Medical Research Research Articles

Identifying interventions that improve medication safety & rational use of medicines in India

Background & objectives Medication-related harm is known to be the cause for about 1/10th of hospitalizations. Some estimates from India show that about 90 per cent of medicines consumed are inessential or irrational and contribute towards high out-of-pocket expenditure on health. In this context, the Indian Council of Medical Research in 2022 constituted a National Task Force (NTF) to explore possible solutions that could improve safe and rational use of medicines (SRUMs). The objective of this study was to identify research ideas in the field of SRUM through a survey of relevant stakeholders, and further to prioritize the research ideas using a pre-identified set of criteria. Methods The responses from the identified stakeholders were assessed using the Child Health and Nutrition Research Initiative method, which is an established research priority-setting methodology. First, the NTF asked for two to six research ideas from relevant Indian and global stakeholders on solutions to improve SRUM. The ideas were checked for duplicates, re-phrased where necessary and classified into various sub-themes. Subsequently, the research ideas were scored by Indian experts with relevant technical expertise using a pre-defined set of five criteria: innovativeness, effectiveness, translational value, answerability and applicability. Each research idea received from a stakeholder was assigned a score under each of the five criteria. The overall research priority score was calculated as a mean of all five criteria-specific scores and converted into a percentage. Results The final output of the prioritization process was a list of research ideas or questions, ranked by their scores. Total 209 unique ideas were received from 190 respondents, which were scored by 27 experts. The top three research topics on medication safety focused on cost-effective strategies for improving antimicrobial stewardship, safe use of poly-pharmacy in geriatric patients and drug take-back policy interventions. Regarding the rational use of medicine, the top three topics included testing mobile application-based antimicrobial stewardship interventions, development of diagnostics for antimicrobial resistance, and behavioural interventions. Interpretation & conclusions Several priority ideas found in this study also align with those of global priority, e.g., safe disposal practices and enhanced pharmacovigilance, rational use of medicines. Patient engagement, which underlines many of the top scoring ideas found in this study, is also inclined with the top research priorities reported by the WHO priority exercise on research into the safe use of medicines. However, to the best of our knowledge, this is the first such work from a low- and middle- income country on medication safety and rational use of medicines. The findings of this research priority-setting exercise can help to guide research for the development of policy-relevant and novel interventions to improve SRUM in India.

Analysis of long-term results of conservative and surgical treatment in patients with locally advanced squamous cell carcinoma of the nasal cavity and paranasal sinuses

Introduction. Surgical intervention with subsequent chemoradiation therapy is one of the treatment standards in squamous cell carcinoma of the nasal cavity and paranasal sinuses. However, the question of the optimal therapy for this pathology remains open.Aim. To compare treatment results in patients with locally advanced squamous cell carcinoma of the nasal cavity and paranasal sinuses after conservative and surgical treatment.Materials and methods. The study included 86 patients with squamous cell carcinoma of the nasal cavity and paranasal sinuses, stages III–Iva, who between 2000 and 2020 received treatment at the N.N. Blokhin National medical Research Oncology Center. Surgical treatment with subsequent radiation or chemoradiation therapy was performed in 31 patients, conservative treatment (radiation or chemoradiation therapy) was performed in 55 patients.Results. Five-year overall survival in the conservative treatment group was 46.2 %, in the surgical treatment group – 59.7 % (р = 0.081); 5-year progression-free survival was 17 and 50.5 %, respectively (p = 0.002). In patients with Т3N0 tumor who received surgical treatment, 5-year progression-free survival was significantly higher than in patients who received conservative treatment (p <0,05). Comparison of overall survival and progression-free survival of patients who achieved objective response (complete response + partial response) after conservative treatment (n =36) and after surgical treatment (n = 31) did not show statistically significant differences (р = 0.469 and р = 0.183, respectively). The overall 5-year survival rate in the salvage surgery treatment group (24/55) was 63.1 % compared with 59.7 % in the surgical treatment group (n = 31), there were also no significant differences (p = 0.95). In patients with T3 tumor who received conservative treatment in this study, higher risk of progression was observed compared to patients who underwent surgical treatment.Conclusion. Surgical intervention remains an important treatment method for patients with locally advanced squamous cell carcinoma of the nasal cavity and paranasal sinuses, especially in cases of smaller tumor extent. Conservative therapy seems promising but large-scale prospective controlled randomized clinical trials are necessary to confirm its effectiveness and safety in various patient groups.

Scientific understanding in biomedical research

Motivated by a recent trend that advocates a reassessment of the aim of medical science and clinical practice, this paper investigates the epistemic aims of biomedical research. Drawing on contemporary discussions in epistemology and the philosophy of science, along with a recent study on scurvy, this paper (1) explores the concept of understanding as the aim of scientific inquiry and (2) establishes a framework that will guide the examination of its forms in biomedical research. Using the case of Tuberculosis (TB), (3) it is argued that grasping a mechanistic explanation is crucial for reaching a threshold of understanding at which we may speak of an objectual, biomedical understanding of TB.

Characteristics and career outcomes of dermatology-focused medical student research grant recipients

Although several dermatology-focused research grants for medical students exist, studies have yet to evaluate the outcomes of grant recipients, such as entry into dermatology residency and academic careers. We have described the characteristics of recipients of dermatology-focused medical student research grants and outcomes, including entry into dermatology residency and academic careers, and we have focused on seven dermatology-focused national and regional research grants eligible for U.S. medical students. Data were obtained from publicly available online sources for grants from 2004 to 2023. Of the 235 medical student recipients of dermatology research grants between 2004 and 2023, 45.5% attended one of the top 20 medical schools funded by National Institutes of Health research. Of those who completed medical school, 68.3% advanced to a dermatology residency (n=123/180). Among board-certified dermatologists, 44.7% held an academic position (n=34/76); among those who attended a top 20 medical school, 50% held an academic position (n=23/46) compared to 36.7% who did not (n=11/30). Limitations of this study include selection bias and incomplete data availability. Medical student research grants allow students to thoughtfully engage in dermatology research early in medical education. They may facilitate entry into dermatology residency and academic careers and lead to continued research endeavors.

A novel single near-infrared luminescence of negative thermal quenching materials for optical temperature measurement

In recent years, upconversion (UC) luminescence has gained attention due to its unique optical properties, and the thermal response spectral characteristics of these materials have been widely utilized in various fields including temperature sensing and biomedical research. However, the photoluminescence (PL) intensity of most rare earth ions doped phosphors decreases with increasing temperature, and the visible fluorescence emission penetration is still limited. In the work, the pure phase of Yb3+ and Er3+ ions co-doped Sc2Mo3O12 was successfully prepared. The Sc2Mo3O12: Yb3+, Er3+ sample showed a single emission of UC near-infrared (NIR) light. The optimum doping concentrations of 0.2 for Yb3+ ions and 0.01 for Er3+ ions were achieved. The possible upconversion luminescence (UCL) mechanism was investigated by analysing the UCL spectra, the down-shift (DS) excitation and emission spectra of Sc2Mo3O12: Yb3+, Er3+ phosphor. The excitation path of NIR emission is mainly through Er3+ from 2H11/2 to 4I9/2 energy level. What's more, the temperature-dependent near-infrared UCL properties of sample is explored in the temperature range from 323 K to 673 K. The enhancement of upconversion luminescence intensity shows a linear relationship with increasing temperature. The study paves a new way for non-contact optical temperature measurement with single near-infrared UCL emission.

Probiotic spore-derived multifunctional nanoparticles for enhanced ulcerative colitis treatment by activating metabolic pathways and repairing epithelial barrier

Ulcerative colitis is an agnogenic and refractory intestinal disease. Probiotic therapy has gained prevalence in medical research. Particularly, the probiotic spore coat has shown effectiveness in delivering oral drugs or probiotics for colitis treatment. Nevertheless, challenges persist in understanding the exact mechanism of the spore coat for optimal anti-inflammatory efficacy. Consequently, we develop a type of multifunctional spore coat nanoparticles (CN) derived from probiotic spore coat to comprehensively investigate its mechanisms of action in alleviating inflammation. Surprisingly, our research findings demonstrate that CN exhibits remarkable resistance to the harsh gastric acid environment and possesses the ability to selectively target inflammatory colonic sites characterized by an accumulation of positive charges. Additionally, CN effectively maintains the normal expression levels of zonula-1, occludin, and claudin-1 while simultaneously enhancing the small intestinal mucin 2 to ensure the integrity of intestinal barriers. Furthermore, the metabolomics analysis identifies 88 potential biomarkers that are enriched in three metabolic pathways, including tyrosine metabolism, tryptophan metabolism, and biosynthesis of valine, leucine, and isoleucine. These pathways are associated with Nrf2 signaling pathway activation, NF-κB and Nrf2 signaling pathways regulation, and metabolic disorders regulation. Collectively, our work provides a multifunctional nanomaterial CN and elucidates its anti-inflammatory mechanisms for ulcerative colitis treatment.

Enhancing community engagement, public involvement, and social capital through researchers’ participation in community dance projects: unexpected outcomes in underserved communities

BackgroundThe Dance and Health project aimed to promote public involvement in health research. Public involvement leads worked with project partner community groups, Aakash Odedra Dance Company and Moving Together, to develop a community engagement project with people living in low-socioeconomic areas/deprivation and diverse ethnic minority groups. Dance and Health included a weekly 60-min dance class and 30 min of facilitated health science discussion, that could either be a public involvement discussion for a research project, an activity about a particular biomedical research theme or ongoing discussions with a visiting researcher. The goal of this paper is to explore the impact of the Dance and Health project on the social capital of participants and provide key learnings on how to engage and build partnerships with people from underserved groups in health research contexts.MethodsQualitative interviews and focus groups were completed which explored participant and dance tutor experiences in community venues. Participants were aged between 22 and 90, most were female and were from Asian ethnic minority groups and White British groups living in deprived neighbourhoods in Leicester. Qualitative data were analysed using qualitative content analysis.ResultsThe responses to the Dance and Health project were positive across all the focus groups. Central themes identified were Feedback on the Project, Motivation to Exercise, Criticism of the NHS, Mental Wellbeing, Engagement in a Post Pandemic New Normal, Accessibility and Inclusivity, Empowerment and Building Social Capital.DiscussionThe focus groups evidenced that the project had broad impact. Participants expressed empowerment and ownership and described a range of social capital enrichment generated through the project including networks and friendships, access to the institutional resource of health science, and the opportunity to engage with a health and leisure activity that was valued and meaningful.

Influential factors of adherence to inhalation drug therapy in patients with stable chronic obstructive pulmonary disease.

This study aimed to investigate the influential factors of adherence to inhalation drug therapy (IDT) in patients with stable chronic obstructive pulmonary disease (COPD). A total of 243 patients with stable COPD who visited the chronic disease clinic of the respiratory department of our hospital between April 2022 and October 2022 were selected as participants using the convenience sampling method. Relevant information about all participants was collected by questionnaire for investigation, including basic information, clinical characteristics, inhaled drug names, situational awareness, dose and frequency. Univariate analysis revealed positive correlations between the following factors: (1) the total score of drug adherence and the total scores of the COPD knowledge questionnaire (COPD-Q), social support, subjective support, objective support and support utilisation, (2) the total score of dosage adherence and the total scores of COPD-Q, objective support and support utilisation and (3) the total score of technical standardisation and the total scores of social support, subjective support and objective support (p < 0.05). Multifactorial analysis showed that COPD health literacy, number of acute exacerbations in the past year and social support factors collectively accounted for 37.4% of the variable of patient adherence to IDT, as did COPD health literacy, modified Medical Research Council (mMRC) grading, duration of COPD, utilisation of support and marital status collectively account for 47.4% of the variable of patient dosage adherence. The goodness-of-fit of age, mMRC grading, social support, mode of residence, number of acute exacerbations in the past year and literacy to the patients' inhalation technical standardisation in the model was 47.4%. Dose adherence was predominantly influenced by COPD health literacy, mMRC grading, duration of COPD, utilisation of support and marital status. Inhalation technical standardisation was substantially limited by age, mMRC grading, social support, mode of residence, number of acute exacerbations in the past year and literacy.

Supinator to posterior interosseous nerve transfer to restore hand opening in brachial plexus and spinal cord injury: a systematic review and individual patient-data meta-analysis.

Cervical spinal cord injury (SCI) and lower trunk brachial plexus injury (BPI) commonly result in hand paralysis. Although restoring hand function is complex and challenging to achieve, regaining volitional hand control drastically enhances functionality for these patients. The authors aimed to systematically review the outcomes of hand-opening function after supinator to posterior interosseous nerve (PIN) transfer. A systematic literature review was performed according to the PRISMA guidelines. A total of 16 studies with 88 patients and 119 supinator to PIN transfers were included (87 transfers for SCI and 32 for BPI). In most studies, the time interval from injury to surgery was 6-12 months. Finger extension and thumb extension (Medical Research Council grade ≥ 3/5) recovered in 86.5% (103/119) and 78.1% (93/119) of cases, respectively, over a median follow-up of 19 months. The rates of recovery were similar for the SCI and BPI populations (finger extension, 87.3% in SCI and 84.3% in BPI; thumb extension, 75.8% in SCI and 84.3% in BPI). Type of injury (OR 1.05, 95% CI 0.17-6.4, p = 0.95), time from injury to surgery (OR 1.01, 95% CI 0.8-1.29, p = 0.88), and age (OR 0.97, 95% CI 0.90-1.06, p = 0.60) were not associated with odds of a successful outcome. Duration of follow-up was significantly associated with successful finger extension (OR 1.15, 95% CI 1.01-1.30, p = 0.026). No donor-associated supinator weakness was reported postoperatively given that patients had an intact bicep muscle preoperatively contributing to supination. Supinator to PIN transfer is a safe and effective procedure that can achieve successful restoration of digital extension in the SCI and BPI population at similar rates. Duration of follow-up was associated with superior outcomes, which was expected.

Delving into the clinical impact of NETs in pediatric cancer.

Pediatric cancer, a complex and heterogeneous group of diseases, continues to challenge medical research and treatment strategies. Despite advances in precision medicine and immunotherapy, certain aggressive subtypes of pediatric cancer are resistant to conventional therapies, requiring further exploration of potential therapeutic targets. Neutrophil extracellular traps (NETs), net-like structures released by neutrophils, have emerged as a potential player in the pediatric cancer landscape. However, our understanding of their role in pediatric oncology remains limited. This systematic review examines the current state of the NETs literature in pediatric cancer, focusing on the most frequent subtypes. The review reveals the scarcity of research in this area, highlighting the need for further investigation. The few studies available suggest that NETs may influence infection risk, treatment resistance and prognosis in certain pediatric malignancies. Although the field is still in its infancy, it holds great promise for advancing our understanding of pediatric cancer biology and potential therapeutic pathways. IMPACT: This review identifies a significant gap in research on neutrophil extracellular traps (NETs) in pediatric cancer. It provides a summary of existing studies and their promising findings and potential, as well as a comprehensive overview of current research on NETs in certain tumor types. It also emphasizes the lack of specific studies in pediatric cancer. The review encourages the prioritization of NET research in pediatric oncology, with the aim of improving prognosis and developing new treatments through increased understanding and targeted studies.

Comparison of Medical Research Abstracts Written by Surgical Trainees and Senior Surgeons or Generated by Large Language Models

Artificial intelligence (AI) has permeated academia, especially OpenAI Chat Generative Pretrained Transformer (ChatGPT), a large language model. However, little has been reported on its use in medical research. To assess a chatbot's capability to generate and grade medical research abstracts. In this cross-sectional study, ChatGPT versions 3.5 and 4.0 (referred to as chatbot 1 and chatbot 2) were coached to generate 10 abstracts by providing background literature, prompts, analyzed data for each topic, and 10 previously presented, unassociated abstracts to serve as models. The study was conducted between August 2023 and February 2024 (including data analysis). Abstract versions utilizing the same topic and data were written by a surgical trainee or a senior physician or generated by chatbot 1 and chatbot 2 for comparison. The 10 training abstracts were written by 8 surgical residents or fellows, edited by the same senior surgeon, at a high-volume hospital in the Southeastern US with an emphasis on outcomes-based research. Abstract comparison was then based on 10 abstracts written by 5 surgical trainees within the first 6 months of their research year, edited by the same senior author. The primary outcome measurements were the abstract grades using 10- and 20-point scales and ranks (first to fourth). Abstract versions by chatbot 1, chatbot 2, junior residents, and the senior author were compared and judged by blinded surgeon-reviewers as well as both chatbot models. Five academic attending surgeons from Denmark, the UK, and the US, with extensive experience in surgical organizations, research, and abstract evaluation served as reviewers. Surgeon-reviewers were unable to differentiate between abstract versions. Each reviewer ranked an AI-generated version first at least once. Abstracts demonstrated no difference in their median (IQR) 10-point scores (resident, 7.0 [6.0-8.0]; senior author, 7.0 [6.0-8.0]; chatbot 1, 7.0 [6.0-8.0]; chatbot 2, 7.0 [6.0-8.0]; P = .61), 20-point scores (resident, 14.0 [12.0-7.0]; senior author, 15.0 [13.0-17.0]; chatbot 1, 14.0 [12.0-16.0]; chatbot 2, 14.0 [13.0-16.0]; P = .50), or rank (resident, 3.0 [1.0-4.0]; senior author, 2.0 [1.0-4.0]; chatbot 1, 3.0 [2.0-4.0]; chatbot 2, 2.0 [1.0-3.0]; P = .14). The abstract grades given by chatbot 1 were comparable to the surgeon-reviewers' grades. However, chatbot 2 graded more favorably than the surgeon-reviewers and chatbot 1. Median (IQR) chatbot 2-reviewer grades were higher than surgeon-reviewer grades of all 4 abstract versions (resident, 14.0 [12.0-17.0] vs 16.9 [16.0-17.5]; P = .02; senior author, 15.0 [13.0-17.0] vs 17.0 [16.5-18.0]; P = .03; chatbot 1, 14.0 [12.0-16.0] vs 17.8 [17.5-18.5]; P = .002; chatbot 2, 14.0 [13.0-16.0] vs 16.8 [14.5-18.0]; P = .04). When comparing the grades of the 2 chatbots, chatbot 2 gave higher median (IQR) grades for abstracts than chatbot 1 (resident, 14.0 [13.0-15.0] vs 16.9 [16.0-17.5]; P = .003; senior author, 13.5 [13.0-15.5] vs 17.0 [16.5-18.0]; P = .004; chatbot 1, 14.5 [13.0-15.0] vs 17.8 [17.5-18.5]; P = .003; chatbot 2, 14.0 [13.0-15.0] vs 16.8 [14.5-18.0]; P = .01). In this cross-sectional study, trained chatbots generated convincing medical abstracts, undifferentiable from resident or senior author drafts. Chatbot 1 graded abstracts similarly to surgeon-reviewers, while chatbot 2 was less stringent. These findings may assist surgeon-scientists in successfully implementing AI in medical research.

Towards robotic laboratory automation plug & play: Reference architecture model for robot integration

Supportive robotic solutions take over mundane, but essential tasks from human workforce in biomedical research and development laboratories. The newest technologies in collaborative and mobile robotics enable the utilization in the human-centered and low-structured environment. Their adaptability, however, is hindered by the additional complexity that they introduce. In our paper we aim to entangle the convoluted laboratory robot integration architectures. We begin by hierarchically decomposing the laboratory workflows, and mapping the activity representations to layers and components of the automation control architecture. We elaborate the framework in detail on the example of pick-and-place labware transportation - a crucial supportive step, which we identified as the number one area of interest among experts of the field. Our concept proposal serves as a reference architecture model, the key principles of which were used in reference implementations, and are in line with international standardization efforts.

Complete de novo assembly of Wolbachia endosymbiont of Drosophila willistoni using long-read genome sequencing

Wolbachia is an obligate intracellular α-proteobacterium, which commonly infects arthropods and filarial nematodes. Different strains of Wolbachia are capable of a wide range of regulatory manipulations in their diverse hosts, including the modulation of host cellular differentiation to influence host reproduction. The genetic basis for the majority of these phenotypes is unknown. The wWil strain from the neotropical fruit fly, Drosophila willistoni, exhibits a remarkably high affinity for host germline-derived cells relative to the somatic cells. This trait could be leveraged for understanding how Wolbachia influences the host germline and for controlling host populations in the field. To further the use of this strain in biological and biomedical research, we sequenced the genome of the wWil strain isolated from host cell culture cells. Here, we present the first high quality Nanopore assembly of wWil, the Wolbachia endosymbiont of D. willistoni. Our assembly resulted in a circular genome of 1.27 Mb with a BUSCO completeness score of 99.7%. Consistent with other insect-associated Wolbachia strains, comparative genomic analysis revealed that wWil has a highly mosaic genome relative to the closely related wMel and wAu strains from Drosophila melanogaster and Drosophila simulans, respectively.

Deciphering the Role of Peroxisome Proliferator-activated Receptor α and Phosphodiesterase Type 5 Targets in Alzheimer's Disease.

The most prevalent cause of dementia is Alzheimer's disease (AD). Although the global AD rate is on a constant rise, medical research is yet to find a cure for this neurological condition. Current available therapeutic drugs for AD treatment only provide symptomatic alleviation. Therefore, it is essential to establish effective AD treatment strategies in addressing clinical needs. The development of disease-modifying treatments for use in the disease's early stages and the advancement of symptomatic drugs principally used in the disease's later stages are priorities in AD research. Given that the etiology of AD is difficult to comprehend, using a multimodal therapy intervention that targets molecular targets of AD-related degenerative processes is a practical strategy to change the course of AD progression. The current review article discussed PPAR-α (Peroxisome proliferator-activated receptor-α) and PDE5 (Phosphodiesterase type 5) targets with evidence for their preclinical and clinical importance. Furthermore, we support the targets with AD-related processes, functions, and remedial measures. A unique synergistic method for treating AD may involve the beneficial combinatorial targeting of these two receptors. Furthermore, we reviewed different PDE chemical families in this research and identified PDE5 inhibitors as one of the promising AD-related experimental and clinical disease-modifying medications. Lastly, we suggest jointly targeting these two pathways would be more beneficial than monotherapy in AD treatments.

Psychological and Behavior Investigation of Chinese Residents: concepts, practices, and prospects

To provide researchers with a comprehensive understanding of the Psychological and Behavior Investigation of Chinese Residents (PBICR), this paper introduces its background and features from four aspects. In terms of design concept, the PBICR focuses on various aspects of the mental health and health behaviors of the Chinese population, takes full account of timeliness and efficiency, adheres to the original intention of open data access and data sharing, and builds a high-quality database with large-sample, multi-center, repetitive, and a nationwide cross-sectional design to promote data mining and exchange and cooperation; in terms of survey implementation, the PBICR adopts a combination of population size-proportional, multi-stage sampling and quota sampling, and obtains data through face-to-face field surveys with strict quality control to ensure the representativeness and reliability of the samples. Regarding to the output, the PBICR's research content is rich and updated in line with international hotspots, which can satisfy the demand for research needs on diversified variables and data. Previous research results have had a significant impact in many fields such as public health, management, communication, and psychology. Looking ahead, the PBICR will gradually complete the construction of databases from the general database to sub-databases, pay attention to special populations and globally widespread areas, add perspectives on tracking surveys and biomedical data research, and have greater research potential to drive research on the mental and behavioral health of Chinese population through the overall layout of the multi-dimensional.

Analyzing unmanned aerial vehicle (drone) attacks; a disaster medicine perspective

IntroductionUnmanned aerial vehicles (UAVs), more commonly known as drones, have rapidly become more diverse in capabilities and utilization through technology advancements and affordability. While drones have had significant positive impact on healthcare and consumer delivery particularly in remote and austere environments, Violent Non-State Actors (VNSAs) have increasingly used drones as weapons in planning and executing terrorist attacks resulting in significant morbidity and mortality. We aim to analyze drone-related attacks globally against civilians and critical infrastructure for more effective hospital and prehospital care preparedness. MethodsWe retrospectively reviewed the Global Terrorism Database (GTD) from 1970 to 2020 to analyze the worldwide prevalence of drone-related attacks against civilians and critical infrastructure. Cases were excluded if they had insufficient information regarding a drone involvement, and if attacks were conducted by the government entities. The trends in the number of attacks per month, as well as the number of fatalities and injuries, were examined using time series and trend analysis. ResultsThe database search yielded 253 drone-related incidents, 173 of which met inclusion criteria. These incidents resulted in 92 fatalities and 215 injuries with civilian targets most commonly attacked by drones (76 events, 44%), followed by military (46 events, 27%). The Middle East region was most affected (168 events, 97% of attacks) and the Islamic state of Iraq was the most common perpetrator (106 events, 61%). Almost all attacks were by explosive devices attached to drones (172 events). Time series with linear trend analyses suggested an upward trends of drone attacks from VNSAs, resulting in a greater number of injuries and fatalities, that became more frequent over the years.” ConclusionsOvertime, there were upward trends of drone attacks, with higher lethality and morbidity. There were more injuries compared to fatalities. Most common region affected was the Middle East, and most common type of weapon employed by drone technology was explosive. Investment in medical personnel training, security, and research is crucial for an effective mass-casualty incident response after the drone attacks.

The current status and prospects of large language models in medical application and research

The current status and prospects of large language models in medical application and research

The evolution of simulation-based medical education research: From traditional to virtual simulations

BackgroundSimulation-based medical education (SBME) is a widely used method in medical education. This study aims to analyze publications on SBME in terms of countries, institutions, journals, authors, and keyword co-occurrence, as well as to identify trends in SBME research. MethodsWe retrieved the Publications on SBME from the Web of Science Core Collection (WoSCC) database from its inception to January 27, 2024. Microsoft Excel 2019, CiteSpace, and VOSviewer were used to identify the distribution of countries, journals, and authors, as well as to determine the research hotspots. ResultsWe retrieved a total of 11272 publications from WoSCC. The number of documents published in 2022 was the highest in the last few decades. The USA, the UK, and Canada were three key contributors to this field. The University of Toronto, Stanford University, and Harvard Medical School were the top major institutions with a larger number of publications. Konge, Lars was the most productive author, while McGaghie, William C was the highest cited author. BMC Medical Education has the highest number of publications among journals. The foundational themes of SBME are “Patient simulation,” “extending reality,” and “surgical skills.” ConclusionsSBME has attracted considerable attention in medical education. The research hotspot is gradually shifting from traditional simulations with real people or mannequins to virtual, digitally-based simulations and online education. Further studies will be conducted to elucidate the mechanisms of SBME. The utilization of SBME will be more rationalized.

Molecular Dynamics Modeling of Interacting Magnetic Nanoparticles for Investigating Equilibrium and Dynamic Ensemble Properties

Magnetic nanoparticles have the potential to be used in various biomedical applications, including magnetic drug targeting and hyperthermia for cancer treatment. In both cases, precise prediction of the local particle concentration is required to plan a successful therapy, which is a challenging task due to several complex flow phenomena. Computational macroscopic and microscopic models have been developed to support this process, but they have limitations in terms of interactions implementation, micromagnetic dynamics or computational costs. This study aims to develop a model that can represent micromagnetic dynamics and being employed to study equilibrium properties of particle ensembles in viscous media. Therefore, a kinetic Monte Carlo method in combination with Langevin equations is used. So, magnetization dynamics and mechanical motion can be simulated in combination very efficiently. The new model is validated with another model based on the stochastic Landau-Lifshitz-Gilbert equation. Various interaction potentials like Van der Waals, steric and electrostatic interactions are included to study their specific influence on structural properties. Also, methods to control the errors while integrating the equations of motion and using the Ewald method for calculating interaction quantities are implemented. As a validation we studied equilibrium and time dependent properties of non-interacting particle ensembles as well as errors made by the Ewald-method used for interaction quantities calculation. In all studies we found very good agreement of the simulation results with the theoretical predictions. The developed models can now be used for investigating equilibrium and dynamic properties of ferrofluids, or more general for biomedical research for magnetic drug targeting, hyperthermia, or imaging techniques. Furthermore, the new hybrid model can be also used for simulations in the range of milliseconds with reasonable computational effort.

Epidemiology of Trichomonas vaginalis infection in the Middle East and North Africa: systematic review, meta-analyses, and meta-regressions

Trichomoniasis, caused by the parasite Trichomonas vaginalis (TV), remains an underappreciated sexually transmitted infection (STI), primarily due to inadequate understanding of its epidemiology and public health implications. This study aimed to characterize TV epidemiology in the Middle East and North Africa (MENA). Systematic review and analysis of evidence sourced from international, regional, and national databases were conducted. Findings were reported following PRISMA guidelines. Random-effects meta-analyses and meta-regressions were performed to determine pooled mean prevalence, investigate associations with prevalence, and identify sources of between-study heterogeneity. The review identified 263 relevant publications, encompassing 462TV prevalence measures. The pooled mean TV prevalence was estimated as follows: 4.7% (95% CI: 3.9-5.6%) in the general population of women, 17.2%(95% CI: 5.4-33.6%) among intermediate-risk populations, 10.3% (95% CI: 6.2-15.3%) among female sex workers, 13.9% (95% CI: 12.3-15.6%) among symptomatic women, 7.4% (95% CI: 1.9-15.5%) among infertility clinic attendees, 2.3% (95% CI: 0.1-6.3%) among women with miscarriages or ectopic pregnancies, and 1.6%(95% CI: 0.8-2.7%) among STI clinic attendees. Limited data were found for men. Multivariable meta-regressions explained >40% of the prevalence variation, unveiling a hierarchical prevalence pattern by population type, an inverse correlation with national income, and a prevalence decline at a rate of 1% per calendar year. Despite conservative sexual norms, MENA has a substantial TV prevalence, comparable to the global TV prevalence. The unexpectedly high prevalence of this curable infection may, in part, be attributed to limited access to and underutilization of STI screening and treatment services. This work was supported by the Qatar Research, Development, and Innovation Council [ARG01-0522-230273] and by the Biomedical Research Program at Weill Cornell Medicine-Qatar.