Hasil untuk "Medicine (General)"

Chaomei Chen, Zhigang Hu, Shengbo Liu et al.

K. Ericsson

J. Karlberg

A. McColl, Helen Smith, P. White et al.

Xian Zhou, S. Seto, D. Chang et al.

Traditional Chinese medicine (TCM) is an important part of primary health care in Asian countries that has utilized complex herbal formulations (consisting 2 or more medicinal herbs) for treating diseases over thousands of years. There seems to be a general assumption that the synergistic therapeutic effects of Chinese herbal medicine (CHM) derive from the complex interactions between the multiple bioactive components within the herbs and/or herbal formulations. However, evidence to support these synergistic effects remains weak and controversial due to several reasons, including the very complex nature of CHM, misconceptions about synergy and methodological challenges to study design. In this review, we clarify the definition of synergy, identify common errors in synergy research and describe current methodological approaches to test for synergistic interaction. We discuss the strengths and weaknesses of these models in the context of CHM and summarize the current status of synergy research in CHM. Despite the availability of some scientific data to support the synergistic effects of multi-herbal and/or herb-drug combinations, the level of evidence remains low, and the clinical relevancy of most of these findings is undetermined. There remain significant challenges in the development of suitable methods for synergistic studies of complex herbal combinations.

V. Buch, Irfan Ahmed, M. Maruthappu

Aleksandra Kwasnik, Catalina Castillo-Pedraza

ABSTRACT This April, the American Academy of Sleep Medicine (AASM) took part as exhibitors at the USA Science and Engineering Festival in Washington, DC. This was AASM's first time attending the festival which is the largest conference of its kind promoting and celebrating science and technology in the United States hosting 370,000 attendees including schoolchildren, educators, and the general public. The AASM's exhibit featured interactive games as well as materials aimed at the promotion of healthy sleep habits in all age groups. A few individuals presented with more specific questions and were provided education and directed to online resources approved by the Academy. It was apparent that many people were unaware of the field of sleep medicine and responded favorably to our presence. We hope our account of the experience helps inform thought on further direction the AASM takes in the realm of public outreach and education.

Romil R. Parikh, Nishka U. Shetty, Chinar Singhal et al.

Objective: The aim of this study was to systematically map evidence to inform best practices for sexual and reproductive healthcare delivered via telehealth (TeleSRH) in United States-based Title X-funded clinics. Methods: We searched three databases (2017–2025) for studies evaluating effectiveness, harms, patient and provider experiences, barriers/facilitators, and engagement strategies encompassing TeleSRH for sexually transmitted infections (STIs), contraceptive care/family planning (CC/FP), and sexual wellness, in countries with a human development index of ≥0.8. Results: From 5963 references and 436 articles, we included 142 eligible publications. TeleSRH use declined since the COVID-19 pandemic’s peak but remains higher than pre-pandemic. Evidence comes mostly from poor-quality studies. TeleSRH increases access and adherence to STI prevention (e.g., pre-exposure prophylaxis for HIV). Tele-follow-up may safely facilitate HIV care continuity. For CC/FP, TeleSRH is comparable to in-person care for patient satisfaction and uptake; patients are less likely to select long-acting reversible contraception but post-initiation tele-follow-up may increase its continuation rates. Vasectomy completion rates may be similar between pre-procedural counseling via telehealth versus in-person. TeleSRH’s potential benefits might include reduced travel time, wait times, no-show rates, and clinic human resource burden (via tele-triaging) and increased preventative screening rates for STIs and non-communicable diseases, prescription refill rates, ability to receive confidential care in preferred settings, and rural/marginalized community outreach. Implementation challenges span technological and capital constraints, provider availability, staff capability building, restrictive policies, language incompatibility, and patient mistrust. Supplementing synchronous TeleSRH with asynchronous communication (e.g., mobile application) may improve continued patient engagement. Conclusions: Preventive, diagnostic, and therapeutic TeleSRH can be effective, with high patient acceptability; however, effectiveness and adoption hinge on contextual factors outlined in this review.

Duck-chul Lee, Angelique G. Brellenthin, P. Thompson et al.

Jinya Cao, Jing Wei, Huadong Zhu et al.

a Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; b Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; c Department of Psychology, University of Bologna, Bologna, Italy Received: February 26, 2020 Accepted after revision: March 23, 2020 Published online: March 30, 2020

Pinar Bisgin, Tom Strube, Niklas Tschorn et al.

Noisy labels pose significant challenges for AI model training in veterinary medicine. This study examines expert assessment ambiguity in canine auscultation data, highlights the negative impact of label noise on classification performance, and introduces methods for label noise reduction. To evaluate whether label noise can be minimized by incorporating multiple expert opinions, a dataset of 140 heart sound recordings (HSR) was annotated regarding the intensity of holosystolic heart murmurs caused by Myxomatous Mitral Valve Disease (MMVD). The expert opinions facilitated the selection of 70 high-quality HSR, resulting in a noise-reduced dataset. By leveraging individual heart cycles, the training data was expanded and classification robustness was enhanced. The investigation encompassed training and evaluating three classification algorithms: AdaBoost, XGBoost, and Random Forest. While AdaBoost and Random Forest exhibited reasonable performances, XGBoost demonstrated notable improvements in classification accuracy. All algorithms showed significant improvements in classification accuracy due to the applied label noise reduction, most notably XGBoost. Specifically, for the detection of mild heart murmurs, sensitivity increased from 37.71% to 90.98% and specificity from 76.70% to 93.69%. For the moderate category, sensitivity rose from 30.23% to 55.81% and specificity from 64.56% to 97.19%. In the loud/thrilling category, sensitivity and specificity increased from 58.28% to 95.09% and from 84.84% to 89.69%, respectively. These results highlight the importance of minimizing label noise to improve classification algorithms for the detection of canine heart murmurs. Index Terms: AI diagnosis, canine heart disease, heart sound classification, label noise reduction, machine learning, XGBoost, veterinary cardiology, MMVD.

Aahsan Iqbal, Sohail Khalid, Mujeeb ur Rehman

Hematology analyzers are essential diagnostic and monitoring tools for detecting blood diseases. Although contemporary analyzers produce only basic insights, they are often not as detailed as required under the personalized medicine paradigm. Next-Generation Hematology Analyzers (NGHAs) are revolutionary newcomers in the field, with significant advantages over regular hematology analyzers. They provide deeper insights into cellular morphology, function, and genetic profiles. This detailed information opens up possibilities for tailor-made diagnostic and therapeutic approaches in precision medicine. This review presents some revolutionary technologies that have changed hematology analyzers and provides an overview of their limitations, basic functions, and influence on clinical practice. It focuses on the integration of state-of-the-art technologies, such as microfluidics, advanced optics, artificial intelligence, flow cytometry, and digital imaging, empowering NGHAs to improve diagnostic accuracy, rapidly detect diseases, and support flexible, targeted therapy. Hints regarding point-of-care hematology testing are also provided to discuss its implications for transforming healthcare patterns. This review highlights the data management, standardization, regulatory, and ethical challenges associated with these technologies. A review tracking the current state-of-the-art and trends for the future is provided to show how these advancements may reconfigure hematology analyzer design and act as a stepping stone for future therapeutic reforms.

Laurenz De Cock, Erika D’haenens, Lies Vantomme et al.

Abstract RNA sequencing (RNA-seq) has become key to complementing exome and genome sequencing for variant interpretation. We present a minimally invasive RNA-seq protocol using short-term cultured peripheral blood mononuclear cells (PBMCs) with and without cycloheximide treatment, enabling detection of transcripts subject to nonsense-mediated decay. While broadly applicable, this protocol is particularly suited for neurodevelopmental disorders, as up to 80% of the genes in our intellectual disability and epilepsy gene panel are expressed in PBMCs. Applied to 46 affected individuals and 15 parents, RNA-seq revealed splicing defects in six of nine individuals with splice variants, allowing reclassification of seven variants. Targeted cDNA analysis confirmed aberrant splicing in four individuals but missed intron retention in two. Global analyses (FRASER, OUTRIDER, and monoallelic expression) supported findings but did not yield new diagnoses. We propose a flowchart integrating RNA-seq into diagnostic workflows. Overall, our protocol is easily implementable, captures complex splicing events, and enhances variant classification.

Michael Safo Oduro, Eniola Fasola, Prince Peprah et al.

Abstract Background There is a dearth of studies focused on the impact of self-rated health on life satisfaction among large-bodied adolescents, as well as the moderating role of physical activity in this relationship. Large-bodied adolescents refers to young people (usually aged 10–19 years) whose body size falls within the overweight or obese range as defined by the World Health Organisation’s Growth Reference, based on age- and sex-specific body mass index (BMI) percentiles. This study aimed to address the gap in research by examining the association between self-rated health and life satisfaction in a diverse sample of large-bodied adolescents from 39 countries and regions in Europe and North America. The moderating role of physical activity in the association was also examined. Methods The study analysed data from the Health Behaviour in School-aged Children (HBSC) survey, involving a sample of 24,839 large-bodied adolescents. Three sequential binary mixed effects logit models were fitted: the first assessing self-rated health alone, the second adjusting for multiple covariates, and the third incorporating an interaction term between physical activity and self-rated health. The analysis was performed using R Software (v4.1.2), with significance determined at a level of 0.05. Results The results show that adolescents who rated their health as “poor” were a little more than six times (AOR = 6.32, 95%CI: 5.30–7.54, p < 0.001) as likely to report lower life satisfaction compared to those who rated their health as “excellent”. Those who rated their health as “good” had 1.71 times higher odds (AOR = 1.71, 95%CI: 1.44–2.04, p < 0.001) of reporting lower life satisfaction compared to those who rated their health as “excellent”. The analysis further indicated that physical activity plays a partial moderating role in the relationship between self-rated health and life satisfaction. Participants who considered themselves “somewhat active” reported higher life satisfaction compared to their “inactive” peers (AOR = 0.58, p = 0.031, 95% CI: 0.36–0.95). Conclusions The study supports the hypothesis that poorer self-rated health is associated with lower life satisfaction among large-bodied adolescents. It further suggests that increased physical activity can ‘partly’ buffer the negative effects of poor self-rated health on life satisfaction. These findings emphasise the importance of interventions promoting physical activity and positive self-care to improve general well-being in large-bodied adolescents.

Chung-wah Cheng, Tai-xiang Wu, H. Shang et al.

Chinese herbal medicine (CHM) formulas are the major components of traditional Chinese medicine (TCM) interventions. The general reporting quality of randomized controlled trials (RCTs) of CHM formulas is disappointing, although CONSORT (Consolidated Standards of Reporting Trials) Statement extensions for herbal medicinal interventions and acupuncture interventions are available. A group of TCM clinical experts, methodologists, epidemiologists, and editors has developed this CONSORT Extension for CHM Formulas (CONSORT-CHM Formulas 2017) through a comprehensive process, including publication of the draft version, solicitation of comments, revision, and finalization. The CONSORT 2010 Statement was extended by introducing the idea of TCM Pattern and the features of CHM formulas. One new checklist subitem, keywords, was added to facilitate indexing and data searching. Seven of the 25 CONSORT checklist items, namely title and abstract, background and objectives, participants, interventions, outcomes, generalizability, and interpretation, are now elaborated, and the explanation of harms specific to CHM formulas is revised. Illustrative examples and explanations are also provided. The group hopes that CONSORT-CHM Formulas 2017 can improve the reporting quality of RCTs of CHM formulas.

Aylin Bayındır-Gümüş, Ebru Öztürk, Mihály Soós

Background. People live in a technological world, where social media is used very commonly. Social media has effects on eating behaviors, as in other aspects. For this reason, it is important to measure social media effect. Objective. This study aimed to adapt the Scale of Effects of Social Media on Eating Behaviour (SESMEB) that examines the effect of social media on eating behavior in Hungarian university students. Material and methods. The SESMEB was translated into the target language by taking various stages. The online questionnaire including general information, social media use, and the eighteen-item SESMEB was used to collect data. The scale was administered to the study group consisting of 213 Hungarian university students, and data from 203 of them were analyzed. Confirmatory factor analyses were performed to test construct validity, and the Cronbach alpha coefficient was calculated for the reliability of the scale in Hungarian. Results. Total correlation value was higher than 0.50 for all items of the scale. The fit indices were at an acceptable level or had a perfect fit. The t-values were significant at the level of 0.1 and ranged between 2.927 and 5.706. The Spearman–Brown coefficient was calculated at 0.894. The reliability coefficient of the scale was calculated to be 0.866. SESMEB scores were different according to spending time daily, sharing content, and using filters or Photoshop on social media (p < 0.05). Conclusions. Higher than 0.80 Cronbach’s alpha coefficient and other results show that Hungarian SESMEB is a valid and reliable tool. Therefore, Hungarian SESMEB will be useful for further studies to determine the impact of social media on eating behaviors.

Calum McHale, Susanne Cruickshank, Tamara Brown et al.

Abstract Objectives To determine the feasibility and acceptability of implementing the Mini-AFTERc intervention. Design Non-randomised cluster-controlled pilot trial. Setting Four NHS out-patient breast cancer centres in Scotland. Participants Ninety-two women who had successfully completed primary treatment for breast cancer were screened for moderate levels of fear of cancer recurrence (FCR). Forty-five were eligible (17 intervention and 28 control) and 34 completed 3-month follow-up (15 intervention and 21 control). Intervention Mini-AFTERc, a single brief (30 min) structured telephone discussion with a specialist breast cancer nurse (SBCN) trained to target the antecedents of FCR. Outcomes Feasibility and acceptability of Mini-AFTERc and the study design were assessed via recruitment, consent, retention rates, patient outcomes (measured at baseline, 2, 4, and 12 weeks), and post-study interviews with participants and SBCNs, which were guided by Normalisation Process Theory. Results Mini-AFTERc was acceptable to patients and SBCNs. SBCNs believe the implementation of Mini-AFTERc to be feasible and an extension of discussions that already happen routinely. SBCNs believe delivery, however, at the scale required would be challenging given current competing demands for their time. Recruitment was impacted by variability in the follow-up practices of cancer centres and COVID-19 lockdown. Consent and follow-up procedures worked well, and retention rates were high. Conclusions The study provided invaluable information about the potential challenges and solutions for testing the Mini-AFTERc intervention more widely where limiting high FCR levels is an important goal following recovery from primary breast cancer treatment. Trial registration ClinicalTrials.gov, NCT0376382 . Registered on 4 December 2018.

Giuliano Colosimo, Gwyneth Montemuro, Gregory A. Lewbart et al.

As the analysis of blood metabolites has become more readily accessible thanks to the use of point-of-care analyzers, it is now possible to evaluate stress level of wild animals directly in the field. Lactate is receiving much attention as a good stress level proxy in individuals subjected to capture, manual restraint, and data sampling in the wild, and appropriate protocols to maintain lactate values low should be preferred. In this study we compare how two different capture methodologies, hand grab vs. noose pole, affect the variation of blood lactate values in Cyclura carinata iguanas when captured for sampling. We used blood lactate concentration, measured immediately upon- and 15 min after-capture, as a proxy for stress level. While the primary goal of this work is to determine the least stressful capture methodology to be favored when sampling this and other wild iguanas, we also evaluated additional baseline physiological parameters relevant to the health and disease monitoring for this species. Our results show that while initial lactate values level-out in sampled individuals after 15 min in captivity, regardless of the capture methodology, rock iguanas captured by noose pole showed significantly higher lactate concentration and increased heartbeat rate immediately after capture. While the overall health evaluation determined that all analyzed individuals were in good health, based on our results we recommend that, when possible, hand capture should be preferred over noose pole when sampling wild individuals.

S. Leucht, S. Hierl, Werner Kissling et al.

R. Dar, Mohd. Shahnawaz, P. Qazi

Medicinal plants have been playing an essential role in the development of human culture. As a source of medicine, Medicinal plants have always been at forefront virtually all cultures of civilizations. Medicinal plants are regarded as rich resources of traditional medicines and from these plants many of the modern medicines are produced. For thousands of years medicinal plants have been used to treat health disorders, to add flavor and conserve food and to prevent diseases epidemics. The secondary metabolites produced by the plants are usually responsible for the biological characteristics of plant species used throughout the world. The microbial growth in diverse situations is controlled by plant derived products. In this review we gave general overview of the medicinal plants.