Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 145
Filtrar
Más filtros

Medicinas Complementárias
Tipo del documento
Intervalo de año de publicación
1.
Cogn Res Princ Implic ; 9(1): 19, 2024 04 03.
Artículo en Inglés | MEDLINE | ID: mdl-38568356

RESUMEN

Artificial intelligence is already all around us, and its usage will only increase. Knowing its capabilities is critical. A facial recognition system (FRS) is a tool for law enforcement during suspect searches and when presenting photos to eyewitnesses for identification. However, there are no comparisons between eyewitness and FRS accuracy using video, so it is unknown whether FRS face matches are more accurate than eyewitness memory when identifying a perpetrator. Ours is the first application of artificial intelligence to an eyewitness experience, using a comparative psychology approach. As a first step to test system accuracy relative to eyewitness accuracy, participants and an open-source FRS (FaceNet) attempted perpetrator identification/match from lineup photos (target-present, target-absent) after exposure to real crime videos with varied clarity and perpetrator race. FRS used video probe images of each perpetrator to achieve similarity ratings for each corresponding lineup member. Using receiver operating characteristic analysis to measure discriminability, FRS performance was superior to eyewitness performance, regardless of video clarity or perpetrator race. Video clarity impacted participant performance, with the unclear videos yielding lower performance than the clear videos. Using confidence-accuracy characteristic analysis to measure reliability (i.e., the likelihood the identified suspect is the actual perpetrator), when the FRS identified faces with the highest similarity values, they were accurate. The results suggest FaceNet, or similarly performing systems, may supplement eyewitness memory for suspect searches and subsequent lineup construction and knowing the system's strengths and weaknesses is critical.


Asunto(s)
Inteligencia Artificial , Crimen , Humanos , Reproducibilidad de los Resultados , Suplementos Dietéticos , Prueba de Esfuerzo
2.
Rev. int. med. cienc. act. fis. deporte ; 24(95): 1-23, mar.-2024. graf, tab
Artículo en Inglés | IBECS | ID: ibc-ADZ-313

RESUMEN

CBA is a sports event that allows fans to enjoy themselves and players to give full play, and traditional Chinese cultural values have a profound influence on it. This paper takes the 100 sets of historical rating data of the fourteen teams in CBA league as the basic basis, firstly, we simply deal with the 100 sets of historical rating data and use Excel function formula to find out the mean, extreme deviation and variance of each team, then we carry out SAS normal test, and we find that except for the very few data with large deviation, the historical rating data satisfy the normal distribution. Through the outlier algorithm to screen the values, compare the confidence intervals as well as carry out hypothesis testing, to objectively and scientifically explore the probability of each team winning the championship in the CBA league. Compare the probability of winning the championship of these fourteen teams and predict the top four teams in the CBA league to ensure that the prediction results are as reasonable as possible. With the help of hierarchical analysis to qualitatively analyze the level of each team, and then through cluster analysis to compare these data, and combined with the trend of the development of the world's basketball movement, the use of multiple regression and SPSS to analyze the level of the team's factors, in-depth thinking about the league, a more reasonable to give a more scientific to improve the probability of the team's winning the championship, and to promote better development of the basketball movement. (AU)


Asunto(s)
Humanos , Intervalos de Confianza , Pruebas de Hipótesis , Predicción , Apoyo a la Investigación como Asunto , Baloncesto
3.
Gynecol Oncol ; 183: 1-6, 2024 04.
Artículo en Inglés | MEDLINE | ID: mdl-38460222

RESUMEN

BACKGROUND: Patients with a personal or family history of cancer may have elevated risk of developing future cancers, which often remains unrecognized due to lapses in screening. This pilot study assessed the usability and clinical outcomes of a cancer risk stratification tool in a gynecologic oncology clinic. METHODS: New gynecologic oncology patients were prompted to complete a commercially developed personal and family history-based risk stratification tool to assess eligibility for genetic testing using National Comprehensive Cancer Network criteria and estimated lifetime breast cancer risk using the Tyrer-Cuzick model. After use of the risk stratification tool, usability was assessed via completion rate and the System Usability Scale, and health literacy was assessed using the BRIEF Health Literacy Screening Tool. RESULTS: 130 patients were prompted to complete the risk stratification tool; 93 (72%) completed the tool. Race and ethnicity and insurance type were not associated with tool completion. The median System Usability Scale score was 83 out of 100 (interquartile range, 60-95). Health literacy positively correlated with perceived usability. Public insurance and race or ethnicity other than non-Hispanic White was associated with lower perceived usability. Sixty (65%) patients met eligibility criteria for genetic testing, and 21 (38% of 56 eligible patients) were candidates for enhanced breast cancer screening based on an estimated lifetime breast cancer risk of ≥20%. CONCLUSIONS: A majority of patients completed the digital cancer risk stratification tool. Older age, lower health literacy, public insurance, and race or ethnicity other than non-Hispanic White were associated with lower perceived tool usability.


Asunto(s)
Pruebas Genéticas , Alfabetización en Salud , Humanos , Proyectos Piloto , Femenino , Persona de Mediana Edad , Medición de Riesgo/métodos , Adulto , Pruebas Genéticas/métodos , Predisposición Genética a la Enfermedad , Neoplasias de la Mama/genética , Neoplasias de la Mama/diagnóstico , Anciano
4.
Brief Bioinform ; 25(2)2024 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-38324622

RESUMEN

Liquid chromatography coupled with high-resolution mass spectrometry data-independent acquisition (LC-HRMS/DIA), including MSE, enable comprehensive metabolomics analyses though they pose challenges for data processing with automatic annotation and molecular networking (MN) implementation. This motivated the present proposal, in which we introduce DIA-IntOpenStream, a new integrated workflow combining open-source software to streamline MSE data handling. It provides 'in-house' custom database construction, allows the conversion of raw MSE data to a universal format (.mzML) and leverages open software (MZmine 3 and MS-DIAL) all advantages for confident annotation and effective MN data interpretation. This pipeline significantly enhances the accessibility, reliability and reproducibility of complex MSE/DIA studies, overcoming previous limitations of proprietary software and non-universal MS data formats that restricted integrative analysis. We demonstrate the utility of DIA-IntOpenStream with two independent datasets: dataset 1 consists of new data from 60 plant extracts from the Ocotea genus; dataset 2 is a publicly available actinobacterial extract spiked with authentic standard for detailed comparative analysis with existing methods. This user-friendly pipeline enables broader adoption of cutting-edge MS tools and provides value to the scientific community. Overall, it holds promise for speeding up metabolite discoveries toward a more collaborative and open environment for research.


Asunto(s)
Metabolómica , Programas Informáticos , Reproducibilidad de los Resultados , Flujo de Trabajo , Metabolómica/métodos , Espectrometría de Masas/métodos , Cromatografía Liquida/métodos
5.
Rev. bras. educ. méd ; 48(2): e050, 2024. tab, graf
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-1559446

RESUMEN

RESUMO Introdução: Demandas sociais suscitaram questionamentos sobre o ensino médico. Assim, surgiram tendências de formação generalista, que atendam às necessidades da população. A matriz curricular da Faculdade de Medicina da Universidade Federal de Alagoas é composta pelos eixos: teórico-prático integrado, aproximação à prática médica e à comunidade, e desenvolvimento pessoal, indissociáveis e de caráter interdisciplinar. Objetivo: Este estudo teve como objetivo desenvolver atividades interdisciplinares entre os três eixos curriculares no curso de Medicina de uma universidade pública. Método: Utilizou-se a pesquisa-ação como estratégia metodológica com análise de conteúdo, e adotou-se o software Iramuteq para análise das discussões entre pesquisadores e participantes, as quais foram divididas em cinco encontros permeados por obras literárias e música motivadora, correlacionando-se com a interdisciplinaridade. Resultado: Em relação aos debates sobre a temática, foram geradas nuvens de palavras, análises de similitude e dendrogramas que refletiram o pensamento dos participantes e a complexidade da temática. Os participantes focaram o discurso na saúde do aluno, nas relações interpessoais, em espaços que propiciem a interdisciplinaridade, bem como na comunicação entre os professores. Além disso, discutiram-se a necessidade da interdisciplinaridade no currículo médico e a importância da relação médico-paciente e da visão holística da medicina. Por fim, foram criados dois casos clínicos que evidenciaram os aspectos socioeconômicos e patológicos das doenças. Conclusão: A pesquisa-ação e a utilização do Iramuteq foram de suma importância para a coleta de dados de maneira fidedigna e rápida. Observou-se que o curso de Medicina prima pelo ensino da ética e da bioética nas disciplinas eletivas e obrigatórias até o sexto período e tem uma lacuna nos demais períodos, sendo sugerida a criação da disciplina de Humanidades para o sétimo período. Há uma demanda por uma interação mais expressiva nos projetos de extensão e por maior socialização dos professores e comunicação entre as disciplinas intra e intereixos.


ABSTRACT Introduction: Social demands have raised questions about medical education. This has led to trends towards generalist training that meets the needs of the population. The curricular matrix of the Faculty of Medicine of the Universidade Federal de Alagoas is made up of the following axes: integrated theoretical-practical, approach to medical practice and the community, and personal development, which are inseparable and interdisciplinary in nature. Objective: This study aimed to develop interdisciplinary activities between the three curricular axes in the medical course of a public university. Method: Action research was used as a methodological strategy with content analysis using Iramuteq software to analyse the discussions between researchers and participants, which were divided into five meetings, permeated by literary works and motivating music, correlated with interdisciplinarity. Results: Word clouds, similarity analyses and dendrograms were generated from the debates on the subject, reflecting the participants' thoughts and the complexity of the subject. Participants focused their discourse on student health, interpersonal relationships, spaces that foster interdisciplinarity and communication between teachers. They also discussed the need for interdisciplinarity in the medical curriculum and the importance of the doctor-patient relationship and a holistic view of medicine. Finally, two clinical cases were created which highlighted the socio-economic aspects of disease.

6.
Front Neurosci ; 17: 1292478, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38053608

RESUMEN

Objective: The relationship between acupoint sensitization and acupoint specificity is a topic of significant interest in acupuncture research. Numerous clinical studies have demonstrated that needling pain sensitive acupoints yields superior therapeutic outcomes compared to traditional acupoints, particularly in the context of pain disorders. However, there is a lack of bibliometric analysis in acupuncture area. Therefore, the objective of this study is to offer a comprehensive overview of the knowledge structure and research hotspots pertaining to acupoint sensitization and acupoint specificity. Methods: The search for publications pertaining to acupoint sensitization and acupoint specificity was conducted in the Web of Science Core Collection (WoSCC) database from its inception until August 11, 2023. Subsequently, bibliometric analyses were carried out using VOSviewer, CiteSpace, R software (Bibliometrix package), and GraphPad Prism software. Results: This study includes 4,940 articles from 72 countries, with China and the United States being the leading countries. The number of publications related to acupoint sensitization and specificity has been increasing annually. Major research institutions involved in this field include the Shanghai University of Traditional Chinese Medicine, Kyung Hee University, Beijing University of Chinese Medicine, Chinese Academy of Chinese Medical Sciences, and China Medical University, among others. "Evidence-based Complementary and Alternative Medicine" is the most popular journal in acupuncture field, and "PAIN" is the most co-cited journal. Publications are contributed by 20,325 authors from all over the world, with Wu Huangan, Fang Jianqiao, Lin Yi-Wen, Liu Huirong, and Chen Rixin having published the most articles. Han Ji-Sheng is the most cited author in this research area. The main directions include the study of temperature specificity of acupoints, the diagnosis of acupoint sensitization diseases, and the study of the mechanism of acupoint sensitization. The most listed keywords in recent years are "TRPV1," "signaling pathway," and "diagnosis." Conclusion: This is the first bibliometric study to comprehensively summarize research trends and advances in acupoint sensitization and acupoint specificity, and the information highlights recent research preliminary and main directions that serve as a reference for acupoint sensitization and acupoint specificity research.

7.
J Med Internet Res ; 25: e50158, 2023 12 20.
Artículo en Inglés | MEDLINE | ID: mdl-38117545

RESUMEN

Digital health tools, platforms, and artificial intelligence- or machine learning-based clinical decision support systems are increasingly part of health delivery approaches, with an ever-greater degree of system interaction. Critical to the successful deployment of these tools is their functional integration into existing clinical routines and workflows. This depends on system interoperability and on intuitive and safe user interface design. The importance of minimizing emergent workflow stress through human factors research and purposeful design for integration cannot be overstated. Usability of tools in practice is as important as algorithm quality. Regulatory and health technology assessment frameworks recognize the importance of these factors to a certain extent, but their focus remains mainly on the individual product rather than on emergent system and workflow effects. The measurement of performance and user experience has so far been performed in ad hoc, nonstandardized ways by individual actors using their own evaluation approaches. We propose that a standard framework for system-level and holistic evaluation could be built into interacting digital systems to enable systematic and standardized system-wide, multiproduct, postmarket surveillance and technology assessment. Such a system could be made available to developers through regulatory or assessment bodies as an application programming interface and could be a requirement for digital tool certification, just as interoperability is. This would enable health systems and tool developers to collect system-level data directly from real device use cases, enabling the controlled and safe delivery of systematic quality assessment or improvement studies suitable for the complexity and interconnectedness of clinical workflows using developing digital health technologies.


Asunto(s)
Inteligencia Artificial , Sistemas de Apoyo a Decisiones Clínicas , Humanos , Salud Digital , Algoritmos , Aprendizaje Automático
8.
Estima (Online) ; 21(1): e1260, jan-dez. 2023.
Artículo en Inglés, Portugués | LILACS, BDENF | ID: biblio-1510119

RESUMEN

Objetivo:Investigar estudos que apresentem sistemas computacionais de auxílio à cicatrização de feridas e quais sistemas se referem ao uso de laser de baixa intensidade. Método: Revisão de escopo que visou responder à questão de pesquisa: Quais sistemas computacionais auxiliam na cicatrização de feridas? Uma subquestão foi: quais sistemas computacionais se referem ao uso do laser de baixa intensidade? Resultados: A partir da busca, aplicando os critérios de elegibilidade, 49 artigos compuseram a amostra final. Os sistemas apresentaram várias finalidades de apoio à cicatrização de feridas, em que a maioria apresentou como usuário do sistema o profissional de saúde, sendo a medicina a área profissional mais mencionada, embora a enfermagem esteja envolvida com o manejo do cuidado às pessoas com feridas. Foi relatada com frequência a inovação na assistência a partir do uso do sistema computacional, o que demonstra a importância desse tipo de ferramenta para a prática clínica. Verificou-se com frequência o uso de plataforma mobile, como tendência da atualidade. Conclusão: Os sistemas computacionais têm sido utilizados como ferramentas para apoiar pacientes e principalmente profissionais na cicatrização de feridas. Quanto ao laser de baixa intensidade, houve escassez de sistemas computacionais com essa finalidade, com apenas um estudo.


Objective:To investigate studies that present computational systems to aid healing and systems which refer to the use of low-level laser. Method: Scope review that aimed to answer the question: Which computer systems help in wound healing? A subquestion was: Which of the computer systems refer to the use of low-level laser? Results: From the search, applying the eligibility criteria, 49 articles made up the final sample. The systems served multiple purposes in support of wound healing; the majority presented the health professional as a user of the system; medicine was the most mentioned professional area despite nursing being involved in the management of care for people with wounds. Innovation in care using the computer system was frequently reported, demonstrating the importance of this type of tool for clinical practice. There was a high frequency of the mobile platform, showing that this is a current trend. Conclusion: Computer systems have been used as tools to support patients and especially professionals in wound healing. Regarding the systems aimed at the low intensity laser, there was a shortage of computer systems for this purpose, with a study.


Objetivo:Investigar estudios que presenten sistemas computacionales de ayuda a la cicatrización y sistemas que se refieran al uso de láser de bajo nivel. Método: Revisión de alcance que tuvo como objetivo responder a la pregunta: ¿Qué sistemas informáticos ayudan en la cicatrización de heridas? Una subpregunta fue: ¿Cuál de los sistemas informáticos se refieren al uso de láser de bajo nivel? Resultados: A partir de la búsqueda, aplicando los criterios de elegibilidad, 49 artículos conformaron la muestra final. Los sistemas sirvieron para múltiples propósitos en apoyo de la cicatrización de heridas; la mayoría presentó al profesional de la salud como usuario del sistema; la medicina fue el área profesional más mencionadas, a pesar de que la enfermería está involucrada en la gestión del cuidado de las personas con heridas. La innovación en la atención basada en el uso del sistema informático fue relatada con frecuencia, demostrando la importancia de este tipo de herramienta para la práctica clínica. Hubo una alta frecuencia de la plataforma móvil, lo que demuestra que esta es una tendencia actual. Conclusión: Los sistemas informáticos se han utilizado como herramientas de apoyo a los pacientes y especialmente a los profesionales en la cicatrización de heridas. En cuanto a los sistemas dirigidos al láser de baja intensidad, hubo escasez de sistemas informáticos para este fin, con un estudio.


Asunto(s)
Humanos , Cicatrización de Heridas , Programas Informáticos , Terapia por Luz de Baja Intensidad , Biología de Sistemas/métodos , Simulación por Computador
9.
JMIR Mhealth Uhealth ; 11: e47407, 2023 10 30.
Artículo en Inglés | MEDLINE | ID: mdl-37933414

RESUMEN

Background: Digital therapeutics (DTx) are therapeutic interventions driven by software and directly provided to patients, allowing them to manage their health with ease in any setting. A growing interest in DTx has spurred a discussion concerning their reimbursement pathways. However, DTx are still at a premature stage, with insufficient evidence on effectiveness, efficiency, and safety. Currently, although industries desire to quickly enter the market, especially by getting their products reimbursed by the National Health Insurance (NHI) fund, the NHI is cautious about DTx due to their uncertainties. Thus, public discussion and social consensus are crucial in deciding whether to reimburse DTx by the NHI fund. Objective: This study examined multiple stakeholders' awareness and attitudes toward DTx and perceptions of regulatory pathways for adopting DTx. Methods: In-depth interviews were conducted with 11 stakeholders in South Korea (industry: n=4, health care: n=3, academia: n=2, and consumer: n=2) using semistructured guidelines. They were purposively sampled to identify individuals with expertise in DTx and NHI policies. The interviews were conducted either in person or via a videoconference for 45-70 minutes. Qualitative data were analyzed using directed content analysis, which uses interview guidelines as an analytical framework. Results: Findings were divided into three categories: (1) awareness and attitude toward DTx, (2) perception of whether DTx are worth entering the market and being reimbursed by the NHI fund, and (3) perception of how to enter the market and how to reimburse DTx by the NHI fund if they are worth it. Although consumer stakeholders were not familiar with the basic concept of DTx, the other stakeholders understood it thoroughly. However, all participants showed positive attitudes and acceptance of DTx. Most of them responded that DTx are worth entering the market, but they could not reach an agreement on the pathways for DTx to enter the market. Although participants were in favor of the reimbursement of DTx in principle, they responded that a conservative approach is required due to insufficient clinical evidence for DTx. Conclusions: We found that stakeholders in South Korea had positive attitudes toward DTx, perceived them as worth using, and agreed to allow them to enter the market. The main issue was not the problem of the technology itself but the difference in opinion as to the pathways for reimbursement. Therefore, this study concluded that the NHI fund, which is operated very conservatively, is insufficient to quickly adopt and implement DTx. Various reimbursement methods, including tax-based financing, raising innovation funds for new technologies, and pilot studies using the NHI fund, should be used to rapidly generate clinical evidence and reduce the uncertainties of DTx to secure a stable market.


Asunto(s)
Atención a la Salud , Política de Salud , Humanos , Programas Nacionales de Salud , República de Corea , Investigación Cualitativa
10.
Environ Sci Pollut Res Int ; 30(54): 115322-115336, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37884723

RESUMEN

China's critical reliance on well-crafted public policies, coupled with the effective execution of central government directives at the local level, drives the achievement of the "dual carbon" goal including the peaking of CO2 emissions and attaining carbon neutrality. Therefore, examining policy records can unveil the holistic strategy for attaining carbon neutrality during the period of peak CO2 emissions; at the same time, it can also highlight the potential obstacles in policy implementation. In this study, we adopt a policy instruments perspective to investigate data related to policies addressing peak CO2 emissions across 29 provincial administrative regions in China. We apply Nvivo12 software to conduct a quantitative literature assessment and content analysis to establish a theoretical framework for the policy process. This framework encompasses dimensions such as political feasibility, regional coordination, attributes of low-carbon initiatives, and policy refinement. Subsequently, we employ the model to carry out a retrospective analysis of policy documents pertaining to peak CO2 emissions in China. Our research findings underscore the pivotal role of political feasibility in shaping policy effectiveness, while also highlighting the facilitative influence of regional coordination, shedding light on the essential synergy between provinces and cities in achieving emissions reduction goals. Similarly, the estimated results highlight the motivating impact of specific attributes within low-carbon initiatives. Moreover, policy enhancements are identified as a critical driver in advancing the path toward carbon neutrality. Consequently, to achieve the objective of carbon neutrality, it is imperative for every province and city to sequentially reach the peak of CO2 emissions. Our research offers a comprehensive "China strategy," providing valuable insights to guide future policy formulation and accelerate progress toward sustainable environmental objectives.


Asunto(s)
Dióxido de Carbono , Política Pública , Estudios Retrospectivos , Carbono , China , Desarrollo Económico
11.
Acta Neurochir (Wien) ; 165(11): 3397-3402, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-37787840

RESUMEN

PURPOSE: Deep brain stimulation (DBS) relies on precise targeting of key structures such as the subthalamic nucleus (STN) for Parkinson's disease (PD) and the ventro-intermedius nucleus of the thalamus (Vim) for essential tremor (ET). Segmentation software, such as GuideXT© and Suretune©, are commercially available for atlas-based identification of deep brain structures. However, no study has compared the concordance of the segmentation results between the two software. METHODS: We retrospectively compared the concordance of segmentation of GuideXT© and Suretune© software by comparing the position of the segmented key structures with clinically predicted targets obtained using the newly developed RebrAIn© software as a reference. RESULTS: We targeted the STN in 44 MRI from PD patients (88 hemispheres) and the Vim in 31 MRI from ET patients (62 hemispheres) who were elected for DBS. In 22 STN targeting (25%), the target positioning was not correlating between GuideXT© and Suretune©. Regarding the Vim, targets were located in the segmented Vim in 37%, the posterior subthalamic area (PSA) in 60%, and the STN in 3% of the cases using GuideXT©; the proportions were 34%, 60%, and 6%, respectively, using Suretune©. The mean distance from the centre of the RebrAIn© targeting to the segmented Vim by Suretune© was closer (0.64 mm) than with GuideXT© (0.96 mm; p = 0.0004). CONCLUSION: While there is some level of concordance in the segmentation results of key structures for DBS treatment among software models, differences persist. Therefore, such software should still be considered as tools and should not replace clinician experience in DBS planning.


Asunto(s)
Estimulación Encefálica Profunda , Temblor Esencial , Enfermedad de Parkinson , Núcleo Subtalámico , Humanos , Estimulación Encefálica Profunda/métodos , Estudios Retrospectivos , Tálamo , Núcleo Subtalámico/diagnóstico por imagen , Enfermedad de Parkinson/diagnóstico por imagen , Enfermedad de Parkinson/terapia , Temblor Esencial/diagnóstico por imagen , Temblor Esencial/terapia , Programas Informáticos
12.
Zhongguo Zhen Jiu ; 43(8): 965-9, 2023 Aug 12.
Artículo en Chino | MEDLINE | ID: mdl-37577897

RESUMEN

A user-friendly teaching software for visual analysis of acupoint compatibility laws has been developed based on the principles of partial order mathematics. This software is designed to provide auxiliary teaching of structured organization and visualization of law knowledge of compatibility data of acupuncture and moxibustion prescriptions from ancient texts, textbooks, and clinical case records. The software is installed as a plugin in the Microsoft Office Excel, allowing the generation of visually appealing graphs and associated rules that align with the cognitive patterns of teachers and students majoring in acupuncture and moxibustion. Its aim is to facilitate the discovery and analysis of underlying patterns and structured knowledge embedded in acupoint compatibility data, thus contributing to the enhancement of teaching effectiveness in acupoint compatibility.


Asunto(s)
Terapia por Acupuntura , Acupuntura , Meridianos , Moxibustión , Humanos , Puntos de Acupuntura , Programas Informáticos
13.
Int J Hyperthermia ; 40(1): 2218627, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37455017

RESUMEN

INTRODUCTION: Hyperthermic IntraPEritoneal Chemotherapy (HIPEC) aims to treat microscopic disease left after CytoReductive Surgery (CRS). Thermal enhancement depends on the temperatures achieved. Since the location of microscopic disease is unknown, a homogeneous treatment is required to completely eradicate the disease while limiting side effects. To ensure homogeneous delivery, treatment planning software has been developed. This study compares simulation results with clinical data and evaluates the impact of nine treatment strategies on thermal and drug distributions. METHODS: For comparison with clinical data, three treatment strategies were simulated with different flow rates (1600-1800mL/min) and inflow temperatures (41.6-43.6 °C). Six additional treatment strategies were simulated, varying the number of inflow catheters, flow direction, and using step-up and step-down heating strategies. Thermal homogeneity and the risk of thermal injury were evaluated. RESULTS: Simulated temperature distributions, core body temperatures, and systemic chemotherapeutic concentrations compared well with literature values. Treatment strategy was found to have a strong influence on the distributions. Additional inflow catheters could improve thermal distributions, provided flow rates are kept sufficiently high (>500 mL/min) for each catheter. High flow rates (1800 mL/min) combined with high inflow temperatures (43.6 °C) could lead to thermal damage, with CEM4310 values of up to 27 min. Step-up and step-down heating strategies allow for high temperatures with reduced risk of thermal damage. CONCLUSION: The planning software provides valuable insight into the effects of different treatment strategies on peritoneal distributions. These strategies are designed to provide homogeneous treatment delivery while limiting thermal injury to normal tissue, thereby optimizing the effectiveness of HIPEC.


Asunto(s)
Hipertermia Inducida , Neoplasias Peritoneales , Humanos , Quimioterapia Intraperitoneal Hipertérmica , Terapia Combinada , Hipertermia Inducida/métodos , Neoplasias Peritoneales/tratamiento farmacológico , Neoplasias Peritoneales/cirugía , Quimioterapia del Cáncer por Perfusión Regional/métodos , Procedimientos Quirúrgicos de Citorreducción/métodos
14.
SN Comput Sci ; 4(4): 358, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37131499

RESUMEN

The availability of high-throughput molecular diagnostics builds the foundation for Molecular Tumor Boards (MTBs). Although more fine-grained data is expected to support decision making of oncologists, assessment of data is complex and time-consuming slowing down the implementation of MTBs, e.g., due to retrieval of the latest medical publications, assessment of clinical evidence, or linkage to the latest clinical guidelines. We share our findings from analysis of existing tumor board processes and defininion of clinical processes for the adoption of MTBs. Building on our findings, we have developed a real-world software prototype together with oncologists and medical professionals, which supports the preparation and conduct of MTBs and enables collaboration between medical experts by sharing medical knowledge even across the hospital locations. We worked in interdisciplinary teams of clinicians, oncologists, medical experts, medical informaticians, and software engineers using design thinking methodology. With their input, we identified challenges and limitations of the current MTB approaches, derived clinical process models using Business Process and Modeling Notation (BMPN), and defined personas, functional and non-functional requirements for software tool support. Based on it, we developed software prototypes and evaluated them with clinical experts from major university hospitals across Germany. We extended the Kanban methodology enabling holistic tracking of patient cases from "backlog" to "follow-up" in our app. The feedback from interviewed medical professionals showed that our clinical process models and software prototype provide suitable process support for the preparation and conduction of molecular tumor boards. The combination of oncology knowledge across hospitals and the documentation of treatment decision can be used to form a unique medical knowledge base by oncologists for oncologists. Due to the high heterogeneity of tumor diseases and the spread of the latest medical knowledge, a cooperative decision-making process including insights from similar patient cases was considered as a very valuable feature. The ability to transform prepared case data into a screen presentation was recognized as an essential feature speeding up the preparation process. Oncologists require special software tool support to incorporate and assess molecular data for the decision-making process. In particular, the need for linkage to the latest medical knowledge, clinical evidence, and collaborative tools to discuss individual cases were named to be of importance. With the experiences from the COVID-19 pandemic, the acceptance of online tools and collaborative working is expected to grow. Our virtual multi-site approach proved to allow a collaborative decision-making process for the first time, which we consider to have a positive impact on the overall treatment quality.

15.
J Cardiovasc Transl Res ; 16(4): 758-767, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-36715820

RESUMEN

Cardiomyocyte contractility is the crucial feature of heart function. Quantifying cardiomyocyte contraction in vitro is essential for disease phenotype characterization, mechanism illumination, and drug screening. Although many experimental methods have been employed to determine contraction dynamics in vitro, a time-saving and easy-to-use software is still needed to be developed. We presented a reliable tool, named MyocytoBeats, to measure cardiomyocyte contraction by processing recorded videos. Analysis results by MyocytoBeats of various experimental models have shown a significant linear relationship with another validated software. We also performed pharmacology screen in the platform, and astragaloside IV was identified to stabilize the frequency and amplitude of cardiomyocyte in the arrhythmia model. MyocytoBeats is a high-performance tool for generating cardiomyocyte contraction data of vitro study and shows a great potential in cardiac pharmacology study.


Asunto(s)
Miocitos Cardíacos , Programas Informáticos , Humanos , Evaluación Preclínica de Medicamentos/métodos , Contracción Miocárdica , Arritmias Cardíacas
17.
Abdom Radiol (NY) ; 48(2): 694-703, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36399208

RESUMEN

PURPOSE: To evaluate diagnostic accuracy, safety, and efficiency of an MRI-TRUS fusion-guided transperineal prostate biopsy method in an outpatient setting under local anaesthesia. METHODS: Patients undergoing transperineal prostate biopsy were included from March 2021 to May 2022. Biopsies were performed under local anaesthesia in an outpatient setting, using specialised fusion software. Primary outcome was (clinically significant) cancer detection rate. Secondary outcomes were procedure time, patient discomfort during the procedure and complication rate. RESULTS: We included 203 male patients (69 years +-SD 8.2) with PI-RADS score > 2. In total 223 suspicious lesions were targeted. Overall cancer detection rate and clinically significant cancer detection rate were 73.5% and 60.1%, respectively. (Clinically significant) cancer detection rates in PI-RADS 3, 4 and 5 lesions were 46.4% (23.2%), 78.5% (66.1%) and 93.5% (89.1%), respectively. Mean duration of the procedure including fusion, targeted and systematic biopsies was 22.5 min. Patients rated injection of local anaesthesia on a numeric pain rating scale on average 3.7/10 (SD 2.09) and biopsy core sampling 1.6/10 (SD 1.65). No patient presented with acute urinary retention on follow-up consultation. Two (1%) patients presented with infectious complications. Four (2%) patients experienced a vasovagal reaction. CONCLUSION: Transperineal targeted biopsy with MRI-TRUS fusion software has high overall and clinically significant cancer detection rates. The method is well tolerated under local anaesthesia and in an outpatient setting.


Asunto(s)
Próstata , Neoplasias de la Próstata , Humanos , Masculino , Próstata/diagnóstico por imagen , Próstata/patología , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/patología , Imagen por Resonancia Magnética , Pacientes Ambulatorios , Anestesia Local , Biopsia Guiada por Imagen/métodos , Programas Informáticos , Ultrasonografía Intervencional/métodos
18.
Front Med (Lausanne) ; 10: 1305415, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38259836

RESUMEN

The growing interest in data-driven medicine, in conjunction with the formation of initiatives such as the European Health Data Space (EHDS) has demonstrated the need for methodologies that are capable of facilitating privacy-preserving data analysis. Distributed Analytics (DA) as an enabler for privacy-preserving analysis across multiple data sources has shown its potential to support data-intensive research. However, the application of DA creates new challenges stemming from its distributed nature, such as identifying single points of failure (SPOFs) in DA tasks before their actual execution. Failing to detect such SPOFs can, for example, result in improper termination of the DA code, necessitating additional efforts from multiple stakeholders to resolve the malfunctions. Moreover, these malfunctions disrupt the seamless conduct of DA and entail several crucial consequences, including technical obstacles to resolve the issues, potential delays in research outcomes, and increased costs. In this study, we address this challenge by introducing a concept based on a method called Smoke Testing, an initial and foundational test run to ensure the operability of the analysis code. We review existing DA platforms and systematically extract six specific Smoke Testing criteria for DA applications. With these criteria in mind, we create an interactive environment called Development Environment for AuTomated and Holistic Smoke Testing of Analysis-Runs (DEATHSTAR), which allows researchers to perform Smoke Tests on their DA experiments. We conduct a user-study with 29 participants to assess our environment and additionally apply it to three real use cases. The results of our evaluation validate its effectiveness, revealing that 96.6% of the analyses created and (Smoke) tested by participants using our approach successfully terminated without any errors. Thus, by incorporating Smoke Testing as a fundamental method, our approach helps identify potential malfunctions early in the development process, ensuring smoother data-driven research within the scope of DA. Through its flexibility and adaptability to diverse real use cases, our solution enables more robust and efficient development of DA experiments, which contributes to their reliability.

19.
Pharmaceuticals (Basel) ; 15(11)2022 Nov 08.
Artículo en Inglés | MEDLINE | ID: mdl-36355543

RESUMEN

Herbal medicine and nutritional supplements are suggested to treat premenstrual somatic and psycho-behavioural symptoms in clinical guidelines; nonetheless, this is at present based on poor-quality trial evidence. Hence, we aimed to design a systematic review and meta-analysis for their effectiveness in alleviating premenstrual symptoms. The published randomized controlled trials (RCTs) were extracted from Google scholar, PubMed, Scopus and PROSPERO databases. The risk of bias in randomized trials was assessed by Cochrane risk-of-bias tool. The main outcome parameters were analysed separately based on the Premenstrual Symptom Screening Tool and PMTS and DRSP scores. Secondary parameters of somatic, psychological, and behavioural subscale symptoms of PSST were also analysed. Data synthesis was performed assuming a random-effects model, and standardized mean difference (SMDs) was analysed using SPSS version 28.0.0 (IBM, Armonk, NY, USA). A total of 754 articles were screened, and 15 RCTs were included (n = 1211 patients). Primary results for participants randomized to an intervention reported reduced PSST (n = 9), PMTS (n = 2), and DSR (n = 4) scores with (SMD = -1.44; 95% CI: -1.72 to -1.17), (SMD = -1.69; 95% CI: -3.80 to 0.42) and (SMD = 2.86; 95% CI: 1.02 to 4.69) verses comparator with substantial heterogeneity. Physical (SMD = -1.61; 95% CI = -2.56 to -0.66), behavioural (SMD = -0.60; 95% CI = -1.55 to0.35) and mood (SMD = 0.57; 95% CI = -0.96 to 2.11) subscale symptom groupings of PSST displayed similar findings. Fifty-three studies (n = 8) were considered at low risk of bias with high quality. Mild adverse events were reported by four RCTs. Based on the existing evidence, herbal medicine and nutritional supplements may be effective and safe for PMS.

20.
Mar Drugs ; 20(9)2022 Sep 19.
Artículo en Inglés | MEDLINE | ID: mdl-36135775

RESUMEN

SARS-CoV-2 is the causative agent of the COVID-19 pandemic. This in silico study aimed to elucidate therapeutic efficacies against SARS-CoV-2 of phyco-compounds from the seaweed, Ulva fasciata. Twelve phyco-compounds were isolated and toxicity was analyzed by VEGA QSAR. Five compounds were found to be nonmutagenic, noncarcinogenic and nontoxic. Moreover, antiviral activity was evaluated by PASS. Binding affinities of five of these therapeutic compounds were predicted to possess probable biological activity. Fifteen SARS-CoV-2 target proteins were analyzed by the AutoDock Vina program for molecular docking binding energy analysis and the 6Y84 protein was determined to possess optimal binding affinities. The Desmond program from Schrödinger's suite was used to study high performance molecular dynamic simulation properties for 3,7,11,15-Tetramethyl-2-hexadecen-1-ol-6Y84 for better drug evaluation. The ligand with 6Y84 had stronger binding affinities (-5.9 kcal/mol) over two standard drugs, Chloroquine (-5.6 kcal/mol) and Interferon α-2b (-3.8 kcal/mol). Swiss ADME calculated physicochemical/lipophilicity/water solubility/pharmacokinetic properties for 3,7,11,15-Tetramethyl-2-hexadecen-1-ol, showing that this therapeutic agent may be effective against SARS-CoV-2.


Asunto(s)
Antivirales , SARS-CoV-2 , Ulva , Antivirales/química , Antivirales/farmacología , Cloroquina , Alcoholes Grasos/química , Alcoholes Grasos/farmacología , Humanos , Interferón-alfa , Ligandos , Simulación del Acoplamiento Molecular , Simulación de Dinámica Molecular , Inhibidores de Proteasas/química , SARS-CoV-2/efectos de los fármacos , Terpenos/química , Terpenos/farmacología , Ulva/química , Tratamiento Farmacológico de COVID-19
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA