Translational Medical Research Research Articles

Differences in the annotation between facial images and videos for training an artificial intelligence for skin type determination.

The Grand-AID research project, consisting of GRANDEL-The Beautyness Company, the dermatology department of Augsburg University Hospital and the Chair of IT Infrastructure for Translational Medical Research at Augsburg University, is currently researching the development of a digital skin consultation tool that uses artificial intelligence (AI) to analyze the user's skin and ultimately perform a personalized skin analysis and a customized skin care routine. Training the AI requires annotation of various skin features on facial images. The central question is whether videos are better suited than static images for assessing dynamic parameters such as wrinkles and elasticity. For this purpose, a pilot study was carried out in which the annotations on images and videos were compared. Standardized image sequences as well as a video with facial expressions were taken from 25 healthy volunteers. Four raters with dermatological expertise annotated eight features (wrinkles, redness, shine, pores, pigmentation spots, dark circles, skin sagging, and blemished skin) with a semi-quantitative and a linear scale in a cross-over design to evaluate differences between the image modalities and between the raters. In the videos, most parameters tended to be assessed with higher scores than in the images, and in some cases significantly. Furthermore, there were significant differences between the raters. The present study shows significant differences between the two evaluation methods using image or video analysis. In addition, the evaluation of the skin analysis depends on subjective criteria. Therefore, when training the AI, we recommend regular training of the annotating individuals and cross-validation of the annotation.

Progress in study on animal models of trigeminal neuralgia.

Trigeminal neuralgia is a manifestation of orofacial neuropathic pain disorder, always deemed to be an insurmountable peak in the field of pain research and treatment. The pain is recurrent, abrupt in onset and termination similar to an electric shock or described as shooting. A poor quality of life has been attributed to trigeminal neuralgia, as the paroxysms of pain may be triggered by innocuous stimuli on the face or inside the oral cavity, such as talking, washing face, chewing and brushing teeth in daily life. The pathogenesis of trigeminal neuralgia has not been fully elucidated, although the microvascular compression in the trigeminal root entry zone is generally considered to be involved in the emergence and progression of the pain disorder. In addition, orofacial neuropathic pain restricted to one or more divisions of the trigeminal nerve might be secondary to peripheral nerve injury. Based on current hypotheses regarding the potential causes, a variety of animal models have been designed to simulate the pathogenesis of trigeminal neuralgia, including models of compression applied to the trigeminal nerve root or trigeminal ganglion, chronic peripheral nerve injury, peripheral inflammatory pain and center-induced pain. However, it has not yet been possible to determine which model can be perfectly employed to explain the mechanisms. The selection of appropriate animal models is of great significance for the study of trigeminal neuralgia. Therefore, it is necessary to discuss the characteristics of the animal models in terms of animal strains, materials, operation methods and behavior observation, in order to gain insight into the research progress in animal models of trigeminal neuralgia. In the future, animal models that closely resemble the features of human trigeminal neuralgia pathogenesis need to be developed, with the aim of making valuable contributions to the relevant basic and translational medical research.

Translational medical bioengineering research of traumatic brain injury among Chinese and American pedestrians caused by vehicle collision based on human body finite element modeling

Based on the average human body size in China and the THUMS AM50 finite element model of the human body, the Kriging interpolation algorithm was used to model the Chinese 50th percentile human body, and the biological fidelity of the model was verified. We built three different types of passenger vehicle models, namely, sedan, sports utility vehicle (SUV), and multi-purpose vehicle (MPV), and used mechanical response analysis and finite element simulation to compare and analyze the dynamic differences and head injury differences between the Chinese 50th percentile human body and the THUMS AM50 model during passenger vehicle collisions. The results showed that there are obvious differences between the Chinese mannequin and THUMS in terms of collision time, collision position, invasion speed, and angle. When a sedan collided with the mannequins, the skull damage to the Chinese human body model was more severe, and when a sedan or SUV collided, the brain damage to the Chinese human body was more severe. The abovementioned results suggest that the existing C-NCAP pedestrian protection testing regulations may not provide the best protection for Chinese human bodies, and that the regulations need to be improved by combining collision damage mechanisms and the physical characteristics of Chinese pedestrians. This thorough investigation is positioned to shed light on the fundamental biomechanics and injury mechanisms at play. Furthermore, the amalgamation of clinically rooted translational and engineering research in the realm of traumatic brain injury has the potential to establish a solid foundation for discerning preventive methodologies. Ultimately, this endeavor holds the potential to introduce effective strategies aimed at preventing and safeguarding against traumatic brain injuries.

Development and application of the Rapha® device for the treatment of diabetic foot ulcers.

Transforming medical research into real-world healthcare solutions is a complex endeavor that may benefit from the synergy between academic research, governmental support, and industry innovation. In this article we delve into the framework of Translational Medical Research (TMR) in Brazil, elucidating the possible interplay between public universities and other pivotal stakeholders in the translational journey. Our focal point is the Rapha® device, an innovative medical technology, as we explore its ethical and regulatory journey. We seek to understand the environment that shapes healthcare technology development through a mixed-methods research design, combining policy analysis with stakeholder interviews. The research begins by examining public policies, aiming to carve out a socially inclusive and advantageous ecosystem. We then highlight the pivotal components-steps, milestones, stakeholders, and policies that underpin the TMR process. Our findings reveal that while TMR frequently culminates in patents and technology transfer agreements, specific regulatory and production challenges exist, particularly during transitioning from the T3 (clinical trials) to T4 (public health practice) phase. We provide insights into its translational progression by tracing the developmental stages from foundational research (T0) to clinical trials (T3) for the Rapha® device. Ultimately, this study underscores TMR's vital role in advancing healthcare access and posits that academic institutions can significantly influence the creation of ethically robust, regulated, and impactful medical innovations, contributing meaningfully to global healthcare.

Cognition of nursing translational medical research among nursing practitioners in China

BackgroundNursing translational research (TR) begins with clinical discovery and medical research and leads to clinical application in patients. TR is key to improving nursing quality and developing the nursing profession. However, its development in China remains limited, and the reasons for this are unclear. We aim to enhance the recognition of nursing TR among nursing practitioners in China by exploring their cognition about nursing TR and associated influences. MethodsWe distributed an internet-based questionnaire to 683 nursing practitioners between February 13 and March 15, 2023. We analyzed the characteristics and cognition of nursing TR using descriptive statistics, the chi-squared test, Fisher's exact test, the Wilcoxon rank-sum test, Kruskal–Wallis H test, and stepwise logistic regression analysis. The majority (79.65%) of nursing practitioners who responded to the questionnaire were willing to participate in nursing TR. FindingsNursing practitioners with a higher educational level, stronger recognition of the importance of nursing TR, and stronger recognition of transdisciplinary nursing TR were more willing to participate in nursing TR. DiscussionThe results of this study can accelerate nursing practitioners' willingness to participate in nursing TR. Application to practiceWe identified strategies to promote TR: provide further education, optimize courses in higher education, disseminate information, provide guidance on the importance of nursing TR, and establish a nursing TR platform with appropriate potential collaborators.

Advances in Cell Therapy for Liver Regeneration

With the development of translational medicine, cell therapy has been applied in clinical practice, especially in the regenerative treatment of severe liver diseases. This article introduces the origin, development, and prospects of cell therapy from the aspects of liver disease treatment, history, current status, and clinical application feasibility of cell therapy. The article also points out the existing problems in the translational medical research of cell therapy. To achieve a favorable development in cell therapy, more fundamental and clinical are warranted.

Adding robustness to rigor and reproducibility for the three Rs of improving translational medical research.

Adding robustness to rigor and reproducibility for the three Rs of improving translational medical research.

Application Status and Prospects of Precision Nursing Under the Concept of Enhanced Recovery After Surgery

With the development of enhanced recovery after surgery (ERAS), major breakthroughs have been made in this field of study. However, the research fields still need to be continuously expanded to meet the needs of patients. The concept of precision therapy is widely applied in the field of nursing. Under the concept of ERAS, practical studies of applying precision nursing for the perioperative period have already been conducted, exploring such issues as precision nursing assessment, precision nursing intervention design, precision risk prediction model, and information technology to assist precision nursing practice. Research findings have preliminarily validated the safety and effectiveness of applying precision nursing for ERAS in the perioperative period. Herein, we reviewed the reported findings of relevant research published in recent years and identified the following problems in the implementation of precision nursing under the ERAS concept, a lack of implementation standards, challenges concerning the the role of nurses, a lack of high-quality research evidence in the existing literature, and a relevant big data processing platform that China does not have and therefore cannot carry out data sharing, integration, mining, and utilization. We also made suggestions for effective improvement and discussed research prospects. In the future, multidisciplinary collaboration, translational medical research, and the development of various innovative tools are to be strengthened to help improve the quality and effectiveness of nursing care. We hope to provide reference for improving the scientific and targeted implementation of precision nursing for ERAS in the perioperative period.

Inhibition of SARS-CoV-2-mediated thromboinflammation by CLEC2.Fc

Abstract Thromboinflammation is the major cause of morbidity and mortality in COVID-19 patients, and post-mortem examination demonstrates the presence of platelet-rich thrombi and microangiopathy in lung and other visceral organs. Moreover, persistent microclots were detected in both acute COVID-19 and long COVID plasma samples. However, the molecular mechanism of SARS-CoV-2-induced thromboinflammation is still unclear. We found that the spleen tyrosine kinase (Syk)-coupled C-type lectin member 2 (CLEC2), which was highly expressed in platelets, interacted with the receptor-binding domain (RBD) of SARS-CoV-2 spike protein (SARS-CoV-2 RBD) directly. Unlike the thread-like NETs, SARS-CoV-2-induced aggregated NET formation in the presence of wild-type (WT), but not CLEC2-deficient platelets. Furthermore, SARS-CoV-2 spike pseudotyped lentivirus was able to induce NET formation via CLEC2, indicating SARS-CoV-2 RBD engaged CLEC2 to activate platelets to enhance NET formation. Administration of CLEC2.Fc inhibited SARS-CoV-2-induced NET formation and thromboinflammation in AAV-ACE2-infected mice. Thus, CLEC2 is a novel pattern recognition receptor for SARS-CoV-2, and CLEC2.Fc is a promising therapeutic agent to inhibit SARS-CoV-2-induced thromboinflammation and reduced the risk of post-acute sequelae of COVID (PASC) in the future. Translational Medical Research Program (AS-TM-108-02-10), Biotechnology Research Park Translational Project (AS-BRPT-110-02), Academia Sinica

Translational Echocardiography: The Dog as a Clinical Research Model of Cardiac Dysfunction

Heart disease is a major contributor to mortality and disability on a global scale. Hence, there is a need for research to improve non-invasive diagnostic techniques. Diseases in dogs with characteristics very similar to those of human pathologies hold promise as a source of data for evaluating and developing echocardiographic techniques and devices. Methods: We conducted a structured literature search from June 2022 to January 2023 to evaluate the relevance of dogs as a translational model for echocardiographic clinical research. We searched various academic databases, including PubMed Central (PMC), Core, DIGITAL.CSIC, DOAB, DOAJ, EBSCO host, Elsevier B.V, Redib, Scopus, and Web of Science, available through the Academic Information System of the Autonomous University of Baja California. Results: Out of the 243 articles initially screened, we identified 119 relevant articles that met our inclusion criteria for further analysis. This review is an introduction to the canine model by analyzing the cardiovascular anatomical similarities between the two species, the pathophysiological overlaps in some diseases, the parallels in echocardiographic techniques in dogs compared to humans, and the suitability of dogs with a naturally occurring cardiac disease as a model for translational clinical research compared to other animal species. Conclusions: This review emphasizes the importance of canine patients as an ideal cardiac disease symmetrical clinical model since they share common heart diseases with humans. Furthermore, dogs have a shorter lifespan, leading to the relatively rapid evolution of these diseases, which makes studying these pathologies and developing echocardiographic techniques more feasible. The results strongly indicate the need for interdisciplinary collaboration and translational medical research to create innovative echocardiographic technologies and improve the connection between veterinary and human cardiac imaging research.

Building a new regional home for implementation science: Annual Midwest Clinical & Translational Research Meetings.

The vision of the Central Society for Clinical and Translational Research (CSCTR) is to "promote a vibrant, supportive community of multidisciplinary, clinical, and translational medical research to benefit humanity." Together with the Midwestern Section of the American Federation for Medical Research, CSCTR hosts an Annual Midwest Clinical & Translational Research Meeting, a regional multispecialty meeting that provides the opportunity for trainees and early-stage investigators to present their research to leaders in their fields. There is an increasing national and global interest in implementation science (IS), the systematic study of activities (or strategies) to facilitate the successful uptake of evidence-based health interventions in clinical and community settings. Given the growing importance of this field and its relevance to the goals of the CSCTR, in 2022, the Midwest Clinical & Translational Research Meeting incorporated new initiatives and sessions in IS. In this report, we describe the role of IS in the translational research spectrum, provide a summary of sessions from the 2022 Midwest Clinical & Translational Research Meeting, and highlight initiatives to complement national efforts to build capacity for IS through the annual meetings.

An ontology for very large numbers of longitudinal health records to facilitate data mining and machine learning

Despite the extensive experience of the authors working in industry with a variety of electronic health records that worked well in their intended context, none currently available in reasonably large numbers seem to have ontologies and formats that will scale well to very large numbers of detailed cradle-to-grave longitudinal health records facilitating knowledge extraction. By that we mean data mining, Deep Learning neural nets and all related analytic and predictive methods for biomedical research and clinical decision support potentially applied to the health records of an entire nation. They are mostly far too complicated to support frequent high-dimensional analysis, which is required because such records will update (or should update) dynamically on a regular basis, will in future include new tests etc. acquired daily by translational medical research, and not least allow public health, research, and diagnostic, vaccine, and drug development teams to respond quickly to emergent epidemics like COVID-19. A Presidential Advisory team call in 2010 for interoperability and ease of data mining for medical records is discussed and the situation seems still not fully resolved. The solution appears to lie between efficient comma separated value files and the ability to embellish these with a moderate degree of more elaborate ontology. One recommendation is made here with discussion and analysis that should guide alternative and future approaches. It combines demographic, comorbidity, genomic, diagnostic, interventional, and outcomes information along with time/date stamping method appropriate to analysis, with facilities for special research studies. By using a “metadata operator”, a suitable balance between a comma separated values file and an ontological structure is possible.

Research Instrument Management System: RIMS, an Application for Lab Instrument Reservation Utilization

Objective: Instrument administration including accessibility control, schedule time for reservation, and periodical machine utilization are essential tasks for high-end molecular laboratory. Such repetitive work can be automated using information technology.Material and Methods: As a part of Laboratory Information Management System (LIMS), the Research Instrument Management System (RIMS) is an online application using a user-friendly platform constructed for efficiency of access, end-user communication, instrument reservation.Results: RIMS utilizes instrument information including the date of set up, machine identification, last preventive maintenance and financial record. Data logging and periodic reports are displayed as a graphical dashboard which is simple and flexible monitoring administration. The researchers are categorized into subgroups according to their experience in operating each instrument and facilitated reservation by the subgroups, i.e., unskilled researchers can make a reservation only after the have attended a training session.Conclusion: The system has now been launched with a continually improving process for fundamental equipment of translational medical research.

SLC13A5 Deficiency Disorder: From Genetics to Gene Therapy.

Epileptic encephalopathies may arise from single gene variants. In recent years, next-generation sequencing technologies have enabled an explosion of gene identification in monogenic epilepsies. One such example is the epileptic encephalopathy SLC13A5 deficiency disorder, which is caused by loss of function pathogenic variants to the gene SLC13A5 that results in deficiency of the sodium/citrate cotransporter. Patients typically experience seizure onset within the first week of life and have developmental delay and intellectual disability. Current antiseizure medications may reduce seizure frequency, yet more targeted treatments are needed to address the epileptic and non-epileptic features of SLC13A5 deficiency disorder. Gene therapy may offer hope to these patients and better clinical outcomes than current available treatments. Here, we discuss SLC13A5 genetics, natural history, available treatments, potential outcomes and assessments, and considerations for translational medical research for an AAV9-based gene replacement therapy.

The current understanding of precision medicine and personalised medicine in selected research disciplines: study protocol of a systematic concept analysis

IntroductionThe terms ‘precision medicine’ and ‘personalised medicine’ have become key terms in health-related research and in science-related public communication. However, the application of these two concepts and their interpretation in...

A framework for operationalising Aboriginal and Torres Strait Islander data sovereignty in Australia: Results of a systematic literature review of published studies.

SummaryBackgroundRacial health disparities are only likely to be meaningfully improved by tailoring public health and clinical interventions to the specific needs of Indigenous people and their communities. Accurate tailoring relies on the availability of high-quality Indigenous-specific data. The potential benefits of increased availability of Indigenous data need to be balanced by efforts to ensure those data are collected and used appropriately. This paper identifies characteristics of Indigenous Data Sovereignty (IDS) principles and considers a framework for operationalisation.MethodsA PRISMA compliant search of the literature was undertaken, using methods detailed in the Cochrane Collaboration Handbook on Systematic Reviews of Health Promotion and Public Health Interventions (1). The search strategy comprised two steps: a search of 11 scientific electronic databases and five grey literature sources. The search was limited by date of publication (1 January 2000 to 1 December 2021). The following keywords and subject heading terms were used: (exp Aboriginal and Torres Strait Islander or Aborigin* or Torres Strait Island* or, Oceanic ancestry group) and (exp research or biomedical research or population surveillance or translational medical research or, research design) and (exp data or datasets or data collection or data management or health surveys or information dissemination or, intellectual property) and (exp self-determination or ownership or control or access or possession or OCAP or sovereignty or, ethics) and, (exp Australia). IDS principles: (i) ownership; (ii) control; (iii) accessibility; (iv) custodianship; (v) accountability to Indigenous people; (vi) amplify Community voice; (vii) relevant and reciprocal; and (viii) sustainably self-determining. Using standard data extraction forms, we examined relevant Australian studies to identify key characteristics and frequency with which they cited IDS principles. These findings were consolidated into an operationalisation framework.Findings34 relevant Australian published studies were identified. The most frequently cited IDS principles were Accountability to Aboriginal and Torres Strait Islander peoples and sustainably self-determining. The least frequently cited principle was Access. A framework to operationalise IDS principles is proposed that is both standardised internationally and able to be tailored to the diverse contexts of Indigenous peoples.InterpretationIDS is emergent in Australia and there is a clear need to establish an agreed set of International IDS principles and a framework for their operationalisation and contextualisation across diverse Indigenous communities and contexts.FundingThis research project is funded through an Australian Research Council (ARC) Discovery Grant from 2017 to 2022. The National Drug and Alcohol Research Centre (NDARC) is funded by the Australian Government Department of Health. The 1st author (ST) is supported by a scholarship co-funded by NDARC and the Lowitja Institute.

Translational Strategies to Eliminate Chronic Hepatitis B in Children: Prophylaxis and Management in East Asian Countries.

Translational medical research on hepatitis B virus (HBV) infection and chronic hepatitis B (CHB) pathogenesis provides guidance on strengthening the treatment and prevention strategies of CHB. Preventing vertical transmission is the key to eliminating HBV infection in children. The understanding of HBV replication, hepatocyte turnover, and the fate of covalently closed circular DNA (cccDNA) would help establish a personalized application of the guidelines, especially concerning the discontinuation of nucleos(t)ide analog (NA) treatment in children. Transplacental leakage of HBV-infected maternal blood is suggested as the leading cause of vertical transmission. Prenatal maternal prophylaxis could diminish maternal HBV viremia at delivery, to reduce the risk of neonatal HBV infection. The meaning of the expression “no additional risk of breast milk feeding” is thereby explained. Understanding the untreated natural course of CHB in children and the course changeable by treatment is important to apply individualistic strategies and avoid the immoral selection of treatment indications. NAs with potent efficacy and a high barrier to drug resistance should be used as first-line treatment to reduce the likelihood of NA-resistant HBV development because the rate of mutant HBV emergence might count on the infected hepatocyte turnover rate in chronic HBV infection. Although elimination of intranuclear cccDNA is difficult by NAs alone, a cure is possible by human immunity and hepatocyte turnover. The reduction of intranuclear cccDNA occurs after the destruction of HBV-infected hepatocytes, non-cytolytic immune response, apoptosis of hepatocytes, and compensatory cell proliferation. Therefore, consolidation therapy after NA-induced hepatitis B e-antigen seroconversion must be necessary for a sufficient period. This review also summarizes the treatment strategies of CHB in children based on the practical application of translational research.

Registers and biobanks in ICU and anesthesia

Anesthesia, perioperative and critical care medicine are specific areas where registries, biobanks and big data are gaining a leading role in increasing knowledge and improving patients' care. The adoption of these robust data infrastructures - aimed at bridling, manipulating, aggregating, and linking patients' multiparametric data - supports anesthesiologists and intensive care physicians in several aspects of bedside practice and clinical research. Indeed, registries-integrated calculators may promote the concept of personalized medicine acting as "sniffers," electronic alarm systems, or decision support systems. Artificial intelligence applied to large databases or meta-registries may further increase dramatically this functionality, identify associations among thousands of different and only apparently uncorrelated variables. From a research perspective, large datasets are increasingly mined to create observations about medical care beyond prospective randomized clinical trials enrolling thousands of patients, often only presumably homogeneous ore well-balanced. Registries in this context may effectively explore the association between patients' management and patients' outcomes with a negligible impact on ethical issues, limited costs, and easy management. Finally, registries may promote self-evaluation and continuous quality improvement in the field of perioperative and critical care medicine. In a different way, the role of biobanks primarily relies on translational medical research. These allow rapidly creating pools of biological samples available for epidemiological description, pathophysiological definition, and treatment effectiveness verification, basically acting as an accelerator of knowledge production in critical care and perioperative medicine. Nowadays, registries and biobanks are thus routine tools for anesthesiologists and critical care physicians.

Rethinking Health Professionals' Motivation to Do Research: A Systematic Review.

BackgroundHealth professionals’ engagement in translational health and medical research (HMR) is fundamental to evidence-based practice leading to better patient health outcomes. However, there is a decline in the number of health professionals undertaking research which has implications for patient health and the economy. Informed by the motivation-based expectancy-value-cost (EVC) and self determination theories (SDT), this systematic literature review examined the barriers and facilitators of health professionals’ (HPs) motivation to undertake research.MethodsThe literature was searched between 2011 and 2021 for relevant peer-reviewed articles written in English, using CINAHL Complete, Informit, Medline Ovid, Medline (PubMed), Scopus, Web of Science and Google Scholar databases. This systematic review was performed and reported in accordance with the PRISMA guidelines.ResultsIdentified barriers to HPs’ engagement with research included the lack of knowledge, skills, and competence to conduct research, lack of protected research time, lack of funding and lack of organisational support. Integration of the findings of this review based on the EVC and SDT theories indicate that research capacity, ie, expectancy and competence is highly influenced by attitude, ie, the type of value (attainment, intrinsic or utility) and connection attributed to research. HPs who had very positive attitude towards research demonstrated all three values and were keen to take up research despite the barriers. Those who had a positive attitude were only motivated to do research because of its utility value and did not necessarily see it as having personal relevance for themselves. HPs who were unmotivated did not see any personal connection or relatedness to the research experience and saw no value in research.ConclusionThe attitude HPs hold in their value of research is a catalyst for motivation or amotivation to engage in research as it directly influences the relevance of barriers. Facilitators that expedite the research journey have been attributed to research training, mentorship programs and supportive organisational research culture. Motivation of HPs explored through EVC and SDT is critical to the maintenance of a research culture and the clinician-researcher development pipeline.

How 3D Printing Is Reshaping Translational Research

“Translational Research” has traditionally been defined as taking basic scientific findings and developing new diagnostic tools, drugs, devices and treatment options for patients, that are translated into practice, reach the people and populations for whom they are intended and are implemented correctly. The implication is of a unidirectional flow from “the bench to bedside”. The rapidly emergent field of additive manufacturing (3D printing) is contributing to a major shift in translational medical research. This includes the concept of bidirectional or reverse translation, early collaboration between clinicians, bio-engineers and basic scientists, and an increasingly entrepreneurial mindset. This coincides with, and is strongly complemented by, the rise of systems biology. The rapid pace at which this type of translational research can occur brings a variety of potential pitfalls and ethical concerns. Regulation surrounding implantable medical devices is struggling to keep up. 3D printing has opened the way for personalization which can make clinical outcomes hard to assess and risks putting the individual before the community. In some instances, novelty and hype has led to loss of transparency of outcomes with dire consequence. Collaboration with commercial partners has potential for conflict of interest. Nevertheless, 3D printing has dramatically changed the landscape of translational research. With early recognition and management of the potential risks, the benefits of reshaping the approach to translational research are enormous. This impact will extend into many other areas of biomedical research, re-establishing that science is more than a body of research. It is a way of thinking.