Hasil untuk "Public aspects of medicine"

N. Wenger, L. Speroff, B. Packard

Peter S Andrus, Claire J Standley, J Russell Stothard et al.

Lake Victoria is a well-known hot spot for intestinal schistosomiasis, caused by infection with the trematode Schistosoma mansoni. The snail intermediate hosts of this parasite are Biomphalaria snails, with Biomphalaria choanomphala being the predominant intermediate host within Lake Victoria. The prevalence of S. mansoni infection within snail populations is influenced by both biotic and abiotic factors, including the physical and chemical characteristics of their environment, the incidence of infection in human populations (and reservoir hosts) and the level of genetic compatibility between the parasite and the host. Using molecular xenomonitoring, we measured the prevalence of S. mansoni infection within B. choanomphala populations along the Kenyan, Tanzanian and Ugandan shorelines of Lake Victoria and related this to the abiotic (habitat type, water depth, turbulence, temperature, conductivity, total dissolved solids, salinity, pH level) and biotic (B. choanomphala abundance, genetic diversity of host snail populations) factors of the lake. The overall mean prevalence of S. mansoni infection at Lake Victoria was 9.3%, with the highest prevalence of infection occurring on the Tanzanian shoreline (13.1%), followed by the Ugandan (8.2%) and Kenyan (4.7%) shorelines. There was a significant difference in B. choanomphala abundance, water temperature, conductivity, salinity, total dissolved solids and major anion/cation concentrations between the Kenyan, Tanzanian and Ugandan shorelines of Lake Victoria. A Spearman's rank analysis found that the prevalence of S. mansoni infection had a significant, positive relationship with higher levels of B. choanomphala abundance, water acidity, and cation (Ca2+, Mg2+) concentrations. Additionally, we observed that sites with S. mansoni infection correlated with B. choanomphala populations with a higher mean haplotype diversity score compared to sites found without infection, though there was no significant relationship between the prevalence of infection and B. choanomphala haplotype diversity scores. Although our analysis is based upon an archival and unique collection of Biomphalaria snails, the abiotic and biotic relationships uncovered are useful for eco-epidemiological comparisons of intestinal schistosomiasis across Lake Victoria in future.

C. López, J. Torres, S.M. Colorado et al.

Emily A. Prentice, Abby Moler, Amanda Sweeney et al.

Background: The Links to Care Community Grants Project was developed to improve breast cancer outcomes by increasing access to appropriate follow-up care, improving processes for care transitions, and enhancing care coordination between community health centers (CHCs) and hospital partners. Methods: This 24-month multi-pronged project encompasses quality improvement (QI) coaching, technical assistance support, and evaluation. QI coaching follows the Model for Improvement to test and adapt to changes. Local and centralized technical assistance supports the individual needs of the health system. A data collection tool was developed to evaluate implemented interventions and assess changes in breast cancer screening and diagnostic testing completion rates, time between care transitions, and process improvements made throughout the project period. Results: Seven CHCs comprised of 27 clinic sites with 26 255 patients eligible for breast cancer screening agreed to participate. Baseline findings demonstrate an average screening rate of 51.1%. Conclusion: The Links to Care Community Grants Project will evaluate the effectiveness of implemented patient, provider, and/or system-level interventions and care coordination process improvements on reducing delays along the breast cancer care continuum.

Mariam Shamal, Hossein Hassani

Access to Kurdish medicine brochures is limited, depriving Kurdish-speaking communities of critical health information. To address this problem, we developed a specialized Machine Translation (MT) model to translate English medicine brochures into Sorani Kurdish using a parallel corpus of 22,940 aligned sentence pairs from 319 brochures, sourced from two pharmaceutical companies in the Kurdistan Region of Iraq (KRI). We trained a Statistical Machine Translation (SMT) model using the Moses toolkit, conducting seven experiments that resulted in BLEU scores ranging from 22.65 to 48.93. We translated three new brochures to improve the evaluation process and encountered unknown words. We addressed unknown words through post-processing with a medical dictionary, resulting in BLEU scores of 56.87, 31.05, and 40.01. Human evaluation by native Kurdish-speaking pharmacists, physicians, and medicine users showed that 50% of professionals found the translations consistent, while 83.3% rated them accurate. Among users, 66.7% considered the translations clear and felt confident using the medications.

P. Andreo

Ovidio A. García-Villarreal

La reparación transcatéter borde a borde constituye un enfoque terapéutico que cambia el paradigma para los pacientes con regurgitación mitral grave que se consideran de alto riesgo para cirugía de la válvula mitral convencional. A pesar de su creciente popularidad, las consecuencias a largo plazo del gradiente transmitral elevado posterior al procedimiento en cuanto a las tasas de mortalidad y morbilidad siguen siendo un tema de intenso debate. La relación recíproca entre la reducción del área mitral y el aumento del gradiente transmitral, resultante de la colocación de un clip sobre ambas valvas de la mitral, puede potencialmente socavar la eficacia y la viabilidad del procedimiento. Es esencial una consideración cuidadosa para sopesar los beneficios y riesgos de reducir la regurgitación mitral residual a ≤ 1+ a expensas de un aumento del gradiente de la válvula mitral > 5 mm Hg. El efecto que un gradiente elevado de la válvula mitral después del procedimiento puede tener sobre el resultado final, como las tasas de muerte por cualquier causa o de hospitalización por regurgitación cardíaca, actualmente es un tema polémico. En esta revisión, se analizan cada uno de estos factores para ofrecer una visión más completa de las complejidades involucradas.

Emmanouil Nikolakakis, Joann Ching, Emmanouil Karystinaios et al.

Music therapy has been shown in recent years to provide multiple health benefits related to emotional wellness. In turn, maintaining a healthy emotional state has proven to be effective for patients undergoing treatment, such as Parkinson's patients or patients suffering from stress and anxiety. We propose fine-tuning MusicGen, a music-generating transformer model, to create short musical clips that assist patients in transitioning from negative to desired emotional states. Using low-rank decomposition fine-tuning on the MTG-Jamendo Dataset with emotion tags, we generate 30-second clips that adhere to the iso principle, guiding patients through intermediate states in the valence-arousal circumplex. The generated music is evaluated using a music emotion recognition model to ensure alignment with intended emotions. By concatenating these clips, we produce a 15-minute "music medicine" resembling a music therapy session. Our approach is the first model to leverage Language Models to generate music medicine. Ultimately, the output is intended to be used as a temporary relief between music therapy sessions with a board-certified therapist.

X. Pei, Shusheng Tang, Hai-Lan Jiang et al.

The risks of Zinc oxide nanoparticles (ZnO NPs) applications in biological medicine, food processing industry, agricultural production and the biotoxicity brought by environmental invasion of ZnO NPs both gradually troubled the public due to the lack of research on detoxification strategies. TFEB-regulated autophagy-pyroptosis pathways were found as the crux of the hepatotoxicity induced by ZnO NPs in our latest study. Here, our study served as a connecting link between preceding toxic target and the following protection mechanism of Paeoniflorin (PF). According to a combined analysis of network pharmacology/molecular docking-intestinal microbiota-metabolomics first developed in our study, PF alleviated the hepatotoxicity of ZnO NPs from multiple aspects. The hepatic inflammatory injury and hepatocyte pyroptosis in mice liver exposed to ZnO NPs was significantly inhibited by PF. And the intestinal microbiota disorder and liver metabolic disturbance were rescued. The targets predicted by bioinformatics and the signal trend in subacute toxicological model exhibited the protectiveness of PF related to the SIRT1-mTOR-TFEB pathway. These evidences clarified multiple protective mechanisms of PF which provided a novel detoxification approach against ZnO NPs, and further provided a strategy for the medicinal value development of PF.

Xin-yue ZHANG, Meng WANG, Feng YU

ObjectiveTo examine the prevalence of second-hand smoke exposure (SHS) in indoor public places and the satisfaction to tobacco control in residents two years after the implementation of the Tobacco Control Regulation – 2019 in Hangzhou city of Zhejiang province, and to provide references for the promotion of the regulation. MethodsUsing stratified random sampling and a self-designed questionnaire, we conducted an on-site self-administered survey among 1 320 residents aged 15 – 75 years at 26 public places (administrative departments, hospitals, training centers, places of entertainment, restaurants, hotels and shopping malls) in two districts and one county of Hangzhou city during January 2021. ResultsAmong the 1315 valid respondents, 1 101 were non-smokers; of the non-smokers, 27.52% (303) reported being exposed to SHS during the past week. For all the respondents, 67.76% reported an overall satisfaction to tobacco control in indoor public places and 64.49%, 59.54%, and 65.63% reported the satisfaction to tobacco control propaganda, supervision on tobacco control, and government agencies′ smoke-free demonstration, respectively. The results of unconditional multivariate logistic regression analysis showed that after adjusting for gender, age, education, marital status, occupation, place of residence, self-reported chronic disease, current smoking status, awareness of core knowledge about tobacco control regulations, awareness of tobacco hazards, and willingness to participate in tobacco control, the residents reporting the satisfaction to tobacco control propaganda, tobacco control supervision and law enforcement in public places, and government agencies′ smoke-free demonstration were more likely to report a higher overall satisfaction to tobacco control. ConclusionThe prevalence of secondhand smoke exposure in indoor public places was relatively low and the satisfaction to tobacco control was high among residents in urban and rural Hangzhou after the implementation of updated tobacco control regulation.

Aaron L. Sarvet, Mats J. Stensrud

Avoiding harm is an uncontroversial aim of personalized medicine and other epidemiologic initiatives. However, the precise mathematical translation of "harm" is disputable. Here we use a formal causal language to study common, but distinct, definitions of "harm". We clarify that commitment to a definition of harm has important practical and philosophical implications for decision making. We relate our practical and philosophical considerations to ideas from medical ethics and legal practice.

Jesutofunmi A. Omiye, Haiwen Gui, Shawheen J. Rezaei et al.

Large language models (LLMs) have been applied to tasks in healthcare, ranging from medical exam questions to responding to patient questions. With increasing institutional partnerships between companies producing LLMs and healthcare systems, real world clinical application is coming closer to reality. As these models gain traction, it is essential for healthcare practitioners to understand what LLMs are, their development, their current and potential applications, and the associated pitfalls when utilized in medicine. This review and accompanying tutorial aim to give an overview of these topics to aid healthcare practitioners in understanding the rapidly changing landscape of LLMs as applied to medicine.

Shishir Rajendran, Prathic Sundararajan, Ashi Awasthi et al.

Nanorobotics offers an emerging frontier in biomedicine, holding the potential to revolutionize diagnostic and therapeutic applications through its unique capabilities in manipulating biological systems at the nanoscale. Following PRISMA guidelines, a comprehensive literature search was conducted using IEEE Xplore and PubMed databases, resulting in the identification and analysis of a total of 414 papers. The studies were filtered to include only those that addressed both nanorobotics and direct medical applications. Our analysis traces the technology's evolution, highlighting its growing prominence in medicine as evidenced by the increasing number of publications over time. Applications ranged from targeted drug delivery and single-cell manipulation to minimally invasive surgery and biosensing. Despite the promise, limitations such as biocompatibility, precise control, and ethical concerns were also identified. This review aims to offer a thorough overview of the state of nanorobotics in medicine, drawing attention to current challenges and opportunities, and providing directions for future research in this rapidly advancing field.

Elizaveta Savchenko, Svetlana Bunimovich-Mendrazitsky

In today's complex healthcare landscape, the pursuit of delivering optimal patient care while navigating intricate economic dynamics poses a significant challenge for healthcare service providers (HSPs). In this already complex dynamics, the emergence of clinically promising personalized medicine based treatment aims to revolutionize medicine. While personalized medicine holds tremendous potential for enhancing therapeutic outcomes, its integration within resource-constrained HSPs presents formidable challenges. In this study, we investigate the economic feasibility of implementing personalized medicine. The central objective is to strike a balance between catering to individual patient needs and making economically viable decisions. Unlike conventional binary approaches to personalized treatment, we propose a more nuanced perspective by treating personalization as a spectrum. This approach allows for greater flexibility in decision-making and resource allocation. To this end, we propose a mathematical framework to investigate our proposal, focusing on Bladder Cancer (BC) as a case study. Our results show that while it is feasible to introduce personalized medicine, a highly efficient but highly expensive one would be short-lived relative to its less effective but cheaper alternative as the latter can be provided to a larger cohort of patients, optimizing the HSP's objective better.

S. Capolongo, A. Rebecchi, M. Dettori et al.

Starting from a previous experience carried out by the working group “Building and Environmental Hygiene” of the Italian Society of Hygiene and Preventive Medicine (SItI), the aim of the present work is to define new strategic goals for achieving a “Healthy and Salutogenic City”, which will be useful to designers, local governments and public bodies, policy makers, and all professionals working at local health agencies. Ten key points have been formulated: 1. climate change and management of adverse weather events; 2. land consumption, sprawl, and shrinking cities; 3. tactical urbanism and urban resilience; 4. urban comfort, safety, and security perception; 5. strengths and weaknesses of urban green areas and infrastructures; 6. urban solid waste management; 7. housing emergencies in relation to socio-economic and environmental changes; 8. energy aspects and environmental planning at an urban scale; 9. socio-assistance and welfare network at an urban scale: importance of a rational and widespread system; and 10. new forms of living, conscious of coparticipation models and aware of sharing quality objectives. Design strategies, actions, and policies, identified to improve public health and wellbeing, underline that the connection between morphological and functional features of urban context and public health is crucial for contemporary cities and modern societies.

Konstantinos Tsamakis, A. Triantafyllis, D. Tsiptsios et al.

COVID-19 pandemic has caused a global public health emergency resulting in unprecedented individual and societal fear and anxiety. The stress surrounding this biothreat appears to have clinical implications in all aspects of medicine, both in mental and physical health spheres. The impact of COVID-19 related anxiety in Cardiology, Paediatrics, Oncology, Dermatology, Neurology and Mental Health and how it affects treatments is discussed. Moreover, the need for introducing novel communication and therapeutic approaches is highlighted in the new landscape of the COVID-19 era.

Juan Carlos Ibarrola-Peña, Francisco José Barbosa-Camacho, Yolanda Lorelei Almanza-Mena et al.

IntroductionUnderstanding how Mexicans behave during the pandemic could present a complete picture of the phenomenon in our country and provide better management of it.ObjectiveThis study aimed to analyze the Mexican population's behavior and preventive measures.MethodsThis was a cross-sectional study in which a total of 4,004 participants from the general population responded to the survey.ResultsAlmost 99% of the participants mentioned knowing the symptoms of COVID-19. Although 77.5% of participants considered that they followed proper social distancing measures, 60% of them mentioned that they knew at least six individuals who did not follow social distancing measures. Furthermore, 96.2% of participants reported using preventive measures at least 50% of the time. Only 51.3% used a certified mask.ConclusionThe COVID-19 pandemic outcomes in Mexico are the result of multiple negative factors, such as high rates of comorbidities, high number of people living together at home, many people breaking social isolation, and most of the population using non-certified preventive measures that may not be effective enough.

Jimmy Martin‐Delgado, Carla Tovar, Israel Pazmiño et al.

Abstract Introduction Diabetes is the second leading cause of death in Ecuador, as 79% of the indigenous population live in rural areas that are difficult to access and have below‐average health resources. The objective of this study was to define person‐centred indicators to monitor the care received by patients with diabetes in the indigenous population. Method Qualitative research combining three focus groups (with the participation of 10 patients and 18 professionals) to capture relevant information and Delphi to reach a consensus on the pertinence, relevance, and feasibility of a set of indicators was conducted. Two rounds of the Delphi technique were performed, with the participation of 64 professionals in the first round (90% response rate) and 34 in the second round (53% response rate). Results A total of 23 indicators were identified which were distributed in the previously identified six dimensions (cosmovision, accessibility, adaptability to cosmovision, resources, equipment, community care, quality culture and results). Conclusions The consensus on the set of indicators among all the participants in this study strengthened the results obtained. These indicators have considered the feasibility and relevance and aimed to achieve comprehensive person‐centred care for diabetes among the indigenous population in Ecuador and possibly the Andean community. Patient or Public Contribution These indicators’ development included patients and caregivers since its conception. During the qualitative phase of this research, relevant information on cultural and social beliefs was gathered directly from the study population to achieve patient‐centred indicators for adequate diabetes care.

Marco Gerardi, Katarzyna Barud, Marie-Catherine Wagner et al.

Machine Learning may push research in precision medicine to unprecedented heights. To succeed, machine learning needs a large amount of data, often including personal data. Therefore, machine learning applied to precision medicine is on a cliff edge: if it does not learn to fly, it will deeply fall down. In this paper, we present Active Informed Consent (AIC) as a novel hybrid legal-technological tool to foster the gathering of a large amount of data for machine learning. We carefully analyzed the compliance of this technological tool to the legal intricacies protecting the privacy of European Citizens.

Amanda M. Buch, Conor Liston, Logan Grosenick

AI-enabled precision medicine promises a transformational improvement in healthcare outcomes by enabling data-driven personalized diagnosis, prognosis, and treatment. However, the well-known "curse of dimensionality" and the clustered structure of biomedical data together interact to present a joint challenge in the high dimensional, limited observation precision medicine regime. To overcome both issues simultaneously we propose a simple and scalable approach to joint clustering and embedding that combines standard embedding methods with a convex clustering penalty in a modular way. This novel, cluster-aware embedding approach overcomes the complexity and limitations of current joint embedding and clustering methods, which we show with straightforward implementations of hierarchically clustered principal component analysis (PCA), locally linear embedding (LLE), and canonical correlation analysis (CCA). Through both numerical experiments and real-world examples, we demonstrate that our approach outperforms traditional and contemporary clustering methods on highly underdetermined problems (e.g., with just tens of observations) as well as on large sample datasets. Importantly, our approach does not require the user to choose the desired number of clusters, but instead yields interpretable dendrograms of hierarchically clustered embeddings. Thus our approach improves significantly on existing methods for identifying patient subgroups in multiomics and neuroimaging data, enabling scalable and interpretable biomarkers for precision medicine.