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1.
Hipertens. riesgo vasc ; 41(2): 78-86, abr.-jun2024. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-ADZ-176

RESUMO

Introducción: La hipertensión arterial (HTA) representa el principal factor de riesgo individual, con mayor carga a nivel mundial de enfermedades cardiovasculares (ECV). En nuestro país, algunos trabajos epidemiológicos han mostrado marcadas diferencias en las prevalencias de estos factores de riesgo de acuerdo con la población evaluada. Sin embargo, no hay estudios epidemiológicos de evaluación de factores de riesgo cardiovascular exclusivos referentes a barrios vulnerables con muy bajos recursos económicos, socioculturales y poca accesibilidad a los sistemas de salud. Materiales y métodos: Estudio observacional de corte transversal multicéntrico en habitantes de comunas vulnerables de muy bajos recursos, como asentamientos populares y barrios carenciados con muestreo aleatorizado simple de casas. Se realizaron tomas de presión arterial (PA), medidas antropométricas, así como cuestionarios epidemiológicos, económicos y socioculturales. Se describen los hallazgos: prevalencia, conocimiento y control de la PA en las distintas regiones. Se efectuó una regresión logística para determinar las variables independientes a los resultados principales. Resultados: Se analizaron 989 participantes. La prevalencia de HTA global fue de 48,2%. Un total de 82% tenía un índice de masa corporal (IMC) >25 kg/m2. De estos pacientes, 45,3% tenían menos de seis años de educación. Este último aspecto se asoció a mayor prevalencia de HTA de forma independiente. De los hipertensos, 44% desconocían su padecimiento y solo en 17,2% estaba controlado, asociándose esto a tener obra social (OS) y mayor nivel educativo. Únicamente 24% estaban bajo tratamiento combinado. Conclusión: La prevalencia de HTA en barrios vulnerables es elevada, superando a la de otros estratos sociales con niveles de conocimiento, tratamiento y control de la HTA bajos, similar a otras poblaciones. Se detectó un uso insuficiente de la terapia combinada.


Introduction: Hypertension (HTN) represents the primary individual risk factor, contributing significantly to the global burden of cardiovascular diseases (CVD). In our country, epidemiological research has highlighted substantial variations in the prevalence of these risk factors across different populations. However, there is a lack of epidemiological studies assessing exclusive cardiovascular risk factors within vulnerable neighborhoods characterized by extremely limited economic resources, sociocultural challenges, and inadequate healthcare access. Methods: A multicenter cross-sectional observational study was conducted among individuals residing in economically deprived and marginalized communities, including informal settlements and underprivileged neighborhoods. Simple random sampling of households was employed. Blood pressure measurements, anthropometric assessments, and epidemiological, economic, and sociocultural questionnaires were administered. Results encompass prevalence rates, awareness levels, and blood pressure control across diverse regions. Logistic regression was utilized to identify independent variables influencing primary outcomes. Results: A total of 989 participants were analyzed. The overall prevalence of hypertension was 48.2%. About 82% had a body mass index (BMI) >25. Approximately 45.3% had less than 6 years of formal education. Independent association was established between education levels below 6 years and higher hypertension prevalence Among hypertensive individuals, 44% were unaware of their condition, with only 17.2% achieving control, correlated with having health insurance and a higher educational background. Merely 24% were receiving combined therapy. Conclusion: The prevalence of hypertension within vulnerable neighborhoods is alarmingly high, surpassing rates in other social strata. Knowledge, treatment, and control levels of hypertension are suboptimal, comparable to other populations... (AU)


Assuntos
Humanos , Ciências da Saúde , Epidemiologia , Hipertensão , Determinantes Sociais da Saúde , Prevalência , Conhecimento , Argentina
2.
BMC Med Educ ; 24(1): 412, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38622577

RESUMO

BACKGROUND: Nowadays, Artificial intelligence (AI) is one of the most popular topics that can be integrated into healthcare activities. Currently, AI is used in specialized fields such as radiology, pathology, and ophthalmology. Despite the advantages of AI, the fear of human labor being replaced by this technology makes some students reluctant to choose specific fields. This meta-analysis aims to investigate the knowledge and attitude of medical, dental, and nursing students and experts in this field about AI and its application. METHOD: This study was designed based on PRISMA guidelines. PubMed, Scopus, and Google Scholar databases were searched with relevant keywords. After study selection according to inclusion criteria, data of knowledge and attitude were extracted for meta-analysis. RESULT: Twenty-two studies included 8491 participants were included in this meta-analysis. The pooled analysis revealed a proportion of 0.44 (95%CI = [0.34, 0.54], P < 0.01, I2 = 98.95%) for knowledge. Moreover, the proportion of attitude was 0.65 (95%CI = [0.55, 0.75], P < 0.01, I2 = 99.47%). The studies did not show any publication bias with a symmetrical funnel plot. CONCLUSION: Average levels of knowledge indicate the necessity of including relevant educational programs in the student's academic curriculum. The positive attitude of students promises the acceptance of AI technology. However, dealing with ethics education in AI and the aspects of human-AI cooperation are discussed. Future longitudinal studies could follow students to provide more data to guide how AI can be incorporated into education.


Assuntos
Estudantes de Medicina , Estudantes de Enfermagem , Humanos , Inteligência Artificial , Emoções , Conhecimento , Escolaridade
3.
Sensors (Basel) ; 24(7)2024 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-38610256

RESUMO

The ongoing biodiversity crisis, driven by factors such as land-use change and global warming, emphasizes the need for effective ecological monitoring methods. Acoustic monitoring of biodiversity has emerged as an important monitoring tool. Detecting human voices in soundscape monitoring projects is useful both for analyzing human disturbance and for privacy filtering. Despite significant strides in deep learning in recent years, the deployment of large neural networks on compact devices poses challenges due to memory and latency constraints. Our approach focuses on leveraging knowledge distillation techniques to design efficient, lightweight student models for speech detection in bioacoustics. In particular, we employed the MobileNetV3-Small-Pi model to create compact yet effective student architectures to compare against the larger EcoVAD teacher model, a well-regarded voice detection architecture in eco-acoustic monitoring. The comparative analysis included examining various configurations of the MobileNetV3-Small-Pi-derived student models to identify optimal performance. Additionally, a thorough evaluation of different distillation techniques was conducted to ascertain the most effective method for model selection. Our findings revealed that the distilled models exhibited comparable performance to the EcoVAD teacher model, indicating a promising approach to overcoming computational barriers for real-time ecological monitoring.


Assuntos
Fala , Voz , Humanos , Acústica , Biodiversidade , Conhecimento
4.
PLoS One ; 19(4): e0301922, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38625952

RESUMO

OBJECTIVE: Use CFIR guidance to create comprehensive, evidence-based, feasible, and acceptable gender-affirming care PROM implementation strategies. DESIGN, SETTING, PARTICIPANTS: A 3-Phase participatory process was followed to design feasible and acceptable strategies for integrating PROMs in gender-affirming care. In Phase 1, barriers and enablers to PROM implementation for gender-affirming care were identified from a previous systematic review and our prior qualitative study. We used the CFIR-ERIC tool to match previously identified barriers and enablers with expert-endorsed implementation strategies. In Phase 2, implementation strategy outputs from CFIR-ERIC were organised according to cumulative percentage value. In Phase 3, gender-affirming care PROM implementation strategies underwent iterative refinement based on rounds of stakeholder feedback with seven patient and public partners and a gender-affirming healthcare professional. RESULTS: The systematic review and qualitative study identified barriers and enablers to PROM implementation spanning all five CFIR domains, and 30 CFIR constructs. The top healthcare professional-relevant strategies to PROM implementation from the CFIR-ERIC output include: identifying and preparing implementation champions, collecting feedback on PROM implementation, and capturing and sharing local knowledge between clinics on implementation. Top patient-relevant strategies include: having educational material on PROMs, ensuring adaptability of PROMs, and collaborating with key local organisations who may be able to support patients. CONCLUSIONS: This study developed evidence-based, feasible, and acceptable strategies for integrating PROMs in gender-affirming care, representing evidence from a systematic review of 286 international articles, a qualitative study of 24 gender-affirming care patients and healthcare professionals, and iteration from 7 patient and public partners and a gender-affirming healthcare professional. The finalised strategies include patient- and healthcare professional-relevant strategies for implementing PROMs in gender-affirming care. Clinicians and researchers can select and tailor implementation strategies best applying to their gender-affirming care setting.


Assuntos
Comportamento Compulsivo , 60708 , Humanos , Pessoal de Saúde , Conhecimento , Medidas de Resultados Relatados pelo Paciente
5.
PLoS One ; 19(4): e0297068, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38593127

RESUMO

Compared with visible light images, thermal infrared images have poor resolution, low contrast, signal-to-noise ratio, blurred visual effects, and less information. Thermal infrared sports target detection methods relying on traditional convolutional networks capture the rich semantics in high-level features but blur the spatial details. The differences in physical information content and spatial distribution of high and low features are ignored, resulting in a mismatch between the region of interest and the target. To address these issues, we propose a local attention-guided Swin-transformer thermal infrared sports object detection method (LAGSwin) to encode sports objects' spatial transformation and orientation information. On the one hand, Swin-transformer guided by local attention is adopted to enrich the semantic knowledge of low-level features by embedding local focus from high-level features and generating high-quality anchors while increasing the embedding of contextual information. On the other hand, an active rotation filter is employed to encode orientation information, resulting in orientation-sensitive and invariant features to reduce the inconsistency between classification and localization regression. A bidirectional criss-cross fusion strategy is adopted in the feature fusion stage to enable better interaction and embedding features of different resolutions. At last, the evaluation and verification of multiple open-source sports target datasets prove that the proposed LAGSwin detection framework has good robustness and generalization ability.


Assuntos
Fontes de Energia Elétrica , Exame Físico , Generalização Psicológica , Conhecimento , Luz
6.
Curr Biol ; 34(7): R273-R275, 2024 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-38593769

RESUMO

Local and indigenous communities often have an intimate connection to nature that is reflected in their ecological knowledge and practices. A new study shows that local ecological knowledge can transform the scientific understanding of an ecological network.


Assuntos
Frutas , Conhecimento , Ecologia , Conservação dos Recursos Naturais
7.
Adv Tech Stand Neurosurg ; 50: 277-293, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38592534

RESUMO

This paper reviews current knowledge on minimally invasive spine surgery (MISS). Although it has significant advantages, such as less postoperative pain, short hospital stay, quick return to work, better cosmetics, and less infection rate, there are also disadvantages. The long learning curve, the need for special instruments and types of equipment, high costs, lack of tactile sensation and biplanar imaging, some complications that are hard to treat, and more radiation to the surgeon and surgical team are the disadvantages.Most studies remark that the outcomes of MISS are similar to traditional surgery. Although patients demand it more than surgeons, we predict the broad applications of MISS will replace most of our classical surgical approaches.


Assuntos
Hospitais , Conhecimento , Humanos , Curva de Aprendizado , Tempo de Internação , Procedimentos Cirúrgicos Minimamente Invasivos
8.
Psychoanal Q ; 93(1): 13-31, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38578260

RESUMO

The author describes and then clinically illustrates what he terms the ontological dimension of psychoanalysis (having to do with coming into being) and the epistemological dimension of psychoanalysis (having to do with coming to know and understand). Neither of these dimensions of psychoanalysis exists in pure form; they are inextricably intertwined. Epistemological psychoanalysis, for which Freud and Klein are the principal architects, involves the work of arriving at understandings of play, dreams, and associations; while ontological psychoanalysis, for which Winnicott and Bion are the principal architects, involves creating conditions in which the patient might become more fully alive and real to him- or herself. The author provides clinical illustrations of the ontological dimension of psychoanalysis in which the process of the patient's coming more fully into being is facilitated by the experiences in which the patient feels recognized for the individual he is and is becoming. This occurs in an analysis in which the analyst and patient invent a form of psychoanalysis that is uniquely their own.


Assuntos
Psicanálise , Humanos , Masculino , Psicanálise/história , Sonhos , Emoções , Processos Mentais , Conhecimento
9.
Nutrients ; 16(7)2024 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-38612952

RESUMO

Food security is a concept with evolving definitions and meanings, shaped by contested knowledge and changing contexts. The way in which food security is understood by governments impacts how it is addressed in public policy. This research investigates the evolution of discourses and practices in Tasmanian food and nutrition policies from 1994 to 2023. Four foundational documents were analysed using qualitative document analysis, revealing persistent food insecurity issues over three decades. The analysis identified a duality in addressing the persistent policy challenges of nutrition-related health issues and food insecurity: the balancing act between advancing public health improvements and safeguarding Tasmania's economy. The research revealed that from 1994 to 2023, Tasmania's food and nutrition policies and strategies have been characterised by various transitions and tensions. Traditional approaches, predominantly emphasising food availability and, to a limited extent, access, have persisted for over thirty years. The transition towards a more contemporary approach to food security, incorporating dimensions of utilisation, stability, sustainability, and agency, has been markedly slow, indicating systemic inertia. This points to an opportunity for future policy evolution, to move towards a dynamic and comprehensive approach. Such an approach would move beyond the narrow focus of food availability to address the complex multi-dimensional nature of food security.


Assuntos
Distúrbios Nutricionais , Política Nutricional , Humanos , Alimentos , Governo , Conhecimento
10.
Nutrients ; 16(7)2024 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-38613043

RESUMO

Orthorexia nervosa (ON) is a disorder characterized by dietary restrictions and an obsessive focus on "healthy" eating. The present study analyzes two aspects of ON. One related to the inner experiences of the individual (intrapersonal). The other concerns the impact of ON on interpersonal relationships (interpersonal). The developed scale was named the Intra- and Interpersonal Effects Scale of Orthorexia (IIESO). The analysis showed an average correlation between the INTER and INTRA factors (r = 0.46). Both the INTER and INTRA scales correlated strongly with both subscales of the TOS but weakly with the ORTO-R score. Females obtained higher scores on the INTER scale (p < 0.01), while no differences were shown for the INTRA subscale or the overall scale score (p < 0.01). Subjects using supplements had higher mean scores on the INTER and INTRA subscales and for the total score. Among the analyzed results, the greatest strength effect was shown for the total score on the IIESO scale (INTER+INTRA) and the TOS scale. The questionnaires used to date have not distinguished between behaviors from interpersonal and intrapersonal perspectives. Research on these dimensions could expand our knowledge of the disorder and refine diagnostic criteria.


Assuntos
Dieta Saudável , Ortorexia Nervosa , Feminino , Humanos , Suplementos Nutricionais , Relações Interpessoais , Conhecimento
11.
Nutrients ; 16(7)2024 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-38613041

RESUMO

The role of minerals in female fertility, particularly in relation to the menstrual cycle, presents a complex area of study that underscores the interplay between nutrition and reproductive health. This narrative review aims to elucidate the impacts of minerals on key aspects of the reproductive system: hormonal regulation, ovarian function and ovulation, endometrial health, and oxidative stress. Despite the attention given to specific micronutrients in relation to reproductive disorders, there is a noticeable absence of a comprehensive review focusing on the impact of minerals throughout the menstrual cycle on female fertility. This narrative review aims to address this gap by examining the influence of minerals on reproductive health. Each mineral's contribution is explored in detail to provide a clearer picture of its importance in supporting female fertility. This comprehensive analysis not only enhances our knowledge of reproductive health but also offers clinicians valuable insights into potential therapeutic strategies and the recommended intake of minerals to promote female reproductive well-being, considering the menstrual cycle. This review stands as the first to offer such a detailed examination of minerals in the context of the menstrual cycle, aiming to elevate the understanding of their critical role in female fertility and reproductive health.


Assuntos
Ciclo Menstrual , Ovulação , Feminino , Humanos , Reprodução , Minerais , Conhecimento
12.
Rev Med Suisse ; 20(869): 748-755, 2024 Apr 10.
Artigo em Francês | MEDLINE | ID: mdl-38616686

RESUMO

HIV pre-exposure prophylaxis (PrEP) is an effective tool in HIV prevention but is rarely prescribed by primary care physicians. A survey conducted among 147 physicians to assess their knowledge and interest in prescribing PrEP shows that 97% stated they have already heard of PrEP, but their knowledge of its indications, dosage, price, and side-effects is often incomplete or incorrect. For 69% of them, the main obstacle to prescribing PrEP is the lack of training on the subject. However, 70% of physicians express interest in receiving training to confidently prescribe PrEP to their patients. To address this demand, the clinical recommendations of the SwissPrEPared program are summarized.


La prophylaxie pré-exposition au VIH (PrEP) est un outil efficace dans la prévention du VIH mais rarement prescrite par les médecins de premier recours. Un sondage mené auprès de 147 médecins pour évaluer leurs connaissances et intérêt à prescrire la PrEP indique que 97 % déclarent avoir déjà entendu parler de la PrEP, mais aussi que leurs connaissances quant aux indications, posologie, prix et effets secondaires restent souvent lacunaires ou erronées. Pour 69 % des sondés, le principal obstacle à la prescription de la PrEP est le manque de formation sur le sujet. Cependant, 70 % des médecins se disent intéressés à être formés afin de prescrire la PrEP en toute confiance à leurs patients. Pour répondre à cette demande, les recommandations cliniques du programme SwissPrEPared sont résumées.


Assuntos
Infecções por HIV , Médicos , Profilaxia Pré-Exposição , Humanos , Conhecimento , Infecções por HIV/prevenção & controle
13.
Int J Med Sci ; 21(5): 848-861, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38617004

RESUMO

Sudden infant death syndrome (SIDS) is a type of death that occurs suddenly and without any apparent explanation, affecting infants between 28 days of life and up to a year. Recognition of this entity includes performing an autopsy to determine if there is another explanation for the event and performing both an external and internal examination of the different tissues to search for possible histopathological findings. Despite the relative success of awareness campaigns and the implementation of prevention measures, SIDS still represents one of the leading causes of death among infants worldwide. In addition, although the development of different techniques has made it possible to make significant progress in the characterization of the etiopathogenic mechanisms underlying SIDS, there are still many unknowns to be resolved in this regard and the integrative consideration of this syndrome represents an enormous challenge to face both from a point of view scientific and medical view as humanitarian. For all these reasons, this paper aims to summarize the most relevant current knowledge of SIDS, exploring from the base the characterization and recognition of this condition, its forensic findings, its risk factors, and the main prevention measures to be implemented. Likewise, an attempt will be made to analyze the causes and pathological mechanisms associated with SIDS, as well as potential approaches and future paths that must be followed to reduce the impact of this condition.


Assuntos
Morte Súbita do Lactente , Lactente , Humanos , Morte Súbita do Lactente/epidemiologia , Morte Súbita do Lactente/etiologia , Conhecimento , Fatores de Risco , Síndrome
14.
Int J Health Policy Manag ; 13: 7841, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38618835

RESUMO

BACKGROUND: Local governments are the closest level of government to the communities they serve. Traditionally providing roads, rates and garbage services, they are also responsible for policy and regulation, particularly land use planning and community facilities and services that have direct and indirect impacts on (equitable) health and well-being. Partnerships between health agencies and local government are therefore an attractive proposition to progress actions that positively impact community health and well-being. Yet, the factors underpinning these partnerships across different contexts are underdeveloped, as mechanisms to improve population health and well-being. METHODS: A scoping review was conducted to gain insight into the concepts, theories, sources, and knowledge gaps that shape partnerships between health and local governments. The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines and was informed by a critical realist approach that identifies necessary, contingent and contextual factors in the literature. MEDLINE, Scopus, Web of Science, and ProQuest Central databases were searched for studies published between January 2005 and July 2021. RESULTS: The search yielded 3472 studies, after deleting duplicates and initial title and abstract screening, 188 papers underwent full text review. Twenty-nine papers were included in the review. Key themes shaping partnerships included funding and resources; partnership qualities; governance and policy; and evaluation and measures of success. The functional, organisational and individual aspects of these themes are explored and presented in a framework. CONCLUSION: Given that local government are the closest level of government to community, this paper provides a sophisticated roadmap that can underpin partnerships between local government and health agencies aiming to influence population health outcomes. By identifying key themes across contexts, we provide a framework that may assist in designing and evaluating evidence-informed health and local government partnerships.


Assuntos
Confiabilidade dos Dados , Governo Local , Humanos , Bases de Dados Factuais , Renda , Conhecimento
15.
Arch Iran Med ; 27(2): 105-109, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38619034

RESUMO

It is important to honor the contributions of scientific leaders who have dedicated their lives to advancing knowledge and serving their country. One way is to document their experiences and personalities in a documentary format, which can serve as a historical record and an inspiration for future generations. Dr. Mostafa Pourtaghva Shahrestani, a renowned physician and specialist in infectious diseases and tropical medicine, has made significant contributions to public health in Iran. He has played a crucial role in controlling infectious diseases such as smallpox, tuberculosis, rabies, plague, and cholera. Throughout his career, he has held various executive positions, including the head of Pasteur Hospital and the director of the Pasteur Institute of Iran. Dr. Pourtaghva's life is a testament to his unwavering dedication to public health services, as evidenced by his continuous effort, love, and interest in honest work. His inspiring story can serve as a model for those who seek to follow in his footsteps.


Assuntos
Academias e Institutos , Cólera , Masculino , Humanos , Hospitais , Irã (Geográfico) , Conhecimento
16.
J Psychopathol Clin Sci ; 133(3): 257-272, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38619461

RESUMO

Women and men are at different risk for posttraumatic stress disorder (PTSD). It is unclear, however, how studies on PTSD risk factors integrate this knowledge into their research. Moreover, the temporal development of women's higher PTSD risk is unknown. In this systematic review and meta-analysis, we examine how prospective studies on PTSD development (k = 47) consider sex and gender across four domains (samples, terminology, analyses, and reporting). Further, we differentially analyze sex/gender differences within five time intervals from 1 month to 5 years posttrauma. PTSD prevalence (OR = 1.72 [1.27-2.34]) and severity (g = 0.31 [0.09, 0.53]) were increased for women relative to men at 1 month posttrauma already, that is, at the first timepoint of a possible PTSD diagnosis. PTSD severity was elevated for women compared to men across all time intervals, but evidence for increased PTSD prevalence for women relative to men was less stable with longer follow-ups. Despite women's higher PTSD burdens, they were clearly underrepresented in samples (68.3% male, 31.7% female participants). Only 5.0% of studies explained or described their understanding of sex and gender, and only 2.6% used sex as discovery variable, that is, investigating sex-dependent risk mechanisms. Sex and gender aspects in design, data, and discussion were considered by only one-third of studies each. Trauma research falls short of its potential to adequately consider sex and gender. Sex- and gender-sensitive practices can advance rigor, innovation, and equity in psychopathology research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Conhecimento , Psicopatologia , Humanos , Feminino , Masculino , Estudos Prospectivos , Bases de Dados Factuais , Fatores de Risco
17.
PDA J Pharm Sci Technol ; 78(2): 169-175, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38609148

RESUMO

The continuous processing session at the 2023 Viral Clearance Symposium (VCS) focused on understanding how to effectively design viral clearance operations for use in continuous processes and methods to perform viral clearance studies. In this session, an approach to directly address control considerations with operating continuous-flow reactors for low pH viral inactivation was presented. Continuous-flow low pH incubation chamber design and implications for residence time determination were discussed. Additionally, viral clearance capability between batch operation and connected operation were demonstrated to be comparable for a connected bind-elute chromatography and flow-through chromatography step. Overall, this session provided additional scientific knowledge to support viral clearance strategies when implementing a continuous manufacturing process.


Assuntos
Comércio , Conhecimento , Cinética , Fatores de Tempo , Inativação de Vírus
18.
J Transl Med ; 22(1): 348, 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38609955

RESUMO

This review aims to encapsulate the current knowledge in extracellular vesicles extracted from amniotic fluid and amniotic fluid derived stem/stromal cells. Amniotic fluid (AF) bathes the developing fetus, providing nutrients and protection from biological and mechanical dangers. In addition to containing a myriad of proteins, immunoglobulins and growth factors, AF is a rich source of extracellular vesicles (EVs). These vesicles originate from cells in the fetoplacental unit. They are biological messengers carrying an active cargo enveloped within the lipid bilayer. EVs in reproduction are known to play key roles in all stages of pregnancy, starting from fertilisation through to parturition. The intriguing biology of AF-derived EVs (AF-EVs) in pregnancy and their untapped potential as biomarkers is currently gaining attention. EV studies in numerous animal and human disease models have raised expectations of their utility as therapeutics. Amniotic fluid stem cell and mesenchymal stromal cell-derived EVs (AFSC-EVs) provide an established supply of laboratory-made EVs. This cell-free mode of therapy is popular as an alternative to stem cell therapy, revealing similar, if not better therapeutic outcomes. Research has demonstrated the successful application of AF-EVs and AFSC-EVs in therapy, harnessing their anti-inflammatory, angiogenic and regenerative properties. This review provides an overview of such studies and discusses concerns in this emerging field of research.


Assuntos
Vesículas Extracelulares , Células-Tronco Mesenquimais , Animais , Humanos , Feminino , Gravidez , Líquido Amniótico , Conhecimento
19.
Philos Ethics Humanit Med ; 19(1): 5, 2024 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-38594714

RESUMO

Medicine is faced with a number of intractable modern challenges that can be understood in terms of hyper-intellectualization; a compassion crisis, burnout, dehumanization, and lost meaning. These challenges have roots in medical philosophy and indeed general Western philosophy by way of the historic exclusion of human emotion from human reason. The resolution of these medical challenges first requires a novel philosophic schema of human knowledge and reason that incorporates the balanced interaction of human intellect and human emotion. This schema of necessity requires a novel extension of dual-process theory into epistemology in terms of both intellect and emotion each generating a distinct natural kind of knowledge independent of the other as well as how these two forms of mental process together construct human reason. Such a novel philosophic schema is here proposed. This scheme is then applied to the practice of medicine with examples of practical applications with the goal of reformulating medical practice in a more knowledgable, balanced, and healthy way. This schema's expanded epistemology becomes the philosophic foundation for more fully incorporating the humanities in medicine.


Assuntos
Medicina , Filosofia , Humanos , Filosofia Médica , Emoções , Conhecimento
20.
BMC Res Notes ; 17(1): 102, 2024 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-38594730

RESUMO

Immune checkpoint blockade (ICB) therapy holds promise for bringing long-lasting clinical gains for the treatment of cancer. However, studies show that only a fraction of patients respond to the treatment. In this regard, it is valuable to develop gene expression signatures based on RNA sequencing (RNAseq) data and machine learning methods to predict a patient's response to the ICB therapy, which contributes to more personalized treatment strategy and better management of cancer patients. However, due to the limited sample size of ICB trials with RNAseq data available and the vast number of candidate gene expression features, it is challenging to develop well-performed gene expression signatures. In this study, we used several published melanoma datasets and investigated approaches that can improve the construction of gene expression-based prediction models. We found that merging datasets from multiple studies and incorporating prior biological knowledge yielded prediction models with higher predictive accuracies. Our finding suggests that these two strategies are of high value to identify ICB response biomarkers in future studies.


Assuntos
Inibidores de Checkpoint Imunológico , Melanoma , Humanos , Inibidores de Checkpoint Imunológico/farmacologia , Inibidores de Checkpoint Imunológico/uso terapêutico , Melanoma/tratamento farmacológico , Melanoma/genética , Conhecimento , Aprendizado de Máquina , RNA
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