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Acupuncture for the treatment of diabetic peripheral neuropathy in the elderly: a systematic review and meta-analysis 针灸治疗老年人糖尿病周围神经病变:系统综述和荟萃分析
Frontiers in Medicine Pub Date : 2024-06-14 DOI: 10.3389/fmed.2024.1339747
Xinyu Zhang, Lingyong Xiao, Yuan Qin, Huan Yang, Xiangcheng Wei, Lanping Li, Shiqing Zhao, Xiaoyu Dai
{"title":"Acupuncture for the treatment of diabetic peripheral neuropathy in the elderly: a systematic review and meta-analysis","authors":"Xinyu Zhang, Lingyong Xiao, Yuan Qin, Huan Yang, Xiangcheng Wei, Lanping Li, Shiqing Zhao, Xiaoyu Dai","doi":"10.3389/fmed.2024.1339747","DOIUrl":"https://doi.org/10.3389/fmed.2024.1339747","url":null,"abstract":"Diabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes mellitus, often causing pain or numbness in the patient’s limbs and even leading to amputation and death. Elderly patients with DPN usually have higher morbidity and more severe results. Acupuncture has been widely used as an effective treatment for DPN in China. However, the efficacy of acupuncture in the treatment of DPN remains unclear. In this review, we aimed to explore the impact of acupuncture in alleviating symptoms of DPN.Six databases were searched from inception to October 2023. We searched Medline, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and three Chinese databases, namely China National Knowledge Infrastructure (CNKI), SinoMed, and Wanfang. All randomized controlled trials related to the effect of acupuncture on DPN will be included. There was no restriction in language or publication year. The primary outcome is the response rate. The secondary outcomes are the Toronto clinical scoring system (TCSS), nerve conduction velocities (NCVs), and blood glucose before and after the treatment. Two researchers will be responsible for the selection of study, data extraction, and assessment of study quality independently. RevMan V5.1.0 software will be used to assess the risk of bias and generate data.We searched 4518 studies, among which 9 RCTs were considered eligible. Overall, acupuncture treatment had a higher response rate than controls (relative risk (RR), −2.87 [95% confidence interval (CI), −5.27 to −0.48], p = 0.02) and significantly alleviated the symptoms of DPN patients, reduced their blood glucose levels, and improved their NCVs compared to the control group. This study will provide a high-quality synthesis of current available evidence for the clinical treatment of DPN with this therapy.The results suggested that acupuncture might be effective in improving symptoms of DPN in elderly patients. Owing to the overall low quality of the literature included, we need more large-sample, high-quality, and low-bias studies to prove it.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"32 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141340387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical analysis of lupus miliaris disseminatus faciei: a cross-sectional study and literature review 散发型红斑狼疮的临床分析:横断面研究与文献综述
Frontiers in Medicine Pub Date : 2024-06-14 DOI: 10.3389/fmed.2024.1382526
Yaqi Wang, Jiahui Li, Shuang Wang
{"title":"Clinical analysis of lupus miliaris disseminatus faciei: a cross-sectional study and literature review","authors":"Yaqi Wang, Jiahui Li, Shuang Wang","doi":"10.3389/fmed.2024.1382526","DOIUrl":"https://doi.org/10.3389/fmed.2024.1382526","url":null,"abstract":"The clinical similarity of lupus miliaris disseminatus faciei (LMDF) and other papular granulomatous facial disorders often makes its correct diagnosis challenging. Diagnosis often requires the assistance of pathological examination, and dermoscopy can be used as an auxiliary and non-invasive examination method, however, the current findings remain incomplete.This study aimed to summarize the clinical, histopathological and dermoscopic features of LMDF in the Chinese Han population and aiming to provide practical significance to correct diagnosis.109 patients of LMDF were collected in the Department of Dermatology, the Second Affiliated Hospital of Xi’an Jiaotong University from August 2015 to August 2023. The clinical and histopathological manifestations of all patients, as well as the dermoscopic image features of 44 cases, including background, follicular findings, vessels, and other structures, were summarized and evaluated.The most significant histopathological features of LMDF in 109 cases is epithelioid granulomatous infiltrate in the superficial dermis, with or without caseation. The most significant dermoscopic features of LMDF in all 44 cases were orange structureless background (30/44), follicular plug (32/44), follicular white scar-like area (32/44), unspecific linear vessels (24/44), linear vessels with branch (24/44) and white streaks (18/44).Histopathologically, LMDF is characterized by the presence of epithelioid granulomatous infiltrate in the superficial dermis, with or without caseation. Dermoscopically, it exhibits a distinctive orange structureless background, follicular plug, follicular white scar-like area, nonspecific linear vessels, linear vessels with branches, and white streaks.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"25 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141344264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Critical thinking pedagogical practices in medical education: a systematic review 医学教育中的批判性思维教学实践:系统回顾
Frontiers in Medicine Pub Date : 2024-06-14 DOI: 10.3389/fmed.2024.1358444
Beatriz Araújo, Sandra F. Gomes, Laura Ribeiro
{"title":"Critical thinking pedagogical practices in medical education: a systematic review","authors":"Beatriz Araújo, Sandra F. Gomes, Laura Ribeiro","doi":"10.3389/fmed.2024.1358444","DOIUrl":"https://doi.org/10.3389/fmed.2024.1358444","url":null,"abstract":"The development of critical thinking (CT) has been a universal goal in higher education. A systematic review of the literature was conducted to evaluate the effectiveness of currently used pedagogical practices to foster CT/ clinical reasoning (CR)/ clinical judgment (CJ) skills and/or dispositions in undergraduate medical students.PubMed, Web of Science and Scopus databases were searched from January 2010 to April 2021 with a predefined Boolean expression.Of the 3221 articles originally identified, 33 articles were included by using PICOS methodology. From these, 21 (64%) reported CR pedagogical practices and 12 (36%) CT pedagogical practices.Overall, pedagogical practices such as cognitive/visual representation, simulation, literature exposure, test-enhancing and team-based learning, clinical case discussion, error-based learning, game-based learning seem to enhance CT/CR skills and/or dispositions. Further research is required to identify the optimal timing, duration and modality of pedagogical interventions for effectively foster CT/CR in medical education.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141344144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Case report: A rare case of simultaneous necrotizing fasciitis of the breast and forearm 病例报告:一例罕见的乳房和前臂同时坏死性筋膜炎病例
Frontiers in Medicine Pub Date : 2024-06-14 DOI: 10.3389/fmed.2024.1413593
Ruofei Xu, Tingting Fang, Weikang Cai
{"title":"Case report: A rare case of simultaneous necrotizing fasciitis of the breast and forearm","authors":"Ruofei Xu, Tingting Fang, Weikang Cai","doi":"10.3389/fmed.2024.1413593","DOIUrl":"https://doi.org/10.3389/fmed.2024.1413593","url":null,"abstract":"Necrotizing fasciitis is an aggressive bacterial infection that causes necrosis of the fascia and subcutaneous tissues with rapid progression and high mortality. Early stages often lead to misdiagnosis, resulting in improper treatment and severe implications. This case study presents a patient with diabetes mellitus combined with hepatitis B who rapidly developed necrotizing fasciitis of the left forearm and left breast after trauma and controlled the infection with early surgical treatment. It is worth noting that early surgical exploration is the gold standard for the diagnosis of necrotizing fasciitis and is the most effective means of reducing mortality and amputation rates in necrotizing fasciitis.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"21 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141340684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors associated with self-reported medical errors among undergraduate health science students in southern Ethiopia 与埃塞俄比亚南部健康科学专业本科生自述医疗失误有关的因素
Frontiers in Medicine Pub Date : 2024-06-13 DOI: 10.3389/fmed.2024.1354270
K. K. Toitole, Fekade Tesfaye Danaso, Saron Assefa Alto, Tofik Mohammed, Sisay Dejene, Wanzahun Godana Boynito
{"title":"Factors associated with self-reported medical errors among undergraduate health science students in southern Ethiopia","authors":"K. K. Toitole, Fekade Tesfaye Danaso, Saron Assefa Alto, Tofik Mohammed, Sisay Dejene, Wanzahun Godana Boynito","doi":"10.3389/fmed.2024.1354270","DOIUrl":"https://doi.org/10.3389/fmed.2024.1354270","url":null,"abstract":"Medical errors are not uncommon, but they are seldom reported. Patient safety practices are among the key areas for service improvement. This study aimed to assess factors associated with self-reported medical errors among undergraduate health science students in southern Ethiopia.A facility-based cross-sectional study was conducted among health science students of Arba Minch University in 2018. The sample size was calculated using a single population proportion formula. A total of 287 medical students in their fourth year and above, nursing and midwifery students in their second year and above, and other health science students in their third year and above were included.The majority (82.1, 95%CI: 77.63–86.67) of the study participants had a ‘good’ knowledge score on patient safety. Approximately 62.5% (95%CI: 56.8–68.2) of the participants had a ‘favorable’ patient safety attitude. Only 38.6% (95%CI: 32.8–44.3) of the study participants had ‘good’ patient safety practices. At adjusted analysis, the practical attachment unit, having ever managed a patient independently, having ever witnessed harm to patients by colleagues or other healthcare workers, and having ever witnessed harm to a close friend or family member were statistically significantly associated with self-reported medical errors. Participants who were doing their practical clinical attachment in the surgical and obstetric units were three times more likely to self-report medical errors as compared to those practicing in the pediatrics, internal medicine, and other units (AOR = 2.72, 95%CI: 1.16–6.39.97). Students who had never managed a patient independently were less likely to self-report medical error (AOR = 0.24, 95%CI: 0.08–0.72). The odds of self-reporting medical errors were less among among participants who had not ever witnessed harm to patients by colleagues or other healthcare workers (AOR = 0.12, 95%CI: 0.05–0.29) and participants who had not ever witnessed harm to a close friend or family member (AOR = 0.36, 95%CI: 0.16–0.80).One in five of the participants reported having harmed patients while practicing. Most of the students had good patient safety knowledge, while approximately two-thirds of the participants had a favorable attitude toward patient safety. Only 38.6% of the study participants had good patient safety practices. Having worked in surgical and obstetrics units, having managed a patient independently, and having witnessed harm to a patient were associated with self-reporting of medical errors.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"4 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141346598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Investigating the role of Caspase-1 in a mouse model of Juvenile X-linked Retinoschisis 研究 Caspase-1 在幼年 X 连锁视网膜裂伤小鼠模型中的作用
Frontiers in Medicine Pub Date : 2024-06-13 DOI: 10.3389/fmed.2024.1347599
Ella J. Gehrke, Araniko Pandey, Jacob Thompson, Sajag Bhattarai, Prajwal Gurung, Ying Hsu, Arlene V. Drack
{"title":"Investigating the role of Caspase-1 in a mouse model of Juvenile X-linked Retinoschisis","authors":"Ella J. Gehrke, Araniko Pandey, Jacob Thompson, Sajag Bhattarai, Prajwal Gurung, Ying Hsu, Arlene V. Drack","doi":"10.3389/fmed.2024.1347599","DOIUrl":"https://doi.org/10.3389/fmed.2024.1347599","url":null,"abstract":"Previous studies have reported Caspase-1 (Casp1) is upregulated in mouse models of Juvenile X-linked Retinoschisis (XLRS), however no functional role for Casp1 in disease progression has been identified. We performed electroretinogram (ERG) and standardized optical coherence tomography (OCT) in mice deficient in the Retinoschisin-1 (Rs1) and Casp1 and Caspase-11 (Casp11) genes (Rs1-KO;Casp1/11−/−) to test the hypothesis that Casp1 may play a role in disease evolution and or severity of disease. Currently, no studies have ventured to investigate the longer-term effects of Casp1 on phenotypic severity and disease progression over time in XLRS, and specifically the effect on electroretinogram.Rs1-KO;Casp1/11−/− mice were generated by breeding Rs1-KO mice with Casp1/11−/− mice. OCT imaging was analyzed at 2-, 4-, and 15–16 months of age. Outer nuclear layer (ONL) thickness and adapted standardized cyst severity score were measured and averaged from 4 locations 500 μm from the optic nerve. Adapted standardized cyst severity score was 1: absent cysts, 2: <30 μm, 3: 30–49 μm, 4: 50–69 μm, 5: 70–99 μm, 6: >99 μm. Electroretinograms (ERG) were recorded in dark-adapted and light-adapted conditions at 2 and 4 months. Results obtained from Rs1-KO and Rs1-KO;Casp1/11−/− eyes were compared with age matched WT control eyes at 2 months.Intraretinal schisis was not observed on OCT in WT eyes, while schisis was apparent in most Rs1-KO and Rs1-KO;Casp1/11−/− eyes at 2 and 4 months of age. There was no difference in the cyst severity score from 2 to 4 months of age, or ONL thickness from 2 to 16 months of age between Rs1-KO and Rs1-KO;Casp1/11−/− eyes. ERG amplitudes were similarly reduced in Rs1-KO and Rs1-KO;Casp1/11−/− compared to WT controls at 2 months of age, and there was no difference between Rs1-KO and Rs1-KO;Casp1/11−/− eyes at 2 or 4 months of age, suggesting no impact on the electrical function of photoreceptors over time in the absence of Casp1.Although Casp1 has been reported to be significantly upregulated in Rs1-KO mice, our preliminary data suggest that removing Casp1/11 does not modulate photoreceptor electrical function or alter the trajectory of the retinal architecture over time.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"11 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141348835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Do professionalism, leadership, and resilience combine for professional identity formation? Evidence from confirmatory factor analysis 专业精神、领导力和应变能力是否共同作用于专业身份的形成?确证因子分析提供的证据
Frontiers in Medicine Pub Date : 2024-06-13 DOI: 10.3389/fmed.2024.1385489
Á. Ryan, C. N. Moran, David Byrne, Anne Hickey, Fiona Boland, Denis W Harkin, S. S. Guraya, Abdelsalam Bensaaud, Frank Doyle
{"title":"Do professionalism, leadership, and resilience combine for professional identity formation? Evidence from confirmatory factor analysis","authors":"Á. Ryan, C. N. Moran, David Byrne, Anne Hickey, Fiona Boland, Denis W Harkin, S. S. Guraya, Abdelsalam Bensaaud, Frank Doyle","doi":"10.3389/fmed.2024.1385489","DOIUrl":"https://doi.org/10.3389/fmed.2024.1385489","url":null,"abstract":"Professional identity formation (PIF) is an ongoing, self-reflective process involving habits of thinking, feeling and acting like a physician and is an integral component of medical education. While qualitative work has suggested that PIF is informed by professionalism, resilience, and leadership, there is a dearth of quantitative work in this area. Multiple methods build rigor and the present study aimed to quantitatively assess the relative psychometric contributions of professionalism, resilience, and leadership constructs to informing PIF, using a latent factor analysis approach.We analyzed data from the PILLAR study, which is an online cross-sectional assessment of a pre-clinical cohort of medical students in the RCSI University of Medicine and Health Sciences, Dublin, using established and validated quantitative measures in each area of interest: PIF, professionalism, leadership and resilience. A total of 76 items, combining four validated scales, along with a selection of demographic questions, were used. The hypothesis that PIF is informed by, and correlates with, professionalism, resilience and leadership was examined by conducting a confirmatory factor analysis of a proposed three-factor higher-order model. Model estimation used Maximum Likelihood Method (MLM) with geomin rotation. The hypothesized (measurement) model was examined against an alternative (saturated) model, as well as a three-factor model.Latent variable analysis from 1,311 students demonstrated that a three-factor higher-order model best fit the data; suggesting PIF is informed by professionalism, resilience, and leadership, and that these constructs are statistically distinct and account for differential aspects of PIF. This higher-order model of PIF outperformed both the saturated model and the three-factor model. The analysis of which component may be the most or least influential was inconclusive, and the overall model was not influenced by year of training.Building upon existing conceptual contentions, our study is the first to quantitatively support the contribution of professionalism, resilience, and leadership to the development of professional identity, and to delineate the inter-relationships between PIF and these constructs. This information can be used by medical educators when designing curricula and educational strategies intended to enhance PIF. Future work should seek to assess the influence of these constructs longitudinally.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"5 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141347991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of serum ferritin and all-cause mortality in AKI patients: a retrospective cohort study 急性肾损伤患者血清铁蛋白与全因死亡率的关系:一项回顾性队列研究
Frontiers in Medicine Pub Date : 2024-06-13 DOI: 10.3389/fmed.2024.1368719
Xiaoxu Ren, Zhiming Jiang, Fen Liu, Quanzhen Wang, Hairong Chen, Lifeng Yu, Chaoqun Ma, Rong Wang
{"title":"Association of serum ferritin and all-cause mortality in AKI patients: a retrospective cohort study","authors":"Xiaoxu Ren, Zhiming Jiang, Fen Liu, Quanzhen Wang, Hairong Chen, Lifeng Yu, Chaoqun Ma, Rong Wang","doi":"10.3389/fmed.2024.1368719","DOIUrl":"https://doi.org/10.3389/fmed.2024.1368719","url":null,"abstract":"Serum ferritin (SF) is clinically found to be elevated in many disease conditions, and our research examines serum ferritin in patients with acute kidney injury (AKI) and its implication on the risk of short-term mortality in AKI.Data were extracted from the Medical Information Mart for Intensive Care IV 2.2 (MIMIC-IV 2.2) database. Adult patients with AKI who had serum ferritin tested on the first day of ICU admission were included. The primary outcome was 28-day mortality. Kaplan–Meier survival curves and Cox proportional hazards models were used to test the relationship between SF and clinical outcomes. Subgroup analyses based on the Cox model were further conducted.Kaplan–Meier survival curves showed that a higher SF value was significantly associated with an enhanced risk of 28-day mortality, 90-day mortality, ICU mortality and hospital mortality (log-rank test: p < 0.001 for all clinical outcomes). In multivariate Cox regression analysis, high level of SF with mortality was significantly positive in all four outcome events (all p < 0.001). This result remains robust after adjusting for all variables. Subgroup analysis of SF with 28-day mortality based on Cox model-4 showed that high level of SF was associated with high risk of 28-day mortality in patients regardless of the presence or absence of sepsis (p for interaction = 0.730). Positive correlations of SF and 28-day mortality were confirmed in all other subgroups (p for interaction>0.05).High level of SF is an independent prognostic predictor of 28-day mortality in patients with AKI.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"51 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141349550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Developing digital competencies of nursing professionals in continuing education and training – a scoping review 在继续教育和培训中培养护理专业人员的数字化能力--范围界定审查
Frontiers in Medicine Pub Date : 2024-06-13 DOI: 10.3389/fmed.2024.1358398
Tim Tischendorf, Martina Hasseler, Tom Schaal, Sven-Nelson Ruppert, Maria Marchwacka, André Heitmann-Möller, Sandra Schaffrin
{"title":"Developing digital competencies of nursing professionals in continuing education and training – a scoping review","authors":"Tim Tischendorf, Martina Hasseler, Tom Schaal, Sven-Nelson Ruppert, Maria Marchwacka, André Heitmann-Möller, Sandra Schaffrin","doi":"10.3389/fmed.2024.1358398","DOIUrl":"https://doi.org/10.3389/fmed.2024.1358398","url":null,"abstract":"The German health and care system is transforming due to advancing digitalization. New technological applications in nursing, such as social and assistance robotics, artificial intelligence and legal framework conditions are increasingly focused in numerous research projects. However, the approaches to digitalization in nursing are very different. When integrating technologies such as robotics and artificial intelligence into nursing, it is particularly important to ensure that ethical and human aspects are taken into account. A structured classification of the development of digitalization in nursing care is currently hardly possible. In order to be able to adequately deal with this digital transformation, the acquisition of digital competences in nursing education programs is pivotal. These include the confident, critical and creative use of information and communication technologies in a private and professional context. This paper focuses on the question which specific training offers already exist at national and international level for nursing professions to acquire digital competences.A scoping review according to the PRISMA scheme was conducted in the PubMed and CINAHL databases. The search period for the scoping review extended from 2017 to 2024.The selection of the studies took place by inclusion and exclusion criteria and the content-related orientation of the publications. After reviewing the titles and abstracts, eight studies were included. Of these, four were published in German-speaking countries and another four in international English-language journals.The topic of digitization of the nursing professions and the question of how nurses can acquire digital competences is gaining international attention. Nevertheless, the research on explicit continuing education programs for nursing professions is still undifferentiated. No specific continuing education offer for the development of digital competences of nursing professionals was identified. Many authors remained at the meta-level when developing methodological concepts for the acquisition of digital competences. The systematic integration of digitalization into higher education and continuing vocational training is mentioned in the publications. The development of theory- and research-based educational frameworks, which can be used as a basis for curricula in nursing studies and continuing education, is highly recommendable.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"52 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141345124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
KEAP1 overexpression is correlated with poor prognosis and immune infiltration in liver hepatocellular carcinoma KEAP1 过表达与肝脏肝细胞癌的不良预后和免疫浸润有关
Frontiers in Medicine Pub Date : 2024-06-13 DOI: 10.3389/fmed.2024.1391843
Xin Wei, Yigui Tang, Meijuan Zheng, Yuanhong Xu, Zhongxin Wang
{"title":"KEAP1 overexpression is correlated with poor prognosis and immune infiltration in liver hepatocellular carcinoma","authors":"Xin Wei, Yigui Tang, Meijuan Zheng, Yuanhong Xu, Zhongxin Wang","doi":"10.3389/fmed.2024.1391843","DOIUrl":"https://doi.org/10.3389/fmed.2024.1391843","url":null,"abstract":"Liver hepatocellular carcinoma (LIHC) is the most common type of liver cancer, but there is a lack of effective indicators for its early diagnosis and prognosis, so we explored the role of KEAP1 in LIHC patients in this study.The Cancer Genome Atlas (TCGA) dataset was used to investigate the relationship between KEAP1 expression and clinicopathological features and prognosis of LIHC patients. KEAP1 expression related pathways were enriched by Gene Ontology (GO) and gene set enrichment analysis (GSEA). Besides, KEAP1 expression-related immune infiltration was performed by single-sample GSEA (ssGSEA), and function of immune cells was detected by flow cytometry.It was found that KEAP1 expression was significantly increased and correlated with overall survival of LIHC patients. A total of 231 differentially expressed genes (DEGs) between LIHC patients with high- and low-KEAP1 expression were found, which associated with various biological pathways. Besides, KEAP1 expression was positively correlated with the infiltration level of T helper cells and Th2 cells but negatively correlated with DCs and cytotoxic cells. Functional analysis revealed that the expression of IL 4 in Th2 cells and CD107a, GrA and GrB in cytotoxic cells was significantly greater in LIHC patients than in HCs. In addition, KEAP1 expression was closely correlated with liver function in LIHC patients.Highly expressed KEAP1 was closely related to the diagnosis, prognosis, immune cell infiltration, and liver function of LIHC, which might promote the progression of LIHC through regulating cell development, signal transduction, and abnormal immune response. The current study partially revealed the role of KEAP1 in LIHC and provided a potential biomarker for the diagnosis, prognosis and treatment of LIHC.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"16 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141348902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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