Acta Informatica Medica最新文献

Background: Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer with main option for therapeutic is chemotherapy. Natural compounds, such as durian (Durio zibethinus) and sapodilla (Manilkara zapota) extracts, have demonstrated anticancer properties, including apoptosis induction and the potential to overcome chemotherapy resistance.

Objective: This systematic review evaluates the effects of these extracts on TNBC cells, focusing on their ability to enhance chemotherapy sensitivity with induced apoptosis and decreased chemotherapy resistance.

Methods: A systematic review was conducted in accordance with PRISMA guidelines. Literature searches in PubMed, Scopus, Web of Science, and Google Scholar identified studies investigating the effects of durian and sapodilla extracts on breast cancer. Data extraction focused on study design, cell lines, preparation and concentrations of extracts, and outcomes such as apoptosis, chemotherapy sensitivity, and molecular marker expression.

Results: Included studies demonstrated that durian and sapodilla extracts significantly enhanced the efficacy of chemotherapy agents such as paclitaxel and doxorubicin. Both extracts contained bioactive that reduced Fas, Caspase-3, Caspase-9, and XIAP expression. The combination treatments were shown to synergistically enhance chemotherapy-induced cytotoxicity while reducing resistance mechanisms.

Conclusion: Bioactive compounds in durian and sapodilla extracts target multiple pathways involved in TNBC apoptosis, progression and chemotherapy resistance. These findings suggest their potential as natural adjuvants to enhance chemotherapy efficacy. Further studies are needed to validate these results in vivo and explore their clinical applicability.

Background: The coronavirus disease 2019 (COVID-19) pandemic significantly impacted global health, with India experiencing one of the highest case and death tolls. However, data specific to India's sociodemographic and clinical factors influencing COVID-19 mortality remains limited.

Objective: This study aimed to identify sociodemographic and clinical factors associated with COVID-19 mortality in India.

Methods: This retrospective, cross-sectional study analyzed medical records of 4961 adult COVID-19 patients admitted to a tertiary care center in North India, from April 2020 to December 2021. Sociodemographic and clinical data were captured using a structured proforma. Univariate analysis (chi-square test) and Kaplan-Meier survival analysis were performed to identify factors associated with mortality.

Results: Of the 4961 patients, 557 (11.2%) died, and 4404 (88.8%) survived. Increased age, rural residency, professional occupation, and comorbidities (diabetes and hypertension), multimorbidity, increased disease severity, cold and flu symptoms, breathlessness, and the need for intensive care unit (ICU) admission and ventilator support were significantly (P <0.05) associated with higher COVID-19 mortality. While some associations were observed with sociodemographic factors like religion, education level, and monthly family income in univariate analysis, these were not significant in survival analysis.

Conclusion: In this cohort of COVID-19 patients in India, advanced age, rural residency, professional occupation, comorbidities, multimorbidity, severe symptoms, and the need for ICU admission and ventilator support were identified as significant risk factors for mortality. Early identification and intervention for these high-risk groups may improve survival rates.

Background: According to the World Health Organization's 2021 statistics, cardiovascular diseases (CVDs), particularly coronary artery disease (CAD), remain among the leading causes of global morbidity and mortality, affecting both high-income and low-income countries like Vietnam.

Objective: Acute myocardial infarction (AMI) remains a major cause of mortality and cardiovascular complications, with a poor prognosis in patients with left ventricular systolic dysfunction (LVSD). High-sensitivity cardiac troponin I (hs-cTnI) is a specific biomarker of myocardial injury linked to infarct size and LVSD. However, its role in predicting left ventricular ejection fraction (LVEF) in non-ST-elevation myocardial infarction (NSTEMI) is underexplored. This study investigates the correlation between hs-cTnI and LVSD in NSTEMI patients.

Methods: A descriptive, cross-sectional study was conducted on 117 patients with first-time NSTEMI treated at Cho Ray Hospital from February 2024 to April 2024. Admission hs-cTnI levels were measured and correlated with LVEF, assessed via echocardiography. The predictive value and optimal cut-off points of hs-cTnI for LVSD (LVEF < 50% and ≤ 40%) were determined using receiver operating characteristic (ROC) curve analysis.

Results: Hs-cTnI levels showed a significant inverse correlation with LVEF (r = - 0.569, p < 0.001). Patients with moderate-to-severe LVSD (LVEF ≤ 40%) had the highest median hs-cTnI levels (25,000 pg/mL, p < 0.001). The area under the ROC curve (AUC) for predicting LVEF < 50% was 0.78, with a cut-off of 12,344 pg/mL (sensitivity 68.5%, specificity 82.5%). For LVEF ≤ 40%, the AUC was 0.82, with a cut-off of 20,979 pg/mL (sensitivity 73.3%, specificity 88.5%, accuracy 84.6%). These findings underscore hs-cTnI's utility in identifying LVSD.

Conclusion: Hs-cTnI is inversely correlated with LVEF and serves as a reliable biomarker for predicting LVSD in NSTEMI patients, facilitating risk stratification and early management decisions.

Background: Hospitalized patients experience significant physical, emotional burden mainly due to a wide range of stressors, related to the hospital environment and their disease including the procedures they undergo.

Objective: was to explore prevalence of anxiety and insomnia in hospitalized patients with cardiovascular disease and the associated factors with anxiety.

Methods: In the present cross-sectional study were enrolled were enrolled 140 hospitalized patients with cardiovascular disease. The data collection was carried out via interviews using the "State-Trait Anxiety Inventory (STAI)" scale and the "Athens Insomnia scale AIS" which included patients' characteristics.

Results: Regarding state and trait anxiety, half of participants scored below 43 and 49 respectively (median), while 25% scored above 52 and 53, respectively. These values indicate moderate levels of anxiety. Regarding insomnia, at least 50% of patients scored below 6 (median). These values indicate moderate levels of insomnia. The correlation between patients' anxiety and insomnia was positive linear (rho>0.2, p<0.05), meaning that an increase in the insomnia score implies an increase in the state and trait anxiety score (more anxiety). State anxiety was found to be statistically significantly related to family status (p=0.008), occupation (p=0.005), type of disease (p=0.048), and whether they suffered from other disease (p=0.005). Trait anxiety was found to be statistically significantly associated only with marital status (p=0.043).

Conclusion: Improving mental health of hospitalized patients in a general hospital requires the attention by clinical health professionals. Knowledge of the association between insomnia and anxiety in hospitalized patients with cardiovascular diseases is important for identifying potential high-risk groups and implementing interventions to alleviate this burden.

Background: Interactive virtual reality (iVR) has found extensive application as a treatment modality for individuals suffering from persistent musculoskeletal conditions. With the rising application of Interactive Virtual Reality (iVR) in treating chronic musculoskeletal disorders, it is essential to understand its efficacy concerning psychological relief and functional improvement.

Objective: This study delves into the comparative benefits of iVR against conventional therapeutic methods and non-rehabilitation.

Methods: A thorough search was performed in four electronic databases (PubMed, Cochrane CENTRAL, SCOPUS, and Web of Science) from January 2018 to December 2021. The study focused on randomized controlled trials that employed interactive virtual reality (iVR) in regards to psychological well-being effect in patients with chronic musculoskeletal disorders. Additionally, a subgroup analysis was conducted to compare the effects of nonimmersive and immersive iVR on the measured outcomes.

Results and discussion: Our study proves that non-immersive iVR showed a reduction in psychological distress compared to no rehabilitation, but no significant difference was observed between nonimmersive and immersive iVR. Although previous studies suggested that interactive virtual reality (iVR) could be a therapeutic option, this study particularly shown that non-immersive iVR can enhance psychological well-being.

Conclusions: Nonimmersive iVR is suggested for improving psychological well-being, comparable to conventional rehabilitation.

Background: Out of 25-30% of individuals do not respond to 5-Alpha Reductase Inhibitors (5-ARI) as a primary treatment of Benign Prostatic Hyperplasia (BPH), 7% experience disease progression despite treatment. Personalized medicine, which leverages human genomics, offers an approach to tailor treatments based on individual genetic profiles, facilitating early detection of drug resistance and optimizing therapeutic strategies.

Objective: The aim of the study was to advance personalized medicine in BPH by identifying genetic factors that influence treatment outcomes, thus improving therapeutic efficacy.

Methods: This cohort study involved patients responsive and resistant to treatment of BPH. After prostate resection, DNA was extracted and subjected to protein sequencing. The quality of the DNA was assessed, and next-generation sequencing (NGS) was performed. The sequencing data analyzed using FastQC, Samtools, MuTect2, ANNOVAR, and VEP. Whole-genome sequencing (WGS) data were compared to the Human GRCh38 reference genome. Single nucleotide polymorphisms (SNPs) and their positions were visualized through Integrated Genomics Viewer (IGV). Statistical analyses were conducted using R software.

Result: Two genetic variants associated with BPH, was a single nucleotide polymorphism (SNP) in the NOS3 gene at rs1799983 (T>A/G), and an SNP at rs61767072 in the SRD5A2 gene. All samples that exhibited resistance to combination drug therapy showed mutations in SNP rs61767072, specifically a deletion at base A in the SRD5A2 gene. Strong correlation reported between SNP rs61767072 and resistance to BPH combination therapy while mutations involving base A and base G in the NOS3 gene did not exhibit any significant correlation with resistance to BPH combination therapy.

Conclusion: Variations in genetic makeup significantly affect personalized medical care. Identification of specific SNPs such as rs61767072 may be the basis for the development of more personalized therapies. This study provides evidence that pharmacogenomic approaches are needed in urology practice to improve treatment outcomes.

Background: Hypertension is a persistent elevation in blood pressure that poses serious health risks.

Objective: This case-control study aimed to identify factors linked to hypertension at Amplas Health Center.

Methods: This study asks questionnaires to all patients aged 30-65 years and not diagnosed with hypertension who sought treatment at the Amplas Health Center from September 2-13, 2024. The analysis used bivariate and multivariate logistic regression. Results with p-value <0.05 were statistically significant.

Results: Participants were 110 individuals aged 30-65 without a prior hypertension diagnosis, aged 48-65 years, with elementary education level, a family history of hypertension, a salt intake pattern >1 teaspoon, a moderate stress level, low social support, and a poor quality of life had a p-value <0.05.

Conclusion: Biopsychosocial factors influence hypertension risk. Older age, stress, and lack of social support notably increase the likelihood of developing the condition. These findings highlight the need for comprehensive strategies considering lifestyle, emotional well-being, and social support in hypertension prevention.

Background: Cancer pain is common and often undertreated. Although opioids are effective when prescribed appropriately, clinical practice remains cautious and variable.

Objective: The aim of this study was to assess physicians' knowledge and identify barriers to opioid prescribing for cancer pain in a tertiary hospital in Saudi Arabia's Eastern Province.

Methods: A cross-sectional survey was conducted during March-April 2025 among physicians managing cancer pain. An anonymous REDCap questionnaire, adapted from Ayoub et al. (2022), collected data on demographics, practice patterns, guideline use, access to the national monitoring system (Raqeeb), opioid-prescribing knowledge, and perceived barriers at staff, system, and patient levels. Descriptive statistics summarized the data.

Results: Of 132 respondents (median age 38 years; 5 years' experience), 47.0% always and 31.1% often managed cancer pain, yet only 31.1% routinely initiated opioids. Morphine (86.4%) and tramadol (74.2%) were most used. Awareness of the local guideline was 23.5%, and 62.9% had Raqeeb access. Only 32.5% received training within five years. Foundational knowledge was adequate (opioids for moderate-severe pain 95.7%; co-prescribing laxatives 81.0%), while advanced topics were limited (no ceiling dose for morphine 25.9%; titration 45.7%; rotation 46.6%). Major barriers included limited protocol familiarity (57.6%), insufficient training (56.1%), e-prescribing workload (40.2%), perceived over-regulation (39.4%), and patient fears of addiction (51.5%) or side effects (44.7%).

Conclusion: Physicians frequently encounter cancer pain but demonstrate gaps in guideline awareness, training, and system access. Unified guidelines, structured training, and improved Raqeeb functionality are priorities for safer opioid use.

Background: The Hepatitis B Virus (HBV) is a major global health concern, primarily due to its potential to cause chronic liver disease and cancer. The HBV core protein (HBc) is essential for the viral life cycle, specifically in the assembly of the viral capsid, making it a prime target for antiviral drug development. Scorodocarpus borneensis, a plant native to Southeast Asia, is rich in diverse phytochemicals but its potential as a source for antiviral agents against HBV remains largely unexplored.

Objective: This study aimed to identify and evaluate secondary metabolites from S. borneensis as potential inhibitors of the HBV core protein through a comprehensive in silico screening and analysis pipeline.

Methods: Thirty-two compounds derived from S. borneensis were computationally evaluated. The process began with drug-likeness screening based on Lipinski's Rule of Five and initial toxicity predictions. Compounds that passed this filter were then subjected to molecular docking studies against the active site of the HBV core protein (PDB ID: 6J10) to determine their binding affinities and interaction modes. The most promising candidates were selected for in-depth ADMET (Absorption, Distribution, Metabolism, Excretion, and Toxicity) analysis and 20 ns molecular dynamics (MD) simulations to assess the stability of the protein-ligand complexes.

Results: From the initial screening, 17 of the 32 compounds successfully met Lipinski's criteria and showed no significant toxicity. The molecular docking analysis identified three compounds-Scodopin (12), Cadalen-15-oic acid (13), and Icariside B (15)-as the strongest candidates due to their low binding affinities and their occupation of the same active site as the native ligand. Subsequent ADMET prediction highlighted compound 13 for its favorable safety and bioavailability profile. The MD simulation further confirmed that the complex formed between the HBV protein and compound 13 was highly stable, whereas the complexes with compounds 12 and 15 were not.

Conclusion: The combined results from drug-likeness prediction, molecular docking, ADMET analysis, and molecular dynamics simulations strongly suggest that Cadalen-15-oic acid (13) is a highly promising lead compound from S. borneensis for developing a novel drug to inhibit the HBV core protein.

Background: Mental health nurses often deal with complex clinical situations and face difficulties with the decision-making process. The development of educational techniques during nurses' clinical practice is crucial to improve nurses' skills in communication, assessment and effective intervention in patients with mental disorders. Problem Based Learning (PBL) teaching method is a student-centered educational method based on the integration of a real problem into the learning process.

Objective: The aim of this study was to investigate the effect of the PBL on the development of critical thinking in undergraduate nursing students, in mental health clinical practice.

Methods: A quasi - experimental study was conducted with a pre- and post-test design in an experimental group and a control group, in Greece, at the Larissa School of Nursing of the University of Thessaly. The study was conducted throughout the 6th spring semester of an undergraduate nursing program, in the course Psychiatry - Mental Health Nursing (clinical practice) during the academic year 2022-2023.

Results: The study samples were comprised 67 students each. None of the students in either group had received PBL training previously. CTΑSS scores in intervention group differed statistically significantly in all subscales before and after the experimental procedure, p<0.05). Intervention group achieved significantly higher scores compared with the control group in certain subscales (interpretation, analysis, inference, and explanation-p=0.037, p=0.025, p=0.036 and p=0.001, respectively). Gender had an effect on explanation and inference; Women improved significantly their scores, whereas men had worse performance (p=0.001 and p=0.043 respectively).

Conclusion: Our study confirms the effect of PBL on critical thinking development and implies a role of gender in PBL education process. Future research should assess the viability of PBL effects on critical thinking by monitoring and re-assessing the trajectories of critical thinking development in subsequent years.