Clear aligner treatment is a novel technique in current orthodontic practice.Distinct from traditional fixed orthodontic appliances,clear aligners have different material features and biomechanical characteristics and...Clear aligner treatment is a novel technique in current orthodontic practice.Distinct from traditional fixed orthodontic appliances,clear aligners have different material features and biomechanical characteristics and treatment efficiencies,presenting new clinical challenges.Therefore,a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique.This expert consensus discusses case selection and grading of treatment difficulty,principle of clear aligner therapy,clinical procedures and potential complications,which are crucial to the clinical success of clear aligner treatment.展开更多
Some studies have confirmed the neuroprotective effect of remote ischemic conditioning against stroke. Although numerous animal researches have shown that the neuroprotective effect of remote ischemic conditioning may...Some studies have confirmed the neuroprotective effect of remote ischemic conditioning against stroke. Although numerous animal researches have shown that the neuroprotective effect of remote ischemic conditioning may be related to neuroinflammation, cellular immunity, apoptosis, and autophagy, the exact underlying molecular mechanisms are unclear. This review summarizes the current status of different types of remote ischemic conditioning methods in animal and clinical studies and analyzes their commonalities and differences in neuroprotective mechanisms and signaling pathways. Remote ischemic conditioning has emerged as a potential therapeutic approach for improving stroke-induced brain injury owing to its simplicity, non-invasiveness, safety, and patient tolerability. Different forms of remote ischemic conditioning exhibit distinct intervention patterns, timing, and application range. Mechanistically, remote ischemic conditioning can exert neuroprotective effects by activating the Notch1/phosphatidylinositol 3-kinase/Akt signaling pathway, improving cerebral perfusion, suppressing neuroinflammation, inhibiting cell apoptosis, activating autophagy, and promoting neural regeneration. While remote ischemic conditioning has shown potential in improving stroke outcomes, its full clinical translation has not yet been achieved.展开更多
Acute pancreatitis(AP) is not a disorder limited to a single organ,the pancreas,but often results in transient or sustained dysfunction,and even failure,of multiple organs,particularly as the disease progresses.^([1])...Acute pancreatitis(AP) is not a disorder limited to a single organ,the pancreas,but often results in transient or sustained dysfunction,and even failure,of multiple organs,particularly as the disease progresses.^([1]) Therefore,although AP is primarily a localized disease with systemic consequences in a subset of patients,its clinical manifestations extend beyond digestive system symptoms to encompass a variety of additional symptoms,particularly during disease progression from mild AP(MAP) to severe AP(SAP).展开更多
The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a pati...The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a patient's health status directly from their perspective,encompassing various domains such as symptom severity,functional status,and overall quality of life.By integrating PROMs into routine clinical practice and research,healthcare providers can achieve a more nuanced understanding of patient experiences and tailor treatments accordingly.The deployment of PROMs supports dynamic patient-provider interactions,fostering better patient engagement and adherence to tre-atment plans.Moreover,PROMs are pivotal in clinical settings for monitoring disease progression and treatment efficacy,particularly in chronic and mental health conditions.However,challenges in implementing PROMs include data collection and management,integration into existing health systems,and acceptance by patients and providers.Overcoming these barriers necessitates technological advancements,policy development,and continuous education to enhance the acceptability and effectiveness of PROMs.The paper concludes with recommendations for future research and policy-making aimed at optimizing the use and impact of PROMs across healthcare settings.展开更多
Osteoarthritis(OA)is a degenerative joint disease with significant clinical and societal impact.Traditional diagnostic methods,including subjective clinical assessments and imaging techniques such as X-rays and MRIs,a...Osteoarthritis(OA)is a degenerative joint disease with significant clinical and societal impact.Traditional diagnostic methods,including subjective clinical assessments and imaging techniques such as X-rays and MRIs,are often limited in their ability to detect early-stage OA or capture subtle joint changes.These limitations result in delayed diagnoses and inconsistent outcomes.Additionally,the analysis of omics data is challenged by the complexity and high dimensionality of biological datasets,making it difficult to identify key molecular mechanisms and biomarkers.Recent advancements in artificial intelligence(AI)offer transformative potential to address these challenges.This review systematically explores the integration of AI into OA research,focusing on applications such as AI-driven early screening and risk prediction from electronic health records(EHR),automated grading and morphological analysis of imaging data,and biomarker discovery through multi-omics integration.By consolidating progress across clinical,imaging,and omics domains,this review provides a comprehensive perspective on how AI is reshaping OA research.The findings have the potential to drive innovations in personalized medicine and targeted interventions,addressing longstanding challenges in OA diagnosis and management.展开更多
Arboviral diseases are viral infections transmitted to humans through the bites of arthropods,such as mosquitoes,often causing a variety of pathologies associated with high levels of morbidity and mortality.Over the p...Arboviral diseases are viral infections transmitted to humans through the bites of arthropods,such as mosquitoes,often causing a variety of pathologies associated with high levels of morbidity and mortality.Over the past decades,these infections have proven to be a significant challenge to health systems worldwide,particularly following the considerable geographic expansion of the dengue virus(DENV)and its most recent outbreak in Latin America as well as the difficult-tocontrol outbreaks of yellow fever virus(YFV),chikungunya virus(CHIKV),and Zika virus(ZIKV),leaving behind a substantial portion of the population with complications related to these infections.Currently,the world is experiencing a period of intense globalization,which,combined with global warming,directly contributes to wider dissemination of arbovirus vectors across the globe.Consequently,all continents remain on high alert for potential new outbreaks.Thus,this review aims to provide a comprehensive understanding of the pathogenesis of the four main arboviruses today(DENV,ZIKV,YFV,and CHIKV)discussing their viral characteristics,immune responses,and mechanisms of viral evasion,as well as important clinical aspects for patient management.This includes associated symptoms,laboratory tests,treatments,existing or developing vaccines and the main associated complications,thus integrating a broad historical,scientific and clinical approach.展开更多
Exosomes(Exos)are extracellular vesicles secreted by cells and serve as crucial mediators of intercellular communication.They play a pivotal role in the pathogenesis and progression of various diseases and offer promi...Exosomes(Exos)are extracellular vesicles secreted by cells and serve as crucial mediators of intercellular communication.They play a pivotal role in the pathogenesis and progression of various diseases and offer promising avenues for therapeutic interventions.Exos derived from mesenchymal stem cells(MSCs)have significant immunomodulatory properties.They effectively regulate immune responses by modulating both innate and adaptive immunity.These Exos can inhibit excessive inflammatory responses and promote tissue repair.Moreover,they participate in antigen presentation,which is essential for activating immune responses.The cargo of these Exos,including ligands,proteins,and microRNAs,can suppress T cell activity or enhance the population of immunosuppressive cells to dampen the immune response.By inhibiting lymphocyte proliferation,acting on macrophages,and increasing the population of regulatory T cells,these Exos contribute to maintaining immune and metabolic homeostasis.Furthermore,they can activate immune-related signaling pathways or serve as vehicles to deliver microRNAs and other bioactive substances to target tumor cells,which holds potential for immunotherapy applications.Given the immense therapeutic potential of MSC-derived Exos,this review comprehensively explores their mechanisms of immune regulation and therapeutic applications in areas such as infection control,tumor suppression,and autoimmune disease management.This article aims to provide valuable insights into the mechanisms behind the actions of MSC-derived Exos,offering theoretical references for their future clinical utilization as cell-free drug preparations.展开更多
Objective:This study aimed to assess the feasibility and safety of the SHURUI single-port robotic surgical system for a range of major urological surgeries.Methods:In this prospective,multicenter clinical trial,we exa...Objective:This study aimed to assess the feasibility and safety of the SHURUI single-port robotic surgical system for a range of major urological surgeries.Methods:In this prospective,multicenter clinical trial,we examined the effectiveness of the SHURUI single-port robotic surgical system in urological interventions.The first 50 patients from four centers in China underwent single-port surgeries including partial nephrectomy,radical prostatectomy,partial adrenalectomy,and pyeloureteroplasty,exclusively by the SHURUI single-port robotic surgical system.The study's primary endpoints focused on the success of surgeries,defined as no deviations from planned procedures,no need for more than one port,and no re-operations within 24 h after surgery.Secondary endpoints encompassed a range of surgical metrics,functional outcomes,and patient demographic data.Clinical assessments were conducted before surgery,before discharge,and 1 month after discharge.Results:The surgical procedures were executed successfully without requiring intraoperative conversions or transfusions.Both estimated blood loss and operation durations were maintained within satisfactory limits.For each type of surgery,the mean console times and estimated blood loss were 179.8(standard deviation[SD]39.4)min and 125.6(SD 126.0)mL for radical prostatectomy,126.7(SD 47.8)min and 39.2(SD 54.4)mL for partial nephrectomy,112.6(SD 37.4)min and 20.0(SD 13.2)mL for partial adrenalectomy,and 148.0(SD 18.2)min and 18.0(SD 17.9)mL for pyeloureteroplasty,respectively.Across the cohort,17 patients experienced a total of 25 adverse events,while 10 postoperative complications,all rated as Clavien-Dindo grade I,were encountered by eight patients.All patients had shown recovery or improvement from these events before the end of this trial.Conclusion:The SHURUI single-port robotic surgical system demonstrated feasibility and safety in the performance of major urological surgeries.These initial findings highlight the system's potential,though further research and longer follow-up are required to assess long-term outcomes.展开更多
The minimal clinically important difference(MCID)represents a pivotal metric in bridging the gap between statistical significance and clinical relevance,addressing the direct impact of medical interventions from the p...The minimal clinically important difference(MCID)represents a pivotal metric in bridging the gap between statistical significance and clinical relevance,addressing the direct impact of medical interventions from the patient's perspective.This comprehensive review analyzes the evolution,applications,and challenges of MCID across medical specialties,emphasizing its necessity in ensuring that clinical outcomes not only demonstrate statistical significance but also offer genuine clinical utility that aligns with patient expectations and needs.We discuss the evolution of MCID since its inception in the 1980s,its current applications across various medical specialties,and the methodologies used in its calculation,highlighting both anchor-based and distribution-based approaches.Furthermore,the paper delves into the challenges associated with the application of MCID,such as methodological variability and the interpretation difficulties that arise in clinical settings.Recommendations for the future include standardizing MCID calculation methods,enhancing patient involvement in setting MCID thresholds,and extending research to incorporate diverse global perspectives.These steps are critical to refining the role of MCID in patient-centered healthcare,addressing existing gaps in methodology and interpretation,and ensuring that medical interventions lead to significant,patient-perceived improvements.展开更多
The general objective of our study was to describe the clinical and epidemiological aspects of anxiety disorders. This was a retrospective descriptive cross-sectional study, lasting 5 years, from January 01, 2019 to D...The general objective of our study was to describe the clinical and epidemiological aspects of anxiety disorders. This was a retrospective descriptive cross-sectional study, lasting 5 years, from January 01, 2019 to December 31, 2023, on 225 patients seen in consultation for anxiety disorders in the department. The prevalence of anxiety disorders was 2.5% in consultation. The 20 - 29 age group was the most represented at 33.3%. Females were slightly represented at 55.1%, with a sex ratio of 1.2. The secondary level was the most affected, accounting for 36.4% of cases. Insomnia was the most frequent reason for consultation, accounting for 71.1% of cases. A larger general population study would be necessary to better assess the extent of anxiety disorders in Guinea.展开更多
The article"Secondary diabetes due to different etiologies:Four case reports"by Song et al,published in the World Journal of Clinical Cases,delves into the identi-fication of rare causes of secondary diabete...The article"Secondary diabetes due to different etiologies:Four case reports"by Song et al,published in the World Journal of Clinical Cases,delves into the identi-fication of rare causes of secondary diabetes and emphasizes the necessity for healthcare professionals to recognize these conditions.Failure to do so can result in treatment delays and compromised patient outcomes.The article discusses spe-cific types of diabetes,including maturity onset of diabetes in young,pancreas-related diseases,endocrinopathies,drug-induced diabetes,infections,and con-genital genetic syndromes associated with diabetes mellitus.Case summaries highlight how patients with secondary diabetes,stemming from conditions such as Williams-Beuren syndrome and pituitary adenoma,often exhibit distinct characteristics overlooked in clinical practice.The authors stress the importance of a holistic diagnostic approach and advocate for proactive management through early intervention,including genetic tests and antibody detection.Increased awa-reness and education are crucial for timely identification and proper management,ultimately improving patient well-being.These findings prompt a call to action for healthcare professionals to consider rare causes of secondary diabetes,facili-tating better glycemic control and overall patient care.展开更多
Machine learning(ML)is a type of artificial intelligence that assists computers in the acquisition of knowledge through data analysis,thus creating machines that can complete tasks otherwise requiring human intelligen...Machine learning(ML)is a type of artificial intelligence that assists computers in the acquisition of knowledge through data analysis,thus creating machines that can complete tasks otherwise requiring human intelligence.Among its various applications,it has proven groundbreaking in healthcare as well,both in clinical practice and research.In this editorial,we succinctly introduce ML applications and present a study,featured in the latest issue of the World Journal of Clinical Cases.The authors of this study conducted an analysis using both multiple linear regression(MLR)and ML methods to investigate the significant factors that may impact the estimated glomerular filtration rate in healthy women with and without non-alcoholic fatty liver disease(NAFLD).Their results implicated age as the most important determining factor in both groups,followed by lactic dehydrogenase,uric acid,forced expiratory volume in one second,and albumin.In addition,for the NAFLD-group,the 5th and 6th most important impact factors were thyroid-stimulating hormone and systolic blood pressure,as compared to plasma calcium and body fat for the NAFLD+group.However,the study's distinctive contribution lies in its adoption of ML methodologies,showcasing their superiority over traditional statistical approaches(herein MLR),thereby highlighting the potential of ML to represent an invaluable advanced adjunct tool in clinical practice and research.展开更多
The second near-infrared window(NIR-II,900-1880 nm)overcomes critical limitations of visible(360-760 nm)and NIR-I(760-900 nm)imaging—including restricted penetration depth,low signal-to-back⁃ground ratio,and tissue a...The second near-infrared window(NIR-II,900-1880 nm)overcomes critical limitations of visible(360-760 nm)and NIR-I(760-900 nm)imaging—including restricted penetration depth,low signal-to-back⁃ground ratio,and tissue autofluorescence—establishing its pivotal role for in vivo deep-tissue bioimaging.With exponential growth in NIR-II photodiagnosis and phototherapy research over the past decade,bibliometric analy⁃sis is essential to map the evolving landscape and guide strategic priorities.We systematically analyzed 2,491 NIR-II-related publications(2009-2023)from the Web of Science Core Collection,employing scientometric tools for distinct analytical purposes:(a)VOSviewer,SCImago Graphica,and Gephi for co-authorship and co-occur⁃rence network mapping;(b)the R bibliometrix package for tracking field evolution and identifying high-impact publications/journals.The search retrieved 2491 studies from 359 journals originating from 54 countries.The country with the most published articles is China.Chinese institutions drive>60%of publications,with Stanford University(USA)and Nanyang Technological University(Singapore)ranked as the top two institutions by re⁃search quality.International cooperation is becoming increasingly frequent.Fan Quli,Tang Benzhong and Dai Hongjie are the top 3 productive authors in this field.Keyword evolution identifies"photodynamic therapy"and"immunotherapy"as pivotal future directions.We summarize the most cited literatures and NIR-II imaging clini⁃cal trials.This study delineates the NIR-II research trajectory,highlighting China's leadership,intensifying glob⁃al collaboration,and interdisciplinary convergence.Future efforts should prioritize the novel NIR-II probe devel⁃opment for NIR-II imaging and clinical translation of photodynamic/immunotherapy combinational platforms.展开更多
BACKGROUND Mucosal healing has become an important goal of Crohn’s disease(CD)treat-ments.Modulen,enriched with transforming growth factor-beta 2,and budeso-nide are commonly accepted treatments for mild-moderate CD....BACKGROUND Mucosal healing has become an important goal of Crohn’s disease(CD)treat-ments.Modulen,enriched with transforming growth factor-beta 2,and budeso-nide are commonly accepted treatments for mild-moderate CD.However,their effects on the small bowel(SB)mucosa remain underexplored.AIM To prospectively assess clinical and mucosal responses to Modulen vs budesonide in adults with CD,using SB capsule endoscopy.METHODS Thirty patients were divided into two groups:Modulen+home-based diet(21 patients)and budesonide(9 patients)for an eight-week intervention followed by four weeks of follow-up.Clinical,laboratory,and endoscopic responses were evaluated.The mucosal changes were assessed through SB capsule endoscopy.RESULTS Results indicated significant clinical improvement in the Modulen group with reduced CD activity index(P=0.041)and improved inflammatory bowel disease questionnaire score(P=0.016).Moreover,Modulen was associated with a signifi-cant SB mucosal improvement,evidenced by a decrease in Lewis score(P=0.027).No significant changes were observed in calprotectin or other laboratory parame-ters.Conversely,budesonide exhibited more modest clinical effects,but it improved calprotectin,hemoglobin,and C-reactive protein levels(P=0.051,P=0.014,and P=0.038,respectively).The capsule endoscopy did not reveal a significant mucosal response in the budesonide group.CONCLUSION Both interventions have a role in CD treatment.Yet,their effects differ and may complement each other:Modulen yields clinical and mucosal improvements,while budesonide primarily leads mainly to laboratory improvements.展开更多
BACKGROUND The adoption of telehealth services surged after the coronavirus disease 2019 pandemic,revolutionizing traditional healthcare delivery models.Amazon Clinic's recent nationwide launch marks a significant...BACKGROUND The adoption of telehealth services surged after the coronavirus disease 2019 pandemic,revolutionizing traditional healthcare delivery models.Amazon Clinic's recent nationwide launch marks a significant milestone in this trend.This study aims to offer a strengths,weaknesses,opportunities,and threats(SWOT)analysis of Amazon Clinic and compare its features with leading virtual healthcare platforms.AIM To evaluate Amazon Clinic's telehealth services through a SWOT analysis and compare its features with other leading virtual healthcare platforms.METHODS The initial search terms included were,amazon clinic odds ratio(OR)amwell OR Teladoc OR Walmart virtual health service OR CVS minute clinic OR CirrusMD OR brightside health,from 2000 to 2023.This search yielded 111 articles,from which duplicates were removed,and unrelated titles were filtered out.Eight articles were retained for a final review,including comparative studies,usability research,retrospective analyses,observational studies,and review articles.The data was organized and analyzed using Rayyan software and summarized in a table and PRISMA flowcharts.RESULTS The review included eight articles focusing on various aspects of telehealth.Comparative studies highlighted differences between Teladoc and traditional physician offices,noting lower diagnostic imaging orders and antibiotic prescriptions for Teladoc.User demographics for Teladoc showed younger,less engaged patients.Usability studies emphasized the importance of website design for telemedicine adoption.Tele-mental health platforms like Brightside showed superior outcomes in treating depression compared to traditional methods.Telemedicine for specialized fields like skin reconstruction demonstrated cost efficiency and reduced waiting times.The SWOT analysis identified Amazon Clinic's strengths,such as its vast consumer base and transparent pricing,and weaknesses like the lack of pediatric care.Opportunities included potential partnerships and service expansions,while threats involved competition and regulatory challenges.CONCLUSION Amazon Clinic's entry into the telehealth sector represents a significant development with various strengths and opportunities.However,it faces challenges from established healthcare providers and regulatory landscapes.The future success of Amazon Clinic will depend on strategic collaborations,addressing service gaps,and navigating competition and regulations.Telemedicine's impact will hinge on its ability to effectively leverage these opportunities and overcome inherent challenges in the ever-evolving healthcare landscape.展开更多
Introduction: Diabetes remains a real public health problem today, due to its associated morbidity and mortality. It induces numerous metabolic, biochemical, hematological, and immunological changes, responsible for m...Introduction: Diabetes remains a real public health problem today, due to its associated morbidity and mortality. It induces numerous metabolic, biochemical, hematological, and immunological changes, responsible for multiple complications. The objective of this study was to characterize clinically and biologically type 2 diabetic patients followed at the National Center for Diabetology and Arterial Hypertension of the Central Hospital of Yaoundé. Method: This prospective, cross-sectional, and analytical study took place from April 5 to July 31, 2023 (4 months) on 100 diabetic patients of both sexes (61 women and 39 men), aged from 31 to 88 years. Body Mass Index, systolic and diastolic blood pressure, and cardiac frequency were measured on each of the patients. Subsequently, blood was collected from the patients for the determination of the complete blood count, HBA1c, lipid profile, serum albumin, TNF-α, and IL-6 levels. The data were analyzed using SPSS 17.0 software. Results: The age average of our population was 56.99 ± 11.51 years, the population was primarily female (61%) and primarily between the ages of 55 and 88. 67% of respondents were married. 59% went to secondary school. 73% of them lived in urban areas. 30% were obese and 40% were overweight, with an average BMI of 28.75 kg/m2. 76% of patients took oral antidiabetic medications. HbA1c level average was 8.65%, with 60% having readings above 6.5%. Low hemoglobin and hypochromia were among the abnormalities of red blood cells observed. Lipid profiles revealed low HDL-cholesterol and high triglycerides and cholesterol. Elevated levels of TNF-α and IL-6 indicated inflammation and cardiovascular risk. Conclusion: These results indicate the necessity of focused diabetic care and management on diabetic patients attending the central hospital of Yaoundé, Cameroon.展开更多
Graphical abstracts(GAs)are emerging as a pivotal tool in medical literature,enhancing the dissemination and comprehension of complex clinical data through visual summaries.This editorial highlights the significant ad...Graphical abstracts(GAs)are emerging as a pivotal tool in medical literature,enhancing the dissemination and comprehension of complex clinical data through visual summaries.This editorial highlights the significant advantages of GAs,including improved clarity,increased reader engagement,and enhanced visibility of research findings.By transforming intricate scientific data into accessible visual formats,these abstracts facilitate quick and effective knowledge transfer,crucial in clinical decision-making and patient care.However,challenges such as potential data misrepresentation due to oversimplification,the skill gap in graphic design among researchers,and the lack of standardized creation guidelines pose barriers to their widespread adoption.Additionally,while software such as Adobe Illustrator,BioRender,and Canva are commonly employed to create these visuals,not all researchers may be proficient in their use.To address these issues,we recommend that academic journals establish clear guidelines and provide necessary design training to researchers.This proactive approach will ensure the creation of high-quality GAs,promote their standardization,and expand their use in clinical reporting,ultimately benefiting the medical community and improving healthcare outcomes.展开更多
The Chinese Society of Clinical Oncology Non-small Cell Lung Cancer(CSCO NSCLC)guidelines were first published in 2016,ranking among the earliest-released guidelines within the CSCO series.In 2020 the CSCO published s...The Chinese Society of Clinical Oncology Non-small Cell Lung Cancer(CSCO NSCLC)guidelines were first published in 2016,ranking among the earliest-released guidelines within the CSCO series.In 2020 the CSCO published separate guidelines for NSCLC and small cell lung cancer(SCLC)for the first time to improve clinical usability.展开更多
Traditional Chinese medicine(TCM)represents a paradigmatic approach to personalized medicine,developed through the systematic accumulation and refinement of clinical empirical data over more than 2000 years,and now en...Traditional Chinese medicine(TCM)represents a paradigmatic approach to personalized medicine,developed through the systematic accumulation and refinement of clinical empirical data over more than 2000 years,and now encompasses large-scale electronic medical records(EMR)and experimental molecular data.Artificial intelligence(AI)has demonstrated its utility in medicine through the development of various expert systems(e.g.,MYCIN)since the 1970s.With the emergence of deep learning and large language models(LLMs),AI’s potential in medicine shows considerable promise.Consequently,the integration of AI and TCM from both clinical and scientific perspectives presents a fundamental and promising research direction.This survey provides an insightful overview of TCM AI research,summarizing related research tasks from three perspectives:systems-level biological mechanism elucidation,real-world clinical evidence inference,and personalized clinical decision support.The review highlights representative AI methodologies alongside their applications in both TCM scientific inquiry and clinical practice.To critically assess the current state of the field,this work identifies major challenges and opportunities that constrain the development of robust research capabilities—particularly in the mechanistic understanding of TCM syndromes and herbal formulations,novel drug discovery,and the delivery of high-quality,patient-centered clinical care.The findings underscore that future advancements in AI-driven TCM research will rely on the development of high-quality,large-scale data repositories;the construction of comprehensive and domain-specific knowledge graphs(KGs);deeper insights into the biological mechanisms underpinning clinical efficacy;rigorous causal inference frameworks;and intelligent,personalized decision support systems.展开更多
Background: Clinical decision support tools provide suggestions to support healthcare providers and clinicians, as they attend to patients. Clinicians use these tools to rapidly consult the evidence at the point of ca...Background: Clinical decision support tools provide suggestions to support healthcare providers and clinicians, as they attend to patients. Clinicians use these tools to rapidly consult the evidence at the point of care, a practice which has been found to reduce the time patients spend in hospitals, promote the quality of care and improve healthcare outcomes. Such tools include Medscape, VisualDx, Clinical Key, DynaMed, BMJ Best Practice and UpToDate. However, use of such tools has not yet been fully embraced in low-resource settings such as Uganda. Objective: This paper intends to collate data on the use and uptake of one such tool, UpToDate, which was provided at no cost to five medical schools in Uganda. Methods: Free access to UpToDate was granted through the IP addresses of five medical schools in Uganda in collaboration with Better Evidence at The Global Health Delivery Project at Harvard and Brigham and Women’s Hospital and Wolters Kluwer Health. Following the donation, medical librarians in the respective institutions conducted training sessions and created awareness of the tool. Usage data was aggregated, based on logins and content views, presented and analyzed using Excel tables and graphs. Results: The data shows similar trends in increased usage over the period of August 2022 to August 2023 across the five medical schools. The most common topics viewed, mode of access (using either the computer or the mobile app), total usage by institution, ratio of uses to eligible users by institution and ratio of uses to students by institution are shared. Conclusion: The study revealed that the tool was used by various user categories across the institutions with similar steady improved usage over the year. These results can inform the librarians as they encourage their respective institutions to continue using the tool to support uptake of point-of-care tools in clinical practice.展开更多
文摘Clear aligner treatment is a novel technique in current orthodontic practice.Distinct from traditional fixed orthodontic appliances,clear aligners have different material features and biomechanical characteristics and treatment efficiencies,presenting new clinical challenges.Therefore,a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique.This expert consensus discusses case selection and grading of treatment difficulty,principle of clear aligner therapy,clinical procedures and potential complications,which are crucial to the clinical success of clear aligner treatment.
基金supported partly by the National Natural Science Foundation of China,No.82071332the Chongqing Natural Science Foundation Joint Fund for Innovation and Development,No.CSTB2023NSCQ-LZX0041 (both to ZG)。
文摘Some studies have confirmed the neuroprotective effect of remote ischemic conditioning against stroke. Although numerous animal researches have shown that the neuroprotective effect of remote ischemic conditioning may be related to neuroinflammation, cellular immunity, apoptosis, and autophagy, the exact underlying molecular mechanisms are unclear. This review summarizes the current status of different types of remote ischemic conditioning methods in animal and clinical studies and analyzes their commonalities and differences in neuroprotective mechanisms and signaling pathways. Remote ischemic conditioning has emerged as a potential therapeutic approach for improving stroke-induced brain injury owing to its simplicity, non-invasiveness, safety, and patient tolerability. Different forms of remote ischemic conditioning exhibit distinct intervention patterns, timing, and application range. Mechanistically, remote ischemic conditioning can exert neuroprotective effects by activating the Notch1/phosphatidylinositol 3-kinase/Akt signaling pathway, improving cerebral perfusion, suppressing neuroinflammation, inhibiting cell apoptosis, activating autophagy, and promoting neural regeneration. While remote ischemic conditioning has shown potential in improving stroke outcomes, its full clinical translation has not yet been achieved.
基金Science and Technology Planning Project of Xi’an,China (No. 22YXYJ0111, to LFP)。
文摘Acute pancreatitis(AP) is not a disorder limited to a single organ,the pancreas,but often results in transient or sustained dysfunction,and even failure,of multiple organs,particularly as the disease progresses.^([1]) Therefore,although AP is primarily a localized disease with systemic consequences in a subset of patients,its clinical manifestations extend beyond digestive system symptoms to encompass a variety of additional symptoms,particularly during disease progression from mild AP(MAP) to severe AP(SAP).
文摘The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a patient's health status directly from their perspective,encompassing various domains such as symptom severity,functional status,and overall quality of life.By integrating PROMs into routine clinical practice and research,healthcare providers can achieve a more nuanced understanding of patient experiences and tailor treatments accordingly.The deployment of PROMs supports dynamic patient-provider interactions,fostering better patient engagement and adherence to tre-atment plans.Moreover,PROMs are pivotal in clinical settings for monitoring disease progression and treatment efficacy,particularly in chronic and mental health conditions.However,challenges in implementing PROMs include data collection and management,integration into existing health systems,and acceptance by patients and providers.Overcoming these barriers necessitates technological advancements,policy development,and continuous education to enhance the acceptability and effectiveness of PROMs.The paper concludes with recommendations for future research and policy-making aimed at optimizing the use and impact of PROMs across healthcare settings.
基金supported by the National Natural Science Foundation of China(82302757)Shenzhen Science and Technology Program(JCY20240813145204006,SGDX20201103095600002,JCYJ20220818103417037,KJZD20230923115200002)+1 种基金Shenzhen Key Laboratory of Digital Surgical Printing Project(ZDSYS201707311542415)Shenzhen Development and Reform Program(XMHT20220106001).
文摘Osteoarthritis(OA)is a degenerative joint disease with significant clinical and societal impact.Traditional diagnostic methods,including subjective clinical assessments and imaging techniques such as X-rays and MRIs,are often limited in their ability to detect early-stage OA or capture subtle joint changes.These limitations result in delayed diagnoses and inconsistent outcomes.Additionally,the analysis of omics data is challenged by the complexity and high dimensionality of biological datasets,making it difficult to identify key molecular mechanisms and biomarkers.Recent advancements in artificial intelligence(AI)offer transformative potential to address these challenges.This review systematically explores the integration of AI into OA research,focusing on applications such as AI-driven early screening and risk prediction from electronic health records(EHR),automated grading and morphological analysis of imaging data,and biomarker discovery through multi-omics integration.By consolidating progress across clinical,imaging,and omics domains,this review provides a comprehensive perspective on how AI is reshaping OA research.The findings have the potential to drive innovations in personalized medicine and targeted interventions,addressing longstanding challenges in OA diagnosis and management.
基金Supported by the Permanecer Program(part of the actions of the Office of Affirmative Actions)Education and Diversity of the Dean of Student Assistance at the Federal University of Bahia(UFBA)and CNPq Research Productivity Fellow.
文摘Arboviral diseases are viral infections transmitted to humans through the bites of arthropods,such as mosquitoes,often causing a variety of pathologies associated with high levels of morbidity and mortality.Over the past decades,these infections have proven to be a significant challenge to health systems worldwide,particularly following the considerable geographic expansion of the dengue virus(DENV)and its most recent outbreak in Latin America as well as the difficult-tocontrol outbreaks of yellow fever virus(YFV),chikungunya virus(CHIKV),and Zika virus(ZIKV),leaving behind a substantial portion of the population with complications related to these infections.Currently,the world is experiencing a period of intense globalization,which,combined with global warming,directly contributes to wider dissemination of arbovirus vectors across the globe.Consequently,all continents remain on high alert for potential new outbreaks.Thus,this review aims to provide a comprehensive understanding of the pathogenesis of the four main arboviruses today(DENV,ZIKV,YFV,and CHIKV)discussing their viral characteristics,immune responses,and mechanisms of viral evasion,as well as important clinical aspects for patient management.This includes associated symptoms,laboratory tests,treatments,existing or developing vaccines and the main associated complications,thus integrating a broad historical,scientific and clinical approach.
基金Supported by the National Natural Science Foundation of China,No.82072537the General Project of Hunan Natural Science Foundation,No.2022JJ30412 and No.2021JJ30464.
文摘Exosomes(Exos)are extracellular vesicles secreted by cells and serve as crucial mediators of intercellular communication.They play a pivotal role in the pathogenesis and progression of various diseases and offer promising avenues for therapeutic interventions.Exos derived from mesenchymal stem cells(MSCs)have significant immunomodulatory properties.They effectively regulate immune responses by modulating both innate and adaptive immunity.These Exos can inhibit excessive inflammatory responses and promote tissue repair.Moreover,they participate in antigen presentation,which is essential for activating immune responses.The cargo of these Exos,including ligands,proteins,and microRNAs,can suppress T cell activity or enhance the population of immunosuppressive cells to dampen the immune response.By inhibiting lymphocyte proliferation,acting on macrophages,and increasing the population of regulatory T cells,these Exos contribute to maintaining immune and metabolic homeostasis.Furthermore,they can activate immune-related signaling pathways or serve as vehicles to deliver microRNAs and other bioactive substances to target tumor cells,which holds potential for immunotherapy applications.Given the immense therapeutic potential of MSC-derived Exos,this review comprehensively explores their mechanisms of immune regulation and therapeutic applications in areas such as infection control,tumor suppression,and autoimmune disease management.This article aims to provide valuable insights into the mechanisms behind the actions of MSC-derived Exos,offering theoretical references for their future clinical utilization as cell-free drug preparations.
基金funded by the National Key Research and Development Program of China(Grant No.2022YFB4700904 to Wang L)the Shanghai Shenkang Hospital Development Center's project for the Promotion of Clinical Skills and Clinical Innovation Three-Year Action Plan(Project No.SHDC2022CRT006 to Wang L and SHDC2022CRS010B to Tang S).
文摘Objective:This study aimed to assess the feasibility and safety of the SHURUI single-port robotic surgical system for a range of major urological surgeries.Methods:In this prospective,multicenter clinical trial,we examined the effectiveness of the SHURUI single-port robotic surgical system in urological interventions.The first 50 patients from four centers in China underwent single-port surgeries including partial nephrectomy,radical prostatectomy,partial adrenalectomy,and pyeloureteroplasty,exclusively by the SHURUI single-port robotic surgical system.The study's primary endpoints focused on the success of surgeries,defined as no deviations from planned procedures,no need for more than one port,and no re-operations within 24 h after surgery.Secondary endpoints encompassed a range of surgical metrics,functional outcomes,and patient demographic data.Clinical assessments were conducted before surgery,before discharge,and 1 month after discharge.Results:The surgical procedures were executed successfully without requiring intraoperative conversions or transfusions.Both estimated blood loss and operation durations were maintained within satisfactory limits.For each type of surgery,the mean console times and estimated blood loss were 179.8(standard deviation[SD]39.4)min and 125.6(SD 126.0)mL for radical prostatectomy,126.7(SD 47.8)min and 39.2(SD 54.4)mL for partial nephrectomy,112.6(SD 37.4)min and 20.0(SD 13.2)mL for partial adrenalectomy,and 148.0(SD 18.2)min and 18.0(SD 17.9)mL for pyeloureteroplasty,respectively.Across the cohort,17 patients experienced a total of 25 adverse events,while 10 postoperative complications,all rated as Clavien-Dindo grade I,were encountered by eight patients.All patients had shown recovery or improvement from these events before the end of this trial.Conclusion:The SHURUI single-port robotic surgical system demonstrated feasibility and safety in the performance of major urological surgeries.These initial findings highlight the system's potential,though further research and longer follow-up are required to assess long-term outcomes.
文摘The minimal clinically important difference(MCID)represents a pivotal metric in bridging the gap between statistical significance and clinical relevance,addressing the direct impact of medical interventions from the patient's perspective.This comprehensive review analyzes the evolution,applications,and challenges of MCID across medical specialties,emphasizing its necessity in ensuring that clinical outcomes not only demonstrate statistical significance but also offer genuine clinical utility that aligns with patient expectations and needs.We discuss the evolution of MCID since its inception in the 1980s,its current applications across various medical specialties,and the methodologies used in its calculation,highlighting both anchor-based and distribution-based approaches.Furthermore,the paper delves into the challenges associated with the application of MCID,such as methodological variability and the interpretation difficulties that arise in clinical settings.Recommendations for the future include standardizing MCID calculation methods,enhancing patient involvement in setting MCID thresholds,and extending research to incorporate diverse global perspectives.These steps are critical to refining the role of MCID in patient-centered healthcare,addressing existing gaps in methodology and interpretation,and ensuring that medical interventions lead to significant,patient-perceived improvements.
文摘The general objective of our study was to describe the clinical and epidemiological aspects of anxiety disorders. This was a retrospective descriptive cross-sectional study, lasting 5 years, from January 01, 2019 to December 31, 2023, on 225 patients seen in consultation for anxiety disorders in the department. The prevalence of anxiety disorders was 2.5% in consultation. The 20 - 29 age group was the most represented at 33.3%. Females were slightly represented at 55.1%, with a sex ratio of 1.2. The secondary level was the most affected, accounting for 36.4% of cases. Insomnia was the most frequent reason for consultation, accounting for 71.1% of cases. A larger general population study would be necessary to better assess the extent of anxiety disorders in Guinea.
文摘The article"Secondary diabetes due to different etiologies:Four case reports"by Song et al,published in the World Journal of Clinical Cases,delves into the identi-fication of rare causes of secondary diabetes and emphasizes the necessity for healthcare professionals to recognize these conditions.Failure to do so can result in treatment delays and compromised patient outcomes.The article discusses spe-cific types of diabetes,including maturity onset of diabetes in young,pancreas-related diseases,endocrinopathies,drug-induced diabetes,infections,and con-genital genetic syndromes associated with diabetes mellitus.Case summaries highlight how patients with secondary diabetes,stemming from conditions such as Williams-Beuren syndrome and pituitary adenoma,often exhibit distinct characteristics overlooked in clinical practice.The authors stress the importance of a holistic diagnostic approach and advocate for proactive management through early intervention,including genetic tests and antibody detection.Increased awa-reness and education are crucial for timely identification and proper management,ultimately improving patient well-being.These findings prompt a call to action for healthcare professionals to consider rare causes of secondary diabetes,facili-tating better glycemic control and overall patient care.
文摘Machine learning(ML)is a type of artificial intelligence that assists computers in the acquisition of knowledge through data analysis,thus creating machines that can complete tasks otherwise requiring human intelligence.Among its various applications,it has proven groundbreaking in healthcare as well,both in clinical practice and research.In this editorial,we succinctly introduce ML applications and present a study,featured in the latest issue of the World Journal of Clinical Cases.The authors of this study conducted an analysis using both multiple linear regression(MLR)and ML methods to investigate the significant factors that may impact the estimated glomerular filtration rate in healthy women with and without non-alcoholic fatty liver disease(NAFLD).Their results implicated age as the most important determining factor in both groups,followed by lactic dehydrogenase,uric acid,forced expiratory volume in one second,and albumin.In addition,for the NAFLD-group,the 5th and 6th most important impact factors were thyroid-stimulating hormone and systolic blood pressure,as compared to plasma calcium and body fat for the NAFLD+group.However,the study's distinctive contribution lies in its adoption of ML methodologies,showcasing their superiority over traditional statistical approaches(herein MLR),thereby highlighting the potential of ML to represent an invaluable advanced adjunct tool in clinical practice and research.
基金Supported by National Natural Science Foundation of China(81874059 and 82102105)the Natural Science Foundation of Zhejiang Province(LQ22H160017)the China Postdoctoral Science Foundation(2021M702825).
文摘The second near-infrared window(NIR-II,900-1880 nm)overcomes critical limitations of visible(360-760 nm)and NIR-I(760-900 nm)imaging—including restricted penetration depth,low signal-to-back⁃ground ratio,and tissue autofluorescence—establishing its pivotal role for in vivo deep-tissue bioimaging.With exponential growth in NIR-II photodiagnosis and phototherapy research over the past decade,bibliometric analy⁃sis is essential to map the evolving landscape and guide strategic priorities.We systematically analyzed 2,491 NIR-II-related publications(2009-2023)from the Web of Science Core Collection,employing scientometric tools for distinct analytical purposes:(a)VOSviewer,SCImago Graphica,and Gephi for co-authorship and co-occur⁃rence network mapping;(b)the R bibliometrix package for tracking field evolution and identifying high-impact publications/journals.The search retrieved 2491 studies from 359 journals originating from 54 countries.The country with the most published articles is China.Chinese institutions drive>60%of publications,with Stanford University(USA)and Nanyang Technological University(Singapore)ranked as the top two institutions by re⁃search quality.International cooperation is becoming increasingly frequent.Fan Quli,Tang Benzhong and Dai Hongjie are the top 3 productive authors in this field.Keyword evolution identifies"photodynamic therapy"and"immunotherapy"as pivotal future directions.We summarize the most cited literatures and NIR-II imaging clini⁃cal trials.This study delineates the NIR-II research trajectory,highlighting China's leadership,intensifying glob⁃al collaboration,and interdisciplinary convergence.Future efforts should prioritize the novel NIR-II probe devel⁃opment for NIR-II imaging and clinical translation of photodynamic/immunotherapy combinational platforms.
文摘BACKGROUND Mucosal healing has become an important goal of Crohn’s disease(CD)treat-ments.Modulen,enriched with transforming growth factor-beta 2,and budeso-nide are commonly accepted treatments for mild-moderate CD.However,their effects on the small bowel(SB)mucosa remain underexplored.AIM To prospectively assess clinical and mucosal responses to Modulen vs budesonide in adults with CD,using SB capsule endoscopy.METHODS Thirty patients were divided into two groups:Modulen+home-based diet(21 patients)and budesonide(9 patients)for an eight-week intervention followed by four weeks of follow-up.Clinical,laboratory,and endoscopic responses were evaluated.The mucosal changes were assessed through SB capsule endoscopy.RESULTS Results indicated significant clinical improvement in the Modulen group with reduced CD activity index(P=0.041)and improved inflammatory bowel disease questionnaire score(P=0.016).Moreover,Modulen was associated with a signifi-cant SB mucosal improvement,evidenced by a decrease in Lewis score(P=0.027).No significant changes were observed in calprotectin or other laboratory parame-ters.Conversely,budesonide exhibited more modest clinical effects,but it improved calprotectin,hemoglobin,and C-reactive protein levels(P=0.051,P=0.014,and P=0.038,respectively).The capsule endoscopy did not reveal a significant mucosal response in the budesonide group.CONCLUSION Both interventions have a role in CD treatment.Yet,their effects differ and may complement each other:Modulen yields clinical and mucosal improvements,while budesonide primarily leads mainly to laboratory improvements.
文摘BACKGROUND The adoption of telehealth services surged after the coronavirus disease 2019 pandemic,revolutionizing traditional healthcare delivery models.Amazon Clinic's recent nationwide launch marks a significant milestone in this trend.This study aims to offer a strengths,weaknesses,opportunities,and threats(SWOT)analysis of Amazon Clinic and compare its features with leading virtual healthcare platforms.AIM To evaluate Amazon Clinic's telehealth services through a SWOT analysis and compare its features with other leading virtual healthcare platforms.METHODS The initial search terms included were,amazon clinic odds ratio(OR)amwell OR Teladoc OR Walmart virtual health service OR CVS minute clinic OR CirrusMD OR brightside health,from 2000 to 2023.This search yielded 111 articles,from which duplicates were removed,and unrelated titles were filtered out.Eight articles were retained for a final review,including comparative studies,usability research,retrospective analyses,observational studies,and review articles.The data was organized and analyzed using Rayyan software and summarized in a table and PRISMA flowcharts.RESULTS The review included eight articles focusing on various aspects of telehealth.Comparative studies highlighted differences between Teladoc and traditional physician offices,noting lower diagnostic imaging orders and antibiotic prescriptions for Teladoc.User demographics for Teladoc showed younger,less engaged patients.Usability studies emphasized the importance of website design for telemedicine adoption.Tele-mental health platforms like Brightside showed superior outcomes in treating depression compared to traditional methods.Telemedicine for specialized fields like skin reconstruction demonstrated cost efficiency and reduced waiting times.The SWOT analysis identified Amazon Clinic's strengths,such as its vast consumer base and transparent pricing,and weaknesses like the lack of pediatric care.Opportunities included potential partnerships and service expansions,while threats involved competition and regulatory challenges.CONCLUSION Amazon Clinic's entry into the telehealth sector represents a significant development with various strengths and opportunities.However,it faces challenges from established healthcare providers and regulatory landscapes.The future success of Amazon Clinic will depend on strategic collaborations,addressing service gaps,and navigating competition and regulations.Telemedicine's impact will hinge on its ability to effectively leverage these opportunities and overcome inherent challenges in the ever-evolving healthcare landscape.
文摘Introduction: Diabetes remains a real public health problem today, due to its associated morbidity and mortality. It induces numerous metabolic, biochemical, hematological, and immunological changes, responsible for multiple complications. The objective of this study was to characterize clinically and biologically type 2 diabetic patients followed at the National Center for Diabetology and Arterial Hypertension of the Central Hospital of Yaoundé. Method: This prospective, cross-sectional, and analytical study took place from April 5 to July 31, 2023 (4 months) on 100 diabetic patients of both sexes (61 women and 39 men), aged from 31 to 88 years. Body Mass Index, systolic and diastolic blood pressure, and cardiac frequency were measured on each of the patients. Subsequently, blood was collected from the patients for the determination of the complete blood count, HBA1c, lipid profile, serum albumin, TNF-α, and IL-6 levels. The data were analyzed using SPSS 17.0 software. Results: The age average of our population was 56.99 ± 11.51 years, the population was primarily female (61%) and primarily between the ages of 55 and 88. 67% of respondents were married. 59% went to secondary school. 73% of them lived in urban areas. 30% were obese and 40% were overweight, with an average BMI of 28.75 kg/m2. 76% of patients took oral antidiabetic medications. HbA1c level average was 8.65%, with 60% having readings above 6.5%. Low hemoglobin and hypochromia were among the abnormalities of red blood cells observed. Lipid profiles revealed low HDL-cholesterol and high triglycerides and cholesterol. Elevated levels of TNF-α and IL-6 indicated inflammation and cardiovascular risk. Conclusion: These results indicate the necessity of focused diabetic care and management on diabetic patients attending the central hospital of Yaoundé, Cameroon.
文摘Graphical abstracts(GAs)are emerging as a pivotal tool in medical literature,enhancing the dissemination and comprehension of complex clinical data through visual summaries.This editorial highlights the significant advantages of GAs,including improved clarity,increased reader engagement,and enhanced visibility of research findings.By transforming intricate scientific data into accessible visual formats,these abstracts facilitate quick and effective knowledge transfer,crucial in clinical decision-making and patient care.However,challenges such as potential data misrepresentation due to oversimplification,the skill gap in graphic design among researchers,and the lack of standardized creation guidelines pose barriers to their widespread adoption.Additionally,while software such as Adobe Illustrator,BioRender,and Canva are commonly employed to create these visuals,not all researchers may be proficient in their use.To address these issues,we recommend that academic journals establish clear guidelines and provide necessary design training to researchers.This proactive approach will ensure the creation of high-quality GAs,promote their standardization,and expand their use in clinical reporting,ultimately benefiting the medical community and improving healthcare outcomes.
文摘The Chinese Society of Clinical Oncology Non-small Cell Lung Cancer(CSCO NSCLC)guidelines were first published in 2016,ranking among the earliest-released guidelines within the CSCO series.In 2020 the CSCO published separate guidelines for NSCLC and small cell lung cancer(SCLC)for the first time to improve clinical usability.
基金supported by the National Key Research and Development Program(No.2023YFC3502604)the National Natural Science Foundation of China(Nos.U23B2062,82274352,82174533,82374302,82204941)+3 种基金the Noncommunicable Chronic Diseases-National Science and Technology Major Project(No.2023ZD0505700)the Beijing-Tianjin-Hebei Basic Research Co〓〓operation Project(No.22JCZXJC00070)the State Key Laboratory on Technologies for Chinese Medicine Pharmaceutical Process Control and Intelligent Manufacture(No.SKL2024Z0102)Key R&D project of Ningxia Autonomous Region(No.2022BEG02036)。
文摘Traditional Chinese medicine(TCM)represents a paradigmatic approach to personalized medicine,developed through the systematic accumulation and refinement of clinical empirical data over more than 2000 years,and now encompasses large-scale electronic medical records(EMR)and experimental molecular data.Artificial intelligence(AI)has demonstrated its utility in medicine through the development of various expert systems(e.g.,MYCIN)since the 1970s.With the emergence of deep learning and large language models(LLMs),AI’s potential in medicine shows considerable promise.Consequently,the integration of AI and TCM from both clinical and scientific perspectives presents a fundamental and promising research direction.This survey provides an insightful overview of TCM AI research,summarizing related research tasks from three perspectives:systems-level biological mechanism elucidation,real-world clinical evidence inference,and personalized clinical decision support.The review highlights representative AI methodologies alongside their applications in both TCM scientific inquiry and clinical practice.To critically assess the current state of the field,this work identifies major challenges and opportunities that constrain the development of robust research capabilities—particularly in the mechanistic understanding of TCM syndromes and herbal formulations,novel drug discovery,and the delivery of high-quality,patient-centered clinical care.The findings underscore that future advancements in AI-driven TCM research will rely on the development of high-quality,large-scale data repositories;the construction of comprehensive and domain-specific knowledge graphs(KGs);deeper insights into the biological mechanisms underpinning clinical efficacy;rigorous causal inference frameworks;and intelligent,personalized decision support systems.
文摘Background: Clinical decision support tools provide suggestions to support healthcare providers and clinicians, as they attend to patients. Clinicians use these tools to rapidly consult the evidence at the point of care, a practice which has been found to reduce the time patients spend in hospitals, promote the quality of care and improve healthcare outcomes. Such tools include Medscape, VisualDx, Clinical Key, DynaMed, BMJ Best Practice and UpToDate. However, use of such tools has not yet been fully embraced in low-resource settings such as Uganda. Objective: This paper intends to collate data on the use and uptake of one such tool, UpToDate, which was provided at no cost to five medical schools in Uganda. Methods: Free access to UpToDate was granted through the IP addresses of five medical schools in Uganda in collaboration with Better Evidence at The Global Health Delivery Project at Harvard and Brigham and Women’s Hospital and Wolters Kluwer Health. Following the donation, medical librarians in the respective institutions conducted training sessions and created awareness of the tool. Usage data was aggregated, based on logins and content views, presented and analyzed using Excel tables and graphs. Results: The data shows similar trends in increased usage over the period of August 2022 to August 2023 across the five medical schools. The most common topics viewed, mode of access (using either the computer or the mobile app), total usage by institution, ratio of uses to eligible users by institution and ratio of uses to students by institution are shared. Conclusion: The study revealed that the tool was used by various user categories across the institutions with similar steady improved usage over the year. These results can inform the librarians as they encourage their respective institutions to continue using the tool to support uptake of point-of-care tools in clinical practice.
