Medicine Advances最新文献

{"title":"Treatment of lumbar intervertebral disc herniation using open spinal endoscopy: Techniques and clinical outcomes","authors":"Bing Yu,&nbsp;Jun Zheng","doi":"10.1002/med4.63","DOIUrl":"https://doi.org/10.1002/med4.63","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The aims of this paper are to introduce Open spinal endoscopy (OSE), which is a new single hole split-type spinal endoscopic technique that can achieve adequate decompression and lumbar discectomy with preservation of the facet joints and posterior ligamentous complex, and to determine whether it can be widely performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 58 patients who were treated for lumbar disc herniation using the open spinal endoscopic technique at Anhui No. 2 Provincial People's Hospital between July, 2021 and February, 2022 were retrospectively analyzed. Pain in the lower back and legs was evaluated using the visual analog scale (VAS) score, neurologic status by the Japanese Orthopedic Association (JOA) score, and degree of disability by the Oswestry Disability Index (ODI). These evaluations were performed on the day before surgery and at the final postoperative follow-up. Surgical outcomes were assessed using the modified MacNab criteria. The method described by Dohzono and Matsumura was used to evaluate facet joint preservation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After surgery, the VAS score decreased from 8.4 ± 3.1 to 0.8 ± 0.8 (<i>p</i> &lt; 0.005) for leg pain and from 5.4 ± 2.9 to 1.8 ± 1.5 (<i>p</i> &lt; 0.05) for back pain. The JOA score improved from 14.7 ± 8.2 to 23.7 ± 4.8 (<i>p</i> &lt; 0.005). The average rate of improvement in the JOA score was 74.7% ± 34.7%. The ODI decreased from 46.1 ± 5.8 to 14.6 ± 7.0 (<i>p</i> &lt; 0.005). The final clinical outcome was excellent in 47 patients (81.0%), good in 10 (17.3%), and fair in one (1.7%). No patient had a poor final outcome. There were few operative complications. Dural injury occurred during use of the endoscope in two patients. The facet joint was preserved in 83.5% ± 7.4% of cases on the approach side and in 94.5% ± 7.3% on the contralateral side.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>OSE is a single hole split-type endoscopic technology. Compared with that for other minimally invasive spinal endoscopic techniques, the learning curve is less steep and easier to master. Open spinal endoscopy can achieve adequate decompression and lumbar discectomy with preservation of the facet joints and posterior ligamentous complex and can be performed widely.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100913,"journal":{"name":"Medicine Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/med4.63","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141488422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eosinophil count in cecal biopsies using artificial intelligence-based machine learning","authors":"Harsh C. Shah,&nbsp;Anjali D. Amarapurkar","doi":"10.1002/med4.64","DOIUrl":"10.1002/med4.64","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Tissue eosinophilia is a diagnostically challenging entity. An accurate diagnosis can benefit the patient with appropriate treatment. Histopathology is the gold standard. Manual counting results in errors and is time consuming. Artificial intelligence (AI) acts like a human brain in terms of memory and reproducibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The aim of this study was to determine the eosinophil count in gastrointestinal biopsies using AI and compare it with the manual method. A total of 400 digital images of hematoxylin and eosin-stained slides of gastrointestinal biopsies were included in the study. Annotations were performed on images containing eosinophils. The neural network prepared using the Python language was a modified U-Net architecture containing five down blocks and five up blocks. The results obtained using the AI model were compared with manual counts. Pearson's correlation coefficient and Cohen's kappa coefficient of agreement were used for statistical analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pearson's correlation coefficient demonstrated a strong positive correlation between AI and manual eosinophil (0.8), which suggests a very strong correlation. The Cohen's kappa coefficient of agreement was 0.85, which corresponds to excellent agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The manual eosinophil count and AI predictions demonstrated a very strong positive correlation. It is necessary to count eosinophils using an AI model because it saves time, and eliminates interobserver variability and human error.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100913,"journal":{"name":"Medicine Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/med4.64","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141338863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integration of proteinogenic amino acids in the pathogenesis of schizophrenia","authors":"Michelle S. Carvalho,&nbsp;Mauricio Luis Sforca,&nbsp;Silvana Aparecida Rocco,&nbsp;Danielle Zildeana Sousa Furtado,&nbsp;Cristiane da Silva Silverio,&nbsp;Marielle F. Queiroz Nunes,&nbsp;Marcel Vella Nunes,&nbsp;Marcelo P. Machado Adelino,&nbsp;Leonardo Afonso dos Santos,&nbsp;Andrea Jackowski,&nbsp;Rodrigo Affonseca Bressan,&nbsp;Acioly Luiz Tavares Lacerda,&nbsp;Nilson Antônio Assunção","doi":"10.1002/med4.65","DOIUrl":"10.1002/med4.65","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Schizophrenia (SCZ) is a severe mental disorder of multifactorial origin in which the role of amino acids is relatively unknown. Based on the hypothesis that there is an imbalance in amino acid levels in individuals with SCZ compared with healthy controls (HCs), the aim of this study was to identify the 20 proteinogenic amino acids involved in protein synthesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 43 sex- and age-matched individuals: 20 HCs and 23 with SCZ diagnosed using the Diagnostic and Statistical Manual of Mental Disorders criteria. Using proton nuclear magnetic resonance, we identified the serum levels of the 20 amino acids proteinogenic. We perform multivariate statistical exploratory analyzes to identify compounds, quantify, and identify the main biomarkers of SCZ.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified the serum levels of 19 of the 20 amino acids. Cysteine, the main precursor of glutathione, was not detected. Multivariate exploratory analysis identified lysine, Tryptophan (TRP), and glutamate as possible biomarkers of SCZ. Both lysine and TRP levels were lower and glutamate levels were higher in individuals with SCZ than in HCs. The observed reduction in plasma TRP levels in SCZ was attributed to the activation of the kynurenine pathway and has implications for serotonin synthesis. A strong positive correlation was observed between lysine and TRP, and a weak negative correlation between lysine and glutamate. This result is consistent with the lysine catalysis process because lysine degradation generates glutamate and favors an increase in dopamine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results are consistent with the lysine catalysis process because lysine degradation generates glutamate and favors an increase in dopamine. We were unable to identify any studies suggesting a relationship between lysine catabolism and SCZ pathophysiology, but we recognize this association as innovative.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100913,"journal":{"name":"Medicine Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/med4.65","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141341930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudden hemoptysis originating from spontaneous right bronchial artery bleeding during arterial duct closure in an adult patient with chronic myeloid leukemia","authors":"Diwen Li,&nbsp;Tianli Zhao,&nbsp;Xueyang Gong,&nbsp;Yiliya Ahemaiti,&nbsp;Luyao Wei,&nbsp;Shijun Hu","doi":"10.1002/med4.60","DOIUrl":"10.1002/med4.60","url":null,"abstract":"<p>Adult patients with patent ductus arteriosus (PDA) have a higher procedural risk during transcatheter PDA closures than infants and children. Limited information is available on transcatheter occlusion in patients with PDA and concomitant comorbidities such as leukemia. We report a case of a 32-year-old man with chronic myeloid leukemia who developed sudden hemoptysis during PDA catheter closure. Immediate treatment involved embolization of a bleeding bronchial artery with polyvinyl alcohol particles. The patient successfully underwent PDA closure and hematopoietic cell transplantation 3 months later. This case emphasizes the importance of evaluating fragile vasculature in patients with comorbid chronic diseases.</p>","PeriodicalId":100913,"journal":{"name":"Medicine Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/med4.60","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141338783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visualization analysis of research progress and trends in coexistence of lung cancer and pulmonary tuberculosis using bibliometrics","authors":"Ling Yang,&nbsp;Zhaoyang Ye,&nbsp;Linsheng Li,&nbsp;Li Zhuang,&nbsp;Jingzhi Guan,&nbsp;Wenping Gong","doi":"10.1002/med4.58","DOIUrl":"10.1002/med4.58","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The incidence of lung cancer combined with pulmonary tuberculosis has been increasing, but there is relatively limited published literature on the topic of lung cancer combined with tuberculosis (LC-PTB) from a bibliometric perspective. Therefore, in this study, we aimed to quantitatively analyze the LC-PTB-related literature to better understand the current status of this field and identify future research trends.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched for articles related to LC-PTB using the Web of Science Core Collection (SCI-E) and conducted a visual analysis of publication quantity, countries, institutions, authors, journals, references, and keywords using bibliometric software (CiteSpace, VOSviewer, and Scimago Graphica).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>As of January 8, 2024, a total of 460 publications related to LC-PTB were included for analysis from 3705 retrieved records. The number of publications has been increasing almost yearly, with most from China (<i>n</i> = 123), followed by the United States (<i>n</i> = 77). Taipei Medical University contributed the most publications (<i>n</i> = 11). Jing-Yang Huang and Yung-Po Liaw (eight documents each) ranked first among the included authors. The <i>Journal of Thoracic Oncology</i> was the most productive academic journal on LC-PTB. The aggregation of key nodes in the co-citation network and the chronological sequence indicated that LC-PTB research has shifted from initial hotspots such as lung diseases, bronchitis, and exposure to recent areas, including immunotherapy, immune checkpoint inhibitors, and nivolumab.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this study, we visualized the current status of LC-PTB research as well as future trends using bibliometric methods, providing new insights into the differential diagnosis of LC-PTB and its related promoting mechanisms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100913,"journal":{"name":"Medicine Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/med4.58","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141350893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between metabolically healthy obesity and risk of dementia: A systematic review and meta-analysis","authors":"Yanyi Su,&nbsp;Yuecai Li,&nbsp;Rongqi Ding,&nbsp;Ziyi Zheng,&nbsp;Jiaqi Wang,&nbsp;Qixiang Fu,&nbsp;Jialin Deng,&nbsp;Hong Zhou","doi":"10.1002/med4.57","DOIUrl":"10.1002/med4.57","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Some studies suggest that the metabolic alterations linked to obesity in humans may increase the likelihood of developing dementia. However, there are currently no existing meta-analyses exploring the possible occurrence of dementia in patients with metabolically healthy obesity (MHO). In the present study, we aimed to investigate a potential correlation between individuals with MHO and the likelihood of developing dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Our research focused on searching three databases to locate pertinent studies starting from January 10, 2023. We used sensitivity analysis, the Egger's test, and a visual funnel plot to separately assess the reliability of the research results and publication bias. We conducted this study according to a pre-established protocol in the PROSPERO registry (CRD42023449459).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We incorporated three potential cohort investigations. Individuals with good metabolic health and obesity showed a decreased likelihood of developing dementia compared with those who were metabolically healthy but not obese (hazard ratio (HR) = 0.79; 95% confidence interval (CI) 0.68–0.92). In contrast, individuals who were metabolically unhealthy and nonobese had an increased likelihood of developing dementia (HR = 1.33; 95% CI 1.25–1.42), whereas the population with metabolically unhealthy obesity did not exhibit a notable association with dementia onset (HR = 1.06; 95% CI 0.83–1.37).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>According to our meta-analysis, patients with MHO had a reduced likelihood of developing general dementia and Alzheimer disease. Maintaining a well-functioning metabolism can provide advantages in reducing the occurrence of dementia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100913,"journal":{"name":"Medicine Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/med4.57","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141372625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective, randomized, multicenter, open-label trial comparing survival in subjects receiving peritoneal dialysis or conventional in-center hemodialysis","authors":"Li Fan,&nbsp;Xiao Yang,&nbsp;Huaying Shen,&nbsp;Menghua Chen,&nbsp;Hao Zhang,&nbsp;Zhaohui Ni,&nbsp;Hongli Lin,&nbsp;Hongtao Yang,&nbsp;Qinkai Chen,&nbsp;Hongyu Chen,&nbsp;Gengru Jiang,&nbsp;Jianqin Wang,&nbsp;Jiuyang Zhao,&nbsp;Zhuxing Sun,&nbsp;Aiping Yin,&nbsp;Aili Jiang,&nbsp;Yun Li,&nbsp;Hui Peng,&nbsp;Nan Chen,&nbsp;Chuanming Hao,&nbsp;Yaozhong Kong,&nbsp;Rong Rong,&nbsp;Jie Li,&nbsp;Xia Zou,&nbsp;Haotian Luo,&nbsp;Jiaqi Qian,&nbsp;Xueqing Yu","doi":"10.1002/med4.56","DOIUrl":"10.1002/med4.56","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Peritoneal dialysis (PD) and conventional in-center hemodialysis (HD) are treatment options for patients with end-stage kidney disease (ESKD). However, their impact on all-cause mortality is unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a multicenter, open-label, randomized, non-inferiority trial to determine the effect of dialysis modality on mortality in patients with ESKD. Eligible patients were recruited from 30 sites across China and assigned to receive either PD or HD in a ratio of 1:1. The primary outcome was all-cause mortality. Non-inferiority was defined as the upper bound of the one-sided 95% confidence interval (CI) for the hazard ratio (HR) being ≤1.25.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 414 patients with incident ESKD were randomly assigned to PD (<i>n</i> = 213) or HD (<i>n</i> = 201). During a median follow-up of 1.7 years, 37 patients in the PD group and 31 in the HD group died, giving respective event rates per patient-year of 0.061 and 0.071. The HR for mortality on PD in comparison with HD was 0.76 (95% CI 0.47–1.24) after adjustment for age, sex, and diabetes status, achieving the limit for non-inferiority. There were more adverse events (<i>p = </i>0.003), serious adverse events (<i>p = </i>0.009), and adverse events leading to hospitalization (<i>p = </i>0.003) in the PD group than in the HD group; however, there was no significant between-group difference in adverse events leading to death or discontinuation of treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PD was non-inferior to conventional in-center HD in terms of survival in patients with ESKD. Our findings underscore the need for shared decision-making between physicians and patients regarding the selection of dialysis modality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial registration</h3>\u0000 \u0000 <p>Registered at ClinicalTrials.gov (NCT01413074).</p>\u0000 </section>\u0000 </div>","PeriodicalId":100913,"journal":{"name":"Medicine Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/med4.56","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141385404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applications of artificial intelligence and machine learning in clinical medicine: What lies ahead?","authors":"Gerard Marshall Raj,&nbsp;Sathian Dananjayan,&nbsp;Kiran Kumar Gudivada","doi":"10.1002/med4.62","DOIUrl":"https://doi.org/10.1002/med4.62","url":null,"abstract":"<p>The co-existence of artificial intelligence (AI) and human intelligence in solving complex medical issues is inevitable in the future. However, the question remains regarding whether this relationship would continue to be symbiotic and make room for better human-human interactions (the much-yearned patient-physician relationship) in clinical medicine [<span>1</span>].</p><p>The evolution of computational power, data science, and machine learning (ML) models is highly perceptible and sometimes unpredictable. Even Gordon Moore (cofounder of Intel®) had to revise his “Moore's law” from <i>‘the number of transistors on an integrated circuit would double every year’ (1960)</i> to <i>‘… every 2 years’</i> (1975) [<span>2</span>]. The same standard holds true for the application of AI in medicine, which ranges from diagnostics, therapeutics (personalized), prognostics, biomedical research (including clinical trials), public health (including pandemic preparedness), and administrative purposes [<span>3</span>]. Some of these possible current applications were barely foreseen and are largely unprecedented (Figure 1).</p><p>Through the aforementioned transitions, in addition to the scientific rigor and robustness of AI and ML concepts in medicine, the other considerations are ethical implications, regulatory standards, and legal challenges. Among these, the ethical intricacies surrounding AI in clinical applications are currently being considered upon more keenly and ethical guidelines are being fine-tuned across the world [<span>4-6</span>]. Instances of ethical issues include unfairly incentivizing people of the lower socio-economic strata to contribute personal data to AI development; the chances of cyberattacks on AI technologies, and the ensuing breach in data security and access to sensitive and private information; lack of transparency and explainability regarding how AI-based decisions and recommendations are derived (i.e., how the output is being derived from the input?—“black-box issue”); and overreliance on output from AI-driven technologies (“automation bias”) [<span>5, 7, 8</span>].</p><p>Overall, the principles of “transparency”, “justice, fairness, and equity”, “non-maleficence”, “responsibility and accountability”, and “privacy” were found to be common in global guidelines on ethical AI [<span>6, 9</span>].</p><p>Additionally, recently, the chatbots (like, ChatGPT and its successor GPT-4) have been the buzzwords in various health-related applications, from academic writing to clearing medical licensing exams, despite their inherent limitations and controversies [<span>10, 11</span>], including language bias [<span>12</span>], regional divide [<span>13</span>], environmental impact [<span>14</span>], and more importantly, compromise on publication ethics [<span>15</span>].</p><p>The medical profession is still based on the core principles of love, empathy, and compassion, but this may not always be replicated by ML-based healthcare tools ","PeriodicalId":100913,"journal":{"name":"Medicine Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/med4.62","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141487897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of ultra-high-field magnetic resonance imaging in the detection and management of brain metastases","authors":"Sadegh Ghaderi,&nbsp;Sana Mohammadi","doi":"10.1002/med4.59","DOIUrl":"10.1002/med4.59","url":null,"abstract":"<p>This letter discusses the clinical utility of ultra-high field magnetic resonance imaging (MRI) at 7 Tesla (7T) for the detection and management of brain metastases. Brain metastases are the most common intracranial tumors and their early detection and management are crucial for improving patient outcomes. Conventional MRI may miss subtle lesions, and 7T provides unprecedented anatomical details with high spatial resolution and improved contrast. It allows the visualization of fine tumor structures and margins, as well as early infiltration and angiogenesis. Techniques such as susceptibility-weighted imaging and quantitative susceptibility mapping exploit the 7T increased sensitivity to magnetic susceptibility effects, facilitating the detection of additional small or hemorrhagic lesions. Advanced methods have also provided novel neuroimaging biomarkers that characterize neuroinflammation and neurovascular changes. While acknowledging limitations including cost and technical challenges, earlier detection and targeted treatment informed by 7T MRI insights could minimize brain metastasis damage and improve patient outcomes.</p>","PeriodicalId":100913,"journal":{"name":"Medicine Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/med4.59","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141279066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why the Mostafa Maged maneuver is better: Mostafa Maged maneuver compared with bimanual uterine compression for postpartum hemorrhage","authors":"Mostafa Maged Ali,&nbsp;Mustafa Rabie Mohamed Elsharkawy","doi":"10.1002/med4.61","DOIUrl":"https://doi.org/10.1002/med4.61","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to investigate the effectiveness of the Mostafa Maged maneuver compared with bimanual uterine compression for the management of postpartum hemorrhage during vaginal delivery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a prospective study involving 200 patients divided into two groups with 100 patients in each group. Group I received (Mostafa Maged maneuver), and Group II received (routine bimanual uterine compression). The Mostafa Maged maneuver requires placing the right hand in the posterior fornix and positioning the left hand on the uterine fundus and posterior uterine wall via the abdomen exteriorly. The subsequent step involves holding the entire uterus against the symphysis pubis. We determined the duration of each maneuver until practitioner fatigue and evaluated whether oxytocin was administered after compression for each maneuver.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No patients required blood transfusions in Group I (Mostafa Maged maneuver), unlike in Group II, in which 17/100 patients received blood transfusions after bimanual compression. There was a statistically significant difference (<i>p</i> &lt; 0.001) between the groups regarding the administration of oxytocin. The mean duration of applying the Mostafa Maged maneuver was 12.7 min (range: 11–15 min). The mean duration of bimanual uterine compression (Group II) was 4.04 min (range: 3.5–4.5 min). There was a statistically significantly shorter duration for the Mostafa Maged maneuver and shorter time to onset of fatigue compared with bimanual uterine compression (<i>p</i> = 0.02, and <i>p</i> = 0.001, respectively). In contrast, there were no statistically significant differences between both groups for the dealing with the patient and the blood transfusion rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Mostafa Maged maneuver is easy to learn and feasible to perform compared with bimanual uterine compression. The Mostafa Maged maneuver may be a valuable addition to current conservative treatments for atonic postpartum hemorrhage, especially for obstetricians who lack the training and expertise to perform more complex procedures and those working in minimally equipped facilities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial registration</h3>\u0000 \u0000 <p>Clinical trial registration, including the date of registration: NCT06002256.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100913,"journal":{"name":"Medicine Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/med4.61","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141489042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}