Health Care Issues Research Articles

Chronopharmacology: Optimizing drug therapy through biological rhythms

Digital therapeutics are evidence-based therapeutic interventions that utilize digital technologies to prevent, manage, or treat medical disorders. These interventions utilize digital technologies such as mobile applications or online platforms to deliver evidence-based therapeutic interventions and treatments for various health conditions. Digital therapeutics undergo rigorous clinical validation and regulatory processes to ensure their safety and efficacy. Digital therapeutics offer several benefits in health care, including improved accessibility, personalized treatment, cost-effectiveness, continuous monitoring and feedback, enhanced patient engagement, scalability, and support for various health conditions. They have practical applications in areas such as psychiatry, drug development, substance abuse treatment, chronic insomnia, Parkinson’s disease, cardiac rehabilitation, and oncology care. Digital therapeutics can significantly improve the quality of life for individuals across different populations by providing tailored interventions for mental health disorders and addressing health conditions related to different age groups. However, challenges to the widespread adoption of digital therapeutics include resistance to change within health-care systems, interoperability issues, privacy concerns, and limited reimbursement policies. Collaboration among health-care providers, regulators, technology developers, and patients is necessary to address these challenges and ensure the safety and effectiveness of digital therapeutics.

Evaluating Practices, Overcoming Pitfalls, and Integrating Artificial Intelligence for Enhanced Quality in Advancing Ambulatory Care

BACKGROUND: For delivering health-care services in addressing preventive care, medical requirements of nonemergency, and the management of chronic diseases, ambulatory care is characterized outside of the hospital setting. The interest in artificial intelligence (AI) integration into ambulatory care settings has increased with the rise of technological advancements. However, by prompting the requirements for systemic assessment across different health-care systems, the AI implementation in ambulatory care is varied. OBJECTIVE: The aim of conducting this study is to investigate the current status of AI in the services of ambulatory care across five Asian countries such as Myanmar, Malaysia, China, Indonesia, and the Philippines. The implications for health-care delivery are discussed and the common challenges are identified during this study. MATERIALS AND METHODS: The descriptive research strategy was employed during this study, and within ambulatory care, the surveys targeting administrators, nurses, and doctors were utilized. For assessing the impact of AI implementation, statistical analysis including quantitative techniques and Likert scale ratings was conducted. The sample size can be validated and the respondents can be selected using the pilot study and purposive sampling. RESULTS: The significant variations in treatment protocols and health-care delivery models across surveyed countries were revealed by the obtained findings. The compromised health-care quality and accessibility issues were identified as a few of the challenges in ambulatory care services that are identified during the findings. For enhancing patient engagement, data management, and decision support, the AI integration into electronic health records was evaluated. DISCUSSION: For enhancing patient outcomes and health-care delivery, the understanding of variation significance in ambulatory care practices is emphasized by the respondents. As an essential aspect of different countries, collaboration among health-care professionals is highlighted. The challenges in ambulatory care services are addressed by system-level interventions. The implications of AI integration are discussed during this study along with its roles in enhancing cost reduction in ambulatory care settings. CONCLUSION: The significance of AI integration in enhancing patient outcomes across diverse health-care systems is underscored. The collaboration among stakeholders is fostered and the complex challenges are addressed by the successful implementation of AI.

Learning and Optimization of Patient–Physician Matching Index in Specialty Care

It is challenging for a patient without medical knowledge to select a ‘capable’ physician based on nontransparent medical information. The situation becomes pervasive in specialty care. Motivated by this existing patient-physician matching problem, we propose a novel physician matching index (PMI) obtained by an analytical framework integrated with an improved multi-disease pre-diagnosing Bayesian network (BN) model. The pre-diagnosis BN structure learning is critical since it provides the causal map among diseases and symptoms, but it has been proved to be NP-hard. To improve the computational tractability of the BN structure learning, we propose a dynamic programming based cache calculation algorithm integrated with expert knowledge. The optimal BN structure is obtained through an improved branch-and-bound algorithm. Given patients’ symptoms and physicians’ specialty information, we apply the trained pre-diagnosis BN model to obtain PMI, which can be extended to the weighted matching index by considering patient preferences. A case study of the patient-physician matching problem in the ear, nose, and throat (ENT) department is conducted. The branch-and-bound algorithm with the proposed cache calculation algorithm learns the optimal BN structure with high pre-diagnosing accuracy and time efficiency. We disclose that the proposed PMI can rectify the misdiagnosis since the highly related diseases usually belong to one specialty. Moreover, we demonstrate the significance of the consistency between the physicians’ specialty and the patients’ disease distribution. We also highlight that the proposed PMI guides the patients in choosing physicians more appropriately under independent patient preferences. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Note to Practitioners</i> —This research is motivated by a potential healthcare quality issue caused by the mismatch between patient and physician in specialty care, which is critical for both referral and non-referral systems. We propose a novel physician matching index (PMI) according to patients’ symptoms and physicians’ specialties based on potential disease(s) pre-diagnosed by a Bayesian network model. In the case study of the ear, nose, and throat (ENT) department, we show that PMI can rectify a large portion of misdiagnosed cases. Under the consideration of independent patient preferences, we also find that PMI improves the matching performance. To improve the systematic matching outcome, we suggest that physicians’ specialty cross-training programs be consistent with the patient’s disease distribution. However, we assume that patients’ symptoms are known and physicians’ specialties are clearly described, which might need to be further investigated. The framework proposed in this research can be extended to other specialty care departments, e.g., neurology and orthopedics.

Syndemic Challenges: Addressing the Resurgence of Mpox Amidst Concurrent Outbreaks in the DRC

The Democratic Republic of Congo (DRC) faces a syndemic of infectious diseases, including monkeypox (mpox), cholera, measles, anthrax, and plague, worsening public health challenges and socioeconomic disparities. This review synthesizes and discusses epidemiological data and consequences of simultaneous outbreaks in the DRC between January 2023 and March 2024. The findings highlight a 6.7% fatality rate and 3319 confirmed cases of mpox, with significant outbreaks in Kinshasa and 22 other provinces. Anthrax occasionally surfaced among cattle‐raising villages, measles affected fewer than five children susceptible to the disease, and cholera outbreaks persisted in North Kivu, South Kivu, and Tanganyika. Plague incidences, mostly bubonic, have been reported in Ituri province. Vulnerable groups, including children, mothers, the elderly, and those with compromised immune systems, face increased risks due to poor healthcare access, hunger, and underlying medical conditions. Cultural beliefs, healthcare system issues, and socioeconomic instability impede effective response tactics. This strain on the fragile healthcare system highlights the need for increased surveillance, immunization efforts, and community involvement. To mitigate the effects of syndemic outbreaks, strengthening the DRC’s health systems through international cooperation, integrated public health initiatives, and improved access to healthcare is crucial.

A Systematic Review on Cybersecurity Threats and Challenges in Hospitals

The inception of cybercrime can be traced back to the late 1970s, a period that coincided with the early development of the computer information technology (IT) sector. Due to its system vulnerabilities, healthcare has become particularly vulnerable to digital assaults. Hardware, software, networks, operating systems, medical devices, processes, and users make this sector vulnerable. This report identifies healthcare cybersecurity issues and solutions and opportunities for improvement in response to rising threats. This review’s methodology was organised so that it complies to PRISMA criteria. A thorough search was undertaken in Web of Science, Scopus, Google Scholar, Saudi Digital Library, ACM Digital Library, PMC, and NCBI/PubMed. The search strategy included threats, ransomware, cybercrime, healthcare, and hospitals. The above overview of “cybersecurity” includes technological and organisational measures. Healthcare organisations cybersecurity defence concerns were the focus of the research questions. The search technique targeted relevant literature from bibliographic databases to answer these research concerns. A total of 352 potential entries were obtained from the search in the chosen databases. Of these, 13 were manually picked following preliminary assessment. The study examined these studies, which fit its focus on “cybersecurity, dangers, and challenges,” in detail. Data confidentiality, integrity, and availability are the foundation of information security. The study examined cyberthreats and their cascade effects. The growing usage of varied technologies for sensitive patient data transfer makes it difficult for healthcare organisations to stay up with the newest cybersecurity breaches and threats. A cohesive and integrated strategy involving training programmes, awareness campaigns, and cyberattack information sharing is advocated to protect healthcare organisations from cyberattacks. To protect our infrastructure and provide excellent patient care, all healthcare workers must recognise and accept their role in cybersecurity risk management.

The Effect of Foreign Aid on Health Outcomes in Nigeria: A Case Study of Lagos State Teaching Hospital

The paper examined the effect of foreign aid on health outcomes in the Lagos State Teaching Hospital in Nigeria. The purpose of the study was to uncover the actual effect of foreign aid inflows on health outcomes in Nigeria. The paper employed a quantitative research methodology which explored secondary resources from WHO publications, journals and thesis on foreign aids and their contribution to health outcomes in developing countries especially Nigeria, and other official reports, and statistical bulletins. Qualitative methodology was also applied in this research. A semi-structured questionnaire was administered within the Lagos State Teaching Hospital, with a sample population of 50 healthcare personnel. The qualitative methodology was adopted to give a holistic view of the research study based on the concepts of the literature review, and to fully understand the situation of the topic under study in the country. One of the situation which the paper found out, is that Nigeria have received substantial amount of foreign aid and yet these amount of foreign aid is still considered to be low given the huge healthcare issues in Nigeria. The paper also revealed that, the foreign aid received through the Government in the country have been largely ineffective in addressing the health issues of Nigeria. This could be as a result of the lack of balance between the health challenges in Nigeria and the rate at which these aids are used to fund it. Lack of appropriate policies on disbursement rate of foreign aids to various health cases such as tuberculosis, malaria, HIV/AIDS, and others, could be the case for the perception of how low foreign aids are to the issues of healthcare. This is, without the articulation of the corruption laced on handling of foreign aids in Nigeria. The paper finally revealed foreign aid has a positive impact on the Nigeria health outcomes especially in the area of maternal health, but grossly ineffective in other areas. The study recommended that, the Nigeria government should ensure that foreign aid meant for the health sector is not diverted to other sectors and that; foreign aid dedicated to the health sector should be used judiciously

Prosthodontic Research in the Digital Era: Current Trends and Future Prospects

Prosthodontic Research in the Digital Era: Current Trends and Future Prospects

Underuse of SGLT2 inhibitors in clinical practice

SGLT2 inhibitors (gliflozins) have proven their efficacy in reducing complications due to atherosclerotic cardiovascular disease, heart failure and chronic kidney disease both in placebo-controlled clinical trials and in real-life studies versus other glucose-lowering agents (except GLP-1 analogues) in patients with type 2 diabetes. Hence, observational studies demonstrate that they are poorly used in -clinical practice, including in patients at high cardiorenal risk. -Reasons are multiple and involve physicians, patients and health care system with restricted criteria for prescription and reimbursement in many countries. Bridging the gap between scientific proves from evidence-based medicine and clinical practice represents a major health-care issue.

The impact of glucagon and exenatide on oxidative stress levels and antioxidative enzyme expression in in vitro induced steatosis in HepG2 cell culture.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a healthcare issue of growing concern. Its development is multifactorial, and it is more commonly seen in obese patients. In those circumstances, intracellular lipid overload ensues, resulting in oxidative stress that might be responsible for progression toward steatohepatitis. Novel therapeutic approaches that are effective in weight management are expected to improve the course of MASLD. One of the potential mechanisms involved in such protective properties may relate to the reduction in oxidative stress. The induction of steatosis and the assessment of oxidative stress level and expression of antioxidant enzymes (superoxide dismutase - SOD, glutathione peroxidase - GPx and catalase - Cat) in HepG2 hepatoma cell line subjected to glucagon and exenatide treatment. Exenatide monotherapy successfully reduced lipid accumulation by 25%. Significant reductions in markers of oxidative stress (reactive oxygen species and malondialdehyde) were obtained in cells subjected to combined treatment with glucagon and exenatide (by 24 and 21%, respectively). Reduced burden of oxidative stress was associated with elevated expression of SOD and GPx but not Cat. Combined activation of glucagon-like peptide-1 (GLP-1) and glucagon receptors reduces oxidative stress in HepG2 steatotic cell cultures. This observation may stem from increased antioxidative potential.

Analysis of Healthcare Services in 2019 Arbaeen March: A Qualitative Study

Background: The Arbaeen march ritual stands as one of the largest congregations, attended by tens of millions every year. Given the large number of participants in this ritual, it is essential to minimize the health repercussions for pilgrims and ensure their prompt access to medical care. The present study was conducted to analyze the healthcare services during the 2019 Arbaeen march. Materials and Methods: Employing a qualitative approach, this study utilized various data collection methods, including in-depth and semi-structured interviews, field observations, and document review. The target population comprised healthcare decision-makers, managers, and providers of the 2019 Arbaeen march. The interview and data collection guide were developed in accordance with the World Health Organization (WHO) guidelines. Data collection continued until data saturation. Directed content analysis was employed to analyze the data. Results: Data saturation was achieved after conducting 30 personal interviews. Out of the challenges and significant factors found in healthcare deliveries during the Imam Hussein (AS) Arbaeen march, 9 main themes and categories were identified: Trauma system, disease surveillance system, health issues, health education and promotion, healthcare coordination and collaboration command in the health system, information and communication management, response planning, support and resource management, and safety and security. Conclusion: This study identified the major healthcare issues in the AS Arbaeen march, serving as an evidence-based guide for policymakers and planners of this famous religious ritual. The results of this study are applicable to similar public gatherings and marches.

Association between multimorbidity and utilization of medical and long-term care among older adults in a rural mountainous area in Japan.

With the accelerated population aging, multimorbidity has become an important healthcare issue. However, few studies have examined multimorbidity and its impact on the use of medical and long-term care services in Japan. Therefore, this study aimed to examine the association between multimorbidity and the use of medical and long-term care services among older adults living in the depopulated mountainous areas of Japan. A cross-sectional study was conducted using insurance claims data from late-stage medical insurance and long-term care insurance (April 2017 to March 2018) for older adults ≥75 years residing in a mountainous area in the Tottori prefecture. In addition to the descriptive analysis, multiple generalized linear regressions with family gamma and log-link functions were used to examine the association between the number of morbidities and total annual medical and long-term care expenditures. A total of 970 participants ≥75 years were included in the analysis. Participants who had two or more morbidities constituted 86.5% of the total sample. Furthermore, participants with mental disorders were found to have more comorbidities. The number of comorbidities is associated with higher medical and long-term care expenditures. Multimorbidity was dominant among late-stage older adults living in depopulated mountainous areas of Japan, and the number of morbidities was associated with higher economic costs of medical and long-term care services. Mitigating the impact of multimorbidity among older adults in depopulated regions of Japan is an urgent challenge. Future research should investigate the degree and effectiveness of social protections for vulnerable older adults living in remote areas.

Лучевые методы диагностики заболеваний молочной железы

Abstract. Breast cancer is one of the most common and urgent healthcare issues. For primary diagnosis and clarification of the diagnosis of breast cancer specialists use most often such methods of breast examination as examination and palpation, computed tomography, magnetic resonance imaging, ultrasound, radionuclide examination of the mammary glands. Radiologists and mammalogists-oncologists face an important task of early detection of various forms of breast cancer, which enables to improve significantly the disease prognosis, as this is a priority. To solve the issue the world community is developing and putting into practice new methods of mammary gland research, the X-ray method of investigation has a leading position. In addition to breast cancer, the attention of the diagnostician should also be directed to benign breast dysplasia due to its correlation with the risk of developing breast cancer. The severity of dysplasia determines the risk of developing cancer. The practical application of methods of early diagnosis of benign and malignant breast diseases, increased funding of medical institutions to raise the technical level, and retraining of personnel can significantly reduce the incidence and increase the frequency of breast cancer detection in the early stages of its development.

A Brief Review of Anatomy Education in Korea, Encompassing Its Past, Present, and Future Direction.

Anatomy is a foundational subject in medicine and serves as its language. Hippocrates highlighted its importance, while Herophilus pioneered human dissection, earning him the title of the founder of anatomy. Vesalius later established modern anatomy, which has since evolved historically. In Korea, formal anatomy education for medical training began with the introduction of Western medicine during the late Joseon Dynasty. Before and after the Japanese occupation, anatomy education was conducted in the German style, and after liberation, it was maintained and developed by a small number of domestic anatomists. Medicine in Korea has grown alongside the country's rapid economic and social development. Today, 40 medical colleges produce world-class doctors to provide the best medical care service in the country. However, the societal demand for more doctors is growing in order to proactively address to challenges such as public healthcare issues, essential healthcare provision, regional medical service disparities, and an aging population. This study examines the history, current state, and challenges of anatomy education in Korea, emphasizing the availability of medical educators, support staff, and cadavers for gross anatomy instruction. While variations exist between Seoul and provincial medical colleges, each manages to deliver adequate education under challenging conditions. However, the rapid increase in medical student enrollment threatens to strain existing anatomy education resources, potentially compromising educational quality. To address these concerns, we propose strategies for training qualified gross anatomy educators, ensuring a sustainable cadaver supply, and enhancing infrastructure.

Assisted Reproduction for a Same-Sex Couple: Interdisciplinary Preclinical Active Learning Module Combining Case-Based Small Group Discussion and Patient Panel.

Physicians often feel they are not equipped to serve the lesbian, gay, bisexual, and queer (LGBTQ) community, but integrating education that incorporates LGBTQ content and perspective into an already-condensed medical school curriculum is challenging. We developed a preclinical active learning module on assisted reproductive technologies (ART) in LGBTQ care, integrating clinical and basic science content with patient perspective. We created a module that combined a case-based small group discussion with a patient panel. We developed a case for discussion in collaboration with a female cis-gender same-sex couple who conceived through ART. A patient panel with the same couple followed the discussion. All first-year medical students attended both parts of the module. Prior to participation, students learned reproductive endocrinology and genetics concepts through lectures. After the module, students voluntarily completed an anonymous survey to evaluate self-perceived changes in familiarity and confidence with LGBTQ patients and satisfaction with the module. Of the 126 students who attended, 72 (57%) completed the survey. Of these, 69 (95.8%) felt the module gave them better perspectives on LGBTQ patient experiences, and 66 to 69 (92-96%) agreed the small group discussion achieved its learning objectives on LGBTQ health barriers and the application of ART. Students valued the patient panel (84.7%) and cited a better understanding of reproductive barriers for LGBTQ patients as its most valuable point. A preclerkship module combining a case-based small group discussion and patient panel on ART delivered in the context of a real-life LGBTQ patient experience provided an opportunity for the students to integrate basic science and clinical science knowledge to reflect on the healthcare needs of this patient population. Creating the case in collaboration with the same-sex couple and having them present their own experience provided an authentic perspective to students on reproductive healthcare issues and how they impact members of the LGBTQ community.

The impact of Internet use and involvement on residents' attitudes to healthcare in China: A propensity score matching analysis.

The recent surge in Internet growth has significantly altered how residents obtain health information and services, underscoring the need to investigate its impact on healthcare perceptions. However, current studies often fail to distinguish between Internet use and involvement, as well as the diverse range of healthcare stakeholders, resulting in incomplete and inconsistent understanding. To address this, this study utilized data from the 2018 China Family Panel Study (CFPS 2018), categorizing attitudes toward healthcare into three dimensions: doctor trust, satisfaction with medical institutions, and perception of systemic healthcare issues. Employing propensity score matching (PSM) to control for thirteen confounding variables, this study examined the Internet's impact on public attitudes toward healthcare among similar demographic, psychological, and health-related variables. Results revealed that both Internet use and involvement affect residents' attitudes toward healthcare to some extent, with involvement having a more pronounced effect. While Internet use increased the perception of systemic healthcare issues, Internet involvement enhanced doctor trust, yet reduced satisfaction with medical institutions and exaggerated the perception of systemic healthcare issues. These findings have significant theoretical and practical implications. They enhance the comprehension of diverse levels and purposes of Internet use, thereby advancing our knowledge of its multi-faced influence on public attitudes toward healthcare. Furthermore, they offer insights for medical institutions to improve service quality, assist Internet media in optimizing information delivery, and illuminate the implications for residents who effectively use the Internet to assess health information.

Through the big top: An exploratory study of circus-based artistic knowledge translation in rural healthcare services, Québec, Canada.

The conventional methods and strategies used for knowledge translation (KT) in academic research often fall short in effectively reaching stakeholders, such as citizens, practitioners, and decision makers, especially concerning complex healthcare issues. In response, a growing number of scholars have been embracing arts-based knowledge translation (ABKT) to target a more diverse audience with varying backgrounds and expectations. Despite the increased interest, utilization, and literature on arts-based knowledge translation over the past three decades, no studies have directly compared traditional knowledge translation with arts-based knowledge translation methods. Thus, our study aimed to evaluate and compare the impact of an arts-based knowledge translation intervention-a circus show-with two traditional knowledge translation interventions (webinar and research report) in terms of awareness, accessibility, engagement, advocacy/policy influence, and enjoyment. To conduct this exploratory convergent mixed method study, we randomly assigned 162 participants to one of the three interventions. All three knowledge translation methods were used to translate the same research project: "Rural Emergency 360: Mobilization of decision-makers, healthcare professionals, patients, and citizens to improve healthcare and services in Quebec's rural emergency departments (UR360)." The findings revealed that the circus show outperformed the webinar and research report in terms of accessibility and enjoyment, while being equally effective in raising awareness, increasing engagement, and influencing advocacy/policy. Each intervention strategy demonstrates its unique array of strengths and weaknesses, with the circus show catering to a diverse audience, while the webinar and research report target more informed participants. These outcomes underscore the innovative and inclusive attributes of Arts-Based Knowledge translation, showcasing its capacity to facilitate researchers' engagement with a wider array of stakeholders across diverse contexts. As a relevant first step and a complementary asset, arts-based knowledge translation holds immense potential in increasing awareness and mobilization around crucial health issues.

Insight into the management of patients with melanoma in times of the COVID-19 pandemic: A single-center experience

Background/Aim. Despite all innovations in medicine, melanoma still has a rising incidence and high mortality and thus represents a significant challenge for the healthcare system. The pandemic of the coronavirus disease 2019 (COVID-19), spanning three years, redirected healthcare resources, suspended preventive programs, and strained the healthcare system, significantly impacting melanoma management. The aim of this study was to assess the influence of the COVID-19 pandemic on the treatment of melanoma patients. Methods. This retrospective study analyzed melanoma patients treated at a single tertiary care center over two distinct three-year periods: pre-COVID period (2017-2020) and the COVID-19 pandemic period (2020-2022). The following data were collected and compared: patient demographics, melanoma characteristics, time intervals from biopsy to surgery, and the share of thin and thick melanoma. Results. During the COVID-19 pandemic period, there was a 30% reduction in melanoma patients compared to the pre-COVID- 19 period. The decline was most pronounced in 2020 when the state of emergency was introduced in the country. Thin melanoma percentage as a measurement of successful screening programs decreased significantly during the COVID-19 pandemic (11.57% vs. 24.01%), while median Breslow thickness remained stable. The distribution of different histological types was consistent across both periods. The average time from biopsy to surgery remained similar between the two periods, around 40 days. Conclusion. Despite challenges posed by the COVID-19 pandemic, melanoma remains a critical healthcare issue. This study emphasized the significance of prioritizing melanoma care in emergencies, ensuring patient identification and timely treatment in order to optimize survival and minimize treatment costs.

Patient Complaint Systems from the Perspective of Healthcare Bioethics

This article aims to analyze the complaint systems from the unique and crucial perspective of Healthcare Bioethics, a new theoretical branch of Clinical Bioethics developed in Latin America, in the Post-graduate Program in Bioethics of the University of Brasilia. Healthcare Bioethics, with its four main axes: Patients’ Rights, patient centrality, the partnership relationship between the actors in the clinical encounter, and clinical empathy, provides a comprehensive and ethical lens through which to view healthcare issues. Complaints in healthcare, considered complex narratives that reveal important information about the organization and exert important impacts on healthcare and the clinical relationship, are no exception. The methodological approach is theoretical and documental. The basis for the theoretical framework adopted by Healthcare Bioethics were the studies by Albuquerque and Albuquerque and Tanure, since they are precursors in Brazil to the research developed on the subject. The conclusions drawn are that organizations need to have complaint systems based on Healthcare Bioethics to contribute to the patients and their families feeling welcomed and recognizing patient centrality concerning the complaints presented. Finally, it is necessary to highlight the scarcity of studies that draw on this new paradigm of healthcare applied to the analysis of patient complaints.

Pediatric Traumatic Brain Injury: Models, Therapeutics, and Outcomes.

Pediatric traumatic brain injury (TBI) is a significant healthcare issue, but potential treatments are absent despite robust investigation in several clinical trials. Factors attributed to clinical TBI, such as heterogeneity of injury and single-dose pharmacological treatments as well as timing of administration, may be reasons for the negative studies. Preclinical models of TBI can reduce some of the impediments by highlighting differences in injury depending on injury severity and location and by conducting dose response studies, thus providing better therapeutic targets and pharmacological profiles for clinical use. In this chapter, there were sufficient reports to make comparisons between the models in terms of pathophysiology, behavioral dysfunction, and the efficacy of therapeutic interventions. The models used to date include controlled cortical impact (CCI), weight drop, fluid percussion, and abusive head trauma. Several therapeutics were identified after CCI injury but none in the other models, which underscores the need for studies evaluating the therapies reported after CCI injury as well as novel potential approaches.

Research progress of mitochondria in chronic obstructive pulmonary disease: a bibliometric analysis based on the Web of Science Core Collection.

Due to its high morbidity and mortality, chronic obstructive pulmonary disease (COPD) has become a major global healthcare issue. Although there is abundant research regarding COPD, a bibliometric analysis of the literature related to mitochondria and COPD is lacking. Thus this study aimed to summarize the research status, research direction, and research hotspots of the published articles concerning COPD and mitochondria. A literature search for included publications related to COPD and mitochondria was carried out on the Web of Science Core Collection from the date of database establishment to December 15, 2022. A subsequent bibliometric and visual analysis of the included publications was conducted via Microsoft Excel, R software, CiteSpace, and VOSviewer. A total of 227 published articles on COPD and mitochondria from 139 journals were included. Over the study period, the annual publication number and citation frequency in this field both showed a trend of continuous growth. The United States had the highest centrality and was the most productive country. The frequently occurring keywords were "oxidative stress", "obstructive pulmonary disease", "dysfunction", "mitochondria", "inflammation", and "cigarette smoke", among others. Recent research hotspots included autophagy, model, mitochondria, health, and extracellular vesicles (EVs). Despite an abundance and variety of research, there is still relatively little academic communications between scholars and institutions. This bibliometric study can help researchers gain a quick overview of the research into mitochondria and COPD and thus inform novel ideas and directions for future research in this field.