A decade of unprecedented progress in artificial intelligence (AI) has demonstrated the potential for many fields—including medicine—to benefit from the insights that AI techniques can extract from data. Here we survey recent progress in the development of modern computer vision techniques—powered by deep learning—for medical applications, focusing on medical imaging, medical video, and clinical deployment. We start by briefly summarizing a decade of progress in convolutional neural networks, including the vision tasks they enable, in the context of healthcare. Next, we discuss several example medical imaging applications that stand to benefit—including cardiology, pathology, dermatology, ophthalmology–and propose new avenues for continued work. We then expand into general medical video, highlighting ways in which clinical workflows can integrate computer vision to enhance care. Finally, we discuss the challenges and hurdles required for real-world clinical deployment of these technologies.
Circular RNA (circRNA) is a novel member of the noncoding cancer genome with distinct properties and diverse cellular functions, which is being explored at a steadily increasing pace. The list of endogenous circRNAs involved in cancer continues to grow; however, the functional relevance of the vast majority is yet to be discovered. In general, circRNAs are exceptionally stable molecules and some have been shown to function as efficient microRNA sponges with gene-regulatory potential. Many circRNAs are highly conserved and have tissue-specific expression patterns, which often do not correlate well with host gene expression. Here we review the current knowledge on circRNAs in relation to their implications in tumorigenesis as well as their potential as diagnostic and prognostic biomarkers and as possible therapeutic targets in future personalized medicine. Finally, we discuss future directions for circRNA cancer research and current caveats, which must be addressed to facilitate the translation of basic circRNA research into clinical use.
Hypertrophic cardiomyopathy (HCM) is an important genetic heart muscle disease for which prevalence in the general population has not been completely resolved. For the past 20 years, most data have supported the occurrence of HCM at about 1 in 500. However, the authors have interrogated a number of relevant advances in cardiovascular medicine, including widespread fee-for-service genetic testing, population genetic studies, and contemporary diagnostic imaging, as well as a greater index of suspicion and recognition for both the clinically expressed disease and the gene-positive-phenotype-negative subset (at risk for developing the disease). Accounting for the potential impact of these initiatives on disease occurrence, the authors have revisited the prevalence of HCM in the general population. They suggest that HCM is more common than previously estimated, which may enhance its recognition in the practicing cardiovascular community, allowing more timely diagnosis and the implementation of appropriate treatment options for many patients.
Allison N. Capizzi, J. Woo, Monica Verduzco-Gutierrez
Traumatic brain injury (TBI) is an acquired insult to the brain from an external mechanical force that may result in temporary or permanent impairment. The goal of this article is to provide a general review of the epidemiology, pathophysiology and medical management of adult patients with TBI for providers practicing outside the field of physical medicine and rehabilitation. The medical and rehabilitation management of moderate to severe TBI is the focus of this article, with a brief discussion of the management of mild injuries.
In the last years, consumers are paying much more attention to natural medicines and principles, mainly due to the general sense that natural compounds are safe. On the other hand, there is a growing demand by industry for plants used in traditional medicine that could be incorporated in foods, nutraceuticals, cosmetics, or even pharmaceuticals. Glycyrrhiza glabra Linn. belongs to the Fabaceae family and has been recognized since ancient times for its ethnopharmacological values. This plant contains different phytocompounds, such as glycyrrhizin, 18β‐glycyrrhetinic acid, glabrin A and B, and isoflavones, that have demonstrated various pharmacological activities. Pharmacological experiments have demonstrated that different extracts and pure compounds from this species exhibit a broad range of biological properties, including antibacterial, anti‐inflammatory, antiviral, antioxidant, and antidiabetic activities. A few toxicological studies have reported some concerns. This review addresses all those issues and focuses on the pharmacological activities reported for G. glabra. Therefore, an updated, critical, and extensive overview on the current knowledge of G. glabra composition and biological activities is provided here in order to explore its therapeutic potential and future challenges to be utilized for the formulation of new products that will contribute to human well‐being.
a Department of Pediatrics, National Taiwan University Children’s Hospital and National Taiwan University College of Medicine, Taipei, Taiwan b Department of Pediatrics, New Taipei City Hospital, New Taipei City, Taiwan c Department of Pediatrics, Section of Infection, Taichung Veterans General Hospital, Taichung, Taiwan d Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine at Linkou, Taoyuan, Taiwan e Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan f Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
Placing a patient in a state of general anesthesia is crucial for safely and humanely performing most surgical and many nonsurgical procedures. How anesthetic drugs create the state of general anesthesia is considered a major mystery of modern medicine. Unconsciousness, induced by altered arousal and/or cognition, is perhaps the most fascinating behavioral state of general anesthesia. We perform a systems neuroscience analysis of the altered arousal states induced by five classes of intravenous anesthetics by relating their behavioral and physiological features to the molecular targets and neural circuits at which these drugs are purported to act. The altered states of arousal are sedation-unconsciousness, sedation-analgesia, dissociative anesthesia, pharmacologic non-REM sleep, and neuroleptic anesthesia. Each altered arousal state results from the anesthetic drugs acting at multiple targets in the central nervous system. Our analysis shows that general anesthesia is less mysterious than currently believed.
Cristina Mocanu (Chitan), Radu-Cristian Cimpeanu, Teodor Salmen
et al.
<i>Background and Objectives:</i> Peripheral neuropathy (PNP) is a frequent and debilitating complication among patients with diabetes mellitus (DM) and other metabolic conditions, substantially affecting morbidity, functional status, and quality of life. Identifying predictors of PNP is essential for optimizing early diagnostic strategies and improving long-term management outcomes. The aim of this study was to determine the predictive factors of PNP in a cohort of patients with DM. <i>Materials and Methods:</i> A cross-sectional study including 117 patients diagnosed with DM assessed for PNP was conducted. All patients were evaluated clinically and biologically. PNP was clinically assessed using the Toronto Clinical Scoring System (TCSS) score and sudomotor function by Sudoscan. <i>Results:</i> The patients included were mostly males with type 2 DM and metabolic syndrome phenotypes. Moreover, the patients with PNP were much older than those without PNP (65 [57–69] vs. 59.50 [46–68] years, <i>p</i> = 0.008), with a longer duration of DM (10 [6–15.50] vs. 5.5 (2–14] years, <i>p</i> = 0.019), and associated autonomic diabetic neuropathy (χ<sup>2</sup> = 24.382, <i>p</i> < 0.001). Furthermore, TCSS and Sudoscan were correlated with a history of PNP, especially Sudoscan, which showed a very good discriminative ability for diabetic neuropathy diagnosis (AUC = 0.816). In a multivariable logistic regression including age, DM duration, and HbA1c, age was independently associated with PNP, with each additional year increasing the odds of neuropathy by approximately 6% (OR = 1.06, 95% CI 0.02–1.09, <i>p</i> = 0.002). When age was excluded, DM duration showed a borderline association with PNP (OR = 1.055, CI95% 0.997–1.117), suggesting potential overlap between these variables. Adding sudomotor assessment to the initial model improved the model performance (AUC 0.70–0.72). <i>Conclusions</i>: Age emerged as the main independent predictor of diabetic neuropathy, highlighting the role of cumulative metabolic exposure in the development of neural damage. Moreover, sudomotor assessment may have a complementary role in PNP assessment.
Chanisra Suebbook, Raiwada Sanguantrakul Teeracharoensub, Pongtong Puranitee
et al.
Purpose To develop a culturally and locally validated and reliable questionnaire for clinical teacher evaluation containing constructs specific to the Thai resident learning context. Methods We followed seven steps for developing questionnaires for educational research. We generated a list of good clinical teacher attributes from a literature review and focus groups. The Delphi procedure was employed to identify the desirable characteristics for residents, involving three stakeholder groups. The content validity index (CVI) of each item was calculated. The average CVI across the items was greater than 0.8, indicating an acceptable level of reliability. Residents then underwent cognitive interviews before pilot testing of the questionnaire. Construct validity was examined using exploratory factor analysis. Reliability was measured using Cronbach’s alpha analysis. Results We identified 44 key clinical teacher characteristics through a literature review and focus groups. After two rounds of the Delphi procedure (35 panelists), 23 characteristics were selected. An initial 23-item questionnaire was developed with a high CVI score. A total of 216 completed questionnaires evaluating 36 clinical teachers were analyzed. Exploratory factor analysis yielded a two-factor model within a 20-item questionnaire. The clinical facilitator domain contained 14 items. The professional identity support domain included six items. Cronbach’s alpha of the model was 0.976. Conclusion A clinical teacher evaluation questionnaire for Thai residents was developed with robust validity and reliability. This validated tool not only allows systematic assessment and improvement of clinical teaching but also provides a replicable framework for developing culturally adapted teacher evaluation instruments in other settings.
Homayoun Sadeghi-Bazargani, Ali Jafari-Khounigh, Hamid Sharifi
et al.
Background — Travel restrictions and adhering to health protocols while traveling was among the key strategies to combat COVID-19 pandemic.
Objective — The present study aims to measure and evaluate travel patterns and compliance with COVID-19 prevention protocols during traveling.
Methods — In this cross-sectional study, 589 individuals from the capitals of six provinces of Iran were included in the study using the cluster sampling method. There were 40 clusters. For data analysis, the mean value of responses in each individual was calculated for each section of the questionnaire.
Results — The response rate was 92% (589/640). Of all participants, 309 (52.5%) were women. The mean age of study participants was 42.84 years (SD=16.59). Among participants, 355 (60.3%) had a travel history during the COVID-19 pandemic. We revealed statistically significant relationships of the travel history with age (P<0.001), education level (P<0.001), and province (P<0.001). No statistically significant relationships of the travel history with socioeconomic status (SES), gender, and occupation subgroup were detected (P>0.05). The majority of study participants (38.5%) traveled for recreational purposes.
Conclusion: According to our findings, unnecessary travel was not avoided in Iran during the COVID-19 pandemic. Most of the participants who traveled during the COVID-19 pandemic did not follow safety precautions. Thus, some of the most important issues such as cultural influences, different risk tolerance levels among people, law enforcement, and stricter oversight by decision makers need to be taken into account.
Introduction. The health of centenarians is a major focus in global studies. Dyslipidemia is directly linked to the risk of cardiovascular diseases, which pose a growing burden on healthcare due to the increasing elderly population. Studying the lipid profiles of centenarians is important for preventing circulatory system diseases and promoting healthy aging. This research aims to compare the prevalence of dyslipidemia in centenarians (median age 96 [95-97]) with elderly individuals (median age was 69 [64 – 74]) in the Republic of Kazakhstan and examine potential predictors of dyslipidemia in the centenarian group.
Methods. The study involved 46 centenarians (study group) and 82 elderly individuals (control group). Statistical analysis was used to process the data, including blood markers and demographic variables, to identify factors contributing to dyslipidemia.
Results and conclusion. The prevalence of hypercholesterolemia in centenarians was 32.6% (15 people - 3 men; 12 women), with elevated LDL levels in 4.3% (2 women). In the control group, hypercholesterolemia prevalence was 29.3% (24 people - 6 men; 18 women) and elevated triglycerides in 6.1% (3 women; 2 men). The study and control groups were compared based on their lipid profile characteristics, which showed similarities as indicated by all p-values being above 0.05: Cholesterol (p=0.348), HDL (p=0.975), LDL (p=0.161), and Triglycerides (p=0.159). Decreased physical activity was a predictor of dyslipidemia in centenarians. Excessive cholesterol levels were significantly higher among women than men in both groups. The primary factor for dyslipidemia was low physical activity, with other predictors having no significant impact on the lipid profiles of centenarians. This factor should be considered when assessing cardiovascular disease risks and all-cause mortality.