Hasil untuk "Medicine (General)"

S. Counce

garded as a general introduction to the interesting new field of atomic medicine, it covers a vast amount of information on radioisotopes which are used in medical research, diagnosis, and therapy. The background of nuclear physics on each aspect of this new field of medicine is concisely explained. The medical use of high energy particle accelerators such as cyclotron, betatron, synchrotron, and linear accelerators are briefly described. The linear accelerator is considered as the machine which has real practical value in radiotherapy. In radiotherapy today in England there is considerable competition between linear accelerator and large telecurie units, such as Cobalt-60 or Cesium-137. Both these developments are important by-products of atomic energy development. The three dangerous biological effects of radiation to man are discussed in some detail: (1) immediate danger of tissue damage from individual high exposure, (2) long-term danger of chronic damage to tissue with possible induction of cancer, (3) remote but important danger of permanent genetic damage that may seriously affect future generations. The common levels of radiation exposure are listed in detail based on the data published in Great Britain. Some interesting estimated figures on radiation received by the whole population of Great Britain to reproductive organs in the first 30 years of life as a genetic hazard are abstracted as follows: Natural body radioactivity, 690 mr. The dose required to double human mutation rate is estimated to be 50,000 mr. The author also stresses the opinion that genetic damage by radiation is not yet fully understood and must be worked out as one of our most urgent problems. The material chosen is mainly from the British sources and is based on a comprehensive review of the literature of the subject. The illustrations .are excellent but no bibliography is appended. It is easy and pleasing to read and it should be recommended to medical students, nurses, and physicians who want to have a general and up-to-date view of this subject. "How does development produce entities which have Form, in the sense of integration or wholeness; how does evolution bring into being organisms which have Ends, in the sense of goal-seeking or directiveness?" An examination of these questions provides the unifying theme for this collection of essays which are Professor Waddington's most recent contribution to theoretical biology. Although portions of four of the five essays have appeared elsewhere in different form, they are essentially new and contain much …

D. Powell, B. Abramson, J. Balint et al.

D. Lindberg, B. Humphreys, A. McCray

T. Pawlik, K. Devon, C. Fields et al.

A. Coronato, Muddasar Naeem, G. Pietro et al.

Discovering new treatments and personalizing existing ones is one of the major goals of modern clinical research. In the last decade, Artificial Intelligence (AI) has enabled the realization of advanced intelligent systems able to learn about clinical treatments and discover new medical knowledge from the huge amount of data collected. Reinforcement Learning (RL), which is a branch of Machine Learning (ML), has received significant attention in the medical community since it has the potentiality to support the development of personalized treatments in accordance with the more general precision medicine vision. This report presents a review of the role of RL in healthcare by investigating past work, and highlighting any limitations and possible future contributions.

C. Dietrich, C. Nolsøe, R. G. Barr et al.

The present, updated document describes the fourth iteration of recommendations for the hepatic use of contrast-enhanced ultrasound, first initiated in 2004 by the European Federation of Societies for Ultrasound in Medicine and Biology. The previous updated editions of the guidelines reflected changes in the available contrast agents and updated the guidelines not only for hepatic but also for non-hepatic applications. The 2012 guideline requires updating as, previously, the differences in the contrast agents were not precisely described and the differences in contrast phases as well as handling were not clearly indicated. In addition, more evidence has been published for all contrast agents. The update also reflects the most recent developments in contrast agents, including U.S. Food and Drug Administration approval and the extensive Asian experience, to produce a truly international perspective. These guidelines and recommendations provide general advice on the use of ultrasound contrast agents (UCAs) and are intended to create standard protocols for the use and administration of UCAs in liver applications on an international basis to improve the management of patients.

D. Roden, H. McLeod, M. Relling et al.

Genomic medicine, which uses DNA variation to individualise and improve human health, is the subject of this Series of papers. The idea that genetic variation can be used to individualise drug therapy-the topic addressed here-is often viewed as within reach for genomic medicine. We have reviewed general mechanisms underlying variability in drug action, the role of genetic variation in mediating beneficial and adverse effects through variable drug concentrations (pharmacokinetics) and drug actions (pharmacodynamics), available data from clinical trials, and ongoing efforts to implement pharmacogenetics in clinical practice.

D. Bonderman

SummaryDecision-making is complex in modern medicine and should ideally be based on available data, structured knowledge and proper interpretation in the context of an individual patient. Automated algorithms, also termed artificial intelligence that are able to extract meaningful patterns from data collections and build decisions upon identified patterns may be useful assistants in clinical decision-making processes. In this article, artificial intelligence-based studies in clinical cardiology are reviewed. The text also touches on the ethical issues and speculates on the future roles of automated algorithms versus clinicians in cardiology and medicine in general.

Neha Kumari, Ashita Kalaskar, Nishant Gupta

Background: The most frequent consequence of osteoporosis is osteoporotic fractures, which commonly affect older women and rise with age. The gold standard for measuring bone mineral density (BMD), Dual-Energy X-ray Absorptiometry (DEXA), is helpful in diagnosing osteoporosis. Cone beam computed tomography (CBCT), is the popular dental radiography technique that shows promise for early osteoporosis identification and referral. Objective: To assess the reliability of CBCT-based radiomorphometric indices - Cortical Index (CTCI), Mental Index (CTMI), Computed Tomography Mandibular Index (CTI (S), CTI (I), and CTI), Bone Density of Mandibular Condyle (BDMC) in predicting osteoporosis in postmenopausal women, and to correlate them with DEXA (Dual-Energy X-ray Absorptiometry) findings. Methods: A CBCT scan of 60 postmenopausal females aged over 45 years was analyzed for radiomorphometric indices. Subjects who exhibited positive osteoporosis symptoms, such as ankle pain, restricted joint movement, and vertebral fracture was assessed by Osteoporosis Risk Assessment Instrument (ORAI) and subsequently referred for DEXA scanning of spine and femur. Results: All radiomorphometric indices showed statistically significant differences across groups, except CTI (I). BDMC Showed a moderate positive correlation with DEXA T-score. Conclusion: CBCT-based radiomorphometric indices and BDMC could be used as a screening tool to predict and hence identify postmenopausal women with low BMD.

Bilu Gu, Yiming Lv, Jiyu Zhu et al.

BackgroundHumanistic care is a good glue for the doctor-patient relationship, and it is a general trend to improve the practice of humanistic care.MethodsA narrative research method was used to conduct semi-structured interviews with 18 master’s degree nursing students from China who were in the clinical rotation stage, and the data were content analyzed and explored from the perspective of the learners who were learning about humanistic caring practices using the social learning theory model.ResultsThere is a triple tension structure in the practice of humanistic care: At the cognitive level, there is a knowledge-activity rupture, with learners showing theoretical clarity but practical confusion. At the environmental level, it is divided into the dual role of facilitating and inhibiting environments. “rewarding” environments included positive psychological attitudes of patients, caring-friendly departmental environment, perceptually rewarding mindfulness environment, and loving family environment. In contrast, “punishing” environments included patients’ irresponsible attitudes toward themselves, poor care experiences, inflexible management mechanisms, missing incentives. At the behavioral level, there is a dialectical game between constructive and alienating practices. “forward” behaviors included personalized care in the details, respect for patient autonomy, proactive communication and empathy, systemic support and teamwork. Conversely, “backward” behaviors included mechanized procedures and emotional detachment, disregard for privacy and dignity, systemic issues that exacerbate apathy.ConclusionBased on the framework of social learning theory, this study constructs a learning trajectory model of humanistic care to explain the synergistic mechanism between cognitive dimension and environmental system and its two-way shaping of caring practice behavior. The study finds that there is a “black box” phenomenon in which the theory of humanistic care is clear but the practice of humanistic care is confusing in the cognitive dimension, and in the environmental dimension, there are systematic limitations in the traditional biomedical model. Based on the above two-dimensional analysis, this study proposes an optimization path combining cognitive explicit cultivation and environmental support system reconstruction, which points out the direction for breaking through the dilemma of humanistic care practice.

Claire Delehouzé, Melodie Mallais, Arnaud Comte et al.

Abstract In the past two decades, various non-apoptotic pathways of regulated cell death have been identified; a small subset of these, including necroptosis and ferroptosis, manifests the phenotypic features of necrotic death. These two regulated necroses are being extensively studied because of their putative roles in severe acute and chronic pathologies. Moreover, as these regulated necrotic pathways are coactivated in a number of common pathologies, the development of multi-target directed ligands (that is, the use of a polypharmacological strategy) is a path-breaking avenue of research. In this study, we determined that the 7-azaindole derivative, sibiriline, inhibited both RIPK1-driven necroptosis (induced by Tumor Necrosis Factor-α) and ferroptosis (triggered by various classes of ferroptosis inducers), with EC50s against each in the µM range. We next performed a combined large-scale transcriptomic study in order to determine the molecular mechanisms of action of sibiriline. We identified the stress response protein heme oxygenase-1 (HMOX1) as the main biomarker of ferroptosis inhibition by sibiriline. We hypothesized that this compound reacts as an antioxidant to block ferroptosis; indeed, we found that sibiriline inhibits lipid peroxidation by trapping phospholipid-derived peroxyl radicals as a radical-trapping antioxidant (RTA). Taken together, these results show that sibiriline is a new dual inhibitor of necroptosis and ferroptosis cell death pathways; it works by inhibition of both RIPK1 kinase and (phospho)lipid peroxidation. We also demonstrate the in vitro efficacy of sibiriline to inhibit cell death in cell-based models of Parkinson’s disease and cystic fibrosis. These findings shed light on the high therapeutic potency of RIPK1 inhibitors with RTA activity.

Andrew T. Wolanin, E. Hong, D. Marks et al.

N. Stanton, E. Angova, K. Diamantopoulos

Introduction Sexual dysfunction (SD) is common in psychotic illness including schizophrenia, occurring in 30-82% of patients. It negatively impacts wellbeing and antipsychotic compliance, resulting in higher risk of relapse and hospitalisation. Due to over-reliance on spontaneous reports from patients, SD is typically under-identified which prevents investigation and treatment. Objectives To establish whether SD is under-identified in patients with psychosis in a general adult community mental health team; to elicit whether the Arizona Sexual Experience Scale (ASEX) improves identification; to investigate and manage identified cases of SD; to make recommendations about identification and monitoring of SD in this patient population. Methods A 12-month retrospective audit of patients with psychosis prescribed a long-acting injectable (LAI) antipsychotic (n=36) to identify sexual symptoms was completed. The ASEX was subsequently issued to screen for SD. Results Audit: 3/36 (8%) patients had documented sexual symptoms. Of the 18/36 patients that completed the ASEX: 10 (56%) exhibited SD. 4 consented to further investigation. 5 patients experienced significant difficulties with the language used in the ASEX. At the end of the project we revised the ASEX with simpler, colloquial language. Conclusions Implementation of the ASEX results in clear improvements in identification and monitoring of SD. Maudsley Practice Guidelines can inform investigation and management of SD. We suggest a review of NICE guidance to incorporate the above into clinical practice. Further work is needed to establish whether the revised ASEX can be developed and validated. Disclosure of Interest None Declared

Na Kyung Lee, Woong Bi Jang, Dong Sik Seo et al.

Cardiovascular disease remains a global health concern. Stem cell therapy utilizing human cardiac progenitor cells (hCPCs) shows promise in treating cardiac vascular disease. However, limited availability and senescence of hCPCs hinder their widespread use. To address these challenges, researchers are exploring innovative approaches. In this study, a bioengineered cell culture plate was developed to mimic the natural cardiac tissue microenvironment. It was coated with a combination of extracellular matrix (ECM) peptide motifs and mussel adhesive protein (MAP). The selected ECM peptide motifs, derived from fibronectin and vitronectin, play crucial roles in hCPCs. Results revealed that the Fibro-P and Vitro-P coated plates significantly improved hCPC adhesion, proliferation, migration, and differentiation compared to uncoated plates. Additionally, long-term culture on the coated plates delayed cellular senescence and maintained hCPC stemness. These enhancements were attributed to the activation of integrin downstream signaling pathways. The findings suggest that the engineered ECM peptide motif-MAP-coated plates hold potential for enhancing the therapeutic efficacy of stem cell-based therapies in cardiac tissue engineering and regenerative medicine.

Lisha Nie, Siyi Li, Bing Wu et al.

Abstract The development of 7‐Tesla (7T) magnetic resonance imaging systems has opened new avenues for exploring the advantages of diffusion imaging at higher field strengths, especially in neuroscience research. This review investigates whether 7T diffusion imaging offers significant benefits over lower field strengths by addressing the following: Technical challenges and corresponding strategies: Challenges include achieving shorter transverse relaxation/effective transverse relaxation times and greater B0 and B1 inhomogeneities. Advanced techniques including high‐performance gradient systems, parallel imaging, multi‐shot acquisition, and parallel transmission can mitigate these issues. Comparison of 3‐Tesla and 7T diffusion imaging: Technologies such as multiplexed sensitivity encoding and deep learning reconstruction (DLR) have been developed to mitigate artifacts and improve image quality. This comparative analysis demonstrates significant improvements in the signal‐to‐noise ratio and spatial resolution at 7T with a powerful gradient system, facilitating enhanced visualization of microstructural changes. Despite greater geometric distortions and signal inhomogeneity at 7T, the system shows clear advantages in high b‐value imaging and high‐resolution diffusion tensor imaging. Additionally, multiplexed sensitivity encoding significantly reduces image blurring and distortion, and DLR substantially improves the signal‐to‐noise ratio and image sharpness. 7T diffusion applications in structural analysis and disease characterization: This review discusses the potential applications of 7T diffusion imaging in structural analysis and disease characterization.

Yesica A. López-Mora, Juan P. Martínez-Hernández, David Gómez-Almaguer

M. Sharpe, D. Wilks

Enrico La Spina, Sebastiano Giallongo, Cesarina Giallongo et al.

Chronic myeloproliferative neoplasms encompass the BCR-ABL1-negative neoplasms polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). These are characterized by calreticulin (CALR), myeloproliferative leukemia virus proto-oncogene (MPL) and the tyrosine kinase Janus kinase 2 (JAK2) mutations, eventually establishing a hyperinflammatory tumor microenvironment (TME). Several reports have come to describe how constitutive activation of JAK-STAT and NFκB signaling pathways lead to uncontrolled myeloproliferation and pro-inflammatory cytokines secretion. In such a highly oxidative TME, the balance between Hematopoietic Stem Cells (HSCs) and Mesenchymal Stromal Cells (MSCs) has a crucial role in MPN development. For this reason, we sought to review the current literature concerning the interplay between HSCs and MSCs. The latter have been reported to play an outstanding role in establishing of the typical bone marrow (BM) fibrotic TME as a consequence of the upregulation of different fibrosis-associated genes including PDGF- β upon their exposure to the hyperoxidative TME characterizing MPNs. Therefore, MSCs might turn to be valuable candidates for niche-targeted targeting the synthesis of cytokines and oxidative stress in association with drugs eradicating the hematopoietic clone.

E. Ernst

E. Ernst, A. White