Medical Research Articles

Non-invasive neurostimulation: an emerging therapeutic modality in veterinary neurology

Non-invasive neurostimulation involves techniques that stimulate the nervous system without penetrating the skin. These techniques, which range from electrical and magnetic to other types of stimulation, are designed to alter the activity of nerve cells and the broader networks they form. Although these methods have proven effective and safe for treating certain neurological conditions in humans, their success varies significantly from one individual to another. This variability can be because of the lack of standardised stimulation protocols, biological differences among individuals and the particular state of the neural areas being targeted. Various non-invasive neurostimulation techniques have been investigated, particularly in human medicine, including transcutaneous vagal nerve stimulation, transcutaneous electrical nerve stimulation on various nerves, repetitive transcranial magnetic stimulation and transcranial direct current stimulation. Of these, repetitive transcranial magnetic stimulation has emerged as the leading technique in research for human and veterinary medicine because of its potential in treating a wide range of neurological disorders. In the field of veterinary medicine, the use of non-invasive neurostimulation as a treatment approach is still in its early phases, with only a few reports documenting its application in managing seizures and behavioural issues in animals.

Mechanism of Polygala-Acorus in Treating Autism Spectrum Disorder Based on Network Pharmacology and Molecular Docking.

Recent epidemic survey data have revealed a globally increasing prevalence of autism spectrum disorders (ASDs). Currently, while Western medicine mostly uses a combination of comprehensive intervention and rehabilitative treatment, patient outcomes remain unsatisfactory. Polygala-Acorus, used as a pair drug, positively affects the brain and kidneys, and can improve intelligence, wisdom, and awareness; however, the underlying mechanism of action is unclear. We performed network pharmacology analysis of the mechanism of Polygala-Acorus in treating ASD and its potential therapeutic effects to provide a scientific basis for the pharmaceutical's clinical application. The chemical compositions and targets corresponding to Polygala-Acorus were obtained using the Traditional Chinese Medicine Systematic Pharmacology Database and Analysis Platform, Chemical Source Website, and PharmMapper database. Disease targets in ASD were screened using the DisGeNET, DrugBank, and GeneCards databases. Gene Ontology functional analysis and metabolic pathway analysis (Kyoto Encyclopedia of Genes and Genomes) were performed using the Metascape database and validated via molecular docking using AutoDock Vina and PyMOL software. Molecular docking analysis showed that the key active components of Polygala- Acorus interacted with the following key targets: EGFR, SRC, MAPK1, and ALB. Thus, the key active components of Polygala-Acorus (sibiricaxanthone A, sibiricaxanthone B tenuifolin, polygalic acid, cycloartenol, and 8-isopentenyl-kaempferol) have been found to bind to EGFR, SRC, MAPK1, and ALB. This study has preliminarily revealed the active ingredients and underlying mechanism of Polygala-Acorus in the treatment of ASD, and our predictions need to be proven by further experimentation.

Trends on Novel Targets and Nanotechnology-Based Drug Delivery System in the Treatment of Parkinson's disease: Recent Advancement in Drug Development.

Parkinson's disease (PD) is a progressive neurodegenerative disorder that impacts a significant portion of the population. Despite extensive research, an effective cure for PD remains elusive, and conventional pharmacological treatments often face limitations in efficacy and management of symptoms. There has been a lot of discussion about using nanotechnology to increase the bioavailability of small- molecule drugs to target cells in recent years. It is possible that PD treatment might become far more effective and have fewer side effects if medication delivery mechanisms were to be improved. Potential alternatives to pharmacological therapy for molecular imaging and treatment of PD may lie in abnormal proteins such as parkin, α-synuclein, leucine-rich repeat serine and threonine protein kinase 2. Published research has demonstrated encouraging outcomes when nanomedicine-based approaches are used to address the challenges of PD therapy. So, to address the present difficulties of antiparkinsonian treatment, this review outlines the key issues and limitations of antiparkinsonian medications, new therapeutic strategies, and the breadth of delivery based on nanomedicine. This review covers a wide range of subjects, including drug distribution in the brain, the efficacy of drug-loaded nano-carriers in crossing the blood-brain barrier, and their release profiles. In PD, the nano-carriers are also used. Novel techniques of pharmaceutical delivery are currently made possible by vesicular carriers, which eliminate the requirement to cross the blood-brain barrier (BBB).

Transformative Learning Among Organ Procurement Organization Donor Family Volunteers.

Introduction: Some family members who previously made the decision to donate a family member's organs support the organ procurement organization (OPO) through volunteer work. Volunteers were asked to describe their family's organ donation story to educate the general and medical communities about organ donation. This study explored the transformative learning experienced by volunteers during and following the organ donation consent process and throughout their volunteer work. Methods/Approach: A narrative inquiry research methodology and transformative learning theoretical framework was used and 6 volunteers were recruited to participate. Two semistructured virtual interviews were conducted. Interviews were transcribed, radically reduced, and subjected to holistic-content and holistic-form narrative analysis. Findings: Participants experienced strong emotional responses during and after the loss of their family member, characterized as a period of disorientation, which lasted for an extended period preventing transformative learning. After the OPO contacted participants regarding the opportunity to volunteer, participants experienced a period of self-examination when they reengaged with the topic of organ donation. Critical reflection occurred through the act of storytelling about their family's organ donation story during their volunteer work. Storytelling to the community facilitated making meaning of their loss and transformations. Conclusion: Volunteering for an OPO played an important role by initiating self-examination and critical reflection of their prior assumptions. Through storytelling, participants reflected on their roles and made meaning of their organ donation experiences. The act of inviting donor families to reengage with the topic of organ donation through volunteer work fostered positive permanent meaningful transformations.

Exploring Parent Treatment Decision-Making in Relapsed and Refractory Neuroblastoma: A Qualitative Study

Parents often become involved in making treatment decisions for their child with cancer when there is no standard treatment protocol, typically seen in poor-prognosis cancers. Advances in scientific medicine has led to more treatment options being available for children resulting in parents making repeated treatment decisions depending on their child’s response to treatment. The emotional turmoil of their child's cancer diagnosis can be exacerbated when combined with making decisions that have uncertain outcomes. This study aimed to identify, describe, explore, and explain how parents made repeated treatment decisions and the role of emotion in decision-making when their child had relapsed or refractory neuroblastoma, a poor-prognosis cancer.Data were collected using qualitative interviews between 2020-2022 with parents of children with relapsed or refractory neuroblastoma in the United Kingdom. Data were analysed using Reflexive Thematic Analysis.Eighteen parents who made between one to six treatment decisions participated. Decision-making incorporated four themes which enabled, influenced, and informed how parents made treatment decisions: 1) time as a structure within decision-making; 2) uncertainty and its relationships with treatment risk, side effects and outcomes; 3) parent oscillation of their cognitive and emotional adjustment; 4) parent responsibility and involvement in decision-making. Time was the central organising concept which structured and organised parent decision-making. We adopted Orlikowski and Yates’s (2002) temporal structures to characterise the experience of time and Stroebe and Schut’s (1999) dual-processing theory to explore the oscillation of parent adjustment of their situation cognitively and emotionally. A conceptual framework showed the interrelationships of these themes.

Orally administered Cannabigerol (CBG) in rats: Cannabimimetic actions, anxiety-like behavior, and inflammation-induced pain

Cannabigerol (CBG) is a phytocannabinoid found in cannabis that is promoted for medical use and other health benefits, but current empirical data on the behavioral effects of CBG are lacking. The purpose of this study was to evaluate the effects of a wide dose range of orally administered CBG on outcomes related to its potential cannabimimetic effects (cannabinoid tetrad), as well as effects on anxiety-like behavior, inflammation and related pain hypersensitivity. In a series of experiments, male and female Sprague Dawley rats received oral CBG (per os [p.o.]) or vehicle prior to testing of effects on 1) the cannabinoid tetrad (30–600 mg/kg, p.o.): assessments of locomotor activity, body temperature, antinociception (tail flick test), and catalepsy (bar test); 2) acoustic startle response (ASR) test of anxiety-like behavior (30–300 mg/kg, p.o.); 3) carrageenan-induced inflammation (paw edema), hyperalgesia (Hargreaves test), and allodynia (von Frey test) tests (10–60 mg/kg, p.o.). Positive control groups were administered THC (0–30 mg/kg, p.o.) for the cannabinoid tetrad assay, the benzodiazepine lorazepam (0–3 mg/kg, intraperitoneal [i.p.]) for the ASR test, or the opioid analgesic morphine (0–10 mg/kg, i.p.) for the carrageenan-induced inflammation and pain hypersensitivity tests. CBG did not produce cannabimimetic actions in the tetrad, but increased locomotor activity at the highest doses (300–600 mg/kg). THC produced typical dose-related cannabimimetic effects. CBG did not produce anxiolytic effects in the ASR test, while groups pretreated with lorazepam did show reductions in ASR. Finally, pretreatment with CBG prior to an intraplantar injection of carrageenan did not prevent the induction of an acute inflammatory state (i.e., increased paw edema and associated hyperalgesia and allodynia). In contrast, morphine alleviated hyperalgesia and allodynia induced by intraplantar carrageenan but did not affect the development of paw edema. In sum, these data do not support the use of oral CBG for anxiety or inflammatory pain.

Pre-clinical experiences among nursing students of reputable Islamic university in the capital city of Indonesia

Clinical trainings were employed in the nursing sciences in order to provide student’s experiences in applying nursing care according to the theory. They required to accomplish some competencies depending on their study levels. Students would also experience the possible barriers and challenge during clinical trainings. However, there were limited number of research which explored these experiences, especially in nursing students. This study aimed to explore the experiences of nursing students in performing fundamental nursing pre-clinical activities. This research conducted qualitative study with phenomenological approach. This study involved 5 nursing students according to inclusive criteria. Data collection method used in-depth interview techniques. The obtained data were analysed further using Colaizzi test. The collected data identified six themes of student’s experiences, such as student’s understanding about pre-clinic, their experiences during preclinic, theoretical gaps with hospital procedures, some barriers in clinical practice, student’s expectation, and obtained support during pre-clinic trainings. Pre-clinical trainings allowed nursing students to gain various medical experience and knowledge regarding nursing care. They could implement and compare the nursing theory with actual conditions in the hospital and society living. This topic needed to assess further about the benefits of pre-clinic trainings.

A Descriptive Analysis of the Nutraceutical Constituents, Extraction Techniques, and Possible Health Benefits of Tamarind

Background: Tamarind is a multifunctional tree, with nearly every portion having significant nutritional or therapeutic use. The fruit, which produces acidic pulp, is the most valuable and often utilized portion. Objective: The aim of this paper is to discuss the distribution, habitat, chemical constituents and extraction techniques of tamarind. Methods: This study reviews the chemical constituents, health benefits and extraction techniques of tamarind. Databases such as PubMed, Scopus, Science Direct, and Google Scholar were used to search articles from 1990 to 2022. The key search terms included tamarind, phytoconstituents extraction and anti-nutritional factor. Research studies also included similar plant parts extracted from similar solvents which were considered in this review. Results: According to our observations, Tamarindus indica is a crucial plant with significant pharmacological properties. It is extensively used as a conventional medicine to treat a variety of disorders; however, its active ingredients require further investigation for future drug development and pharmacological activity. Tamarind contains a diverse range of bioactive compounds, including polyphenols, flavonoids, alkaloids, vitamins, and minerals, which have been associated with various health-promoting properties. The study examines different extraction methods used to isolate tamarind's bioactive constituents, such as solvent extraction, supercritical fluid extraction (SFE), and microwave-assisted extraction (MAE). Furthermore, the research highlights the potential health benefits of tamarind, including antioxidant activity, anti-inflammatory effects, gastrointestinal support, cardiovascular benefits, and antimicrobial properties. Discussion: Tamarind includes citric acid, linoleic acid, volatile oils, vitamin C, potassium, Camp sterol, -amyrin, Tannins, saponins, and glycosides as a result of this. It has several pharmacological properties such as reducing swelling, preventing oxidation, hypolipidemic, weight loss, antibacterial, hepatoprotective, anthelmintic, and painkiller properties. These properties will assist to generate interest in Tamarind and develop novel preparations with more medicinal and commercial potential. The findings indicate that tamarind holds significant promise as a natural resource for developing functional foods, nutraceuticals, and pharmaceuticals with potential positive impacts on human health.

Exploring potentials of Electuaries for Controlling Chronic Respiratory Diseases in Unani Medicine: A Systematic Review

Background: Chronic respiratory diseases rate has been increasing alarmingly, causing huge burden on the mortality and morbidity. Environmental pollution and occupational exposure, the major identified risk factors and endless adverse effects of conventional medicine put forward the need for better alternative options. Electuaries are the pharmaceutical formulation of poly herbal drugs that are employed as effective remedy for respiratory disorders in Unani system of medicine. Objective: The aim is to assess the effectiveness of Unani pharmaco-therapeutics in the management of various respiratory diseases and the computation of drug/water and drug/sugar ratio for the elaborated electuaries. Methods: A web-based review on certain selected Unani drugs and its molecular mechanism was carried out using the data bases such as Pub Med, Google Scholar, Science Direct and Scopus published until the end of June 2022. Results: It was observed that several single drugs such as Khayarshambar (Cassia fistula L.), Sapistan (Cordia dichotama Forst), Asl-us- Soos (Glycyrrhiza glabra L.), Khatmi (Althea officianialis L.), Za’fran (Crocus sativus L.), Behīdāna (Cydonia oblonga Mill.) etc. used in Unani formulations claimed to be effective in management of respiratory diseases like COVID 19. The herbs and its chemical constituents showed the preventive effect on respiratory diseases with inflammatory cell mediators, lung pathologies, airway response and immunomodulatory effects. The results of research studies (preclinical, clinical or in silico) and their molecular mechanisms on Electuaries have proved to be optimal for the respiratory system. Conclusion: Unani poly-pharmaceutics showed anti-inflammatory, anti-viral, anti-bacterial, anti-allergic, anti- tussive, mucolytic actions arresting respiratory diseases.

Nature’s Signature in Ayurveda with an Ethnopharmacological Approach: A Narrative Review

: The nature's signature in Āyurveda i.e. Doctrine of Signatures (DOS), which calls for utilizing natural substances that resemble a particular body part or organ, is consistent with the ethnopharmacological practice of choosing therapeutic plants based on their visible physical qualities. In order to promote health and treat ailments, the ancient Indian medical system known as Āyurveda employs natural ingredients including plants, minerals, and animal products. The study of conventional medicine and the application of natural products for therapeutic reasons are known as ethno-pharmacology. This review explores various research on ayurvedic herbs, their doctrinal signature, and the status of our understanding of ethno-pharmacology. However, by integrating Āyurveda plants' doctrinal signatures with ethnopharmacological methods, it might be better to comprehend the therapeutic potential of plants and create novel treatments for a range of ailments. Combining these two perspectives might assist in understanding how nature may heal and how natural medicines could improve health and wellness. It was believed that a plant containing parts that resembled portions of human bodies, animals, or other items had practical use for those parts, animals, or objects. This philosophy was shown in some of the Indian medicinal plants that are discussed in this article.

Investigating the Significance of the Transgenerational Impact of High and Repeated Doses of Ivermectin: Effects on Paternal Testis Histopathology, Pups' Development, and Sexual Behavior

Paternal exposure to environmental challenges is critical for the offspring's future health, and the transmission of acquired traits through generations increases the risk of offspring developing diseases. Ivermectin (IVM) is widely used in veterinary and human medicine to treat parasitosis. Our previous studies showed that IVM acute administration induced disorganization of the germinal epithelium and could cause damage to sperm production. Thus, this study investigated the effects of paternal exposure to repeated high ivermectin doses on paternal testis histology. After mating, their pups' development and sexual behavior in adult rats were examined. Method: Two groups of male rats were treated with IVM or its vehicle once a week for three weeks. We observed these males' body weight, organs and testis histology, and testosterone levels. These rats were mated with females without any treatment: the reproductive performance, the offspring development, and the male and female sexual behavior observed in adulthood. Relative to controls, the IVM paternal testis histology showed hypertrophy and hyperplasia of Leydig cells and increased diameter of the seminiferous tubules—no impairment in reproductive performance. In males and females, the physical and reflexes were modified. In adult age, female rats of the IVM group showed reduced sexual behavior and sexual preferences for the same sex, while male sexual behavior was not altered. Thus, it is possible that paternal exposure to IVM interfered with pups' hormonal and growth factors during development and in adult age. Further studies are needed to explore IVM transgenerational effects identifying possible mechanisms underpinning behavioral effects.

A Medical Student Online Community: A Qualitative Analysis of Step 1 Subreddit Posts

A Medical Student Online Community: A Qualitative Analysis of Step 1 Subreddit Posts

Analysis of prognosis and medical resource utilization in elderly patients with trauma: A retrospective cohort study in one trauma center

Background: Trauma is consistently among the top ten causes of death worldwide. The aging population, constituting 15.21% of adults aged over 65 in Taiwan as of November 2019, has significantly impacted healthcare expenditures. This study aimed to explore the prognosis and resource utilization in patients with geriatric trauma. Methods: This retrospective analysis included ER admissions between January 2015 and December 2017 at a Level I trauma center in southern Taiwan. Of the 5,185 eligible patients, 1,743 were elderly. Comparisons between the age groups assessed medical resource use, patient characteristics, trauma profiles, and management. Outcomes examined included mortality, complications, length of hospital stay, duration of ICU stay, and costs. Results: Elderly patients, predominantly women, exhibit more blunt injuries often resulting from accidental falls. They experienced longer hospital stays and higher medical expenses, as well as increased complication and mortality rates. Mortality predictors included age, GCS score, trauma severity score (≥16), complications, surgery, and initial hypotension. Complications correlated with prolonged length of hospital stay (LOS), early blood transfusion, and mortality, impacting overall expenditure along with trauma severity, ICU days, surgery, and AIS score (≥3). Conclusion: Elderly patients had a longer LOS, higher mortality and complication rates, and higher total medical costs. The required medical expenses for elderly trauma cases were relatively higher than those for younger individuals. Relevant authorities should consider patient age when formulating policies for trauma reimbursement. Based on our findings, healthcare resource utilization can be reduced by decreasing the length of hospital stay and mitigating trauma severity. We recommend collecting more detailed data, extending the study period, and engaging in multicenter collaborations to validate our findings and provide a roadmap for further research. We suggested that interventional studies are needed to test strategies aimed at reducing resource utilization and improving outcomes in elderly trauma patients, which would be valuable.

Association Between X/Twitter and Prescribing Behavior During the COVID-19 Pandemic: Retrospective Ecological Study

Background Social media has become a vital tool for health care providers to quickly share information. However, its lack of content curation and expertise poses risks of misinformation and premature dissemination of unvalidated data, potentially leading to widespread harmful effects due to the rapid and large-scale spread of incorrect information. Objective We aim to determine whether social media had an undue association with the prescribing behavior of hydroxychloroquine, using the COVID-19 pandemic as the setting. Methods In this retrospective study, we gathered the use of hydroxychloroquine in 48 hospitals in the United States between January and December 2020. Social media data from X/Twitter was collected using Brandwatch, a commercial aggregator with access to X/Twitter’s data, and focused on mentions of “hydroxychloroquine” and “Plaquenil.” Tweets were categorized by sentiment (positive, negative, or neutral) using Brandwatch’s sentiment analysis tool, with results classified by date. Hydroxychloroquine prescription data from the National COVID Cohort Collaborative for 2020 was used. Granger causality and linear regression models were used to examine relationships between X/Twitter mentions and prescription trends, using optimum time lags determined via vector auto-regression. Results A total of 581,748 patients with confirmed COVID-19 were identified. The median daily number of positive COVID-19 cases was 1318.5 (IQR 1005.75-1940.3). Before the first confirmed COVID-19 case, hydroxychloroquine was prescribed at a median rate of 559 (IQR 339.25-728.25) new prescriptions per day. A day-of-the-week effect was noted in both prescriptions and case counts. During the pandemic in 2020, hydroxychloroquine prescriptions increased significantly, with a median of 685.5 (IQR 459.75-897.25) per day, representing a 22.6% rise from baseline. The peak occurred on April 2, 2020, with 3411 prescriptions, a 397.6% increase. Hydroxychloroquine mentions on X/Twitter peaked at 254,770 per day on April 5, 2020, compared to a baseline of 9124 mentions per day before January 21, 2020. During this study’s period, 3,823,595 total tweets were recorded, with 10.09% (n=386,115) positive, 37.87% (n=1,448,030) negative, and 52.03% (n=1,989,450) neutral sentiments. A 1-day lag was identified as the optimal time for causal association between tweets and hydroxychloroquine prescriptions. Univariate analysis showed significant associations across all sentiment types, with the largest impact from positive tweets. Multivariate analysis revealed only neutral and negative tweets significantly affected next-day prescription rates. Conclusions During the first year of the COVID-19 pandemic, there was a significant association between X/Twitter mentions and the number of prescriptions of hydroxychloroquine. This study showed that X/Twitter has an association with the prescribing behavior of hydroxychloroquine. Clinicians need to be vigilant about their potential unconscious exposure to social media as a source of medical knowledge, and health systems and organizations need to be more diligent in identifying expertise, source, and quality of evidence when shared on social media platforms.

OZONIOTERAPIA EM CONTAMINAÇÃO DE FERIDA CIRÚRGICARELATO DE CASO EM CÃO CAUDECTOMIZADO

Integrative medicine offers a wide variety of therapies that can be associated with conventional medicine, providing patients appropriate treatment with satisfactory results. Among the therapies used in integrative medicine, we have ozone therapy, which is widely used for various purposes due to its bactericidal, fungicidal and virucidal properties and the fact that it has practically no side effects with low toxicity, being used in chronic pathological conditions, in cases of dermatitis, ulcers and redness, burns and wound healing processes. The case report shows a healing process promoted by ozone therapy and associated therapies in a dog, presenting positive results. Ozone is a colorless gas with a characteristic odor and analgesic and anti-inflammatory functions, also contributing to the immune system and body oxygenation of animals. It can be applied in distinct ways, split into local or systemic, and can be subcutaneous, intravaginal, blood therapies, bagging and cupping methods. In addition, the technique offers low cost and promotes an improvement in the animal's quality of life.

Symptom trajectories over time by cannabis use status among patients undergoing cancer treatment.

Adults with cancer may perceive cannabis as beneficial for managing their cancer-related symptoms, but the evidence supporting its medical use is varied and inconclusive. This study characterized associations of cannabis use with cancer-related symptom trajectories. Participants were adults undergoing cancer treatment at the Stephenson Cancer Center (SCC; n = 218) in Oklahoma; they were 71% female, 10% minoritized race, and 45% had stage III or IV cancer. Participants completed surveys at baseline and 2-, 4-, and 6-months post-baseline. Assessments queried about cannabis use behavior, physical and psychological distress via the Rotterdam Symptoms Checklist (RSCL), respiratory symptoms via the American Thoracic Society Questionnaire (ATSQ), and quality of life indices (physical and social functioning, pain interference, sleep quality, fatigue) via the Patient Reported Outcomes Measurement Information System (PROMIS-29). Cannabis use status was categorized based on self-reported past 30-day cannabis use at each assessment as non-use [no use at any assessment], occasional-use [use at 1-2 assessments], or consistent-use [use at 3-4 assessments]. Longitudinal hierarchical linear modeling evaluated associations of cannabis use status with average symptoms and symptom trajectories across all four assessments. One-third (33%) of participants reported past 30-day cannabis use at ≥ 1 assessment. Participants who reported cannabis use (occasional-use and consistent-use) had more severe symptoms overall across assessments. While most cancer symptom trajectories did not differ by cannabis use status, participants who reported consistent cannabis use uniquely showed worsening physical function over time. Cannabis use was associated with greater cancer-related symptom severity over time.

Identifying perceptions and knowledge gaps among pre-clinical and clinical medical students regarding placebo therapy

Background: Misleading definitions and perceptions of placebo and placebo effect result in fewer realizations on the subject, hence reducing its perceived importance and applications. This study aims to assess undergraduate medical students' perceptions and knowledge gaps regarding placebo therapy across different stages of their education. Methods: A comparative cross-sectional study was conducted for six months, from December 2022 to May 2023, among 350 pre-clinical students (1st and 2nd year MBBS) and 526 clinical students (3rd, 4th, and Final-year MBBS) to assess their perceptions regarding placebo and placebo effect through a validated questionnaire. SPSS was used for analyses, and Pearson's Chi-square was applied, keeping the statistically significant value of <0.05. Results: The study included 876 medical students, with 350 pre-clinical and 526 clinical participants. The mean age was 21.32 years (±1.606). A significant gender distribution was observed, with 45.5% males and 54.5% females. Clinical students demonstrated a greater acceptance of placebo use (68.3% vs. 62.3%, p=0.031) and were more likely to find placebo therapy ethical in psychological cases (70.3% vs. 60.3%, p=0.006). Knowledge assessment revealed that 65% had fair knowledge of placebo therapy, 31.8% had good knowledge, while only 3.2% were highly knowledgeable. Conclusion: The study revealed that many pre-clinical and clinical students held misconceptions about placebo therapy, believing it permissible and beneficial in treating organic disorders. This highlights a significant knowledge gap, emphasizing the need for improved education on placebo use and ethics.

A Computational Protocol for the Knowledge-Based Assessment and Capture of Pathologies.

We propose that one of the main hurdles in delivering comprehensively informed care results from the challenges surrounding the extraction, representation, and retention of prior clinical experience and basic medical knowledge, as well as its translation into time- and context-informed actionable interventions. While emerging applications in artificial intelligence-based techniques, for example, large language models, offer impressive pattern association capabilities, they often fall short in producing human-readable explanations crucial to their integration into clinical care. Moreover, they require large well-defined and well-integrated data sets that typically conflict with the availability of such data in all but a few areas of medicine, for example, medical imaging and neuroimaging, noninvasive monitoring of bio-electrical activity, etc. In this chapter, we argue that approximate reasoning rooted in the knowledge that is explainable to the human clinician may offer attractive avenues for the introduction of such knowledge in a systematic way that supports formal retention, sharing, and reuse of new clinical and basic medical experience. We outline a conceptual protocol that targets the use of sparse and disparate data of different types and from different sources, seamlessly drawing on our collective experience and that of others. We illustrate the utility of such an integrative approach by applying the latter to the assessment and reconciliation of data from different experimental models, human and animal, in the example use case of a complex health condition.

Health Diagnostic Assistant using LLMs

The Health Diagnostic Assistant leverages advanced Large Language Models (LLMs) and Natural Language Processing (NLP) techniques to enhance patient diagnosis and healthcare decision-making. This innovative system employs Retrieval-Augmented Generation (RAG) to combine the strengths of pre-trained language models with a dynamic retrieval mechanism, allowing it to access and synthesize real-time medical knowledge from a wide array of databases. By analyzing patient symptoms, medical histories, and contextual data, the assistant generates accurate, context-aware recommendations and insights. The project aims to streamline the diagnostic process, reduce the burden on healthcare professionals, and improve patient outcomes by providing evidence-based suggestions tailored to individual cases. Through continuous learning and integration of user feedback, the Health Diagnostic Assistant aspires to evolve into a reliable tool for both patients and clinicians, fostering informed decision-making in the healthcare landscape.

Revisiting a Faculty Career Management Life Cycle Model: Anticipating and Navigating Career Transitions in Academic Medicine.

Career management models are valuable tools for faculty pursuing a career in academic medicine. These models help faculty transition through various stages of their careers, including commonly pursued academic advancements from assistant professor to full professor, as well as less common transitions like moving from full-time to part-time status, taking sabbaticals, going on medical leave, or assuming executive leadership roles. The success of faculty members across these stages is influenced by both environmental factors and individual-level characteristics. Recognizing career stages and transitions, as well as the impact of personal and environmental factors on career growth, is crucial. The proposed Faculty Career Self-Management Model (FCSM) provides a visual and descriptive framework to guide individual faculty and the professionals who support them in understanding, preparing for, and navigating career stages and professional transitions to build and sustain meaningful careers in academic medicine. The FCSM serves as a framework to explore, develop, and share best practices in supporting faculty vitality across the career lifespan.