JMA journal最新文献

{"title":"The Era of Preemptive Medicine: Developing Medical Digital Twins through Omics, IoT, and AI Integration.","authors":"Tadao Ooka","doi":"10.31662/jmaj.2024-0213","DOIUrl":"10.31662/jmaj.2024-0213","url":null,"abstract":"<p><p>Preemptive medicine represents a paradigm shift from reactive treatment to proactive disease prevention. The integration of omics technologies, the Internet of Things (IoT), and artificial intelligence (AI) has facilitated the development of personalized, predictive, and preemptive healthcare strategies. Omic technologies, such as genomics, proteomics, and metabolomics, provide comprehensive insights into molecular profile of an individual, revealing potential disease predispositions and health trajectories. IoT devices, such as wearables and smartphones, enable continuous and periodic monitoring of physiological parameters, thus providing a dynamic view of an individual's health status. AI algorithms analyze comprehensive and complex data from omics and IoT technologies to identify patterns and correlations that inform predictive models of disease risk, progression, and response to interventions. Medical digital twins, or virtual replicas of an individual's biological processes, have emerged as the cornerstone of preemptive medicine. The integration of omics, IoT, and AI enables the development of medical digital twins, which in turn allows for precise simulation of human physiological profiles, prediction of future health outcomes, and virtual individual clinical trials, facilitating personalized proactive interventions and preemptive disease control. This review demonstrates the convergence of omics, IoT, and AI in preemptive medicine, highlighting their potential to revolutionize healthcare by enabling early disease detection, personalized treatment strategies, and chronic disease prevention. We show how AI leverages omics and IoT in preemptive medicine through several case studies while also discussing the necessary data for developing medical digital twins and addressing ethical and social aspects that warrant consideration. Medical digital twins signify a fundamental transformation in health management, shifting from treating diseases after their occurrence to controlling them before their occurrence. This approach enhances the effectiveness of medical interventions and improves overall health outcomes, preparing for a healthier future.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 1","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384163","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":"Impact of Falls on Quality of Life among Filipinos with Parkinson's Disease from a Referral Center Ambulatory Care PD Clinic.","authors":"Jeryl Ritzi T Yu, Anna Deborah L Sarmiento-Santos, Milthon Cua, Michelle J Tanglao, Raymond L Rosales","doi":"10.31662/jmaj.2024-0144","DOIUrl":"10.31662/jmaj.2024-0144","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 1","pages":"276-280"},"PeriodicalIF":1.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384103","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":"Patient Sex and Physician Gender as Modifiers of Low-density Lipoprotein Cholesterol Control in High-risk Patients of Atherosclerotic Disease: A Cross-sectional Study.","authors":"Hiromitsu Yamashita, Nozomi Kubota, Masayoshi Shiota","doi":"10.31662/jmaj.2024-0245","DOIUrl":"10.31662/jmaj.2024-0245","url":null,"abstract":"<p><strong>Introduction: </strong>Inadequate management of low-density lipoprotein (LDL) cholesterol is more common in female patients than in male patients in the context of preventing atherosclerotic cardiovascular disease. Moreover, the effect of physician gender on patient outcomes has been acknowledged. However, to date, no study in Japan has investigated this issue or explored the potential interactions between patient sex and physician gender. This study aimed to assess disparities in achieving LDL cholesterol targets between male and female patients and examine the impact of the patient-physician gender dyad.</p><p><strong>Methods: </strong>We conducted a cross-sectional study using electronic medical records from an urban Japanese clinic. Patients aged 40-79 years with coronary artery disease, noncardiogenic stroke, or diabetes mellitus were included in the study. The modified Poisson regression model with robust error variance was used, and patients were stratified by sex to evaluate the interaction between patient sex and physician gender.</p><p><strong>Results: </strong>Among the 714 patients (44.1% women), female patients were less likely to achieve LDL cholesterol targets than male patients (70.7% male vs. 63.9% female). Adjusted analyses revealed that this trend persisted for female patients (adjusted prevalence ratio: 0.86, 95% confidence interval [CI]: 0.77-0.96). A notable interaction between patient sex and physician gender was observed; male patients managed by female physicians had lower LDL cholesterol target achievement than male patients managed by male physicians (adjusted prevalence ratio: 0.74 [95% CI: 0.62-0.88]).</p><p><strong>Conclusions: </strong>Female patients were less likely to achieve LDL cholesterol targets, and patient-physician gender discordance was associated with poorer lipid management. These findings highlight the need for quality improvement interventions to address the disparity.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 1","pages":"255-263"},"PeriodicalIF":1.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384181","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":"Presenting New Ideas and Opinions in Academic Journals.","authors":"Soichiro Saeki","doi":"10.31662/jmaj.2024-0339","DOIUrl":"10.31662/jmaj.2024-0339","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 1","pages":"310-311"},"PeriodicalIF":1.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384182","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":"Effect of Cytokine Concentrations on Long-term Neurological Outcomes in Fetal Pleural Effusion Managed with Thoracoamniotic Shunt.","authors":"Kenji Imai, Sho Tano, Kazuya Fuma, Seiko Matsuo, Takafumi Ushida, Hiroaki Kajiyama, Tomomi Kotani","doi":"10.31662/jmaj.2024-0227","DOIUrl":"10.31662/jmaj.2024-0227","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 1","pages":"288-292"},"PeriodicalIF":1.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384294","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":"AI in Echocardiography: State-of-the-art Automated Measurement Techniques and Clinical Applications.","authors":"Yukina Hirata, Kenya Kusunose","doi":"10.31662/jmaj.2024-0180","DOIUrl":"10.31662/jmaj.2024-0180","url":null,"abstract":"<p><p>The artificial intelligence (AI) technology in automated measurements has seen remarkable advancements across various vendors, thereby offering new opportunities in echocardiography. Fully automated software particularly has the potential to elevate the analysis and the interpretation of medical images to a new level compared to previous algorithms. Tasks that traditionally required significant time, such as ventricular and atrial volume measurements and Doppler tracing, can now be performed swiftly through AI's automated phase setting and waveform tracing capabilities. The benefits of AI-driven systems include high-precision and reliable measurements, significant time savings, and enhanced workflow efficiency. By automating routine tasks, AI can reduce the burden on clinicians, allowing them to gather additional information, perform additional tests, and improve patient care. While many studies confirm the accuracy and the reproducibility of AI-driven techniques, it is crucial for clinicians to verify AI-generated measurements and ensure high-quality imaging and Doppler waveforms to fully take advantage of the benefits from these technologies. This review discusses the current state of AI-driven automated measurements in echocardiography, their impact on clinical practice, and the strategies required for the effective integration of AI into clinical workflows.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 1","pages":"141-150"},"PeriodicalIF":1.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384175","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":"Medical AI and AI for Medical Sciences: An Editorial.","authors":"Eiryo Kawakami","doi":"10.31662/jmaj.2024-0355","DOIUrl":"10.31662/jmaj.2024-0355","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 1","pages":"38-39"},"PeriodicalIF":1.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384176","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":"Clinical Significance of Pregnancies with Macrosomia (Birth Weight ≥ 4,000 g) Compared with Deliveries with Neonatal Birth Weight of 3,500-3,999 g.","authors":"Shunji Suzuki","doi":"10.31662/jmaj.2024-0117","DOIUrl":"10.31662/jmaj.2024-0117","url":null,"abstract":"<p><strong>Introduction: </strong>We examined the clinical characteristics and perinatal outcomes of pregnancy with macrosomia (birth weight ≥ 4,000 g) compared with delivery with neonatal birth weight of 3,500-3,999 g.</p><p><strong>Methods: </strong>This study analyzed data obtained from singleton pregnant women who delivered at ≥22 weeks of gestation from January 2002 to December 2010.</p><p><strong>Results: </strong>During the study period, there were 12,497 singleton deliveries, of which 136 (1.1%) had macrosomia (average: 4,181 g, range: 4,000-4,726 g; macrosomia group) and 1,139 (9.1%) had neonatal birth weight of 3,500-3,999 g (average: 3,670 g; control group). Compared with the control group, the macrosomia group had advanced maternal age and births after 41 weeks of gestation. In addition, elective cesarean delivery was more common in the macrosomia group (<i>P</i> < 0.01). Furthermore, the rate of shoulder dystocia was higher in this group in cases of vaginal delivery (<i>P</i> < 0.01). A high rate of neonatal asphyxia was also observed in the macrosomia group (<i>P</i> < 0.01), although there were no significant differences in the rate of low umbilical artery pH or the incidence of neonatal hypoglycemia between the groups. Multivariate analysis revealed that the significant complications in the macrosomia group compared with the control group were shoulder dystocia (<i>P</i> = 0.01) and neonatal asphyxia (<i>P</i> = 0.03).</p><p><strong>Conclusions: </strong>The results of this study indicate that particular attention should be paid to the possibility of shoulder dystocia during delivery of macrosomia.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 1","pages":"249-254"},"PeriodicalIF":1.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384227","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":"Cardiovascular-kidney-metabolic Syndrome Entangled: \"In Rhythm with Time, from Days to Years\".","authors":"Atsushi Mizuno","doi":"10.31662/jmaj.2024-0291","DOIUrl":"10.31662/jmaj.2024-0291","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 1","pages":"286-287"},"PeriodicalIF":1.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384237","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":"Communicating Hydrocephalus Secondary to Pseudomeningocele following Cervical Spine Surgery: A Case Report.","authors":"Yushi Sakamoto, Nobuaki Taniguchi, Kosuke Iwaisako","doi":"10.31662/jmaj.2024-0179","DOIUrl":"10.31662/jmaj.2024-0179","url":null,"abstract":"<p><p>Pseudomeningocele (PMC) after spinal surgery involves cerebrospinal fluid (CSF) continuously leaking from a compromised dura mater and accumulating subcutaneously. PMC is a rare postcervical spine surgery that can be spontaneously resolved; therefore, asymptomatic cases are often observed. This report presents a case of communicating hydrocephalus resulting from PMC following posterior decompression at the craniocervical junction. A 77-year-old man with advanced dementia and a history of C2-T3 posterior fixation was admitted after a head injury, presenting quadriplegia at the MMT2 level. Magnetic resonance imaging (MRI) revealed severe spinal cord compression at C1/2. A posterior decompression of the craniocervical junction was performed. However, dura mater damage occurred during surgery, and the damaged area was repaired with artificial dura mater and fibrin glue. One month postsurgery, subcutaneous swelling was observed and an MRI identified PMC. As the patient was asymptomatic, observation was chosen. Four months postsurgery, the patient exhibited drowsiness and vomiting. An MRI was conducted, revealing the presence of communicating hydrocephalus. Ventricular drainage and ventriculoperitoneal shunt were performed, and the hydrocephalus and PMC improved. Dural injury during spinal surgery is a relatively common complication; but, if inadequately repaired, CSF leakage may persist and lead to PMC. Persistent leakage of CSF into the PMC may have hindered CSF absorption, leading to communicating hydrocephalus. Severe cognitive impairment and quadriplegia may have hindered neurological evaluation and delayed the detection of the hydrocephalus, and more careful follow-up would have been desirable.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 1","pages":"302-305"},"PeriodicalIF":1.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384254","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}