Treatment Process Of Patients Research Articles

Intervertebral disc degeneration and regenerative medicine

AbstractIntervertebral disc (IVD) degeneration is a common phenomenon that affects patients with increasing prevalence with increasing age. Both conservative treatments, such as the use of pain medication or physical therapy, and surgical treatments, such as fusion or disc replacement therapies, are offered to patients. Both non‐invasive and invasive treatments have been shown to improve pain and quality of life for patients. This review explores the role of regenerative medicine techniques as a promising therapeutic intervention that can be used before or in combination with conservative therapy and surgery to enhance the treatment process in patients with IVD degeneration or disc pathology. Currently, there are four major modules of regenerative medicine: genetic therapy, platelet‐rich plasma therapy, stem cell transplantation and tissue engineering. Several research studies have shown promising outcomes of stem cell transplantation and tissue engineering when combined with either surgical or conservative treatment, resulting in improved pain outcomes. The additional benefit of regenerative medicine techniques, specifically stem cell transplantation, is the potential for treating the root pathology of degeneration. Regenerative medicine techniques also have the potential to either halt or reverse degeneration as opposed to current standards of care for managing symptoms. There is a plethora of current research highlighting the benefits of regenerative medicine techniques; however, there remains clinical concerns and ethical concerns regarding the use of regenerative therapy techniques such as stem cell transplantation in the context of IVD degeneration.

Case series of 3 Pressure Ulcers Cured with Education through Telemedicine

Objectives: The case series with pressure ulcers who was cured by education through telemedicine will be presented as a model for how a Korean medicine doctor can participate in the telemedicine of pressure ulcers. We also aim to report on the perspectives of medical staff and patients regarding the improved telemedicine services in Korean medicine.Methods: The study included three cases of pressure ulcers in home care, and education on pressure ulcer management was provided to patients, caregivers, and collaborators via telemedicine. Basic training was provided to teach the sealed wet dressing therapy method. After the basic training, feedback on the treatment was provided by taking photos or videos of the patient's treatment process, and the feedback process was repeated until the dressing method was perfected.Results: A combination of telemedicine, home visits, and home care successfully treated pressure ulcers in home care patients using a multidisciplinary approach. The education through telemedicine alone improved the National Pressure Ulcer Advisory Panel (NPUAP) stages and the total score of the Pressure Ulcer Scale for Healing (PUSH) Tool, and all three cases were finally cured with an average treatment duration of 26.7 days. The patient's and clinician's perspectives also showed that telemedicine can effectively engage patients, caregivers, and collaborators, and motivate them to manage pressure ulcers.Conclusions: For patients having trouble visiting the hospital or desiring treatment at home, consideration can be given to telemedicine for traditional Korean medicine education in pressure ulcer management.

Advances in the Application of AI Robots in Critical Care: Scoping Review.

In recent epochs, the field of critical medicine has experienced significant advancements due to the integration of artificial intelligence (AI). Specifically, AI robots have evolved from theoretical concepts to being actively implemented in clinical trials and applications. The intensive care unit (ICU), known for its reliance on a vast amount of medical information, presents a promising avenue for the deployment of robotic AI, anticipated to bring substantial improvements to patient care. This review aims to comprehensively summarize the current state of AI robots in the field of critical care by searching for previous studies, developments, and applications of AI robots related to ICU wards. In addition, it seeks to address the ethical challenges arising from their use, including concerns related to safety, patient privacy, responsibility delineation, and cost-benefit analysis. Following the scoping review framework proposed by Arksey and O'Malley and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we conducted a scoping review to delineate the breadth of research in this field of AI robots in ICU and reported the findings. The literature search was carried out on May 1, 2023, across 3 databases: PubMed, Embase, and the IEEE Xplore Digital Library. Eligible publications were initially screened based on their titles and abstracts. Publications that passed the preliminary screening underwent a comprehensive review. Various research characteristics were extracted, summarized, and analyzed from the final publications. Of the 5908 publications screened, 77 (1.3%) underwent a full review. These studies collectively spanned 21 ICU robotics projects, encompassing their system development and testing, clinical trials, and approval processes. Upon an expert-reviewed classification framework, these were categorized into 5 main types: therapeutic assistance robots, nursing assistance robots, rehabilitation assistance robots, telepresence robots, and logistics and disinfection robots. Most of these are already widely deployed and commercialized in ICUs, although a select few remain under testing. All robotic systems and tools are engineered to deliver more personalized, convenient, and intelligent medical services to patients in the ICU, concurrently aiming to reduce the substantial workload on ICU medical staff and promote therapeutic and care procedures. This review further explored the prevailing challenges, particularly focusing on ethical and safety concerns, proposing viable solutions or methodologies, and illustrating the prospective capabilities and potential of AI-driven robotic technologies in the ICU environment. Ultimately, we foresee a pivotal role for robots in a future scenario of a fully automated continuum from admission to discharge within the ICU. This review highlights the potential of AI robots to transform ICU care by improving patient treatment, support, and rehabilitation processes. However, it also recognizes the ethical complexities and operational challenges that come with their implementation, offering possible solutions for future development and optimization.

CHANGES IN CIRCADIAN CHARACTERISTICS OF PATIENTS WITH PARKINSON DISEASE AFTER CORRECTION OF POOR SLEEP QUALITY USING MELATONIN: AN OPEN-LABEL CONTROLLED RANDOMISED TRIAL

Introduction. Recent studies are increasing the amount of evidence suggesting that the circadian system is disrupted in Parkinson's disease that can lead to poor sleep. Currently, international guidelines for managing non-motor symptoms of Parkinson's disease do not have recommendations with proven efficacy, but only methods with potential benefit. Two of the most widely available methods for correcting poor sleep quality in patients with Parkinson's disease in Ukraine are sleep hygiene training, also known as somnoeducation, and melatonin administration. The aim of the study is to compare the state of circadian characteristics before and after the correction of poor sleep quality in patients with Parkinson's disease in the context of sleep hygiene and an integrated approach with the implementation of chronotherapy using melatonin. Materials and methods. We conducted a clinical trial at the Centre for Patients with Parkinson's Disease and Other Neurodegenerative Diseases, which included 34 patients with poor sleep quality who were randomised into 2 groups: group 1a (n = 17) consisted of patients with Parkinson's disease who followed sleep hygiene rules and received chronotherapy; group 1b (n = 17) involved patients with Parkinson's disease who followed sleep hygiene rules but did not take any medications to improve sleep. Circadian characteristics were analysed using the Munich Chronotype Questionnaire. Results. Our study has found that the correction of poor sleep quality by introducing sleep hygiene into the treatment process of patients with Parkinson's disease demonstrates a shift in the time of sleep onset and mid-sleep to earlier, accompanied by a shift in chronotypes towards earlier, as well as an increase in sleep duration against a decrease in the time spent in bed, which led to an increase in the average actual sleep efficiency. At the same time, melatonin supplementation helps to reduce sleep latency in Parkinson's disease. Conclusions. Adherence to sleep hygiene recommendations contributes to changes in circadian characteristics and improves sleep efficiency in patients with Parkinson's disease, regardless of melatonin administration. Additional use of melatonin to correct the quality of sleep for 1 month is accompanied by a reduction in the sleep latency period.

Effectiveness of Neurolinguistic Programme Upon Emotional Intelligence among Nursing Faculty

Emotional intelligence among nursing faculty is vital for modelling effective communication and support for students, fostering a positive learning environment. It also enhances faculty resilience, enabling them to manage stress effectively and provide quality education consistently. This study aimed to assess the the Effectiveness of Neurolinguistic Programme upon Emotional intelligence among Nursing Faculty at Selected Nursing Colleges, Chennai. Methods: The Quasi-Experimental Research design was used to assess the Effectiveness of the Neurolinguistic Programme upon Emotional intelligence among 180 nursing faculty (90- control & 90-intervention group) who were selected using purposive sampling technique. Data was collected using tools such as Proforma to assess the Background characteristics of the college faculty, Emotional intelligence Self-evaluation inventory-Schuttee. Collected data were tabulated and analyzed using descriptive statistics like frequency, Mean, SD and inferential statistics such as using one-way ANOVA/t test in SPSS 24. Results: Study findings revealed that there is statistically significant difference in Emotional intelligence scores between Control (102.32/165±18.64) and Interventional group of Faculty in the post test (134.50/165±19.764, p<0.001). ie. Emotional intelligence scores were significantly high in the interventional group than the control group of Faculty, which can be attributed to the effectiveness of Neurolinguistic Programme upon Emotional intelligence nursing faculty. Conclusion: NLP techniques increase emotional intelligence in nursing faculty, promoting compassionate communication and patient care. These benefits extend to teaching, which improves the learning experience for students. Healthcare settings benefit from improved emotional understanding in both patient treatment and educational processes.

Correlations among family functions, lifestyles and resilience of nurses working in COVID-19 intensive care units in post-corona era

ABSTRACT Background: Despite the passing of time since the outbreak of Covid-19, the virus still impacts individuals and families. Hence, the present study investigated the effect of corona pandemic on correlations among nurses’ family functions, lifestyles, and resilience. Method: The present descriptive-correlational study examined 205 nurses working in Covid-19 Intensive Care Units (ICUs) in 2021–2022. The subjects were selected by convenience sampling and three questionnaires on family functioning, lifestyle and resilience were used to collect data, which were then analyzed by the Pearson correlation coefficient and Fisher’s test. Results: A negative correlation was observed between the FAD Total score and the Lifestyle Scale during COVID-19 (r = −0.15, 95% CI: −0.28 to −0.01, P = 0.031) and Resilience Scale Total Score (r = −0.16, 95% CI: −0.29 to −0.03, P = 0.020). We found a positive correlation between the Lifestyle Scale during COVID-19 Total score and the Resilience Scale Total score (r = 0.59, 95% CI: 0.49–0.67, P < 0.001). Conclusion: The results of the study revealed moderate resilience, lifestyle, and family functioning of nurses. Also, family functioning negatively correlated with lifestyle and resilience, i.e. nurses with family dysfunctions manifested weaker lifestyle and resilience, mostly due to Civid-19 complications. Thus, nurse-supporting programs dealing with the unpredictable care and treatment process of Covid-19 patients must be presented.

간호학 교육에서 영화를 활용한 질병 체험 내러티브 교수법의 적용 효과

This study is a non-equivalent control group, pre-post, time-lag design study to confirm the effect of applying the disease experience narrative teaching method using movies to nursing students. The illness narrative teaching method program consisted of partially providing the &lt;Wit&gt; movie and writing and presenting a patient experience worksheet. 63 people in the experimental group and 59 people in the control group participated. Data analysis was performed using ²-test, t-test, ANCOVA, and paired t-test using SPSS 24.0. As a result of this study, the experimental group's empathy (F=108.202 p=.&lt;.001), caring efficacy (F=104.756 p=.&lt;.001), and attitude toward end-of-life care (t=-2.104, p=.002) were higher than those of the control group. It was confirmed that there was statistically significant improvement. In future research, it is suggested to confirm the effects on patient-centered attitude, communication, and ethical decision-making through disease experience narrative teaching methods using not only movies but also actual patient experience interviews and documentaries. In addition, we propose a study that compares the effects of empathy and caring efficacy after nursing students indirectly experience the patient's perspective by participating in the patient's treatment process during the clinical training period.

Incidentally found parotid gland lesion in 18F-FDG PET/CT for staging evaluation of patients with hepatocellular carcinoma: remote possibility of metastatic tumor or second primary salivary gland malignancy

ObjectivesWe primarily aimed to evaluate whether parotid incidental lesion (PIL) in 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for staging evaluation of patients with hepatocellular carcinoma (HCC) would represent a possibility of extrahepatic metastasis or second primary malignancy (SPM). Additionally, we explored the incidence of PIL in HCC patients and examined any associated risk factors.MethodsWe retrospectively analyzed patients with HCC who underwent 18F-FDG PET/CT at our institution from 2010 to 2022. The pathological findings of PILs in HCC patients were investigated for confirmatory identification of the risk of HCC metastasis or SPM in parotid gland. Healthy controls received 18F-FDG PET/CT for health screening were also enrolled to compare the incidence of PILs with HCC patients. Various parameters associated with patient demographics and characteristics of HCC were analyzed to find the related factors of PILs.ResultsA total of 17,674 patients with HCC and 2,090 healthy individuals who had undergone 18F-FDG PET/CT scans were enrolled in the analyses. Among the 54 HCC patients who underwent pathological confirmation for PILs, benign primary parotid tumor was most commonly observed (n = 43 [79.6%]); however, no malignant lesions were detected, including HCC metastasis. The incidence of PILs was higher in patients diagnosed with HCC compared with the control group (485 [2.7%] vs. 23 [1.1%], p = 0.002). Analysis for the risk factors for PILs revealed that patient age, sex, and positive viral markers were significantly associated with the incidence of PILs in patients with HCC (all p < 0.001).ConclusionsOur study demonstrates that PILs are more frequently identified in patients with HCC on 18F-FDG PET/CT. However, no malignant PIL, including extrahepatic metastasis of HCC, was identified. Therefore, the presence of PIL should not impede or delay the treatment process for patients with HCC. Additionally, we suggested that for future swift and straightforward differential diagnoses of PIL, the development of additional protocols within the PET/CT imaging could be beneficial.

Comparing attitudes towards compulsory interventions in severe and persistent mental illness among psychiatrists in India and Switzerland.

Psychiatrists face a major ethical challenge when deciding whether to make use of coercive measures in the treatment process of patients suffering from severe and persistent mental illness (SPMI). As India and Switzerland show major cultural, political and financial differences, it is hypothesized that attitudes towards coercive measures among Indian and Swiss psychiatrists will vary too. Exploring differences in attitudes between cultures strengthens the critical reflection on one's own stances and in consequence, on our way of action. Especially when it comes to situations involving power imbalances between patients and health practitioners, self-reflection is essential to prevent ethically inappropriate behavior. An online survey on aspects of care for patients with SPMI was sent to 3'056 members of the Indian Psychiatric Society between April and June 2020 and to 1'311 members of the Swiss Society for Psychiatry and Psychotherapy between February and March 2016. The respondents' answers were compared. This article deals with the questionnaire's items on autonomous decision making and the implementation of coercive measures in clinical practice. More precisely, participating psychiatrists were asked to rate the importance of patient's autonomy in general and their willingness to apply coercive measures regarding two specific case vignettes depicting a patient with schizophrenia and one with depression. The statistical analysis, namely descriptive data analysis and calculation of arithmetic means, Shapiro Wilks tests and Mann-Whitney U tests, was carried out using IBM SPSS Statistics version 27. Answers were received from 206 psychiatrists in India and 457 psychiatrists in Switzerland. Indian participants tended to value autonomous decision making as slightly less important than Swiss participants (62.2% vs. 91%, p =.01). Regarding a case of severe and persistent depression, psychiatrists in the Indian group were on average more in favor of acting against the wishes of the patient (55% vs. 34.1%, p <.0001) as well as of accepting a temporary decrease in quality of life due to coercion (40% vs. 23%, p =.008). Answers concerning a case of schizophrenia revealed that Indian participants were more in favor of acting against the patient's wishes than Swiss participants (39% vs. 37%, p =.007), whereas the comparison whether to accept a temporary decrease in quality of life regarding this case showed no significant difference (p =.328). The significant difference in attitudes towards coercive measures among Indian compared to Swiss psychiatrists found in this study might arise from a predominantly more collectivist society in India compared to Switzerland. Moreover, differences in financial resources, the organization of the health care system, and the historical background might have an influence. Continuous and critical reflection on one's own views and behavior is essential, especially if ethical principles and individual rights could be violated through a power imbalance, as in the case of coercive measures.

Design and Implementation of a Primary Healthcare Cloud Platform

This paper presents the design and implementation of a primary healthcare cloud platform that aims to optimize primary medical services through informatization. The cloud platform integrates multiple functional modules including patient information management, diagnostic and treatment processes, pharmaceutical inventory, online appointments, financial management, and data analysis to meet the daily operational needs of primary healthcare institutions. Starting with the project background and current situation analysis, the paper details user needs research and functional design, and gives key discussions on the selection of system architecture and critical technology modules. During system development, technologies such as Spring Boot, Spring Cloud, and MySQL were used to build an efficient, stable, and secure platform. The system's reliability was ensured through unit testing, integration testing, system testing, and user acceptance testing. The paper concludes with a look into the future development direction of the platform, including further optimization of user experience, introduction of natural language processing and artificial intelligence technologies, and expansion of collaborative functions between primary healthcare institutions.

Emerging Trends in AI-Driven Health Tech: A Comprehensive Review and Future Prospects

Purpose: The purpose of this research is to explore the integration of artificial intelligence (AI) in healthcare, specifically within the realm of health informatics (HI). The study aims to understand the impact of AI on patient treatment, research, and operational processes within healthcare systems. Additionally, it seeks to address the challenges posed by the increasing volume of unorganized and unstructured data generated by AI technologies in healthcare.&#x0D; Materials and Methods: This research employs a comprehensive analysis approach, utilizing complex health information systems, clinical images, and intricate language. It examines the current utilization of AI in healthcare, focusing on its effects on patient and clinician involvement in healthcare decision-making. The assessment emphasizes key skill areas of Health Informatics, including IT, health information systems, security and privacy, telemedicine, m-Health, consumer health informatics, and clinical informatics.&#x0D; Findings: The study identifies several significant findings regarding the role of AI in healthcare. It highlights how AI technologies contribute to the generation of unstructured data, posing challenges for research and analysis. Additionally, the research underscores AI's ability to enhance personalized medical guidance, identify complex illnesses, forecast negative health occurrences, and improve patient outcomes. Moreover, it discusses AI's impact on social media and mobile apps, emphasizing its potential to gather valuable insights from online sources for a deeper understanding of patient needs and behaviors.&#x0D; Implications to Theory, Practice and Policy: Based on the findings, the research suggests several recommendations for future research and progress in the field of AI usage in healthcare. These recommendations may include further exploration of AI applications in healthcare decision-making, addressing challenges related to unstructured data, enhancing security and privacy measures, and leveraging AI for improving patient outcomes and clinician engagement. Additionally, the study emphasizes the importance of ongoing research and development to maximize the potential benefits of AI in healthcare.

Healthcare 5.0: A secure and distributed network for system informatics in medical surgery

IntroductionHealth records serve not only as a database of a patient's health history and treatment process but also as a crucial tool for doctors to diagnose and treat patients. However, the storage and sharing of these records are sensitive issues as they involve maintaining patient privacy and ensuring data transparency, security, and interoperability between different parties. Challenges to achieving these goals in the current surgical process can impact the allocation of medical resources and surgical outcomes. MethodsThis article proposes a healthcare 5.0 framework for medical surgery that deploys a secure and distributed network using Blockchain to demonstrate transactions between different parties in the orthopedic surgery process. The proposed network uses the Hyperledger Composer platform for deployment, and a patient-doctor-supplier orthopedic surgery network is designed and implemented to enable the safe sharing of medical records. ResultsA benchmarking tool was implemented for analyzing different scenarios of applying blockchain technology to orthopedic surgery. The application of blockchain technology to orthopedic surgery presents a promising solution for data sharing and supply chain management in the field. The integration of blockchain with cloud storage and hybrid encryption ensures secure and efficient storage of Electronic Health Record (EHR) and Personal Health Record (PHR) data. By leveraging the tamper-proof nature of blockchain and addressing concerns regarding centralized data storage, this scenario demonstrates enhanced security, improved access efficiency, and privacy protection in medical data sharing. ConclusionsThe article demonstrates the feasibility of using an IoT-based blockchain network in orthopedic surgery, which can reduce medical errors and improve data interoperability among different parties. This unique application of blockchain enables secure sharing of medical records, ensuring transparency, security, and interoperability. The network design may also be applicable to other surgeries and medical applications in the future.

Model Dukungan Sosial Berbasis Health Belief Model untuk Meningkatkan Penerimaan Diri terhadap Stigma dan Diskriminasi Pasien TB

This study aims to develop an effective intervention to improve self-acceptance of TB patients who experience stigma and discrimination using the Health Belief Model-Based Social Support approach. Web of Science, ProQuest and Pubmed databases were used to search for keywords derived from the Medical Subject Headings (MeSH) system for relevant articles in the preparation of this systematic. The results showed the initial literature search yielded 74 articles (48 Web Of Science, 7 from Proquest and 19 from Pubmed). After reviewing the abstracts for relevance and matching the inclusion criteria, 21 articles were selected for full-text review. Finally, 16 articles were selected for review and the results of the 16 articles analyzed showed that social support with the Health Belief Model can help reduce stigma and discrimination in TB patients. The conclusion of this study is that the results of the systematic review provide evidence for policy makers to consider alternative interventions using this method to fight stigma and discrimination so that the treatment process of TB patients becomes faster. Keywords: Social support Models, Health belief Model, Accept Yourself, Tuberculosis, Stigma, Discrimination.

Management of the diagnostic and treatment process in the admission department of a multiprofile hospital during COVID-19 pandemic

Introduction. High contagiousness of COVID-19 and its unpredictability have radically changed the work pattern in the emergency department of a multidisciplinary hospital.&#x0D; The purpose of our study is analysis of approaches to managing the diagnostic and treatment process for emergency patients during the COVID-19 pandemic.&#x0D; Material and methods. We analyzed data of two thousand seven hundred sixty seven patients with suspected coronavirus infection who sought emergency care at the Municipal Clinical Hospital named after. S.P. Botkin and those who underwent triage with further routing in the emergency department.&#x0D; Results. 112 569 patients were admitted from 01.04.2020 to 01.04.2022 for emergency assistance. 2,767 patients (2.46%) were suspected to have coronavirus infection. According to the results of PCR coronavirus infection was confirmed in 2064 people (1.83% of the total number and 74.59% of those with suspected infection). All patients with suspected COVID-19 were sent to the isolation room (2726 patients, the number differs from the total number of patients suspected with COVID-19). The patients were mostly suffered from emergency neurosurgical (3.65%), pulmonological (2.43%) and therapeutic (2.32%) diseases.&#x0D; Limitations. The data of 112569 patients with various pathologies who applied for emergency medical care at the admission department were analyzed as part of the study dedicated to introduction of a new model of work of the admission department of a multidisciplinary hospital. &#x0D; Conclusions. COVID-19 is not a contraindication for emergency care. Separation of patient flows, and correct diagnostics help to prevent the spread of COVID-19, speed up diagnosis and route the patient correctly.

Analysis of the Epidemiological Trend of Tuberculosis in Sistan and Baluchestan Province during 2015-2019

Introduction: Tuberculosis is one of the oldest and best-known diseases that has been with mankind for many years. Despite the reduction of infectious diseases in Iran, tuberculosis still remains in some parts of the country, especially in the south of Iran. The aim of this study was the epidemiological investigation of tuberculosis in Sistan and Baluchistan Province.&#x0D; Methods: The current research was conducted cross-sectionally in 2022. The study population included all the patients with tuberculosis in Sistan and Baluchistan Province. Data were collected by census method and using standard checklist. Data analysis was done using SPSS v16 software and descriptive and analytical tests.&#x0D; Results: In this study, the files of 5382 patients with tuberculosis in Sistan and Baluchistan Province were examined. 2489 patients (42.6%) were men. The most affected group were 2309 elderly people (39.5%) and 20 patients (0.34%) with HIV. The number of 4309 patients (73.8%) were suffering from pulmonary tuberculosis. There was a significant relationship between the elderly age group (P=0.04), female gender (P=0.02), non-Iranian nationality (P=0.02), and urban residences (P=0.03) with tuberculosis. However, no significant relationship was observed between marital status (P=0.06) and prison history (P=0.07).&#x0D; Conclusion: The incidence of tuberculosis fluctuated during the five years, but the overall incidence has been decreasing. Considering that some factors such as age groups, gender and symptoms such as cough, weight loss and chest pain increase the chance of contracting the disease. Therefore, doctors of health centers can take an important step in reducing the incidence of tuberculosis with timely visits and regular monitoring of the treatment process of patients.

Temporal topic model for clinical pathway mining from electronic medical records

BackgroundIn recent years, the discovery of clinical pathways (CPs) from electronic medical records (EMRs) data has received increasing attention because it can directly support clinical doctors with explicit treatment knowledge, which is one of the key challenges in the development of intelligent healthcare services. However, the existing work has focused on topic probabilistic models, which usually produce treatment patterns with similar treatment activities, and such discovered treatment patterns do not take into account the temporal process of patient treatment which does not meet the needs of practical medical applications.MethodsBased on the assumption that CPs can be derived from the data of EMRs which usually record the treatment process of patients, this paper proposes a new CPs mining method from EMRs, an extended form of the traditional topic model - the temporal topic model (TTM). The method can capture the treatment topics and the corresponding treatment timestamps for each treatment day.ResultsExperimental research conducted on a real-world dataset of patients’ hospitalization processes, and the achieved results demonstrate the applicability and usefulness of the proposed methodology for CPs mining. Compared to existing benchmarks, our model shows significant improvement and robustness.ConclusionOur TTM provides a more competitive way to mine potential CPs considering the temporal features of the EMR data, providing a very prospective tool to support clinical diagnostic decisions.

The effects of Annual SZ drug on dynamic changes in lymphocytes and cytokines of COVID-19 patients: A randomized clinical trial

BackgroundThe search for a potent anti-coronavirus therapy has remained an overwhelming task since the outbreak of COVID-19. Annual SZ is a novel formulation of artemisinin and its derivatives. We aim to investigate the effect of Annual SZ on clinical outcomes, cellular immune responses, and cytokine changes in COVID-19 patients. MethodsThis study included 80 COVID-19 hospitalized patients, which were randomly allocated into two groups (intervention and control). Both groups received standard supportive treatment. In addition, the intervention group (n = 40) received Annual SZ syrup, and the control group (n = 40) received a placebo. Dynamic changes in lymphocytes, cytokines, and clinical status were evaluated since hospital admission to 7 and 14 days after treatment. ResultsThe dynamic count of total T lymphocytes and T lymphocyte subsets (CD4+ and CD8+) in the Annual SZ group was significantly higher than the placebo group (p < 0.05). In addition, Programmed Death 1 (PD-1) was significantly increased in the CD4+ and CD8+ T cells in the placebo group compared with the Annual SZ group (p < 0.05). Also, the CD4+/CD8+ ratio was not significantly different between the groups (p > 0.9). Moreover, IL-6 levels were significantly reduced (p < 0.05), while IL-4 and IFN-γ levels were not statistically different between the two groups (p > 0.05). ConclusionThis research indicated that the Annual SZ syrup significantly improved clinical status and lymphocyte frequency with less exhaustion of T lymphocytes and a reduction of inflammatory responses, which seems to be beneficial in the treatment process of COVID-19 patients.

Prognostic factors of pediatric ependymomas at a National Cancer Reference Center in Peru.

Ependymomas are central nervous system tumors that significantly impact the quality of life and carry a high mortality rate. Both the disease itself and its treatment cause significant morbidity. At a national level in Peru, there are no reports on clinical characteristics of the disease. This retrospective study captured patient aged less than 19 years with a diagnosis of ependymoma from 2012 to 2022 at a tertiary center in Lima. 85 patients were included with a median follow-up time was 51.6 months. The 5-year overall survival and progression-free survival were 55.89% (95% CI: 44.28 - 65.99) and 37.71% (95% CI: 26,21-49,16) respectively. The main prognostic factors identified were completed treatment (p=0.019), adjuvant chemotherapy (p=0.048), presence of metastasis (p=0.012), and disease recurrence (p=0.02). The survival of patients with ependymoma is below that reported in high-income countries. Incomplete treatment and treatment abandonment are factors that negatively impact the prognosis. Further studies are needed to identify barriers in the referral and treatment process for patients with ependymoma.

ChatGPT’nin kadınlarda alt üriner sistem semptomları ile ilgili soruları yanıtlama performansının değerlendirilmesi

OBJECTIVE: ChatGPT is a language model developed by OpenAI. As a language model, ChatGPT can be used for various natural language processing tasks, such as answering questions, providing information, engaging in conversations, and more. We aimed to evaluate ChatGPT’s suitability to accurately inform patients and medical students by analyzing the reliability and accuracy of lower urinary tract symptoms (LUTS) information in women. MATERIAL and METHODS: Systematically organized frequently asked questions from urology association websites, hospitals, and social media platforms regarding lower urinary tract symptoms (LUTS) in women, along with questions compiled from European Association of Urology (EAU) recommendations, were analyzed. All questions were systematically submitted to ChatGPT 3.5 and 4.0 versions. Two expert urologists independently evaluated the data and answers to the questions and assigned scores from 1 to 4 to each answer. RESULTS: A hundred and three frequently asked questions and 36 questions compiled from EAU guideline recommendations regarding LUTS in women were included in the study. 83.50% of the frequently asked questions (85.44% for version 4.0) and 80.56% of the questions compiled from EAU recommendations (80.56% for version 4.0) were rated as ‘completely correct’ (Grade 1). The rate of completely incorrect answers to the questions (Grade 4) was 0.97% in the frequently asked questions group (0.97% for version 4.0) and 2.78% in the guide-based questions group (2.78% for version 4.0). The success rate of both versions in answering questions was found to be close to each other. CONCLUSION: ChatGPT provided acceptable responses to the posed questions. Despite its limitations, we believe that utilizing this continuously evolving platform under the guidance of urologists in urology clinics will contribute to the diagnosis and treatment processes for patients and their families. Keywords: artificial intelligence, ChatGPT, education, female LUTS

Effect analysis of information-guided enteral nutrition-associated diarrhea treatment process in patients with chronic obstructive pulmonary disease undergoing continuous non-invasive assisted ventilation: a mixed cohort study of pre- and post-control

To clarify the application effect of information-guided enteral nutrition-associated diarrhea (ENAD) management process in patients with chronic obstructive pulmonary disease (COPD) undergoing non-invasive assisted ventilation. A mixed cohort study of pre- and post-control was conducted. Thirty-nine patients with COPD who were admitted to the emergency intensive care unit (ICU) of Huzhou First People's Hospital from July 1, 2021 to July 31, 2022 were enrolled. Taking the completion of the software development of ENAD management software for critically ill patients on January 28, 2022 as the time node, 20 patients admitted from July 1, 2021 to January 28, 2022 were set as the control group, and 19 patients admitted from January 29 to July 31, 2022 were set as the observation group. The two groups of patients received the same enteral nutrition support treatment, and the control group implemented the conventional ENAD treatment process with enteral nutrition intolerance disposal process as the core. On the basis of the control group, the observation group implemented the information-guided ENAD treatment process, and the system software actively captured the information of ENAD patients and reminded the medical team to improve the patient's diarrhea-related examination and provide alternative treatment plans. The duration of antidiarrhea, feeding interruption rate, and energy and protein intake, blood biochemical indexes, incidence of abnormal blood electrolyte metabolism, daily continuous non-invasive assisted ventilation and endotracheal intubation after 7 days of targeted diarrhea intervention were compared between the two groups. Except for the basal pulse rate, there were no significant differences in gender distribution, age, and vital signs, basic nutritional status, arterial blood gas analysis and blood biochemistry at admission between the two groups, indicating comparability between the two groups. When ENAD occurred, the patients in the observation group obtained earlier cessation of diarrhea than those in the control group [days: 3.00 (2.00, 3.25) vs. 4.00 (3.00, 5.00), P < 0.01], and the feeding interruption rate was significantly lower than that in the control group [10.53% (2/19) vs. 65.00% (13/20), P < 0.01]. After 7 days of diarrhea intervention, the energy intake of the observation group was significantly higher than that of the control group [kJ×kg-1×d-1: 66.28 (43.34, 70.36) vs. 47.88 (34.60, 52.32), P < 0.01], the levels of hemoglobin (Hb), albumin (Alb) and serum prealbumin (PAB) were significantly higher than those in the control group [Hb (g/L): 119.79±10.04 vs. 110.20±7.75, Alb (g/L): 36.00 (33.75, 37.25) vs. 31.00 (30.00, 33.00), PAB (mg/L): 155.79±25.78 vs. 140.95±14.97, all P < 0.05], the daily continuous non-invasive assisted ventilation duration was significantly shorter than that of the control group [hours: 14 (12, 16) vs. 16 (14, 18), P < 0.01], and the arterial partial pressure of carbon dioxide (PaCO2) was significantly lower than that of the control group [mmHg (1 mmHg ≈ 0.133 kPa): 66.00 (62.00, 70.00) vs. 68.00 (67.50, 70.05), P < 0.05]. However, there were no significant differences in protein intake, incidence of abnormal electrolyte metabolism, and incidence of endotracheal intubation due to acute respiratory failure between the two groups. The information-guided ENAD treatment process can enable the COPD patients undergoing continuous non-invasive assisted ventilation who experience ENAD to receive earlier cessation of diarrhea, and improve the protein energy metabolism and respiratory function of the patients.