Issue Of Medicine Research Articles

Optimizing Virtual Health Technologies Through a Performance-based Readiness Model: Lessons From the Field Deployment of National Emergency Tele-Critical Care Network.

The advancement of the Army's National Emergency Tele-Critical Care Network (NETCCN) and planned evolution to an Intelligent Medical System rest on a digital transformation characterized by the application of analytic rigor anchored and machine learning.The goal is an enduring capability for telecritical care in support of the Nation's warfighters and, more broadly, for emergency response, crisis management, and mass casualty situations as the number and intensity of disasters increase nationwide. That said, technology alone is unlikely to solve the most pressing issues in operational medicine and combat casualty care. A total performance system (TPS) creates opportunities to address vulnerabilities and overcome barriers to success. As applied during the NETCCN project, the TPS captures the best performance-centric information and know-how, increasing the potential to save lives, improve readiness, and accomplish missions. The purpose of this project was to apply a performance-based readiness model to aid in the evaluation of Army telehealth technologies. Through various user-facing surveys, polls, and reporting techniques, the project aimed to measure the perceived value of telehealth technologies within a sample of the project team member population. By providing a detailed approach to the collection of lessons learned, researchers were able to determine the importance of information and methods versus a focus on technology alone. The use of an emoji-based feedback assessment indicated that most lessons learned were helpful to the project team. Through the NETCCN TPS, we have been able to address product-related measures, knowledge of product efficacy, project metrics, and many implementation considerations that can be further investigated by setting and engagement type. Through the Technology in Disaster Environments learning accelerator, it was possible to rapidly acquire, process, organize, and disseminate best practices and learnings in near real time, providing a critical feedback and improvement loop.

Delayed Onset Muscle Soreness (DOMS): Management Update

Delayed Onset Muscle Soreness (DOMS) is a prevalent issue in sports medicine and among physically active individuals, causing significant pain and disability. While the exact pathophysiology of DOMS remains incompletely understood, this article delves into non-pharmacological approaches to effectively manage and alleviate its symptoms.
 The research discusses multifaceted aspects of DOMS, encompassing its complex etiology, theories, and contributing factors. Numerous theories have been proposed, including delayed inflammatory responses, lactic acid accumulation, muscle spasms, connective tissue damage, and muscle micro-tears. These theories underscore the intricate nature of DOMS and the need for a diverse management approach.
 The article explores non-pharmacological strategies to address DOMS, focusing on evidence-based methods. These methods include massage, exercise, nutrition, and natural supplements. Research has shown that massage therapy enhances muscle recovery, exercise therapy reduces soreness, and nutrition therapy through protein and amino acid intake can alleviate DOMS. Furthermore, natural supplements like ginger, tart cherry juice, and curcumin have demonstrated the potential to reduce inflammation and manage DOMS.
 While pharmacological interventions may be considered for severe cases, the article underscores the importance of exercising caution due to potential side effects. In summary, DOMS management necessitates a holistic approach, combining multiple modalities and nutritional strategies to alleviate pain, enhance muscle recovery, and minimize the impact of this common condition on physically active individuals and athletes.

Structural elucidation and in-silico evaluation of 1,2,4-triazole derivative as potent Omicron variant of SARS-CoV-2 spike protein inhibitor with pharmacokinetics ADMET and drug-likeness predictions

One of the most significant issues in contemporary medicine and pharmacy is the search for powerful bioactive, efficient, low-toxic anti-COVID agents. In this contrast, present work involves the synthesis of triazole derivative 6-(4-Flurophenyl)-3-(pyridine-4yl)-7H-(1,2,4)triazolo(3,4-b) (1,3,4)thiadiazine (FPTT) and its characterizations using various spectroscopic techniques (LCMS, NMR, UV-vis, FTIR). The vibrational wavenumbers were evaluated and found to be in good agreement with theoretical values. The crystal structure is determined using single crystal X-ray diffraction study and the structure is reinforced by several intra-, intermolecular and π···π interactions. These interactions result in the formation of R12(7), R33(17), S(5) and S(6) synthons which significantly contribute towards the stability of the crystal structure. Further, these interactions are validated through Hirshfeld surface and 2D fingerprint plot analysis. The C-H···N and H···H contacts are the major contributors and are in consistency with the topology and natural bond orbital results. The optimized geometrical parameters through density functional theory (DFT) are in good agreement with the experimental data. Further, various electronic properties of the compound were evaluated using the optimized structure. The molecular electrostatic potential map (MEP) and Fukui function analysis revealed the most active sites. Analysis of non-covalent interactions based on a gradient of reduced density revealed the presence of van der Waals interactions. Intrigued, by the presence of large amounts of non-covalent interactions the pharmacokinetic profiles of the compound were evaluated through ADMET provides an insight into potential inhibitors and novel drug candidates. Further in-silico studies such as molecular docking was carried out against the Omicron variant of SARS-CoV-2 spike protein with an intention to assist towards the production of improved vaccines and therapeutics.

Editorial on the special issue of Chinese Medicine for the 4th Sino-CPLP Symposium on Natural Medicine and Biodiversity Resources (SNMBR) & The International Forum on Research and Development of Traditional Chinese Medicine Industry (Macau) on Medicinal Plant Resource, Natural Product and Function, Pharmacology and Regulatory

Editorial on the special issue of Chinese Medicine for the 4th Sino-CPLP Symposium on Natural Medicine and Biodiversity Resources (SNMBR) & The International Forum on Research and Development of Traditional Chinese Medicine Industry (Macau) on Medicinal Plant Resource, Natural Product and Function, Pharmacology and Regulatory

Medicinal Importance, Pharmacological Activity and Analytical Aspects of Flavonoid 'Irisflorentin' from Belamcanda chinensis (L.) DC.

Flavonoids are an important class of phytochemicals found to be present in plants and their derived products. Belamcanda chinensis (L.) DC has been used in Traditional Chinese medicine for multiple therapeutic purposes for a very long time. Belamcanda chinensis have been reported to have antipyretic, antidote, expectorant, antiphlogistic, and analgesic activity in the scientific fields. Scientific information on irisflorentin for its medicinal importance and pharmacological activity has been collected through electronic search engines, including Science Direct, Google, Google Scholar, PubMed, and Scopus, and analyzed in the present investigation in order to know the biological potential of irisflorentin. However, analytical aspects of irisflorentin are also discussed in the present work. Further detailed pharmacological activity data of irisflorentin have been collected and analyzed in the present work in order to know the therapeutic potential of irisflorentin in medicine. Scientific data analysis of different research work signified the biological importance and therapeutic benefit of Belamcanda chinensis and irisflorentin in medicine. Scientific data analysis revealed the biological effectiveness of irisflorentin against Parkinson's disease, inflammation, cancer, and brain disorders. Further scientific data analysis also signified the biological potential of irisflorentin for its α-glucosidase inhibitory potential and immunotherapeutic adjuvant in medicine. Metabolism and pharmacokinetic parameters have also been discussed in the present work. Analytical data showed the importance of various analytical methods for separation, identification and estimation of irisflorentin in different biological samples. Scientific data analysis of various research works signified the biological potential and therapeutic effectiveness of irisflorentin in medicine. However, clinical data of irisflorentin should be also investigated in order to know their pharmacokinetic parameters and safety issue in medicine.

Physiotherapy work with transgender individuals

Transgenderism is a difficult issue in medicine, although it has accompanied humans almost since the beginning of mankind. It includes transsexualism – incompatibility of mental sex and registered sex. Transgender people seek to change their gender through hormone therapy and surgery. In their work, physiotherapists may encounter transgender people at various stages of therapy. In order to avoid causing additional psychological burden for transgender patients, it is necessary for physiotherapists to know the specifics of transsexualism and the issues they should pay attention to while practicing their profession. The aim of the work is to show what transgenderism is and how a physiotherapist should work with transgender people.

Examination of the Effectiveness of a Public Health Nurses’ National Call Center for Young Families

Abstract Background The Public Health Nurses Call Center (PHNCC) is an innovative, free-of-charge Israeli national pilot aimed at parents of 0-6 years old children. The Center provides information, counseling, and guidance re- issues of health and preventative medicine and is active when the daily Infant-Parent Centers are closed. Aims Examining the PHNCC's suitability for the target population's needs and evaluating its effectiveness in locating situations needing intervention, improving patient experience, and promoting the children's and their parent's health. Methods Three sub-studies were conducted: (1) a descriptive study using an initial analysis of 6,000 calls received at the Center, as well as a profound analysis of randomly selected 1,500 calls; (2) a comparative study among 201 parents who had called the Center and 232 parents who had not; and (3) a qualitative study which included interviews with 20 parents who had called the Center and six of the PHNCC nurses. Findings The PHNCC provides a fast, professional, and accessible response. Caller satisfaction is high, as is that of the Center's nurses. The population of people calling the Center is mainly made up of young parents to first-born children, as well as parents characterized by high levels of parental efficacy perception, social support, and health literacy, as opposed to the population of parents who did not call. There is a direct association between callers’ satisfaction with the PHNCC and their level of trust in the Center nurses. Conclusions Both parents and nurses describe an accessible, professional Center and high satisfaction levels. However, the study's findings highlight the need to minimize health-related gaps and make the Center accessible to additional populations, such as parents with lower health literacy. Key messages • Both parents and nurses describe an accessible, professional Center suitable for the target population's needs. • The PHNCC is a service with excellent implementation potential for promoting public health. It should be budgeted accordingly and made accessible to the various populations of Israeli society.

Antimicrobial and Antiproliferative Coatings for Stents in Veterinary Medicine-State of the Art and Perspectives.

Microbial colonization in veterinary stents poses a significant and concerning issue in veterinary medicine. Over time, these pathogens, particularly bacteria, can colonize the stent surfaces, leading to various complications. Two weeks following the stent insertion procedure, the colonization becomes observable, with the aggressiveness of bacterial growth directly correlating with the duration of stent placement. Such microbial colonization can result in infections and inflammations, compromising the stent's efficacy and, subsequently, the animal patient's overall well-being. Managing and mitigating the impact of these pathogens on veterinary stents is a crucial challenge that veterinarians and researchers are actively addressing to ensure the successful treatment and recovery of their animal patients. In addition, irritation of the tissue in the form of an inserted stent can lead to overgrowth of granulation tissue, leading to the closure of the stent lumen, as is most often the case in the trachea. Such serious complications after stent placement require improvements in the procedures used to date. In this review, antibacterial or antibiofilm strategies for several stents used in veterinary medicine have been discussed based on the current literature and the perspectives have been drawn. Various coating strategies such as coating with hydrogel, antibiotic, or other antimicrobial agents have been reviewed.

Long-term cryopreservation of whole gingival tissue.

Stem cells obtained from the body tissue, such as adipose tissue, dental pulp and gingival tissue. Fresh tissue is often used to isolate and culture for regenerative medicine. However, availability of tissue as and when required is one of the measure issue in regenerative medicine. Cryopreservation of tissue provides benefit over tissue availability, storage for significant amount of period and helps preserve the original cell structures. The effects of cryopreservation of gingival tissue for mesenchymal stem cell (MSC) are not well documented; however this process is of increasing importance for regenerative therapies. This study examined the effect of cryopreservation on the long term survival the whole gingival biopsy tissue. We studied cell outgrowth, cell morphology, MSC surface-markers and differentiation of mesenchymal stem cells derived from cryopreserved gingiva. In this study, gingival tissue was cryopreserved for 3, 6, 9months. Cryopreserved tissue has been thawed and cells were isolated by using explant culture method. The fresh and cryopreserved gingival tissue cells were cultured and characterized for surface marker analysis, CFU-f, population doubling time, and osteogenic, chondrogenic and adipogenic differentiation. The fresh and cryopreserved tissue has similar stem cell properties. Results indicate that cryopreservation of the entire gingival tissue does not affect the properties of stem cells. This opens door for gingival tissue banking for future use in periodontology and regenerative medicine.

Morphological Changes when Hemoben is Used in Bleeding from Acute Wounds of the Face-Jaw Area

One of the main issues of modern medicine, surgery, traumatology, urology, gynecology, neurosurgery, oncology, otorhinolaryngology, maxillofacial surgery is to stop the mine flow during and after surgery. In recent years, the number of local mining equipment has been increasing. This raises the question of whether these agents should be chosen based on their efficacy and safety. The value of a local anti-mine agent is limited in most studies to the study of its hemostatic effectiveness, that is, its main criterion is the question of stopping primary and secondary mining. But when using these drugs for cleaning wounds, studying the effect of the drug on soft tissues on the surface of the wound will help to positively resolve the issue of primary wound burns.
 Currently, due to the increasing exposure to anti-inflammatory substances in modern medicine, the development of new effective types of them is becoming an urgent issue. In this matter, local hemostatic drugs are of great importance. Local hemostatic drugs are used both for diffuse bleeding and for bleeding from large vessels. Today, there are various locally used hemostatic agents with different chemical compositions. Various chemical substances and their mixtures are used for their production. When checking the effectiveness of these substances, their safety level, ease of use, price and other factors are taken into account.
 Despite the large number of local mine suppressants, among them there are very few drugs that can be used universally.Therefore, the creation of highly effective local mine deterrents is an actual issue.

The value of osteopontin in predicting fibrosis in patients with chronic viral hepatitis C

Background. Diagnosis of an asymptomatic course of chronic viral hepatitis C (HCV) and the existing development of the fibrotic process by determining the marker capabilities of biochemical blood parameters (primarily osteopontin — OP) is an urgent issue in modern medicine. Purpose: to evaluate the prognostic value of biochemical blood markers for diagnosing an asymptoma­tic course of HCV and the existing fibrotic process. Materials and me­thods. Seventy-eight people were examined: 47 from the main group — 19 (40.4 %) women and 28 (59.6 %) men with chronic HCV, and 31 controls — 17 (54.8 %) women and 14 (45.2 %) men without chronic HCV. The median, as well as 25.0% and 75.0% quartiles and relative values were calculated for quantitative and qualitative measures, respectively. Predictors were determined using logistic regression analysis. Results. The data obtained by a univariate analysis indicate a significantly increased risk of develo­ping liver fibrosis on the background of chronic HCV, with alanine aminotransferase (ALT) levels increased by 1.037 times, aspartate aminotransferase (AST) by 1.051 times, gamma-glutamyl transferase (GGT) by 1.017 times; thymol turbidity test by 1.424 times; total protein by 1.162 times and OP by 3.002 times. With increased levels of triglycerides and very low-density lipoproteins, a significant decrease in these risks was found, by 74.7 and 94.7 %, respectively. A multivariate analysis found significantly increased risks of deve­loping liver fibrosis on the background of chronic HCV, with higher levels of AST, total protein, and OP (by 1.028, 1.195 and 2.510 times, respectively). Conclusions. With a significant liver damage by a fibrotic process (stage 3–4), as compared to stage 0–2, there is a probable predominance of biochemical liver markers in the blood of patients with HCV: ALT, AST, GGT, total protein and OP. AST, total protein, and OP were identified as reliable predictors of liver fibrosis. The developed mathematical model has high sensitivity and specificity: 87.5 and 83.9 %, respectively.

Practical, Privacy and Ethical, and Philosophical Considerations for Using Big Data in Medical Education.

In this issue of Academic Medicine , Thelen and colleagues present a thoughtful perspective on the emerging opportunity to use longitudinal educational data to improve graduate medical education and optimize the education of individual residents, and call for the accelerated development of large interinstitutional data sets for this purpose. Such applications of big data to medical education hold great promise in terms of informing the teaching of individuals, enhancing transitions between phases of training and between institutions, and permitting better longitudinal education research. At the same time, there is a tension between whose data they are and consequently how they ought to be used. This commentary proposes some practical, privacy and ethical, and philosophical considerations that need to be explored as early efforts to aggregate data across the medical education continuum mature and new efforts are undertaken.

What is Stress in Epilepsy? A Content Analysis and an open letter to the World Health Organization (WHO): Highly Time to Define Stress

Aim: Stress is one of the most researched issues in Behavioral Medicine and Health Psychology. The background review illustrated that much peer-reviewed quantitative studies do not define accurately the concept of stress in epilepsy and/or use a different rationale in their definition. This contributes further in major medical and psychological debates and research questions in the last decade of whether stress is ‘epileptogenic’ and ‘seizure triggering’ for epileptic patients. Material and Method: The present qualitative study applied a content analysis on Chapter 5 of World Health Organization’s (WHO) first and latest global report on epilepsy -from a Health Psychology point of view-, seeking for (i) a universal definition of stress in epilepsy, (ii) what stressors are more related to ‘epileptogenesis’ and ‘seizure triggering’ –if any- and (iii) any proposed stress relief and management strategies to be delivered by psychologists. Results and Conclusions: Primary and secondary content analysis presented that WHO does not define stress as a single entity, but rather shows an unspecified link with ‘social stigma’ or ‘social stressors’. Moreover, WHO does not show taking leadership in defining stress for research purposes. Lastly, there are some thoughts that although WHO applies the biopsychosocial model in this report, it considers that the ‘psycho’ part of the model concerns entirely the field of ‘psychopathology’.

Prospects for hormonal contraception in patients with breast diseases: the Mona Lisa smile effect. A review

Breast diseases (BD) are among the most urgent issues of modern reproductive medicine. This organ is an integral part of the female reproductive system and undergoes cyclic changes during the menstrual cycle. The modern "nosological trio" of BD is mastodynia, benign dysplasia, and breast cancer. These diseases have an extremely high prevalence, and breast cancer, in turn, ranks 1st in the structure of mortality from malignant neoplasms of the female reproductive system. All these aspects warrant the research of the key pathogenetic mechanisms of these conditions. However, one of the most relevant topics in modern gynecology is the counseling on the selection of contraceptive methods in these patients. Therefore, it is necessary to address the safety of hormonal contraceptive methods and to analyze innovations in hormonal contraceptives, which may have several protective and risk-reducing properties for BD.

Resolving the tissue response to neoadjuvant chemotherapy in rectal cancer

In this issue of Cell Reports Medicine, Qin etal.1 present a comprehensive single-cell transcriptomics analysis of the tumor microenvironment of rectal cancer tumors before and after neoadjuvant chemotherapy.

Семейный случай наследуемой хромосомной интеграции ВГЧ-6А с проведением филогенетического анализа

The paper reports a familial case of HHV-6A chromosomal integration being an important and relevant issue of genetics and medicine. The study was aimed to test the hypothesis of HHV-6A chromosomal integration and vertical transmission in patient with persistent virus detection during recurrent respiratory diseases and the asymptomatic period when there were no health complaints. Sequencing of the patient’s father genome DNA was performed, and a phylogenetic tree was constructed by aligning 270 HHV-6A/B genome assemblies from the GenBank database. As a result, a familial case of ciHHV-6A transmission was identified. It was found that the detected ciHHV-6A observed on the phylogenetic tree was closely related to other two chromosomally integrated HHV-6A sequences reported by Moscow researchers. The study confirmed HHV-6A chromosomal integration. Further precise chromosome mapping of ciHHV-6A would be useful in terms of excluding probable somatic disorders associated with the chromosome structure alteration following HHV-6, particularly HHV-6A, integration, as well as for identification of insertion sites specific for various geographic locations.

Deep learning for precision medicine: Guiding laser therapy in ischemic retinal diseases

In this issue of Cell Reports Medicine, Zhao and colleagues1 report a multi-tasking artificial intelligence system that can assist the whole process of fundus fluorescein angiography (FFA) imaging and reduce the reliance on retinal specialists in FFA examination.

IMPOSTORS AMONG FAMILY DOCTORS

Introduction. Human resources policy issues in medicine have always played a significant role in ensuring quality medical care for the population. Young specialists face high labor market demands and constant management pressure, without having ready adaptation strategies. The beginning of a success story is always challenging, and sometimes the impostor syndrome can have its influence. Persistent self-doubt leads to emotional exhaustion and the development of a cynical attitude towards others, which can further transform into burnout syndrome.
 THE AIM: To analyze the prevalence of the impostor phenomenon among young doctors in the field of “General Practice – Family Medicine” and explore potential correlations with burnout syndrome.
 MATERIALS AND METHODS. We conducted an anonymous cross-sectional survey of 27 young family doctors using The Clance Impostor Phenomenon Scale and Maslach Burnout Inventory Human Services Survey for Medical Personnel. The research procedure adhered to accepted moral norms, rights, interests, and personal dignity of the participants, in line with the principles of bioethics outlined in the Helsinki Declaration “Ethical Principles for Medical Research Involving Human Subjects” and the “Universal Declaration on Bioethics and Human Rights (UNESCO)”.
 RESULTS. All respondents demonstrated a certain level of impostor syndrome severity, which might be related to a shift in professional role – the transition from intern to independent practitioner – a family doctor. Every fourth intern already showed signs of emotional exhaustion and depersonalization, with 7% having developed burnout syndrome. It is not excluded that these changes are linked to working conditions and military actions on the territory of Ukraine.
 CONCLUSIONS. Nearly half of the respondents were categorized under intermediate burnout syndrome profiles (Overloaded, Ineffective, Detached), which can be corrected with timely identification and effective management. Without exception, all respondents exhibited various degrees of the impostor phenomenon. The impostor syndrome is closely related to emotional exhaustion (p=0.002) and depersonalization (p=0.000214) within the structure of burnout syndrome, allowing for the development of new correction approaches and optimization of burnout prevention strategies.

Burnout Rates in Clinical Radiation Oncology and Variations across Professional Subgroups

Physician and medical professional burnout has emerged as an important issue in clinical medicine and has been shown to negatively affect patient outcomes. The aim of this study is to determine how rates of burnout vary between different radiation oncology professional subgroups. Participants were selected from those employed in one of the professional subgroups (radiation therapists, nurses, physicists, dosimetrists, and physicians) at two institutions that cover a total of seven sites. 126 individuals were recruited to participate. In addition to demographics, participants were asked to respond to questions regarding professional burnout utilizing the Maslach Burnout Inventory (MBI). Responses were on a seven-point Likert scale with subcategories of Exhaustion, Depersonalization, and Personal Achievement. Each participant's score per subcategory was categorized as either low, moderate, or high. For our primary outcome, frequencies and proportions were reported and Fisher's Exact Test was used to evaluate whether there was a statistically significant difference in proportions in categorized burnout scores across professional subgroups. Secondary analyses were performed comparing burnout across sex, age, and categorized years in position. An alpha level of 0.05 was used for all analyses. In total, 55 participants responded to the survey: 12 nurses, 8 dosimetrists, 12 physicians, 5 physicists, and 18 radiation therapists for a response rate of 43.6%. Demographics were consistent across professional subgroups with the exception of participant sex (p = .0397), which had a greater proportion of females (72.22%) in the Radiation Therapist subgroup. Among the three subcategories, only Exhaustion had a significant difference between groups (p = .0494) with Dosimetrists (62.50%) and Physicists (40.00%) experiencing the highest level of burnout. For Depersonalization, at least one individual in each subgroup identified high burnout with higher rates among the Dosimetrists (25.00%) and Physicists (40.00%). Similarly, at least one person in each subgroup reported high burnout in Personal Achievement, but the highest response was among Dosimetrists (37.50%). In total, at least 12.75% of participants reported high burnout in at least one subcategory. No statistically significant differences in burnout were detected in our secondary analyses across sex, age, and years in position. Our study showed that burnout rates are moderate in members of the radiation oncology team, with dosimetrists and physicists displaying the highest levels of burnout. In order to better estimate professional burnout, larger studies should be conducted to determine causes of burnout. Furthermore, wellness programs should be encouraged and incentivized to help reduce burnout and improve workplace morale, occupational fulfillment, and effective patient care.

On the gap between theory and practice in defining and understanding risk

The risk concept is used in all types of situations and applications, ranging from technology to medicine and security issues. Many definitions of the concept exist, and there is an ongoing discussion on what is the most suitable way of defining and understanding the concept. In recent years, several overriding frameworks have been developed, aiming at providing conceptual clarity and structure and including most of the existing definitions as special cases. A key feature of these frameworks is that uncertainty is a main component of risk. Risk science literature and recognized societies and organizations have actively promoted these frameworks and definitions. Nonetheless, applied risk analysis and management is characterized by all types of definitions and understandings of risk, many that go back to conventions made several decades ago. It can be argued that there is a considerable gap between contemporary risk science knowledge and the practice of risk analysis and risk management in these areas. This paper discusses why we have this gap, why it is important to close it and how this can be achieved. A main goal of the paper is to refute the claim that the gap is due to a disconnection between risk science and the application of risk science.