Background:Rural populations in the UK face healthcare inequities despite the NHS’s aim of providing universal healthcare.These disparities include restricted access,transportation challenges,and healthcare workforce...Background:Rural populations in the UK face healthcare inequities despite the NHS’s aim of providing universal healthcare.These disparities include restricted access,transportation challenges,and healthcare workforce shortages,resulting in delayed care and poorer health outcomes.This research aims to investigate the use of telemedicine in rural areas of the United Kingdom to improve access to healthcare facilities.Methods:The research process combines a systematic literature review with a thematic analysis using open coding.The results were presented through thematic representation from an open-coding method,following an established search strategy,inclusion/exclusion criteria,a two-step screening procedure,and data extraction.The PRISMA framework was used to screen the articles for the research.Results:Findings reveal that telemedicine significantly improves access to healthcare in rural areas by reducing travel barriers,enhancing mental health services,and increasing patient engagement.Studies highlight its expanding use during pandemics,cross-border reach,and beneficial effects on mental health services.Digital literacy programs and targeted resource distribution were identified as critical to maximizing the effectiveness of telemedicine.Measures like digital literacy and equitable resource allocation are called for in response to issues like specialized care delivery and equitable access.Together,these projects present a thorough strategy for using telemedicine’s promise of equal access to healthcare in rural areas.Conclusion:Even though studies show that telemedicine was used more frequently during the epidemic,the review underscores the need for enhanced digital literacy and infrastructure to ensure equitable access.Difficulties,including legal complications,a lack of technological literacy,and communication obstacles,still exist.Initiatives to promote digital literacy,fair resource distribution,and regulatory changes for smooth integration are highlighted in the suggested solutions.Overall,telemedicine holds the potential to significantly reduce healthcare disparities in rural areas,provided these challenges are addressed.展开更多
Stroke is a leading cause of mortality and disability worldwide,and current therapeutic strategies are often limited in efficacy and scope.Gene therapy has emerged as a promising intervention that targets molecular pa...Stroke is a leading cause of mortality and disability worldwide,and current therapeutic strategies are often limited in efficacy and scope.Gene therapy has emerged as a promising intervention that targets molecular pathways to mitigate neuronal damage and inflammation and enhance recovery.This study provides a comprehensive review of the recent advances,challenges,and future directions for the application of gene therapy in stroke management.A narrative review of the literature was conducted to evaluate the current status of gene therapy in stroke patients.Anti-inflammatory therapies using micro ribonucleic acids(miRNAs)and genetic targets have demonstrated efficacy in reducing inflammation and neuronal apoptosis in preclinical models.Delivery innovations,such as exosome-mediated systems and nanoparticle-based carriers,have enhanced the precision of gene therapy and the ability to cross the blood–brain barrier.Neuroprotective strategies,including vascular endothelial growth factor(VEGF)and heme oxygenase-1(HO-1)gene delivery,showed promise in promoting recovery and reducing ischemic damage.Combined genetic and pharmacological approaches,such as clustered regularly interspaced short palindromic repeats(CRISPR)/dCas9-mediated Sirt1 upregulation,exhibit synergistic effects and improve therapeutic outcomes.However,most studies have focused on ischemic stroke with limited exploration of hemorrhagic stroke and its long-term safety profile.Key challenges include translational gaps between animal models and human physiology,complexity of stroke subtypes,off-target effects,and resource-intensive trial requirements.Ethical concerns such as informed consent,patient selection,and access disparities further complicate clinical applications.展开更多
Post-stroke epilepsy(PSE)is a common complication of stroke,signifcantly impacting patient’s quality of life.Repetitive transcranial magnetic stimulation(rTMS)is an emerging potential non-invasive treatment for PSE.T...Post-stroke epilepsy(PSE)is a common complication of stroke,signifcantly impacting patient’s quality of life.Repetitive transcranial magnetic stimulation(rTMS)is an emerging potential non-invasive treatment for PSE.This review explores current evidence for rTMS in PSE,highlighting its potential benefts and limitations.Initial studies suggested that rTMS may reduce the seizure burden.Some studies observed a trend towards fewer seizures within two weeks of treatment initiation,indicating a relatively rapid response.Additionally,rTMS may be more efective when used in combination with medication,particularly for patients with specifc lesion locations(frontal/temporal lobes)and seizure types(complex partial seizures).This points towards the potential of personalized treatment protocols.However,current evidence has limitations.Studies often involve small sample sizes and methodological variations,necessitating larger,well-designed trials with standardized protocols to confrm the efcacy and safety of rTMS in PSE.Future research should also focus on the optimization of treatment parameters,including stimulation frequency,duration,coil placement,and treatment course.Long-term studies are needed to evaluate the persistence of treatment efects on seizure control,cognitive function,and overall patient outcomes.Refning patient selection criteria and investigating the underlying mechanisms of therapeutic efects of rTMS in PSE are also crucial areas for future exploration.展开更多
文摘Background:Rural populations in the UK face healthcare inequities despite the NHS’s aim of providing universal healthcare.These disparities include restricted access,transportation challenges,and healthcare workforce shortages,resulting in delayed care and poorer health outcomes.This research aims to investigate the use of telemedicine in rural areas of the United Kingdom to improve access to healthcare facilities.Methods:The research process combines a systematic literature review with a thematic analysis using open coding.The results were presented through thematic representation from an open-coding method,following an established search strategy,inclusion/exclusion criteria,a two-step screening procedure,and data extraction.The PRISMA framework was used to screen the articles for the research.Results:Findings reveal that telemedicine significantly improves access to healthcare in rural areas by reducing travel barriers,enhancing mental health services,and increasing patient engagement.Studies highlight its expanding use during pandemics,cross-border reach,and beneficial effects on mental health services.Digital literacy programs and targeted resource distribution were identified as critical to maximizing the effectiveness of telemedicine.Measures like digital literacy and equitable resource allocation are called for in response to issues like specialized care delivery and equitable access.Together,these projects present a thorough strategy for using telemedicine’s promise of equal access to healthcare in rural areas.Conclusion:Even though studies show that telemedicine was used more frequently during the epidemic,the review underscores the need for enhanced digital literacy and infrastructure to ensure equitable access.Difficulties,including legal complications,a lack of technological literacy,and communication obstacles,still exist.Initiatives to promote digital literacy,fair resource distribution,and regulatory changes for smooth integration are highlighted in the suggested solutions.Overall,telemedicine holds the potential to significantly reduce healthcare disparities in rural areas,provided these challenges are addressed.
文摘Stroke is a leading cause of mortality and disability worldwide,and current therapeutic strategies are often limited in efficacy and scope.Gene therapy has emerged as a promising intervention that targets molecular pathways to mitigate neuronal damage and inflammation and enhance recovery.This study provides a comprehensive review of the recent advances,challenges,and future directions for the application of gene therapy in stroke management.A narrative review of the literature was conducted to evaluate the current status of gene therapy in stroke patients.Anti-inflammatory therapies using micro ribonucleic acids(miRNAs)and genetic targets have demonstrated efficacy in reducing inflammation and neuronal apoptosis in preclinical models.Delivery innovations,such as exosome-mediated systems and nanoparticle-based carriers,have enhanced the precision of gene therapy and the ability to cross the blood–brain barrier.Neuroprotective strategies,including vascular endothelial growth factor(VEGF)and heme oxygenase-1(HO-1)gene delivery,showed promise in promoting recovery and reducing ischemic damage.Combined genetic and pharmacological approaches,such as clustered regularly interspaced short palindromic repeats(CRISPR)/dCas9-mediated Sirt1 upregulation,exhibit synergistic effects and improve therapeutic outcomes.However,most studies have focused on ischemic stroke with limited exploration of hemorrhagic stroke and its long-term safety profile.Key challenges include translational gaps between animal models and human physiology,complexity of stroke subtypes,off-target effects,and resource-intensive trial requirements.Ethical concerns such as informed consent,patient selection,and access disparities further complicate clinical applications.
文摘Post-stroke epilepsy(PSE)is a common complication of stroke,signifcantly impacting patient’s quality of life.Repetitive transcranial magnetic stimulation(rTMS)is an emerging potential non-invasive treatment for PSE.This review explores current evidence for rTMS in PSE,highlighting its potential benefts and limitations.Initial studies suggested that rTMS may reduce the seizure burden.Some studies observed a trend towards fewer seizures within two weeks of treatment initiation,indicating a relatively rapid response.Additionally,rTMS may be more efective when used in combination with medication,particularly for patients with specifc lesion locations(frontal/temporal lobes)and seizure types(complex partial seizures).This points towards the potential of personalized treatment protocols.However,current evidence has limitations.Studies often involve small sample sizes and methodological variations,necessitating larger,well-designed trials with standardized protocols to confrm the efcacy and safety of rTMS in PSE.Future research should also focus on the optimization of treatment parameters,including stimulation frequency,duration,coil placement,and treatment course.Long-term studies are needed to evaluate the persistence of treatment efects on seizure control,cognitive function,and overall patient outcomes.Refning patient selection criteria and investigating the underlying mechanisms of therapeutic efects of rTMS in PSE are also crucial areas for future exploration.
