Hasil untuk "Medicine (General)"

Run-zhi Zhang, Xue Zhu, Hong Bai et al.

The research field of systems biology has greatly advanced and, as a result, the concept of network pharmacology has been developed. This advancement, in turn, has shifted the paradigm from a “one-target, one-drug” mode to a “network-target, multiple-component-therapeutics” mode. Network pharmacology is more effective for establishing a “compound-protein/gene-disease” network and revealing the regulation principles of small molecules in a high-throughput manner. This approach makes it very powerful for the analysis of drug combinations, especially Traditional Chinese Medicine (TCM) preparations. In this work, we first summarized the databases and tools currently used for TCM research. Second, we focused on several representative applications of network pharmacology for TCM research, including studies on TCM compatibility, TCM target prediction, and TCM network toxicology research. Third, we compared the general statistics of several current TCM databases and evaluated and compared the search results of these databases based on 10 famous herbs. In summary, network pharmacology is a rational approach for TCM studies, and with the development of TCM research, powerful and comprehensive TCM databases have emerged but need further improvements. Additionally, given that several diseases could be treated by TCMs, with the mediation of gut microbiota, future studies should focus on both the microbiome and TCMs to better understand and treat microbiome-related diseases.

Jenni A. M. Sidey-Gibbons, C. Sidey-Gibbons

BackgroundFollowing visible successes on a wide range of predictive tasks, machine learning techniques are attracting substantial interest from medical researchers and clinicians. We address the need for capacity development in this area by providing a conceptual introduction to machine learning alongside a practical guide to developing and evaluating predictive algorithms using freely-available open source software and public domain data.MethodsWe demonstrate the use of machine learning techniques by developing three predictive models for cancer diagnosis using descriptions of nuclei sampled from breast masses. These algorithms include regularized General Linear Model regression (GLMs), Support Vector Machines (SVMs) with a radial basis function kernel, and single-layer Artificial Neural Networks. The publicly-available dataset describing the breast mass samples (N=683) was randomly split into evaluation (n=456) and validation (n=227) samples.We trained algorithms on data from the evaluation sample before they were used to predict the diagnostic outcome in the validation dataset. We compared the predictions made on the validation datasets with the real-world diagnostic decisions to calculate the accuracy, sensitivity, and specificity of the three models. We explored the use of averaging and voting ensembles to improve predictive performance. We provide a step-by-step guide to developing algorithms using the open-source R statistical programming environment.ResultsThe trained algorithms were able to classify cell nuclei with high accuracy (.94 -.96), sensitivity (.97 -.99), and specificity (.85 -.94). Maximum accuracy (.96) and area under the curve (.97) was achieved using the SVM algorithm. Prediction performance increased marginally (accuracy =.97, sensitivity =.99, specificity =.95) when algorithms were arranged into a voting ensemble.ConclusionsWe use a straightforward example to demonstrate the theory and practice of machine learning for clinicians and medical researchers. The principals which we demonstrate here can be readily applied to other complex tasks including natural language processing and image recognition.

Marium Malik, M. Tariq, Maira Kamran et al.

T. Shanafelt, S. Boone, Litjen L J Tan et al.

J. Nolan, C. Sandroni, B. Böttiger et al.

The European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) have collaborated to produce these post-resuscitation care guidelines for adults, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics covered include the post-cardiac arrest syndrome, diagnosis of cause of cardiac arrest, control of oxygenation and ventilation, coronary reperfusion, haemodynamic monitoring and management, control of seizures, temperature control, general intensive care management, prognostication, long-term outcome, rehabilitation, and organ donation.

D. Sackett, W. Rosenberg, James Douglas Allan Gray et al.

D. Goldberg, V. Hillier

G. Atkinson, A. Nevill

G. T. Strickland

Part I CLINICAL PRACTICE in the TROPICS. General Principles. Pulmonary Diseases. Cardiovascular Diseases. Gastrointestinal Diseases. Hepatobiliary Diseases. Hematologic Diseases. Urinary Tract Diseases. Dermatologic Diseases. Neurologic Diseases. Opthalmolgic Diseases. Sexually Transmitted Diseases. Malignant Diseases. Surgery. Orthopedics. Maternal and Child Health. Integrated Management of Childhood Illness. Heat-Associated Illness. Traditional Medicine. Health and Nutrition Among. Refugees and Displaced Persons. Environmental and Occupational. Health in the Tropics. Imaging in the Tropics and The. Imaging of Tropical Diseases. Part II VIRAL INFECTIONS. General Principles. Human Immunodeficiency Virus. And AIDS. Human T Cell Lymphotropic Virus. Infections. Viral Infections with Cutaneous Lesions. Viral Respiratory Infections. Enteric Viral Infections. Viral Hepatitis. Viral Febrile Illnesses. Viral Encephalitis. Viral Hemorrhagic Fevers. PART III BACTERIAL INFECTIONS. Section a Infections of the Eye and Throat. Trachoma and Inclusion Conjunctivitis Diphtheria. Section B Respiratory Tract Infections. Q Fever. Psittacosis. Pertussis. Melioidosis. Actinomycoses. Nocardiosis. Section C Gastrointestinal Tract Infections. Shigellosis. Cholera and Other Vibrioses. Diarrhea Caused By Escherichia Coli. Campylobacter Enteritis. Miscellaneous Bacterial Enteritides. Helicobacter PyloriInfections. Section D Sexually Transmitted Infections. Chlamydial Infections. Lymphogranuloma Venereum. Syphilis and the Endemic Treponematoses. Gonococcal Infections. Chancroid. Granuloma Inguinale. Section E Infections Causing Neurological Manifestations. Acute Bacterial Meningitis. Tetanus. Botulism. Section F Infections of Skin and Soft Tissues. Anthrax. Glanders. Gas Gangrene. Pyomyositis. Tropical Phagedenic Ulcer. Section G Febrile Lymphadenitis. Bartonella-Associated Infections. Plague. Tularemia. Pasteurella. Brucellosis. Section H Disseminated Febrile Illnesses. Rickettsial Infections: General. Principles. Typhus. Spotted Fevers. Trench Fever. Scrub Typhus. Ehrlichiosis. Relapsing Fever. Leptospirosis. Lyme Disease. Meningococcal Disease. Typhoid Fever. Nontyphoidal Salmonellosis. Section I Mycobacterial Infections. Tuberculosis. Leprosy. Nontuberculosis Mycobacterial. Part IV the MYCOSES. General Principles. Superficial Mycoses. Subcutaneous Mycoses. Systemic Mycoses. Treatment of Systemic Mycoses. Part V PROTOZOAL INFECTIONS. General Principles. Section a Intestinal and Genital Infections. Amebiasis. Giardiasis. Cryptosporidiosis. Cyclosporiasis. Miscellaneous Intestinal Protozoa. Trichomoniasis. Section B Infections of the Blood and Reticuloendothelial System. Malaria. African Trypanosomiasis. American Trypanosomiasis. Leishmaniasis. Babesiosis. Section C Tissue Infections. Toxoplasmosis. Pneumocystosis. Free-Living Amebic Infections. OtherTissue Protozoa Infections. PART VI HELMINTHIC INFECTIONS. General Principles. Section a Intestinal Nematode Infections. General Principles. Nematodes Limited to the . Intestinal Tract. Intestinal Nematodes That. Migrate Through Lungs. Intestinal Nematodes That. Migrate Through Skin And. Lung. Section B Filarial Infections. Filariasis. Loiasis. Onchocerciasis. Miscellaneous Filarial Infections. Section C Other Tissue Nematode Infections. Dracunculiasis. Trichinosis. Toxocariasis. Gnathostomiasis. Angiostrongyliasis. Cutaneous Larva Migrans. Anisakiasis. Section D Trematode Infections. General Principles. Schistosomiasis. Intestinal Fluke Infections. Liver Fluke Infections. Lung Fluke Infections: Paragonimiasis. Section E Cestode Infections . General Principles. Tapeworm Infections. Larval Cestode Infections. PART VII POISONOUS and TOXIC PLANTS and ANIMALS. Poisonous Plants and Fish. Animals Hazardous to Humans. Pentastomiasis. Injurious Arthropods. PART VIII NUTRITIONAL PROBLEMS and DEFICIENCY DISEASES. General Principles. Protein-Energy Malnutrition. Vitamin Deficiencies. Mineral Deficiencies. Other Nutrition-Related Disorders. PART IX VECTOR TRANSMISSION of DISEASES. General Principles of Infectious . Disease Transmission. Zoonoses. Mollusks Involved in Disease. Transmission. Ticks and Mites in Disease. Transmission. Insects in Disease Transmission. Control of Arthropods of Medical. Importance. PART X TROPICAL DISEASE in a TEMPERATE CLIMATE. General Principles. Establishing a Travel Clinic. Adviceto Travelers. Screening Long Term Travelers. Diarrhea in Travelers. Fever in Travelers. Skin Lesions in Travelers. Eosinophilia in Travelers and Immigrants. Diseases of Immigrants. Global Epidemiology of Infectious Diseases. PART XI LABORATORY DIAGNOSIS of PARASITIC DISEASES. Examination of Stool and Urine Specimens. Examination of Blood, Other Body Fluids, Tissues, And Sputum. Parasitic Immunodiagnosis .

C. Ardern, F. Büttner, R. Andrade et al.

Poor reporting of medical and healthcare systematic reviews is a problem from which the sports and exercise medicine, musculoskeletal rehabilitation, and sports science fields are not immune. Transparent, accurate and comprehensive systematic review reporting helps researchers replicate methods, readers understand what was done and why, and clinicians and policy-makers implement results in practice. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement and its accompanying Explanation and Elaboration document provide general reporting examples for systematic reviews of healthcare interventions. However, implementation guidance for sport and exercise medicine, musculoskeletal rehabilitation, and sports science does not exist. The Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science (PERSiST) guidance attempts to address this problem. Nineteen content experts collaborated with three methods experts to identify examples of exemplary reporting in systematic reviews in sport and exercise medicine (including physical activity), musculoskeletal rehabilitation (including physiotherapy), and sports science, for each of the PRISMA 2020 Statement items. PERSiST aims to help: (1) systematic reviewers improve the transparency and reporting of systematic reviews and (2) journal editors and peer reviewers make informed decisions about systematic review reporting quality.

Yunhan Zhang, Ying Zhang, Jiaoyan Song et al.

Abstract Piezo1 plays a key role in the immune response during sepsis. To date, our understanding of the role of Piezo1 in inflammatory diseases has mostly been limited to influencing vasomotor function and regulating inflammatory infiltration. Whether and how Piezo1 in macrophages is involved in developing septic cardiac dysfunction has never been explored. Here, we have successfully established a mouse model with myeloid cell-specific knockdown of Piezo1. The intraperitoneal injection of lipopolysaccharide (LPS) resulted in a significant increase in cardiac macrophage infiltration, as well as an increase in the expression of inflammatory factors and the inflammatory response. However, myeloid cell-specific knockdown of Piezo1 impaired this response, leading to an increase in macrophage polarization towards the M2 type and the decreased inflammatory response. As a result, myocardial injury caused by sepsis was attenuated. We have also demonstrated that the PI3K/AKT pathway is significantly activated after Piezo1 knockdown, resulting in reduced myocardial dysfunction. Our data indicate that myeloid cell-specific knockdown of Piezo1 can influence macrophage polarization and thus exert cardioprotective effects in a murine model of sepsis, providing potential ideas and targets for the treatment of infectious cardiac dysfunction.

Fuzhuo Wang, Jiashuang Xu, Hong Sun et al.

BackgroundNumerous studies have demonstrated a close association between perceived stress and depression in colorectal cancer patients; however, the underlying mechanisms remain incompletely understood. This study aims to investigate the impact of perceived stress on depression in this population, as well as the mediating role of illness perception and the moderating role of self-efficacy.MethodA cross-sectional design was employed. From May to November 2024, a questionnaire survey was conducted among 290 colorectal cancer patients at two Grade A tertiary hospitals in Shenyang and Jinzhou, Liaoning Province, China. The questionnaire comprised sections on general demographics, perceived stress, illness perception, self-efficacy, and depression. Descriptive statistics and correlation analyses were performed using SPSS 25.0 and the PROCESS 3.5 macro. Mediation and moderation effects were tested using bootstrap resampling.ResultsA significant positive correlation was found between perceived stress and depression (β = 0.483, P < 0.001) and this relationship was partially mediated by illness perception (β = 0.083). Self-efficacy moderated the association between perceived stress and illness perception (β = 0.024, P < 0.001), with higher levels of self-efficacy strengthening the relationship between perceived stress and illness perception.ConclusionThis study identifies illness perception as a mediating pathway in the association between perceived stress and depression, while self-efficacy moderates the relationship between perceived stress and illness perception. Accordingly, a multidimensional clinical approach may be considered for addressing depressive symptoms in colorectal cancer patients. Such an approach could concurrently target perceived stress reduction, modification of illness perception, and enhancing self-efficacy.

M. Beeson, Rahul G Bhat, J. Broder et al.

Laura Oh, MD , ‡ , ∗∗∗ Viral Patel, MD , ††† Loren Touma, DO , ‡‡‡ , §§§ Melissa A. Barton, M.D. , ∗ and Julia N. Keehbauch ∗, 2022 EM Model Review Task Force; Melissa A. Barton, M.D. ∗, and Julia N. Keehbauch ∗ , American Board of Emergency Medicine ∗ American Board of Emergency Medicine, East Lansing, Michigan, ∗American Board of Emergency Medicine, East Lansing, Michigan, † Summa Health, Akron, Ohio, ‡ American College of Emergency Physicians, Irving, Texas, §Medstar Washington Hospital Center, Georgetown University School of Medicine, Washington, District of Columbia, ||Society for Academic Emergency Medicine, Des Plaines, Illinois, ¶Duke University School of Medicine, Durham, North Carolina, #New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, ∗∗Accreditation Council for Graduate Medical Education, Chicago, Illinois, †† Emergency Medicine Residents’ Association, Irving, Texas, ‡‡ Hennepin County Medical Center, Minneapolis, Minnesota, §§American Academy of Emergency Medicine, Milwaukee, Wisconsin, ||||Sentara Norfolk General Hospital, Eastern Virginia Medical School, Norfolk, Virginia, ¶¶Council of Residency Directors in Emergency Medicine, Irving, Texas, ##Virginia Commonwealth University School of Medicine, Richmond, Virginia, ∗∗∗Emory University, Atlanta, Georgia, ††† UMass Chan Medical School, Worcester, Massachusetts, ‡‡‡ American Academy of Emergency Medicine Resident and Student Association, Milwaukee, Wisconsin, and §§§Jefferson Health Northeast Emergency Medicine, Philadelphia, Pennsylvania Reprint Address: Julia N. Keehbauch, American Board of Emergency Medicine, 3000 Coolidge Road, East Lansing, MI 48823

Göktuğ Bender, Samer Faraj, Anand Bhardwaj

Artificial intelligence (AI) has become increasingly central to precision medicine by enabling the integration and interpretation of multimodal data, yet implementation in clinical settings remains limited. This paper provides a scoping review of literature from 2019-2024 on the implementation of AI in precision medicine, identifying key barriers and enablers across data quality, clinical reliability, workflow integration, and governance. Through an ecosystem-based framework, we highlight the interdependent relationships shaping real-world translation and propose future directions to support trustworthy and sustainable implementation.

Kayla H Szymanik, Emily A Rex, Vamshikrishna R Pothireddy et al.

Proper recognition of viral pathogens is an essential part of the innate immune response. A common viral replicative intermediate and chemical signal that cells use to identify pathogens is the presence of a triphosphorylated 5' end (5'ppp) RNA, which activates the cytosolic RNA sensor RIG-I and initiates downstream antiviral signaling. While 5'pppRNA generated by viral RNA-dependent RNA polymerases (RdRps) can be a potent activator of the immune response, endogenous RNA polymerase III (RNAPIII) transcripts can retain the 5'ppp generated during transcription and induce a RIG-I-mediated immune response. We have previously shown that host RNA triphosphatase dual-specificity phosphatase 11 (DUSP11) can act on both host and viral RNAs, altering their levels and reducing their ability to induce RIG-I activation. Our previous work explored how experimentally altered DUSP11 activity can impact immune activation, prompting further exploration into natural contexts of altered DUSP11 activity. Here, we have identified viral DUSP11 homologs (vDUSP11s) present in some avipoxviruses. Consistent with the known functions of host DUSP11, we have shown that expression of vDUSP11s: 1) reduces levels of endogenous RNAPIII transcripts, 2) reduces a cell's sensitivity to 5'pppRNA-mediated immune activation, and 3) restores virus infection defects seen in the absence of DUSP11. Our results identify a context where DUSP11 activity has been co-opted by viruses to alter RNA metabolism and influence the outcome of infection.

M. Rethlefsen, Ann M. Farrell, Leah C Osterhaus Trzasko et al.

In-Gyu Lee, Jun-Young Oh, Hee-Jung Yu et al.

Recently, with increasing interest in pet healthcare, the demand for computer-aided diagnosis (CAD) systems in veterinary medicine has increased. The development of veterinary CAD has stagnated due to a lack of sufficient radiology data. To overcome the challenge, we propose a generative active learning framework based on a variational autoencoder. This approach aims to alleviate the scarcity of reliable data for CAD systems in veterinary medicine. This study utilizes datasets comprising cardiomegaly radiograph data. After removing annotations and standardizing images, we employed a framework for data augmentation, which consists of a data generation phase and a query phase for filtering the generated data. The experimental results revealed that as the data generated through this framework was added to the training data of the generative model, the frechet inception distance consistently decreased from 84.14 to 50.75 on the radiograph. Subsequently, when the generated data were incorporated into the training of the classification model, the false positive of the confusion matrix also improved from 0.16 to 0.66 on the radiograph. The proposed framework has the potential to address the challenges of data scarcity in medical CAD, contributing to its advancement.

Shogo Watanabe

This report presents a small language model (SLM) for Japanese clinical and medicine, named NCVC-slm-1. This 1B parameters model was trained using Japanese text classified to be of high-quality. Moreover, NCVC-slm-1 was augmented with respect to clinical and medicine content that includes the variety of diseases, drugs, and examinations. Using a carefully designed pre-processing, a specialized morphological analyzer and tokenizer, this small and light-weight model performed not only to generate text but also indicated the feasibility of understanding clinical and medicine text. In comparison to other large language models, a fine-tuning NCVC-slm-1 demonstrated the highest scores on 6 tasks of total 8 on JMED-LLM. According to this result, SLM indicated the feasibility of performing several downstream tasks in the field of clinical and medicine. Hopefully, NCVC-slm-1 will be contributed to develop and accelerate the field of clinical and medicine for a bright future.

Magdalena Sevilla-González, Maria Fernanda Garibay-Gutiérrez, Arsenio Vargas-Vázquez et al.

Background: A risk haplotype in SLC16A11 characterized by alterations in fatty acid metabolism emerged as a genetic risk factor associated with increased susceptibility to type 2 diabetes (T2D) in Mexican population. Its role on treatment responses is not well understood. Objectives: We aimed to determine the impact of the risk haplotype on the metabolomic profile during a lifestyle intervention (LSI). Methods: We recruited Mexican-mestizo individuals with ≥1 prediabetes criteria according to the American Diabetes Association with a body mass index between 25 and 45 kg/m2. We conducted a 24-wk quasiexperimental LSI study for diabetes prevention. Here, we compared longitudinal plasma liquid chromatography/mass spectrometry metabolomic changes between carriers and noncarriers. We analyzed the association of risk haplotype with metabolites leveraging repeated assessments using multivariable-adjusted linear mixed models. Results: Before the intervention, carriers (N = 21) showed higher concentrations of hippurate, C16 carnitine, glycine, and cinnamoylglycine. After 24 wk of LSI, carriers exhibited a deleterious metabolomic profile. This profile was characterized by increased concentrations of hippurate, cinnamoglycine, xanthosine, N-acetylputrescine, L-acetylcarnitine, ceramide (d18:1/24:1), and decreased concentrations of citrulline and phosphatidylethanolamine. These metabolites were associated with higher concentrations of total cholesterol, triglycerides, and low density lipoprotein cholesterol. The effect of LSI on the risk haplotype was notably more pronounced in its impact on 2 metabolites: methylmalonylcarnitine (β: −0.56; P-interaction = 0.014) and betaine (β: −0.64; P-interaction = 0.017). Interestingly, lower consumption across visits of polyunsaturated (β: −0.038; P = 0.017) fatty acids were associated with higher concentrations of methylmalonylcarnitine. Covariates for adjustment across models included age, sex, genetic ancestry principal components, and body mass index. Conclusions: Our study highlights the persistence of deleterious metabolomic patterns associated with the risk haplotype before and during a 24-wk LSI. We also emphasize the potential regulatory role of polyunsaturated fatty acids on methylmalonylcarnitine concentrations suggesting a route for improving interventions for individuals with high-genetic risk.

Graziano Domenico Luigi Crudele, Alberto Amadasi, Lorenzo Franceschetti et al.

Background: In forensic pathology, asphyxia presents a problem as frequently as it is thorny and challenging. Some knowledge in forensic pathology is still considered to be traditionally acquired and is not critically assessed with modern statistical or technical tools. In this study, we seek to examine the injuries that are considered to be typical of cases of hanging (neck lesions, haemorrhages, and pleural and epicardial petechiae). Methods: We evaluated whether there was, indeed, a statistically significant association between these injuries and deaths from hanging as compared to non-hanging deaths. We collected 399 cases (32 deaths by hanging and 367 cases of non-hangings), built contingency tables and performed chi-square tests for each variable (lesion) examined; we also analysed this association in various subgroups of the sample (according to sex, age and weight ranges). Results: Our results did not deviate from the expected outcome based on traditional knowledge, although they do provide a more detailed demonstration and clarification of traditional knowledge regarding this topic. Conclusions: These findings provide valuable insights for future discussion, examination and deepening of knowledge that is traditionally accepted but often undersupported in the literature.