Hasil untuk "Other systems of medicine"

M. Cascella, J. Montomoli, Valentina Bellini et al.

This paper aims to highlight the potential applications and limits of a large language model (LLM) in healthcare. ChatGPT is a recently developed LLM that was trained on a massive dataset of text for dialogue with users. Although AI-based language models like ChatGPT have demonstrated impressive capabilities, it is uncertain how well they will perform in real-world scenarios, particularly in fields such as medicine where high-level and complex thinking is necessary. Furthermore, while the use of ChatGPT in writing scientific articles and other scientific outputs may have potential benefits, important ethical concerns must also be addressed. Consequently, we investigated the feasibility of ChatGPT in clinical and research scenarios: (1) support of the clinical practice, (2) scientific production, (3) misuse in medicine and research, and (4) reasoning about public health topics. Results indicated that it is important to recognize and promote education on the appropriate use and potential pitfalls of AI-based LLMs in medicine.

Matt Fredrikson, S. Jha, Thomas Ristenpart

F. Danhier, E. Ansorena, Joana M. Silva et al.

M. Kanehisa, S. Goto, Miho Furumichi et al.

Most human diseases are complex multi-factorial diseases resulting from the combination of various genetic and environmental factors. In the KEGG database resource (http://www.genome.jp/kegg/), diseases are viewed as perturbed states of the molecular system, and drugs as perturbants to the molecular system. Disease information is computerized in two forms: pathway maps and gene/molecule lists. The KEGG PATHWAY database contains pathway maps for the molecular systems in both normal and perturbed states. In the KEGG DISEASE database, each disease is represented by a list of known disease genes, any known environmental factors at the molecular level, diagnostic markers and therapeutic drugs, which may reflect the underlying molecular system. The KEGG DRUG database contains chemical structures and/or chemical components of all drugs in Japan, including crude drugs and TCM (Traditional Chinese Medicine) formulas, and drugs in the USA and Europe. This database also captures knowledge about two types of molecular networks: the interaction network with target molecules, metabolizing enzymes, other drugs, etc. and the chemical structure transformation network in the history of drug development. The new disease/drug information resource named KEGG MEDICUS can be used as a reference knowledge base for computational analysis of molecular networks, especially, by integrating large-scale experimental datasets.

S. Kalogirou

S. Woolf, Richard Grol, A. Hutchinson et al.

R. Maheshwari, A. Singh, J. Gaddipati et al.

C. Gabay, I. Kushner

S. Jan, Giovanni Santin, D. Strul et al.

Monte Carlo simulation is an essential tool in emission tomography that can assist in the design of new medical imaging devices, the optimization of acquisition protocols and the development or assessment of image reconstruction algorithms and correction techniques. GATE, the Geant4 Application for Tomographic Emission, encapsulates the Geant4 libraries to achieve a modular, versatile, scripted simulation toolkit adapted to the field of nuclear medicine. In particular, GATE allows the description of time-dependent phenomena such as source or detector movement, and source decay kinetics. This feature makes it possible to simulate time curves under realistic acquisition conditions and to test dynamic reconstruction algorithms. This paper gives a detailed description of the design and development of GATE by the OpenGATE collaboration, whose continuing objective is to improve, document and validate GATE by simulating commercially available imaging systems for PET and SPECT. Large effort is also invested in the ability and the flexibility to model novel detection systems or systems still under design. A public release of GATE licensed under the GNU Lesser General Public License can be downloaded at http://www-lphe.epfl.ch/GATE/. Two benchmarks developed for PET and SPECT to test the installation of GATE and to serve as a tutorial for the users are presented. Extensive validation of the GATE simulation platform has been started, comparing simulations and measurements on commercially available acquisition systems. References to those results are listed. The future prospects towards the gridification of GATE and its extension to other domains such as dosimetry are also discussed.

H. Klein, D. Anstee

Carli Friedman

IntroductionIntersectionality recognizes and maps the ways oppressions interact and intersect for multiply marginalized people. This framework is a pushing back against the historical approach to discrimination that has taken a “single-axis” view of discrimination, focusing on one single type of oppression, even for people with multiple identities. Little attention has been drawn to intersectionality when it comes to disability, especially related to disability and race.ObjectiveIn recognition of the intersectional nature of ableism and racism, the aim of this study was to develop and validate the Symbolic Intersecting Ableism and Racism Scale (SIARS).Materials and methodsWe piloted the SIARS with 512 people (July-October 2024) and conducted an exploratory factor analysis to examine the underlying structure of the SIARS.ResultsThe SIARS has adequate validity and reliability. Our findings suggest the SIARS is comprised of a complex combination of a denial of continuing discrimination, individualism, and empathy. The findings also indicated many points of contention with the single-axis symbolic ableism scale measure, which examines disability only, further reinforcing the need to measure and attend to intersectionality.ConclusionWithout doing so, we will never truly be able to dismantle oppression and discrimination, including the ableism disabled people face.

Sneha Pallatt, Sibin Nambidi, Subhamay Adhikary et al.

Lynch syndrome (LS) is an autosomal dominant disorder caused by germline mutations in DNA mismatch repair (MMR) genes. These mutations result in frameshift alterations, leading to the accumulation of errors within microsatellites. Individuals with LS have an elevated risk of developing colorectal and distant malignancies, including endometrial cancer (EC), which is one of the most common cancer associated with LS. Despite its significance, the association between EC and LS is often underexplored. Given the slow progression of colorectal cancer (CRC), there is an opportunity for early detection and intervention, which can aid in reducing both incidence and mortality through the identification and management of pre-malignant lesions and early-stage tumors in colorectum/endometrium. Recognizing individuals with a heightened risk of CRC is essential for implementing personalized screening strategies. This review summarizes the original research work on LS to find out the correlation of CRC following an endometrial cancer diagnosis in individuals with MMR gene mutations, may involve refine treatment strategies and moreover this review may help clinicians and researchers to get an up-to date information on LS and its advanced treatment possibilities.

Diana Veneri, Raquel DiVincenzo, Madeline Lynch et al.

Introduction: The purpose of this study was to determine muscle activation during four standing yoga poses and their chair equivalent versions. Methods: The approval was obtained from the university’s institutional review board committee. Twenty-six healthy adults, 7 males and 19 females, with an average age of 23.73 ± 1.64 years participated. Surface electromyographic was collected using the Noraxon TeleMyo 2400GT. Electrodes were placed over the muscle bellies of bilateral biceps femoris (BF), rectus femoris (RF), external obliques (EOs), and the erector spinae (ES) on the side of the nondominant leg. Subjects performed the 8 poses in random order and held each for 10 s with the dominant leg forward for the 3 asymmetrical poses. Results: Results of the nonparametric Wilcoxon signed-rank test revealed that muscle activation was significantly greater during standing for all muscles except for the right EO during both extended side angle and goddess pose. Similarly, peaceful warrior demonstrated significantly more activation during standing for all muscles except for the left EO. Warrior I only demonstrated significant differences between left RF and left BF with standing having greater activation. Conversely, goddess pose demonstrated more activation of the left EO and left ES during sitting, P < 0.05. Discussion: Muscle activation was higher in the legs (BF and RF) during the standing poses, and core activation was higher during the seated poses (EO and ES). Conclusion: This is the first study to compare muscle activation during standing and chair equivalent versions of select yoga poses.

Корина РОТАРУ-ЛУГНУ

Toxocaroza, o helmintozoonoză provocată de Toxocara canis și Toxocara cati , afectează în special copiii, care sunt mai predispuși la infectare din cauza expunerii la medii contaminate. Studiul a inclus 50 de copii, diagnosticul fiind confirmat prin testare ELISA, iar tratamentele utilizate au fost Albendazol, atât în monoterapie, cât și în combinație cu Proteflazid. Rezultatele au arătat o reducere semnificativă a simptomelor respiratorii, a nivelurilor de eozinofile și a anticorpilor specifici după tratament, cu efecte mai pronunțate în grupul care a primit tratamentul combinat. Concluziile studiului sugerează că abordările terapeutice combinate pot optimiza gestionarea toxocarozei la copii, îmbunătățind astfel răspunsul imunologic.

Yunfan ZHAO, Xinyi TAN, Xiaoyun CHEN et al.

Abstract. Narrative medicine has gained significant attention in recent decades. The similarities between “parallel charts” and “medical cases” in traditional Chinese medicine (TCM) primarily lie in their authenticity. However, they differ in structure and narrative methods. Furthermore, medical case teaching is a prevalent pedagogical approach in TCM education that practitioners must master. This study explores the connection between TCM medical case teaching and narrative medicine, and concludes that the evolution of modern TCM case teaching aligns with the international standards of narrative medicine while integrating key TCM characteristics to enhance its value. This approach is essential for fostering humanistic sentiments, empathy, and reflective capabilities among future well-rounded TCM practitioners.

Denys Tietbol Wolkmann Eilert, Angela Peña Ghisleni, Graciele Sbruzzi

A Organização Mundial da Saúde reconhece o modelo de práticas colaborativas para  enfrentamento das altas demandas de trabalho em saúde, apesar de existirem barreiras para sua implementação. Num contexto adverso e de investimentos reduzidos na saúde, a pandemia da COVID-19 desafiou profissionais da saúde a desenvolver, conforme preconizadas na literatura, competências para o trabalho interprofissional e colaborativo com o objetivo de oferecer uma assistência mais eficiente. Esta pesquisa objetiva identificar e analisar as competências colaborativas que foram desenvolvidas para atuar no enfrentamento da pandemia sob a perspectiva da interprofissionalidade e da visão dos profissionais do HCPA (Hospital de Clínicas de Porto Alegre, RS, Brasil), hospital público e vinculado ao ensino, referência no atendimento aos pacientes com COVID-19. O estudo é qualitativo do tipo estudo de caso, foram realizadas entrevistas com 18 profissionais das equipes assistenciais COVID-19 do HCPA (fisioterapeutas, médicos, enfermeiros, fonoaudiólogos, nutricionistas e psicólogos). A partir da seleção e classificação das falas, a análise de conteúdo foi realizada para interpretação dos dados objetivos e subjetivos e para compreensão do corpus dos dados coletados. Observou-se, apesar dos desacordos quanto à tomada de decisão, o desenvolvimento das competências interprofissionais: respeito, compreensão dos papéis, liderança, solução de conflitos, compartilhamento de decisões e conhecimentos, cuidado centrado nos usuários e comunicação, sendo esta identificada como basilar para o trabalho interprofissional e desenvolvimento das demais competências.

Verna Stavric, Verna Stavric, Nicola M. Kayes et al.

ObjectiveThe aim of this systematic review was to determine the effectiveness of self-guided digital physical activity (PA) and exercise interventions to improve physical activity and exercise (PA&amp;E) outcomes for people living with chronic health conditions. Digital health interventions, especially those with minimal human contact, may offer a sustainable solution to accessing ongoing services and support for this population.MethodsA comprehensive and systematic search was conducted up to December 2021, through seven databases, for randomized trials that evaluated the effect of self-guided web- or internet-based PA interventions on physical activity or exercise outcomes. Included studies had to have interventions with minimal human contact and interaction with participants needed to be automatically generated. All studies were screened for eligibility and relevant data were extracted. Two independent reviewers assessed the risk of bias using the Cochrane risk of bias tool. Standardized mean differences and 95% confidence intervals (CI) were calculated. PA data were pooled, and forest plots were generated.ResultsSixteen studies met the eligibility criteria and included a total of 2,439 participants. There was wide variation in health conditions and intervention characteristics in mode and parameters of delivery, and in the application of theory and behavioral strategies. Self-reported PA in the intervention group was greater than controls at the end of the intervention [standardized mean difference (SMD) 0.2, 95% CI = 0.1, 0.3] and at follow up (SMD 0.3, 95% CI 0.2–0.5). The difference in objectively measured PA was small and non-significant (SMD 0.3, 95% CI −0.2 to 0.9). All interventions included behavioral strategies and ten of the sixteen were underpinned by theory.ConclusionsSelf-guided digital PA&amp;E interventions provided a positive effect on PA immediately after the intervention. An unexpected and positive finding was a sustained increase in PA at follow-up, particularly for interventions where the behavioral strategies were underpinned by a theoretical framework. Interventions with minimal contact have the potential to support sustained PA engagement at least as well as interventions with supervision.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42019132464.

Celina Albanus, Travis Heggie, Simone Kattner et al.

Background: Water quality for tourists visiting South Luangwa National Park and other less developed regions is of the utmost importance in order to avoid gastrointestinal infections; one of the most common diseases among tourists. It is also important to the health of the local tourist accommodations and the local tourist economy. Methods: Water quality samples assessing microbiological contamination were taken from the borehole and point of use in 14 tourist lodges and camps. Turbidity was assessed optically with a DelAlgua turbidity tube. For microbiological analysis, samples were incubated in the DelAgua Dual Incubator at 37°C and 44°C. Thermotolerant Escherichia coli (E. coli) was used as the indicator bacterium for fecal pollution. Water samples were classified based of risk levels for pollution determined by the World Health Organization (WHO). Results: Fifty percent of borehole samples showed no contamination. Two were found to be at high risk and the others ranged between low and intermediate risk. At the point of use, 80% of the samples were clean and compliant with WHO guidelines. Water contamination generally improved from the borehole to point of use. Turbidity at borehole samples were clear in 75% of possible samples. At the point of use, turbidity was clear in 81% of samples. Conclusion: This study establishes the first baseline water quality data for tourist facilities at South Luangwa National Park in Zambia. While water quality at most sites is clean for human use, a regular monitoring system accompanied by maintenance is recommended.

Patrice Cunningham, Emma Patton, Brandon N. VanderVeen et al.

Abstract Background Quercetin is an organic flavonoid present in several fruits and vegetables. The anti-inflammatory, antiviral, antioxidant, cardio-protective, anti-carcinogenic and neuroprotective properties demonstrated by this dietary supplement endorses it as a possible treatment for inflammatory diseases and cancer. Unfortunately, conflicting research has cast uncertainties on the toxicity of quercetin. The main purpose of this study was to determine if quercetin has any toxic properties in mice at doses that have shown efficacy in pre-clinical studies regarding cancer, cancer therapy, and their off-target effects. Methods A sub-chronic toxicity study of quercetin was examined in male and female CD2F1 mice. Three different doses of quercetin (62, 125, and 250 mg/kg of diet) were infused into the AIN-76A purified diet and administered to mice ad libitum for 98 days. Body weight (BW), food consumption, water intake, body composition, blood count, behavior, and metabolic phenotype were assessed at various timepoints during the course of the experiment. Tissue and organs were evaluated for gross pathological changes and plasma was used to measure alkaline phosphatase (AP), aspartate transaminase (AST), and alanine transaminase (ALT). Results We found that low (62 mg/kg of diet), medium (125 mg/kg of diet), and high (250 mg/kg of diet) quercetin feeding had no discernible effect on body composition, organ function, behavior or metabolism. Conclusions In summary, our study establishes that quercetin is safe for use in both female and male CD2F1 mice when given at ~ 12.5, 25, or 50 mg/kg of BW daily doses for 14 weeks (i.e. 98 days). Further studies will need to be conducted to determine any potential toxicity of quercetin following chronic ingestion.

Mahmoud F, Ghadban A, Harhara T et al.

Fatma Mahmoud,1 Aiat Ghadban,1 Thana Harhara,2 Halah Ibrahim2 1Education Institute, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates; 2Department of Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab EmiratesCorrespondence: Fatma Mahmoud Tel +971555006525Email famahmoud@seha.aeAbstract: Pandemics create unprecedented public health challenges that require comprehensive and coordinated responses from health care systems and can, thereby, cause substantial and prolonged disruption to residency training. The coronavirus 2019 (COVID-19) pandemic has impacted medical education worldwide. Currently, there is a gap in the literature from the trainee&rsquo;s perspective, and little advice on resuming post-pandemic operations. As internal medicine residents serving on the frontlines of a COVID-19 designated government hospital in the United Arab Emirates, we also faced significant challenges and uncertainties during the pandemic. We are fortunate to have overcome the initial surges and have spent the past 6 months navigating a new reality. We believe that the COVID-19 crisis provides an opportunity for graduate medical education programs worldwide to implement targeted changes that can lead to sustainable improvements in the system. In supporting learning during these times, our residency program has adopted flexible scheduling, focused on frequent and transparent communication, incorporated different strategies to build community and promote psychological wellbeing, and advanced virtual teaching modalities. The aim of this article is to share the strategies that have helped us to move forward in the aftermath of the first phases of the pandemic, whilst we prepare for the uncertainty of the future. We hope that the lessons we have learned can help inform other programs as they react and adapt to the global after-effects of this crisis.Keywords: COVID-19, pandemic, crisis response, medical education, internal medicine, residents