Treatment Strategies For Different Types Research Articles

A flexible deep learning framework for liver tumor diagnosis using variable multi-phase contrast-enhanced CT scans

BackgroundLiver cancer is a significant cause of cancer-related mortality worldwide and requires tailored treatment strategies for different types. However, preoperative accurate diagnosis of the type presents a challenge. This study aims to develop an automatic diagnostic model based on multi-phase contrast-enhanced CT (CECT) images to distinguish between hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), and normal individuals.MethodsWe designed a Hierarchical Long Short-Term Memory (H-LSTM) model, whose core components consist of a shared image feature extractor across phases, an internal LSTM for each phase, and an external LSTM across phases. The internal LSTM aggregates features from different layers of 2D CECT images, while the external LSTM aggregates features across different phases. H-LSTM can handle incomplete phases and varying numbers of CECT image layers, making it suitable for real-world decision support scenarios. Additionally, we applied phase augmentation techniques to process multi-phase CECT images, improving the model’s robustness.ResultsThe H-LSTM model achieved an overall average AUROC of 0.93 (0.90, 1.00) on the test dataset, with AUROC for HCC classification reaching 0.97 (0.93, 1.00) and for ICC classification reaching 0.90 (0.78, 1.00). Comprehensive validation in scenarios with incomplete phases was performed, with the H-LSTM model consistently achieving AUROC values over 0.9.ConclusionThe proposed H-LSTM model can be employed for classification tasks involving incomplete phases of CECT images in real-world scenarios, demonstrating high performance. This highlights the potential of AI-assisted systems in achieving accurate diagnosis and treatment of liver cancer. H-LSTM offers an effective solution for processing multi-phase data and provides practical value for clinical diagnostics.

Qualitative Study on Playing-related Injury of College Student Pianists

This study aimed to investigate student pianists' playing-related musculoskeletal disorder (PRMD) from the perspective of qualitative research. This study used a transcendental phenomenological approach to collect data through one-on-one interviews and focus group discussions. Four themes emerged in these data: experiencing memories of PRMD, pianist's self-awareness, social support, and deal with injury. The findings are highly relevant regarding self-awareness, social relationships, education, and healthcare and provide educators and healthcare personnel with an experienced way to understand the PRMD of student pianists. The results show that maintaining student pianists' playing careers and coping with PRMD requires joint efforts from multiple fields, including the pianists themselves to establish good self-awareness, social relations to provide support and help, higher education institutions to provide and strengthen health education, and health care personnel to develop tailored ways to deal with injury for pianists. The study suggests that more research in the future could focus on the experiences of musicians and the group of tertiary music students. The study also hopes that this kind of research can be paid attention to and valued by music education, health education, and medical care to develop suitable PRMD intervention and treatment strategies for different types of musicians.

Analysis of surgical approaches and mandibular treatment strategies for different types of tumors involving parapharyngeal space

In view of the surgical complexity of parapharyngeal space tumors involved, this paper summarized the disease data of patients with parapharyngeal space tumors involved in the Department of Oral and Maxillofacial Surgery, the First Hospital of Shanxi Medical University from January 2015 to January 2021. It also summarized the surgical approach and mandibular management, so as to explore surgical strategies for different characteristics of parapharyngeal space tumors involved. A total of 49 patients, including 28 males and 21 females, median age 52 years (range 24-72 years). They were treated with four surgical approaches for tumor resection, 25 cervical approach, 5 cheek and neck approach, 3 transoral approach, and 16 cervical-maxillary approach. Among the patients treated with cervical-maxillary approach, 3 patients were treated with mandible square resection, and 6 patients were treated with temporary mandible dissection. Seven cases were treated with tumor resection and partial mandibular resection. There are various surgical approaches and mandibular management methods involving tumors in the parapharyngeal space, and clinical decisions should be made based on tumor diameter, location, boundary, blood supply and pathological types.

Advances in the technology of surgical treatment for atlantoaxial dislocation

The etiology and pathological morphology of atlantoaxial dislocation (AAD) are complex. Based on the pathological anatomical characteristics of AAD, combined with clinical techniques, it is essential to formulate reasonable classification criteria and develop corresponding treatment strategies for different types of AAD. The satisfactory outcome of surgical treatment for AAD can only be achieved through the comprehensive application of various atlantoaxial reduction techniques, tension band releasing techniques, internal fixation and fusion techniques. This article discusses the latest advancements in surgical treatment techniques for AAD, thoroughly explores treatment strategies based on different types of AAD, and analyzes the practicality and effectiveness of clinical classification and treatment strategies. The posterior atlantoaxial facet releasing and distraction compression reduction technique may pose challenges to traditional treatment strategies in the future. In the development of surgical treatment techniques for AAD, microspinal surgical techniques may play a significant role in improving surgical methods and enhancing treatment outcomes.

Stem cells and pain.

Pain can be defined as an unpleasant sensory and emotional experience caused by either actual or potential tissue damage or even resemble that unpleasant experience. For years, science has sought to find treatment alternatives, with minimal side effects, to relieve pain. However, the currently available pharmacological options on the market show significant adverse events. Therefore, the search for a safer and highly efficient analgesic treatment has become a priority. Stem cells (SCs) are non-specialized cells with a high capacity for replication, self-renewal, and a wide range of differentiation possibilities. In this review, we provide evidence that the immune and neuromodulatory properties of SCs can be a valuable tool in the search for ideal treatment strategies for different types of pain. With the advantage of multiple administration routes and dosages, therapies based on SCs for pain relief have demonstrated meaningful results with few downsides. Nonetheless, there are still more questions than answers when it comes to the mechanisms and pathways of pain targeted by SCs. Thus, this is an evolving field that merits further investigation towards the development of SC-based analgesic therapies, and this review will approach all of these aspects.

Release of frustration drives corneal amyloid disaggregation by brain chaperone

TGFBI-related corneal dystrophy (CD) is characterized by the accumulation of insoluble protein deposits in the corneal tissues, eventually leading to progressive corneal opacity. Here we show that ATP-independent amyloid-β chaperone L-PGDS can effectively disaggregate corneal amyloids in surgically excised human cornea of TGFBI-CD patients and release trapped amyloid hallmark proteins. Since the mechanism of amyloid disassembly by ATP-independent chaperones is unknown, we reconstructed atomic models of the amyloids self-assembled from TGFBIp-derived peptides and their complex with L-PGDS using cryo-EM and NMR. We show that L-PGDS specifically recognizes structurally frustrated regions in the amyloids and releases those frustrations. The released free energy increases the chaperone’s binding affinity to amyloids, resulting in local restructuring and breakage of amyloids to protofibrils. Our mechanistic model provides insights into the alternative source of energy utilized by ATP-independent disaggregases and highlights the possibility of using these chaperones as treatment strategies for different types of amyloid-related diseases.

Anatomical observation, classification, fracture and finite element analysis of the posterior process of the Asian adult talus

BackgroundFractures of the posterior process of the talus are rarely seen and frequently overlooked. In our study, anatomical observation and classification of the posterior process of the talus were carried out, and related imaging and finite element methods were combined. The study aimed to observe and provide anatomical data related to posterior process of talus in Asian adults and explore the potential relationships between the different types with fracture of posterior process of talus.MethodsCombined with the anatomical morphology and imaging data, the posterior process of talus was divided into four types, and the incidence and fracture situation were statistically analyzed. The finite element models of four different types of talus processes were established and verified, and the stress and strain were simulated and analyzed.ResultsThe total incidence of the posterior process of the talus was 97.47%. The proportions of the four types were neck-like 10.13%, flat 36.29%, pointy 12.66% and round blunt 38.39%. The overall incidence of bone cracks of the posterior process of the talus was 4.98%; the most common type was neck-like type. Compared with the value on the other types, the maximum von Mises stress increased by 67.66%, 83.90% and 111.18% on the neck-like posterior process of talus respectively.ConclusionsIt is speculated that different types of the posterior process of the talus may be related to the probability of fracture, and it may be better to consider different treatment strategies for different types of fractures.

Treatment Strategies for Different Types of Intraneural Offending Vessels in Microvascular Decompression Surgery for Trigeminal Neuralgia: An Analytic Report of 58 Cases.

Microvascular decompression (MVD) surgery is the treatment of choice for trigeminal neuralgia (TGN). However, decompression becomes difficult when the offending vessel penetrates the trigeminal nerve root. To estimate the rates and patterns of different types of intraneural offending vessels in patients with TGN for MVD and to discuss respective management strategies. All patients with TGN undergoing MVD in our center from January 1, 2015, to December 31, 2019, were analyzed retrospectively. The intraneural offending vessels included veins and arteries. The postoperative pain relief rate, complications, and recurrences were evaluated. Of the 302 TGN cases, the intraneural offending vessels were identified in 58 of the cases (19.2%). The 9 cases (15.5%) of intraneural offending arteries were decompressed using shredded Teflon wrapping interposition. Of the 49 cases (84.5%) of intraneural offending veins (INOVs), 29 were not considered true offending vessels, and the treatment only addressed the offending artery in these patients. Of the remaining 20 INOVs, 15 were electrocoagulated and divided, and 5 were decompressed with shredded Teflon. Complete pain relief was achieved in all 58 patients. However, the pain recurred in 5 patients (8.6%), and transient hemifacial numbness occurred in 4 patients (6.9%). Intraneural offending vessels requiring treatment are uncommon and are seen in less than 1 in 10 patients undergoing MVD for TGN. For intraneural offending artery, decompression by shredded Teflon wrapping interposition is recommended. Management of the INOV depends on the individual situations, and the management includes sacrifice, wrapping decompression, or leaving them untreated.

Artificial Intelligence, Machine Learning, and Cardiovascular Disease.

Artificial intelligence (AI)-based applications have found widespread applications in many fields of science, technology, and medicine. The use of enhanced computing power of machines in clinical medicine and diagnostics has been under exploration since the 1960s. More recently, with the advent of advances in computing, algorithms enabling machine learning, especially deep learning networks that mimic the human brain in function, there has been renewed interest to use them in clinical medicine. In cardiovascular medicine, AI-based systems have found new applications in cardiovascular imaging, cardiovascular risk prediction, and newer drug targets. This article aims to describe different AI applications including machine learning and deep learning and their applications in cardiovascular medicine. AI-based applications have enhanced our understanding of different phenotypes of heart failure and congenital heart disease. These applications have led to newer treatment strategies for different types of cardiovascular diseases, newer approach to cardiovascular drug therapy and postmarketing survey of prescription drugs. However, there are several challenges in the clinical use of AI-based applications and interpretation of the results including data privacy, poorly selected/outdated data, selection bias, and unintentional continuance of historical biases/stereotypes in the data which can lead to erroneous conclusions. Still, AI is a transformative technology and has immense potential in health care.

Atrial electromechanical delay assessment in early phase after catheter ablation for patients with atrial fibrillation.

Variation of atrial electromechanical delay (AED) in early phase after catheter ablation in patients with atrial fibrillation (AF) is lacking. Fifty-five consecutive patients restored sinus rhythm after ablation was included. Echocardiography was performed at 4h, 1 day, and 3 days after radiofrequency catheter ablation, and AED was measured simultaneously by echocardiography with pulse Doppler imaging and pulse wave tissue Doppler imaging. AED parameters were significantly longer in the nonparoxysmal atrial fibrillation (NPAF) group than in the paroxysmal atrial fibrillation (PAF) group at each checking point after ablation (P<0.05). Compared with other checking points, AED parameters were significantly longer 4h postablation in the NPAF group, while no significant difference was found between different checking points in the PAF group. AED-leap, representing the variation of AED in NPAF patients, was significantly positively correlated with the duration of NPAF (r=0.5291, P=0.0113). Compared with PAF, NPAF patients have a longer AED postablation, and an abrupt decrease in the initial-h postablation. Such phenomenon gives rise to the different clinical features of PAF and NPAF, and could guide different assessment and treatment strategies for different types of AF.

Implementing treatment strategies for different types of depression.

Diagnosing and treating major depressive disorder (MDD) accurately and efficiently is challenging for many clinicians. Recent additions to the Diagnostic and Statistical Manual of Mental Disorders (DSM) as well as potential moderators of antidepressant response such as pretreatment phenomenological characteristics (eg, body mass index, drug metabolism markers) may help physicians to better stratify patients and make informed decisions on the best course of treatment to obtain remission. The evidence base suggests that combining traditional antidepressant therapy with atypical antipsychotics may increase the chance for remission. Other strategies that may help include switching to another antidepressant as monotherapy or combining lithium, thyroid hormone, or psychotherapy. Moreover, in some cases, a manualized-based psychotherapeutic approach may be an appropriate first-line or alternative treatment avenue for adults with MDD.

Essential oils and their constituents as anticancer agents: a mechanistic view.

Exploring natural plant products as an option to find new chemical entities as anticancer agents is one of the fastest growing areas of research. Recently, in the last decade, essential oils (EOs) have been under study for their use in cancer therapy and the present review is an attempt to collect and document the available studies indicating EOs and their constituents as anticancer agents. This review enlists nearly 130 studies of EOs from various plant species and their constituents that have been studied so far for their anticancer potential and these studies have been classified as in vitro and in vivo studies for EOs and their constituents. This review also highlights in-depth various mechanisms of action of different EOs and their constituents reported in the treatment strategies for different types of cancer. The current review indicates that EOs and their constituents act by multiple pathways and mechanisms involving apoptosis, cell cycle arrest, antimetastatic and antiangiogenic, increased levels of reactive oxygen and nitrogen species (ROS/RNS), DNA repair modulation, and others to demonstrate their antiproliferative activity in the cancer cell. The effect of EOs and their constituents on tumour suppressor proteins (p53 and Akt), transcription factors (NF-κB and AP-1), MAPK-pathway, and detoxification enzymes like SOD, catalase, glutathione peroxidase, and glutathione reductase has also been discussed.