Technology and Health Care最新文献

BackgroundRare disease clinical trials face challenges due to limited sample sizes and ethical imperatives to minimize futile treatments. Bayesian sequential design dynamically optimizes decisions under uncertainty, offering efficiency gains over traditional fixed-sample approaches.MethodsPropose a framework integrating sequential Bayes factor and adaptive stopping rules for trials with binary endpoint. Bayesian posterior probabilities define early termination thresholds (superiority/futility), while Bayes Factor Design Analysis validates trial feasibility. Sequential Bayes factor updates iteratively guide interim decisions based on evidence strength.ResultsThe approach enables earlier trial termination (for superiority or futility), reducing sample size, time, and costs. Patients avoid unnecessary exposure to futility treatments, while results remain interpretable even if thresholds are unmet.ConclusionThe primary goal is to confirm treatment efficacy earlier, enabling trials to be stopped promptly for either superiority or futility treatments. This strategy reduces sample size, time, and financial costs, and prevents patient exposure to futile treatments. Moreover, the study aims to promote the adoption of Bayesian sequential decision-making, thereby accelerating rare disease clinical trial approvals and drug marketing.

ObjectiveThis analysis aims to examine studies on artificial intelligence (AI) applications in breast cancer diagnosis through bibliometric methods, focusing on temporal and geographical trends. It contributes to shaping the field's roadmap and helping researchers adapt to technological innovations.MethodA comprehensive search was conducted in the Web of Science (WOS) database. Bibliometric analyses of data from 2013-2024 were performed using VOSviewer and Bibliometrix R programs.ResultsThe analysis included 1537 articles. A significant rise in research activity was observed in 2019. The thematic analysis highlighted topics like histopathology, feature selection, deep learning, and machine learning. India was the most productive country with 405 studies. Keyword analysis showed increased usage of terms like transfer learning, CNN, and radiomics. U.S. was the most cited country with 7511 citations. Concept co-occurrence analysis revealed strong associations between terms such as feature selection, datasets, algorithm performance, and classification methods. Bejnordi's 2017 study was identified as the most influential, with 1909 citations.Discussion and ConclusionThis study identifies key authors, influential works, and trending topics, offering a broad understanding of the field's structure and evolution. It helps outline the advancements and emerging directions in AI applications for breast cancer diagnosis.

BackgroundWith the use of sevoflurane, the incidence of emergence agitation (EA) has also increased.ObjectiveWe aimed to investigate whether S-ketamine can prevent EA after sevoflurane anesthesia in children.MethodsChildren undergoing otolaryngology surgery were assigned to one of four groups randomly. Drugs were given five minutes before the operation was accomplished. The incidence of EA was measured by the Pediatric Anesthesia Emergence Delirium Scale (PAED) scores. Face, Legs, Activity, Cry, and Consolability scale (FLACC) scores and the rate of adverse events were evaluated.ResultsThe incidence of EA was significantly lower in children given 2 mg/kg propofol, 0.25 mg/kg S-ketamine and 0.5 mg/kg S-ketamine compared with that in children given normal saline. At 3 h and 6 h after operation, the FLACC scores in children given 0.25 mg/kg S-ketamine and 0.5 mg/kg S-ketamine were significantly lower than those in children given 2 mg/kg propofol and saline (p < 0.001). No statistical differences were found in adverse reactions among children in the four groups.ConclusionIntravenous injection of propofol 2 mg/kg, S-ketamine 0.25 mg/kg and S-ketamine 0.5 mg/kg before end of the operation can all reduce the incidence of occurrence of emergence agitation in children undergoing tonsillectomy with or without adenoidectomy after sevoflurane anesthesia. Compared with children given propofol 2 mg/kg and S-ketamine 0.5 mg/kg, children given S-ketamine 0.25 mg/kg has the advantage of not prolonging the awakening time.

BackgroundCerebral infarction is often associated with underlying cerebral vascular stenosis, such as carotid artery stenosis or cerebral artery stenosis due to arteriosclerosis. Existing imaging techniques, including carotid ultrasound, computed tomography angiography (CTA), and magnetic resonance angiography (MRA), are useful for diagnosis, but have limitations such as radiation exposure, contrast medium use side effects, and high cost. Therefore, the need for a simple, noninvasive, and cost-effective screening tool is emerging.ObjectiveIn this study, we propose a novel cerebral infarction screening technique using PPG signals measured from both index fingers for 120 s.MethodsPPG is a noninvasive optical technology that measures pulse waves that appear according to changes in blood volume. The collected waveforms were divided into windows and then normalized. Maximum Positive Amplitude (MPA) and Maximum Negative Amplitude (MNA) were extracted from each section, and the normal group and cerebral infarction patients were classified through linear discriminant analysis.ResultsAs a result of analyzing a total of 100 subjects (50 patients with cerebral infarction and 50 normal controls), the recognition rate based on MNA was 84%, MPA was 81%, and when the two indices were combined, it was 80%. Sensitivity was 80% for MNA and 72% for MPA, and specificity was 88% and 90%, respectively, suggesting that amplitude-based PPG indices can effectively reflect the presence or absence of cerebrovascular lesions.ConclusionThis study suggests the possibility of simply identifying patients with cerebral infarction by analyzing PPG signals of both fingers. The proposed technique can be used as a screening tool to complement existing imaging techniques, and is expected to contribute to reducing the burden of stroke through early diagnosis and preventive intervention in the future.

BackgroundFunctional dyspepsia (FD) is a prevalent gastrointestinal disorder associated with impaired motility, mucosal barrier disruption, and dysbiosis of intestinal microbiota. While pharmacological treatments exist, non-invasive therapeutic approaches leveraging traditional medicine are gaining attention for their holistic benefits and minimal side effects.ObjectiveThis study aimed to evaluate the therapeutic impact of abdominal massage, a non-pharmacological intervention rooted in Traditional Chinese Medicine (TCM), on gastrointestinal motility, duodenal barrier integrity, and gut microbiota in a rat model of FD.MethodsEighteen male rats were assigned to control, model, and massage groups. The FD model was established via multifactorial stress. The massage group underwent daily abdominal massage for 7 days. Food intake, body weight, gastric emptying, and intestinal propulsion were assessed. Duodenal tissue morphology, expression of tight junction proteins (occludin and claudin-1), and intestinal microbiota profiles (via 16S rRNA sequencing) were analyzed using histological, immunofluorescence, and high-throughput sequencing technologies.ResultsAbdominal massage significantly improved gastric emptying and intestinal propulsion in FD rats. Histological examination revealed restoration of duodenal villi architecture, and immunofluorescence showed increased expression of occludin and claudin-1. Microbiota analysis suggested a shift toward a more balanced community, with trends indicating increased abundance of beneficial taxa such as Enterococcaceae and Lachnospiraceae.ConclusionAbdominal massage effectively enhances gastrointestinal motility, suggests potential to promote intestinal microbiota homeostasis, and repairs mucosal barrier dysfunction in FD rats. These findings suggest the potential of massage therapy as a safe, non-invasive, and technologically integrable modality in the management of gastrointestinal disorders.

BackgroundAcupoint thread embedding treatment (ATET) is a traditional therapeutic approach used in stroke rehabilitation.ObjectiveTo explore the application of ATET in combination with modern medical technology, examining its effects on neurological function and key serum biomarkers in stroke patients.MethodsA total of 108 stroke patients were randomly assigned to ATE treatment group (n = 52) and Control Group (n = 56). Various parameters including baseline characteristics, levels of inflammatory markers, macrophage efferocytosis-related factors, the National Institutes of Health Stroke Scale (NIHSS) scores, therapeutic efficacy, and adverse events were assessed and compared between the two groups.ResultsA significant improvement in NIHSS scores was observed in the treatment group compared to the control group. Additionally, serum levels of SIRT1, HIF-1α, and macrophage efferocytosis-related factors were significantly altered, suggesting that ATET may influence biological pathways involved in stroke recovery.ConclusionThe application of ATET, supported by advanced diagnostic technologies, shows promising effects in stroke rehabilitation. This study highlights the potential for integrating traditional therapies with modern medicine to improve clinical outcomes in stroke patients.

BackgroundMagnetic Resonance Imaging (MRI) is a cornerstone in diagnosing brain tumors. However, the complex nature of these tumors makes accurate segmentation in MRI images a demanding task.ObjectiveAccurate brain tumor segmentation remains a critical challenge in medical image analysis, with early detection crucial for improving patient outcomes.MethodsTo develop and evaluate a novel UNet-based architecture for improved brain tumor segmentation in MRI images. This paper presents a novel UNet-based architecture for improved brain tumor segmentation. The UNet model architecture incorporates Leaky ReLU activation, batch normalization, and regularization to enhance training and performance. The model consists of varying numbers of layers and kernel sizes to capture different levels of detail. To address the issue of class imbalance in medical image segmentation, we employ focused loss and generalized Dice (GDL) loss functions.ResultsThe proposed model was evaluated on the BraTS'2020 dataset, achieving an accuracy of 99.64% and Dice coefficients of 0.8984, 0.8431, and 0.8824 for necrotic core, edema, and enhancing tumor regions, respectively.ConclusionThese findings demonstrate the efficacy of our approach in accurately predicting tumors, which has the potential to enhance diagnostic systems and improve patient outcomes.

BackgroundThis study was designed to investigate the mechanism of Circ_0046336 in oral squamous cell carcinoma (OSCC).MethodsThe expression pattern of Circ_0046336 and its distribution in OSCC cell lines (SCC-9 and CAL-27) were identified. Fluorescence in situ hybridization was applied to determine the location of Circ_0046336. Circ_0046336 silencing was detected by methylthiazolyldiphenyl-tetrazolium bromide (MTT), flow cytometry and transwell assays. The binding relation between Circ_0046336 and miR-181d-3p or ADAM12 and miR-181d-3p was investigated using bioinformatics and dual luciferase reporter assay. ADAM12 and miR-181d-3p expressions in OSCC cells with Circ_0046336 knockdown were quantified. Rescue assays were carried out, and the expressions of epithelial-mesenchymal transition (EMT)-related proteins were measured via Western blot.ResultsCirc_0046336 was overexpressed and mainly distributed in the cytoplasm of OSCC cells. Circ_0046336 targeted miR-181d-3p and miR-181d-3p targeted ADAM12 in OSCC cells. Circ_0046336 silencing facilitated apoptosis, and suppressed viability, migration and invasion of OSCC cells, while upregulating miR-181d-3p and downregulating ADAM12. MiR-181d-3p deficiency reversed the regulatory role of Circ_0046336 in biological behaviors of OSCC cells. Circ_0046336 silencing promoted E-cadherin expression and inhibited N-cadherin and Vimentin expressions, but such effects were reversed by miR-181d-3p downregulation.ConclusionCirc_0046336 acts as a ceRNA to regulate apoptosis, migration, invasion and EMT of OSCC cells via miR-181d-3p/ADAM12 axis.

BackgroundBortezomib is the first-line drug in the treatment of multiple myeloma (MM) and its resistance is the main obstacle to cure MM. MicroRNA-361-5p (MiRNA-361-5p) in bone marrow mesenchymal stem cells (BMSCs) might participate in the bortezomib resistance via paracrine pathway. The study was to characterize the role and molecular mechanism of miR-361-5p in bortezomib resistance in MM.MethodsThe exosomes of BMSCs were obtained and characterized by transmission electron microscopy and nanoparticle tracking analysis. The MM cell U266 was treated with bortezomib, bortezomib and BMSC exosomes, bortezomib and BMSC exosomes transfected with miR-361-5p inhibitor. The cell viability was measured by cell counting kit. Protein expression of PDPK1, PI3K, p-PI3K, mTOR, p-mTOR, AKT, and Pan-AKT was detected by western blot. The apoptosis level of bortezomib resistant cell lines was detected by flow cytometry.ResultsLow expression of miR-361-5p promoted the survival of U266 cells and inhibited cell apoptosis, reversing the inhibitory effect of bortezomib on U266 cells. PDPK1 may be a downstream target of miR-361-5p. Low expression of BMSCs-derived exosomal miR-361-5p may reverse the effect of bortezomib on U266 cells by regulating the PDPK1/PI3K/AKT/mTOR axis.ConclusionLow expression of BMSCs-derived exosomal miR-361-5p may overcome bortezomib resistance in MM by regulating PDPK1/PI3K/AKT/mTOR axis.

BackgroundDespite its clinical relevance, there is a relative lack of research examining flexibility and stability based on the acceleration or speed of localized limb segments, such as the shank and thigh.ObjectiveThis study aimed to evaluate gait characteristics based on acceleration in the thigh and shank to identify differences between the affected and unaffected sides in stroke hemiplegic patients.MethodForty individuals with stroke-induced hemiplegia were assessed during a 5-meter walk using a 3D motion analysis system and Inertial Measurement Units (IMUs). Spatial-temporal and acceleration parameters were calculated.ResultsSignificant differences were observed between the affected and unaffected sides in stance time, swing time, swing phase, and stance phase. In terms of acceleration, the mean acceleration in the anterior-posterior (AP) direction of the thigh and the mean value of the center of mass (CoM) in the AP direction differed significantly. These spatial-temporal findings were consistent with known characteristics of hemiplegic gait. A notable posterior shift of the thigh CoM on the affected side was identified, likely reflecting impaired propulsion and reduced stability.ConclusionThe posterior displacement of the thigh CoM on the affected side may represent a compensatory mechanism to maintain balance during gait. Clinically, this posterior CoM shift could serve as a meaningful indicator of hemiplegic gait and a potential target for rehabilitation interventions aimed at restoring gait symmetry and improving functional mobility.