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Machine learning applications in stroke medicine:advancements,challenges,and future prospectives

Neural Regeneration Research 2024年第4期19卷 769-773页

作者： Mario Daidone Sergio Ferrantelli Antonino Tuttolomondo Internal Medicine and Stroke care Ward Department of Health PromotionMother and Child CareInternal Medicine and Medical SpecialtiesUniversity of Palermo Molecular and Clinical Medicine PhD program University of Palermo

Stroke is a leading cause of disability and mortality worldwide,necessitating the development of advanced technologies to improve its diagnosis,treatment,and patient *** recent years,machine learning techniques have emerged as promising tools in stroke medicine,enabling efficient analysis of large-scale datasets and facilitating personalized and precision medicine *** abstract provides a comprehensive overview of machine learning’s applications,challenges,and future directions in stroke *** introduced machine learning algorithms have been extensively employed in all the fields of stroke *** learning models have demonstrated remarkable accuracy in imaging analysis,diagnosing stroke subtypes,risk stratifications,guiding medical treatment,and predicting patient *** the tremendous potential of machine learning in stroke medicine,several challenges must be *** include the need for standardized and interoperable data collection,robust model validation and generalization,and the ethical considerations surrounding privacy and *** addition,integrating machine learning models into clinical workflows and establishing regulatory frameworks are critical for ensuring their widespread adoption and impact in routine stroke *** learning promises to revolutionize stroke medicine by enabling precise diagnosis,tailored treatment selection,and improved *** research and collaboration among clinicians,researchers,and technologists are essential for overcoming challenges and realizing the full potential of machine learning in stroke care,ultimately leading to enhanced patient outcomes and quality of *** review aims to summarize all the current implications of machine learning in stroke diagnosis,treatment,and prognostic *** the same time,another purpose of this paper is to explore all the future perspectives these techniques can provide in combating this disabling dis

关键词： cerebrovascular disease deep learning machine learning reinforcement learning stroke stroke therapy supervised learning unsupervised learning

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Mental Health Consequences among Sudanese Due to the Armed Conflicts and Civil Unrest of 2023: One Year Later

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Journal of Biosciences and Medicines 2024年第4期12卷 21-37页

作者： Sahar Moawia Balla Elnour Nahla Yousif Osman Mohammed Saeed Awadia Babiker Mohammed Osman Abeer Alawad Hassan Eman Mohamed Nour Hamad Alneel Mustafa Rowa Abdelmonem Sidig Hamato Malaz Mohamed Khair Alsafi Mohamed Amna Alnaim Mohamed Ahmed Osman Awab Abdelbagi Mustafa Ahmed Jalal Abdelrasool Hassan Eltaib Department of Family Medicine Health Gates Riyadh Saudi Arabia Family Medicine Department Ultracare Home Health Care Riyadh Saudi Arabia Psychiatic Department Erada Hospital and Mental Health Alkharj Saudi Arabia Family Medicine Department Ahmed Gasim Diabetic Center Portsudan Sudan QCHP Qatar Qatar Primary care Najran Health Cluster Najran Saudi Arabia Emergency Department Best Care Hospital Khartoum Sudan Family Medicine Department Mouwasat Hospital Khobar Saudi Arabia

Aim: To investigate depression, anxiety, PTSD, and insomnia levels among Sudanese citizens after a year has passed since the start of Armed Forces conflict in Sudan. Methods: An online survey was distributed. It is composed of five parts, covering the following areas: 1) sociodemographic data;2) depression assessment;3) generalized anxiety disorder assessment;4) post-traumatic stress disorder assessment;and 5) insomnia assessment. Statistical Package for Social Sciences version 27 was used for data analysis;frequency and percentage were used to describe the qualitative variables. Spearman’s correlation analysis and Chi-square test were used for correlation and association analysis;a P-value equal to or less than 0.05 was considered statistically significant. Results: The study included 283 participants, primarily female (76.0%), with a mean age of 35.26 ± 6.96 years. The majority of participants were married (50.5%) and had a university level of education (50.2%). At the start of the war, 70.3% of participants were inside the war zones, and at the time of data collection, 73.5% were outside Sudan. The length of stay in the war zone ranged from 1 to 300 days, with a mean of 48.59 ± 70.284 days. Additionally, 63.3% of participants stated that they did not receive any form of mental health intervention, and the remaining did not provide an answer. There was a high prevalence of moderate-severe depression (50.5%), moderate anxiety (35.3%), PTSD (56.5%), and sub-threshold insomnia (53.4%) among the participants. Correlation analyses revealed associations between demographic factors such as sex, age, marital status, and education and mental health issues. Notably, female participants showed a higher prevalence of PTSD (53.0%) compared to male participants (67.6%). Conclusions: There is a substantial impact of war-related trauma on mental health, revealing a high prevalence of moderate-severe depression, moderate anxiety, PTSD, and sub-threshold insomnia among the particip

关键词： Sudan War Conflict Mental Health

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Gastrointestinal manifestations of critical ill heatstroke patients and their associations with outcomes:A multicentre,retrospective,observational study

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World Journal of Gastroenterology 2024年第4期30卷 346-366页

作者： Yu-Cong Wang Xin-Yang Jin Zheng Lei Xiao-Jiao Liu Yu Liu Bang-Guo Zhang Jian Gong Lie-Tao Wang Lv-Yuan Shi Ding-Yuan Wan Xin Fu Lu-Ping Wang Ai-Jia Ma Yi-Song Cheng Jing Yang Min He Xiao-Dong Jin Yan Kang Bo Wang Zhong-Wei Zhang Qin Wu Department of Critical care Medicine West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina School of Pharmacy Macao University of Science and TechnologyMacao 999078China Department of Critical care Medicine The First People's Hospital of Ziyang CityZiyang 641399Sichuan ProvinceChina Department of Critical care Medicine The First People's Hospital of Guanghan CityChengdu 618399Sichuan ProvinceChina Department of Critical care Medicine Lezhi County Traditional Chinese Medicine HospitalChengdu 641599Sichuan ProvinceChina Department of Critical care Medicine Chengdu Qingbaijiang District People's HospitalChengdu 610399Sichuan ProvinceChina Department of Critical care Medicine Ziyang People's HospitalChengdu 641399Sichuan ProvinceChina

BACKGROUND Extreme heat exposure is a growing health problem,and the effects of heat on the gastrointestinal(GI)tract is *** study aimed to assess the incidence of GI symptoms associated with heatstroke and its impact on *** To assess the incidence of GI symptoms associated with heatstroke and its impact on *** Patients admitted to the intensive care unit(ICU)due to heatstroke were included from 83 *** history,laboratory results,and clinically relevant outcomes were recorded at ICU admission and daily until up to day 15,ICU discharge,or *** symptoms,including nausea/vomiting,diarrhoea,flatulence,and bloody stools,were *** characteristics of patients with heatstroke concomitant with GI symptoms were *** regression analyses were performed to determine significant predictors of GI *** A total of 713 patients were included in the final analysis,of whom 132(18.5%)patients had at least one GI symptom during their ICU stay,while 26(3.6%)suffered from more than one *** with GI symptoms had a significantly higher ICU stay compared with those *** mortality of patients who had two or more GI symptoms simultaneously was significantly higher than that in those with one GI *** logistic regression analysis revealed that older patients with a lower GCS score on admission were more likely to experience GI *** The GI manifestations of heatstroke are common and appear to impact clinically relevant hospitalization outcomes.

关键词： Extreme heat Flatulence Sunstroke Intensive care units Diarrhea

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Bibliometric study of sepsis-associated liver injury from 2000 to 2023

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World Journal of Gastroenterology 2024年第30期30卷 3609-3624页

作者： Zheng Zhang Xiao-Jiao Tan Hai-Qing Shi Huan Zhang Jian-Bo Li Xue-Lian Liao Department of Critical care Medicine West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Critical care Medicine West China Tianfu Hospital of Sichuan UniversityChengdu 610200Sichuan ProvinceChina

BACKGROUND Sepsis-associated liver injury(SLI)is a severe and prevalent complication of *** To explore the literature on SLI via a bibliometric *** Reviews and articles correlated with SLI published from January 1,2000 to October 28,2023 were searched from the Web of Science Core ***,the searched data were analyzed using VOSviewer,CiteSpace,and R *** There were 787 publications involved in this paper,comprising 745 articles and 42 ***,the United States,and Germany are the primary publication sources in this *** related to SLI primarily focused on mechanisms of pathogenesis,as evidenced by analyzing keywords,references,and the counting of original *** studies mainly involved tumor necrosis factor alpha,inflammation,oxidative stress,and nuclear factor-kappa *** There is significant growth in the research on *** investigations primarily involve basic experiments that aimed at uncovering pathogenic *** to the analyzed literature,the identified pathogenic mechanisms and potential therapeutic targets serve as the foundation for translating findings from basic research to clinical applications.

关键词： Sepsis Liver injury Bibliometric analysis Cite space VOS viewer

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Dietary fiber intake and its association with diabetic kidney disease in American adults with diabetes:A cross-sectional study

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World Journal of Diabetes 2024年第3期15卷 475-487页

作者： Xin-Hua Jia Sheng-Yan Wang Ai-Qin Sun Department of Critical care Medicine Dezhou People’s HospitalDezhou 253000Shandong ProvinceChina Emergency Intensive care Unit Dezhou People’s HospitalDezhou 253000Shandong ProvinceChina

BACKGROUND Dietary fiber(DF)intake may have a protective effect against type 2 diabetes(T2D);however,its relationship with diabetic kidney disease(DKD)remains *** To investigate the potential association between DF intake and the prevalence of DKD in individuals diagnosed with *** This cross-sectional study used data from the National Health and Nutrition Examination Survey collected between 2005 and *** intake was assessed through 24-h dietary recall interviews,and DKD diagnosis in individuals with T2D was based on predefined criteria,including albuminuria,impaired glomerular filtration rate,or a combination of *** regression analysis was used to assess the association between DF intake and DKD,and comprehensive subgroup and sensitivity analyses were *** Among the 6032 participants,38.4%had *** lower DF intake-T1(≤6.4 g/1000 kcal/day)-as a reference,the adjusted odds ratio for DF and DKD for levels T2(6.5-10.0 g/1000 kcal/day)and T3(≥10.1 g/1000 kcal/day)were 0.97(95%CI:0.84-1.12,P=0.674)and 0.79(95%CI:0.68-0.92,P=0.002),*** subgroup analysis yielded consistent results across various demographic and health-related subgroups,with no statistically significant interactions(all P>0.05).CONCLUSION In United States adults with T2D,increased DF intake may be related to reduced DKD *** research is required to confirm these findings.

关键词： Dietary fiber diabetic kidney disease Type 2 diabetes National Health and Nutrition Examination Survey Crosssectional study

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Evaluating the Impact of the Universal Test and Treat Strategy on the Survival of Patients in the Northwest Region of Cameroon

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World Journal of AIDS 2024年第3期14卷 45-60页

作者： Emmanuel Mboh Nshom Bereynuy Jude Cholong Kum Kang Walter Khan Eveline Mboh Keng Vitalis Noela F. Ijang Gwendoline Nkenu Nsom Mirabel Mbueh Vifeme Esther Bonje Kuni Monju Johnson Vishi Gladys Enih Fosah Pius Muffih Tih AIDS care and Prevention program Cameroon Baptist Convention Health Services Bamenda Cameroon Regional Technical Group for the Fight against HIV and AID Northwest Region Cameroon

Introduction: The main outcome of efficiently implemented universal test and treat (UTT) program is improved survival. UTT implementation has been ongoing in Cameroon since 2016 but evaluation data are scarce. This study aims to assess the survival of antiretroviral therapy (ART) patients initiated under UTT in Northwest region of Cameroon. Methods: This retrospective cohort study included HIV-positive patients initiated in 2016 at 27 purposefully selected sites and followed until 2021. Data was anonymously abstracted from ART registers and patients’ charts. Kaplan-Meier survival estimates and Cox model were used to compare the survival of patients initiated under UTT with those initiated otherwise, using stata version 14.0. Results: In total, 2490 HIV-positive patients (median age 42.7 years, 94.7% adults, and 69.0% female) participated in the study. Of 1389 patients with viral load (VL) test results, 55% were initiated on ART late. The VL suppression rate of patients initiated late and those initiated early were similar. During follow-up, 1020 (40.9%) participants censored. The survival curves of patients initiated early on ART and those initiated late were similar during the first 2.5 years of follow-up but significantly (p Conclusions: This study confirms the expected impact of UTT. programs only need to close existing implementation gaps along the critical pathways (diagnosis and treatment) of UTT, focusing more on males.

关键词： Universal Test and Treat Viral Load Survival Northwest Cameroon

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Advancing Pediatric Hemodialysis care through the Novel Intervention in Children’s Healthcare (NICH) program

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Open Journal of Nephrology 2024年第3期14卷 295-301页

作者： Jessica Williams Natalia Garban Cynthia Wong Elizabeth Talley Department of Pediatric Nephrology Lucille Packard Childrens Hospital Stanford Palo Alto USA NICH program care Team Lucille Packard Childrens Hospital Stanford Palo Alto USA

Racial, ethnic, and socioeconomic disparities present daunting hurdles that prevent equitable health outcomes for patients with end-stage kidney disease (ESKD) on hemodialysis. Additional resources, such as the Novel Intervention in Children’s Health (NICH) at Lucille Packard Children’s Hospital Stanford, provide individualized support to best assist families by assessing barriers to care with the goal of improving health outcomes. In this retrospective cohort study, we reviewed patients with ESKD on hemodialysis involved in NICH to explore if NICH serves as a liaison between the patients and multidisciplinary medical team and to explore if NICH helps patients better manage the challenges of end-stage kidney disease. Through the electronic medical record system, EPIC, we reviewed the patients’ surveys to identify barriers to care, which included school and life engagement difficulty, lack of mental health resources, food and transportation insecurity, and cultural/language barriers. We also tracked the number of hospitalizations and ED visits before and during the patients’ enrollment in NICH. We discovered that through NICH, the aforementioned barriers to care were eliminated, the number of hospitalizations and emergency department visits was reduced, and all patients transitioned from inactive to active on the transplant list. NICH successfully improved the health outcomes of these patients and empowered patients to be more engaged in their care.

关键词： Pediatric Hemodialysis ESKD NICH Healthcare Disparities

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Approach to traumatic cardiac arrest in the emergency department: a narrative literature review for emergency providers

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World Journal of Emergency Medicine 2024年第1期15卷 3-9页

作者： Rashed Alremeithi Quincy K.Tran Megan T.Quintana Soroush Shahamatdar Ali Pourmand Department of Emergency Medicine George Washington University School of Medicine and Health SciencesWashington DC 20037USA Department of Emergency Medicine University of Maryland School of MedicineBaltimore 21201USA program in Trauma the R Adams Cowley Shock Trauma CenterUniversity of Maryland School of MedicineBaltimore 21201USA Center for Trauma and Critical care Department of Surgerythe George Washington University School of Medicine&Health SciencesWashington DC 20037USA

BACKGROUND:Traumatic cardiac arrest(TCA)is a major contributor to mortality and morbidity in all age groups and poses a significant burden on the healthcare *** there have been advances in treatment modalities,survival rates for TCA patients remain *** narrative literature review critically examines the indications and eff ectiveness of current therapeutic approaches in treating ***:We performed a literature search in the PubMed and Scopus databases for studies published before December 31,*** search was refi ned by combining search terms,examining relevant study references,and restricting publications to the English *** the search,943 articles were retrieved,and two independent reviewers conducted a screening ***:A review of various studies on pre-and intra-arrest prognostic factors showed that survival rates were higher when patients had an initial shockable *** were conflicting results regarding other prognostic factors,such as witnessed arrest,bystander cardiopulmonary resuscitation(CPR),and the use of prehospital or in-hospital *** thoracotomy was found to result in more favorable outcomes in cases of penetrating trauma than in those with blunt *** endovascular balloon occlusion of the aorta(REBOA)provides an advantage to emergency thoracotomy in terms of occupational safety for the operator as an alternative in managing hemorrhagic *** implemented in the setting of aortic occlusion,emergency thoracotomy and REBOA resulted in comparable mortality ***-venous extracorporeal life support(V-V ECLS)and veno-arterial extracorporeal life support(V-A ECLS)are viable options for treating respiratory failure and cardiogenic shock,*** the context of traumatic injuries,V-V ECLS has been associated with higher rates of survival to discharge than V-A ***:TCA remains a signifi cant challenge for emergency medical services due to its high m

关键词： Traumatic cardiac arrest Emergency thoracotomy Resuscitative endovascular balloon occlusion of the aorta

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Mesenchymal stem cell-derived exosomes: The dawn of diabetic wound healing

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World Journal of Diabetes 2022年第12期13卷 1066-1095页

作者： Jing Wu Li-Hong Chen Shi-Yi Sun Yan Li Xing-Wu Ran Innovation Center for Wound Repair Diabetic Foot Care CenterDepartment of Endocrinology and MetabolismWest China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

Chronic wound healing has long been an unmet medical need in the field of wound repair,with diabetes being one of the major *** chronic wounds(DCWs),especially diabetic foot ulcers,are one of the most threatening chronic complications of *** the treatment strategies,drugs,and dressings for DCWs have made great progress,they remain ineffective in some patients with refractory *** cell-based therapies have achieved specific efficacy in various fields,with mesenchymal stem cells(MSCs)being the most widely *** MSCs have achieved good feedback in preclinical studies and clinical trials in the treatment of cutaneous wounds or other situations,the potential safety concerns associated with allogeneic/autologous stem cells and unknown long-term health effects need further attention and *** studies have reported that stem cells mainly exert their trauma repair effects through paracrine secretion,and exosomes play an important role in intercellular communication as their main bioactive ***-derived exosomes(MSC-Exos)inherit the powerful inflammation and immune modulation,angiogenesis,cell proliferation and migration promotion,oxidative stress alleviation,collagen remodeling imbalances regulation of their parental cells,and can avoid the potential risks of direct stem cell transplantation to a large extent,thus demonstrating promising performance as novel"cell-free"therapies in chronic *** review aimed to elucidate the potential mechanism and update the progress of MSC-Exos in DCW healing,thereby providing new therapeutic directions for DCWs that are difficult to be cured using conventional therapy.

关键词： diabetic wounds Wound and injuries Mesenchymal stem cells Exosomes Pre-conditioning Preclinical translation

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Neuroprotective effects of chaperone-mediated autophagy in neurodegenerative diseases

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Neural Regeneration Research 2024年第6期19卷 1291-1298页

作者： Qi Jia Jin Li Xiaofeng Guo Yi Li You Wu Yuliang Peng Zongping Fang Xijing Zhang Department of Anesthesiology and Perioperative Medicine and Department of Intensive care Unit Xijing HospitalThe Fourth Military Medical UniversityXi’anShaanxi ProvinceChina Department of Critical care Medicine Air Force Medical CenterBeijingChina Translational Research Institute of Brain and Brain-Like Intelligence Shanghai Fourth People’s HospitalSchool of MedicineTongji UniversityShanghaiChina

Chaperone-mediated autophagy is one of three types of autophagy and is characterized by the selective degradation of ***-mediated autophagy contributes to energy balance and helps maintain cellular homeostasis,while providing nutrients and support for cell ***-mediated autophagy activity can be detected in almost all cells,including *** to the extreme sensitivity of neurons to their environmental changes,maintaining neuronal homeostasis is critical for neuronal growth and ***-mediated autophagy dysfunction is closely related to central nervous system *** has been shown that neuronal damage and cell death are accompanied by chaperone-mediated autophagy *** certain conditions,regulation of chaperone-mediated autophagy activity attenuates *** this paper,we review the changes in chaperone-mediated autophagy in neurodegenerative diseases,brain injury,glioma,and autoimmune *** also summarize the most recent research progress on chaperone-mediated autophagy regulation and discuss the potential of chaperone-mediated autophagy as a therapeutic target for central nervous system diseases.

关键词： chaperone-mediated autophagy neurodegenerative disease neuronal homeostasis neuroprotection

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