Microneedles(MNs)have been extensively investigated for transdermal delivery of large-sized drugs,including proteins,nucleic acids,and even extracellular vesicles(EVs).However,for their sufficient skin penetration,con...Microneedles(MNs)have been extensively investigated for transdermal delivery of large-sized drugs,including proteins,nucleic acids,and even extracellular vesicles(EVs).However,for their sufficient skin penetration,conventional MNs employ long needles(≥600μm),leading to pain and skin irritation.Moreover,it is critical to stably apply MNs against complex skin surfaces for uniform nanoscale drug delivery.Herein,a dually amplified transdermal patch(MN@EV/SC)is developed as the stem cell-derived EV delivery platform by hierarchically integrating an octopusinspired suction cup(SC)with short MNs(≤300μm).While leveraging the suction effect to induce nanoscale deformation of the stratum corneum,MN@EV/SC minimizes skin damage and enhances the adhesion of MNs,allowing EV to penetrate deeper into the dermis.When MNs of various lengths are applied to mouse skin,the short MNs can elicit comparable corticosterone release to chemical adhesives,whereas long MNs induce a prompt stress response.MN@EV/SC can achieve a remarkable penetration depth(290μm)for EV,compared to that of MN alone(111μm).Consequently,MN@EV/SC facilitates the revitalization of fibroblasts and enhances collagen synthesis in middle-aged mice.Overall,MN@EV/SC exhibits the potential for skin regeneration by modulating the dermal microenvironment and ensuring patient comfort.展开更多
Background: In the global burden of non-communicable diseases, the top slot among them all is occupied by various cardiovascular diseases (CVD), which also claim primacy in mortality rates. Generally speaking, the pat...Background: In the global burden of non-communicable diseases, the top slot among them all is occupied by various cardiovascular diseases (CVD), which also claim primacy in mortality rates. Generally speaking, the pathophysiological pathway frequently involves either (or a combination of) elevated serum cholesterol levels, predominantly attributed to dietary patterns characterized by extremely high levels of saturated and trans-fat consumption. Day-to-day nutritional epidemiology among university students suggests that they represent a crucial demographic for the study of preventive interventions. Objective: This in-depth study and investigation were specifically aimed to quantitatively assess and compare prevailing patterns of dietary fat consumption between female students enrolled in health sciences and non-health sciences programs at major universities in Riyadh, Saudi Arabia. Methodology: This cross-sectional study was comprised of 434 Saudi female university students (age range: 18 - 25 years), utilizing a validated Block Dietary Fat Screener accompanied by anthropometric measurements and comprehensive demographic data collection. The sampling methodology consisted of a snowball technique that was spread across three major academic institutions in Riyadh. Results: Statistical analysis revealed a significant association between academic specialization and patterns of dietary fat consumption (p = 0.012). Paradoxically, students of health science exhibited a higher prevalence of very high fat intake (41.9%) compared with their non-health sciences counterparts (27.6%). Surprisingly, anthropometric stratification revealed that it was the underweight students who demonstrated very high levels of fat consumption. A notable socioeconomic gradient was observed, with students from households earning 15,000 - 20,000 SR monthly showing the highest prevalence of very high-fat consumption (47.1%), although this association did not achieve statistical significance (p = 0.104). Conclusion: These findings challenge the conventional assumption that health sciences education correlates with superior dietary behaviors. The data suggests a critical need for enhanced education in nutrition, as well as intervention using various behavioral programs across all academic disciplines, particularly those addressing the disconnect between nutritional knowledge and dietary practices among students of health sciences. Future longitudinal studies are warranted in order to elucidate the temporal relationship between academic specialization and dietary behaviors.展开更多
Background:Oral health issues persistently affect the overall health and well-being of rural populations.Village health volunteers(VHVs)play a crucial role in advancing oral health literacy in their community.This stu...Background:Oral health issues persistently affect the overall health and well-being of rural populations.Village health volunteers(VHVs)play a crucial role in advancing oral health literacy in their community.This study aimed to examine the factors related to nutritional literacy for oral health among VHVs.Methods:This was a mixed-methods study employing an explanatory sequential design.The quantitative data were gathered through questionnaires distributed to a cohort of 10,514 VHVs registered in Health Region 1.A stratified random sampling technique was used to ensure adequate representation of various subgroups within the VHV population,considering factors such as age,education level,and geographical distribution across the region.This approach allowed for a more representative sample that accurately reflects the diversity of the VHV population.Qualitative data were obtained through semi-structured interviews with a purposive sampling of 20 participants based on specific criteria.Quantitative data were analyzed using descriptive statistics and biserial correlation techniques,while qualitative data were analyzed using content analysis.Results:The study found that the sample group possessed a moderate level of knowledge of health literacy principles and nutrition for oral health.However,their self-assessed skills in nutritional literacy for oral health were rated as high.A statistically significant negative correlation was found between knowledge of nutrition for oral health and skills in nutritional literacy for oral health.VHVs equated health literacy with knowledge because their public health training had focused more on imparting knowledge rather than developing skills based on health literacy principles.Conclusion:There is a need to emphasize skill-based health literacy training and to use effective skill development techniques that are tailored to the specific roles and responsibilities of health volunteers.It is also recommended to continuously monitor and evaluate the outcomes of these efforts.展开更多
The pandemic highlighted significant gaps in the public health infrastructure impacted by shortages of public health workers, an undertrained workforce, and years of disinvestment. These gaps required innovative probl...The pandemic highlighted significant gaps in the public health infrastructure impacted by shortages of public health workers, an undertrained workforce, and years of disinvestment. These gaps required innovative problem-solving by public health agencies (PHAs), including local health departments (LHDs), to respond to rapidly changing community conditions during and after the pandemic. Many schools and programs of public health (SPPH) worked with PHAs to mobilize public health (PH) students through practice-based teaching (PBT). Current research indicates PBT benefits all stakeholders—PHAs, students, faculty, SPPH, and ultimately the community served. However, more research is needed on the utility of PBT in addressing a community’s systemic public health issues, the extent to which the academic-community collaboration enhances a PHA’s capacity, and the impact of the pedagogy on preparing the workforce for an evolving PH landscape. This paper examines the process of a semester-long PBT course, guided by the PBT STEPS framework, which includes five steps from collaboration to implementation to evaluation of a PBT course. The collaborating PHA and its student group addressed community trauma and resilience issues during the semester. Additionally, it examines the longer-term impacts after the semester for the PHA, community, and the workforce by 1) conducting a formative evaluation to understand needs and gaps in the community;2) redesigning an intervention that merged the results of the formative evaluation with the intervention developed during the semester;and 3) securing funding and resources for intervention sustainability. Through the documentation of a post-course partnership between an LHD and faculty at a large school of public health, this case study illustrates the potential for PBT to lay the foundation for ongoing research that supports more impactful interventions for PHAs while bolstering the workforce abilities of students as future practitioners.展开更多
Background:It has been broadly witnessed that a large number of adolescents are suffering emotional and mental health problems after COVID-19,and such adverse experiences in early life often extend into adulthood,resu...Background:It has been broadly witnessed that a large number of adolescents are suffering emotional and mental health problems after COVID-19,and such adverse experiences in early life often extend into adulthood,resulting in serious long-term implications.However,it is accepted that the literature examining the relationship between mental health problems in adolescents and their underlying psychological factors is limited.The purposes of the current study were to identify mental health problems of Korean adolescents and to investigate the possible influence of self-esteem,self-efficacy,and health locus of control on mental health problems.Methods:A total of 2104 Korean adolescents were randomly recruited from junior high and high schools located in Seoul,Korea.The Korean Symptom Checklist,and Self-esteem Scale,Health Locus of Control Scale,Self-efficacy Scale were applied to identify mental health problems and psychological factors among adolescents.Frequency analysis,independent t-tests,one-way ANOVA,correlation analysis,and multiple regression analysis were performed to test the study hypothesis.Results:Korean adolescents showed a high prevalence of depression(61.4%),anxiety(44.7%),interpersonal sensitivity(76.1%),and hostility(40.3%).In addition,the findings indicated significant gender and age differences in adolescent mental health problems.Moreover,results reported that the adolescents’mental health problems were significantly associated with psychological factors(R^(2)=0.51 for depression,0.38 for anxiety,0.33 for interpersonal sensitivity,and 0.23 for hostility).Conclusions:The current findings highlight the need for comprehensive,culturally relevant mental health strategies for Korean adolescents.The interventions that foster psychological resilience,promote positive self-concept,and encourage internal control beliefs may be effective in mitigating mental health challenges.展开更多
Objectives:Population aging is occurring at a rapid speed all over the world,bringing considerable public health challenges,including for the mental health of older adults.Considering that older populations are prone ...Objectives:Population aging is occurring at a rapid speed all over the world,bringing considerable public health challenges,including for the mental health of older adults.Considering that older populations are prone to depression and stress,the need for effective preventive interventions is critical.Thus,we conducted a study aimed at exploring the preventive impact of a community-based Tai Chi program over 8 weeks on depression and perceived stress in healthy older adults in South Korea.Methods:A quasi-experimental design was utilized,with 63 older adults participating(31 individuals in the Tai Chi group and 32 in the control group).The Tai Chi intervention was a supervised session 3 times per week.Data were obtained anonymously at baseline and post-intervention(week 8),with validated measures,including the Geriatric Depression Scale and the Korean version of the Brief Encounter Psychosocial Instrument.Data analysis included frequency distributions,descriptive statistics,and repeated measures analysis of variance to examine group×time interaction effects.Results:Baseline characteristics were comparable between groups.A repeated measures analysis of variance revealed significant group×time interaction effects for depression(Wilks’Lambda=0.868,F1,57=8.63,p=0.005,partialη^(2)=0.13)and perceived stress(Wilks’Lambda=0.831,F1,57=11.62,p=0.001,partialη^(2)=0.17).In particular,participants in the Tai Chi group had significantly greater reductions in depression and perceived stress than participants in the control group.Conclusions:These results suggest that Tai Chi may contribute to more favorable changes in depression and perceived stress among healthy older adults compared to no intervention,suggesting its usefulness as a culturally appropriate intervention for sustainable enhancement of mental health and successful aging in rapidly aging societies,including South Korea.展开更多
BACKGROUND Metabolic dysfunction-associated fatty liver disease(MAFLD)is a recently proposed term that highlights the role of metabolic dysfunction in hepatic steatosis.It currently affects more than one-third of adul...BACKGROUND Metabolic dysfunction-associated fatty liver disease(MAFLD)is a recently proposed term that highlights the role of metabolic dysfunction in hepatic steatosis.It currently affects more than one-third of adults worldwide and is associated with liver fibrosis,hepatocellular carcinoma,cardiovascular disease,and chronic kidney disease.Given its high prevalence,asymptomatic progression,and revised definition,evaluating its epidemiology and risk profile remains an important public health priority.AIM To assess the prevalence and characteristics of MAFLD among Vietnamese individuals undergoing health check-ups.METHODS This retrospective study included 331 adults undergoing routine health check-ups at The Health Evaluation and Promotion Center,International University of Health and Welfare Center,Cho Ray Hospital,from June to October 2023.MAFLD was diagnosed based on the 2020 international expert consensus.Data collected included demographic,clinical,laboratory information,and metabolic risk factors from routine health check-up records.Descriptive statistics,χ^(2) tests,and ttests/Mann-Whitney tests were applied as appropriate.Significance was defined as P<0.05.RESULTS MAFLD was identified in 97 of 331 individuals(29.31%).Prevalence was significantly higher in men than women(44.51%vs 14.37%;P<0.001).In females,prevalence increased sharply after age 50(P=0.008).According to body mass index groups,prevalence was 0%(underweight),9.27%(normal),and 48.26%(overweight/obese).The MAFLD group had significantly higher rates of hypertension(19.59%vs 2.99%),dyslipidemia(98.96%vs 89.32%),prediabetes/diabetes(65.98%vs 28.20%),hyperuricemia(64.95%vs 31.19%),and metabolic syndrome(54.64%vs 7.69%)compared to the non-MAFLD group(all P<0.001).CONCLUSION MAFLD is prevalent in Vietnamese adults undergoing health screening.It is strongly associated with sex,age,body mass index,and metabolic disorders,indicating the importance of early detection and integrated management.展开更多
Objectives Few studies have investigated longitudinal associations of loneliness with health outcomes in Africa.This study aimed to assess the longitudinal associations between loneliness and mental and physical healt...Objectives Few studies have investigated longitudinal associations of loneliness with health outcomes in Africa.This study aimed to assess the longitudinal associations between loneliness and mental and physical health among aging adults in South Africa.Methods Data from the 7-year longitudinal Health and Ageing in Africa(HAALSI)study conducted in South Africa were used in the analysis(analytic sample:n=3707,aged 40 years and older).Loneliness was measured with one question.Longitudinal relationships between loneliness and each health outcome were estimated using Generalized Estimating Equations analysis(GEE),hazard ratios(HRs)(95%CI)were used to determine the relationship between loneliness and 7-year mortality in the entire sample,and correlations between incident health outcomes and loneliness were evaluated using logistic regressions.Results The prevalence of loneliness was 12.1%in 2015,16.9%in 2019,and 16.3%in 2022.Multivariable analysis showed that loneliness was positively associated with the prevalence and/or incidence of four poor mental health indicators(e.g.,poor sleep quality,AOR=1.53,95%CI:1.30–1.80),four physical ill-health indicators(e.g.,incident kidney disease,AOR=2.50,95%CI:1.41–4.42),mortality(Hazard Ratio=1.20,95%CI=1.04–1.39),and three poor behavioral health indicators(e.g.,current tobacco use,AOR=1.21,95%CI=1.04–1.42).Conclusion The study discovered that several outcomes related to mental,physical,and behavioral health were associated with loneliness.Enhancing the detection and management of loneliness could lower mental and physical illness in aging adults in South Africa.展开更多
This review aims to analyze the development and impact of Artificial Intelligence(AI)in the context of Saudi Arabia’s public healthcare system to fulfill Vision 2030 objectives.It is extensively devoted to AI technol...This review aims to analyze the development and impact of Artificial Intelligence(AI)in the context of Saudi Arabia’s public healthcare system to fulfill Vision 2030 objectives.It is extensively devoted to AI technology deployment relevant to disease management,healthcare delivery,epidemiology,and policy-making.However,its AI is culturally sensitive and ethically grounded in Islam.Based on the PRISMA framework,an SLR evaluated primary academic literature,cases,and practices of Saudi Arabia’s AI implementation in the public healthcare sector.Instead,it categorizes prior research based on how AI can work,the issues it poses,and its implications for the Kingdom’s healthcare system.The Saudi Arabian context analyses show that AI has increased the discreet prediction of diseases,resource management,and monitoring outbreaks during mass congregations such as hajj.Therefore,the study outlines critical areas for defining the potential for artificial intelligence and areas for enhancing digital development to support global healthcare progress.The key themes emerging from the review include Saudi Arabia:(i)the effectiveness of AI with human interaction for sustainable health services;(ii)conditions and quality control to enhance the quality of health care services using AI;(iii)environmental factors as influencing factors for public health care;(iv)Artificial Intelligence,and advanced decision-making technology for Middle Eastern health care systems.For policymakers,healthcare managers,and researchers who will engage with AI innovation,the review proclaims that AI applications should respect the country’s socio-cultural and ethical practices and pave the way for sustainable healthcare provision.More empirical research is needed on the implementation issues with AI,creating culturally appropriate models of AI,and finding new applications of AI to address the increasing demand for healthcare services in Saudi Arabia.展开更多
Irrational drug use and prescription safety are pressing global concerns.The World Health Organization estimated that over half of all prescriptions worldwide contain errors,leading to substantial harm[1,2].In China,p...Irrational drug use and prescription safety are pressing global concerns.The World Health Organization estimated that over half of all prescriptions worldwide contain errors,leading to substantial harm[1,2].In China,prescription errors occur at a rate of 32%,and improper medication use is reported in over 70%of households[3,4].Vulnerable populations,including children(16.7%)and older adults(30.4%),are particularly affected[5].展开更多
The rapid evolution of digital health technologies has sparked transformative changes across the healthcare landscape.These advancements were at the heart of discussions during the recent academic conference co-organi...The rapid evolution of digital health technologies has sparked transformative changes across the healthcare landscape.These advancements were at the heart of discussions during the recent academic conference co-organized by The First Affiliated Hospital,Sun Yat-sen University(FAH-SYSU)and University of California at Berkeley,the Pacific-Rim Conference on Healthcare Innovation(PRC-HI 2024),convening under the theme“The Future of Medicine:Integrating Robotics,AI and Healthcare.”This article distills the key developments and their implications for the future of healthcare,focusing on innovations in robotic surgery,health data science,and AI for medicine.展开更多
Background:In recent years,there has been a growing trend in the utilization of observational studies that make use of routinely collected healthcare data(RCD).These studies rely on algorithms to identify specific hea...Background:In recent years,there has been a growing trend in the utilization of observational studies that make use of routinely collected healthcare data(RCD).These studies rely on algorithms to identify specific health conditions(e.g.,diabetes or sepsis)for statistical analyses.However,there has been substantial variation in the algorithm development and validation,leading to frequently suboptimal performance and posing a significant threat to the validity of study findings.Unfortunately,these issues are often overlooked.Methods:We systematically developed guidance for the development,validation,and evaluation of algorithms designed to identify health status(DEVELOP-RCD).Our initial efforts involved conducting both a narrative review and a systematic review of published studies on the concepts and methodological issues related to algorithm development,validation,and evaluation.Subsequently,we conducted an empirical study on an algorithm for identifying sepsis.Based on these findings,we formulated specific workflow and recommendations for algorithm development,validation,and evaluation within the guidance.Finally,the guidance underwent independent review by a panel of 20 external experts who then convened a consensus meeting to finalize it.Results:A standardized workflow for algorithm development,validation,and evaluation was established.Guided by specific health status considerations,the workflow comprises four integrated steps:assessing an existing algorithm’s suitability for the target health status;developing a new algorithm using recommended methods;validating the algorithm using prescribed performance measures;and evaluating the impact of the algorithm on study results.Additionally,13 good practice recommendations were formulated with detailed explanations.Furthermore,a practical study on sepsis identification was included to demonstrate the application of this guidance.Conclusions:The establishment of guidance is intended to aid researchers and clinicians in the appropriate and accurate development and application of algorithms for identifying health status from RCD.This guidance has the potential to enhance the credibility of findings from observational studies involving RCD.展开更多
Over the past ten years,numerous papers have been published on the use of indocyanine green(ICG)fluorescence in liver surgery for hepatocellular carcinoma(HCC).There are many different applications.The first involves ...Over the past ten years,numerous papers have been published on the use of indocyanine green(ICG)fluorescence in liver surgery for hepatocellular carcinoma(HCC).There are many different applications.The first involves targeting superficial tumors in patients with macronodular cirrhosis and an irregular liver surface.In a minimally invasive setting,the lack of tactile feedback on the hepatic surface makes detecting subcapsular HCC with ultrasound alone challenging.ICG fusion images can mimic the tactile feedback of the hand and act as an ultrasound booster.ICG fluorescence can be used to evaluate tumor residues after minimally invasive thermal ablation.ICG fluorescence imaging can also be used to identify the grade of HCC early on and evaluate the microinvasive component.展开更多
BACKGROUND Intimate partner violence(IPV)is a major public health concern linked to psychiatric and physical morbidity.However,evidence from East Asia,particularly from registry-based and sex-inclusive analyses,remain...BACKGROUND Intimate partner violence(IPV)is a major public health concern linked to psychiatric and physical morbidity.However,evidence from East Asia,particularly from registry-based and sex-inclusive analyses,remains limited.We hypothesized that IPV survivors would have elevated risks of psychiatric disorders and stressrelated physical conditions.AIM To assess psychiatric and physical health risks following IPV exposure in Taiwan.METHODS We conducted a nationwide,registry-based case control study using data from Taiwan’s Health and Welfare Data Science Center.Adults aged 18-64 years with a first IPV report in 2019(n=43393)were matched 1:1 by sex and age to controls.Incident diagnoses within 1 year were identified from claims data.Conditional logistic regression was used to estimate adjusted odds ratios(AORs).RESULTS Compared to controls,IPV survivors had higher risks of depressive disorders[AOR=4.18,95%confidence interval(CI):3.78-4.60,P<0.001],bipolar disorder(AOR=4.81,95%CI:3.83-6.10,P<0.001),schizophrenia(AOR=1.75,95%CI:1.46-2.10,P<0.001),and alcohol/substance use disorders(AOR=5.98,95%CI:2.21-8.50,P<0.001).The risk of asthma was modestly elevated(AOR=1.31,95%CI:1.08-1.60,P=0.006).No significant association was observed for irritable bowel syndrome(P=0.94).CONCLUSION IPV survivors in Taiwan face substantially increased psychiatric risk and a modestly elevated risk of asthma,warranting early screening and integrated mental and physical health care.展开更多
Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy remains a challenging field in therapeutic endoscopy due to the complex anatomical reconstructions that limit access to t...Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy remains a challenging field in therapeutic endoscopy due to the complex anatomical reconstructions that limit access to the biliary tree.Over the past two decades,device-assisted enteroscopy(DAE),including singleballoon,double-balloon,and motorized spiral enteroscopy,has expanded the feasibility of ERCP in this population,with overall technical success rates generally reported between 70%and 90%.Nevertheless,these techniques are technically demanding,time-consuming,and frequently affected by limited reach and unstable positioning.More recently,interventional endoscopic ultrasound(EUS)-guided procedures have emerged as highly effective alternatives,significantly improving clinical outcomes in selected patients,particularly in those with long-limb Roux-en-Y reconstructions where conventional methods are less effective.Percutaneous transhepatic biliary drainage continues to represent a valuable salvage option when endoscopic approaches fail,though it is associated with a greater burden of reinterventions and adverse events.This minireview provides a comprehensive overview of the main endoscopic strategies for biliary drainage in altered anatomy,focusing on technical considerations,efficacy,and safety profiles of DAE-assisted ERCP,EUS-guided interventions,and motorized systems.The evolving landscape of biliary drainage in this setting highlights the need for tailored treatment strategies,multidisciplinary collaboration,referral to high-volume centers,and further prospective studies to refine patient selection and optimize clinical outcomes.展开更多
The rapid growth of biomedical data,particularly multi-omics data including genomes,transcriptomics,proteomics,metabolomics,and epigenomics,medical research and clinical decision-making confront both new opportunities...The rapid growth of biomedical data,particularly multi-omics data including genomes,transcriptomics,proteomics,metabolomics,and epigenomics,medical research and clinical decision-making confront both new opportunities and obstacles.The huge and diversified nature of these datasets cannot always be managed using traditional data analysis methods.As a consequence,deep learning has emerged as a strong tool for analysing numerous omics data due to its ability to handle complex and non-linear relationships.This paper explores the fundamental concepts of deep learning and how they are used in multi-omics medical data mining.We demonstrate how autoencoders,variational autoencoders,multimodal models,attention mechanisms,transformers,and graph neural networks enable pattern analysis and recognition across all omics data.Deep learning has been found to be effective in illness classification,biomarker identification,gene network learning,and therapeutic efficacy prediction.We also consider critical problems like as data quality,model explainability,whether findings can be repeated,and computational power requirements.We now consider future elements of combining omics with clinical and imaging data,explainable AI,federated learning,and real-time diagnostics.Overall,this study emphasises the need of collaborating across disciplines to advance deep learning-based multi-omics research for precision medicine and comprehending complicated disorders.展开更多
This study investigated the effects of varicocele on semen parameters in infertile men based on the new 2010 World Health Organization laboratory manual for the examination of human semen. Semen analysis results （vol...This study investigated the effects of varicocele on semen parameters in infertile men based on the new 2010 World Health Organization laboratory manual for the examination of human semen. Semen analysis results （volume, sperm count, motility, and morphology） were the primary outcomes. An electronic search to collect the data was conducted using the Medline/PubMed, SJU discover, and Google Scholar databases. We searched articles published from 2010 to August 2015, i.e., after the publication of the 2010 WHO manual. We included only those studies that reported the actual semen parameters of adult infertile men diagnosed with clinical varicocele and contained a control group of either fertile men or normozoospermic men who were not diagnosed with varicocele. Ten studies were included in the meta-analysis, involving 1232 men. Varicocele was associated with reduced sperm count （mean difference： -44.48 x 106 ml-1; 95% Ch -61.45, -27.51 x 106 ml-1; P〈 0.001）, motility （mean difference： -26.67%; 95% Ch -34.27, -19.08; P 〈 0.001）, and morphology （mean difference： -19.68%; 95% Ch -29.28, -10.07; P 〈 0.001） but not semen volume （mean difference： -0.23 ml; 95% CI： -0.64, 0.17）. Subgroup analyses indicated that the magnitude of effect was influenced by control subtype but not WHO laboratory manual edition used for semen assessment. We conclude that varicocele is a significant risk factor that negatively affects semen quality, but the observed pooled effect size on semen parameters does not seem to be affected by the WHO laboratory manual edition. Given most of the studies published after 2010 still utilized the 1999 manual for semen analysis, further research is required to fully understand the clinical implication of the 2010 WHO laboratory manual on the association between varicocele and semen parameters.展开更多
Objective: The purpose of this study was to examine the relationships between osteoporosis knowledge, beliefs and calcium intake among college students. This study also examined perceived susceptibility, severity, ben...Objective: The purpose of this study was to examine the relationships between osteoporosis knowledge, beliefs and calcium intake among college students. This study also examined perceived susceptibility, severity, benefits, barriers and self-efficacy related to osteoporosis prevention. Participants: Seven hundred and ninety two (n = 792) men and women ages 17 - 31 of all ethnicities at a mid-western regional university in the US participated in the study. Methods: The Osteoporosis Knowledge Test, Osteoporosis Health Belief Scale, and Osteoporosis Preventing Behaviors Survey were utilized. Each of these tools were previously validated and found reliable. Correlation and multiple regression analyses were completed. Results: Participants did not perceive themselves as susceptible to osteoporosis and perceived minimal barriers to calcium intake. Their knowledge was minimal concerning alternate sources of calcium. Conclusions: Prevention programs should aim to increase osteoporosis knowledge of risk factors and osteoprotective behaviors and to decrease high-risk behaviors during college years when behavior changes can have the strongest impact on bone health.展开更多
AIM. To evaluate health-related quality of life （HRQOL） in Chinese patients with chronic hepatitis C （CH-C）, and the impact of antiviral treatment. METHODS： Short Form 36 （SF-36） Health-related Quality of Life ...AIM. To evaluate health-related quality of life （HRQOL） in Chinese patients with chronic hepatitis C （CH-C）, and the impact of antiviral treatment. METHODS： Short Form 36 （SF-36） Health-related Quality of Life Questionnaires to interview CH-C patients, and age- and sex-matched control subjects at outpatient clinics of a medical center in Taiwan were used. Data were transformed to scores for comparisons of eight major SF-36 domains. We also enrolled consecutive CH-C patients who completed one course of antiviral treatment （interferon α with ribavirin）, and measured the HRQOL before, at the 12m wk of treatment, at the end of treatment, and at mo 6, after stopping the treatment to evaluate the impact of antiviral treatment. RESULTS： A total of 371 outpatients were enrolled, including 182 with CH-C and 189 age- and sex-matched subjects without CH-C. CH-C subjects had obviously lower educational status （P〈0.01）. Mean scores of domains in general health, physical functioning, role-physical, role-emotional, vitality, and mental health of the SF-36 were significantly lower in subjects with CH-C than those without CH-C （P〈0.05）. In an analysis of 47 CH-C patients who received and completed the whole course of antiviral treatment, mean scores of all domains were significantly lower at wk 12 of treatment compared to baseline. The scores returned to pretreatment values by the end of treatment, but were significantly increased at mo 6 after stopping the treatment. Among the 47 CH-C patients, 21 had sustained responses and 26 had nonsustained responses to antiviral treatment. Compared to pretreatment values, subjects with sustained responses had significantly lower social functioning scores at wk 12 of treatment, and scores for all SF-36 domains returned to pretreatment values, and increased significantly at mo 6 after stopping the treatment. For non-sustained virological responders, scores of all SF-36 domains significantly decreased at wk 12 of treatment, and did not increase significantly by the end of treatment, or at mo 6 after stopping the treatment when compared to the pretreatment values. CONCLUSION： HRQOL in CH-C patients is significantly impaired in most SF-36 domains. Antiviral treatment impaired HRQOL of CH-C subjects during early treatment, mainly in non-sustained virological responders, and improved at mo 6 after stopping the treatment, mainly in sustained virological responders.展开更多
基金supported by National Research Foundation of Korea(NRF)grants funded by the Korean government(MSIT)(No.RS-2023-00256265,RS-2024-00352352,RS-2024-00405818)the Korean Fund for Regenerative Medicine(KFRM)grant funded by the Korea government(the Ministry of Science and ICT,the Ministry of Health&Welfare).(No.25A0102L1)support from the Market-led K-sensor technology program(RS-2022-00154781,Development of large-area wafer-level flexible/stretchable hybrid sensor platform technology for form factor-free highly integrated convergence sensor),funded By the Ministry of Trade,Industry&Energy(MOTIE,Korea).
文摘Microneedles(MNs)have been extensively investigated for transdermal delivery of large-sized drugs,including proteins,nucleic acids,and even extracellular vesicles(EVs).However,for their sufficient skin penetration,conventional MNs employ long needles(≥600μm),leading to pain and skin irritation.Moreover,it is critical to stably apply MNs against complex skin surfaces for uniform nanoscale drug delivery.Herein,a dually amplified transdermal patch(MN@EV/SC)is developed as the stem cell-derived EV delivery platform by hierarchically integrating an octopusinspired suction cup(SC)with short MNs(≤300μm).While leveraging the suction effect to induce nanoscale deformation of the stratum corneum,MN@EV/SC minimizes skin damage and enhances the adhesion of MNs,allowing EV to penetrate deeper into the dermis.When MNs of various lengths are applied to mouse skin,the short MNs can elicit comparable corticosterone release to chemical adhesives,whereas long MNs induce a prompt stress response.MN@EV/SC can achieve a remarkable penetration depth(290μm)for EV,compared to that of MN alone(111μm).Consequently,MN@EV/SC facilitates the revitalization of fibroblasts and enhances collagen synthesis in middle-aged mice.Overall,MN@EV/SC exhibits the potential for skin regeneration by modulating the dermal microenvironment and ensuring patient comfort.
文摘Background: In the global burden of non-communicable diseases, the top slot among them all is occupied by various cardiovascular diseases (CVD), which also claim primacy in mortality rates. Generally speaking, the pathophysiological pathway frequently involves either (or a combination of) elevated serum cholesterol levels, predominantly attributed to dietary patterns characterized by extremely high levels of saturated and trans-fat consumption. Day-to-day nutritional epidemiology among university students suggests that they represent a crucial demographic for the study of preventive interventions. Objective: This in-depth study and investigation were specifically aimed to quantitatively assess and compare prevailing patterns of dietary fat consumption between female students enrolled in health sciences and non-health sciences programs at major universities in Riyadh, Saudi Arabia. Methodology: This cross-sectional study was comprised of 434 Saudi female university students (age range: 18 - 25 years), utilizing a validated Block Dietary Fat Screener accompanied by anthropometric measurements and comprehensive demographic data collection. The sampling methodology consisted of a snowball technique that was spread across three major academic institutions in Riyadh. Results: Statistical analysis revealed a significant association between academic specialization and patterns of dietary fat consumption (p = 0.012). Paradoxically, students of health science exhibited a higher prevalence of very high fat intake (41.9%) compared with their non-health sciences counterparts (27.6%). Surprisingly, anthropometric stratification revealed that it was the underweight students who demonstrated very high levels of fat consumption. A notable socioeconomic gradient was observed, with students from households earning 15,000 - 20,000 SR monthly showing the highest prevalence of very high-fat consumption (47.1%), although this association did not achieve statistical significance (p = 0.104). Conclusion: These findings challenge the conventional assumption that health sciences education correlates with superior dietary behaviors. The data suggests a critical need for enhanced education in nutrition, as well as intervention using various behavioral programs across all academic disciplines, particularly those addressing the disconnect between nutritional knowledge and dietary practices among students of health sciences. Future longitudinal studies are warranted in order to elucidate the temporal relationship between academic specialization and dietary behaviors.
文摘Background:Oral health issues persistently affect the overall health and well-being of rural populations.Village health volunteers(VHVs)play a crucial role in advancing oral health literacy in their community.This study aimed to examine the factors related to nutritional literacy for oral health among VHVs.Methods:This was a mixed-methods study employing an explanatory sequential design.The quantitative data were gathered through questionnaires distributed to a cohort of 10,514 VHVs registered in Health Region 1.A stratified random sampling technique was used to ensure adequate representation of various subgroups within the VHV population,considering factors such as age,education level,and geographical distribution across the region.This approach allowed for a more representative sample that accurately reflects the diversity of the VHV population.Qualitative data were obtained through semi-structured interviews with a purposive sampling of 20 participants based on specific criteria.Quantitative data were analyzed using descriptive statistics and biserial correlation techniques,while qualitative data were analyzed using content analysis.Results:The study found that the sample group possessed a moderate level of knowledge of health literacy principles and nutrition for oral health.However,their self-assessed skills in nutritional literacy for oral health were rated as high.A statistically significant negative correlation was found between knowledge of nutrition for oral health and skills in nutritional literacy for oral health.VHVs equated health literacy with knowledge because their public health training had focused more on imparting knowledge rather than developing skills based on health literacy principles.Conclusion:There is a need to emphasize skill-based health literacy training and to use effective skill development techniques that are tailored to the specific roles and responsibilities of health volunteers.It is also recommended to continuously monitor and evaluate the outcomes of these efforts.
文摘The pandemic highlighted significant gaps in the public health infrastructure impacted by shortages of public health workers, an undertrained workforce, and years of disinvestment. These gaps required innovative problem-solving by public health agencies (PHAs), including local health departments (LHDs), to respond to rapidly changing community conditions during and after the pandemic. Many schools and programs of public health (SPPH) worked with PHAs to mobilize public health (PH) students through practice-based teaching (PBT). Current research indicates PBT benefits all stakeholders—PHAs, students, faculty, SPPH, and ultimately the community served. However, more research is needed on the utility of PBT in addressing a community’s systemic public health issues, the extent to which the academic-community collaboration enhances a PHA’s capacity, and the impact of the pedagogy on preparing the workforce for an evolving PH landscape. This paper examines the process of a semester-long PBT course, guided by the PBT STEPS framework, which includes five steps from collaboration to implementation to evaluation of a PBT course. The collaborating PHA and its student group addressed community trauma and resilience issues during the semester. Additionally, it examines the longer-term impacts after the semester for the PHA, community, and the workforce by 1) conducting a formative evaluation to understand needs and gaps in the community;2) redesigning an intervention that merged the results of the formative evaluation with the intervention developed during the semester;and 3) securing funding and resources for intervention sustainability. Through the documentation of a post-course partnership between an LHD and faculty at a large school of public health, this case study illustrates the potential for PBT to lay the foundation for ongoing research that supports more impactful interventions for PHAs while bolstering the workforce abilities of students as future practitioners.
基金supported by Seoul National University of Science and Technology.
文摘Background:It has been broadly witnessed that a large number of adolescents are suffering emotional and mental health problems after COVID-19,and such adverse experiences in early life often extend into adulthood,resulting in serious long-term implications.However,it is accepted that the literature examining the relationship between mental health problems in adolescents and their underlying psychological factors is limited.The purposes of the current study were to identify mental health problems of Korean adolescents and to investigate the possible influence of self-esteem,self-efficacy,and health locus of control on mental health problems.Methods:A total of 2104 Korean adolescents were randomly recruited from junior high and high schools located in Seoul,Korea.The Korean Symptom Checklist,and Self-esteem Scale,Health Locus of Control Scale,Self-efficacy Scale were applied to identify mental health problems and psychological factors among adolescents.Frequency analysis,independent t-tests,one-way ANOVA,correlation analysis,and multiple regression analysis were performed to test the study hypothesis.Results:Korean adolescents showed a high prevalence of depression(61.4%),anxiety(44.7%),interpersonal sensitivity(76.1%),and hostility(40.3%).In addition,the findings indicated significant gender and age differences in adolescent mental health problems.Moreover,results reported that the adolescents’mental health problems were significantly associated with psychological factors(R^(2)=0.51 for depression,0.38 for anxiety,0.33 for interpersonal sensitivity,and 0.23 for hostility).Conclusions:The current findings highlight the need for comprehensive,culturally relevant mental health strategies for Korean adolescents.The interventions that foster psychological resilience,promote positive self-concept,and encourage internal control beliefs may be effective in mitigating mental health challenges.
基金supported by the Bio&Medical Technology Development Program of the National Research Foundation(NRF)&funded by the Korean government(MSIT)(NRF-2021M3A9E4080780)Hankuk University of Foreign Studies(2024).
文摘Objectives:Population aging is occurring at a rapid speed all over the world,bringing considerable public health challenges,including for the mental health of older adults.Considering that older populations are prone to depression and stress,the need for effective preventive interventions is critical.Thus,we conducted a study aimed at exploring the preventive impact of a community-based Tai Chi program over 8 weeks on depression and perceived stress in healthy older adults in South Korea.Methods:A quasi-experimental design was utilized,with 63 older adults participating(31 individuals in the Tai Chi group and 32 in the control group).The Tai Chi intervention was a supervised session 3 times per week.Data were obtained anonymously at baseline and post-intervention(week 8),with validated measures,including the Geriatric Depression Scale and the Korean version of the Brief Encounter Psychosocial Instrument.Data analysis included frequency distributions,descriptive statistics,and repeated measures analysis of variance to examine group×time interaction effects.Results:Baseline characteristics were comparable between groups.A repeated measures analysis of variance revealed significant group×time interaction effects for depression(Wilks’Lambda=0.868,F1,57=8.63,p=0.005,partialη^(2)=0.13)and perceived stress(Wilks’Lambda=0.831,F1,57=11.62,p=0.001,partialη^(2)=0.17).In particular,participants in the Tai Chi group had significantly greater reductions in depression and perceived stress than participants in the control group.Conclusions:These results suggest that Tai Chi may contribute to more favorable changes in depression and perceived stress among healthy older adults compared to no intervention,suggesting its usefulness as a culturally appropriate intervention for sustainable enhancement of mental health and successful aging in rapidly aging societies,including South Korea.
文摘BACKGROUND Metabolic dysfunction-associated fatty liver disease(MAFLD)is a recently proposed term that highlights the role of metabolic dysfunction in hepatic steatosis.It currently affects more than one-third of adults worldwide and is associated with liver fibrosis,hepatocellular carcinoma,cardiovascular disease,and chronic kidney disease.Given its high prevalence,asymptomatic progression,and revised definition,evaluating its epidemiology and risk profile remains an important public health priority.AIM To assess the prevalence and characteristics of MAFLD among Vietnamese individuals undergoing health check-ups.METHODS This retrospective study included 331 adults undergoing routine health check-ups at The Health Evaluation and Promotion Center,International University of Health and Welfare Center,Cho Ray Hospital,from June to October 2023.MAFLD was diagnosed based on the 2020 international expert consensus.Data collected included demographic,clinical,laboratory information,and metabolic risk factors from routine health check-up records.Descriptive statistics,χ^(2) tests,and ttests/Mann-Whitney tests were applied as appropriate.Significance was defined as P<0.05.RESULTS MAFLD was identified in 97 of 331 individuals(29.31%).Prevalence was significantly higher in men than women(44.51%vs 14.37%;P<0.001).In females,prevalence increased sharply after age 50(P=0.008).According to body mass index groups,prevalence was 0%(underweight),9.27%(normal),and 48.26%(overweight/obese).The MAFLD group had significantly higher rates of hypertension(19.59%vs 2.99%),dyslipidemia(98.96%vs 89.32%),prediabetes/diabetes(65.98%vs 28.20%),hyperuricemia(64.95%vs 31.19%),and metabolic syndrome(54.64%vs 7.69%)compared to the non-MAFLD group(all P<0.001).CONCLUSION MAFLD is prevalent in Vietnamese adults undergoing health screening.It is strongly associated with sex,age,body mass index,and metabolic disorders,indicating the importance of early detection and integrated management.
基金HAALSI(Health and Aging in Africa:A Longitudinal Study of an INDEPTH Community in South Africa)is sponsored by the National Institute on Aging(grant number 5P01AG041710-05)and is conducted by the Harvard Center for Population and Development Studies in Partnership with Witwatersrand UniversityThe Agincourt HDSS was supported by the Wellcome Trust,UK(058893/Z/99/A,069683/Z/02/Z,085477/Z/08/Z and085477/B/08/Z),the University of the Witwatersrand and South African Medical Research Council.
文摘Objectives Few studies have investigated longitudinal associations of loneliness with health outcomes in Africa.This study aimed to assess the longitudinal associations between loneliness and mental and physical health among aging adults in South Africa.Methods Data from the 7-year longitudinal Health and Ageing in Africa(HAALSI)study conducted in South Africa were used in the analysis(analytic sample:n=3707,aged 40 years and older).Loneliness was measured with one question.Longitudinal relationships between loneliness and each health outcome were estimated using Generalized Estimating Equations analysis(GEE),hazard ratios(HRs)(95%CI)were used to determine the relationship between loneliness and 7-year mortality in the entire sample,and correlations between incident health outcomes and loneliness were evaluated using logistic regressions.Results The prevalence of loneliness was 12.1%in 2015,16.9%in 2019,and 16.3%in 2022.Multivariable analysis showed that loneliness was positively associated with the prevalence and/or incidence of four poor mental health indicators(e.g.,poor sleep quality,AOR=1.53,95%CI:1.30–1.80),four physical ill-health indicators(e.g.,incident kidney disease,AOR=2.50,95%CI:1.41–4.42),mortality(Hazard Ratio=1.20,95%CI=1.04–1.39),and three poor behavioral health indicators(e.g.,current tobacco use,AOR=1.21,95%CI=1.04–1.42).Conclusion The study discovered that several outcomes related to mental,physical,and behavioral health were associated with loneliness.Enhancing the detection and management of loneliness could lower mental and physical illness in aging adults in South Africa.
基金funded by the Scientific ResearchDeanship at theUniversity ofHa’il-Saudi Arabia through project number-RG-23251.
文摘This review aims to analyze the development and impact of Artificial Intelligence(AI)in the context of Saudi Arabia’s public healthcare system to fulfill Vision 2030 objectives.It is extensively devoted to AI technology deployment relevant to disease management,healthcare delivery,epidemiology,and policy-making.However,its AI is culturally sensitive and ethically grounded in Islam.Based on the PRISMA framework,an SLR evaluated primary academic literature,cases,and practices of Saudi Arabia’s AI implementation in the public healthcare sector.Instead,it categorizes prior research based on how AI can work,the issues it poses,and its implications for the Kingdom’s healthcare system.The Saudi Arabian context analyses show that AI has increased the discreet prediction of diseases,resource management,and monitoring outbreaks during mass congregations such as hajj.Therefore,the study outlines critical areas for defining the potential for artificial intelligence and areas for enhancing digital development to support global healthcare progress.The key themes emerging from the review include Saudi Arabia:(i)the effectiveness of AI with human interaction for sustainable health services;(ii)conditions and quality control to enhance the quality of health care services using AI;(iii)environmental factors as influencing factors for public health care;(iv)Artificial Intelligence,and advanced decision-making technology for Middle Eastern health care systems.For policymakers,healthcare managers,and researchers who will engage with AI innovation,the review proclaims that AI applications should respect the country’s socio-cultural and ethical practices and pave the way for sustainable healthcare provision.More empirical research is needed on the implementation issues with AI,creating culturally appropriate models of AI,and finding new applications of AI to address the increasing demand for healthcare services in Saudi Arabia.
基金supported by the Ministry of Science and Technology of the People’s Republic of China under the“New Generation Artificial Intelligence”Major Project of Science and Technology Innovation 2030(2020AAA0105002).
文摘Irrational drug use and prescription safety are pressing global concerns.The World Health Organization estimated that over half of all prescriptions worldwide contain errors,leading to substantial harm[1,2].In China,prescription errors occur at a rate of 32%,and improper medication use is reported in over 70%of households[3,4].Vulnerable populations,including children(16.7%)and older adults(30.4%),are particularly affected[5].
文摘The rapid evolution of digital health technologies has sparked transformative changes across the healthcare landscape.These advancements were at the heart of discussions during the recent academic conference co-organized by The First Affiliated Hospital,Sun Yat-sen University(FAH-SYSU)and University of California at Berkeley,the Pacific-Rim Conference on Healthcare Innovation(PRC-HI 2024),convening under the theme“The Future of Medicine:Integrating Robotics,AI and Healthcare.”This article distills the key developments and their implications for the future of healthcare,focusing on innovations in robotic surgery,health data science,and AI for medicine.
基金supported by the National Natural Science Foundation of China(82225049,72104155)the Sichuan Provincial Central Government Guides Local Science and Technology Development Special Project(2022ZYD0127)the 1·3·5 Project for Disciplines of Excellence,West China Hospital,Sichuan University(ZYGD23004).
文摘Background:In recent years,there has been a growing trend in the utilization of observational studies that make use of routinely collected healthcare data(RCD).These studies rely on algorithms to identify specific health conditions(e.g.,diabetes or sepsis)for statistical analyses.However,there has been substantial variation in the algorithm development and validation,leading to frequently suboptimal performance and posing a significant threat to the validity of study findings.Unfortunately,these issues are often overlooked.Methods:We systematically developed guidance for the development,validation,and evaluation of algorithms designed to identify health status(DEVELOP-RCD).Our initial efforts involved conducting both a narrative review and a systematic review of published studies on the concepts and methodological issues related to algorithm development,validation,and evaluation.Subsequently,we conducted an empirical study on an algorithm for identifying sepsis.Based on these findings,we formulated specific workflow and recommendations for algorithm development,validation,and evaluation within the guidance.Finally,the guidance underwent independent review by a panel of 20 external experts who then convened a consensus meeting to finalize it.Results:A standardized workflow for algorithm development,validation,and evaluation was established.Guided by specific health status considerations,the workflow comprises four integrated steps:assessing an existing algorithm’s suitability for the target health status;developing a new algorithm using recommended methods;validating the algorithm using prescribed performance measures;and evaluating the impact of the algorithm on study results.Additionally,13 good practice recommendations were formulated with detailed explanations.Furthermore,a practical study on sepsis identification was included to demonstrate the application of this guidance.Conclusions:The establishment of guidance is intended to aid researchers and clinicians in the appropriate and accurate development and application of algorithms for identifying health status from RCD.This guidance has the potential to enhance the credibility of findings from observational studies involving RCD.
文摘Over the past ten years,numerous papers have been published on the use of indocyanine green(ICG)fluorescence in liver surgery for hepatocellular carcinoma(HCC).There are many different applications.The first involves targeting superficial tumors in patients with macronodular cirrhosis and an irregular liver surface.In a minimally invasive setting,the lack of tactile feedback on the hepatic surface makes detecting subcapsular HCC with ultrasound alone challenging.ICG fusion images can mimic the tactile feedback of the hand and act as an ultrasound booster.ICG fluorescence can be used to evaluate tumor residues after minimally invasive thermal ablation.ICG fluorescence imaging can also be used to identify the grade of HCC early on and evaluate the microinvasive component.
基金Supported by National Science and Technology Council,Taiwan,No.MOST 111-2629-H-227-001-MY2.
文摘BACKGROUND Intimate partner violence(IPV)is a major public health concern linked to psychiatric and physical morbidity.However,evidence from East Asia,particularly from registry-based and sex-inclusive analyses,remains limited.We hypothesized that IPV survivors would have elevated risks of psychiatric disorders and stressrelated physical conditions.AIM To assess psychiatric and physical health risks following IPV exposure in Taiwan.METHODS We conducted a nationwide,registry-based case control study using data from Taiwan’s Health and Welfare Data Science Center.Adults aged 18-64 years with a first IPV report in 2019(n=43393)were matched 1:1 by sex and age to controls.Incident diagnoses within 1 year were identified from claims data.Conditional logistic regression was used to estimate adjusted odds ratios(AORs).RESULTS Compared to controls,IPV survivors had higher risks of depressive disorders[AOR=4.18,95%confidence interval(CI):3.78-4.60,P<0.001],bipolar disorder(AOR=4.81,95%CI:3.83-6.10,P<0.001),schizophrenia(AOR=1.75,95%CI:1.46-2.10,P<0.001),and alcohol/substance use disorders(AOR=5.98,95%CI:2.21-8.50,P<0.001).The risk of asthma was modestly elevated(AOR=1.31,95%CI:1.08-1.60,P=0.006).No significant association was observed for irritable bowel syndrome(P=0.94).CONCLUSION IPV survivors in Taiwan face substantially increased psychiatric risk and a modestly elevated risk of asthma,warranting early screening and integrated mental and physical health care.
文摘Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy remains a challenging field in therapeutic endoscopy due to the complex anatomical reconstructions that limit access to the biliary tree.Over the past two decades,device-assisted enteroscopy(DAE),including singleballoon,double-balloon,and motorized spiral enteroscopy,has expanded the feasibility of ERCP in this population,with overall technical success rates generally reported between 70%and 90%.Nevertheless,these techniques are technically demanding,time-consuming,and frequently affected by limited reach and unstable positioning.More recently,interventional endoscopic ultrasound(EUS)-guided procedures have emerged as highly effective alternatives,significantly improving clinical outcomes in selected patients,particularly in those with long-limb Roux-en-Y reconstructions where conventional methods are less effective.Percutaneous transhepatic biliary drainage continues to represent a valuable salvage option when endoscopic approaches fail,though it is associated with a greater burden of reinterventions and adverse events.This minireview provides a comprehensive overview of the main endoscopic strategies for biliary drainage in altered anatomy,focusing on technical considerations,efficacy,and safety profiles of DAE-assisted ERCP,EUS-guided interventions,and motorized systems.The evolving landscape of biliary drainage in this setting highlights the need for tailored treatment strategies,multidisciplinary collaboration,referral to high-volume centers,and further prospective studies to refine patient selection and optimize clinical outcomes.
文摘The rapid growth of biomedical data,particularly multi-omics data including genomes,transcriptomics,proteomics,metabolomics,and epigenomics,medical research and clinical decision-making confront both new opportunities and obstacles.The huge and diversified nature of these datasets cannot always be managed using traditional data analysis methods.As a consequence,deep learning has emerged as a strong tool for analysing numerous omics data due to its ability to handle complex and non-linear relationships.This paper explores the fundamental concepts of deep learning and how they are used in multi-omics medical data mining.We demonstrate how autoencoders,variational autoencoders,multimodal models,attention mechanisms,transformers,and graph neural networks enable pattern analysis and recognition across all omics data.Deep learning has been found to be effective in illness classification,biomarker identification,gene network learning,and therapeutic efficacy prediction.We also consider critical problems like as data quality,model explainability,whether findings can be repeated,and computational power requirements.We now consider future elements of combining omics with clinical and imaging data,explainable AI,federated learning,and real-time diagnostics.Overall,this study emphasises the need of collaborating across disciplines to advance deep learning-based multi-omics research for precision medicine and comprehending complicated disorders.
文摘This study investigated the effects of varicocele on semen parameters in infertile men based on the new 2010 World Health Organization laboratory manual for the examination of human semen. Semen analysis results （volume, sperm count, motility, and morphology） were the primary outcomes. An electronic search to collect the data was conducted using the Medline/PubMed, SJU discover, and Google Scholar databases. We searched articles published from 2010 to August 2015, i.e., after the publication of the 2010 WHO manual. We included only those studies that reported the actual semen parameters of adult infertile men diagnosed with clinical varicocele and contained a control group of either fertile men or normozoospermic men who were not diagnosed with varicocele. Ten studies were included in the meta-analysis, involving 1232 men. Varicocele was associated with reduced sperm count （mean difference： -44.48 x 106 ml-1; 95% Ch -61.45, -27.51 x 106 ml-1; P〈 0.001）, motility （mean difference： -26.67%; 95% Ch -34.27, -19.08; P 〈 0.001）, and morphology （mean difference： -19.68%; 95% Ch -29.28, -10.07; P 〈 0.001） but not semen volume （mean difference： -0.23 ml; 95% CI： -0.64, 0.17）. Subgroup analyses indicated that the magnitude of effect was influenced by control subtype but not WHO laboratory manual edition used for semen assessment. We conclude that varicocele is a significant risk factor that negatively affects semen quality, but the observed pooled effect size on semen parameters does not seem to be affected by the WHO laboratory manual edition. Given most of the studies published after 2010 still utilized the 1999 manual for semen analysis, further research is required to fully understand the clinical implication of the 2010 WHO laboratory manual on the association between varicocele and semen parameters.
文摘Objective: The purpose of this study was to examine the relationships between osteoporosis knowledge, beliefs and calcium intake among college students. This study also examined perceived susceptibility, severity, benefits, barriers and self-efficacy related to osteoporosis prevention. Participants: Seven hundred and ninety two (n = 792) men and women ages 17 - 31 of all ethnicities at a mid-western regional university in the US participated in the study. Methods: The Osteoporosis Knowledge Test, Osteoporosis Health Belief Scale, and Osteoporosis Preventing Behaviors Survey were utilized. Each of these tools were previously validated and found reliable. Correlation and multiple regression analyses were completed. Results: Participants did not perceive themselves as susceptible to osteoporosis and perceived minimal barriers to calcium intake. Their knowledge was minimal concerning alternate sources of calcium. Conclusions: Prevention programs should aim to increase osteoporosis knowledge of risk factors and osteoprotective behaviors and to decrease high-risk behaviors during college years when behavior changes can have the strongest impact on bone health.
基金Supported by the National Science Council, Taiwan, China, NSC 89-2314-B-010-475
文摘AIM. To evaluate health-related quality of life （HRQOL） in Chinese patients with chronic hepatitis C （CH-C）, and the impact of antiviral treatment. METHODS： Short Form 36 （SF-36） Health-related Quality of Life Questionnaires to interview CH-C patients, and age- and sex-matched control subjects at outpatient clinics of a medical center in Taiwan were used. Data were transformed to scores for comparisons of eight major SF-36 domains. We also enrolled consecutive CH-C patients who completed one course of antiviral treatment （interferon α with ribavirin）, and measured the HRQOL before, at the 12m wk of treatment, at the end of treatment, and at mo 6, after stopping the treatment to evaluate the impact of antiviral treatment. RESULTS： A total of 371 outpatients were enrolled, including 182 with CH-C and 189 age- and sex-matched subjects without CH-C. CH-C subjects had obviously lower educational status （P〈0.01）. Mean scores of domains in general health, physical functioning, role-physical, role-emotional, vitality, and mental health of the SF-36 were significantly lower in subjects with CH-C than those without CH-C （P〈0.05）. In an analysis of 47 CH-C patients who received and completed the whole course of antiviral treatment, mean scores of all domains were significantly lower at wk 12 of treatment compared to baseline. The scores returned to pretreatment values by the end of treatment, but were significantly increased at mo 6 after stopping the treatment. Among the 47 CH-C patients, 21 had sustained responses and 26 had nonsustained responses to antiviral treatment. Compared to pretreatment values, subjects with sustained responses had significantly lower social functioning scores at wk 12 of treatment, and scores for all SF-36 domains returned to pretreatment values, and increased significantly at mo 6 after stopping the treatment. For non-sustained virological responders, scores of all SF-36 domains significantly decreased at wk 12 of treatment, and did not increase significantly by the end of treatment, or at mo 6 after stopping the treatment when compared to the pretreatment values. CONCLUSION： HRQOL in CH-C patients is significantly impaired in most SF-36 domains. Antiviral treatment impaired HRQOL of CH-C subjects during early treatment, mainly in non-sustained virological responders, and improved at mo 6 after stopping the treatment, mainly in sustained virological responders.
