Health sciences review (Oxford, England)最新文献

Social needs refer to the needs associated with the downstream influence of sociocultural and economic determinants affecting the availability of basic amenities, services, and health and social care programs and policies. Social needs are instrumental in shaping the lives and health behaviours of individuals with multimorbidity. Previous reviews explored the care needs, treatment, and support in individuals with multimorbidity. However, the social needs of this population are poorly understood. This review aimed to develop a comprehensive understanding social needs of individuals living with multimorbidity. A meta-synthesis was conducted. Literature was searched within eight databases including gray literature databases. In total, 31 studies published from January 2010 to May 2023 were included in the synthesis. Thematic synthesis approach was used to develop analytical themes and the themes were then mapped to Bradshaw's (1972) taxonomy of social needs. The felt needs included: Requiring strong social network to combat disease-associated challenges and combat social isolation & Need for readily available health and social care assistance. The expressed and comparative needs included: Need for improved health insurance to compensate for disease related expenses and need for social action to address unfair societal behaviors. Individuals with multimorbidity sought improved social connectedness and access to readily available health and social care resources. Social stigma associated with disease, race, disability, and physical appearance affects the meeting of individuals' general and health care related social needs.

The aim of this study is to compare external fixation versus intramedullary (IM) nailing to determine which strategy was more suitable for patients with open tibial shaft fractures. Eleven RCTs that compared the therapeutic outcomes between external fixation and IM nailing in patients suffering from open tibial shaft fractures were screened out from the PubMed, Embase, and Cochrane Library in this analysis. For open tibia fractures of Gustilo-Anderson I-IIIA, significantly lower incidence of malunion and superficial infection was revealed for the IM nailing group when compared with the external fixation group. Further subgroup analyses within I-IIIA fractures showed comparable results between fractures managed with IM nails and ring external fixators. In conclusion, IM nailing is recommended over external fixation for open tibia fractures of I-IIIA. In addition, the use of ring external fixators may be more suitable than the ordinary external fixators for the treatment of I-IIIA fractures.

Patella fractures are uncommon injuries but in frail patients they may confer significant morbidity. Tension band metallic wiring (TBW) is frequently employed to manage these injuries yet complication rates are high. Up to one-third of patients require reoperation. In the frail host especially, patella fractures can result in significant functional impairment impacting on independence. Using the PRISMA guidelines, this systematic review interrogates the literature on patella fractures in the frail host. The evidence was found to be minimal and of low quality, comprising only eight cohort studies or case series. Sample sizes were small; in half of the included studies, 16 participants or less were included. 2493 patients were included from all extracted studies. The average age of patients was 71 years old with 60.5 % being female. AO/OTA 34-C2/3 fractures were the most common fracture patterns, comprising 41 % of patients. Current literature suggests that computed tomography (CT) scanning pre-operatively is appropriate. Marked heterogeneity was found in operative strategy; both metallic and non-metallic implants were investigated but metallic TBW and cerclage were the most prevalent techniques. Only one study investigated non-operative treatment. More than one in four patients (26.59 %) required reoperation and over one in five patients (22.53 %) suffered hardware complications. Average range of movement achieved was 121.28° +/- 13° but the investigation of other outcome measures was inconsistent. Further investigation into both patella fractures and, more specifically patella fractures in the poor host, is warranted. Nevertheless, due to its limited incidence, a multicentre approach is required and should be considered a priority for the orthopaedic community.

Carex genus contains over 2000 species distributed all around the globe and used for their medicinal and food values. Owing to their traditional and medicinal properties the genus has gained due attention, especially in the last couple of decades which led to the identification of terpenoids, lignans, quinazolinones, phenolic acids, and phenylpropanoids as the major phytochemicals. Besides these several studies reported the therapeutic applications of the extracts and phytochemicals in different experimental conditions. The present review aims to present a comprehensive overview of the present standing of Carex genus that may promote further scientific exploration and their utilization.

In the era of big data, artificial intelligence (AI) algorithms have the potential to revolutionize healthcare by improving patient outcomes and reducing healthcare costs. AI algorithms have frequently been used in health care for predictive modelling, image analysis and drug discovery. Moreover, as a recommender system, these algorithms have shown promising impacts on personalized healthcare provision. A recommender system learns the behaviour of the user and predicts their current preferences (recommends) based on their previous preferences. Implementing AI as a recommender system improves this prediction accuracy and solves cold start and data sparsity problems. However, most of the methods and algorithms are tested in a simulated setting which cannot recapitulate the influencing factors of the real world. This review article systematically reviews prevailing methodologies in recommender systems and discusses the AI algorithms as recommender systems specifically in the field of healthcare. It also provides discussion around the most cutting-edge academic and practical contributions present in the literature, identifies performance evaluation matrices, challenges in the implementation of AI as a recommender system, and acceptance of AI-based recommender systems by clinicians. The findings of this article direct researchers and professionals to comprehend currently developed recommender systems and the future of medical devices integrated with real-time recommender systems for personalized healthcare.

Posttraumatic stress disorder (PTSD) is one of the most common psychiatric disorders following traumatic injury, affecting up to 51 % of adults admitted to trauma centres. Identification of people at risk of PTSD is an important component of holistic, evidence-based care in trauma centres. This is also increasingly becoming a recommendation across Level 1 Trauma Centres worldwide. The purpose of this paper was to systematically review published literature regarding factors that increase or decrease one's risk of PTSD within a year of admission to a trauma hospital. Systematic review methodology was implemented with utilisation of extensive search criteria. This broadened search strategy was used to address some identified limitations in titles and abstracts of relevant papers. Forward and backward citation of included papers was implemented to ascertain secondary sources. Titles, abstracts, and full texts were independently reviewed by two authors. Sixty-one papers met inclusion criteria and 58 predictors were analysed with at least one analysis. There was strong scientific evidence for assault, acute stress disorder, and baseline pain as predictors of PTSD. There was strong scientific evidence that age, education, ethnicity, premorbid health concerns, marital status, injury severity, mechanism of injury, and length of stay were not predictors. Several methodological concerns were identified across the included papers, such as heterogeneity in operational definitions of predictors and lack of application to theoretical frameworks of PTSD. Gaps remain in the literature regarding the impact of risk factors included in well-known frameworks such as the cognitive model of PTSD, requiring future research to inform appropriate early intervention in this at-risk population.

Brown adipocytes constitute a specialized tissue in heat build-up (i.e., thermogenesis) due to their mitochondrial uncoupling capacity, as they express thermogenic genes, playing a role in the energy metabolism of the whole body in mammals through non-shivering thermogenesis. Beige adipocytes originate in white adipose tissue (WAT) through the tissue browning process and are phenotypically similar to brown adipocytes. Considering that the activity of these cells is essential to reduce the incidence of metabolic diseases, including obesity, type 2 diabetes, and dyslipidemia, the stimulation of the brown fat and the development of beige adipose tissue has become a promising therapeutic target to treat clinical conditions. Due to the low amount of brown adipose tissue (BAT) in human adults, both phenomena (i.e., activation of brown and development of beige adipocytes) are related to better control of body weight, adiposity, insulin resistance, and hyperlipidemia. This review focuses on the comprehensively discussion of the metabolic importance of BAT activation and/or browning of WAT, and approaches that lead to the biogenesis of these thermogenic fats, such as cold exposure, thyroid hormones, physical exercise, diet and pharmacological agents (i.e., β3-adrenergic receptor agonist, glucagon-like peptide 1, mineralocorticoid receptor antagonists, ephedrine). These stimulatory agents have shown promise in activating BAT in humans. Frow our review, concluded that there are still many obstacles to be overcome in the upcoming years to better assess the real impact of BAT activation on metabolic health (i.e., absence of insulin resistance and metabolic syndrome), and elucidate many questions surrounding BAT physiology, so that this organ can indeed be considered an attractive therapeutic target for the prevention and reversal of obesity and metabolic disorders.