Diseases Of Circulatory System Research Articles

Role of AMBRA1 in mitophagy regulation: emerging evidence in aging-related diseases.

Aging is a gradual and irreversible physiological process that significantly increases the risks of developing a variety of pathologies, including neurodegenerative, cardiovascular, metabolic, musculoskeletal, and immune system diseases. Mitochondria are the energy-producing organelles, and their proper functioning is crucial for overall cellular health. Over time, mitochondrial function declines causing an increased release of harmful reactive oxygen species (ROS) and DNA, which leads to oxidative stress, inflammation and cellular damage, common features associated with various age-related pathologies. The impairment of mitophagy, the selective removal of damaged or dysfunctional mitochondria by autophagy, is relevant to the development and progression of age-related diseases. The molecular mechanisms that regulates mitophagy levels in aging remain largely uncharacterized. AMBRA1 is an intrinsically disordered scaffold protein with a unique property of regulating the activity of both proliferation and autophagy core machineries. While the role of AMBRA1 during embryonic development and neoplastic transformation has been extensively investigated, its functions in post-mitotic cells of adult tissues have been limited due to the embryonic lethality caused by AMBRA1 deficiency. Recently, a key role of AMBRA1 in selectively regulating mitophagy in post-mitotic cells has emerged. Here we summarize and discuss these results with the aim of providing a comprehensive view of the mitochondrial roles of AMBRA1, and how defective activity of AMBRA1 has been functionally linked to mitophagy alterations observed in age-related degenerative disorders, including muscular dystrophy/sarcopenia, Parkinson diseases, Alzheimer diseases and age-related macular degeneration.

Mechanisms of Abnormal Lipid Metabolism in the Pathogenesis of Disease

Lipid metabolism is a critical component in preserving homeostasis and health, and lipids are significant chemicals involved in energy metabolism in living things. With the growing interest in lipid metabolism in recent years, an increasing number of studies have demonstrated the close relationship between abnormalities in lipid metabolism and the development of numerous human diseases, including cancer, cardiovascular, neurological, and endocrine system diseases. Thus, understanding how aberrant lipid metabolism contributes to the development of related diseases and how it works offers a theoretical foundation for treating and preventing related human diseases as well as new avenues for the targeted treatment of related diseases. Therefore, we discuss the processes of aberrant lipid metabolism in various human diseases in this review, including diseases of the cardiovascular system, neurodegenerative diseases, endocrine system diseases (such as obesity and type 2 diabetes mellitus), and other diseases including cancer.

Relationship between short-term ozone exposure, cause-specific mortality, and high-risk populations: a nationwide, time-stratified, case-crossover study

BackgroundPrevious studies reported that short-term exposure to ground-level ozone is associated with mortality risk. However, due to the limited monitored areas, existing studies were limited in assessing the nationwide risk and suggesting specific vulnerable populations to the ozone-mortality risk. MethodsWe performed a nationwide time-stratified case-crossover study to evaluate the association between short-term ozone and cause-specific mortality in South Korea (2015– 2019). A machine learning-ensemble prediction model (a test R2>0.96) was used to assess the short-term ozone exposure. Stratification analysis was conducted to examine the high-risk populations, and the excess mortality due to non-compliance with the WHO guideline was also assessed. ResultsFor all-cause mortality (1,343,077 cases), the risk associated with ozone (lag0– 1) was weakly identified (odd ratio: 1.005 with 95% CI: 0.997–1.014), and the risk was prominent in mortality with circulatory system diseases. In addition, based on the point estimates, the ozone-mortality risk was higher in people aged less than 65y, and this pattern was also observed in circulatory system disease deaths and urban areas. ConclusionsThis study provides national estimates of mortality risks associated with short-term ozone. Results showed that the benefits of stricter air quality standards could be greater in vulnerable populations.

Traditional Use, Phytochemistry, Pharmacology, Toxicology and Clinical Applications of Persicae Semen: A Review.

Persicae Semen (Taoren), the seed of mature peaches consumed as both food and medicine, is native to the temperate regions of China, distributed in the provinces of North and East China, and currently cultivated worldwide. The primary components of Persicae Semen include volatile oil, protein, amino acids, amygdalin, and prunasin, all of which have pharmacological properties, such as anti-inflammatory, antioxidant, and immune regulatory effects, and are clinically used in the treatment of gynecological, cardiovascular, cerebrovascular, orthopedic, and digestive system diseases. This review provides a comprehensive perspective on the resource status, ethnopharmacology, phytochemistry, pharmacology, and toxicology, as well as the trend of Persicae Semen patent, global distribution, and clinical applications. This review will help facilitate the development and utilization of Persicae Semen in clinical settings.

Hospitalization among adults with chronic kidney disease: results from the KoreaN cohort study for Outcomes in patients With Chronic Kidney Disease (KNOW-CKD) study.

Chronic kidney disease (CKD) patients are hospitalized for various conditions. Hospitalization increases the readmission rate and mortality rate, seriously deteriorating patients' quality of life. Consequently, it is crucial to analyze the reasons for hospitalization in CKD patients from a broader perspective according to CKD grade. This is a prospective cohort study of CKD patients entitled the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD). A total of 2,238 patients were examined, and the reasons for hospitalization were classified into 16 disease categories. The incidence rate ratio (IRR) according to CKD stage was compared using negative bimodal regression analysis. The all-cause hospitalization incidence was 184.96 per 1,000 person-years. The most common reason for hospitalization was circulatory system disease, followed by infection and digestive system disease. Among hospitalizations for acute kidney injury, endocrine-nutrition-metabolic-related illness, blood-related disease, and diseases of the nervous system and sensory organs, IRR increased as CKD grade advanced. The incidence of ophthalmologic surgery during hospitalization increased according to the CKD stage. The IRR of KNOW-CKD patients was 6.19 (95% confidence interval, 5.92-6.48; p < 0.001) compared with the general population. This in-depth analysis of hospitalizations among CKD patients confirmed that CKD patients were hospitalized for various reasons, such as metabolic, ophthalmic, and hematologic diseases. Early detection and intervention regarding causative diseases of CKD are important to reduce the hospitalization burden and improve patients' quality of life.

Protein Arginine Methyltransferases: Emerging Targets in Cardiovascular and Metabolic Disease.

Cardiovascular diseases (CVDs) and metabolic disorders stand as formidable challenges that significantly impact the clinical outcomes and living quality for afflicted individuals. An intricate comprehension of the underlying mechanisms is paramount for the development of efficacious therapeutic strategies. Protein arginine methyltransferases (PRMTs), a class of enzymes responsible for the precise regulation of protein methylation, have ascended to pivotal roles and emerged as crucial regulators within the intrinsic pathophysiology of these diseases. Herein, we review recent advancements in research elucidating on the multifaceted involvements of PRMTs in cardiovascular system and metabolic diseases, contributing significantly to deepen our understanding of the pathogenesis and progression of these maladies. In addition, this review provides a comprehensive analysis to unveil the distinctive roles of PRMTs across diverse cell types implicated in cardiovascular and metabolic disorders, which holds great potential to reveal novel therapeutic interventions targeting PRMTs, thus presenting promising perspectives to effectively address the substantial global burden imposed by CVDs and metabolic disorders.

The status and influencing factors of COVID-19 vaccination in patients with COPD

In this study, we investigated the status and influencing factors of coronavirus disease 2019 (COVID-19) vaccination in patients with chronic obstructive pulmonary disease (COPD). A questionnaire on COVID-19 vaccination in patients with COPD was developed. The clinical characteristics, COVID-19 vaccination status, other relevant vaccinations, and vaccination status of the patients with COPD were collected anonymously. Logistic regression analysis was used to analyze the factors influencing COVID-19 vaccination in patients with COPD. There were 1898 returned questionnaires, of which 1874 were valid. The proportion of patients who completed the COVID-19 vaccination program was 78.60%. Factors influencing the COVID-19 vaccination rate were: the age of individuals who were 75–85 years old and > 85 years old, acute exacerbation 3–4 times in the previous year, comorbid cardiovascular and endocrine system diseases, failure to take regular medication for COPD, application of non-invasive ventilation machines, believing that their current health condition has deteriorated, believing that the current COVID-19 vaccine is not safe, medical staff not specifying whether they would recommend vaccination against COVID-19, medical staff not recommending the COVID-19 vaccine, and fear of adverse reactions and aggravation of COPD. Patients with COPD had a high COVID-19 vaccination rate in China, whereas patients with pneumonia, influenza, and herpes zoster had a low vaccination rate. Improving the patients’ understanding of the safety and effectiveness of the vaccine and promoting effective communication between medical staff and patients would help increase the vaccination rate of patients with COPD.

A Machine Learning Approach to Evaluating the Impact of Natural Oils on Alzheimer’s Disease Progression

Alzheimer’s Disease is among the major chronic neurodegenerative diseases that affects more than 50 million people worldwide. This disease irreversibly destroys memory, cognition, and the overall daily activities which occur mainly among the elderly. Few drugs are approved for Alzheimer’s Disease management despite its high prevalence. To date, the available drugs in the market cannot reverse the damage of neurons caused by the disease leading to the exacerbation of symptoms and possibly death. Medicinal plants are considered a rich source of chemical constituents and have been contributing to modern drug discovery in many therapeutic areas including cancer, infectious, cardiovascular, neurodegenerative and Central Nervous System (CNS) diseases. Moreover, essential oils that are extracted from plant organs have been reported for a wide array of biological activities, and their roles as antioxidants, antiaging, cytotoxic, anti-inflammatory, antimicrobial, and enzyme inhibitory activities. This article highlights the promising potential of plants’ essential oils in the discovery of novel therapeutic options for Alzheimer’s Disease and halting its progression. In this article, 428 compounds were reported from the essential oils isolated from 21 plants. A comparative study is carried out by employing a variety of machine learning techniques, validation, and evaluation metrics, to predict essential oils’ efficacy against Alzheimer’s Disease progression. Extensive experiments on essential oil data suggest that a prediction accuracy of up to 82% can be achieved given the proper data preprocessing, feature selection, and model configuration steps. This study underscores the potential of integrating machine learning with natural product research to prioritize and expedite the identification of bioactive essential oils that could lead to effective therapeutic interventions for Alzheimer’s Disease. Further exploration and optimization of machine learning techniques could provide a robust platform for drug discovery and development, facilitating faster and more efficient screening of potential treatments.

Morphological Analysis of Nanocapsules Processed based on Deer Antler Extract

The research work is devoted to the acquisition of nanocapsules, which are one of the drug delivery systems, and their morphological analysis. In modern times, the development of new drug delivery systems from natural raw materials in the treatment and prevention of diseases of various origins is considered a priority issue of pharmacy. From this point of view, the preparation and analysis of nanocapsules based on the extract from the studied deer antlers is of great importance. As a result of the morphological analysis of nanocapsules prepared from deer antlers grown in the climatic conditions of Azerbaijan, carrageenan-coated nanocapsules have sizes 118.3-243.6 nm in SEM, 10-248 nm in TEM, and tragacanth-coated nanocapsules have sizes 33.15-224.1 nm in SEM, TEM was determined to be 15-254 nm. During numerous studies, it was determined that nanocapsules prepared with tracagant proved to be more intense and more stable. Researches were carried out in the pharmaceutical technology laboratory of Azerbaijan Medical University and AHTARC (DAYTAM) of Atatürk University of the Republic of Turkey. As a result of the conducted research, it was clear that the use of nanocapsules developed by an effective technological method from deer antlers, which has sufficient raw material reserves in Azerbaijan, is considered appropriate for future treatment of diseases in oncology, infertility, osteoarthritis, cardiovascular, and nervous system.

Hospitalizations and hospital expenses during the COVID-19 pandemic

The study aimed to analyze the epidemiological profile of hospital admissions and hospital expenditures during the COVID-19 pandemic. This is an epidemiological, quantitative and retrospective study, with data collection from DATASUS, by consulting the SIH/SUS of Brazil. In 2020 a total of 10,531,196 and in 2021 a total of 11,479,416 hospitalizations were recorded in Brazil, 13.6% and 9% lower than in 2019. There was a reduction in hospitalizations for pregnancy, childbirth, and puerperium (15.9%), digestive system diseases (25.2%), neoplasms (14.2%), external causes (19.1%), circulatory system diseases (20.9%), and for respiratory system diseases (36.1%). However, they increased for infectious and parasitic diseases, about 79.2%. Although hospitalizations reduced in 2020 (13.6%) and 2021 (5.8%), the average value increased by 19.8% and 50.1% and total costs by 19.8% and 50.1%, respectively. We emphasize the importance of subsidizing policies that strengthen primary care in Brazil and that also encompass programs aimed at improving the social determinants of health, thus reducing the number of hospitalizations and expenditures in Brazil.

Polypharmacy and high-alert medications in patients with nasally placed feeding tube on admission and at hospital discharge: Multicenter cross-sectional study

BackgroundPolypharmacy and the use of high-alert medications in patients with nasally placed feeding tube (NPFT) increase the risks of drug related problems. ObjectiveCharacterize drugs prescribed to patients with NPFT and compare the rates of polypharmacy and high-alert medication use at admission and hospital discharge. Design and settingMulticenter cross-sectional study with 327 participants. MethodsData of patients with NPFT were obtained from the medical records and recorded in an electronic data collection tool. Mean number of drugs, polypharmacy and number of high-alert medications prescribed on admission and at discharge were compared using Wilcoxon or McNemar's tests. Generalized Estimating Equations analyzed the relationship between polypharmacy and high-alert medications according to age and time point. Primary reason for hospital admission, level of consciousness, severity of comorbid diseases and patient care complexity were also assessed. ResultsMost patients were male, older people, hospitalized for circulatory system diseases and had at least one comorbidity. On admission, a significant number of patients were alert (59.9%), at high risk for death (43.1%) and high dependent on nursing care (35.4%). Additionally, 92% patients were on polypharmacy on admission, versus 84.7% at hospital discharge (p = 0,0011). The occurrence of polypharmacy was independent of age (p = 0.2377). >17% of all drugs prescribed were high-alert medications, with no statistically significant difference between admission and discharge (p = 0,3957). There was no statistical evidence that the use of high-alert medications increases with age (n = 0,5426). ConclusionsThese results support the planning of multidisciplinary qualified actions for patients using NPFT.

Outcomes Addressed by Longitudinal Whole-Body Electromyostimulation and Belt Electrode-Skeletal Muscle Electrical Stimulation Trials in Middle Aged-Older Adults - an Evidence Map

Introduction: Due to its time-effective, joint friendly and highly customizable character whole-body-electromyostimulation (WB-EMS) is regarded as a feasible solution for a large variety of training issues. Not least for this reason WB-EMS research has increased considerably during the last few years. To identify gaps in research and summarize prevalent evidence we conducted an evidence map on outcomes addressed by WB-EMS trials in middle-aged to older, non-athletic adults so as to align future research more efficiently. Methods: Based on a comprehensive systematic search in five databases and two study registers according to PRISMA, 54 projects published in 80 articles were ultimately identified as meeting our eligibility criteria. Results: More than 90% of the studies reported outcomes related to the physical fitness or function domain. Body composition parameters were addressed by two thirds of the projects, however only 14 studies considered body composition as the primary outcome. Health-related outcomes addressed by WB-EMS trials as primary (or secondary/subordinate) outcomes included cancer/neoplasm (n=3, (n=4)), endocrine regulation (n=2, (n=6)), glucose metabolism (n=6, (n=9)), nervous system diseases (n=2), cardiovascular system diseases (n=6, (16)), non-specific chronic low back pain (n=4), osteopenia (n=2, (n=3)) and diseases of the renal system (n=1, (n=11)). Outcomes related to inflammation were addressed three times as a primary and 15 times as a secondary/subordinate outcome. Of importance, no studies reported clinically relevant adverse effects related to the WB-EMS intervention. Conclusion: In summary, while considerable evidence on outcomes related to fitness/function and body composition is prevalent, evidence gaps of WB-EMS research were particular evident for diseases of the nervous and cerebrovascular system.

Evaluation of medicinal and nutritional effectiveness of abelmoschus esculentus L

Plants that have been used under the name of traditional treatment for many years have been supported by recent studies. We use plant species as bioactive phytochemicals in many areas of our lives. In addition to being used in cosmetics, food, medical, and industrial applications, it is a potential product for preventing diseases with the compounds found in its structures. Okra (Abelmoschus esculentus L.) with its bioavailability and phytochemical compounds has an important place among such plants. Okra is a vegetable plant that grows in tropical and subtropical environments and belongs to the family Malvaceae. Okra, which is thought to be of African origin, is an edematous plant, especially for Pakistan and India. Okra has various uses with its seed, flower, leaf, bark, and stem parts. It is mostly used as a fresh and green soft vegetable. The edible parts are rich in carbohydrates, protein, fatty acids, fiber, vitamins, and minerals. Due to these compositions, it plays a vital role in human nutrition. Okra seeds are a potential source of oil with concentrations between 20% and 40% decoctions, containing up to 47.4% linoleic acid. Its seeds are rich in linoleic acid. It is also known to be rich in high-quality protein in terms of essential amino acid content. The soft and edible parts become mucilaginous after cooking. Carbohydrates are usually found in the form of mucilage. In recent years, more attention has been paid to the use of metabolites found and obtained in some parts of plants, such as seeds, leaves, and bark, in medical fields and their effects on human health. The different parts of the okra plant (mucilage, seeds, and pods) contain some important bioactive components that give it its medicinal properties. These bioactive components of okra have been studied for their potential effects on various chronic diseases such as type 2 diabetes, cancer, and cardiovascular and digestive system diseases, as well as their anti-fatigue, liver detoxification, and antibacterial activities under the influence of polyphenols, which allow it to have antioxidant properties in its content. In general, okra is recognized as an important food product with various nutritional values and potential health benefits, easy to procure, and low cost.

Based on the Advantages of Acupuncture and Moxibustion Therapy, the Multiple Exploration of the Correlation between the Meridians and the Circulatory System of the Nervous System

The meridians, nervous system, and circulatory system are important components of traditional Chinese medicine and modern medicine. The meridians have a high degree of consistency with the distribution of the nervous and circulatory systems in modern medicine, and are closely related in the process of disease treatment. Therefore, people often confuse the three. Based on the great advantages of acupuncture and moxibustion in the treatment of nervous system and circulatory system diseases, the author has made diversified exploration on its rele⁃ vance in terms of origin, physiological anatomy, physiological function and clinical application. It is believed that meridians have their relative independence, and the nervous and circulatory systems cannot completely replace meridians. However, meridians are closely related to the nervous and circulatory systems, and in clinical practice, meridians can be combined with the nervous and circulatory systems to guide the treatment of diseases.

АНАЛИЗ ВЛИЯНИЯ ОБЛУЧЕНИЯ НА МУЛЬТИМОРБИДНОСТЬ УЧАСТНИКОВ ЛИКВИДАЦИИ ПОСЛЕДСТВИЙ АВАРИИ НА ЧЕРНОБЫЛЬСКОЙ АЭС

Purpose: To give a general idea of the most common combinations of diseases in the male population of the Russian Federation and to identify the combinations of diseases, the development of which could be influenced by ionising radiation. Material and methods: Cohort study of the influence of external gamma irradiation on multimorbidity of the Chernobyl accident liquidation participants according to the data of the National Radiation Epidemiological Registry. Multimorbidity was defined as the presence in one participant of the cohort of two or more diseases from the list consisting of ten groups of diagnoses: diseases of lower respiratory tract, diseases of musculoskeletal system, diseases of endocrine system, mental disorders, oncology, neurology, diseases of digestive organs, diseases of cardiovascular system, diseases of genitourinary system, diseases of sense organs. The cohort consisted of men born between 1919 and 1969 who worked in the accident zone from 1986 to 1987 and had a documented whole-body external gamma dose. Cohort follow-up period: 1992–2021. The cohort size at the beginning of the follow-up was 59 290 people. The study participants were divided into two groups according to external gamma dose: up to 150 mGy – 34602 individuals, 150 mGy and more – 24 688 individuals. For all possible combinations of diagnoses, relative radiation risk was calculated as a measure of the association of exposure with diseases. The relative radiation risk was considered statistically significant if the left border of the one-sided 95 % confidence interval was greater than 1. Statistical analyses were performed using the R programming language for statistical computing and the R arules package. Results: During 30 years of follow-up, multimorbidity was noted in 62 % of individuals. The most common combinations of chronic diseases were combinations of cardiovascular diseases with digestive diseases (23 % of the original cohort), with lower respiratory diseases (22 %) and with musculoskeletal diseases (18 %). A combination of all four diagnosis groups was identified in 5 % of individuals. Nineteen multimorbid combinations with statistically significant relative radiation risk in the range (1.07–1.23) were identified. Conclusions: No effect of radiation exposure on the number of individuals with multimorbidity was found, but in the studied cohort there are individuals with cardiovascular diseases, endocrine diseases, oncology and combinations of these groups of diagnoses with diseases of other body systems may be caused by radiation exposure. The statistically significant relative radiation risk for combinations of diagnoses is, in general, greater than for the individual diseases that make up these combinations.

ОЦЕНКА РАДИАЦИОННОГО РИСКА СМЕРТИ ОТ СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЙ ЛИКВИДАТОРОВ ПОСЛЕДСТВИЙ АВАРИИ НА ЧАЭС – РАБОТНИКОВ ПРЕДПРИЯТИЙ АТОМНОЙ ПРОМЫШЛЕННОСТИ ПО ДАННЫМ О ДОЗАХ РАЗЛИЧНЫХ ВИДОВ ОБЛУЧЕНИЯ

Background: Assessment of the risk of death from circulatory system diseases due to radiation exposure in liquidators of the Chernobyl accident consequences (hereinafter referred to as liquidators) using data on doses of various types of exposure. Material and methods: The work used the information base of the Industry Register of persons exposed to radiation as a result of the accident at the Chernobyl nuclear power plant (hereinafter referred to as the register), nuclear industry workers. The radiation risk assessment study included men - 12,706 liquidators who had data on external emergency radiation doses when working in the 30 km Chernobyl NPP zone, 1,327 of them had data on occupational radiation doses. Poisson regression was chosen as the statistical model of risk. The study covers the period from 1987 to 2021. During the observation period, the register accumulated 304,023 person/years. The majority of the register in 1986 was made up of men – 84.7 %, women – 15.3 %. Results: When data on doses of different types of radiation are used to calculate doses, different results of excess relative risk are obtained. Only the total radiation dose (occupational, emergency, medical, natural) can provide correct results for calculating the radiation risk of death from radiation-induced diseases. Conclusion: The prospect of research should be considered to be filling the information base of the Industry Register with data on doses of all types of radiation.

Gas6-Axl signal promotes indoor VOCs exposure-induced pulmonary fibrosis via pulmonary microvascular endothelial cells–fibroblasts cross-talk

Volatile organic compounds (VOCs) as environmental pollutants were associated with respiratory diseases. Pulmonary fibrosis (PF) was characterized by an increase of extracellular matrix, leading to deterioration of lung function. The adverse effects on lung and the potential mechanism underlying VOCs induced PF had not been elucidated clearly. In this study, the indoor VOCs exposure mouse model along with an ex vivo biosensor assay was established. Based on scRNA-seq analysis, the adverse effects on lung and potential molecular mechanism were studied. Herein, the results showed that VOCs exposure from indoor decoration contributed to decreased lung function and facilitated pulmonary fibrosis in mice. Then, the whole lung cell atlas after VOCs exposure and the heterogeneity of fibroblasts were revealed. We explored the molecular interactions among various pulmonary cells, suggesting that endothelial cells contributed to fibroblasts activation in response to VOCs exposure. Mechanistically, pulmonary microvascular endothelial cells (MPVECs) secreted Gas6 after VOCs-induced PANoptosis phenotype, bound to the Axl in fibroblasts, and then activated fibroblasts. Moreover, Atf3 as the key gene negatively regulated PANoptosis phenotype to ameliorate fibrosis induced by VOCs exposure. These novel findings provided a new perspective about MPVECs could serve as the initiating factor of PF induced by VOCs exposure.

Knowledge-guided generative artificial intelligence for automated taxonomy learning from drug labels.

To automatically construct a drug indication taxonomy from drug labels using generative Artificial Intelligence (AI) represented by the Large Language Model (LLM) GPT-4 and real-world evidence (RWE). We extracted indication terms from 46421 free-text drug labels using GPT-4, iteratively and recursively generated indication concepts and inferred indication concept-to-concept and concept-to-term subsumption relations by integrating GPT-4 with RWE, and created a drug indication taxonomy. Quantitative and qualitative evaluations involving domain experts were performed for cardiovascular (CVD), Endocrine, and Genitourinary system diseases. 2909 drug indication terms were extracted and assigned into 24 high-level indication categories (ie, initially generated concepts), each of which was expanded into a sub-taxonomy. For example, the CVD sub-taxonomy contains 242 concepts, spanning a depth of 11, with 170 being leaf nodes. It collectively covers a total of 234 indication terms associated with 189 distinct drugs. The accuracies of GPT-4 on determining the drug indication hierarchy exceeded 0.7 with "good to very good" inter-rater reliability. However, the accuracies of the concept-to-term subsumption relation checking varied greatly, with "fair to moderate" reliability. We successfully used generative AI and RWE to create a taxonomy, with drug indications adequately consistent with domain expert expectations. We show that LLMs are good at deriving their own concept hierarchies but still fall short in determining the subsumption relations between concepts and terms in unregulated language from free-text drug labels, which is the same hard task for human experts.

Medical reasons for permanent and temporary disqualification of Turkish civil aviation pilots

The aim of this study was to identify diseases that result in permanent and temporary medical disqualification for civil aviation pilots and their changes over the years. A retrospective analysis was conducted on the medical examination records performed in Turkey from 2018 to 2022, in accordance with ICAO and EASA standards. The permanent disqualification rate was 1.3%, and the temporary disqualification rate was 6.6%. The most common reasons for permanent disqualification among pilots were circulatory system diseases (24%), mental and behavioral disorders (22.9%), and nervous system diseases (11.5%). The most common reasons for temporary disqualification among pilots were circulatory system diseases (17.9%), digestive system diseases (11.8%), and health problems related to COVID-19 infection (9.5%). The data obtained from this study may be useful in developing preventive medicine approaches to prevent medical disqualifications and in-flight medical incapacitation.

Prevalence of signs of professional burnout among medical workers involved in providing medical care for circulatory system diseases

BACKGROUND: Among 13 thousand doctors interviewed in 2021, 42% displayed signs of professional burnout. This phenomenon negatively affects the frequency of repeated hospitalizations, the number of adverse events, and increased employee turnover. However, studies concerning burnout in doctors are rare and do not focus on specialists who provide medical care for patients with circulatory system diseases (CSD). AIM: was to assess the level of burnout in medical workers involved in the provision of medical care for patients with CSD and to explore staff perceptions of its prevention. MATERIALS AND METHODS: A sociological survey (based on the standardized Maslach Burnout Inventory questionnaire) was conducted among medical personnel (women represented the majority of the sample — 76%, men — 24%). The sample is represented by doctors (n=89), nursing staff and auxillary nurses (NSAN) (n=128). The mean age for the whole group of respondents was 40.7±0.7, professional experience lasted 12.0±0.6 years. Standard methods of descriptive statistics were used for the data analysis. The age characteristics of the group had no significant differences by professional categories. Doctors had 39.0±1.2 years (min — 24, max — 63), NSAN had 41.0±0.6 years (min — 19, max — 67). Professional experience lasted differed doctors 39.0±1.2 years, in NSAN — 12.3±0.8. Men were characterized by a mean age of 36.7±1.6 years and professional experience lasted 10.0±1.2 years and women 42.0±0.7 years and 12.6±0.7 years, respectively. The character of distribution of quantitative data in the presented study was analyzed using the Kolmogorov–Smirnov and Shapiro–Wilk criterion. RESULTS: 80.2% of respondents presented with a high level of reduced professional accomplishments (RPA), 53.4% — a moderate average level of depersonalization. The emotional exhaustion was similar in all respondents, although average level of emotional exhaustion was the most prevalent (39.6%). 43.8% of doctors had an average level of emotional exhaustion, which is higher compared with NSAN — 37.5%. Clinical and paraclinical units are associated with a medium level of emotional exhaustion and a high RPA. At the same time, paraclinical units are characterized by a medium level of depersonalization, in contrast to clinical units, which are found to have a high level of this factor. According to the respondents, possible measures to prevent emotional burnout should include a set of measures including, rational distribution of responsibilities within departments, workload among the staff, as well as the formation of special skills to overcome stressful situations and optimization of activities with the help of digital solutions (support system for medical decisions, etc.). CONCLUSION: Working as medical staff and providing medical care for patients with CSD is strongly associated with a high level of reduced professional accomplishments (80.2% of respondents). Proper measures for the prevention of emotional burnout should primarily include organizational solutions focused on optimizing internal processes in medical staff’ work. According to the respondents, among the measures aimed at the prevention of emotional burnout, the most demanded may be: rational distribution of responsibilities within departments, workload among staff, as well as the formation of special skills to overcome stressful situations and optimization of activities with the help of digital solutions (medical decision support system, etc.).