Hasil untuk "Medicine (General)"

Wei Y, Wang Y, Cao P et al.

Yuxuan Wei,1,2,* Yongli Wang,3,* Peichun Cao,4,* Yuanyuan Gong,1 Jingjing Gong,1 Li Yang,1 Jin Chen,5 Jingli Wang,4 Xiaodan Li1 1Department of Obstetrics and Gynecology, Peking University People’s Hospital, Beijing, People’s Republic of China; 2School of Nursing, Hebei University, Baoding, People’s Republic of China; 3Department of Pediatrics, Peking University People’s Hospital, Beijing, People’s Republic of China; 4Department of Musculoskeletal Tumor Center, Peking University People’s Hospital, Beijing, People’s Republic of China; 5Department of Breast Center, Peking University People’s Hospital, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiaodan Li, Email lixiaodan@pkuph.edu.cnObjective: To examine the mediating role of medical coping in the relationship between social support and illness uncertainty among patients with malignant tumors, and to explore differences across age groups.Methods: A secondary analysis was conducted using cross-sectional data from 905 hospitalized patients. Patient-reported outcomes were measured using the Mishel Uncertainty in Illness Scale–Adult, the Social Support Rating Scale, and the Medical Coping Modes Questionnaire. Pearson correlation analyses were conducted using SPSS version 25.0, and mediation effects were tested using the PROCESS macro with bootstrap resampling.Results: In the overall sample, medical coping partially mediated the relationship between social support and illness uncertainty (indirect effect: β = 0.177, SE = 0.061, bootstrap 95% CI [0.067, 0.306]). Age-stratified analyses showed a full mediation effect in younger patients (β = 1.362, SE = 0.218, 95% CI [0.875, 1.737]). In contrast, the mediation effects were weaker in middle-aged and older patients, accounting for only 2.96% and 17.65% of the total effect, respectively. These findings indicate that the mediating role of medical coping varies across age groups, with distinct patterns observed among younger, middle-aged, and older patients.Conclusion: In this cross-sectional sample, the results were statistically consistent with an indirect association between social support and illness uncertainty via medical coping, with age-related differences. Younger patients showed a stronger indirect association via coping, whereas middle-aged and older patients showed relatively stronger direct associations between social support and illness uncertainty.Keywords: neoplasms, uncertainty in illness, social support, adaptation, psychological, nursing care

Aliaksandr Marozau, Barbara Karpowicz, Tomasz Kowalewski et al.

Mixed Reality (MR) technologies such as Virtual and Augmented Reality (VR, AR) are well established in medical practice, enhancing diagnostics, treatment, and education. However, there are still some limitations and challenges that may be overcome thanks to the latest generations of equipment, software, and frameworks based on eXtended Reality (XR) by enabling immersive systems that support safer, more controlled environments for training and patient care. Our review highlights recent VR and AR applications in key areas of medicine. In medical education, these technologies provide realistic clinical simulations, improving skills and knowledge retention. In surgery, immersive tools enhance procedural precision with detailed anatomical visualizations. VR-based rehabilitation has shown effectiveness in restoring motor functions and balance, particularly for neurological patients. In mental health, VR has been successful in treating conditions like PTSD and phobias. Although VR and AR solutions are well established, there are still some important limitations, including high costs and limited tactile feedback, which may be overcome with implementing new technologies that may improve the effectiveness of immersive medical applications such as XR, psychophysiological feedback or integration of artificial intelligence (AI) for real-time data analysis and personalized healthcare and training.

Brigitte Dréno, Pierre Lévy, Gregory Caillet et al.

The objective of this retrospective observational study was to estimate the prevalence of actinic keratosis (AK) in individuals aged ≥ 40 years in France, to describe the characteristics of affected patients, and to describe treatments. A representative panel of 20,000 households with ≥ 1 member aged ≥ 40 years were invited to participate. Participants who reported AK lesions diagnosed by a physician were eligible. The study questionnaire collected data on demographics, lesion characteristics, Fitzpatrick phototype, diagnosis, and treatments. In total, 15,246 questionnaires (78.5%) were returned and 639 responders were eligible. The adjusted prevalence of AK was 4.03% (95% CI: 3.73–4.35). Prevalence is probably underestimated due to data collection by self-report and low awareness of AK. 177 participants (27.7%) were aged < 65 years. AK was diagnosed by a dermatologist for 521 participants (81.6%). Some 200 participants (31.3%) had no lesions at the time of the survey and 243 (37.9%) had never been treated; 312 participants (78.6%) were prescribed physical treatment, principally cryotherapy; and 125 (31.5%) were prescribed topical treatment, principally 5-fluorouracil or imiquimod. In conclusion, improving diagnosis of AK in everyday clinical practice is important to ensure that all individuals with AK are treated optimally and encouraged to take sun protection measures to prevent progression to SCC.

Saara H. Huoponen, Katrin Sisa, Tom Saari et al.

ABSTRACT Aim The aim of the study was to survey the observed incidence of adverse effects (AEs) related to electroconvulsive therapy (ECT) in Finnish neuromodulation units, as well as to explore what medical interventions are used to prevent and treat them in those units. Methods An electronic survey was conducted among Finnish neuromodulation units at the end of 2022. The survey included 35 questions related to AEs and their prevention and/or treatment in the responding units’ ECT patient populations. Results Our survey reached 19 out of 26 units in Finland, with 17 units completing the full questionnaire. Headache, myalgia and postictal confusion (PIC) emerged as the most frequently reported AEs. Nausea and high blood pressure were reported less often. Only a few units reported AEs known to be rare, such as accidental awareness during general anesthesia and the aspiration of gastric contents. However, there was considerable variation in the recognition and treatment of those ECT‐related AEs the diagnosis of which depends more on patients’ self‐reporting, including headache, myalgia or nausea. Five units (29%) reported frequent or occasional headache or myalgia and four units (24%) reported occasional nausea experienced by their patients, but these AEs were addressed pharmacologically in those units neither by prophylaxis nor by treatment. This raises concern about whether these AEs are perceived as an insignificant issue in delivering ECT treatment, thus requiring no intervention, or if those AEs should be better recognized and and managed more actively. Conclusions AEs related to ECT treatment are common, but some still appear poorly recognized and treated. Regarding treatment adherence, minimizing potential AEs whenever feasible can be considered important. A thorough preoperative assessment of patients is required to identify possible risk factors for AEs. An objective and structured evaluation tool for recognizing adverse effects in patients undergoing ECT treatment would be useful.

Gal Puris, Angela Chetrit, Eldad Katorza

As medical imaging continues to expand, concerns about the potential risks of ionizing radiation to the developing fetus have led to a preference for non-radiation-based alternatives such as ultrasonography and fetal MRI. This review examines the current evidence on the safety of MRI during pregnancy, with a focus on 3 T MRI and contrast agents, aiming to provide a comprehensive synthesis that informs clinical decision-making, ensures fetal safety and supports the safe use of all available modalities that could impact management. We conducted a comprehensive review of studies from 2000 to 2024 on MRI safety during pregnancy, focusing on 3 T MRI and gadolinium use. The review included peer-reviewed articles and large database studies, summarizing key findings and identifying areas for further research. Fetal MRI, used alongside ultrasound, enhances diagnostic accuracy for fetal anomalies, particularly in the brain, thorax, gastrointestinal and genitourinary systems, with no conclusive evidence of adverse effects on fetal development. While theoretical risks such as tissue heating and acoustic damage exist, studies show no significant harm at 1.5 T or 3 T, though caution is still advised in the first trimester. Regarding gadolinium-based contrast agents, the evidence is conflicting: while some studies suggest risks such as stillbirth and rheumatological conditions, animal studies show minimal fetal retention and no significant toxicity, and later clinical research has not substantiated these risks. The existing literature on fetal MRI is encouraging, suggesting minimal risks; however, further investigation through larger, prospective and long-term follow-up studies is essential to comprehensively determine its safety and late effects.

Gary An, Chase Cockrell

On December 15, 2023, The National Academies of Sciences, Engineering and Medicine (NASEM) released a report entitled: Foundational Research Gaps and Future Directions for Digital Twins. The ostensible purpose of this report was to bring some structure to the burgeoning field of digital twins by providing a working definition and a series of research challenges that need to be addressed to allow this technology to fulfill its full potential. In the work presented herein we focus on five specific findings from the NASEM Report: 1) definition of a Digital Twin, 2) using fit-for-purpose guidance, 3) developing novel approaches to Verification, Validation and Uncertainty Quantification (VVUQ) of Digital Twins, 4) incorporating control as an explicit purpose for a Digital Twin and 5) using a Digital Twin to guide data collection and sensor development, and describe how these findings are addressed through the design specifications for a Critical Illness Digital Twin (CIDT) aimed at curing sepsis.

Parul Singh, Aniruddha Dan, Padma Priya Kannan et al.

This research work showcases a non-toxic approach to synthesize carbon nanoparticles (CNPs) from various medicinal plants namely Syzygium cumini, Holy basil, Azadirachta indica A, Psidium guajava, Mangifera indica, and Bergera koenigii using microwave approach. The optical, morphological, structural, and functional properties of obtained CNPs from all mentioned sources were investigated using UV-Vis, Scanning electron microscopy (SEM), Fourier transform infrared spectrophotometry (FTIR), dynamic light scattering (DLS), zeta potential tests and X-ray diffraction (XRD). With great water dispersibility, and photostability all the medicinal sources chosen yielded in bright red fluorescent nanoparticles under exposure to UV light, thereby giving a significant peak around 650 nm recorded in absorption spectrum. Antoxidant assay was performed on all these six different plant-derived nanoparticles with two different concentrations and all have exhibited excellent free radical (DPPH) scavenging activity, proving their role as antioxidants. This further opens up doors for various other plant and biomedical applications to be targeted using these CNPs.

Atli Jasonarson, Hinrik Hafsteinsson, Bjarki Ármannsson et al.

This paper presents the submission of the Árni Magnusson Institute's team to the WMT24 General translation task. We work on the English->Icelandic translation direction. Our system comprises four translation models and a grammar correction model. For training our models we carefully curate our datasets, aggressively filtering out sentence pairs that may detrimentally affect the quality of our system's output. Some of our data are collected from human translations and some are synthetically generated. A part of the synthetic data is generated using an LLM, and we find that it increases the translation capability of our system significantly.

Yueqi Wang, Shengli Li, Xiaobo Bo et al.

Abstract Circular RNAs (circRNAs) have been shown to play important roles in tumour development and tumour immunology. However, genome‐wide characterisation of circRNAs and their roles in the immunology and immunotherapy of gallbladder carcinoma (GBC) has been lacking. We present a comprehensive characterisation of the circRNA landscape in GBC, revealing GBC‐specific circRNAs. Our analysis found that circRNAs are significantly enriched in cell proliferation and are involved in cancer‐related hallmarks. In particular, circAATF was upregulated in GBC, which was positively correlated with AATF mRNA expression, and promoted GBC cell growth. Through integrating computational and experimental approaches, we revealed that circAATF is positively associated with the CD4+ T cell abundance and PD‐L1 level, and enhances the clinical benefits of anti‐PD‐L1 immunotherapy for GBC. We further demonstrate that circAATF elevates the PD‐L1 level by activating phosphorylated AKT and acting as a sponge for miR‐142‐5p. CircAATF is positively associated with CD4+ T cells and PD‐L1 levels and shows potential to aid anti‐PD‐L1 immunotherapy for GBC. Our study provides insights into roles of circAATF in the tumour development and immunology of GBC and accelerates the development of therapeutic strategies for GBC immunotherapy. Highlights We present a comprehensive characterisation of circRNA landscape in gallbladder carcinoma (GBC). CircAATF is positively associated with CD4+ T cell abundance and PD‐L1 expression and is shown to promote PD‐L1 treatment in mouse model. CircAATF can elevate PD‐L1 level through phosphorylated AKT and linear AATF, which upregulates PD‐L1 by acting as a sponge of miR‐142‐5p.

Sharon Chokuwa, Muhammad H. Khan

Domain generalization for Diabetic Retinopathy (DR) classification allows a model to adeptly classify retinal images from previously unseen domains with various imaging conditions and patient demographics, thereby enhancing its applicability in a wide range of clinical environments. In this study, we explore the inherent capacity of variational autoencoders to disentangle the latent space of fundus images, with an aim to obtain a more robust and adaptable domain-invariant representation that effectively tackles the domain shift encountered in DR datasets. Despite the simplicity of our approach, we explore the efficacy of this classical method and demonstrate its ability to outperform contemporary state-of-the-art approaches for this task using publicly available datasets. Our findings challenge the prevailing assumption that highly sophisticated methods for DR classification are inherently superior for domain generalization. This highlights the importance of considering simple methods and adapting them to the challenging task of generalizing medical images, rather than solely relying on advanced techniques.

Alla G. Polyakova, Anna G. Soloveva, Petr V. Peretyagin et al.

The development of anti-pain technologies in the complex treatment of pain syndromes is one of the most urgent tasks of modern medicine. We undertook a placebo-controlled experimental study of the therapeutic potential of low-intensity laser radiation when applied to acupuncture points that are directly related to the autonomic nervous system. The adaptation effect of puncture photobiomodulation on the induction of stress-mediated autonomic reactions, oxidative metabolism and microcirculation in animals during the acute phase of pain stress was revealed. The data obtained are of interest for use in the complex rehabilitation of patients with pain syndromes.

S. Mehta, L. Rose, D. Cook et al.

Objectives: To review women’s participation as faculty at five critical care conferences over 7 years. Design: Retrospective analysis of five scientific programs to identify the proportion of females and each speaker’s profession based on conference conveners, program documents, or internet research. Setting: Three international (European Society of Intensive Care Medicine, International Symposium on Intensive Care and Emergency Medicine, Society of Critical Care Medicine) and two national (Critical Care Canada Forum, U.K. Intensive Care Society State of the Art Meeting) annual critical care conferences held between 2010 and 2016. Subjects: Female faculty speakers. Interventions: None. Measurements and Main Results: Male speakers outnumbered female speakers at all five conferences, in all 7 years. Overall, women represented 5–31% of speakers, and female physicians represented 5–26% of speakers. Nursing and allied health professional faculty represented 0–25% of speakers; in general, more than 50% of allied health professionals were women. Over the 7 years, Society of Critical Care Medicine had the highest representation of female (27% overall) and nursing/allied health professional (16–25%) speakers; notably, male physicians substantially outnumbered female physicians in all years (62–70% vs 10–19%, respectively). Women’s representation on conference program committees ranged from 0% to 40%, with Society of Critical Care Medicine having the highest representation of women (26–40%). The female proportions of speakers, physician speakers, and program committee members increased significantly over time at the Society of Critical Care Medicine and U.K. Intensive Care Society State of the Art Meeting conferences (p < 0.05), but there was no temporal change at the other three conferences. Conclusions: There is a speaker gender gap at critical care conferences, with male faculty outnumbering female faculty. This gap is more marked among physician speakers than those speakers representing nursing and allied health professionals. Several organizational strategies can address this gender gap.

Artur M. Andermann, Luis G. C. Rego

Non-fullerene acceptor (NFA) materials have posed new paradigms for the design of organic solar cells (OSC), whereby efficient carrier generation is obtained with small driving forces, in order to maximize the open-circuit voltage. In this paper we use a coarse-grained mixed quantum-classical method, that combines Ehrenfest and Redfield theories, to shed light on charge generation process in small energy offset interfaces. We have investigated the influence of the energetic driving force as well as the vibronic effects on the charge generation and photovoltaic energy conversion. By analyzing the effects of the Holstein and Peierls vibrational couplings, we find that vibrational couplings produce an overall effect of improving the charge generation. However, the two vibronic mechanisms play different roles: the Holstein relaxation mechanism decreases the charge generation whereas the Peierls mechanism always assists the charge generation. Moreover, by examining the electron-hole binding energy as a function of time, we evince two distinct regimes for the charge separation: the temperature independent excitonic spread on a sub-100 fs timescale and the complete dissociation of the charge-transfer state that occurs on the timescale of tens to hundreds of picoseconds, depending on the temperature. The quantum dynamics of the system exhibits the three regimes of the Marcus electron transfer kinetics as the energy offset of the interface is varied.

Jack Jewson, David Rossell

Statisticians often face the choice between using probability models or a paradigm defined by minimising a loss function. Both approaches are useful and, if the loss can be re-cast into a proper probability model, there are many tools to decide which model or loss is more appropriate for the observed data, in the sense of explaining the data's nature. However, when the loss leads to an improper model, there are no principled ways to guide this choice. We address this task by combining the Hyvärinen score, which naturally targets infinitesimal relative probabilities, and general Bayesian updating, which provides a unifying framework for inference on losses and models. Specifically we propose the H-score, a general Bayesian selection criterion and prove that it consistently selects the (possibly improper) model closest to the data-generating truth in Fisher's divergence. We also prove that an associated H-posterior consistently learns optimal hyper-parameters featuring in loss functions, including a challenging tempering parameter in generalised Bayesian inference. As salient examples, we consider robust regression and non-parametric density estimation where popular loss functions define improper models for the data and hence cannot be dealt with using standard model selection tools. These examples illustrate advantages in robustness-efficiency trade-offs and provide a Bayesian implementation for kernel density estimation, opening a new avenue for Bayesian non-parametrics.

Sunha Park, Dae-Hyun Jang, Jae-Min Kim et al.

Immune-mediated necrotizing myopathy, a new subgroup of inflammatory myopathies, usually begins with subacute onset of symmetrical proximal muscle weakness. A 35-year-old male presented with severe asymmetric iliopsoas atrophy and low back pain with a previous history of left lower extremity weakness. Although his first left lower extremity weakness occurred 12 years ago, he did not receive a clear diagnosis. Magnetic resonance imaging of both thigh muscles showed muscle edema and contrast enhancement in patch patterns, and the left buttock and thigh muscles were more atrophied compared to the right side. Serum creatine kinase levels were elevated, and serologic testings were all negative. Genetic testing using a targeted gene-sequencing panel for neuromuscular disease including myopathy identified no pathogenic variants. Muscle biopsy on the right vastus lateralis showed scattered myofiber necrosis with phagocytosis and an absence of prominent inflammatory cells, consistent with seronegative necrotizing myopathy. Thus, unusual asymmetric muscle weakness and atrophy can be a manifestation of inflammatory myopathy.

Alexis Laurent, Corinne Scaletta, Philippe Abdel-Sayed et al.

Cultured fibroblast progenitor cells (FPC) have been studied in Swiss translational regenerative medicine for over two decades, wherein clinical experience was gathered for safely managing burns and refractory cutaneous ulcers. Inherent FPC advantages include high robustness, optimal adaptability to industrial manufacture, and potential for effective repair stimulation of wounded tissues. Major technical bottlenecks in cell therapy development comprise sustainability, stability, and logistics of biological material sources. Herein, we report stringently optimized and up-scaled processing (i.e., cell biobanking and stabilization by lyophilization) of dermal FPCs, with the objective of addressing potential cell source sustainability and stability issues with regard to active substance manufacturing in cutaneous regenerative medicine. Firstly, multi-tiered FPC banking was optimized in terms of overall quality and efficiency by benchmarking key reagents (e.g., medium supplement source, dissociation reagent), consumables (e.g., culture vessels), and technical specifications. Therein, fetal bovine serum batch identity and culture vessel surface were confirmed, among other parameters, to largely impact harvest cell yields. Secondly, FPC stabilization by lyophilization was undertaken and shown to maintain critical functions for devitalized cells in vitro, potentially enabling high logistical gains. Overall, this study provides the technical basis for the elaboration of next-generation off-the-shelf topical regenerative medicine therapeutic products for wound healing and post-burn care.

Hira Amir, Ally PH Prebtani

Coronaviruses are important pathogens reported in humans and animals. A novel coronavirus, formally known as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), was identified as a cause of pneumonia cases in Wuhan, China, in late 2019. Since its outbreak in China, it has disproportionately affected many countries. Coronavirus disease 2019 (COVID-19) was officially declared a pandemic on March 11, 2020 and remains a global concern. A spectrum of disease severity has been reported with a variable course of illness from mild upper respiratory symptoms, pneumonia to acute respiratory distress syndrome (ARDS), shock, multiorgan dysfunction and death. The worldwide dissemination of the virus justifies the global efforts in identifying potential treatment strategies and a vaccine for improved clinical and long-term outcomes. This article will reflect on human viral replication and transmission, variable clinical presentation, assessment, treatment and discussion of complications. Isolation precautions according to infection prevention and control including protective apparel will be discussed with emphasis on criteria for discontinuation of transmission precaution.

Noritaka Fukunaga, Sho Sanami, Hiroya Kitasaka et al.

Abstract Purpose To establish an automated pronuclei determination system by analysis using deep learning technology which is able to effectively learn with limited amount of supervised data. Methods An algorithm was developed by explicitly incorporating human observation where the outline around pronuclei is being observed in determining the number of pronuclei. Supervised data were selected from the time‐lapse images of 300 pronuclear stage embryos per class (total 900 embryos) clearly classified by embryologists as 0PN, 1PN, and 2PN. One‐hundred embryos per class (a total of 300 embryos) were used for verification data. The verification data were evaluated for the performance of detection in the number of pronuclei by regarding the results consistent with the judgment of the embryologists as correct answers. Results The sensitivity rates of 0PN, 1PN, and 2PN were 99%, 82%, and 99%, respectively, and the overlapping 2PN being difficult to determine by microscopic observation alone could also be appropriately assessed. Conclusions This study enabled the establishment of the automated pronuclei determination system with the precision almost equivalent to highly skilled embryologists.

Wiraguna AAGP, Hari ED, Praharsini IGAA

Anak Agung Gde Putra Wiraguna, Embun Dini Hari, I Gusti Ayu Agung Praharsini Dermatology and Venereology Department, Faculty of Medicine, Universitas Udayana-Sanglah General Hospital, Denpasar, Bali, IndonesiaCorrespondence: Anak Agung Gde Putra WiragunaDermatology and Venereology Department, Faculty of Medicine, Universitas Udayana-Sanglah General Hospital, Denpasar, Bali, IndonesiaEmail wiraguna@unud.ac.idIntroduction: Melasma is a condition of hyperpigmentation of the facial skin that increases in prevalence with ageing. The alleged involvement of reactive oxygen species and antioxidants is the basis of the pathology of melasma. Glutathione is one of the non-enzymatic antioxidants produced by the body and plays a role in melanogenesis. The purpose of this study was to examine serum glutathione levels on the severity of melasma.Methods: This study used a cross-sectional design conducted at the Cosmetic Dermatology Clinic at Sanglah Hospital, Denpasar, from September to October 2016. Serum glutathione was examined through venous blood with ELISA method, and the severity of melasma was assessed using melasma area severity index (MASI). Independent t-test and ANOVA were used to evaluate differences in plasma glutathione levels based on the characteristics of the sample. Pearson correlation test and linear regression were used to assess the relationship between MASI and plasma glutathione.Results: This study involved 47 people with a clinical diagnosis of melasma. There was a significant strong negative correlation between plasma glutathione and MASI (p&lt; 0.001; r = &minus; 0.624). Mild melasma (1.89 &plusmn; 0.28 &mu;mol/L) had higher plasma glutathione levels compared to moderate melasma (1.53 &plusmn; 0.13 &mu;mol/L) and severe (1.18 &plusmn; 0.20 &mu;mol/L) (p=0.043). Linear regression showed a significant negative linear relationship between MASI scores against plasma glutathione (&beta; = &minus; 58.2; p &lt; 0.01).Conclusion: Glutathione plasma has a strong negative correlation with the MASI score in person with melasma.Keywords: melasma, skin, pigmentation, glutathione

William Whiteley, Jens Gregor

Positron emission tomography (PET) scanners continue to increase sensitivity and axial coverage by adding an ever expanding array of block detectors. As they age, one or more block detectors may lose sensitivity due to a malfunction or component failure. The sinogram data missing as a result thereof can lead to artifacts and other image degradations. We propose to mitigate the effects of malfunctioning block detectors by carrying out sinogram repair using a deep convolutional neural network. Experiments using whole-body patient studies with varying amounts of raw data removed are used to show that the neural network significantly outperforms previously published methods with respect to normalized mean squared error for raw sinograms, a multi-scale structural similarity measure for reconstructed images and with regard to quantitative accuracy.