Interactive Journal of Medical Research最新文献

{"title":"Predictive Value of Physiological Values and Symptom Scores for Exacerbations in Bronchiectasis and Chronic Obstructive Pulmonary Disease With Frequent Exacerbations: Longitudinal Observational Cohort Study.","authors":"Thomas Llewelyn Jones, Claire Roberts, Scott Elliott, Sharon Glaysher, Ben Green, Janis K Shute, Anoop J Chauhan","doi":"10.2196/44397","DOIUrl":"10.2196/44397","url":null,"abstract":"<p><strong>Background: </strong>COPD (chronic obstructive pulmonary disease) and bronchiectasis are common, and exacerbations contribute to their morbidity and mortality. Predictive factors for the frequency of future exacerbations include previous exacerbation frequency and airway colonization. Earlier treatment of exacerbations is likely to reduce severity.</p><p><strong>Objective: </strong>This study tested the hypothesis that, in a population with bronchiectasis, COPD, or both who have frequent exacerbations and airway colonization, changes in symptom scores or physiological variables within 10 days prior to an exacerbation would allow the prediction of the event.</p><p><strong>Methods: </strong>We performed a 6-month, longitudinal, observational, cohort study among 30 participants with bronchiectasis, COPD, or both; at least 2 exacerbations per year; and colonization with Pseudomonas aeruginosa or Haemophilus influenzae. Daily symptom and physiological data were collected, comprising pulse rate, blood pressure, oxygen saturation, peak flow rate, step count, weight, and temperature. Exacerbations (defined as the onset of new antibiotic use for respiratory symptoms) were collected, and predictive values for abnormal values in the 10 days prior to an exacerbation were calculated.</p><p><strong>Results: </strong>A total of 30 participants were recruited, collecting a total of 39,534 physiological and 25,334 symptom data points across 5358 participant-days; these included 78 exacerbations across 27 participants, with the remaining 3 participants not having exacerbations within the 6-month observation period. Peak flow rate, oxygen saturation, and weight were significantly different at the point of exacerbation (all P<.001), but no significant trends around exacerbation were noted and no clinically beneficial predictive value was found in the overall or individually adjusted model. Symptom scores tended to worsen for 10 days on either side of an exacerbation but were of insufficient magnitude for prediction, with area under the receiver operating characteristic curve values of ranging from 0.4 to 0.6.</p><p><strong>Conclusions: </strong>Within this small cohort with bronchiectasis, COPD, or both and airway colonization, physiological and symptom variables did not show sufficient predictive value for exacerbations to be of clinical utility. The self-management education provided as standard of care may be superior to either of these approaches, but benefit in another or larger cohort cannot be excluded.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.2196/resprot.6636.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"13 ","pages":"e44397"},"PeriodicalIF":1.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395195","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":"Shift in Demographic Involvement and Clinical Characteristics of COVID-19 From Wild-Type SARS-CoV-2 to the Delta Variant in the Indian Population: In Silico Analysis.","authors":"Ashutosh Kumar, Adil Asghar, Khursheed Raza, Ravi K Narayan, Rakesh K Jha, Abhigyan Satyam, Gopichand Kumar, Prakhar Dwivedi, Chetan Sahni, Chiman Kumari, Maheswari Kulandhasamy, Rohini Motwani, Gurjot Kaur, Hare Krishna, Sujeet Kumar, Kishore Sesham, Sada N Pandey, Rakesh Parashar, Kamla Kant","doi":"10.2196/44492","DOIUrl":"10.2196/44492","url":null,"abstract":"<p><strong>Background: </strong>The Delta variant (B.1.617.2) was considered the most dangerous SARS-CoV-2 strain; however, in-depth studies on its impact based on demographic and clinical characteristics of COVID-19 are scarce.</p><p><strong>Objective: </strong>We aimed to investigate the shift in demographic and clinical characteristics of the COVID-19 pandemic with the emergence of the SARS-CoV-2 Delta variant compared with the wild-type (WT) strain (B.1).</p><p><strong>Methods: </strong>A cross-sectional study of COVID-19 cases in the Indian population caused by the WT strain (B.1) and Delta variant of SARS-CoV-2 was performed. The viral genomic sequence metadata containing demographic, vaccination, and patient status details (N=9500, N_Delta=6238, N_WT=3262) were statistically analyzed.</p><p><strong>Results: </strong>With the Delta variant, in comparison with the WT strain, a higher proportion of young individuals (<20 years) were infected (0-9 years: Delta: 281/6238, 4.5% vs B.1: 75/3262, 2.3%; 10-19 years: Delta: 562/6238, 9% vs B.1: 229/3262, 7%; P<.001). The proportion of women contracting infection increased (Delta: 2557/6238, 41% vs B.1: 1174/3262, 36%; P<.001). However, it decreased for men (Delta: 3681/6238, 59% vs B.1: 2088/3262, 64%; P<.001). An increased proportion of the young population developed symptomatic illness and were hospitalized (Delta: 27/262, 10.3% vs B.1: 5/130, 3.8%; P=.02). Moreover, an increased proportion of the women (albeit not men) from the young (Delta: 37/262, 14.1% vs B.1: 4/130, 3.1%; P<.001) and adult (Delta: 197/262, 75.2% vs B.1: 72/130, 55.4%; P<.001) groups developed symptomatic illness and were hospitalized. The mean age of men and women who contracted infection (Delta: men=37.9, SD 17.2 years; women=36.6, SD 17.6 years; P<.001; B.1: men=39.6, SD 16.9 years; women=40.1, SD 17.4 years; P<.001) as well as developing symptoms or being hospitalized (Delta: men=39.6, SD 17.4 years; women=35.6, SD 16.9 years, P<.001; B.1: men=47, SD 18 years; women=49.5, SD 20.9 years, P<.001) were considerably lower with the Delta variant than the B.1 strain. The total mortality was about 1.8 times higher with the Delta variant than with the WT strain. With the Delta variant, compared with B.1, mortality decreased for men (Delta: 58/85, 68% vs B.1: 15/20, 75%; P<.001); in contrast, it increased for women (Delta: 27/85, 32% vs B.1: 5/20, 25%; P<.001). The odds of death increased with age, irrespective of sex (odds ratio 3.034, 95% CI 1.7-5.2, P<.001). Frequent postvaccination infections (24/6238) occurred with the Delta variant following complete doses.</p><p><strong>Conclusions: </strong>The increased involvement of young people and women, the lower mean age for illness, higher mortality, and frequent postvaccination infections were significant epidemiological concerns with the Delta variant.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"13 ","pages":"e44492"},"PeriodicalIF":1.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395196","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":"Analyzing Comorbidity Patterns in Patients With Thyroid Disease Using Large-Scale Electronic Medical Records: Network-Based Retrospective Observational Study.","authors":"Yanqun Huang, Siyuan Chen, Yongfeng Wang, Xiaohong Ou, Huanhuan Yan, Xin Gan, Zhixiao Wei","doi":"10.2196/54891","DOIUrl":"10.2196/54891","url":null,"abstract":"<p><strong>Background: </strong>Thyroid disease (TD) is a prominent endocrine disorder that raises global health concerns; however, its comorbidity patterns remain unclear.</p><p><strong>Objective: </strong>This study aims to apply a network-based method to comprehensively analyze the comorbidity patterns of TD using large-scale real-world health data.</p><p><strong>Methods: </strong>In this retrospective observational study, we extracted the comorbidities of adult patients with TD from both private and public data sets. All comorbidities were identified using ICD-10 (International Classification of Diseases, 10th Revision) codes at the 3-digit level, and those with a prevalence greater than 2% were analyzed. Patients were categorized into several subgroups based on sex, age, and disease type. A phenotypic comorbidity network (PCN) was constructed, where comorbidities served as nodes and their significant correlations were represented as edges, encompassing all patients with TD and various subgroups. The associations and differences in comorbidities within the PCN of each subgroup were analyzed and compared. The PageRank algorithm was used to identify key comorbidities.</p><p><strong>Results: </strong>The final cohorts included 18,311 and 50,242 patients with TD in the private and public data sets, respectively. Patients with TD demonstrated complex comorbidity patterns, with coexistence relationships differing by sex, age, and type of TD. The number of comorbidities increased with age. The most prevalent TDs were nontoxic goiter, hypothyroidism, hyperthyroidism, and thyroid cancer, while hypertension, diabetes, and lipoprotein metabolism disorders had the highest prevalence and PageRank values among comorbidities. Males and patients with benign TD exhibited a greater number of comorbidities, increased disease diversity, and stronger comorbidity associations compared with females and patients with thyroid cancer.</p><p><strong>Conclusions: </strong>Patients with TD exhibited complex comorbidity patterns, particularly with cardiocerebrovascular diseases and diabetes. The associations among comorbidities varied across different TD subgroups. This study aims to enhance the understanding of comorbidity patterns in patients with TD and improve the integrated management of these individuals.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"13 ","pages":"e54891"},"PeriodicalIF":1.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367413","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":"Unlocking the Potential of Secondary Data for Public Health Research: Retrospective Study With a Novel Clinical Platform.","authors":"Christopher Gundler, Karl Gottfried, Alexander Johannes Wiederhold, Maximilian Ataian, Marcus Wurlitzer, Jan Erik Gewehr, Frank Ückert","doi":"10.2196/51563","DOIUrl":"10.2196/51563","url":null,"abstract":"<p><strong>Background: </strong>Clinical routine data derived from university hospitals hold immense value for health-related research on large cohorts. However, using secondary data for hypothesis testing necessitates adherence to scientific, legal (such as the General Data Protection Regulation, federal and state protection legislations), technical, and administrative requirements. This process is intricate, time-consuming, and susceptible to errors.</p><p><strong>Objective: </strong>This study aims to develop a platform that enables clinicians to use current real-world data for testing research and evaluate advantages and limitations at a large university medical center (542,944 patients in 2022).</p><p><strong>Methods: </strong>We identified requirements from clinical practitioners, conceptualized and implemented a platform based on the existing components, and assessed its applicability in clinical reality quantitatively and qualitatively.</p><p><strong>Results: </strong>The proposed platform was established at the University Medical Center Hamburg-Eppendorf and made 639 forms encompassing 10,629 data elements accessible to all resident scientists and clinicians. Every day, the number of patients rises, and parts of their electronic health records are made accessible through the platform. Qualitatively, we were able to conduct a retrospective analysis of Parkinson disease over 777 patients, where we provide additional evidence for a significantly higher proportion of action tremors in patients with rest tremors (340/777, 43.8%) compared with those without rest tremors (255/777, 32.8%), as determined by a chi-square test (P<.001). Quantitatively, our findings demonstrate increased user engagement within the last 90 days, underscoring clinicians' increasing adoption of the platform in their regular research activities. Notably, the platform facilitated the retrieval of clinical data from 600,000 patients, emphasizing its substantial added value.</p><p><strong>Conclusions: </strong>This study demonstrates the feasibility of simplifying the use of clinical data to enhance exploration and sustainability in scientific research. The proposed platform emerges as a potential technological and legal framework for other medical centers, providing them with the means to unlock untapped potential within their routine data.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"13 ","pages":"e51563"},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367414","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":"Assessing the Evidence for Nonobstetric Risk Factors for Deformational Plagiocephaly: Systematic Review and Meta-Analysis.","authors":"Christopher Robert Timothy Hillyar, Natalie Bishop, Anjan Nibber, Frances Jean Bell-Davies, Juling Ong","doi":"10.2196/55695","DOIUrl":"10.2196/55695","url":null,"abstract":"<p><strong>Background: </strong>Plagiocephaly is defined as an asymmetrical distortion of the skull, resulting in an oblique trapezoid or parallelogram head shape. Deformational plagiocephaly (DP) is caused by forces acting on one side of the back of the head, distorting normal skull symmetry.</p><p><strong>Objective: </strong>The aims of this systematic review and meta-analysis were to critically assess the evidence for nonobstetric risk factors for DP and to make evidence-based recommendations for reducing the prevalence of DP.</p><p><strong>Methods: </strong>The selection criterion was studies reporting risk factors for DP. Case reviews, case series, expert opinions, and systematic reviews were excluded. PubMed and Web of Science were searched from August 21, 2010, to August 21, 2022. Publication bias was assessed using funnel plots. Meta-analyses were presented using forest plots.</p><p><strong>Results: </strong>A total of 19 studies (cohort studies: n=13, 68%; case-control studies: n=5, 26%; and cross-sectional studies: n=1, 5%) with a total of 14,808 participants were included. Of the 43 investigated potential nonobstetric factors, 16 (37%) were associated with DP. Of these 16 factors, 12 (75%) had odds ratios (ORs) with 95% CIs not crossing 1: insufficient vitamin D intake (OR 7.15, 95% CI 3.77-13.54), head position preference (OR 4.75, 95% CI 3.36-6.73), bottle-only feeding (OR 4.65, 95% CI 2.70-8.00), reduced tummy time (OR 3.51, 95% CI 1.71-7.21), sleeping position (OR 3.12, 95% CI 2.21-4.39), fewer motor milestones reached by the age of 6 months (OR 2.56, 95% CI 1.66-3.96), obesity (OR 2.45, 95% CI 1.02-5.90), maternal education level (OR 1.66, 95% CI 1.17-2.37), male sex (OR 1.51, 95% CI 1.07-2.12), formula feeding (OR 1.51, 95% CI 1.00-2.27), head circumference (OR 1.22, 95% CI 1.06-1.40), and mechanical ventilation (OR 1.10, 95% CI 1.00-1.14). No evidence of publication bias was detected.</p><p><strong>Conclusions: </strong>This study provides a comprehensive assessment of the nonobstetric factors associated with DP and presents 11 evidence-based recommendations for reducing its prevalence. The primary limitation is that only publication bias was assessed.</p><p><strong>Trial registration: </strong>PROSPERO CRD42020204979; https://www.crd.york.ac.uk/prospero/display_record.php? ID=CRD42020204979.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"13 ","pages":"e55695"},"PeriodicalIF":1.9,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300566","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":"Improving Triage Accuracy in Prehospital Emergency Telemedicine: Scoping Review of Machine Learning-Enhanced Approaches.","authors":"Daniel Raff, Kurtis Stewart, Michelle Christie Yang, Jessie Shang, Sonya Cressman, Roger Tam, Jessica Wong, Martin C Tammemägi, Kendall Ho","doi":"10.2196/56729","DOIUrl":"10.2196/56729","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Prehospital telemedicine triage systems combined with machine learning (ML) methods have the potential to improve triage accuracy and safely redirect low-acuity patients from attending the emergency department. However, research in prehospital settings is limited but needed; emergency department overcrowding and adverse patient outcomes are increasingly common.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;In this scoping review, we sought to characterize the existing methods for ML-enhanced telemedicine emergency triage. In order to support future research, we aimed to delineate what data sources, predictors, labels, ML models, and performance metrics were used, and in which telemedicine triage systems these methods were applied.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A scoping review was conducted, querying multiple databases (MEDLINE, PubMed, Scopus, and IEEE Xplore) through February 24, 2023, to identify potential ML-enhanced methods, and for those eligible, relevant study characteristics were extracted, including prehospital triage setting, types of predictors, ground truth labeling method, ML models used, and performance metrics. Inclusion criteria were restricted to the triage of emergency telemedicine services using ML methods on an undifferentiated (disease nonspecific) population. Only primary research studies in English were considered. Furthermore, only those studies using data collected remotely (as opposed to derived from physical assessments) were included. In order to limit bias, we exclusively included articles identified through our predefined search criteria and had 3 researchers (DR, JS, and KS) independently screen the resulting studies. We conducted a narrative synthesis of findings to establish a knowledge base in this domain and identify potential gaps to be addressed in forthcoming ML-enhanced methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 165 unique records were screened for eligibility and 15 were included in the review. Most studies applied ML methods during emergency medical dispatch (7/15, 47%) or used chatbot applications (5/15, 33%). Patient demographics and health status variables were the most common predictors, with a notable absence of social variables. Frequently used ML models included support vector machines and tree-based methods. ML-enhanced models typically outperformed conventional triage algorithms, and we found a wide range of methods used to establish ground truth labels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This scoping review observed heterogeneity in dataset size, predictors, clinical setting (triage process), and reported performance metrics. Standard structured predictors, including age, sex, and comorbidities, across articles suggest the importance of these inputs; however, there was a notable absence of other potentially useful data, including medications, social variables, and health system exposure. Ground truth labeling practices should be reported in a standard fashion as t","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"13 ","pages":"e56729"},"PeriodicalIF":1.9,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11429666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300578","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":"Central Hemodynamic and Thermoregulatory Responses to Food Intake as Potential Biomarkers for Eating Detection: Systematic Review.","authors":"Lucy Chikwetu, Parker Vakili, Andrew Takais, Rabih Younes","doi":"10.2196/52167","DOIUrl":"10.2196/52167","url":null,"abstract":"<p><strong>Background: </strong>Diet-related diseases, such as type 2 diabetes, require strict dietary management to slow down disease progression and call for innovative management strategies. Conventional diet monitoring places a significant memory burden on patients, who may not accurately remember details of their meals and thus frequently falls short in preventing disease progression. Recent advances in sensor and computational technologies have sparked interest in developing eating detection platforms.</p><p><strong>Objective: </strong>This review investigates central hemodynamic and thermoregulatory responses as potential biomarkers for eating detection.</p><p><strong>Methods: </strong>We searched peer-reviewed literature indexed in PubMed, Web of Science, and Scopus on June 20, 2022, with no date limits. We also conducted manual searches in the same databases until April 21, 2024. We included English-language papers demonstrating the impact of eating on central hemodynamics and thermoregulation in healthy individuals. To evaluate the overall study quality and assess the risk of bias, we designed a customized tool inspired by the Cochrane assessment framework. This tool has 4 categories: high, medium, low, and very low. A total of 2 independent reviewers conducted title and abstract screening, full-text review, and study quality and risk of bias analysis. In instances of disagreement between the 2 reviewers, a third reviewer served as an adjudicator.</p><p><strong>Results: </strong>Our search retrieved 11,450 studies, and 25 met our inclusion criteria. Among the 25 included studies, 32% (8/25) were classified as high quality, 52% (13/25) as medium quality, and 16% (4/25) as low quality. Furthermore, we found no evidence of publication bias in any of the included studies. A consistent postprandial increase in heart rate, cardiac output, and stroke volume was observed in at least 95% (heart rate: 19/19, cardiac output: 18/19, stroke volume: 11/11) of the studies that investigated these variables' responses to eating. Specifically, cardiac output increased by 9%-100%, stroke volume by 18%-41%, and heart rate by 6%-21% across these studies. These changes were statistically significant (P<.05). In contrast, the 8 studies that investigated postprandial thermoregulatory effects displayed grossly inconsistent results, showing wide variations in response with no clear patterns of change, indicating a high degree of variability among these studies.</p><p><strong>Conclusions: </strong>Our findings demonstrate that central hemodynamic responses, particularly heart rate, hold promise for wearable-based eating detection, as cardiac output and stroke volume cannot be measured by any currently available noninvasive medical or consumer-grade wearables.</p><p><strong>Trial registration: </strong>PROSPERO CRD42022360600; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=360600.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"13 ","pages":"e52167"},"PeriodicalIF":1.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11422732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300577","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":"Splenectomy as a Risk Factor for Graft Rejection Following Endothelial Transplantation: Retrospective Study.","authors":"Paola Kammrath Betancor, Daniel Böhringer, Philip Maier, Thabo Lapp, Thomas Reinhard","doi":"10.2196/50106","DOIUrl":"10.2196/50106","url":null,"abstract":"<p><strong>Background: </strong>Anterior chamber-associated immune deviation (ACAID) is an active immunotolerance mechanism, which is induced by placing antigen into the anterior eye chamber as long as a major surgical trauma is avoided. For this reason, ACAID may be a major contributor to the favorable immunologic outcomes in Descemet membrane endothelial keratoplasty (DMEK). Rodent models have demonstrated the importance of a functional spleen for the development of an ACAID.</p><p><strong>Objective: </strong>This study aimed to investigate whether splenectomy leads to increased rejection rates after DMEK in humans.</p><p><strong>Methods: </strong>A retrospective evaluation was conducted on the course following DMEK at the Eye Center, Medical Center, University of Freiburg, for patients with a self-reported history of splenectomy compared to patients without this condition. Potential study patients were contacted by mail. A questionnaire to self-report splenectomy and the time thereof was sent out. The medical records of all consenting patients at the Eye Center were reviewed for graft survival and immune reactions.</p><p><strong>Results: </strong>We asked 1818 patients after DMEK to report their history of splenectomy. A total of 1340 patients responded and were included in the study. Of these 1340 patients, 16 (1.2%) reported a history of splenectomy (ie, 26 DMEKs, with 10 patients being transplanted in both eyes and 6 patients being transplanted in 1 eye; median age at surgery 73.7, range 66.7-76.1 y). The remaining patients (1324 patients, ie, 1941 eyes) served as controls, with 1941 DMEKs (median age at surgery 71.5, range 64.1-77.2 y). Five (19%) out of the 26 eyes from the splenectomy group required a second transplant due to dislocation (n=2.8%), failure (n=2.8%), and rejection (n=1.4%). Kaplan-Meier analysis revealed no relevant difference compared with controls.</p><p><strong>Conclusions: </strong>Our results suggest that splenectomy has no major effect on the outcome following DMEK. Subsequent, ACAID may not be the main reason for the favorable immunological outcomes in DMEK, or the camero-splenic axis may be subordinate in humans. However, we only included 16 patients who underwent splenectomy, so it might be possible that we missed a minor effect.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"13 ","pages":"e50106"},"PeriodicalIF":1.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11422749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300579","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":"Narrowing the Digital Divide: Framework for Creating Telehealth Equity Dashboards.","authors":"Michael J Luke, Sansanee Craig, Suzinne Pak-Gorstein, Marlíse Arellano, Jessica Zhang, S Margaret Wright, John Chuo, Philip V Scribano","doi":"10.2196/57435","DOIUrl":"10.2196/57435","url":null,"abstract":"<p><p>Telehealth presents both the potential to improve access to care and to widen the digital divide contributing to health care disparities and obliging health care systems to standardize approaches to measure and display telehealth disparities. Based on a literature review and the operational experience of clinicians, informaticists, and researchers in the Supporting Pediatric Research on Outcomes and Utilization of Telehealth (SPROUT)-Clinical and Translational Science Awards (CTSA) Network, we outline a strategic framework for health systems to develop and optimally use a telehealth equity dashboard through a 3-phased approach of (1) defining data sources and key equity-related metrics of interest; (2) designing a dynamic and user-friendly dashboard; and (3) deploying the dashboard to maximize engagement among clinical staff, investigators, and administrators.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"13 ","pages":"e57435"},"PeriodicalIF":1.9,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134410","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":"Telemedicine Research Trends in 2001-2022 and Research Cooperation Between China and Other Countries Before and After the COVID-19 Pandemic: Bibliometric Analysis.","authors":"Hanlin Feng, Karin Kurata, Jianfei Cao, Kageyama Itsuki, Makoto Niwa, Atsushi Aoyama, Kota Kodama","doi":"10.2196/40801","DOIUrl":"10.2196/40801","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Advancements in technology have overcome geographical barriers, making telemedicine, which offers remote emergency services, healthcare, and medication guidance, increasingly popular. COVID-19 restrictions amplified its global importance by bridging distances.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to analyze Chinese and global literature data, present new global telemedicine research trends, and clarify the development potential, collaborations, and deficiencies in China's telemedicine research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted bibliometrics and network analyses on relevant documents from the Web of Science database from 2001 to 2022. Data collection was completed on October 30, 2023. Considering COVID-19's impact, 2020 was used as a baseline, dividing the data into 2 periods: 2001-2019 and 2020-2022. The development potential was determined based on publication trends. An international coauthorship network analysis identified collaboration statuses and potential. Co-occurrence analysis was conducted for China and the world.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We identified 25,333 telemedicine-related research papers published between 2001 and 2022, with a substantial increase during the COVID-19 period (2020-2022), particularly in China (1.93-fold increase), moving its global publication rank from tenth to sixth. The United States, the United Kingdom, and Australia contributed 62.96% of the literature, far ahead of China's 3.90%. Globally, telemedicine research increased significantly post-2020. Between 2001 and 2019, the United States and Australia were central in coauthor networks; post-2020, the United States remained the largest node. Network hubs included the United States, the United Kingdom, Australia, and Canada. Keyword co-occurrence analysis revealed 5 global clusters from 2001 to 2019 (system technology, health care applications, mobile health, mental health, and electronic health) and 2020 to 2022 (COVID-19, children's mental health, artificial intelligence, digital health, and rehabilitation of middle-aged and older adults). In China, the research trends aligned with global patterns, with rapid growth post-2020. From 2001 to 2019, China cooperated closely with Indonesia, India, Japan, Taiwan, and South Korea. From 2020 to 2022, cooperation expanded to Japan, Singapore, Malaysia, and South Korea, as well as Saudi Arabia, Egypt, South Africa, Ghana, Lebanon, and other African and Middle Eastern countries. Chinese keyword co-occurrence analysis showed focus areas in system technology, health care applications, mobile health, big data analysis, and electronic health (2001-2019) and COVID-19, artificial intelligence, digital health, and mental health (2020-2022). Although psychology research increased, studies on children's mental health and middle-aged and older adults' rehabilitation were limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;We identified the latest trends in telemedicine res","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"13 ","pages":"e40801"},"PeriodicalIF":1.9,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114659","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}