Health sciences review (Oxford, England)最新文献

The detection and classification of traumatic brain injury (TBI) by medical professionals can vary due to subjectivity and differences in experience. Thus, a computational approach for detecting and classifying TBI would be invaluable for an objective diagnosis of this injury. In this review paper, various machine learning algorithms used to detect, classify, and predict the severity and outcomes of TBI in a clinical setting are discussed. The most promising of these algorithms is the convolutional neural network (CNN), which is highlighted in the review.

Purpose

Tuberculosis (TB) and coronavirus disease 2019 (COVID-19) are the two most significant health challenges faced by the public. Numerous confirmed COVID-19 cases worldwide are concentrated in nations already burdened with TB. The COVID-19 pandemic has surpassed all other health issues globally and has significantly impacted the prevalence of TB.

Methods

A PubMed literature search (2020–2022) using the keywords, “Tuberculosis”, “Drug-resistant Tuberculosis”, “Impact of the Pandemic”, “SARS-CoV2” “COVID-19″ and “Public health”, was performed. Additional statistical information has been gathered from online databases such as the WHO COVID-19 dashboard, Nikshay Portal, and Worldometer, India.

Results

India, Indonesia, and the Philippines were the major contributors to the steep fall in global TB case notifications. Being the highest TB burden country, detailed trends were observed in monthly TB reports in India, compared with the newly confirmed COVID-19 cases. Flow diagrams of TB studies along with COVID-19 reports have been included in the review.

Discussion

A remarkable strain in the TB control programs was seen in high-TB troubled countries during the COVID-19 pandemic, in comparison to pre-pandemic and post-pandemic. A possible key to the prevention of the burden of TB lies in dealing with its risk factors; simultaneously raising the funds and sustaining investment in healthcare systems to address the needs of the poor and robust to the threat of epidemics. These countries should have a perpetual TB strategy to reach the target by 2030, together with an effective strategy for COVID-19 management.

Background

Only 48 % of infants worldwide achieve the World Health Organization's recommendation of exclusive breastfeeding for the first six months of life. The leading cause of early breastfeeding cessation is self-reported milk insufficiency. Research into breastfeeding interventions that focus on promoting a person's confidence in their milk supply is therefore recommended.

Purpose

This systematic review aimed to explore whether antenatal milk expression could be optimized as a breastfeeding promotion intervention, using implementation science.

Methods

The Joanna Briggs Institute convergent segregated approach to mixed methods systematic reviews was used. A meta-aggregation and CERQual assessment of qualitative data was undertaken. Effect estimates of relevant quantitative data were summarized in forest plots. Results were organized into the following five implementation outcomes from an evidence-based framework: acceptability, appropriateness, adoption, feasibility, and fidelity.

Results

Of the 207 studies identified, 22 were included. A significant proportion of people will find the intervention acceptable, but those who do not will require additional ongoing support. Among people with diabetes, antenatal milk expression is associated with greater exclusive breastfeeding rates up to three months postpartum. Qualitative data described how antenatal milk expression may physically and psychologically prepare people for breastfeeding, encourage resilience, reassure individuals of their ability to produce milk and lead to a volume of stored colostrum.

Conclusions

There is evidence that antenatal milk expression may prevent early breastfeeding cessation among people with diabetes. Further quantitative research is needed to confirm the efficacy of antenatal milk expression for other groups. Optimal implementation requires training for relevant healthcare professionals, alongside education and ongoing support for the pregnant population.

We aimed to identify community-based interventions to prevent stroke in low-and-middle-income countries. A comprehensive search in Medline through PubMed, Web of Science (core collection), and Scopus was conducted in October, 2021 and updated in August, 2023. Studies published only in English between 1st January, 2000 and August 26, 2023 were included in the review. The screening and data extraction were performed by two reviewers independently. Two authors independently evaluated the included papers' Risk of Bias; we utilized the Cochrane ROB (Risk of Bias) tool for randomized controlled trials (RCT) and non-randomized studies were assessed using ROBANS (Risk of Bias Assessment tool for non-randomized studies). Meta-analysis was not conducted due to the heterogeneity of the included studies in terms of methods and outcomes. A narrative synthesis was performed to report the results. This systematic review was registered in PROSPERO (International prospective register of systematic reviews) – CRD 42021283670. A total of six studies were included in the review. Most of the studies highlighted community-based educational intervention to improve knowledge regarding stroke, it's signs, and risk factors. An important component of community-based intervention found in the review was involving community health professionals in educating the local population about health. Educational interventions were found effective in reducing stroke risk factors such as blood pressure, and cholesterol level. To lessen the enormous burden of stroke, effective community-based programs for prevention can be expanded and incorporated into resource-poor health systems.

The impact of long-term exposure to several heavy metals in the environment on general health is causing growing concern. Mercury in particular falls into this category but other heavy metals are less prevalent. Among all heavy metals, mercury is the most toxic. Oxidative stress and dysfunctional mitochondria are brought on by mercury. This causes the inner mitochondrial membrane to depolarize, auto-oxidize, and undergo severe lipid peroxidation and mitochondrial malfunction. Mercury enhances lipid peroxidation, LDL oxidation, and plasma oxLDL complexes while inhibiting glutathione, catalase, and superoxide dismutase. Chronic mercury exposure (even at very low levels), increases inflammation, oxidative stress, oxidative defense, and nitric oxide bioavailability and stimulates endothelial dysfunction, which increases the risk of CVD and CVA. In the future, more investigations and studies are needed to prevent the patients from mercury toxicity which leads to stroke and other illness.

Driven by the development of innovative electrode materials, the brain-machine interface (BMI) has witnessed significant advancements in recent years. However, traditional implantable electrodes, such as metal-based and polymer-based electrodes, often face limitations in terms of flexibility, chronic stability, and long-term biocompatibility. Liquid metal-based electrodes have emerged as a promising alternative to traditional electrode materials, offering unique properties and numerous advantages for BMI applications. In this Review, we provided an in-depth overview of liquid metal-based electrodes. Liquid metal-based electrodes demonstrate several desirable features, including high electrical conductivity, flexibility, biocompatibility, and the ability to conform to the irregular and delicate structures of the brain. We also systematically and thematically discussed their material properties, biocompatibility considerations, performance characteristics, and assorted applications in neural recording, stimulation, brain-machine interfaces, closed-loop feedback systems, and neuroprosthetics. Meanwhile, long-term stability, biocompatibility, electrode-tissue interface, miniaturization, signal processing, and ethical considerations are areas that require further research and innovation. Addressing these challenges will contribute to the successful integration and widespread use of liquid metal-based electrodes in BMI systems.

Purpose

Statins are the cornerstone therapy for primary or secondary prevention of atherosclerotic cardiovascular disease (ASCVD). However, a significant portion of patients are intolerant to statin or show inadequate lipid-lowering. Bempedoic acid (BA) has been shown to decrease low-density lipoprotein cholesterol (LDL-C) in clinical trials. However, the evidence on the effect of BA on clinical cardiovascular outcomes was limited until the CLEAR Outcomes trial. Thus, to fully appraise the available data, we performed this meta-analysis.

Methods

PubMed, Pubmed Central, Embase, and Scopus databases were searched for relevant articles published before May 1, 2023. Pertinent data from the included studies were extracted and analyzed using RevMan v5.4.

Results

Out of 2209 studies evaluated, five randomized control trials with 17,384 patients with established ASCVD or at high risk of ASCVD were included for analysis. The BA therapy reduced major adverse cardiovascular events (OR 0.85, CI 0.77-0.93; <0.0001), non-fatal myocardial infarction (OR 0.75, 95 % CI 0.64-0.88; p <0.0001), hospitalization for unstable angina (OR 0.69, CI 0.53-0.89; p = 0.005) and coronary revascularization (OR 0.80, CI 0.61-0.91; <0.0001) significantly without decreasing the risk of all-cause death (OR 1.19, CI 0.73-1.94; p = 0.49), cardiovascular death (OR 1.04, CI 0.87-1.25; p = 0.68) and non-fatal stroke (OR 0.84, CI 0.66-1.06; p = 0.15).

Conclusion

Based on our analysis the bempedoic acid addition to therapy reduced cardiovascular events in selective patients who are either intolerant to statins or do not achieve recommended LDL-C levels despite being on a maximum dose of statins and/or ezetimibe.

As the incidence rate of breast cancer is increasing at an alarming rate these days, this is leading to an increase in the use of chemotherapy drugs. Here we used a systematic review to identify studies that reported adverse events related to chemotherapy and its management. We searched PubMed Central, Cochrane Library, Research Gate, Sci-Hub, and Web of Knowledge for relevant references. We included data from 1978 to 2021 in our analysis. Additionally, in this review, we have attempted to elucidate how cancer chemotherapy has affected the mind and body of the cancer survivor. We also provided insight into the adjuvant therapies that enable survivors to lead quality lives. Due to incomplete knowledge and sometimes fear of adverse effects, patients are reluctant to undergo cancer treatment. Combining cancer drugs with those that overcome associated side effects is a promising area for better patient outcomes.