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1.
Ann Med ; 56(1): 2302979, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38466794

RESUMO

AIM: To evaluate the acceptability of two co-designed mobile applications Mit Sygehus [a knowledge-based solution] and Genoptræn.dk [a self-training solution] to support a cross-sectoral, person-centred and empowering stroke rehabilitation. SETTING: The applications were implemented and tested throughout two stroke rehabilitation trajectories in Southern Denmark, comprising two acute, two sub-acute and two municipal stroke rehabilitation settings. METHODS, PARTICIPANTS AND ANALYSIS: A process evaluation focusing on acceptability was conducted. Individual and dyadic interviews were performed with ten stroke survivors (three women and seven men, aged 50-84) with moderate stroke and seven significant others (five women and two men, aged 50-78) post-rehabilitation. A constructivist Grounded Theory analysis was used to explore what, why, when, and how the apps worked or did not work throughout the stroke rehabilitation trajectory and if adaptions were needed. RESULTS: Participants found that Mit Sygehus provided adequate and sufficient knowledge and was easy to use, however, acceptability of Mit Sygehus declined throughout the rehabilitation process. Also, knowledge on 'return-to-work' and 're-gaining driver's license/permission to drive' needed to be developed. The content in Genoptræn.dk was perceived as acceptable, through content being person-centred, motivating and meaningful. Genoptræn.dk furthermore, supported the transfer between rehabilitation settings, provided a sense of progress throughout the rehabilitation process, facilitated positive habits regarding self-training, and relieved the burden on significant others. Genoptræn.dk was perceived most acceptable in the sub-acute rehabilitation setting and declined when rehabilitation continued in the municipal setting. CONCLUSION: Stroke survivors and their significant others found Mit Sygehus and Genoptræn.dk acceptable to support cross-sectoral, person-centred and empowering stroke rehabilitation, however acceptability declined throughout the rehabilitation process. Further investigations are required to determine how cognitive rehabilitation can play a greater role in app-supported stroke rehabilitation and how the need for more long-term follow-up can be supported.


By using process evaluation, the user acceptability of newly developed and complex interventions can be evaluated.ICT and app-based solutions can support cross-sectoral person-centred and empowering stroke rehabilitation.Therapists play an important role in implementing and supporting stroke survivors using app-based solutions to support person-centred and empowering stroke rehabilitation.


Assuntos
Aplicativos Móveis , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Masculino , Humanos , Feminino , Reabilitação do Acidente Vascular Cerebral/métodos , Atenção à Saúde , Poder Psicológico
2.
Front Public Health ; 12: 1348242, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38476491

RESUMO

More young people are living in the world than ever before, 90% of whom reside in low and middle income countries (LMICs). To address their needs, it is critical to have sustainable youth engagement when determining policy and to advance effective implementation of youth-focused interventions. Youth Community Advisory Boards (CABs) are a sustainable mechanism to achieve this goal. This paper describes engagement with youth CAB members across four locations in Tanzania. To set youth CAB meeting agendas and priorities, we asked youth CAB members to write (using free text) the top five challenges faced by young people in their communities (highest to lower priority). The Google Forms survey link was presented at the May 2023 youth CAB meeting and disseminated through WhatsApp. The survey was completed by smartphone, tablet, or paper provided to the youth liaison for data entry. Results were translated from Swahili to English and coded using excel. Findings were then presented back to the youth CABs at the September 2023 meeting. At that meeting, youth CAB members were then asked to write (free text) potential solutions to the most commonly described challenges. The surveys had response rates of 90% (84/93) for challenges and 78% (71/93) for solutions. The number one reported challenge was unemployment and financial instability (45%). Gender based violence (13%), sexual reproductive health issues (8%), and alcohol and drug use (8%) were in the top four both by priority and frequency of report. Other important challenges included physical and mental health, malnutrition, relationships, education, and societal and environmental norms, among others. Solutions included job creation, improved education, expanded legal systems, youth-friendly health care services, and increased social support through peer networks and community support. The National Accelerated Action and Investment Agenda for Adolescent Health and Wellbeing (NAIA-AHW) 2021/22-2024/25 includes most, but not all, of these top challenges and solutions. Ensuring young people have a seat at the policy table is critical to effective youth-empowerment in health and other related programs. Including a youth CAB member to represent this collective in youth-related government activities is a sustainable model to achieve this goal.


Assuntos
Saúde Mental , Poder Psicológico , Humanos , Adolescente , Tanzânia
4.
Sci Rep ; 14(1): 6269, 2024 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-38491134

RESUMO

Soil health is essential for whirling stale soil into rich coffee-growing land. By keeping healthy soil, coffee producers may improve plant growth, leaf health, buds, cherry and bean quality, and yield. Traditional soil monitoring is tedious, time-consuming, and error-prone. Enhancing the monitoring system using AI-based IoT technologies for quick and precise changes. Integrated soil fertility control system to optimize soil health, maximize efficiency, promote sustainability, and prevent crop threads using real-time data analysis to turn infertile land into fertile land. The RNN-IoT approach uses IoT sensors in the coffee plantation to collect real-time data on soil temperature, moisture, pH, nutrient levels, weather, CO2 levels, EC, TDS, and historical data. Data transmission using a wireless cloud platform. Testing and training using recurrent neural networks (RNNs) and gated recurrent units gathered data for predicting soil conditions and crop hazards. Researchers are carrying out detailed qualitative testing to evaluate the proposed RNN-IoT approach. Utilize counterfactual recommendations for developing alternative strategies for irrigation, fertilization, fertilizer regulation, and crop management, taking into account the existing soil conditions, forecasts, and historical data. The accuracy is evaluated by comparing it to other deep learning algorithms. The utilization of the RNN-IoT methodology for soil health monitoring enhances both efficiency and accuracy in comparison to conventional soil monitoring methods. Minimized the ecological impact by minimizing water and fertilizer utilization. Enhanced farmer decision-making and data accessibility with a mobile application that provides real-time data, AI-generated suggestions, and the ability to detect possible crop hazards for swift action.


Assuntos
Fertilizantes , Solo , Agricultura , Fazendas , Poder Psicológico
5.
Health Expect ; 27(2): e14006, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38497286

RESUMO

BACKGROUND: Decisions about driving for individuals living with dementia (ILWD) can be challenging. There are limited evidence-based person-centred interventions in the United Kingdom that support decisions about transitioning to not driving or guidelines for developing decision aids for ILWD. This study aimed to understand the important features of a decision aid through the cultural adaptation of Australian dementia and driving decision aid (DDDA) for ILWD residing in the United Kingdom. METHODS: This qualitative study was theoretically underpinned by a person-centred framework and conducted over three stages: (1) Development of a draft UK-specific DDDA; (2) semistructured interviews with ILWD and an online survey with stakeholders to obtain their views on a draft UK DDDA and (3) content analysis and synthesis of qualitative data to inform the final version of the decision aid. RESULTS: Eleven ILWD and six of their spouses participated in interviews, and 102 stakeholders responded to an online survey. The four broad features identified as important to include in a decision aid for drivers living with dementia were: a structured and interactive format; positive and supportive messaging and presentation; relevant and concise content and choice-centred. The perceived benefits of the decision aid were identified as supporting conversations, enhancing collaborative decision making and enabling agency with decisions about driving and future mobility options. CONCLUSIONS: Decision aids that are underpinned by interactive choice-driven questions enhance a person-centred approach to decisions about driving. Positively framing decision aids through the presentation and content can facilitate engagement with the decision-making process about driving. The findings have implications for the development of decision aids designed for ILWD on other important health and social topics. PATIENT AND PUBLIC INVOLVEMENT: Advocating for the development of a UK DDDA were ILWD. Healthcare professionals contributed to the development of a draft UK DDDA. Former and current drivers living with dementia, family members, healthcare professionals and other support networks of ILWD participated in interviews or an online survey which informed the final version of the UK DDDA.


Assuntos
Técnicas de Apoio para a Decisão , Demência , Humanos , Tomada de Decisões , Respeito , Austrália , Poder Psicológico
6.
BMC Bioinformatics ; 25(1): 112, 2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38486137

RESUMO

BACKGROUND: The constant growth of biomedical data is accompanied by the need for new methodologies to effectively and efficiently extract machine-readable knowledge for training and testing purposes. A crucial aspect in this regard is creating large, often manually or semi-manually, annotated corpora vital for developing effective and efficient methods for tasks like relation extraction, topic recognition, and entity linking. However, manual annotation is expensive and time-consuming especially if not assisted by interactive, intuitive, and collaborative computer-aided tools. To support healthcare experts in the annotation process and foster annotated corpora creation, we present MetaTron. MetaTron is an open-source and free-to-use web-based annotation tool to annotate biomedical data interactively and collaboratively; it supports both mention-level and document-level annotations also integrating automatic built-in predictions. Moreover, MetaTron enables relation annotation with the support of ontologies, functionalities often overlooked by off-the-shelf annotation tools. RESULTS: We conducted a qualitative analysis to compare MetaTron with a set of manual annotation tools including TeamTat, INCEpTION, LightTag, MedTAG, and brat, on three sets of criteria: technical, data, and functional. A quantitative evaluation allowed us to assess MetaTron performances in terms of time and number of clicks to annotate a set of documents. The results indicated that MetaTron fulfills almost all the selected criteria and achieves the best performances. CONCLUSIONS: MetaTron stands out as one of the few annotation tools targeting the biomedical domain supporting the annotation of relations, and fully customizable with documents in several formats-PDF included, as well as abstracts retrieved from PubMed, Semantic Scholar, and OpenAIRE. To meet any user need, we released MetaTron both as an online instance and as a Docker image locally deployable.


Assuntos
Poder Psicológico , Semântica , PubMed
7.
BMC Infect Dis ; 24(1): 338, 2024 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-38515014

RESUMO

BACKGROUND: A dearth of studies showed that infectious diseases cause the majority of deaths among under-five children. Worldwide, Acute Respiratory Infection (ARI) continues to be the second most frequent cause of illness and mortality among children under the age of five. The paramount disease burden in developing nations, including Ethiopia, is still ARI. OBJECTIVE: This study aims to determine the magnitude and predictors of ARI among under-five children in Ethiopia using used state of the art machine learning algorithms. METHODS: Data for this study were derived from the 2016 Ethiopian Demographic and Health Survey. To predict the determinants of acute respiratory infections, we performed several experiments on ten machine learning algorithms (random forests, decision trees, support vector machines, Naïve Bayes, and K-nearest neighbors, Lasso regression, GBoost, XGboost), including one classic logistic regression model and an ensemble of the best performing models. The prediction ability of each machine-learning model was assessed using receiver operating characteristic curves, precision-recall curves, and classification metrics. RESULTS: The total ARI prevalence rate among 9501 under-five children in Ethiopia was 7.2%, according to the findings of the study. The overall performance of the ensemble model of SVM, GBoost, and XGBoost showed an improved performance in classifying ARI cases with an accuracy of 86%, a sensitivity of 84.6%, and an AUC-ROC of 0.87. The highest performing predictive model (the ensemble model) showed that the child's age, history of diarrhea, wealth index, type of toilet, mother's educational level, number of living children, mother's occupation, and type of fuel they used were an important predicting factor for acute respiratory infection among under-five children. CONCLUSION: The intricate web of factors contributing to ARI among under-five children was identified using an advanced machine learning algorithm. The child's age, history of diarrhea, wealth index, and type of toilet were among the top factors identified using the ensemble model that registered a performance of 86% accuracy. This study stands as a testament to the potential of advanced data-driven methodologies in unraveling the complexities of ARI in low-income settings.


Assuntos
Saúde da Criança , Infecções Respiratórias , Criança , Humanos , Teorema de Bayes , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/epidemiologia , Aprendizado de Máquina , Diarreia/epidemiologia , Demografia , Poder Psicológico
8.
J Nurs Adm ; 54(4): 196-197, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38512081

RESUMO

ABSTRACT: Recognizing the positive impact of clinical data outcomes and patient care experiences, coupled with the growing preference for advanced practice RNs among patients, it is imperative that nurse leaders propel legislative reforms and infrastructure support from health systems. This strategic approach is crucial for maximizing the potential of nurses in improving patient care experience and outcomes, as well as increasing accessibility to healthcare in every community.


Assuntos
Atenção à Saúde , Poder Psicológico , Humanos
9.
J Med Virol ; 96(3): e29506, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38445718

RESUMO

With the global pandemic and the continuous mutations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the need for effective and broadly neutralizing treatments has become increasingly urgent. This study introduces a novel strategy that targets two aspects simultaneously, using bifunctional antibodies to inhibit both the attachment of SARS-CoV-2 to host cell membranes and viral fusion. We developed pioneering IgG4-(HR2)4 bifunctional antibodies by creating immunoglobulin G4-based and phage display-derived human monoclonal antibodies (mAbs) that specifically bind to the SARS-CoV-2 receptor-binding domain, engineered with four heptad repeat 2 (HR2) peptides. Our in vitro experiments demonstrate the superior neutralization efficacy of these engineered antibodies against various SARS-CoV-2 variants, ranging from original SARS-CoV-2 strain to the recently emerged Omicron variants, as well as SARS-CoV, outperforming the parental mAb. Notably, intravenous monotherapy with the bifunctional antibody neutralizes a SARS-CoV-2 variant in a murine model without causing significant toxicity. In summary, this study unveils the significant potential of HR2 peptide-driven bifunctional antibodies as a potent and versatile strategy for mitigating SARS-CoV-2 infections. This approach offers a promising avenue for rapid development and management in the face of the continuously evolving SARS-CoV-2 variants, holding substantial promise for pandemic control.


Assuntos
Anticorpos Biespecíficos , COVID-19 , Humanos , Animais , Camundongos , SARS-CoV-2/genética , Anticorpos Monoclonais/uso terapêutico , Imunoglobulina G , Peptídeos/genética , Poder Psicológico
10.
Open Heart ; 11(1)2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38429056

RESUMO

INTRODUCTION: Hypertension is the leading modifiable risk factor for cardiovascular disease and is implicated in half of all strokes and myocardial infarctions. One-third of the adults in Scotland have hypertension yet only a quarter of them have their blood pressure (BP) controlled to target (<140/90 mm Hg). Empowering patients to have a better understanding of their condition and becoming actively involved in the monitoring and management of hypertension may lead to improved patient satisfaction, improved BP control and health outcomes and reduction in the use of primary/secondary care hypertension clinics. METHODS AND ANALYSIS: OPTIMA-BP is a randomised parallel group pilot study comparing the use of home BP monitoring accompanied by access to the web-based cardiovascular educational portal (Kvatchii) and home BP monitoring (HBPM) alone in 200 patients with hypertension attending the Glasgow Blood Pressure Clinic, Queen Elizabeth University Hospital, Glasgow. Consented participants will be asked to complete surveys on lifestyle factors, medication adherence, quality of life and hypertension knowledge, understanding and home monitoring. The intervention group will be asked to complete a survey to help evaluate the Kvatchii portal. At 6 and 12 months, the surveys will be repeated via the CASTOR EDC. Both groups will input their HBPM results at 2-month intervals into a CASTOR-EDC survey. OPTIMA-BP will follow-up with participants over 12 months with the study running over 24 months. The primary outcome is HBPM systolic BP area under the curve between baseline and 6 months ETHICS AND DISSEMINATION: OPTIMA-BP was approved by the North of Scotland Research Ethics Committee 2 (22/NS/0095). Current protocol version 1.2 date 6 June 2023. Written informed consent will be provided by all study participants. Study findings will be submitted to international peer-reviewed journals and will be presented at national and international scientific meetings. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov: NCT05575453. Registered 12 October 2022. https://clinicaltrials.gov/ct2/show/NCT05575453.


Assuntos
Monitorização Ambulatorial da Pressão Arterial , Hipertensão , Adulto , Humanos , Pressão Sanguínea/fisiologia , Monitorização Ambulatorial da Pressão Arterial/métodos , Qualidade de Vida , Projetos Piloto , Educação de Pacientes como Assunto , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Poder Psicológico , Internet , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Eur Radiol Exp ; 8(1): 17, 2024 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-38321340

RESUMO

This review aims to take a journey into the transformative impact of artificial intelligence (AI) on positron emission tomography (PET) imaging. To this scope, a broad overview of AI applications in the field of nuclear medicine and a thorough exploration of deep learning (DL) implementations in cancer diagnosis and therapy through PET imaging will be presented. We firstly describe the behind-the-scenes use of AI for image generation, including acquisition (event positioning, noise reduction though time-of-flight estimation and scatter correction), reconstruction (data-driven and model-driven approaches), restoration (supervised and unsupervised methods), and motion correction. Thereafter, we outline the integration of AI into clinical practice through the applications to segmentation, detection and classification, quantification, treatment planning, dosimetry, and radiomics/radiogenomics combined to tumour biological characteristics. Thus, this review seeks to showcase the overarching transformation of the field, ultimately leading to tangible improvements in patient treatment and response assessment. Finally, limitations and ethical considerations of the AI application to PET imaging and future directions of multimodal data mining in this discipline will be briefly discussed, including pressing challenges to the adoption of AI in molecular imaging such as the access to and interoperability of huge amount of data as well as the "black-box" problem, contributing to the ongoing dialogue on the transformative potential of AI in nuclear medicine.Relevance statementAI is rapidly revolutionising the world of medicine, including the fields of radiology and nuclear medicine. In the near future, AI will be used to support healthcare professionals. These advances will lead to improvements in diagnosis, in the assessment of response to treatment, in clinical decision making and in patient management.Key points• Applying AI has the potential to enhance the entire PET imaging pipeline.• AI may support several clinical tasks in both PET diagnosis and prognosis.• Interpreting the relationships between imaging and multiomics data will heavily rely on AI.


Assuntos
Aprendizado Profundo , Radiologia , Humanos , Inteligência Artificial , Tomografia por Emissão de Pósitrons , Poder Psicológico
12.
PLoS One ; 19(2): e0296338, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38408067

RESUMO

INTRODUCTION: Diabetes and hypertension are prevalent and costly to the health system. We have developed a mobile app (EMPOWER app) which enables remote monitoring and education through personalised nudges. We aim to study the effectiveness of a multi-component intervention comprising the EMPOWER mobile app with health coaching and shared decision-making for diabetes and hypertension. METHODS: We will conduct a two-arm, open-label, pragmatic randomised controlled trial (RCT). Participants with comorbid diabetes and hypertension enrolled from public primary care clinics will be randomised to either intervention or control in a 1:1 ratio. The intervention group participants will have access to health coaching with shared decision-making interventions in addition to the EMPOWER app and their usual primary care. The control group participants will continue to receive usual primary care and will neither receive the EMPOWER app nor health coaching and shared decision-making interventions. Our primary outcome is change in HbA1c level over 9 months. Secondary outcomes include change in systolic blood pressure, quality of life, patient activation, medication adherence, physical activity level, diet, and healthcare cost (direct and indirect) over 9 months. DISCUSSION: Our trial will provide key insights into clinical- and cost-effectiveness of a multi-component intervention comprising EMPOWER mobile app, health coaching and shared decision-making in diabetes and hypertension management. This trial will also offer evidence on cost-effective and sustainable methods for promoting behavioural changes among patients with comorbid diabetes and hypertension. TRIAL REGISTRATION: This study was registered on clintrials.gov on August 3, 2022, with the trial registration number: NCT05486390.


Assuntos
Diabetes Mellitus , Hipertensão , Tutoria , Aplicativos Móveis , Humanos , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Hipertensão/complicações , Hipertensão/epidemiologia , Hipertensão/terapia , Poder Psicológico , Ensaios Clínicos Controlados Aleatórios como Assunto
14.
Obes Surg ; 34(3): 959-966, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38345730

RESUMO

PURPOSE: Despite having the highest medical needs by population for weight loss treatment, Pacific patients in Aotearoa New Zealand face substantial levels of attrition in publicly funded weight loss surgery programs. In collaboration with the Auckland City Hospital bariatric surgery team, a Pacific-led preoperative weight loss surgery program was co-designed, delivered, and evaluated between 2020 and 2023. MATERIALS AND METHODS: This was a single-arm, prospective co-designed evaluation study that took place at Auckland City Hospital in Aotearoa New Zealand. Participants were Pacific patients (n = 14) referred to the weight loss surgery program. Survey and video diaries were analyzed to determine if the program had the potential to increase Pacific patient retention through the preoperative stage of weight loss surgery, increase surgery completion rates, and improve the quality of treatment experiences. RESULTS: Nine out of 14 participants attended all preoperative sessions. Six participants subsequently underwent weight loss surgery. Program components that had positive impacts on patient success and satisfaction were accessibility, information quality, having Pacific role models, cultural safety, and the group support system. The patients found the program to be culturally anchored and there was support for the implementation of the program going forward. CONCLUSION: This study demonstrated how a culturally anchored intervention can increase patient retention for those patients who may not respond to mainstream treatment. Adjusting existing preoperative weight loss surgery programs to integrate Pacific-led models of healthcare has the potential to increase Pacific patient resiliency to follow through with surgery.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Humanos , Obesidade Mórbida/cirurgia , Estudos Prospectivos , Atenção à Saúde , Poder Psicológico
15.
BMJ Open ; 14(2): e077791, 2024 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-38320841

RESUMO

BACKGROUND: Canada's long-term care (LTC) homes were founded on an institutional model that viewed residents as passive recipients of care. Many homes continue to follow this model leaving residents removed from operational decision-making within their homes. However, involving residents in the design of their LTC home's environment, programmes and operations can improve the residents' quality of life and other outcomes. This codesign project creates a toolkit/resource for LTC homes to facilitate meaningful resident engagement in their home's organisational design and governance. METHOD: This three-part project consists of a scoping review, qualitative interviews, toolkit/resource development and prototyping. In part 1, we conduct a scoping review to synthesise existing knowledge on approaches to engaging LTC home residents in organisational design and governance of their LTC homes, as well as explore barriers, challenges and facilitators of engagement, considerations for diversity and cognitive change, and approaches to evaluation. In part 2, we will have interviews and focus groups with residents, team members (staff) and administrators to assess community capacity to implement and sustain a programme to engage LTC residents in organisational design and governance of their LTC homes. The third part of our project uses these findings to help codesign toolkit(s)/resource(s) to enable the engagement of LTC residents in the organisational design and governance of their LTC homes. ETHICS AND DISSEMINATION: The project is conducted in partnership with the Ontario Association of Residents' Councils. We will leverage their communication to disseminate findings and support the use of the codesigned toolkit(s)/resource(S) with knowledge users. We will also publish the study results in an academic journal and present at conferences, webinars and workshops. These results can influence practices within LTC homes by inspiring an organisational culture where residents help shape the place they call home. The interviews and focus groups, conducted in part 2, have been submitted to the University Health Network Research Ethics Board.


Assuntos
Assistência de Longa Duração , Qualidade de Vida , Humanos , Assistência de Longa Duração/psicologia , Ontário , Cuidados Paliativos , Poder Psicológico , Literatura de Revisão como Assunto
16.
Molecules ; 29(4)2024 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-38398653

RESUMO

Drug discovery plays a critical role in advancing human health by developing new medications and treatments to combat diseases. How to accelerate the pace and reduce the costs of new drug discovery has long been a key concern for the pharmaceutical industry. Fortunately, by leveraging advanced algorithms, computational power and biological big data, artificial intelligence (AI) technology, especially machine learning (ML), holds the promise of making the hunt for new drugs more efficient. Recently, the Transformer-based models that have achieved revolutionary breakthroughs in natural language processing have sparked a new era of their applications in drug discovery. Herein, we introduce the latest applications of ML in drug discovery, highlight the potential of advanced Transformer-based ML models, and discuss the future prospects and challenges in the field.


Assuntos
Inteligência Artificial , Aprendizado de Máquina , Humanos , Descoberta de Drogas , Algoritmos , Poder Psicológico
18.
J Clin Neurosci ; 120: 229-231, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38306902

RESUMO

Intraoperative aneurysm rupture (IAR) is a feared complication and an unnerving experience for any neurosurgeon. If not managed properly, the consequences may be devastating. Although overall patient outcomes in IAR have been shown to improve with a neurosurgeon's experience, the likelihood of rupture does not necessarily decrease, and the key to success lies in appropriate management. Microsurgical dexterity, remaining calm and acting sensible are important skills that all neurosurgeons need to master early on in order to achieve good patient outcomes. The landscape of cerebrovascular disease management has evolved significantly, with a growing preference for endovascular approaches. Consequently, the case-load of microsurgical procedures available for trainees have been diminished. As microsurgical cases decline and the remaining cases become more complex, the need for a systematic approach to IAR management becomes critical, to ensure a swift and efficient response and to compensate for reduced experience. This video article aims to empower the next generation of neurosurgeons by emphasizing essential skills and a systematic algorithmic approach required to navigate IAR situations successfully. In this video, we present the unedited sequence of IAR management in a posterior communicating artery (PCoA) aneurysm, from rupture to clipping. A 43-year-old female patient presented with headache and diplopia caused by a left oculomotor nerve palsy. Computed tomography (CT) did not show subarachnoid hemorrhage, but CT angiogram revealed a 7-mm left PCoA aneurysm affecting the oculomotor nerve. Patient consent was obtained for surgical management. The predissection phase was uneventful, however during dissection of the aneurysm neck, IAR occurred from the aneurysm dome. One contributing factor to rupture may have been the traction exerted on the aneurysm with the dissector, possibly due to adhesion of the aneurysm dome to the tentorial edge. Additionally, performing intradural drilling of the anterior clinoid process during the approach could have provided better access to proximal control of the internal carotid artery, making clip application easier. By remaining calm and proceeding with the steps illustrated in the decision algorithm (Fig. 1), the right actions were made, and the aneurysm was successfully clipped. In this article, we provide early career vascular neurosurgeons with a systematic strategy for managing IAR, offering guidance that may facilitate the 'right move' during these high-stress situations.


Assuntos
Aneurisma Roto , Aneurisma Intracraniano , Hemorragia Subaracnóidea , Adulto , Feminino , Humanos , Aneurisma Roto/diagnóstico por imagem , Aneurisma Roto/cirurgia , Aneurisma Roto/complicações , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/cirurgia , Aneurisma Intracraniano/complicações , Neurocirurgiões , Poder Psicológico , Hemorragia Subaracnóidea/cirurgia , Hemorragia Subaracnóidea/complicações
19.
Clin Nurse Spec ; 38(2): 107-109, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38364072

RESUMO

PURPOSE/OBJECTIVES: We aim to explore Current Procedural Terminology (CPT) codes for caregiving training services and their potential impacts on caregivers of people living with dementia. DESCRIPTION OF THE PROJECT/PROGRAM: In response to the growing need for support for caregivers of people living with physical and mental health issues, CPT codes for caregiving training services will be activated for the calendar year 2024. These codes cover (1) family group behavior management and modification training services and (2) caregiver training for techniques to help patients maintain their quality of life. Caregivers will access such training support through the CPT codes provided by treating practitioners. The duration of training will vary by code. OUTCOME: Implementing CPT codes for caregiver training services highlights the vital role of caregivers in patient care. This support may improve their skills and communication with healthcare providers. However, timing and accessibility in care delivery need clarification, especially for caregivers of people living with dementia. Regular skill assessment and culturally competent care are essential. Before providing the service, provider training may also promote person-centered care, benefiting patients and their caregivers. CONCLUSION: Activating CPT codes for caregiving training services may enhance caregivers' support and skills, including dementia care.


Assuntos
Cuidadores , Demência , Humanos , Cuidadores/psicologia , Demência/psicologia , Qualidade de Vida , Pessoal de Saúde , Poder Psicológico
20.
Med Humanit ; 50(1): 95-102, 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38388184

RESUMO

This article explores the ethical implications of mandatory parental consent requirements for adolescents seeking sexual and reproductive health services (SRHS). Using a Reproductive Justice framework, which identifies systemic barriers to accessing healthcare services, we examine ageism as a potential factor restricting adolescents' access to SRHS. While the Reproductive Justice framework has addressed systemic issues like racism and ableism in healthcare, ageism involving adolescents has been less explored. The article challenges the pertinence of mandatory parental consent requirements-as a potential barrier-for adolescents' access to SRHS. We argue that in the specific context of SRHS (contraceptives, abortion, testing and treatment of sexually transmitted infections), adolescents' autonomy (self-determination) should be respected if they request to access those services independently. From a global health perspective, adolescents have a low prevalence and uneven access to SRHS. To address the issue, we propose the integration of adolescence into the Reproductive Justice movement to empower them through education on how to access the SRHS they need.


Assuntos
Serviços de Saúde Reprodutiva , Infecções Sexualmente Transmissíveis , Gravidez , Feminino , Humanos , Adolescente , Comportamento Sexual , Justiça Social , Poder Psicológico
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