In silico prediction of drug-induced nephrotoxicity: current progress and pitfalls.

INTRODUCTION: Due to its role in absorption and metabolism, the kidney is an important target for drug toxicity. Drug-induced nephrotoxicity (DIN) presents a significant challenge in clinical practice and drug development. Conventional methods for assessing nephrotoxicity have limitations, highlighting the need for innovative approaches. In recent years, in silico methods have emerged as promising tools for predicting DIN. AREAS COVERED: A literature search was performed using PubMed and Web of Science, from 2013 to February 2023 for this review. This review provides an overview of the current progress and pitfalls in the in silico prediction of DIN, which discusses the principles and methodologies of computational models. EXPERT OPINION: Despite significant advancements, this review identified issues accentuates the pivotal imperatives of data fidelity, model optimization, interdisciplinary collaboration, and mechanistic comprehension in sculpting the vista of DIN prediction. Integration of multiple data sources and collaboration between disciplines are essential for improving predictive models. Ultimately, a holistic approach combining computational, experimental, and clinical methods will enhance our understanding and management of DIN.

Machine Learning and Vision: Advancing the Frontiers of Diabetic Cataract Management.

This comprehensive review explores the integration of machine learning (ML) in managing diabetic cataracts. It discusses the potential application of ML to identify novel methodologies for early detection, diagnosis, and therapeutic interventions. The review also addresses clinical translation challenges, including pharmacokinetics properties and ethical considerations. The approach toward cataractogenesis, therefore, has to be from a holistic viewpoint, bringing oxidative stress and metabolic disturbances to the top of importance. It outlines the important requirements, including continued research, diversified datasets, and uses interdisciplinary collaborations in making improvements in ML models and thereafter bridging the gap between computational promise and clinical implication, with the aim to help in the maximization of patient care in the management of diabetic cataract. A literature search through databases like PubMed and Scopus focusing on understanding of current innovations, challenges, and future directions in employing ML in diabetic cataract management was undertaken. This review has explored both recent and foundational studies in order to explain the development and gaps of current research with an aim to enhance outcomes of patient care by promoting future investigation. Key findings revealed a wide application of ML in ophthalmology including treatment identification, cataract detection and grading, and improving the surgical outcomes. However, this is accompanied by some obstacles, including risk of bias, concerns regarding artificial intelligence application as a diagnostic tool, and legal regulations. ML promises extraordinary developments in the treatment of diabetic cataracts through betterment in diagnosis, treatment, and patient care. With this, it is full of clinical translation and ethical challenges, yet there is recognition in general that continuous model refinement and interdisciplinary collaboration, along with the expansion of the two identified key elements in enhancing patient outcomes, are essential for this to continue.

Collaborative nursing education between advanced practice registered nurses.

The surge in healthcare demands due to the explosion of growth in the aging adult population demands that academic institutions address enhanced education of Advanced Practice Registered Nurses (APRNs). This is particularly challenging amidst nurse faculty shortages in specialty areas, stemming from factors such as lack of pay competitiveness with clinical positions, and doctoral-prepared nurses seeking faculty positions. Despite efforts to address the shortages, recruitment challenges persist, necessitating innovative approaches. This article explores the interprofessional collaborative teaching between Nurse Anesthesia (NA) and Adult Gerontology Nurse Practitioner (NP) programs, focusing on airway management, sedation techniques, chest X-ray interpretation, and ultrasound skills. To date, this collaboration between NA and NP faculty has proven effective. Both synchronous and online asynchronous teaching have received overwhelmingly positive student feedback. Ongoing communication and collaborations between NA and NP faculty facilitate teaching and educational strategies across programs, sharing faculty expertise, and mitigating reduced faculty numbers. This innovative model benefits faculty and students and provides a platform for firsthand interprofessional collaboration, fostering mutual respect and preparing students for effective interdisciplinary healthcare teamwork.

Improvements in Function With Inpatient Rehabilitation in a Patient Following a Traumatic Brain Injury: A Case Report.

Traumatic brain injury has been a leading cause of morbidity, mortality, and disability. Patients may experience cognitive and functional decline, depending on the severity. In this case report, a patient presents with a closed-head traumatic brain injury that was sustained after a motor vehicle accident. Through a comprehensive inpatient rehabilitation plan with physical therapy, speech therapy, occupational therapy, and neuropsychological assessments, this patient was able to gain functionality, as shown by his Ranchos Los Amigos Revised Scale. This scale is used to describe the cognitive and behavioral patterns found in recovering patients following a traumatic brain injury. With this case report, we hope to raise awareness within the medical community of the benefits of inpatient rehabilitation so that patients suffering from traumatic brain injury can receive better functional and cognitive recovery.

How to Harness the Power of GPT for Scientific Research: A Comprehensive Review of Methodologies, Applications, and Ethical Considerations.

The rapid advancements in natural language processing, particularly with the development of Generative Pre-trained Transformer (GPT) models, have opened up new avenues for researchers across various domains. This review article explores the potential of GPT as a research tool, focusing on the core functionalities, key features, and real-world applications of the GPT-4 model. We delve into the concept of prompt engineering, a crucial technique for effectively utilizing GPT, and provide guidelines for designing optimal prompts. Through case studies, we demonstrate how GPT can be applied at various stages of the research process, including literature review, data analysis, and manuscript preparation. The utilization of GPT is expected to enhance research efficiency, stimulate creative thinking, facilitate interdisciplinary collaboration, and increase the impact of research findings. However, it is essential to view GPT as a complementary tool rather than a substitute for human expertise, keeping in mind its limitations and ethical considerations. As GPT continues to evolve, researchers must develop a deep understanding of this technology and leverage its potential to advance their research endeavors while being mindful of its implications.

Ocular Manifestations of Systemic Diseases: Implications for Comprehensive Patient Care.

Background: Ocular manifestations of systemic diseases pose significant challenges to clinicians due to their diverse presentations and potential impact on vision. Understanding these manifestations is crucial for effective patient management and prevention of vision loss. Materials and Methods: In this prospective clinical study, we investigated ocular manifestations in 50 patients with various systemic diseases, including diabetes mellitus, hypertension, autoimmune disorders, and infectious diseases. Patients underwent comprehensive ocular examinations and systemic evaluations to assess the prevalence and characteristics of ocular complications associated with each systemic condition. Conclusion: Diabetic retinopathy was the most common ocular manifestation among diabetic patients, while hypertensive retinopathy predominated in hypertensive individuals. Autoimmune disorders were associated with uveitis and retinal vasculitis, whereas infectious diseases presented with ocular infections. Correlation analyses revealed significant associations between systemic parameters and ocular findings, emphasizing the importance of systemic disease control in preventing vision-threatening complications.

Exploring the relationship between temporomandibular disorders and sexual function.

INTRODUCTION: Temporomandibular disorders (TMDs) encompass various conditions affecting the temporomandibular joint and surrounding structures, often presenting with pain, limited movement, and functional impairments. TMDs may affect kissing and oral sex, in addition to influencing sexual function, as any other chronic pain condition. OBJECTIVE: The study sought to examine the connection between TMDs and sexual function. METHODS: A literature review was conducted, synthesizing evidence from various disciplines, including dentistry, physical therapy, psychology, and sexual medicine. Relevant studies were analyzed to elucidate the multifaceted nature of TMDs and their potential impact on sexual health. RESULTS: Emerging evidence suggests a complex relationship between TMDs and sexual function, with chronic pain, psychological distress, and physiological factors potentially contributing to sexual dysfunction. CONCLUSION: Understanding the interconnectedness of TMDs and sexual function is essential for providing comprehensive care. Further research is needed to assess the association between TMDs and sexual dysfunction, elucidate the underlying mechanisms, and develop targeted interventions that address both TMD symptoms and sexual health concerns.

Training the Next Generation of Academic Neurosurgeons in Global Health, Academics, and Research.

This article delves into academic global neurosurgeons' role in addressing the inequities in neurosurgical care globally. It outlines a comprehensive training framework incorporating global health education, research, and leadership development into neurosurgery residency programs. The article highlights the importance of interdisciplinary collaboration, cultural humility, and sustainable partnerships and advocates for a holistic approach to global neurosurgery. It underscores the necessity of integrating global health principles into neurosurgical training and practice, aiming to cultivate a new generation of neurosurgeons equipped to tackle the complex health challenges of our interconnected world.

Enhancing diabetic foot management: Advocating for independent prescribing rights for podiatrists in South Africa.

Diabetic foot complications are serious issues resulting from uncontrolled diabetes, primarily affecting the feet. Common complications include diabetic neuropathy, ulcers, PAD, Charcot foot, and gangrene. Preventive measures include controlling blood glucose levels, regular foot inspections, proper foot care, wearing appropriate footwear, and seeking prompt medical attention. A holistic approach to diabetic foot management is crucial due to the complex interplay of physiological, psychological, and environmental factors. Glycaemic control is essential for mitigating neuropathy and vasculopathy, while cardiovascular risk factors like hypertension and dyslipidemia are crucial for preventing complications. In South Africa, podiatrists play a crucial role in diabetic foot care, offering specialized expertise in the assessment, management, and prevention of foot complications associated with diabetes mellitus. They collaborate closely with other healthcare professionals to ensure comprehensive and coordinated care.Pharmacological management is a crucial aspect of podiatric care in the UK, where podiatrists use various medications to treat foot conditions effectively. In South Africa, podiatrists lack prescribing authority, leading to limited treatment options, dependency on referrals, and disparities in access to care. This fragmented approach can compromise patient outcomes, especially in chronic conditions like diabetes. To improve patient outcomes and promote optimal foot condition management, policy reforms, interdisciplinary collaboration, and professional advocacy efforts are needed.Policy recommendations for expanding podiatrist prescribing privileges include legislative reforms, regulatory framework updates, and professional accreditation. Legislative reforms could involve amending existing healthcare laws or introducing new regulations that recognize podiatrists as authorized prescribers. Regulatory framework updates should involve working with regulatory bodies to establish prescribing standards, prescribing limitations, and mechanisms for ongoing oversight and accountability. Professional accreditation should ensure educational programs for podiatrists incorporate training in pharmacology, pharmacotherapy, and prescribing practices to prepare graduates for the expanded scope of practice.Stakeholders in South Africa can improve diabetes management by advocating for policy reforms, professional recognition, and patient empowerment initiatives. By aligning policy, practice, education, research, and advocacy efforts, stakeholders can create a supportive ecosystem that fosters innovation, collaboration, and continuous improvement in diabetic foot care.

Facilitators and Barriers in Integrated Social Care for Families Facing Multiple and Complex Problems: A Scoping Review.

Introduction: Families with multiple and complex problems often deal with multiple professionals and organizations for support. Integrated social care supposedly prevents the fragmentation of care that often occurs.We identified facilitators and barriers experienced by families receiving integrated social care and by the professionals who provide it. Method: We performed a scoping review following Arksey and O'Malley's framework, using the following databases: PsycINFO, Web of Science Core Collection, Psychology and Behavioral Sciences Collection, CINAHL, PubMed, and Medline. Furthermore, conducted a thematic analysis. The results were divided into facilitators and barriers of integrated social care. Results: We identified 278 studies and finally included sixteen in our scoping review. We identified facilitators, including: linking formal care with informal networks, promoting collaboration among professionals e.g., working in pairs, and professionals autonomy. We identified barriers, including: time constraints, tasks outside professionals' expertise, along with resistance to integrated collaboration among organizations. These findings can enhance the advancement of social integrated care as a promising approach to support families facing multiple and complex problems. Conclusion: To empower families, integrated social care requires a systematic approach based on trust. It involves coordinated care, shared decision-making, informal networks and the participation of all family members, including children.

Transforming Healthcare with Nanomedicine: A SWOT Analysis of Drug Delivery Innovation.

Objective: Nanomedicine represents a transformative approach in biomedical applications. This study aims to delineate the application of nanomedicine in the biomedical field through the strengths, weaknesses, opportunities, and threats (SWOT) analysis to evaluate its efficacy and potential in clinical applications. Methods: The SWOT analysis framework was employed to systematically review and assess the internal strengths and weaknesses, along with external opportunities and threats of nanomedicine. This method provides a balanced consideration of the potential benefits and challenges. Results: Findings from the SWOT analysis indicate that nanomedicine presents significant potential in drug delivery, diagnostic imaging, and tissue engineering. Nonetheless, it faces substantial hurdles such as safety issues, environmental concerns, and high development costs. Critical areas for development were identified, particularly concerning its therapeutic potential and the uncertainties surrounding long-term effects. Conclusion: Nanomedicine holds substantial promise in driving medical innovation. However, successful clinical translation requires addressing safety, cost, and regulatory challenges. Interdisciplinary collaboration and comprehensive strategic planning are crucial for the safe and effective application of nanomedicine.

Integrating Pulmonary Health and Maternal Care: Bridging Gaps for Optimal Respiratory Outcomes in Pregnancy and Beyond.

The integration of pulmonary health and maternal care is critical for ensuring optimal respiratory outcomes for both mothers and their infants. Pregnancy induces significant physiological changes in the respiratory system, increasing the risk of pulmonary complications and exacerbating conditions such as asthma. This editorial emphasizes the necessity for collaborative care between pulmonologists and midwives to manage these challenges effectively. By working together, healthcare providers can develop comprehensive care plans that address potential respiratory issues early, monitor and manage chronic conditions, and provide vigilant postpartum care. Enhanced education and interdisciplinary training for both professions are essential for bridging the gaps in care and improving maternal and neonatal health outcomes. This integrated approach is supported by research demonstrating the benefits of coordinated care models in reducing complications and promoting better health outcomes.

A Comprehensive Review of Ocular Manifestations in Systemic Diseases.

Ocular manifestations often serve as critical indicators of underlying systemic diseases, providing valuable diagnostic and prognostic information. This comprehensive review aims to elucidate the complex interplay between ocular symptoms and systemic conditions, emphasising the importance of early recognition and interdisciplinary collaboration in patient management. The review encompasses various systemic diseases, including cardiovascular, autoimmune, infectious, neurological, endocrine, hematologic, genetic, dermatologic, gastrointestinal, hepatic, renal, and connective tissue disorders, highlighting their specific ocular manifestations. Diagnostic approaches, including ophthalmologic examination techniques, imaging modalities, and laboratory tests, are discussed to enhance diagnostic accuracy. Furthermore, the review outlines current management and treatment strategies, emphasising the need for a multidisciplinary approach to care. Emerging therapies and future research directions are also explored, underscoring the necessity of continued innovation in this field. This review aims to improve clinical practices, promote integrative healthcare, and ultimately enhance patient outcomes by providing a detailed overview of ocular manifestations in systemic diseases.

A Systematic Review of Falls Risk of Frail Patients with Dementia in Hospital: Progress, Challenges, and Recommendations.

This review article assesses the effectiveness and limitations of strategies to reduce falls among hospitalized older adults with frailty and dementia. It explores the efficacy of existing fall prevention strategies for a cohort that is acutely susceptible to falls and fall-related consequences. A systematic literature search was conducted across MEDLINE, Embase, CINAHL, and PsycINFO, employing Medical Subject Headings (MeSH) to identify studies on fall prevention strategies in hospitalized older adults with both dementia and frailty published from 2013 to 2023. The initial 643 records were distilled to eight articles, with Structured Interdisciplinary Bedside Rounds (SIBR) emerging as a notable intervention. SIBR demonstrated a reduction in falls by fostering improved interdisciplinary communication and care planning. However, a decline in family engagement during consecutive sessions suggests a need for strategies to sustain familial involvement. The findings advocate for patient-centered interventions that address the cognitive and functional challenges faced by this cohort of older adults. This review advocates for comprehensive and inclusive research in hospital environments to improve fall prevention strategies for frail older adults with dementia.

Detecting and preventing child maltreatment in primary care and PHNs' role-a cross-sectional study.

BACKGROUND: Child maltreatment is a global problem that puts children at risk of mental illness, substance abuse, and premature death. Interdisciplinary collaboration is important in preventing and detecting child maltreatment. In Norway, children undergo universal preventive health assessments and receive complimentary follow-up care from specialized public health nurses in child and family health clinics. These nurses conduct regular check-ups and home visits to monitor children for signs of maltreatment. OBJECTIVE: The objective of this study is to describe how public health nurses at child and family health clinics follow the National Clinical Guidelines to prevent and detect child maltreatment, with a particular focus on clinical procedures and interdisciplinary collaboration. Furthermore, we aim to determine factors that are associated with identification of child maltreatment. DESIGN: A cross-sectional online survey was conducted among public health nurses working in primary care between October 24th and December 31st, 2022. Public health nurses who worked with children aged 0-5 years and had consultations with families were eligible to participate, resulting in 554 responses. The study employed descriptive analysis, including frequency, percentage and mean, as well as a two-step logistic regression analysis. The study was approved by the relevant authority, and informed consent was obtained through questionnaire completion. RESULTS: The public health nurses in this study displayed strong adherence to the guidelines and utilized various comprehensive assessment procedures to monitor child well-being, growth, and development. However, there was limited and infrequent collaboration with other professionals, such as child protection services, general practitioners, and hospitals. Most public health nurses reported occasional suspicion of child maltreatment, with age and years of experience in child and family clinics influencing these suspicions. Older public health nurses were more likely to suspect physical violence, while those with less than two years of experience reported less experience in suspecting maltreatment. Additional education increased the probability of suspecting sexual violence. CONCLUSIONS: This study provides insights into the practices of public health nurses in Norway regarding the detection and prevention of child maltreatment in child and family clinics. While adherence to guidelines is strong, suspicion of maltreatment is relatively rare. Collaboration across agencies is crucial in addressing child maltreatment. Age and experience may influence the detection of maltreatment. Improved collaboration, targeted guidelines, and ongoing professional development are needed to enhance child protection.

Communication and collaboration skills training in radiation oncology: A quantitative validation survey.

INTRODUCTION: Communication and collaboration are integral in radiation oncology practice. A recently published qualitative study identified several deficiencies in skills development for Australian/New Zealand trainees. We aim to validate these findings to guide curriculum development. METHODS: A quantitative survey was developed through an iterative process, using themes identified in the previous qualitative investigation. This survey was distributed to radiation oncologists and trainees across Australia and New Zealand via email. Data collection and management utilised the REDCap system. Question types varied to maximise richness of data, including ranking, likert-scales and free-text questions. Results are primarily reported descriptively. RESULTS: Totally 35 participants submitted completed survey responses with broad representation across geography, gender and clinician seniority. To learn communication, participants reported strong preferences towards informal observation (60% agreement) and self-reflection (49% agreement), and against online learning (77% disagreement) methodologies. Nearly 35% acknowledge poor communication at least weekly, with time pressure being a major barrier (63% agreement). Clinical uncertainty and existing patient/family assumptions (both 74% agreement) contribute to difficulties in breaking bad news, with online learning being the only negatively perceived training modality (23% agreement). No participants reported any formal training/mentoring in multi-disciplinary team (MDT) engagement. Conflict was commonly witnessed/experienced (97%) and 26% of participants avoid MDTs due to difficulties experienced. CONCLUSIONS: This study validates the themes previously identified. We identified a strong preference for informal learning methodologies and against online modules, discordant to published literature. Effective collaboration within MDTs is identified as a particular area of need. We recommend future curriculum modification considers these results to maximise efficacy.

Case report: Early use of whole exome sequencing unveils HNRNPU-related neurodevelopmental disorder and answers additional clinical questions through reanalysis.

This case report chronicles the diagnostic odyssey and resolution of a 27-year-old female with a complex neurodevelopmental disorder (NDD) using Whole Exome Sequencing (WES). The patient presented to a precision medicine clinic with multiple diagnoses including intellectual disability, autism spectrum disorder (ASD), obsessive-compulsive disorder (OCD), tics, seizures, and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). Although this patient previously had chromosomal microarray and several single-gene tests, the underlying cause of this patient's symptoms remained elusive. WES revealed a pathogenic missense mutation in the HNRNPU gene, associated with HNRNPU-related neurodevelopmental disorder (HNRNPU-NDD) and developmental and epileptic encephalopathy-54 (DEE54, OMIM: # 617391). Following this diagnoses, other treating clinicians identified additional indications for genetic testing, however, as the WES data was readily available, the clinical team was able to re-analyze the WES data to address their inquiries without requiring additional tests. This emphasizes the pivotal role of WES in expediting diagnoses, reducing costs, and providing ongoing clinical utility throughout a patient's life. Accessible WES data in primary care settings can enhance patient care by informing future genetic inquiries, enhancing coordination of care, and facilitating precision medicine interventions, thereby mitigating the burden on families and the healthcare system.

Implications of Artificial Intelligence in Addressing Antimicrobial Resistance: Innovations, Global Challenges, and Healthcare's Future.

Antibiotic resistance poses a significant threat to global public health due to complex interactions between bacterial genetic factors and external influences such as antibiotic misuse. Artificial intelligence (AI) offers innovative strategies to address this crisis. For example, AI can analyze genomic data to detect resistance markers early on, enabling early interventions. In addition, AI-powered decision support systems can optimize antibiotic use by recommending the most effective treatments based on patient data and local resistance patterns. AI can accelerate drug discovery by predicting the efficacy of new compounds and identifying potential antibacterial agents. Although progress has been made, challenges persist, including data quality, model interpretability, and real-world implementation. A multidisciplinary approach that integrates AI with other emerging technologies, such as synthetic biology and nanomedicine, could pave the way for effective prevention and mitigation of antimicrobial resistance, preserving the efficacy of antibiotics for future generations.

A Grounded Theory of Interdisciplinary Communication and Collaboration in the Outpatient Setting of the Hospital for Patients with Multiple Long-Term Conditions.

Interdisciplinary communication and collaboration are crucial in the care of people with multiple long-term conditions (MLTCs) yet are often experienced as insufficient. Through the lens of complexity science, this study aims to explain how healthcare professionals (HCPs) adapt to emerging situations in the care of patients with MLTC by examining interdisciplinary communication and collaboration in the outpatient hospital setting. We used the constant comparative method to analyze transcribed data from seven focus groups with twenty-one HCPs to generate a constructivist grounded theory of 'interdisciplinary communication and collaboration in the outpatient setting of the hospital for patients with multiple long-term conditions'. Our theory elucidates the various pathways of communication and collaboration. Why, when, and how team members choose to collaborate influences if and to what degree tailored care is achieved. There is great variability and unpredictability to this process due to internalized rules, such as beliefs on the appropriateness to deviate from guidelines, and the presence of an interprofessional identity. We identified organizational structures that influence the dynamics of the care team such as the availability of time and financial compensation for collaboration. As we strive for tailored care for patients with MLTC, our theory provides promising avenues for future endeavors.