Unmanned aerial vehicles(UAVs),or drones,that were initially developed for military use during World War I[1],have evolved into highly sophisticated aircraft that can be navigated remotely using global positioning sys...Unmanned aerial vehicles(UAVs),or drones,that were initially developed for military use during World War I[1],have evolved into highly sophisticated aircraft that can be navigated remotely using global positioning systems.With constant improvements,drones have become more efficient,and cost-effective,with longer battery life and greater loading capacity.Today,UAVs have proven to be an effective and affordable solution for enhancing healthcare accessibility for patients who face geographical or infrastructural barriers.Using drone networks can greatly reduce the time transporting life-saving equipment,such as delivering automated external defibrillators(AEDs),to cardiac arrest victims,and can provide quick assistance to reduce travel time for the patients.展开更多
The integration of WhatsApp,a widely-used instant messaging application(IMA),into the realm of orthopaedics and trauma surgery has emerged as a significant development in recent years.This paper explores the multiface...The integration of WhatsApp,a widely-used instant messaging application(IMA),into the realm of orthopaedics and trauma surgery has emerged as a significant development in recent years.This paper explores the multifaceted role of WhatsApp in orthopaedics,focusing on its clinical and non-clinical applications,advantages,disadvantages,and future prospects.The study synthesizes findings from various research papers,emphasizing the growing reliance on mobile technology in healthcare.WhatsApp’s role in orthopaedics is notable for its ease of use,real-time communication,and accessibility.Clinically,it facilitates triage,teleconsultation,diagnosis,treatment,patient advice,and post-operative monitoring.Non-clinically,it supports telemedicine,teleradiology,virtual frac-ture clinics,research,and education in orthopaedic surgery.The application has proven beneficial in enhancing communication among healthcare teams,providing quick responses,and motivating junior physicians.Its use in educational settings has been shown to improve learner’s understanding and patient care.However,the use of WhatsApp in orthopaedics is not without challenges.Risks include the potential spread of misleading information,privacy concerns,and issues with image quality affecting diagnosis and treatment decisions.The paper acknowledges the importance of maintaining professional boundaries and the need for oversight measures to ensure content accuracy.Looking forward,the potential of WhatsApp and similar IMAs in orthopaedics lies in their ability to streamline data collection and retrieval,improve doctor-patient communication,and address challenges like bureaucratic red tape and limited resources.The paper suggests that future orthopaedic practice,particularly in emergency departments,will increasingly rely on such technologies for efficient patient management.This shift,however,must be approached with an understanding of the ethical,legal,and practical implications of integrating social media and mobile technology in healthcare.展开更多
In the realm of orthopedics,the adoption of enhanced recovery after surgery(ERAS)protocols marks a significant stride towards enhancing patient well-being.By embracing a holistic approach that encompasses preoperative...In the realm of orthopedics,the adoption of enhanced recovery after surgery(ERAS)protocols marks a significant stride towards enhancing patient well-being.By embracing a holistic approach that encompasses preoperative counseling,dietary optimization,minimally invasive procedures,and early postoperative mobilization,these protocols have ushered in a new era of surgical care.Despite encountering hurdles like resistance to change and resource allocation challenges,the efficacy of ERAS protocols in improving clinical outcomes is undeniable.Noteworthy benefits include shortened hospital stays and bolstered improved patient-safety measures.Looking ahead,the horizon for ERAS in orthopedics appears bright,with an emphasis on tailoring care to individual needs,integrating cutting-edge technologies,and perpetuating research endeavors.This shift towards a more personalized,streamlined,and cost-efficient model of care underscores the transformative potential of ERAS in reshaping not only orthopedic surgery but also the journey to patient recovery.This editorial details the scope and future of ERAS in the orthopedic specialty.展开更多
Magnesium ion batteries(MIBs)are a potential field for the energy storage of the future but are restricted by insufficient rate capability and rapid capacity degradation.Magnesium-sodium hybrid ion batteries(MSHBs)are...Magnesium ion batteries(MIBs)are a potential field for the energy storage of the future but are restricted by insufficient rate capability and rapid capacity degradation.Magnesium-sodium hybrid ion batteries(MSHBs)are an effective way to address these problems.Here,we report a new type of MSHBs that use layered sodium vanadate((Na,Mn)V_(8)O_(20)·5H_(2)O,Mn-NVO)cathodes coupled with an organic 3,4,9,10-perylenetetracarboxylic diimide(PTCDI)anode in Mg^(2+)/Na^(+)hybrid electrolytes.During electrochemical cycling,Mg^(2+)and Na^(+)co-participate in the cathode reactions,and the introduction of Na^(+)promotes the structural stability of the Mn-NVO cathode,as cleared by several ex-situ characterizations.Consequently,the Mn-NVO cathode presents great specific capacity(249.9 mA h g^(−1)at 300 mA g^(−1))and cycling(1500 cycles at 1500 mA g^(−1))in the Mg^(2+)/Na^(+)hybrid electrolytes.Besides,full battery displays long lifespan with 10,000 cycles at 1000 mA g^(−1).The rate performance and cycling stability of MSHBs have been improved by an economical and scalable method,and the mechanism for these improvements is discussed.展开更多
BACKGROUND Medication errors,especially in dosage calculation,pose risks in healthcare.Artificial intelligence(AI)systems like ChatGPT and Google Bard may help reduce errors,but their accuracy in providing medication ...BACKGROUND Medication errors,especially in dosage calculation,pose risks in healthcare.Artificial intelligence(AI)systems like ChatGPT and Google Bard may help reduce errors,but their accuracy in providing medication information remains to be evaluated.AIM To evaluate the accuracy of AI systems(ChatGPT 3.5,ChatGPT 4,Google Bard)in providing drug dosage information per Harrison's Principles of Internal Medicine.METHODS A set of natural language queries mimicking real-world medical dosage inquiries was presented to the AI systems.Responses were analyzed using a 3-point Likert scale.The analysis,conducted with Python and its libraries,focused on basic statistics,overall system accuracy,and disease-specific and organ system accuracies.RESULTS ChatGPT 4 outperformed the other systems,showing the highest rate of correct responses(83.77%)and the best overall weighted accuracy(0.6775).Disease-specific accuracy varied notably across systems,with some diseases being accurately recognized,while others demonstrated significant discrepancies.Organ system accuracy also showed variable results,underscoring system-specific strengths and weaknesses.CONCLUSION ChatGPT 4 demonstrates superior reliability in medical dosage information,yet variations across diseases emphasize the need for ongoing improvements.These results highlight AI's potential in aiding healthcare professionals,urging continuous development for dependable accuracy in critical medical situations.展开更多
BACKGROUND Adipose-derived stem cells(ADSCs)and the stromal vascular fraction(SVF)have garnered substantial interest in regenerative medicine due to their potential to treat a wide range of conditions.Traditional enzy...BACKGROUND Adipose-derived stem cells(ADSCs)and the stromal vascular fraction(SVF)have garnered substantial interest in regenerative medicine due to their potential to treat a wide range of conditions.Traditional enzymatic methods for isolating these cells face challenges such as high costs,lengthy processing time,and regulatory complexities.AIM This systematic review aimed to assess the efficacy and practicality of nonenzymatic,mechanical methods for isolating SVF and ADSCs,comparing these to conventional enzymatic approaches.METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines,a comprehensive literature search was conducted across multiple databases.Studies were selected based on inclusion criteria focused on non-enzymatic isolation methods for SVF and ADSCs from adipose tissue.The risk of bias was assessed,and a qualitative synthesis of findings was performed due to the methodological heterogeneity of the included studies.RESULTS Nineteen studies met the inclusion criteria,highlighting various mechanical techniques such as centrifugation,vortexing,and ultrasonic cavitation.The review identified significant variability in cell yield and viability,and the integrity of isolated cells across different non-enzymatic methods compared to enzymatic procedures.Despite some advantages of mechanical methods,including reduced processing time and avoidance of enzymatic reagents,the evidence suggests a need for optimization to match the cell quality and therapeutic efficacy achievable with enzymatic isolation.CONCLUSION Non-enzymatic,mechanical methods offer a promising alternative to enzymatic isolation of SVF and ADSCs,potentially simplifying the isolation process and reducing regulatory hurdles.However,further research is necessary to standardize these techniques and ensure consistent,high-quality cell yields for clinical applications.The development of efficient,safe,and reproducible non-enzymatic isolation methods could significantly advance the field of regenerative medicine.展开更多
BACKGROUND Current osteoarthritis(OA)treatments focus on symptom relief without addressing the underlying disease process.In regenerative medicine,current treatments have limitations.In regenerative medicine,more rese...BACKGROUND Current osteoarthritis(OA)treatments focus on symptom relief without addressing the underlying disease process.In regenerative medicine,current treatments have limitations.In regenerative medicine,more research is needed for intra-articular stromal vascular fraction(SVF)injections in OA,including dosage optimization,long-term efficacy,safety,comparisons with other treatments,and mechanism exploration.AIM To compare the efficacy of intra-articular SVF with corticosteroid(ICS)injections in patients with primary knee OA.METHODS The study included 50 patients with Kellgren-Lawrence grades II and III OA.Patients were randomly assigned(1:1)to receive either a single intra-articular SVF injection(group A)or a single intra-articular ICS(triamcinolone)(group B)injection.Patients were followed up at 1,3,6,12,and 24 months.Visual analog score(VAS)and International Knee Documentation Committee(IKDC)scores were administered before the procedure and at all followups.The safety of SVF in terms of adverse and severe adverse events was recorded.Statistical analysis was performed with SPSS Version 26.0,IBM Corp,Chicago,IL,United States.RESULTS Both groups had similar demographics and baseline clinical characteristics.Follow-up showed minor patient loss,resulting in 23 and 24 in groups A and B respectively.Group A experienced a notable reduction in pain,with VAS scores decreasing from 7.7 to 2.4 over 24 months,compared to a minor reduction from 7.8 to 6.2 in Group B.This difference in pain reduction in group A was statistically significant from the third month onwards.Additionally,Group A showed significant improvements in knee functionality,with IKDC scores rising from 33.4 to 83.10,whereas Group B saw a modest increase from 36.7 to 45.16.The improvement in Group A was statistically significant from 6 months and maintained through 24 months.CONCLUSION Our study demonstrated that intra-articular administration of SVF can lead to reduced pain and improved knee function in patients with primary knee OA.More adequately powered,multi-center,double-blinded,randomised clinical trials with longer follow-ups are needed to further establish safety and justify its clinical use.展开更多
Based on hourly rain gauge data during May–September of 2016–20,we analyze the spatiotemporal distributions of total rainfall(TR)and short-duration heavy rainfall(SDHR;hourly rainfall≥20 mm)and their diurnal variat...Based on hourly rain gauge data during May–September of 2016–20,we analyze the spatiotemporal distributions of total rainfall(TR)and short-duration heavy rainfall(SDHR;hourly rainfall≥20 mm)and their diurnal variations over the middle reaches of the Yangtze River basin.For all three types of terrain(i.e.,mountain,foothill,and plain),the amount of TR and SDHR both maximize in June/July,and the contribution of SDHR to TR(CST)peaks in August(amount:23%;frequency:1.74%).Foothill rainfall is characterized by a high TR amount and a high CST(in amount);mountain rainfall is characterized by a high TR frequency but a small CST(in amount);and plain rainfall shows a low TR amount and frequency,but a high CST(in amount).Overall,stations with high TR(amount and frequency)are mainly located over the mountains and in the foothills,while those with high SDHR(amount and frequency)are mainly concentrated in the foothills and plains close to mountainous areas.For all three types of terrain,the diurnal variations of both TR and SDHR exhibit a double peak(weak early morning and strong late afternoon)and a phase shift from the early-morning peak to the late-afternoon peak from May to August.Around the late-afternoon peak,the amount of TR and SDHR in the foothills is larger than over the mountains and plains.The TR intensity in the foothills increases significantly from midnight to afternoon,suggesting that thermal instability may play an important role in this process.展开更多
Objective: Evaluate pretreatment sarcopenia and anemia as prognostic factors in women undergoing treatment for cervical cancer (CC) with concurrent chemoradiotherapy (CCRT). Methods: 151 women with CC were analysed in...Objective: Evaluate pretreatment sarcopenia and anemia as prognostic factors in women undergoing treatment for cervical cancer (CC) with concurrent chemoradiotherapy (CCRT). Methods: 151 women with CC were analysed in this cohort study. Pretreatment computed tomography (CT) images were analysed to assess skeletal muscle index (SMI). Hazard ratios (HR) and multivariate Cox proportional HR were used to analyse association between low SMI, age, body mass index (BMI), haemoglobin levels, histological type, and International Federation of Gynaecology and Obstetrics (FIGO) stage with PFS and OS. Results: A total of 151 patients were included, 53 (35.1%) presented pretreatment sarcopenia;51 (34%) stage I/II and 100 (66%) stage III/IV. Among those patients in advanced stage (III/IV) 37 (70%) (p = 0.28) were sarcopenic at the beginning of treatment. Sarcopenia was associated with worse progression-free survival (PFS) and overall survival (OS) in our cohort [HR 0.97 (p = 0.01)] [HR 0.73 (p = 0.001)], as well as anemia [HR 0.73 (p = 0.001)] [HR 0.78 (p = 0.001)]. Linear regression models indicated that despite showing no association with age, neutrophil or platelet counts, sarcopenia was associated with pretreatment anemia levels (p = 0.01). After a multivariate analysis, only haemoglobin (anemia) and complete CCRT remained associated with PFS and OS. Sarcopenia and anemia were associated with worse PFS and OS in FIGO stage I/II. Conclusion: Pretreatment sarcopenia was significantly associated with low haemoglobin levels. Anemia and incomplete CCRT were independently associated with poor prognosis in women with CC. Pretreatment sarcopenia, as low SMI, was a predictor of poor prognostic in early stages of CC.展开更多
Rhodomyrtus tomentosa is an important f leshy-fruited tree and a well-known medicinal plant of the Myrtaceae family that is widely cultivated in tropical and subtropical areas of the world.However,studies on the evolu...Rhodomyrtus tomentosa is an important f leshy-fruited tree and a well-known medicinal plant of the Myrtaceae family that is widely cultivated in tropical and subtropical areas of the world.However,studies on the evolution and genomic breeding of R.tomentosa were hindered by the lack of a reference genome.Here,we presented a chromosome-level gap-free T2T genome assembly of R.tomentosa using PacBio and ONT long read sequencing.We assembled the genome with size of 470.35 Mb and contig N50 of∼43.80 Mb with 11 pseudochromosomes.A total of 33382 genes and 239.31 Mb of repetitive sequences were annotated in this genome.Phylogenetic analysis elucidated the independent evolution of R.tomentosa starting from 14.37MYA and shared a recent WGD event with other Myrtaceae species.We identified four major compounds of anthocyanins and their synthetic pathways in R.tomentosa.Comparative genomic and gene expression analysis suggested the coloring and high anthocyanin accumulation in R.tomentosa tends to be determined by the activation of anthocyanin synthesis pathway.The positive selection and up-regulation of MYB transcription factors were the implicit factors in this process.The copy number increase of downstream anthocyanin transport-related OMT and GST gene were also detected in R.tomentosa.Expression analysis and pathway identification enriched the importance of starch degradation,response to stimuli,effect of hormones,and cell wall metabolism during the f leshy fruit development in Myrtaceae.Our genome assembly provided a foundation for investigating the origins and differentiation of Myrtaceae species and accelerated the genetic improvement of R.tomentosa.展开更多
Background Increasing resilience is a priority in modern pig breeding.Recent research shows that general resilience can be quantified via variability in longitudinal data.The collection of such longitudinal data on we...Background Increasing resilience is a priority in modern pig breeding.Recent research shows that general resilience can be quantified via variability in longitudinal data.The collection of such longitudinal data on weight,feed intake and feeding behaviour in pigs has been facilitated by the development of technologies such as automated feeding stations.The goal of this study was to investigate resilience traits,which were estimated as deviations from longitudinal weight,feed intake and feeding behaviour data during the finishing phase.A dataset with 324,207 records between the age of 95 and 155 days on 5,939 Pietrain pigs with known pedigree and genomic information was used.We provided guidelines for a rigid quality control of longitudinal body weight data,as we found that outliers can significantly affect results.Gompertz growth curve analysis,linear modelling and trajectory analyses were used for quantifying resilience traits.Results To our knowledge,this is the first study comparing resilience traits from longitudinal body weight,feed intake and feeding behaviour data in pigs.We demonstrated that the resilience traits are lowly to moderately heritable for deviations in body weight(h2=2.9%–20.2%),in feed intake(9.4%–23.3%)and in feeding behaviour(16.2%–28.3%).Additionally,these traits have good predictive abilities in cross-validation analyses.Deviations in individual body weight and feed intake trajectories are highly correlated(rg=0.78)with low to moderate favourable genetic correlations with feed conversion ratio(rg=0.39–0.49).Lastly,we showed that some resilience traits,such as the natural logarithm of variances of observed versus predicted body weights(lnvarweight),are more robust to lower observation frequencies and are repeatable over three different time periods of the finishing phase.Conclusions Our results will help future studies investigating resilience traits and resilience-related traits.Moreover,our study provides first results on standardization of quality control and efficient data sampling from automated feeding station data.Our findings will be valuable for breeding organizations as they offer evidence that pigs’general resilience can be selected on with good accuracy.Moreover,this methodology might be extended to other species to quantify resilience based on longitudinal data.展开更多
BACKGROUND Osteoarthritis(OA)is the most common joint disorder,is associated with an increasing socioeconomic impact owing to the ageing population.AIM To analyze and compare the efficacy and safety of bone-marrow-der...BACKGROUND Osteoarthritis(OA)is the most common joint disorder,is associated with an increasing socioeconomic impact owing to the ageing population.AIM To analyze and compare the efficacy and safety of bone-marrow-derived mesenchymal stromal cells(BM-MSCs)and adipose tissue-derived MSCs(AD-MSCs)in knee OA management from published randomized controlled trials(RCTs).METHODS Independent and duplicate electronic database searches were performed,including PubMed,EMBASE,Web of Science,and Cochrane Library,until August 2021 for RCTs that analyzed the efficacy and safety of AD-MSCs and BM-MSCs in the management of knee OA.The visual analog scale(VAS)score for pain,Western Ontario McMaster Universities Osteoarthritis Index(WOMAC),Lysholm score,Tegner score,magnetic resonance observation of cartilage repair tissue score,knee osteoarthritis outcome score(KOOS),and adverse events were analyzed.Analysis was performed on the R-platform using OpenMeta(Analyst)software.Twenty-one studies,involving 936 patients,were included.Only one study compared the two MSC sources without patient randomization;hence,the results of all included studies from both sources were pooled,and a comparative critical analysis was performed.RESULTS At six months,both AD-MSCs and BM-MSCs showed significant VAS improvement(P=0.015,P=0.012);this was inconsistent at 1 year for BM-MSCs(P<0.001,P=0.539),and AD-MSCs outperformed BM-MSCs compared to controls in measures such as WOMAC(P<0.001,P=0.541),Lysholm scores(P=0.006;P=0.933),and KOOS(P=0.002;P=0.012).BM-MSC-related procedures caused significant adverse events(P=0.003)compared to AD-MSCs(P=0.673).CONCLUSION Adipose tissue is superior to bone marrow because of its safety and consistent efficacy in improving pain and functional outcomes.Future trials are urgently warranted to validate our findings and reach a consensus on the ideal source of MSCs for managing knee OA.展开更多
The electrochemical carbon dioxide reduction reaction(CO_(2)RR)for highvalue-added products is a promising strategy to tackle excessive CO_(2) emissions.However,the activity of and selectivity for catalysts for CO_(2)...The electrochemical carbon dioxide reduction reaction(CO_(2)RR)for highvalue-added products is a promising strategy to tackle excessive CO_(2) emissions.However,the activity of and selectivity for catalysts for CO_(2)RR still need to be improved because of the competing reaction(hydrogen evolution reaction).In this study,for the first time,we have demonstrated dual atomic catalytic sites for CO_(2)RR from a core-shell hybrid of the covalent-organic framework and the metal-organic framework.Due to abundant dual atomic sites(with CoN_(4)O and ZnN_(4) of 2.47 and 11.05 wt.%,respectively)on hollow carbon,the catalyst promoted catalysis of CO_(2)RR,with the highest Faradic efficiency for CO of 92.6%at-0.8 V and a turnover frequency value of 1370.24 h^(-1) at-1.0 V.More importantly,the activity and selectivity of the catalyst were well retained for 30 h.The theoretical calculation further revealed that CoN_(4)O was the main site for CO_(2)RR,and the activity of and selectivity for Zn sites were also improved because of the synergetic roles.展开更多
In 1948,a surgical cut-down was used to access the radial artery and described the first method of cardiac catheterization using the radial artery.This method transitioned from the Sones approach of brachial artery cu...In 1948,a surgical cut-down was used to access the radial artery and described the first method of cardiac catheterization using the radial artery.This method transitioned from the Sones approach of brachial artery cut-down to the Seldinger and Judkins technique of percutaneous femoral artery access.[1]The first 100 cases of coronary angiography were published in 1989.Lucien Campeau invented this procedure at the Montreal Heart Institute in 1986.[2]Advances in technology and equipment have made transradial coronary intervention the primary technique for coronary interventional treatment worldwide.展开更多
BACKGROUND Microsatellite instability(MSI)is a predictive biomarker for cancer immunotherapy.The tumor-agnostic nature of MSI makes it a denominator for immunotherapy in several solid tumors.It can be assessed using n...BACKGROUND Microsatellite instability(MSI)is a predictive biomarker for cancer immunotherapy.The tumor-agnostic nature of MSI makes it a denominator for immunotherapy in several solid tumors.It can be assessed using next-generation sequencing(NGS),fluorescent multiplex PCR,and immunohistochemistry(IHC).CASE SUMMARY Here,we report 3 cases with discordant MSI results detected using different methods.A cholangiocellular carcinoma case revealed proficient mismatch repair(MMR)by IHC but high MSI(MSI-H)by liquid NGS.A cervical cancer case revealed deficient MMR by IHC,microsatellite stable by PCR,and MSI-H by NGS.Lastly,an endometrial cancer case revealed proficient MMR by IHC but MSI-H by NGS.CONCLUSION IHC for MMR status is the first choice due to several advantages.However,in cases of indeterminate IHC results,molecular testing by MSI-PCR is preferred.Recently,NGS-based MSI assays are being widely used to detect MSI-H tumors.All three methods have high accuracy;however,the inconsistencies between them may lead to misdiagnosis.展开更多
Objective:To investigate the golden-time-awareness of and the necessary actions in response to acute myocardial infarction among the general public.Methods:This study was conducted with the use of a descriptive resear...Objective:To investigate the golden-time-awareness of and the necessary actions in response to acute myocardial infarction among the general public.Methods:This study was conducted with the use of a descriptive research design and convenience sampling.A sample of 800 subjects,using self-structured knowledge questionnaires,was selected for data collection and analysis.The study was conducted at Dr.M.G.R.Educational and Research Institute,India,from February to November 2022.Awareness of myocardial infarction symptoms and intervention timeline(the golden time)was investigated.A multivariate logistic regression analysis was performed to identify the demographic factors affecting the recognition of the golden time of acute myocardial infarction.Results:A total of 800 subjects were included.Among the subjects,367(45.8%)were male,433(54.2%)were female,and 443(55.3%)participants failed to recognize the golden time.Our multivariate logistic regression analysis showed that people with a bachelor’s degree(OR=0.41,95%CI:0.23-0.74,P=0.03)and a high school level diploma(OR=0.55,95%CI:0.31-0.97,P=0.03)are more likely to know about myocardial infarction(golden time)than illiterate people.Additionally,people who are employed(OR=0.59,95%CI:0.41-0.85,P=0.05)are more likely to know about myocardial infarction(golden time)than those who are not.Conclusions:The majority of people in the awareness group realize that taking myocardial infarction patients to the hospital would be the best course of action.The unawareness of the ideal treatment window for myocardial infarction may cause a delay in seeking medical attention,which can lead to an increase in mortality and morbidity.展开更多
In the last few decades,the treatment strategy for locally advanced resectable gastric cancer(GC)has shifted to a multimodal approach,which potentially decreases recurrence risk and improves survival rates.Perioperati...In the last few decades,the treatment strategy for locally advanced resectable gastric cancer(GC)has shifted to a multimodal approach,which potentially decreases recurrence risk and improves survival rates.Perioperative therapy leads to downstaging,increased curative resection rates,and prolonged disease-free and overall survival,by preventing micrometastases in patients with resectable GC.Application of neoadjuvant therapy provides information about tumor biology and in vivo sensitivity.A consensus regarding the therapeutic approach for non-metastatic GC does not exist,and many clinical trials aim to clarify this aspect.Advances in precision medicine and the role of immunotherapy have been the focus of research in GC treatment.Herein,the current status and possible future developments of perioperative therapy for locally advanced resectable GC are reviewed,based on the most recent randomized clinical trials.展开更多
Objective:To examine the pattern of COVID-19 infection and vaccination,and to explore pregnant women’s willingness and reluctance to accept a booster dose of the COVID-19 vaccine.Methods:This was a cross-sectional,de...Objective:To examine the pattern of COVID-19 infection and vaccination,and to explore pregnant women’s willingness and reluctance to accept a booster dose of the COVID-19 vaccine.Methods:This was a cross-sectional,descriptive study with a convenient sample size using a structured questionnaire among pregnant women attending the gynecology and obstetrics department at Acıbadem Mehmet Ali Aydinlar Hospital,Istanbul,Türkiye.The Health Belief Model scale was used to assess the intention and reluctance to accept a booster dose of the COVID-19 vaccine.Results:A total of 145 participants,with a mean age of(33.5±4.8)years,and a gestational age of(30.9±7.3)weeks,were enrolled in this study.88.8%Received full doses of the Pfizer-BioNTech vaccination.47.8%Participants suffered from vaccine adverse effects.Health Belief Model demonstrated a significant finding of perceived susceptibility(P<0.001),perceived severity of COVID-19 complications(P<0.001),and perceived benefits regarding a booster COVID-19 vaccination(P<0.001).Conclusions:Most pregnant women who received the COVID-19 immunization express a significant intention to receive a booster dose,regardless of the adverse effects experienced from the previous doses.However,a small percentage of the study sample express hesitancy about receiving the booster dose.展开更多
Despite a decrease in publication,case reports remain essential in medical literature as they offer detailed descriptions of individual patient cases and valuable insights for future management.These reports adhere to...Despite a decrease in publication,case reports remain essential in medical literature as they offer detailed descriptions of individual patient cases and valuable insights for future management.These reports adhere to a standardized structure comprising sections such as abstract,introduction,case report,discussion,and conclusion.Obtaining informed consent and adhering to guidelines is essential.Case reports contribute to evidence-based medicine by detecting new therapies and adverse events.They also facilitate clear reporting,guideline adherence,and mentorship programs.These reports are vital for documenting rare occurrences,assisting clinicians in timely management,and communicating novel information to busy medical professionals.Following case report guidelines ensures comprehensive and standardized reporting,enhancing the acceptance and quality of case reports,and advancing medical knowledge.展开更多
Artificial intelligence(AI)tools,like OpenAI's Chat Generative Pre-trained Transformer(ChatGPT),hold considerable potential in healthcare,academia,and diverse industries.Evidence demonstrates its capability at a m...Artificial intelligence(AI)tools,like OpenAI's Chat Generative Pre-trained Transformer(ChatGPT),hold considerable potential in healthcare,academia,and diverse industries.Evidence demonstrates its capability at a medical student level in standardized tests,suggesting utility in medical education,radiology reporting,genetics research,data optimization,and drafting repetitive texts such as discharge summaries.Nevertheless,these tools should augment,not supplant,human expertise.Despite promising applications,ChatGPT confronts limitations,including critical thinking tasks and generating false references,necessitating stringent cross-verification.Ensuing concerns,such as potential misuse,bias,blind trust,and privacy,underscore the need for transparency,accountability,and clear policies.Evaluations of AI-generated content and preservation of academic integrity are critical.With responsible use,AI can significantly improve healthcare,academia,and industry without compromising integrity and research quality.For effective and ethical AI deployment,collaboration amongst AI developers,researchers,educators,and policymakers is vital.The development of domain-specific tools,guidelines,regulations,and the facilitation of public dialogue must underpin these endeavors to responsibly harness AI's potential.展开更多
文摘Unmanned aerial vehicles(UAVs),or drones,that were initially developed for military use during World War I[1],have evolved into highly sophisticated aircraft that can be navigated remotely using global positioning systems.With constant improvements,drones have become more efficient,and cost-effective,with longer battery life and greater loading capacity.Today,UAVs have proven to be an effective and affordable solution for enhancing healthcare accessibility for patients who face geographical or infrastructural barriers.Using drone networks can greatly reduce the time transporting life-saving equipment,such as delivering automated external defibrillators(AEDs),to cardiac arrest victims,and can provide quick assistance to reduce travel time for the patients.
文摘The integration of WhatsApp,a widely-used instant messaging application(IMA),into the realm of orthopaedics and trauma surgery has emerged as a significant development in recent years.This paper explores the multifaceted role of WhatsApp in orthopaedics,focusing on its clinical and non-clinical applications,advantages,disadvantages,and future prospects.The study synthesizes findings from various research papers,emphasizing the growing reliance on mobile technology in healthcare.WhatsApp’s role in orthopaedics is notable for its ease of use,real-time communication,and accessibility.Clinically,it facilitates triage,teleconsultation,diagnosis,treatment,patient advice,and post-operative monitoring.Non-clinically,it supports telemedicine,teleradiology,virtual frac-ture clinics,research,and education in orthopaedic surgery.The application has proven beneficial in enhancing communication among healthcare teams,providing quick responses,and motivating junior physicians.Its use in educational settings has been shown to improve learner’s understanding and patient care.However,the use of WhatsApp in orthopaedics is not without challenges.Risks include the potential spread of misleading information,privacy concerns,and issues with image quality affecting diagnosis and treatment decisions.The paper acknowledges the importance of maintaining professional boundaries and the need for oversight measures to ensure content accuracy.Looking forward,the potential of WhatsApp and similar IMAs in orthopaedics lies in their ability to streamline data collection and retrieval,improve doctor-patient communication,and address challenges like bureaucratic red tape and limited resources.The paper suggests that future orthopaedic practice,particularly in emergency departments,will increasingly rely on such technologies for efficient patient management.This shift,however,must be approached with an understanding of the ethical,legal,and practical implications of integrating social media and mobile technology in healthcare.
文摘In the realm of orthopedics,the adoption of enhanced recovery after surgery(ERAS)protocols marks a significant stride towards enhancing patient well-being.By embracing a holistic approach that encompasses preoperative counseling,dietary optimization,minimally invasive procedures,and early postoperative mobilization,these protocols have ushered in a new era of surgical care.Despite encountering hurdles like resistance to change and resource allocation challenges,the efficacy of ERAS protocols in improving clinical outcomes is undeniable.Noteworthy benefits include shortened hospital stays and bolstered improved patient-safety measures.Looking ahead,the horizon for ERAS in orthopedics appears bright,with an emphasis on tailoring care to individual needs,integrating cutting-edge technologies,and perpetuating research endeavors.This shift towards a more personalized,streamlined,and cost-efficient model of care underscores the transformative potential of ERAS in reshaping not only orthopedic surgery but also the journey to patient recovery.This editorial details the scope and future of ERAS in the orthopedic specialty.
基金support from the National Natural Science Foundation of China,China(22005207,52261160384)the Guangdong Basic and Applied Basic Research Foundation,Guangdong Province,China(2019A1515011819)+2 种基金the Outstanding Youth Basic Research Project of Shenzhen,Shenzhen,China(RCYX20221008092934093)the Joint Funds of the National Natural Science Foundation of China,China(U22A20140)the Science and Technology Development Fund,Macao SAR(0090/2021/A2 and 0049/2021/AGJ).
文摘Magnesium ion batteries(MIBs)are a potential field for the energy storage of the future but are restricted by insufficient rate capability and rapid capacity degradation.Magnesium-sodium hybrid ion batteries(MSHBs)are an effective way to address these problems.Here,we report a new type of MSHBs that use layered sodium vanadate((Na,Mn)V_(8)O_(20)·5H_(2)O,Mn-NVO)cathodes coupled with an organic 3,4,9,10-perylenetetracarboxylic diimide(PTCDI)anode in Mg^(2+)/Na^(+)hybrid electrolytes.During electrochemical cycling,Mg^(2+)and Na^(+)co-participate in the cathode reactions,and the introduction of Na^(+)promotes the structural stability of the Mn-NVO cathode,as cleared by several ex-situ characterizations.Consequently,the Mn-NVO cathode presents great specific capacity(249.9 mA h g^(−1)at 300 mA g^(−1))and cycling(1500 cycles at 1500 mA g^(−1))in the Mg^(2+)/Na^(+)hybrid electrolytes.Besides,full battery displays long lifespan with 10,000 cycles at 1000 mA g^(−1).The rate performance and cycling stability of MSHBs have been improved by an economical and scalable method,and the mechanism for these improvements is discussed.
文摘BACKGROUND Medication errors,especially in dosage calculation,pose risks in healthcare.Artificial intelligence(AI)systems like ChatGPT and Google Bard may help reduce errors,but their accuracy in providing medication information remains to be evaluated.AIM To evaluate the accuracy of AI systems(ChatGPT 3.5,ChatGPT 4,Google Bard)in providing drug dosage information per Harrison's Principles of Internal Medicine.METHODS A set of natural language queries mimicking real-world medical dosage inquiries was presented to the AI systems.Responses were analyzed using a 3-point Likert scale.The analysis,conducted with Python and its libraries,focused on basic statistics,overall system accuracy,and disease-specific and organ system accuracies.RESULTS ChatGPT 4 outperformed the other systems,showing the highest rate of correct responses(83.77%)and the best overall weighted accuracy(0.6775).Disease-specific accuracy varied notably across systems,with some diseases being accurately recognized,while others demonstrated significant discrepancies.Organ system accuracy also showed variable results,underscoring system-specific strengths and weaknesses.CONCLUSION ChatGPT 4 demonstrates superior reliability in medical dosage information,yet variations across diseases emphasize the need for ongoing improvements.These results highlight AI's potential in aiding healthcare professionals,urging continuous development for dependable accuracy in critical medical situations.
文摘BACKGROUND Adipose-derived stem cells(ADSCs)and the stromal vascular fraction(SVF)have garnered substantial interest in regenerative medicine due to their potential to treat a wide range of conditions.Traditional enzymatic methods for isolating these cells face challenges such as high costs,lengthy processing time,and regulatory complexities.AIM This systematic review aimed to assess the efficacy and practicality of nonenzymatic,mechanical methods for isolating SVF and ADSCs,comparing these to conventional enzymatic approaches.METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines,a comprehensive literature search was conducted across multiple databases.Studies were selected based on inclusion criteria focused on non-enzymatic isolation methods for SVF and ADSCs from adipose tissue.The risk of bias was assessed,and a qualitative synthesis of findings was performed due to the methodological heterogeneity of the included studies.RESULTS Nineteen studies met the inclusion criteria,highlighting various mechanical techniques such as centrifugation,vortexing,and ultrasonic cavitation.The review identified significant variability in cell yield and viability,and the integrity of isolated cells across different non-enzymatic methods compared to enzymatic procedures.Despite some advantages of mechanical methods,including reduced processing time and avoidance of enzymatic reagents,the evidence suggests a need for optimization to match the cell quality and therapeutic efficacy achievable with enzymatic isolation.CONCLUSION Non-enzymatic,mechanical methods offer a promising alternative to enzymatic isolation of SVF and ADSCs,potentially simplifying the isolation process and reducing regulatory hurdles.However,further research is necessary to standardize these techniques and ensure consistent,high-quality cell yields for clinical applications.The development of efficient,safe,and reproducible non-enzymatic isolation methods could significantly advance the field of regenerative medicine.
文摘BACKGROUND Current osteoarthritis(OA)treatments focus on symptom relief without addressing the underlying disease process.In regenerative medicine,current treatments have limitations.In regenerative medicine,more research is needed for intra-articular stromal vascular fraction(SVF)injections in OA,including dosage optimization,long-term efficacy,safety,comparisons with other treatments,and mechanism exploration.AIM To compare the efficacy of intra-articular SVF with corticosteroid(ICS)injections in patients with primary knee OA.METHODS The study included 50 patients with Kellgren-Lawrence grades II and III OA.Patients were randomly assigned(1:1)to receive either a single intra-articular SVF injection(group A)or a single intra-articular ICS(triamcinolone)(group B)injection.Patients were followed up at 1,3,6,12,and 24 months.Visual analog score(VAS)and International Knee Documentation Committee(IKDC)scores were administered before the procedure and at all followups.The safety of SVF in terms of adverse and severe adverse events was recorded.Statistical analysis was performed with SPSS Version 26.0,IBM Corp,Chicago,IL,United States.RESULTS Both groups had similar demographics and baseline clinical characteristics.Follow-up showed minor patient loss,resulting in 23 and 24 in groups A and B respectively.Group A experienced a notable reduction in pain,with VAS scores decreasing from 7.7 to 2.4 over 24 months,compared to a minor reduction from 7.8 to 6.2 in Group B.This difference in pain reduction in group A was statistically significant from the third month onwards.Additionally,Group A showed significant improvements in knee functionality,with IKDC scores rising from 33.4 to 83.10,whereas Group B saw a modest increase from 36.7 to 45.16.The improvement in Group A was statistically significant from 6 months and maintained through 24 months.CONCLUSION Our study demonstrated that intra-articular administration of SVF can lead to reduced pain and improved knee function in patients with primary knee OA.More adequately powered,multi-center,double-blinded,randomised clinical trials with longer follow-ups are needed to further establish safety and justify its clinical use.
基金supported by the National Natural Science Foundation of China(Grant Nos. U2142202, 41975056, 42230612, and 41975058)Youth Innovation Promotion Association,Chinese Academy of Sciencesthe National Key Scientific and Technological Infrastructure project “Earth System Numerical Simulation Facility”(EarthLab)
文摘Based on hourly rain gauge data during May–September of 2016–20,we analyze the spatiotemporal distributions of total rainfall(TR)and short-duration heavy rainfall(SDHR;hourly rainfall≥20 mm)and their diurnal variations over the middle reaches of the Yangtze River basin.For all three types of terrain(i.e.,mountain,foothill,and plain),the amount of TR and SDHR both maximize in June/July,and the contribution of SDHR to TR(CST)peaks in August(amount:23%;frequency:1.74%).Foothill rainfall is characterized by a high TR amount and a high CST(in amount);mountain rainfall is characterized by a high TR frequency but a small CST(in amount);and plain rainfall shows a low TR amount and frequency,but a high CST(in amount).Overall,stations with high TR(amount and frequency)are mainly located over the mountains and in the foothills,while those with high SDHR(amount and frequency)are mainly concentrated in the foothills and plains close to mountainous areas.For all three types of terrain,the diurnal variations of both TR and SDHR exhibit a double peak(weak early morning and strong late afternoon)and a phase shift from the early-morning peak to the late-afternoon peak from May to August.Around the late-afternoon peak,the amount of TR and SDHR in the foothills is larger than over the mountains and plains.The TR intensity in the foothills increases significantly from midnight to afternoon,suggesting that thermal instability may play an important role in this process.
文摘Objective: Evaluate pretreatment sarcopenia and anemia as prognostic factors in women undergoing treatment for cervical cancer (CC) with concurrent chemoradiotherapy (CCRT). Methods: 151 women with CC were analysed in this cohort study. Pretreatment computed tomography (CT) images were analysed to assess skeletal muscle index (SMI). Hazard ratios (HR) and multivariate Cox proportional HR were used to analyse association between low SMI, age, body mass index (BMI), haemoglobin levels, histological type, and International Federation of Gynaecology and Obstetrics (FIGO) stage with PFS and OS. Results: A total of 151 patients were included, 53 (35.1%) presented pretreatment sarcopenia;51 (34%) stage I/II and 100 (66%) stage III/IV. Among those patients in advanced stage (III/IV) 37 (70%) (p = 0.28) were sarcopenic at the beginning of treatment. Sarcopenia was associated with worse progression-free survival (PFS) and overall survival (OS) in our cohort [HR 0.97 (p = 0.01)] [HR 0.73 (p = 0.001)], as well as anemia [HR 0.73 (p = 0.001)] [HR 0.78 (p = 0.001)]. Linear regression models indicated that despite showing no association with age, neutrophil or platelet counts, sarcopenia was associated with pretreatment anemia levels (p = 0.01). After a multivariate analysis, only haemoglobin (anemia) and complete CCRT remained associated with PFS and OS. Sarcopenia and anemia were associated with worse PFS and OS in FIGO stage I/II. Conclusion: Pretreatment sarcopenia was significantly associated with low haemoglobin levels. Anemia and incomplete CCRT were independently associated with poor prognosis in women with CC. Pretreatment sarcopenia, as low SMI, was a predictor of poor prognostic in early stages of CC.
基金supported by the Natural Science Foundation of Crops Research Institute and Guangdong Academy of Agricultural(0145)the Scientific Innovation Strategy-Construction of High-Level Academy of Agriculture Science(R2019PY-JX003)Research and Development Program in Key Areas of the Guangdong Province(2021B0707010010)。
文摘Rhodomyrtus tomentosa is an important f leshy-fruited tree and a well-known medicinal plant of the Myrtaceae family that is widely cultivated in tropical and subtropical areas of the world.However,studies on the evolution and genomic breeding of R.tomentosa were hindered by the lack of a reference genome.Here,we presented a chromosome-level gap-free T2T genome assembly of R.tomentosa using PacBio and ONT long read sequencing.We assembled the genome with size of 470.35 Mb and contig N50 of∼43.80 Mb with 11 pseudochromosomes.A total of 33382 genes and 239.31 Mb of repetitive sequences were annotated in this genome.Phylogenetic analysis elucidated the independent evolution of R.tomentosa starting from 14.37MYA and shared a recent WGD event with other Myrtaceae species.We identified four major compounds of anthocyanins and their synthetic pathways in R.tomentosa.Comparative genomic and gene expression analysis suggested the coloring and high anthocyanin accumulation in R.tomentosa tends to be determined by the activation of anthocyanin synthesis pathway.The positive selection and up-regulation of MYB transcription factors were the implicit factors in this process.The copy number increase of downstream anthocyanin transport-related OMT and GST gene were also detected in R.tomentosa.Expression analysis and pathway identification enriched the importance of starch degradation,response to stimuli,effect of hormones,and cell wall metabolism during the f leshy fruit development in Myrtaceae.Our genome assembly provided a foundation for investigating the origins and differentiation of Myrtaceae species and accelerated the genetic improvement of R.tomentosa.
基金This study was partially funded by an FR PhD fellowship(1104320N,WG)two SB PhD fellowships(1S05818N(CW)and 1S37119N(RM))of the Research Foundation Flanders(FWO)+1 种基金Moreover,RM and LC were also partly funded by a KU Leuven C2 project(C24/18/036)KH was funded by the UNIPIG project of VLAIO(HBC.2019.2866).
文摘Background Increasing resilience is a priority in modern pig breeding.Recent research shows that general resilience can be quantified via variability in longitudinal data.The collection of such longitudinal data on weight,feed intake and feeding behaviour in pigs has been facilitated by the development of technologies such as automated feeding stations.The goal of this study was to investigate resilience traits,which were estimated as deviations from longitudinal weight,feed intake and feeding behaviour data during the finishing phase.A dataset with 324,207 records between the age of 95 and 155 days on 5,939 Pietrain pigs with known pedigree and genomic information was used.We provided guidelines for a rigid quality control of longitudinal body weight data,as we found that outliers can significantly affect results.Gompertz growth curve analysis,linear modelling and trajectory analyses were used for quantifying resilience traits.Results To our knowledge,this is the first study comparing resilience traits from longitudinal body weight,feed intake and feeding behaviour data in pigs.We demonstrated that the resilience traits are lowly to moderately heritable for deviations in body weight(h2=2.9%–20.2%),in feed intake(9.4%–23.3%)and in feeding behaviour(16.2%–28.3%).Additionally,these traits have good predictive abilities in cross-validation analyses.Deviations in individual body weight and feed intake trajectories are highly correlated(rg=0.78)with low to moderate favourable genetic correlations with feed conversion ratio(rg=0.39–0.49).Lastly,we showed that some resilience traits,such as the natural logarithm of variances of observed versus predicted body weights(lnvarweight),are more robust to lower observation frequencies and are repeatable over three different time periods of the finishing phase.Conclusions Our results will help future studies investigating resilience traits and resilience-related traits.Moreover,our study provides first results on standardization of quality control and efficient data sampling from automated feeding station data.Our findings will be valuable for breeding organizations as they offer evidence that pigs’general resilience can be selected on with good accuracy.Moreover,this methodology might be extended to other species to quantify resilience based on longitudinal data.
基金Supported by the Basic Science Research Program through the National Research Foundation of Korea,NRF-2021R1I1A1A01040732 and NRF-2022R1I1A1A01068652the National Research Foundation of Korea grant funded by the Korean Government,Ministry of Science and ICT,2020R1A2C2009496.
文摘BACKGROUND Osteoarthritis(OA)is the most common joint disorder,is associated with an increasing socioeconomic impact owing to the ageing population.AIM To analyze and compare the efficacy and safety of bone-marrow-derived mesenchymal stromal cells(BM-MSCs)and adipose tissue-derived MSCs(AD-MSCs)in knee OA management from published randomized controlled trials(RCTs).METHODS Independent and duplicate electronic database searches were performed,including PubMed,EMBASE,Web of Science,and Cochrane Library,until August 2021 for RCTs that analyzed the efficacy and safety of AD-MSCs and BM-MSCs in the management of knee OA.The visual analog scale(VAS)score for pain,Western Ontario McMaster Universities Osteoarthritis Index(WOMAC),Lysholm score,Tegner score,magnetic resonance observation of cartilage repair tissue score,knee osteoarthritis outcome score(KOOS),and adverse events were analyzed.Analysis was performed on the R-platform using OpenMeta(Analyst)software.Twenty-one studies,involving 936 patients,were included.Only one study compared the two MSC sources without patient randomization;hence,the results of all included studies from both sources were pooled,and a comparative critical analysis was performed.RESULTS At six months,both AD-MSCs and BM-MSCs showed significant VAS improvement(P=0.015,P=0.012);this was inconsistent at 1 year for BM-MSCs(P<0.001,P=0.539),and AD-MSCs outperformed BM-MSCs compared to controls in measures such as WOMAC(P<0.001,P=0.541),Lysholm scores(P=0.006;P=0.933),and KOOS(P=0.002;P=0.012).BM-MSC-related procedures caused significant adverse events(P=0.003)compared to AD-MSCs(P=0.673).CONCLUSION Adipose tissue is superior to bone marrow because of its safety and consistent efficacy in improving pain and functional outcomes.Future trials are urgently warranted to validate our findings and reach a consensus on the ideal source of MSCs for managing knee OA.
基金Q.Xu acknowledges financial support from the Natural Science Foundation of Shanghai(20ZR1464000)G.Zeng is grateful for the support from the National Natural Science Foundation of China(21878322,22075309)the Science and Technology Commission of Shanghai(19ZR1479200).The authors also thank the Shanghai Synchrotron Radiation Facility for XAFS measurements at Beamline BL14w1.
文摘The electrochemical carbon dioxide reduction reaction(CO_(2)RR)for highvalue-added products is a promising strategy to tackle excessive CO_(2) emissions.However,the activity of and selectivity for catalysts for CO_(2)RR still need to be improved because of the competing reaction(hydrogen evolution reaction).In this study,for the first time,we have demonstrated dual atomic catalytic sites for CO_(2)RR from a core-shell hybrid of the covalent-organic framework and the metal-organic framework.Due to abundant dual atomic sites(with CoN_(4)O and ZnN_(4) of 2.47 and 11.05 wt.%,respectively)on hollow carbon,the catalyst promoted catalysis of CO_(2)RR,with the highest Faradic efficiency for CO of 92.6%at-0.8 V and a turnover frequency value of 1370.24 h^(-1) at-1.0 V.More importantly,the activity and selectivity of the catalyst were well retained for 30 h.The theoretical calculation further revealed that CoN_(4)O was the main site for CO_(2)RR,and the activity of and selectivity for Zn sites were also improved because of the synergetic roles.
文摘In 1948,a surgical cut-down was used to access the radial artery and described the first method of cardiac catheterization using the radial artery.This method transitioned from the Sones approach of brachial artery cut-down to the Seldinger and Judkins technique of percutaneous femoral artery access.[1]The first 100 cases of coronary angiography were published in 1989.Lucien Campeau invented this procedure at the Montreal Heart Institute in 1986.[2]Advances in technology and equipment have made transradial coronary intervention the primary technique for coronary interventional treatment worldwide.
文摘BACKGROUND Microsatellite instability(MSI)is a predictive biomarker for cancer immunotherapy.The tumor-agnostic nature of MSI makes it a denominator for immunotherapy in several solid tumors.It can be assessed using next-generation sequencing(NGS),fluorescent multiplex PCR,and immunohistochemistry(IHC).CASE SUMMARY Here,we report 3 cases with discordant MSI results detected using different methods.A cholangiocellular carcinoma case revealed proficient mismatch repair(MMR)by IHC but high MSI(MSI-H)by liquid NGS.A cervical cancer case revealed deficient MMR by IHC,microsatellite stable by PCR,and MSI-H by NGS.Lastly,an endometrial cancer case revealed proficient MMR by IHC but MSI-H by NGS.CONCLUSION IHC for MMR status is the first choice due to several advantages.However,in cases of indeterminate IHC results,molecular testing by MSI-PCR is preferred.Recently,NGS-based MSI assays are being widely used to detect MSI-H tumors.All three methods have high accuracy;however,the inconsistencies between them may lead to misdiagnosis.
文摘Objective:To investigate the golden-time-awareness of and the necessary actions in response to acute myocardial infarction among the general public.Methods:This study was conducted with the use of a descriptive research design and convenience sampling.A sample of 800 subjects,using self-structured knowledge questionnaires,was selected for data collection and analysis.The study was conducted at Dr.M.G.R.Educational and Research Institute,India,from February to November 2022.Awareness of myocardial infarction symptoms and intervention timeline(the golden time)was investigated.A multivariate logistic regression analysis was performed to identify the demographic factors affecting the recognition of the golden time of acute myocardial infarction.Results:A total of 800 subjects were included.Among the subjects,367(45.8%)were male,433(54.2%)were female,and 443(55.3%)participants failed to recognize the golden time.Our multivariate logistic regression analysis showed that people with a bachelor’s degree(OR=0.41,95%CI:0.23-0.74,P=0.03)and a high school level diploma(OR=0.55,95%CI:0.31-0.97,P=0.03)are more likely to know about myocardial infarction(golden time)than illiterate people.Additionally,people who are employed(OR=0.59,95%CI:0.41-0.85,P=0.05)are more likely to know about myocardial infarction(golden time)than those who are not.Conclusions:The majority of people in the awareness group realize that taking myocardial infarction patients to the hospital would be the best course of action.The unawareness of the ideal treatment window for myocardial infarction may cause a delay in seeking medical attention,which can lead to an increase in mortality and morbidity.
文摘In the last few decades,the treatment strategy for locally advanced resectable gastric cancer(GC)has shifted to a multimodal approach,which potentially decreases recurrence risk and improves survival rates.Perioperative therapy leads to downstaging,increased curative resection rates,and prolonged disease-free and overall survival,by preventing micrometastases in patients with resectable GC.Application of neoadjuvant therapy provides information about tumor biology and in vivo sensitivity.A consensus regarding the therapeutic approach for non-metastatic GC does not exist,and many clinical trials aim to clarify this aspect.Advances in precision medicine and the role of immunotherapy have been the focus of research in GC treatment.Herein,the current status and possible future developments of perioperative therapy for locally advanced resectable GC are reviewed,based on the most recent randomized clinical trials.
文摘Objective:To examine the pattern of COVID-19 infection and vaccination,and to explore pregnant women’s willingness and reluctance to accept a booster dose of the COVID-19 vaccine.Methods:This was a cross-sectional,descriptive study with a convenient sample size using a structured questionnaire among pregnant women attending the gynecology and obstetrics department at Acıbadem Mehmet Ali Aydinlar Hospital,Istanbul,Türkiye.The Health Belief Model scale was used to assess the intention and reluctance to accept a booster dose of the COVID-19 vaccine.Results:A total of 145 participants,with a mean age of(33.5±4.8)years,and a gestational age of(30.9±7.3)weeks,were enrolled in this study.88.8%Received full doses of the Pfizer-BioNTech vaccination.47.8%Participants suffered from vaccine adverse effects.Health Belief Model demonstrated a significant finding of perceived susceptibility(P<0.001),perceived severity of COVID-19 complications(P<0.001),and perceived benefits regarding a booster COVID-19 vaccination(P<0.001).Conclusions:Most pregnant women who received the COVID-19 immunization express a significant intention to receive a booster dose,regardless of the adverse effects experienced from the previous doses.However,a small percentage of the study sample express hesitancy about receiving the booster dose.
文摘Despite a decrease in publication,case reports remain essential in medical literature as they offer detailed descriptions of individual patient cases and valuable insights for future management.These reports adhere to a standardized structure comprising sections such as abstract,introduction,case report,discussion,and conclusion.Obtaining informed consent and adhering to guidelines is essential.Case reports contribute to evidence-based medicine by detecting new therapies and adverse events.They also facilitate clear reporting,guideline adherence,and mentorship programs.These reports are vital for documenting rare occurrences,assisting clinicians in timely management,and communicating novel information to busy medical professionals.Following case report guidelines ensures comprehensive and standardized reporting,enhancing the acceptance and quality of case reports,and advancing medical knowledge.
文摘Artificial intelligence(AI)tools,like OpenAI's Chat Generative Pre-trained Transformer(ChatGPT),hold considerable potential in healthcare,academia,and diverse industries.Evidence demonstrates its capability at a medical student level in standardized tests,suggesting utility in medical education,radiology reporting,genetics research,data optimization,and drafting repetitive texts such as discharge summaries.Nevertheless,these tools should augment,not supplant,human expertise.Despite promising applications,ChatGPT confronts limitations,including critical thinking tasks and generating false references,necessitating stringent cross-verification.Ensuing concerns,such as potential misuse,bias,blind trust,and privacy,underscore the need for transparency,accountability,and clear policies.Evaluations of AI-generated content and preservation of academic integrity are critical.With responsible use,AI can significantly improve healthcare,academia,and industry without compromising integrity and research quality.For effective and ethical AI deployment,collaboration amongst AI developers,researchers,educators,and policymakers is vital.The development of domain-specific tools,guidelines,regulations,and the facilitation of public dialogue must underpin these endeavors to responsibly harness AI's potential.