Hasil untuk "Other systems of medicine"

Lubomira Tosheva and, V. Valtchev

T. Brennan, L. Blank, Jordan J. Cohen et al.

T. Lammers, S. Aime, W. Hennink et al.

Nanomedicine formulations aim to improve the biodistribution and the target site accumulation of systemically administered (chemo)therapeutic agents. Many different types of nanomedicines have been evaluated over the years, including for instance liposomes, polymers, micelles and antibodies, and a significant amount of evidence has been obtained showing that these submicrometer-sized carrier materials are able to improve the balance between the efficacy and the toxicity of therapeutic interventions. Besides for therapeutic purposes, nanomedicine formulations have in recent years also been increasingly employed for imaging applications. Moreover, paralleled by advances in chemistry, biology, pharmacy, nanotechnology, medicine and imaging, several different systems have been developed in the last decade in which disease diagnosis and therapy are combined. These so-called (nano) theranostics contain both a drug and an imaging agent within a single formulation, and they can be used for various different purposes. In this Account, we summarize several exemplary efforts in this regard, and we show that theranostic nanomedicines are highly suitable systems for monitoring drug delivery, drug release and drug efficacy. The (pre)clinically most relevant applications of theranostic nanomedicines relate to their use for validating and optimizing the properties of drug delivery systems, and to their ability to be used for pre-screening patients and enabling personalized medicine. Regarding the former, the combination of diagnostic and therapeutic agents within a single formulation provides real-time feedback on the pharmacokinetics, the target site localization and the (off-target) healthy organ accumulation of nanomedicines. Various examples of this will be highlighted in this Account, illustrating that by non-invasively visualizing how well carrier materials are able to deliver pharmacologically active agents to the pathological site, and how well they are able to prevent them from accumulating in potentially endangered healthy tissues, important information can be obtained for optimizing the basic properties of drug delivery systems, as well as for improving the balance between the efficacy and the toxicity of targeted therapeutic interventions. Regarding personalized medicine, it can be reasoned that only in patients which show high levels of target site accumulation, and which respond well to the first couple of treatment cycles, targeted therapy should be continued, and that in those in which this is not the case, other therapeutic options should be considered. Based on these insights, we expect that ever more efforts will be invested in developing theranostic nanomedicines, and that these systems and strategies will contribute substantially to realizing the potential of personalized medicine.

T. Kaptchuk

S. Nabavi, Dunja Šamec, M. Tomczyk et al.

Plants, fungi, and microorganisms are equipped with biosynthesis machinery for producing thousands of secondary metabolites. These compounds have important functions in nature as a defence against predators or competitors as well as other ecological significances. The full utilization of these compounds for food, medicine, and other purposes requires a thorough understanding of their structures and the distinct biochemical pathways of their production in cellular systems. In this review, flavonoids as classical examples of secondary metabolites are employed to highlight recent advances in understanding how valuable compounds can be regulated at various levels. With extensive diversity in their chemistry and pharmacology, understanding the metabolic engineering of flavonoids now allows us to fine-tune the eliciting of their production, accumulation, and extraction from living systems. More specifically, recent advances in the shikimic acid and acetate biosynthetic pathways of flavonoids production from metabolic engineering point of view, from genes expression to multiple principles of regulation, are addressed. Specific examples of plants and microorganisms as the sources of flavonoids-based compounds with particular emphasis on therapeutic applications are also discussed.

L. Mishra, Betsy B. Singh, S. Dagenais

S. Amendola, R. Lodato, S. Manzari et al.

The current evolution of the traditional medical model toward the participatory medicine can be boosted by the Internet of Things (IoT) paradigm involving sensors (environmental, wearable, and implanted) spread inside domestic environments with the purpose to monitor the user's health and activate remote assistance. RF identification (RFID) technology is now mature to provide part of the IoT physical layer for the personal healthcare in smart environments through low-cost, energy-autonomous, and disposable sensors. It is here presented a survey on the state-of-the-art of RFID for application to body centric systems and for gathering information (temperature, humidity, and other gases) about the user's living environment. Many available options are described up to the application level with some examples of RFID systems able to collect and process multichannel data about the human behavior in compliance with the power exposure and sanitary regulations. Open challenges and possible new research trends are finally discussed.

Julie S. Jurenka

W. Tao, Xue Xu, Xia Wang et al.

Haajira Beevi Habeeb Rahuman, Ranjithkumar Dhandapani, S. Narayanan et al.

Abstract The alarming effect of antibiotic resistance prompted the search for alternative medicine to resolve the microbial resistance conflict. Over the last two decades, scientists have become increasingly interested in metallic nanoparticles to discover their new dimensions. Green nano synthesis is a rapidly expanding field of interest in nanotechnology due to its feasibility, low toxicity, eco‐friendly nature, and long‐term viability. Some plants have long been used in medicine because they contain a variety of bioactive compounds. Silver has long been known for its antibacterial properties. Silver nanoparticles have taken a special place among other metal nanoparticles. Silver nanotechnology has a big impact on medical applications like bio‐coating, novel antimicrobial agents, and drug delivery systems. This review aims to provide a comprehensive understanding of the pharmaceutical qualities of medicinal plants, as well as a convenient guideline for plant‐based silver nanoparticles and their antimicrobial activity.

S. Pfeifer, M. Attaran, J. Goldstein et al.

There are many proposed classification systems for müllerian anomalies. The American Fertility Society (AFS) Classification from 1988 has been the most recognized and utilized. The advantages of this iconic classification include its simplicity, recognizability, and correlation with clinical pregnancy outcomes. However, the AFS classification has been criticized for its focus primarily on uterine anomalies, with exclusion of those of the vagina and cervix, its lack of clear diagnostic criteria, and its inability to classify complex aberrations. Despite this classification and others, the wide range of müllerian anomalies is still largely unknown and confusing to many providers. Consequently, müllerian anomalies may go undiagnosed for extended periods, receive inappropriate or inadequate surgical interventions, and result in persistent issues such as pain or loss of reproductive function. The American Society for Reproductive Medicine Task Force on Müllerian Anomalies Classification was formed and charged with designing a new classification. The Task Force set goals for a new classification and chose to base it on the iconic AFS classification from 1988 because of its simplicity and recognizability, while expanding and updating it to include all categories of anomalies. In addition, this was recognized as an opportunity to raise awareness of this area of medicine, educate providers and learners, and promote patient advocacy. Presented here is the new American Society for Reproductive Medicine Müllerian Anomalies Classification 2021.

S. Kalogirou

James C. Martin, R. Avant, M. Bowman et al.

BACKGROUND Recognizing fundamental flaws in the fragmented US health care systems and the potential of an integrative, generalist approach, the leadership of 7 national family medicine organizations initiated the Future of Family Medicine (FFM) project in 2002. The goal of the project was to develop a strategy to transform and renew the discipline of family medicine to meet the needs of patients in a changing health care environment. METHODS A national research study was conducted by independent research firms. Interviews and focus groups identified key issues for diverse constituencies, including patients, payers, residents, students, family physicians, and other clinicians. Subsequently, interviews were conducted with nationally representative samples of 9 key constituencies. Based in part on these data, 5 task forces addressed key issues to meet the project goal. A Project Leadership Committee synthesized the task force reports into the report presented here. RESULTS The project identified core values, a New Model of practice, and a process for development, research, education, partnership, and change with great potential to transform the ability of family medicine to improve the health and health care of the nation. The proposed New Model of practice has the following characteristics: a patient-centered team approach; elimination of barriers to access; advanced information systems, including an electronic health record; redesigned, more functional offices; a focus on quality and outcomes; and enhanced practice finance. A unified communications strategy will be developed to promote the New Model of family medicine to multiple audiences. The study concluded that the discipline needs to oversee the training of family physicians who are committed to excellence, steeped in the core values of the discipline, competent to provide family medicine’s basket of services within the New Model, and capable of adapting to varying patient needs and changing care technologies. Family medicine education must continue to include training in maternity care, the care of hospitalized patients, community and population health, and culturally effective and proficient care. A comprehensive lifelong learning program for each family physician will support continuous personal, professional, and clinical practice assessment and improvement. Ultimately, systemwide changes will be needed to ensure high-quality health care for all Americans. Such changes include taking steps to ensure that every American has a personal medical home, promoting the use and reporting of quality measures to improve performance and service, advocating that every American have health care coverage for basic services and protection against extraordinary health care costs, advancing research that supports the clinical decision making of family physicians and other primary care clinicians, and developing reimbursement models to sustain family medicine and primary care practices. CONCLUSIONS The leadership of US family medicine organizations is committed to a transformative process. In partnership with others, this process has the potential to integrate health care to improve the health of all Americans.

J. Mano

Constantine P. Firme, P. Bandaru

Hiroshi Tateishi, Hiroko Kunitake, Masahiro Ohgidani et al.

Background The neuroinflammatory hypothesis has been proposed as the pathophysiology of depression, and microglia are suggested to have crucial roles by modulating neuroinflammatory responses in patients with depression. We have originally developed human blood induced microglia-like (iMG) cells, which are surrogate cells to predict activities of human brain microglia for reverse-translational research. Repetitive transcranial magnetic stimulation (rTMS) is an effective therapeutic method for improving depressive symptoms in patients with treatment-resistant depression (TRD); however, its details remain unknown. The aim of this study was to predict how rTMS alters the phenotype of microglia using iMG cells of patients with TRD.Methods Five patients with TRD were enrolled in a frequency (10 Hz) rTMS study. Microarray analysis of the iMG cells of patients with TRD at baseline and the end of the 6-week rTMS treatment was performed in the five domains of immunity, inflammation, phagocytosis, metabolic syndrome, and lipids.Results Three of the five were rTMS responders and two were non-responders for depressive symptoms. Microarray analysis of responders showed that rTMS treatment significantly increased the RNA expression of 21 genes, including genes related to neuroinflammation, acting in a direction to promote neuroinflammation, and significantly decreased four genes.Limitations The main limitations were the small sample size and the lack of control conditions using the sham rTMS procedure.Conclusion This study suggests that rTMS treatment may alter iMG genes, including immune-related genes, in patients with TRD. Future studies should confirm these findings using a larger patient sample size and a sham rTMS procedure.

Lalesca Faria Zanoti, Giovanna Bardi

Em 2011, a terapia ocupacional foi reconhecida como uma das categorias que podem compor a equipe de referência e a gestão dos equipamentos do SUAS, havendo um aumento de terapeutas ocupacionais neste setor no cenário nacional. Essa pesquisa teve como objetivo mapear a inserção de terapeutas ocupacionais nas unidades socioassistenciais do Espírito Santo de 2012 a 2019, apreendendo dados gerais acerca do trabalho desenvolvido e dos profissionais. Trata-se de uma pesquisa quanti-qualitativa, descritiva e analítica, realizada através da base de dados pública “Censo SUAS”. Em 2019, existiam 34 profissionais em unidades socioassistenciais no Espírito Santo, sendo que a maior parte atuava nos Centros Dia e nos CREAS. Os vínculos de trabalho mais frequentes (67,6%) foram de empregados do setor privado, servidores temporários e trabalhadores de empresa/cooperativa/entidade. A maioria dos profissionais eram técnicos de nível superior (85,2%), com carga horária semanal de trabalho entre 21 e 30 horas (50%), do sexo feminino (91,1%) e com idade entre 21 e 30 anos (50%). Apesar do aumento de terapeutas ocupacionais no SUAS no estado, ainda é necessária organização profissional para maior inserção, sobretudo na proteção social básica, tendo como princípio o trabalho multiprofissional para atender às necessidades da população brasileira.

K. Hylkilä, N. Männikkö, A. Peltonen et al.

Background: This systematic review aimed to synthesize current evidence of an association between problematic social networking site use (PSNSU) and social well-being and predictors of PSNSU among young adults (18–35 years). Methods: The systematic review considered cross-sectional and cohort studies that assessed the association between PSNSU and social well-being among young adults. The JBI systematic review methodology of etiology and risk was followed. Data were collected from eight electronic databases and manually from reference lists of selected studies. Two independent reviewers selected studies by screening titles, abstracts and full texts and assessed the quality of the included studies. Data were extracted and synthesized with narrative methods. Results: Twenty one (n = 21) studies were included in the final review. The results showed that there were associations between PSNSU and different social well-being factors, e.g., associations were found between PSNSU and social and parasocial relationships on social networking sites and social media anxiety. Also some predictive factors were found. Limitations: Although, the search strategies were developed in conjunction with an information specialist, some keywords might have been missed, which could have affected the search results. Social well-being and PSNS use can be defined in many ways, which may have affected which studies were excluded. Language limitations might affect to the study inclusion. Conclusions: In most cases, PSNSU was associated with lower social well-being, although some mixed results were obtained. Definitions of PSNSU and social well-being varied widely. Therefore, in the future, it would be beneficial to have clear concepts for PSNSU and social well-being. It is also important to consider social aspects in PSNSU.

Pikkin Lau, Lingfeng Wang, Wei Wei et al.

In this paper, a novel cyber-insurance model design is proposed based on system risk evaluation with smart technology applications. The cyber insurance policy for power systems is tailored via cyber risk modeling, reliability impact analysis, and insurance premium calculation. A stochastic Epidemic Network Model is developed to evaluate the cyber risk by propagating cyberattacks among graphical vulnerabilities. Smart technologies deployed in risk modeling include smart monitoring and job thread assignment. Smart monitoring boosts the substation availability against cyberattacks with preventive and corrective measures. The job thread assignment solution reduces the execution failures by distributing the control and monitoring tasks to multiple threads. Reliability assessment is deployed to estimate load losses convertible to monetary losses. These monetary losses would be shared through a mutual insurance plan. To ensure a fair distribution of indemnity, a new Shapley mutual insurance principle is devised. Effectiveness of the proposed Shapley mutual insurance design is validated via case studies. The Shapley premium is compared with existent premium designs. It is shown that the Shapley premium has high indemnity levels closer to those of Tail Conditional Expectation premium. Meanwhile, the Shapley premium is nearly as affordable as the coalitional premium and keeps a relatively low insolvency probability.

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.