Hasil untuk "Medical technology"

Xiaoyun Zhou, C. Snoswell, L. Harding et al.

Xiaoyun Zhou, MMH Centaine L. Snoswell, PhD, MPH, BPharm, Louise E. Harding, DipMLS, Matthew Bambling, PhD, Sisira Edirippulige, PhD, Xuejun Bai, PhD, and Anthony C. Smith, PhD, MEd, BN, RN Centre for Online Health, Centre for Health Services Research; Centre for Health Services Research; and Faculty of Medicine, The University of Queensland, Brisbane, Australia. Academy of Behavior and Psychology, Tianjin Normal University, Tianjin, China. Centre for Innovative Medical Technology, University of Southern Denmark, Odense, Denmark.

Joost J. M. van Griethuysen, Andrey Fedorov, Chintan Parmar et al.

J. Allison, K. Amako, J. Apostolakis et al.

Geant4 is a software toolkit for the simulation of the passage of particles through matter. It is used by a large number of experiments and projects in a variety of application domains, including high energy physics, astrophysics and space science, medical physics and radiation protection. Over the past several years, major changes have been made to the toolkit in order to accommodate the needs of these user communities, and to efficiently exploit the growth of computing power made available by advances in technology. The adaptation of Geant4 to multithreading, advances in physics, detector modeling and visualization, extensions to the toolkit, including biasing and reverse Monte Carlo, and tools for physics and release validation are discussed here.

S. Movassaghi, M. Abolhasan, J. Lipman et al.

B. T. T. Yeo, Fenna M. Krienen, J. Sepulcre et al.

S. Agostinelli, J. Allison, K. Amako et al.

P. Siegel

D. Bates, Michael Cohen, L. Leape et al.

S. Nagata

D. Mangelsdorf, C. Thummel, M. Beato et al.

A. Franz, T. Haidegger, W. Birkfellner et al.

Jinghao Mu, Jian Xiong, Shunchang Zhou et al.

BackgroundEstrogen homeostasis is crucial for the structure and function of the urethra, and estrogen deprivation resulting from menopause, ovariectomy, or ovarian dysfunction may lead to various urethral dysfunctions. However, the specific molecular mechanisms involved are still not fully understood.MethodsUrethras from three ovariectomized (OVX) rats and three Sham rats were collected for snRNA-seq analysis. Data analysis included unsupervised clustering using the UMAP algorithm to identify distinct cell types based on marker gene expression. Differential gene expression analysis was performed to identify changes in estrogen-related gene expression across different cell types. Functional enrichment analysis was conducted to elucidate biological pathways associated with differentially expressed genes. Additionally, cellular interactions and developmental trajectories were analyzed to characterize cellular dynamics during menopause.ResultsHere, we profiled 69,529 single-nucleus transcriptomes from rat urethra (three OVX rats and three Sham rats). The snRNA-seq analysis revealed pronounced cellular heterogeneity and menopause-associated transcriptional reprogramming. We identified Fos as a key transcription factor associated with epithelial cell communication and differentiation under estrogen-deprived conditions. In addition, basal epithelial cells displayed EMT-associated transcriptional programs and a potential epithelial-to-mesenchymal continuum toward a mesenchymal-like state in OVX rats. We also identified Tmem233 as a hub gene in a striated muscle contraction-related module enriched in type IIa myofibers, and observed heightened inflammatory activation in immune cells, particularly T cells, in OVX rats.ConclusionIn summary, our study provides a comparative analysis of the snRNA-seq data from the urethra of female rats, elucidating cellular and molecular changes during menopause.

Yi Dong, Juan Cheng, Yun-Lin Huang et al.

Purpose This study aimed to evaluate the contrast-enhanced ultrasound with Sonazoid (Sonazoid-CEUS) features of hepatocellular carcinoma (HCC) in patients with non-alcoholic fatty liver disease (NAFLD). Methods In this retrospective study, patients who underwent surgical resection and were histopathologically diagnosed with NAFLD or cirrhosis-related HCC were included. All patients received Sonazoid-CEUS examinations within 1 week prior to hepatic surgery. The enhancement patterns of HCC lesions were evaluated and compared between the two groups according to the current World Federation for Ultrasound in Medicine and Biology guidelines. Multivariate logistic regression analysis was used to assess the correlations between Sonazoid-CEUS enhancement patterns and clinicopathologic characteristics. Results From March 2022 to April 2023, a total of 151 patients with HCC were included, comprising 72 with NAFLD-related HCC and 79 with hepatitis B virus (HBV) cirrhosis–related HCC. On Sonazoid-CEUS, more than half of the NAFLD-related HCCs exhibited relatively early and mild washout within 60 seconds (54.2%, 39/72), whereas most HBV cirrhosis–related HCCs displayed washout between 60 and 120 seconds (46.8%, 37/79) or after 120 seconds (39.2%, 31/79) (P<0.001). In the patients with NAFLD-related HCC, multivariate analysis revealed that international normalized ratio (odds ratio [OR], 0.002; 95% confidence interval [CI], 0.000 to 0.899; P=0.046) and poor tumor differentiation (OR, 21.930; 95% CI, 1.960 to 245.319; P=0.012) were significantly associated with washout occurring within 60 seconds. Conclusion Characteristic Sonazoid-CEUS features are useful for diagnosing HCC in patients with NAFLD.

Muhammad Azreen Mat Husin, Adrian Anthony Peirera, Thana Seelan et al.

Economic migrant workers are crucial for a country's development but may also contribute to transboundary transmission of antimicrobial resistance (AMR). This study aimed to investigate the silent carriage of ESBL-producing Escherichia coli (ESBLEC) and Klebsiella pneumoniae (ESBLKP) among economic migrants from Indonesia, Bangladesh and Nepal residing in Klang Valley, Malaysia. Between December 2023 and May 2024, 263 study participants of Indonesian, Bangladeshi, and Nepalese migrant communities were recruited and rectal swabs collected. Swabs were then cultured on CHROMagar™ ESBL; presumptive ESBL-positive strains were confirmed and antimicrobial susceptibility-tested using a VITEK 2 system. ESBL genotyping was also performed on confirmed isolates. A total of 67 and five strains were confirmed as ESBLEC and ESBLKP, respectively. Both ESBLEC and ESBLKP strains showed similar resistance to penicillin and 3rd generation cephalosporins, though more ESBLKP strains were resistant to 4th generation cephalosporins. More ESBLEC strains were resistant to ciprofloxacin. No carbapenem-resistant strains were detected. The blaCTX-M-1 gene family was predominantly found in ESBLEC strains from all three nationalities, while ESBLKP strains frequently harboured blaTEM, blaCTX-M, and blaSHV genes. The prevalence of ESBL-producing strains was highest among Bangladeshi participants (n = 16, 31.4 %), followed by Indonesians (n = 47, 29.7 %) and Nepalis (n = 9, 19.1 %) working in domestic or manufacturing sectors. These findings highlight the public health risks of high ESBLEC and ESBLKP carriage in healthy migrant workers, which may impact recruitment and retention, leading to labour shortages and higher costs. Screening and increased awareness are crucial to limit the spread of these pathogens.

Ze Yang, Tian-Tian Pang, Zhuo-Jun Wu et al.

Abstract Background The diagnostic yield of conventional gastrointestinal (GI) endoscopy for early cancers is low because it is mainly based on morphological changes of tumors. Molecular functional changes in tumors precede morphological changes. Cherenkov luminescence endoscopy (CLE) system can perform molecular imaging of GI cancers, achieving early diagnosis of cancers. However, previous CLE systems had only been able to detect Cherenkov luminescence (CL) from about one μCi nuclide at a minimum (in vivo), but the nuclide probe absorbed by the tumor of a patient was often much less than one μCi at a routinely administered dose. This study aims to construct a clinically usable high-sensitivity CLE for molecular imaging of GI cancers. Results The minimum resolvable radioactivity of the CLE reached 0.020 μCi within 300 s (in vivo), with a sensitivity at the nanocurie for the first time. The detection sensitivity of the CLE increased by up to nearly twenty-two times over the previous system. In tumor-bearing nude mice, CLE could effectively identify all tumors with 100% concordance with both histopathology and PET/CT, and the CL signals of tumors were much stronger than those of the surrounding normal tissues (P < 0.05). The quality of CLE imaging at 60 s was comparable to that at 300 s (signal-to-background ratio, 2.70 ± 0.48 versus 2.98 ± 0.69, P = 0.56). Conclusions We constructed a high-sensitivity CLE that could detect radionuclides at the nanocurie radioactivity. The CLE could detect cancers accurately through rapid molecular imaging and had the potential for early diagnosis of GI cancers in clinical practice.

Ahmed Azeez Hasan, Anis Kausar Ghazali, Najib Majdi Yaacob et al.

Objectives This study aimed to validate the psychometric properties of the recently developed knowledge, attitudes, and perceptions questionnaire for community-based surveillance of infectious diseases (KAP-CBS-ID questionnaire), using confirmatory factor analysis (CFA) and item response theory (IRT). Methods A cross-sectional study using multistage sampling recruited 470 schoolteachers from Kelantan, Malaysia. The self-administered KAP-CBS-ID questionnaire consists of 3 domains: knowledge (31 items), attitudes (23 items), and perceptions (21-items). Two-parameter logistic (2-PL) IRT analysis and CFA were performed to validate the knowledge section. For attitudes and perceptions sections, CFA proceeded using a 4-factor model to evaluate both model fit and construct validity. Results Two-PL IRT analysis of the knowledge section resulted in elimination of 14 items due to inadequate discrimination or difficulty parameters. The 3-factor CFA model demonstrated good fit indices for knowledge (root mean square error of approximation [RMSEA], 0.028; comparative fit index [CFI], 0.945; Tucker-Lewis index [TLI], 0.941) without any modifications. The attitudes section required re-specification, ultimately yielding 21 items across 4 factors with acceptable fit indices (standardized root mean square residual [SRMR], 0.067; RMSEA, 0.055; CFI, 0.937; TLI, 0.927). Similarly, the perceptions section was refined to 17 items across 4 factors, showing good model fit (SRMR, 0.055; RMSEA, 0.059; CFI, 0.962; TLI, 0.954). Factor loadings ranged from 0.33 to 0.98, while Raykov’s rho reliability estimates ranged from 0.71 to 0.93. Factor determinacy exceeded 80% for all factors. Conclusion The KAP-CBS-ID is a valid and reliable instrument for assessing community representatives’ knowledge, attitudes, and perceptions regarding community-based surveillance of infectious diseases.

Shengsong Xu, Linling Li, Yingting Zhu et al.

Abstract Background Previous Artificial Intelligence (AI) models are mainly based on hospital data to predict myopia progression in myopic children. However, school-level AI models for predicting myopia onset in non-myopic children are lacking. There is a need for more precise and comprehensive tools for full myopia management, from the onset of myopia to its progression. Methods This study was conducted in 870 centers dispersed across seven cities in China from September 2019 to December 2021, with participants observed for two years. Machine learning models were trained and internally validated on datasets from Shenzhen, and then externally tested from the other six cities. Of 1,123,602 children and adolescents aged 4–18 years old, 1,105,271 individuals were confirmed eligible. After two-year follow-up, 915,991 individuals were included in analysis. Data were analyzed from June 2022 to July 2023. Main outcomes and measures are the occurrence of myopia, and the change of spherical equivalent refraction in 2 years. Results Of 915,991 participants, 405,784 (44.3%) were identified as myopic at baseline. In two years, the occurrence of myopia was 45.5% and the overall myopic shift was − 0.97 ± 1.32D. The optimal machine learning models were established for predicting myopia occurrence in non-myopic individuals; and predicting progression of any amount (defined as an annual progression of < − 0.25D) in myopic individuals. The performance in predicting occurrence (AUC 0.962, 95% CI 0.956–0.968) and progression (AUC 0.923, 95% CI 0.912–0.934) were acceptable in the external test set. The interactions between age and other variables were revealed by the algorithms, and hence the final prediction models were established based on age segmentation. In the external test set, the performance of the models for both 4–11-years (occurrence prediction: AUC 0.978, 95% CI 0.972–0.984; progression prediction: AUC 0.957, 95% CI 0.951–0.963) and 11–18-years age groups (occurrence prediction: AUC 0.966, 95% CI 0.960–0.972; progression prediction: AUC 0.928, 95% CI 0.917–0.939) were improved. Finally, user-friendly software was developed, which makes this model accessible for school use. Conclusions The algorithm developed in the current study for predicting myopia occurrence and progression showed excellent performance in school settings using real-world data, indicating its potential application in school-level myopia management. Trial registration chictr.org Identifier: ChiCTR2200057391.

Se Young Kim, Dae Ho Kim, Min Ji Kim et al.

With increasing electronic medical data and the development of artificial intelligence, clinical decision support systems (CDSSs) assist clinicians in diagnosis and prescription. Traditional knowledge-based CDSSs follow an accumulated medical knowledgebase and a predefined rule system, which clarifies the decision-making process; however, maintenance cost issues exist in the medical data quality control and standardization processes. Non-knowledge-based CDSSs utilize vast amounts of data and algorithms to effectively make decisions; however, the deep learning black-box problem causes unreliable results. EXplainable Artificial Intelligence (XAI)-based CDSSs provide valid rationales and explainable results. These systems ensure trustworthiness and transparency by showing the recommendation and prediction result process using explainable techniques. However, existing systems have limitations, such as the scope of data utilization and the lack of explanatory power of AI models. This study proposes a new XAI-based CDSS framework to address these issues; introduces resources, datasets, and models that can be utilized; and provides a foundation model to support decision-making in various disease domains. Finally, we propose future directions for CDSS technology and highlight societal issues that need to be addressed to emphasize the potential of CDSSs in the future.

Taijyu Satoh, Nobuhiro Yaoita, Satoshi Higuchi et al.

ABSTRACT Patients with borderline pulmonary hypertension (PH) often experience shortness of breath or exacerbation of PH during exercise, known as exercise‐induced PH. However, the pathogenesis of exercise‐induced post‐capillary PH (post‐EIPH) and its treatment strategies remain unclear. Recent guidelines and consensus documents have highlighted the benefits of sodium‐glucose cotransporter‐2 (SGLT2) inhibitors in heart failure and chronic kidney disease (CKD). This study aimed to investigate the effects of SGLT2 inhibitors in patients with post‐EIPH and CKD. This single‐center prospective cohort study enroled 10 patients with CKD (age, 68 years; female, 60%) who exhibited post‐EIPH between 1 July 2022 and 31 December 2023. Post‐EIPH was defined as a pulmonary capillary wedge pressure (PCWP)/cardiac output (CO) slope > 2 and peak PCWP during exercise ≥ 25 mmHg measured by catheterization. The patients received SGLT2 inhibitor treatment for 6 months. At rest, patients with post‐EIPH had borderline‐PH (21.5 ± 1.8 mmHg), with preserved left and right ventricular function. SGLT2 inhibitors treatment significantly reduced the PCWP/CO slope during exercise (3.9 ± 1.2 vs. 2.4 ± 1.2 mmHg/L/min, p = 0.013) and improved the 6‐min walking distance (489.9 ± 80.2 vs. 568.3 ± 91.9 m, p = 0.014). Magnetic resonance imaging revealed a lower left ventricular global longitudinal strain in patients with post‐EIPH, which was increased by SGLT2 inhibitor treatment (−13.8 ± 2.0 vs. −17.3 ± 2.0%, p = 0.003). SGLT2 treatment inhibitors mitigated post‐EIPH hemodynamic abnormalities and exercise intolerance, suggesting their potential as its therapeutic option.

Kunpeng Liu, Haitao Gong, Binbin Jiao et al.

This study aims to evaluate the therapeutic potential of cationic liposomal neostigmine bromide (NB), a novel drug delivery system, for the treatment of detrusor underactivity. By comparing the characteristics of NB‐liposomes (NLP), NB‐β‐cyclodextrin inclusion complex liposomes (NCLP), and NB‐mesoporous silica nanoparticle@CaCO3 liposomes (NMCLP), NMCLP is selected as the main research subject. It has an average particle size and zeta potential of 100 nm and +50 mV, and its encapsulation efficiency and loading capacity of NB are 14.75% and 12.8%, respectively. Most importantly, NMCLP shows the best in vitro release performance among the three liposomes, demonstrating its ability in sustained release of NB. During cell and animal assays, efficient cellular uptake of liposomes through liposome‐specific pathways is observed, facilitating targeted drug delivery, and in vivo experiments demonstrate the efficacy of NMCLP in improving bladder function in mice. Urodynamic measurements show increased bladder capacity and reduced voiding pressure, indicating enhanced bladder muscle activity. Histological analysis reveals the distribution and deep penetration of NMCLP within bladder tissues, supporting its localized drug effect. Therefore, NMCLP holds promise as a targeted and effective therapeutic strategy for detrusor underactivity.