Frontiers in Medicine最新文献

{"title":"Non-invasive testing in metabolic dysfunction-associated steatotic liver disease.","authors":"Sanad Dawod, Kimberly Brown","doi":"10.3389/fmed.2024.1499013","DOIUrl":"https://doi.org/10.3389/fmed.2024.1499013","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD), previously referred to as non-alcoholic fatty liver disease (NAFLD), is a leading cause of chronic liver disease, affecting up to 30% of the global population. MASLD is strongly associated with metabolic risk factors such as obesity and type 2 diabetes, and can progress to advanced stages including cirrhosis and hepatocellular carcinoma. Early diagnosis and accurate staging of fibrosis are critical in managing the disease and preventing complications. While liver biopsy has long been considered the gold standard for assessing fibrosis, it is invasive and carries associated risks. In response, non-invasive tests (NITs) have emerged as essential alternatives for the diagnosis and monitoring of MASLD. Key methods include blood-based biomarkers such as the Fibrosis-4 (FIB-4) score, NAFLD Fibrosis Score (NFS), and Enhanced Liver Fibrosis (ELF) test, as well as imaging modalities like vibration-controlled transient elastography (VCTE) and magnetic resonance elastography (MRE). These tests provide safer, more accessible methods for identifying liver fibrosis and guiding clinical management. They are integral in assessing disease severity, guiding treatment decisions, and monitoring disease progression, particularly in light of emerging therapies. NITs have become increasingly recommended by clinical guidelines as they reduce the need for invasive procedures like liver biopsy, improving patient care and outcomes. In conclusion, non-invasive testing plays a crucial role in the effective management of MASLD, offering reliable alternatives for diagnosis and monitoring while minimizing risks associated with traditional invasive methods.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1499013"},"PeriodicalIF":3.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11598437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between the diameter of esophageal varices measured using a virtual ruler under endoscopy and portal pressure gradient.","authors":"Yudi Mao, Zhongliang Fang, Yingying He, Jing Jin, Xiping Ding, Derun Kong","doi":"10.3389/fmed.2024.1443581","DOIUrl":"https://doi.org/10.3389/fmed.2024.1443581","url":null,"abstract":"<p><strong>Background: </strong>Esophageal variceal diameter (EVD) is a crucial factor in determining the risk of esophageal variceal bleeding, which is associated with an increased portal pressure gradient (PPG). However, research into the relationship between EVD and PPG has been limited, primarily because the assessment of EVD depends on visual estimation during endoscopy. Recently, we developed an artificial intelligence (AI)-based method to accurately detect EVD. In this study, we aim to investigate the correlation between EVD and PPG, with the goal of evaluating EVD as a potential non-invasive indicator of PPG.</p><p><strong>Methods: </strong>This study included both retrospective and prospective data from 128 patients diagnosed with portal hypertension and gastroesophageal varices, gathered from two medical institutions. Clinical data including PPG, biochemical markers, and routine blood tests were collected. In the retrospective phase, EVD was evaluated using an AI-based virtual ruler. In the prospective phase, PPG was measured using radiological intervention methods, and EVD was measured during endoscopy with the aid of AI.</p><p><strong>Results: </strong>A positive correlation between PPG and EVD was identified (<i>r</i> = 0.521, <i>P</i> < 0.001), which was further supported by multivariate linear regression analysis (b = 6.521, t = 6.872, <i>P</i> < 0.001). When patients were stratified into two groups based on PPG levels (27 patients with PPG < 20 mmHg and 101 patients with PPG ≥ 20 mmHg), a significant difference in EVD was observed between the groups (OR = 29.275, 95% CI 5.590-153.304, <i>P</i> < 0.001), with larger EVD in the higher PPG group. These findings suggest that EVD may serve as a predictor of adverse events associated with elevated PPG levels. In addition, receiver operating characteristic (ROC) curve analysis showed that EVD had an accuracy of 0.814 in diagnosing PPG function (standard error 0.048, 95% CI 0.720-0.908; P < 0.001), indicating that PPG levels are likely to exceed 20 mmHg when the variceal diameter is greater than 1.1 cm.</p><p><strong>Conclusion: </strong>EVD demonstrated a positive correlation with PPG and could potentially be used as a predictive marker for assessing PPG levels. These findings provide novel insights for the non-invasive evaluation of PPG in clinical practice.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1443581"},"PeriodicalIF":3.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11598435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fostering the international interoperability of clinical research networks to tackle undiagnosed and under-researched rare diseases.","authors":"Galliano Zanello, Chun-Hung Chan, Samantha Parker, Daria Julkowska, David A Pearce","doi":"10.3389/fmed.2024.1415963","DOIUrl":"https://doi.org/10.3389/fmed.2024.1415963","url":null,"abstract":"<p><p>Clinical research is an essential component to advance diagnosis and therapeutic development. In 2022, the International Rare Diseases Research Consortium (IRDiRC) and the European Joint Programme on Rare Diseases (EJP RD) brought together key stakeholders from across the globe to discuss common themes in clinical research networks (CRNs) for rare diseases. Various topics were raised during discussions including current state of CRNs, the need for new CRNs, multi-stakeholder perspectives on value of CRNs, and ways to collaborate on a global scale. Communication and coordination between various groups, taking advantage of existing experiences, can expedite establishment and execution of complex collaborations that will be necessary for CRNs. In this perspective, we discuss opportunities and highlight key considerations for developing successful collaborative CRNs across the globe.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1415963"},"PeriodicalIF":3.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11598342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum: Patients with microscopic colitis have altered levels of inhibitory and stimulatory biomarkers in colon biopsies and sera compared to non-inflamed controls.","authors":"Alexandra Lushnikova, Johan Bohr, Anna Wickbom, Andreas Münch, Klas Sjöberg, Olof Hultgren, Anders Wirén, Elisabeth Hultgren Hörnquist","doi":"10.3389/fmed.2024.1506094","DOIUrl":"10.3389/fmed.2024.1506094","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fmed.2021.727412.].</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1506094"},"PeriodicalIF":3.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142727476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of perceived stress on professional identity among nursing students: a chain mediating role of self-control and self-directed learning ability.","authors":"Xin Zhao, Wen-Kai Zheng, Xiu-Huan Wang, Jiao Fang, Wen-Jin Chen, Na Li, Hai-Tao Wen, Xiu-Juan Feng, Mei-Fang Wang, Chun-Ni Heng, Wei-Na Cao","doi":"10.3389/fmed.2024.1429014","DOIUrl":"10.3389/fmed.2024.1429014","url":null,"abstract":"<p><strong>Background: </strong>A positive professional identity is key for nursing students in determining career direction and predicting future engagement in the profession. Despite its complexity and susceptibility to various influences, the factors shaping nursing students' professional identity remain poorly understood.</p><p><strong>Objectives: </strong>This study aims to investigate how perceived stress can directly and indirectly influence professional identity among nursing students, with self-control and self-directed learning ability as mediators.</p><p><strong>Materials and methods: </strong>A cross-sectional survey was conducted from October to December 2023, collecting data from 675 nursing students across five tertiary hospitals in Xi'an, Shaanxi Province, China. The survey captured detailed data on sociodemographic characteristics, perceived stress, self-control, self-directed learning ability, and professional identity among the participants. Descriptive analysis and correlation matrices were used to analyze participant characteristics and assess bivariate correlations. The mediation model was analyzed using the PROCESS macro for SPSS.</p><p><strong>Results: </strong>Perceived stress showed a direct and negative influence on professional identity among nursing students; self-control was shown to play a mediating role between perceived stress and professional identity; self-directed learning ability was shown to play a mediating role between perceived stress and professional identity; and self-control and self-directed learning ability were shown to play a chain mediating role between perceived stress and professional identity.</p><p><strong>Conclusion: </strong>Self-control and self-directed learning ability have a chain mediating role in between perceived stress and professional identity among nursing students. It suggests that nursing managers and educators can improve the self-control and self-directed learning ability of nursing students to mitigate the negative impact of perceived stress on professional identity.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1429014"},"PeriodicalIF":3.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142727499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and attitudes toward over-the-counter medications among pharmacy students: insights from a cross-sectional study in Taif University, Saudi Arabia.","authors":"Mohammed S Alharthi, Hassan Almalki, Faisal Alsubaie, Fawaz Alotaibe, Abdullah Abuasiah, Faisal Basha, Mohammed M Aldurdunji, Nasser M Alorfi","doi":"10.3389/fmed.2024.1435707","DOIUrl":"10.3389/fmed.2024.1435707","url":null,"abstract":"<p><strong>Introduction: </strong>Over-the-counter (OTC) medications are those obtained without a medical prescription from a healthcare professional. With the increasing availability of information from various sources, including social media, pharmacy students may be exposed to unreliable or inaccurate data. Incorrect medication use is particularly concerning due to its potential risk of causing adverse health effects.\" Hence, this study aims to determine students' knowledge and attitudes at Taif University's pharmacy college.</p><p><strong>Methods: </strong>This research utilized a cross-sectional online questionnaire-based study, employing data from a sample of 450 pharmacy students from Taif University in Saudi Arabia. Descriptive analysis included descriptive and differential analysis. The data were analyzed using statistical package for social sciences (SPSS) Version 27.</p><p><strong>Results: </strong>The majority of participants, 297 (88.2%), were aware that inappropriate use of over-the-counter medications might have negative implications. A total of 233 participants (51.8%) reported having previously used an OTC medication. Also, 293 (65.1%), were aware that using OTC medications beyond their expiration date was harmful. A total of 280 participants (62.2%) had a high knowledge of OTC medication, whereas 170 respondents (37.8%) had a low level of knowledge. A significant correlation was found between age, year of study, and the use of OTC medication <i>p</i>-values <0.05 (0.016*, 0.003*, and 0.001* respectively) and understanding of OTC medication. Gender had no significant influence on knowledge of OTC (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>The study found positive attitudes toward OTC medications. Due to increased pharmaceutical exposure and self-medication, upper-year students and OTC course graduates comprehend OTC medications better. The examination found safety protocol violations in expiration dates, prescription label interpretation, and storage. Therefore, the study provides useful information for future attempts. Also, this study may contribute to the literature and guide future research to fill knowledge gaps.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1435707"},"PeriodicalIF":3.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142727502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver transplantation and comprehensive rehabilitation in the reversal of hepatic myelopathy: a case report.","authors":"Mingyue Liu, Rongping Wang, Wenwen Zhou, Chunyan Tian, Qian Wang, Qin Zhang, Shasha Jin, Liang Wu","doi":"10.3389/fmed.2024.1467611","DOIUrl":"10.3389/fmed.2024.1467611","url":null,"abstract":"<p><p>Hepatic myelopathy (HM) is a rare complication of end-stage chronic liver disease, primarily presenting as symmetrical lower limb weakness that progresses to spastic paralysis without sensory or sphincter dysfunction. We report a case of decompensated cirrhosis associated with hepatitis B virus and HM. The patient showed significant recovery after liver transplantation (LT) and comprehensive rehabilitation training. We summarize the patient's clinical characteristics post-diagnosis and the assessment outcomes following integrated treatment.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1467611"},"PeriodicalIF":3.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142727621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum: Deep learning-driven ultrasound-assisted diagnosis: optimizing GallScopeNet for precise identification of biliary atresia.","authors":"Yupeng Niu, Jingze Li, Xiyuan Xu, Pu Luo, Pingchuan Liu, Jian Wang, Jiong Mu","doi":"10.3389/fmed.2024.1518391","DOIUrl":"https://doi.org/10.3389/fmed.2024.1518391","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fmed.2024.1445069.].</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1518391"},"PeriodicalIF":3.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142727554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current status of ultrasound training in obstetrics and gynecology: a scoping literature review.","authors":"Julia Matschl, Jorge Jimenez-Cruz, Valentin Sebastian Schäfer, Agnes Wittek, Christoph Berg, Annegret Geipel, Ulrich Gembruch, Brigitte Strizek, Florian Recker","doi":"10.3389/fmed.2024.1426484","DOIUrl":"10.3389/fmed.2024.1426484","url":null,"abstract":"<p><strong>Introduction: </strong>As a widely accessible, cost-effective, and safe imaging tool, obstetric and gynecologic (OB/GYN) ultrasound (ULS) plays a vital role in diagnostics and patient care. With its growing relevance, the demand for comprehensive education in this field increases. The objective of this work was to outline the current state of OB/GYN ULS education.</p><p><strong>Methods: </strong>A scoping literature search was performed until May 2023 using the medical database PubMed according to PRISMA guidelines. Using specific keywords, relevant publications were filtered. Subsequently, abstracts were independently reviewed by two authors and the inclusion of each publication was assessed against pre-defined key search terms. Full-text versions of the included publications were scrutinized and pertinent information was extracted.</p><p><strong>Results: </strong>In this review, 126 articles from the literature search matched the inclusion criteria and were investigated. Our findings revealed a diverse range of course concepts and programs, a lot of them not meeting the expectations of trainees and international guidelines. OB/GYN ULS training primarily targets residents, yet opportunities for early exposure and continuing education are underexplored. International organizations, such as the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) and the German Society for Ultrasound in Medicine (DEGUM) have proposed guidelines and curricula for standardized training. However, adoption remains varied. There is an emergent need to innovate teaching methods.</p><p><strong>Conclusion: </strong>There is consensus that standardizing OB/GYN ULS curricula could enhance training quality and streamline the creation of new programs, ultimately improving patient care. Further research is needed to define the most effective strategies for curriculum development and implementation.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1426484"},"PeriodicalIF":3.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142727477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between high-sensitivity C-reactive protein and gallstones: a cross-sectional analysis.","authors":"Zhimeng Jiang, Huixin Jiang, Xingyu Zhu, Donglin Zhao, Feifei Su","doi":"10.3389/fmed.2024.1453129","DOIUrl":"10.3389/fmed.2024.1453129","url":null,"abstract":"<p><strong>Background and objective: </strong>High-sensitivity C-reactive protein (hs-CRP), a classical indicator of inflammation, holds significant clinical value in various diseases. The relationship between hs-CRP and gallstones, however, remains poorly studied at present. The relationship between hs-CRP and gallstones will be investigated in this study.</p><p><strong>Methods: </strong>Data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES) were analyzed, focusing on participants aged 20 years and older who provided complete hs-CRP and gallstone information. Due to the skewed distribution of hs-CRP, the data were log-transformed [Log (hs-CRP)] to achieve normalization. Logistic regression analysis, subgroup analysis, and smoothed fitted curves were applied to determine the relationship between Log (hs-CRP) and the presence of gallstones.</p><p><strong>Results: </strong>The study included 4,484 participants with an average Log (hs-CRP) of 1.18 ± 0.74. The prevalence of gallstones was 11.15%, increasing with higher Log (hs-CRP) levels (quartile 1: 8.31%; quartile 2: 8.76%; quartile 3: 11.98%; quartile 4: 16.36%; <i>p</i> < 0.0001). Adjusting for all covariates in Model 3, each 10-fold increase in hs-CRP [corresponding to a one-unit increase in log10 (hs-CRP)] corresponded to a 29% increased odds of gallstones prevalence [1.29 (1.12-1.49)]. The smoothed fitted curve showed a positive linear relationship between Log (hs-CRP) and gallstones prevalence. The results of subgroup analyses exhibited a more pronounced positive correlation in the 20-40 age group [1.70 (1.33, 2.16)], compared to those aged 40-60 years [1.22 (1.01, 1.48)], and 60-80 years [1.14 (0.98, 1.34)].</p><p><strong>Conclusion: </strong>Higher Log (hs-CRP) levels are linked to a greater prevalence of gallstones. We still need to carry out further large prospective research to explore the causal relationship of this association.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1453129"},"PeriodicalIF":3.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142727635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}