvic alignment and exacerbates menstrual discomfort in young females. Studies have reported the importance of involving myofascial components in treating scoliotic patients; however, few studies have been conducted. Therefore, this study aimed to investigate the effect of adding myofascial release (MFR) to corrective stabilizing exercise on spinal curvature, premenstrual symptoms, and health-related quality of life (HRQOL) in young females with idiopathic scoliosis. Methods Fifty-two females with idiopathic scoliosis, aged 18–25 years, and with a body mass index (BMI) of 18.5–24.9 kg/m2 were randomly assigned to two groups equal in number. The control group received corrective stabilizing exercises two sessions/week for 8 weeks. The MFR group received the same exercises and MFR therapy two sessions/week for 8 weeks. The scoliometer was used to evaluate thoracic and lumbar angles, Italian Spine Youth Quality of Life (ISYQOL) to assess HRQOL, and menstrual symptoms questionnaire (MSQ) to evaluate premenstrual symptoms before and after the treatment. Results There was a significant decrease (p < 0.05) in the thoracic and lumbar angles, menstrual backache, and PMS score and a significant increase (p < 0.05) in the HRQOL score in the control and MFR groups. However, there were no significant differences (p > 0.05) between both groups after treatment. Conclusion Corrective stabilizing exercises with or without MFR effectively improve thoracic and lumbar angles, HRQOL, menstrual backache, and premenstrual symptoms. The addition of MFR to stabilizing exercises produced changes that are clinically important for females with idiopathic scoliosis.

Robert W. Emmerton, Christina Camilleri, Stephen Sammut

Background: Scientific literature indicates a continued global decline in mental health, including among university students, with continued efforts to comprehend potential contributors. Our cross-sectional study sought to build upon our previous work and investigate the current dynamic of mental health and potential stressors reported among a sample of university students, as well as potential similarities/differences to previous years. Methods: University students (n = 820 participants who met inclusion criteria; aged 18+) were administered an anonymous survey consisting of questions assessing: (1) demographics, (2) mental health (depression, anxiety, stress), and (3) potential stressors. Results: Our results indicate a significant proportion of students reporting severe and extremely severe levels of depression, anxiety and stress, with a substantial increase in severe and extremely severe levels relative to previous years. Similar to our previous work, academic performance, pressure to succeed and quality of sleep were among the top stressors reported. Significant predictors of mental health included pressure to succeed, self-esteem, body image and relationship with friends and family. Limitations: A key limitation of this study includes its cross-sectional, rather than longitudinal, design. Conclusions: The university student population appears to be experiencing a continued shift towards worse mental health. In addition to the traditional college-related sources of stress, consideration is also necessary of the impact of non-college-specific stressors that could linger beyond the individual's time in college. This approach, along with consideration of the deeper underlying contributors to such stressors, may potentially assist in more appropriately, proactively, and successfully addressing the global mental health pandemic.

Flávia Eduarda Thomazini Stela, Arianne Peruzo Pires Gonçalves Sereno, Graziela Vendrame Rodrigues

O câncer de colo de útero é uma doença maligna que atinge mulheres em todo o mundo, sendo o quarto tipo de câncer mais frequente nas mulheres mundialmente. Cerca de 99,7% dos casos são causados por Papiloma Virus Humanos, sendo ele o principal fator de risco, junto aos mais comuns, que são o HPV 16 e 18. Nem sempre a infecção do vírus progride para a neoplasia maligna, podendo regredir. Quando diagnosticado precocemente, tem regressão em quase sua totalidade de casos. Sendo incidente em regiões com o nível socioeconômico menor, estando relacionada com a falta de conhecimento da população e não tendo acesso a informações, educação, e ao serviço de saúde. Esta é uma pesquisa baseada na coleta de dados obtidos pelo DATASUS, tendo o objetivo de analisar a epidemiologia da doença nas regiões brasileiras, tendo em vista a dificuldade nos números de casos informados, pois, ainda hoje, há subnotificações de casos, causados pela falta de conhecimento da população, até mesmo de profissionais da saúde, e a falta de acesso ao sistema de saúde pública em algumas regiões. Os números de casos aumentaram ao decorrer dos anos, em maior concentração na região sudeste, tendo a faixa etária predominante de 40 a 49 anos; a modalidade terapêutica mais utilizada é a radioterapia. Sendo de extrema importância o rastreamento do câncer, incentivando as mulheres e conscientizando-as sobre os exames preventivos periódicos, assim percebemos que haverá uma diminuição da incidência de casos. Mediante a isso, torna-se essencial o conhecimento da população sobre o Câncer de colo Uterino. Entre prevenção, diagnóstico precoce, tratamento correto, todos contribuem para a diminuição de incidência e mortes em decorrência dessa neoplasia maligna.

Michael Carl, Kaustubh Lall, Darren Pai et al.

Evaluation of the 3D bone morphology of the glenohumeral joint is necessary for pre-surgical planning. Zero echo time (ZTE) magnetic resonance imaging (MRI) provides excellent bone contrast and can potentially be used in the place of computed tomography. Segmentation of the shoulder anatomy, particularly the humeral head and the acetabulum, is needed for the detailed assessment of each anatomy and for pre-surgical preparation. In this study, we compared the performance of two popular deep learning models based on Google’s DeepLab and U-Net to perform automated segmentation on ZTE MRI of human shoulders. Axial ZTE images of normal shoulders (n = 31) acquired at 3-Tesla were annotated for training with DeepLab and 2D U-Net, and the trained model was validated with testing data (n = 13). While both models showed visually satisfactory results for segmenting the humeral bone, U-Net slightly over-estimated while DeepLab under-estimated the segmented area compared to the ground truth. Testing accuracy quantified by Dice score was significantly higher (<i>p</i> < 0.05) for U-Net (88%) than DeepLab (81%) for the humeral segmentation. We have also implemented the U-Net model onto an MRI console for push-button DL segmentation processing. Although this is an early work with limitations, our approach has the potential to improve shoulder MR evaluation hindered by manual post-processing and may provide clinical benefit for quickly visualizing bones of the glenohumeral joint.

Yijun Chen, Kanghong Shi, Ian R. Petersen et al.

In the transition to achieving net zero emissions, it has been suggested that a substantial expansion of electric power grids will be necessary to support emerging renewable energy zones. In this paper, we propose employing battery-based feedback control and nonlinear negative imaginary (NI) systems theory to reduce the need for such expansion. By formulating a novel Luré-Postnikov-like Lyapunov function, stability results are presented for the feedback interconnection of two single nonlinear NI systems, while output feedback consensus results are established for the feedback interconnection of two networked nonlinear NI systems based on a network topology. This theoretical framework underpins our design of battery-based control in power transmission systems. We demonstrate that the power grid can be gradually transitioned into the proposed NI systems, one transmission line at a time.

Suiyi He, Maziar Zamanpour, Jianshe Guo et al.

Red light violation is a major cause of traffic collisions and resulting injuries and fatalities. Despite extensive prior work to reduce red light violations, they continue to be a major problem in practice, partly because existing systems suffer from the flaw of providing the same guidance to all drivers. As a result, some violations are avoided, but other drivers ignore or respond inappropriately to red light running systems, resulting in safety issues overall. We show a method of providing accurate warnings to individual drivers to avoid the broad guidance approach of most existing systems. Recognizing if a driver will run red lights is highly dependent on signal phase and timing, traffic conditions along the road, and individual driver behaviour, the proposed warning system contains three parts: a traffic prediction algorithm, an individual warning signal optimizer, and a driver warning display. The traffic prediction algorithm predicts future traffic states along the road towards the signalized intersections using the latest traffic conditions obtained through vehicle-to-vehicle and vehicle-to-infrastructure communications. Then, an optimization problem is formulated to compute the optimal warning signal based on predicted traffic states and driver reaction model. Finally, the optimal warning signal is shown on the display screen to advise driver on how much braking is needed to avoid running the red light. The system continuously updates the latest warning signal as the vehicle is approaching the intersection. Both numerical simulated driving scenarios and real-world road tests are used to demonstrate the proposed algorithm's performance under different conditions by comparing with previous work on red light running warning system. The results show that the system provides more effective and accurate warning signals to drivers, helping them avoid running red lights.

Frederik Baymler Mathiesen, Sofie Haesaert, Luca Laurenti

This paper introduces a novel abstraction-based framework for controller synthesis of nonlinear discrete-time stochastic systems. The focus is on probabilistic reach-avoid specifications. The framework is based on abstracting a stochastic system into a new class of robust Markov models, called orthogonally decoupled Interval Markov Decision Processes (odIMDPs). Specifically, an odIMDPs is a class of robust Markov processes, where the transition probabilities between each pair of states are uncertain and have the product form. We show that such a specific form in the transition probabilities allows one to build compositional abstractions of stochastic systems that, for each state, are only required to store the marginal probability bounds of the original system. This leads to improved memory complexity for our approach compared to commonly employed abstraction-based approaches. Furthermore, we show that an optimal control strategy for a odIMDPs can be computed by solving a set of linear problems. When the resulting strategy is mapped back to the original system, it is guaranteed to lead to reduced conservatism compared to existing approaches. To test our theoretical framework, we perform an extensive empirical comparison of our methods against Interval Markov Decision Process- and Markov Decision Process-based approaches on various benchmarks including 7D systems. Our empirical analysis shows that our approach substantially outperforms state-of-the-art approaches in terms of both memory requirements and the conservatism of the results.

Sen Zhan, Nikolaos G. Paterakis, Wouter van den Akker et al.

We investigate the real-time voltage regulation problem in distribution systems employing online feedback optimization (OFO) with short-range communication between physical neighbours. OFO does not need an accurate grid model nor estimated consumption of non-controllable loads, affords fast calculations, and demonstrates robustness to uncertainties and disturbances, which render it particularly suitable for real-time distribution system applications. However, many OFO controllers require centralized communication, making them susceptible to single-point failures. This paper proposes a distributed OFO design based on a nested feedback optimization strategy and analyzes its convergence. The strategy preserves end-users' privacy by keeping voltage data local. Numerical study results demonstrate that the proposed design achieves effective voltage regulation and outperforms other distributed and local approaches.

Tim Hulsen

In recent years, more and more health data are being generated. These data come not only from professional health systems, but also from wearable devices. All these ‘big data’ put together can be utilized to optimize treatments for each unique patient (‘precision medicine’). For this to be possible, it is necessary that hospitals, academia and industry work together to bridge the ‘valley of death’ of translational medicine. However, hospitals and academia often are reluctant to share their data with other parties, even though the patient is actually the owner of his/her own health data. Academic hospitals usually invest a lot of time in setting up clinical trials and collecting data, and want to be the first ones to publish papers on this data. There are some publicly available datasets, but these are usually only shared after study (and publication) completion, which means a severe delay of months or even years before others can analyse the data. One solution is to incentivize the hospitals to share their data with (other) academic institutes and the industry. Here, we show an analysis of the current literature around data sharing, and we discuss five aspects of data sharing in the medical domain: publisher requirements, data ownership, growing support for data sharing, data sharing initiatives and how the use of federated data might be a solution. We also discuss some potential future developments around data sharing, such as medical crowdsourcing and data generalists.

Hidetomo Nakamoto, Ryutaro Aoyagi, Takeru Kusano et al.

Abstract In 2022, the government approved the telemedicine system for peritoneal dialysis (PD) in Japan in the form of medical fees. In 2000, we completed a telemedicine system for PD using an automatic peritoneal dialysis (APD) machine. We have published several papers and obtained international patents, but it was impossible to spread them. In recent years, the use of the internet and the spread of COVID-19 have led to the recognition of the importance of telemedicine, leading to the approval of medical fees for telemedicine in PD treatment in Japan. This change is believed to indicate the future direction of PD medicine. However, the current systems are still inadequate. They are difficult to use, and it is difficult for older patients to master their use. Therefore, we hope to develop a system that is easy to use, even for older patients. The new system is a wristwatch or mobile phone monitoring system for blood pressure, heart rate, partial pressure of oxygen, and electrocardiogram. However, development competition for such a mechanism occurs worldwide. Soon, the use of telemedicine in home medical care is expected to become a common practice. It is expected that the telemedicine system, which has been approved for patients using APD in Japan, will also be available for patients undergoing PD other than APD and patients undergoing home hemodialysis in the future. One important feature would be cooperation among doctors, nurses, clinical engineers, medical care teams, and primary care physicians. Advances in artificial intelligence (AI) and information technology (IT) are expected to significantly expand PD medical care in the future. This review is focused on the use of AI and IT for PD medical care in Japan and expectations for the future.

LI Ning(李宁), BAI Li(白莉)

Antimicrobial resistance (AMR) is involved in veterinary medicine, food, environment, medicine, and other fields. It endangers food safety, international trade, economic development, and life health. It has become a major public health problem facing the world. China was the world's largest producer and consumer of antimicrobials, about 60% of which were used in breeding industry. Due to its wide spread use and abuse in the breeding industry, many antimicrobial resistant bacteria appeared and spreaded rapidly. Following the “One Health” strategy, the United Nations encouraged countries to establish cross-sectoral AMR coordination mechanisms. This research compared the development, framework, and some monitoring results of foodborne bacterial antimicrobial resistance surveillance systems in China, the United States, and Europe. National surveillance systems basically covered population and food animal and food-related foodborne bacterial antimicrobial resistance, while also monitoring the use of antimicrobials in human medicine and food animals. American and European countries and regions started earlier and had relatively perfect systems. Through the development of nearly 30 years, they have mastered the baseline level of drug resistance and drug use of foodborne bacteria. Furthermore, scientific evaluation of surveillance data can play a risk management role, like optimizing surveillance programs (such as increasing surveillance of antimicrobial resistance in pets and environmental monitoring) and proposing interventions to limit the spread of resistant bacteria. The surveillance system of foodborne bacterial antimicrobial resistance started late in China. The surveillance of foodborne bacterial antimicrobial resistance in humans, food animals and related foods developed rapidly for 20 years, while the monitoring of antibiotic drug use in food animals began in 2018, and further improvement was needed for all aspects. At the same time, the EU monitoring system implemented the mechanism of breaking down departments to achieve data sharing. At present, different departments responsible for foodborne bacteria antimicrobial resistance monitoring systems have been established in our country. However, the data sharing mechanism has not been realized, and data “chimney” and information isolated island existed, which made it impossible to maximize the utility of existing data resources. By discussing the experiences of the United States and Europe, this research has the following inspirations for the antimicrobial resistance surveillance system in China. It is necessary to gradually improve the antimicrobial resistance surveillance system, establish a multi-sectoral collaborative governance mechanism, and accelerate the application of new technologies in data mining, to comprehensively improve the ability to curb bacterial resistance and protect people's health.(抗微生物药物耐药性(antimicrobial resistance,AMR)涉及兽医、食品、环境、医学等多个领域,危及食品安全、国际贸易、经济发展和生命健康,已成为全球面临的重大公共卫生问题。我国是全球最大的抗微生物药物生产和消费国,其中约60%的抗微生物药物被用于养殖业。由于抗微生物药物在养殖业的广泛使用甚至滥用,导致大量耐药细菌的出现和迅速传播。遵循“One Health”策略,联合国鼓励各国建立跨部门间的AMR协调机制。研究比较了中美欧食源性细菌耐药性监测系统的发展、框架及部分监测结果,发现各国监测体系基本涵盖人群、食品动物和相关食品食源性细菌耐药性,同时也监测人医和食品动物抗微生物药物使用量。欧美国家和地区起步较早,通过近30多年的发展,基本掌握了食源性细菌耐药性的基线水平及药物使用水平。我国食源性细菌耐药性监测体系起步较晚,人群、食品动物和相关食品食源性细菌耐药性监测发展近20年,而食品动物抗生素药物使用量监测于2018年开始启动,各方面都需要进一步完善。欧盟监测体系实施跨部门协作机制,数据共享共用；目前,虽然我国已经建立了不同部门负责的食源性细菌耐药性监测体系,但尚未建立数据共享机制,存在数据“烟囱”和信息孤岛,无法最大化发挥现有数据资源的效用。欧美经验对我国食源性细菌耐药性监测系统有一定启发:我国应逐步完善耐药监测系统、建立多部门协同共治机制及加快新技术在数据挖掘中的运用,从而综合提升遏制细菌耐药性的能力,保障人民健康。)

Francy Cruz-Sanabria, Leonardo Massoni, Miriam Violi et al.

Background: Sleep and circadian rhythm disruptions can contribute to cognitive disturbances in bipolar disorder (BD); however, the profile of specific sleep/circadian phenotypes remains to be elucidated. The aim of our work is to compare sleep/circadian parameters and sustained attention between patients with BD and comorbid delayed sleep-wake phase disorder (BD-DSWPD), patients with BD without DSWPD comorbidity (BD-Control), and healthy controls (HC). Methods: BD patients (N = 70, BD-DWSPD N = 25, BD-Control N = 45) and HC (N = 86) were evaluated through actigraphy for sleep and circadian rhythm parameters, the Pittsburgh Sleep Quality Index for sleep quality, the reduced Morningness-Eveningness Questionnaire for chronotype and the Psychomotor Vigilance Task for sustained attention. Results: The BD-DSWPD diagnosis was associated with poorer self-reported sleep quality, lower sleep efficiency, higher wake after sleep onset, and later acrophase compared to both HC and BD-Control groups. BD-DSWPD was also associated with lower relative amplitude compared to HC. Regarding sustained attention variables, the diagnosis of BD-DSWPD was associated with increased response times compared to HC, while both BD-DSWPD and BD-Control were associated with major lapses than HC. Limitations: Sample size and multivariate statistics not adjusted for pharmacological treatment. Conclusions: Patients with BD-DSWPD showed greater disturbances in sleep and circadian rhythm parameters compared to both HC and BD-Controls; moreover, BD-DSWPD showed increased response times compared to HC. Further studies are required to evaluate whether treatments focused on advancing the sleep phase may contribute to improving cognition, sleep, and circadian rhythmicity in patients with BD and comorbid DSWPD.

Aaron L. Sarvet, Mats J. Stensrud

Avoiding harm is an uncontroversial aim of personalized medicine and other epidemiologic initiatives. However, the precise mathematical translation of "harm" is disputable. Here we use a formal causal language to study common, but distinct, definitions of "harm". We clarify that commitment to a definition of harm has important practical and philosophical implications for decision making. We relate our practical and philosophical considerations to ideas from medical ethics and legal practice.

K. Keenan, M. Ainslie, A. Barker et al.

Szymon Paprocki, Meha Qassem, Panicos A Kyriacou

The field of alcohol intoxication sensing is over 100 years old, spanning the fields of medicine, chemistry, and computer science, aiming to produce the most effective and accurate methods of quantifying intoxication levels. This review presents the development and the current state of alcohol intoxication quantifying devices and techniques, separated into six major categories: estimates, breath alcohol devices, bodily fluid testing, transdermal sensors, mathematical algorithms, and optical techniques. Each of these categories was researched by analyzing their respective performances and drawbacks. We found that the major developments in monitoring ethanol intoxication levels aim at noninvasive transdermal/optical methods for personal monitoring. Many of the “categories” of ethanol intoxication systems overlap with each other with to a varying extent, hence the division of categories is based only on the principal operation of the techniques described in this review. In summary, the gold-standard method for measuring blood ethanol levels is through gas chromatography. Early estimation methods based on mathematical equations are largely popular in forensic fields. Breath alcohol devices are the most common type of alcohol sensors on the market and are generally implemented in law enforcement. Transdermal sensors vary largely in their sensing methodologies, but they mostly follow the principle of electrical sensing or enzymatic reaction rate. Optical devices and methodologies perform well, with some cases outperforming breath alcohol devices in terms of the precision of measurement. Other estimation algorithms consider multimodal approaches and should not be considered alcohol sensing devices, but rather as prospective measurement of the intoxication influence. This review found 38 unique technologies and techniques for measuring alcohol intoxication, which is testament to the acute interest in the innovation of noninvasive technologies for assessing intoxication.

Selena Aranda, Esther Jiménez, Lourdes Martorell et al.

Background: The comorbidities associated with bipolar disorder (BD) can worsen patients’ prognosis and increase economic costs to society. Currently, efforts are being made to identify new endophenotypes characterized by the presence of BD and another concomitant condition. Methods: We performed a search on PubMed and GWAS catalog databases to find genome-wide association studies carried out on patients with BD with any other comorbid condition. We extracted the associated SNPs that attained statistical significance and listed them to appraise their potential to define new BD endophenotypes based on the presence of comorbidities. Results: Six articles fulfilled the inclusion criteria, and all included only patients with BD type-I (BDI). The identified comorbid conditions were migraine, externalizing disorders and eating disorders. BDI with comorbid migraine was associated with rs1160720 in the NBEA gene. BDI with comorbid anorexia or bulimia nervosa was associated with rs4854912 and rs13100379 in the SOX2-OT gene. BDI with comorbid substance abuse was associated with rs1039002 in the PDE10A gene, rs12563333 upstream of the MARK1 gene, and rs13220542 downstream of the MAP3K7 gene. BDI with comorbid alcohol dependence and substance abuse was associated with rs2727943, which is located between CNTN4 and CNTN6. However, such associations were not strong enough to replicate. Limitations: The main limitations are the small size and poor description of the samples used in the included articles. Conclusions: Some genes involved in neurotransmission, stress response, neurogenesis and synaptic plasticity may be associated with comorbid BDI. However, evidence is too weak to consider new endophenotypes in BDI.

Punkanit Harirugsakul, Issarapong Kaewkamnerdpong, Sudaduang Krisdapong et al.

Purpose – The number of older adults in Thailand is currently increasing. To create the appropriate oral health service for this age group requires an understanding of the factors that are associated with their dental service utilization. This study aimed to determine the associations between social backgrounds, oral behaviors and dental service utilization among Thai older adults. Design/methodology/approach – This was a cross-sectional study on a representative sample of older adults in the 8th Thai National Oral Health Survey (TNOHS). Data of 4,130 Thai older adults were collected through interviews. The association between social backgrounds, oral behaviors and dental service utilization were investigated using chi-square and logistic regression models. Findings – Of the older adults aged 60–74 years old, 38.4% had used dental services in the last 12 months. Smokers used dental services the least (32.1%). Location, income, education and social welfare were significantly associated with dental service utilization. Among the oral behaviors evaluated, smoking was significantly associated with low dental service utilization. Originality/value – Thai older adults with a poor social background including location, income, education, entitlement to the Universal Coverage Scheme (UCS) and smoking made less use of dental services.