Extracellular vesicles-derived CXCL4 is a candidate serum tumor biomarker for colorectal cancer.

Extracellular vesicles (EVs) were promising circulating biomarkers for multiple diseases, but whether serum EVs-derived proteins could be used as a reliable tumor biomarker for colorectal cancer (CRC) remained inconclusive. In this study, we identified CXCL4 by a 4D data-independent acquisition-based quantitative proteomics assay of serum EVs-derived proteins in 40 individuals and subsequently analyzed serum EVs-derived CXCL4 levels by ELISA in 2 cohorts of 749 individuals. The results revealed that EVs-derived CXCL4 levels were dramatically elevated in CRC patients than in benign colorectal polyp patients or healthy controls (HC). Furthermore, receiver operating characteristic curves revealed that EVs-derived CXCL4 exhibited superior diagnostic performance with area under the curve of 0.948 in the training cohort. Additionally, CXCL4 could effectively distinguish CRC in stage I/II from HC. Notably, CRC patients with high levels of EVs-derived CXCL4 have shorter 2-year progression-free survival than those with low levels. Overall, our findings demonstrated that serum EVs-derived CXCL4 was a candidate diagnostic and prognostic biomarker for CRC.

Scoping review of obesity interventions: Research frontiers and publication status.

Obesity and overweight are significant global health issues, and numerous obesity intervention studies have been conducted. Summarizing current knowledge of interventions aims to inform researchers and policymakers to keep up-to-date with the latest scientific advancements and trends. In this review, we comprehensively retrieved and screened 4,541 studies on obesity intervention published between 2018 and 2022 in the Web of Science Core Collection, and objectively presented research frontiers using bibliometric analysis. The research frontiers of intervention are mainly focused on dietary, exercise, pharmacological interventions, bariatric surgery, environmental, and cognitive interventions. Time-restricted eating is the hottest research topic, followed by probiotics and Roux-en-Y gastric bypass. Gut microbiota is located in the "Basic and transversal themes" quadrant with a high centrality and low density, which has great development potentiality. Obesity intervention is becoming increasingly common,and we advocate for researchers to undertake more focused research endeavors that consider the specific characteristics of diverse populations or patients.

Professional Identity Formation of Medical Science Educators: An Imperative for Academic Medicine.

Medical schools increasingly seek the expertise of talented medical science faculty to engage in the educational mission of the school; yet, the professional identity of these individuals is in flux. As courses and departments have become more integrated and less discipline-based, faculty with doctorates in biomedical science disciplines who primarily teach may suffer a loss of connection to their discipline, either in the courses they are teaching or in their home departments. Recent reports suggest that most medical science educators transitioned from the laboratory to the classroom by happenstance-not the most ideal way to build this key segment of the faculty. This article addresses the importance of foundational sciences in medical training, highlights the unique contributions of science educators in medical schools, and makes a case for why the professional identity of medical science educators should be studied. An imperative for academic medicine is to understand the factors that underpin the professional identity formation of medical science educators and to invest in training and nurturing this group of faculty members that are vital to educating the next generation of health professionals.

Design and Development of Hypertuned Deep learning Frameworks for Detection and Severity Grading of Brain Tumor using Medical Brain MR images.

BACKGROUND: Brain tumor is a grave illness causing worldwide fatalities. The current detection methods for brain tumors are manual, invasive, and rely on histopathological analysis. Determining the type of brain tumor after its detection relies on biopsy measures and involves human subjectivity. The use of automated CAD techniques for brain tumor detection and classification can overcome these drawbacks. OBJECTIVE: The paper aims to create two deep learning-based CAD frameworks for automatic detection and severity grading of brain tumors - the first model for brain tumor detection in brain MR images and model 2 for the classification of tumors into three types: Glioma, Meningioma, and Pituitary based on severity grading. METHODS: The novelty of the research work includes the architectural design of deep learning frameworks for detection and classification of brain tumor using brain MR images. The hyperparameter tuning of the proposed models is done to achieve the optimal parameters that result in maximizing the models' performance and minimizing losses. RESULTS: The proposed CNN models outperform the existing state of the art models in terms of accuracy and complexity of the models. The proposed model developed for detection of brain tumors achieved an accuracy of 98.56% and CNN Model developed for severity grading of brain tumor achieved an accuracy of 92.36% on BraTs dataset. CONCLUSION: The proposed models have an edge over the existing CNN models in terms of less complexity of the structure and appreciable accuracy with low training and test errors. The proposed CNN Models can be employed for clinical diagnostic purposes to aid the medical fraternity in validating their initial screening for brain tumor detection and its multi-classification.

A Virtual Case Presentation Platform: Protocol Study.

Gaining practical experience is indispensable for medical students. Therefore, when medical students were prevented access to hospitals during the COVID-19 pandemic in Romania, there was an urgent need to find a solution that would allow medical students to develop the skills they would usually develop in hospitals but without the need to be physically present in a hospital. This was the reason behind the idea of developing a Virtual Case Presentation Platform. The platform offers the possibility for medical students to reproduce virtually, in clinically valid scenarios, the diagnostic process and treatment recommendation, as well as the interactions with patients that usually take place in hospitals using natural language through speech and text. On the platform, the students receive valuable feedback from the professors about their performance. In order to reproduce the whole targeted experience for students, without missing anything, before starting the development of the platform, it was mandatory to identify and understand all the aspects that should be covered by the platform. The proposed platform covers the different aspects that have been identified for the diagnostic process and treatment recommendation. It enables medical students to develop essential skills for their future careers as doctors.

Application and mechanisms of Sanhua Decoction in the treatment of cerebral ischemia-reperfusion injury.

Cerebral ischemia-reperfusion is a process in which the blood supply to the brain is temporarily interrupted and subsequently restored. However, it is highly likely to lead to further aggravation of pathological damage to ischemic tissues or the nervous system., and has accordingly been a focus of extensive clinical research. As a traditional Chinese medicinal formulation, Sanhua Decoction has gradually gained importance in the treatment of cerebrovascular diseases. Its main constituents include Citrus aurantium, Magnolia officinalis, rhubarb, and Qiangwu, which are primarily used to regulate qi. In the treatment of neurological diseases, the therapeutic effects of the Sanhua Decoction are mediated via different pathways, including antioxidant, anti-inflammatory, and neurotransmitter regulatory pathways, as well as through the protection of nerve cells and a reduction in cerebral edema. Among the studies conducted to date, many have found that the application of Sanhua Decoction in the treatment of neurological diseases has clear therapeutic effects. In addition, as a natural treatment, the Sanhua Decoction has received widespread attention, given that it is safer and more effective than traditional Western medicines. Consequently, research on the mechanisms of action and efficacy of the Sanhua Decoctions in the treatment of cerebral ischemia-reperfusion injury is of considerable significance. In this paper, we describe the pathogenesis of cerebral ischemia-reperfusion injury and review the current status of its treatment to examine the therapeutic mechanisms of action of the Sanhua Decoction. We hope that the findings of the research presented herein will contribute to a better understanding of the efficacy of this formulation in the treatment of cerebral ischemia-reperfusion, and provide a scientific basis for its application in clinical practice.

A machine learning model identifies M3-like subtype in AML based on PML/RARα targets.

The typical genomic feature of acute myeloid leukemia (AML) M3 subtype is the fusion event of PML/RARα, and ATRA/ATO-based combination therapy is current standard treatment regimen for M3 subtype. Here, a machine-learning model based on expressions of PML/RARα targets was developed to identify M3 patients by analyzing 1228 AML patients. Our model exhibited high accuracy. To enable more non-M3 AML patients to potentially benefit from ATRA/ATO therapy, M3-like patients were further identified. We found that M3-like patients had strong GMP features, including the expression patterns of M3 subtype marker genes, the proportion of myeloid progenitor cells, and deconvolution of AML constituent cell populations. M3-like patients exhibited distinct genomic features, low immune activity and better clinical survival. The initiative identification of patients similar to M3 subtype may help to identify more patients that would benefit from ATO/ATRA treatment and deepen our understanding of the molecular mechanism of AML pathogenesis.

[Scientometric analysis of the main thematic fields and keywords in the subject area «Public health, environmental and occupational health¼].

Research in the field of public health at the global, national, regional and organizational levels continue to be relevant, attracting attention of the researchers who find new aspects of various problems and issues for consideration and analysis in this area. The paper presents results of a scientometric analytical study of the publication landscape for 2019-2021 in the field of public health, using the analytical platform SciVal, the data source for which is the international scientific database Scopus. The study shows positive dynamics and steady growth in most scientometric indicators in the subject area under consideration during the study period. A structural-functional and semantic-linguistic analysis of the top-50 keywords was also carried out, which showed that their ranking position significantly depends on the choice of one of two indicators: either by the number of publications or by relevance. Publications on public health are characterized by a polythematic distribution, providing researchers with the opportunity to make a wide choice in conducting scientific research in the branches of medical science they are interested in, taking into account scientometric indicators characterizing the publication landscape in these areas.

Investigating the advantages and disadvantages of electronic logbooks for education goals promotion in medical sciences students: A systematic review.

Background and Aims: Electronic logbook (E-Logbook) is one of the practical software in medical science that serves as an auxiliary tool for comprehensive education, formative evaluation, and student learning documentation in clinical education. E-logbooks are available to people on the Internet without any time or place restrictions. Experts' familiarity with e-logbooks and their advantages and disadvantages can be effective in their better design so professors and students can use their potential benefits. Therefore, this study examines the advantages and disadvantages of an e-logbook. Methods: This systematic review was conducted until June 13, 2022, by searching relevant keywords such as logbook, e-logbook, and medical students in PubMed, Scopus, and Web of Science databases. Data were extracted using the data extraction form. The contents of the studies were analyzed based on the study's aim. The results of the analyses were presented in the form of descriptive statistics (tables and figures). Results: Out of 365 retrieved studies, 13 were selected to investigate the advantages and disadvantages of e-logbooks. Most studies were conducted in Pakistan (n = 4) and focused on medical students with different specialties (n = 10). The advantages and disadvantages of e-logbooks were classified into nine and four categories, respectively. Most advantages of e-logbooks were related to monitoring and evaluating the performance of students and instructors (n = 11). Their most disadvantages were associated with hardware and software (n = 8). Conclusion: According to the results, e-logbooks can improve clinical education, provide feedback to people, control the achievement of educational goals, and increase professor-student interaction. Hence, it is recommended to address their disadvantages and barriers to improve the quality of students' performance.

The predictive value of modified-DeepSurv in overall survivals of patients with lung cancer.

The traditional prognostic model may induce the possibility of incorrect assessment of mortality risk under the assumption of linearity. It is urgent to develop a non-linearity precise prognostic model for achieving personalized medicine in lung cancer. In our study, we develop and validate a prognostic model "Modified-DeepSurv" for patients with lung carcinoma based on deep learning and evaluate its value for prognosis, while Cox proportional hazard regression was used to develop another model "CPH." The C-index of the Modified-DeepSurv and CPH was 0.956 (95% confidence interval [CI]: 0.946-0.974) and 0.836 (95% CI: 0.774-0.896), respectively, in the training cohort, while the C-index of the Modified-DeepSurv and CPH was 0.932 (95%CI: 0.908-0.964) and 0.777 (95%CI: 0.633-0.919), respectively, in the test dataset. The Modified-DeepSurv model visualization was realized by a user-friendly graphic interface. Modified-DeepSurv can effectively predict the survival of lung cancer patients and is superior to the conventional CPH model.

Chronic graft-versus-host disease is characterized by high levels and distinctive tissue-of-origin patterns of cell-free DNA.

Chronic graft-versus-host disease (cGvHD) is a devastating complication of hematopoietic stem cell transplantation (HSCT). Effective early detection may improve the outcome of cGvHD. The potential utility of circulating cell-free DNA (cfDNA), a sensitive marker for tissue injury, in HSCT and cGvHD remains to be established. Here, cfDNA of prospectively collected plasma samples from HSCT recipients (including both cGvHD and non-cGvHD) and healthy control (HC) subjects were evaluated. Deconvolution methods utilizing tissue-specific DNA methylation signatures were used to determine cfDNA tissue-of-origin. cfDNA levels were significantly higher in HSCT recipients than HC and significantly higher in cGvHD than non-cGvHD. cGvHD was characterized by a high level of cfDNA from innate immune cells, heart, and liver. Non-hematologic tissue-derived cfDNA was significantly higher in cGvHD than non-cGvHD. cfDNA temporal dynamics and tissue-of-origin composition have distinctive features in patients with cGvHD, supporting further exploration of the utility of cfDNA in the study of cGvHD.

From quality improvement to equality improvement projects: A scoping review and framework.

Increasing awareness of health disparities has led to proposals for a pay-for-equity scheme. Implementing such proposals requires systematic methods of collecting and reporting health outcomes for targeted demographics over time. This lays the foundation for a shift from quality improvement projects (QIPs) to equality improvement projects (EQIPs) that could evaluate adherence to standards and progress toward health equity. We performed a scoping review on EQIPs to inform a new framework for quality improvement through a health equity lens. Forty studies implemented an intervention after identifying a disparity compared to 149 others which merely identified group differences. Most evaluated race-based differences and were conducted at the institutional level, with representation in both the inpatient and outpatient settings. EQIPs that improved equity leveraged multidisciplinary expertise, healthcare staff education, and developed tools to track health outcomes continuously. EQIPs can help bridge the inequality gap and form part of an incentivized systematic equality improvement framework.

A novel APA-based prognostic signature may predict the prognosis of lung adenocarcinoma in an East Asian population.

The role of alternative polyadenylation (APA) in tumor development is becoming increasingly evident, but the impact of APA events on the prognosis of LUAD patients is unclear. Therefore, in the present study, we aimed to analyze specific APA events in LUAD to identify novel prognostic biomarkers for LUAD. We first identified prognostic candidate genes for LUAD associated with APA events and validated them in both the East Asian and the USA cohorts, finding that five genes (DCUN1D5, PSMC4, TFAM, THRA, and TMEM100) were of prognostic significance in both populations. Based on this, an APA-based prognostic signature was constructed for the East Asian population. The predictive accuracy of the prognostic signature was further evaluated by the time-dependent ROC, with 1-, 2-, and 3-year AUCs of 0.86, 0.81, and 0.71, respectively. This study may provide new markers for individualized diagnosis and prognostic assessment of LUAD and potential targets for precision treatment.

The impact of Bacillus Calmette-Guérin vaccination on antibody response after COVID-19 vaccination.

Earlier studies showed that BCG vaccination improves antibody responses of subsequent vaccinations. Similarly, in older volunteers we found an increased IgG receptor-binding domain (RBD) concentration after SARS-CoV-2 infection if they were recently vaccinated with BCG. This study aims to assess the effect of BCG on the serum antibody concentrations induced by COVID-19 vaccination in a population of adults older than 60 years. Serum was collected from 1,555 participants of the BCG-CORONA-ELDERLY trial a year after BCG or placebo, and we analyzed the anti-SARS-CoV-2 antibody concentrations using a fluorescent-microsphere-based multiplex immunoassay. Individuals who received the full primary COVID-19 vaccination series before serum collection and did not test positive for SARS-CoV-2 between inclusion and serum collection were included in analyses (n = 945). We found that BCG vaccination before first COVID-19 vaccine (median 347 days [IQR 329-359]) did not significantly impact the IgG RBD concentration after COVID-19 vaccination in an older European population.

Biomarkers of alcohol abuse potentially predict delirium, delirium duration and mortality in critically ill patients.

Carbohydrate-deficient transferrin (CDT) and the γ-glutamyltransferase-CDT derived Anttila-Index are established biomarkers for sustained heavy alcohol consumption and their potential role to predict delirium and mortality in critically ill patients is not clear. In our prospective observational study, we included 343 consecutive patients admitted to our ICU, assessed the occurrence of delirium and investigated its association with biomarkers of alcohol abuse measured on the day of ICU admission. 35% of patients developed delirium during ICU stay. We found significantly higher CDT levels (p = 0.011) and Anttila-Index (p = 0.001) in patients with delirium. CDT above 1.7% (OR 2.06), CDT per percent increase (OR 1.26, AUROC 0.75), and Anttila-Index per unit increase (OR 1.28, AUROC 0.74) were associated with delirium development in adjusted regression models. Anttila-Index and CDT also correlated with delirium duration exceeding 5 days. Additionally, Anttila-Index above 4, Anttila-Index per unit increase, and CDT per percent increase were independently associated with hospital mortality.

Literature review and prospect on oral cognition and disease diagnosis and treatment between Han and Tang dynasties.

Chinese medicine entered a significant period from foundation to maturity between Han and Tang dynasties when the Chinese traditional stomatology was a key stage. Sorting and analysis of existing literature and research outcomes have showed that current research on stomatology between Han and Tang dynasties focuses on oral physiology, pathology, diagnosis and treatment, and health care. It also involves stomatology history and explanation of termino-logies related to mouth and teeth recorded in medical books, use of simple methods, and thinking with citation and analysis of literature simply listed and reasoning preliminarily deducted. From the macro perspective, current research has not unveiled the whole picture of stomatology between the two dynasties and left a series of key issues unresolved. Thus, new methods should be developed and employed to carry out medical research on stomatology between Han and Tang dynasties given that is has a prosperous future.

[Cognitive differences between Taoism and medical science in the location of "Jiaji"].

The differences in the cognition on the location of "Jiaji" between Taoism and medical science are summarized through literature searching. In the medical field, "Jiaji" is generally described as "Jiaji Xue (point)", which is considered as EX-B 2, while, in Taoism, it is expressed as "Jiaji Guan (pass)", focusing on the crucial parts of the body. Medical scholars lay their attention to the distance of "Jiaji" lateral to the spine, in which "Jia" (place on both sides) is mostly considered. In comparison, the Taoists emphasize the central axis on the back of human body expressed as "Jiaji Gu (bone)" and "Jiaji Sanguan (three crucial parts)", in which, "Ji (spine)" is the key. Due to the therapeutic purposes of acupuncture, medical scholars focus on the communication of "Jiaji" with the body surface ultimately. Based on the inner perspective of Taoism, "Jiaji" is connoted to be the three-dimensional structural space located deeply inside of the body. The cognitive differences in the location of "Jiaji" between Taoism and medical science reflect the discrepancy in the cognitive dimensions and approaches to the human body between them, which provide the references for the textual research of "Jiaji" in traditional Chinese medicine.

Keeping medical science trustworthy: The threat by predatory journals.

Since most scientific journals tend to ask article processes costs from authors, a new category of journals has developed of which the business model is commonly exclusively based on financial contributions by authors. Such journals have become known as predatory journals. The financial contributions that they ask are not always lower than those asked by high-quality journals although they offer less: there is commonly no real review, texts are not edited, and there are commonly no printed editions. The lack of serious reviews makes predatory journals attractive, however, particularly for authors of low-quality (or even fraudulent) manuscripts. It is shown here that numerous - commonly fairly recent - journals, some of which may predatory, attract manuscripts by approaching authors of articles in high-quality journals like Complementary Therapies in Medicine. Publication of articles in such journals contaminates thorough literature and undermines the trustworthiness of the medical society. Any involvement in such journals (as an author, reviewer or editor) of such journals should therefore be discouraged.

Determinant Factors of Voluntary or Mandatory Vaccination against COVID-19: A Survey Study among Students at Albanian University.

INTRODUCTION: The world faced serious health and socioeconomic issues with the advent of COVID-19. Along with handwashing, social distancing, and the wearing of masks, vaccination was considered by medical authorities as a key way to curb the spread of the virus. One of the measures that have been proposed to increase vaccinations is the mandatory policy. The purpose of this study was to compare the determinants of voluntary and mandatory vaccination among students at Albanian University. METHODOLOGY: This cross-sectional study, conducted by means of an online survey, was conducted among students enrolled at the private Albanian University, Tirana, Albania during the last week of the winter semester, 7-14 February 2022. RESULTS: In sum, 878 students participated in this study, among whom 612 (69.7%) were females and 266 (30%) were males. Of the participants, 506 (57%) were enrolled in medical science (MS) and 372 (42.3%) were in the non-medical science (Non-MS) group. A total of 773 (88%) were vaccinated against COVID-19, and 105 (11.8%) were not vaccinated. A total of 466 (53%) reported voluntary vaccination, and 412 (46.9%) reported mandatory vaccination. Among the students who were vaccinated voluntarily, 266 (57%) were from the MS group and 200 (42.9%) were from the Non-MS group. A total of 237 (57.5%) of students in the mandatory vaccination group were from the MS group, and 175 (42.4%) were from the Non-MS group. CONCLUSIONS: Vaccine safety and efficacy were hindering factors in vaccination. Additionally, based on the results of this study, the students felt encouraged by the academic staff to vaccinate. This clearly demonstrates that the staff does not lack the skills to enhance students' knowledge about the risk of infectious diseases and the importance of vaccination. Therefore, to influence students' attitudes as much as possible toward vaccination, comprehensive educational programs, including modifications of existing curricula, should be considered.