-
Advances and prospects in deuterium metabolic imaging (DMI): a systematic review of in vivo studies.European Radiology Experimental Jun 2024Deuterium metabolic imaging (DMI) has emerged as a promising non-invasive technique for studying metabolism in vivo. This review aims to summarize the current... (Review)
Review
BACKGROUND
Deuterium metabolic imaging (DMI) has emerged as a promising non-invasive technique for studying metabolism in vivo. This review aims to summarize the current developments and discuss the futures in DMI technique in vivo.
METHODS
A systematic literature review was conducted based on the PRISMA 2020 statement by two authors. Specific technical details and potential applications of DMI in vivo were summarized, including strategies of deuterated metabolites detection, deuterium-labeled tracers and corresponding metabolic pathways in vivo, potential clinical applications, routes of tracer administration, quantitative evaluations of metabolisms, and spatial resolution.
RESULTS
Of the 2,248 articles initially retrieved, 34 were finally included, highlighting 2 strategies for detecting deuterated metabolites: direct and indirect DMI. Various deuterated tracers (e.g., [6,6'-H2]glucose, [2,2,2'-H3]acetate) were utilized in DMI to detect and quantify different metabolic pathways such as glycolysis, tricarboxylic acid cycle, and fatty acid oxidation. The quantifications (e.g., lactate level, lactate/glutamine and glutamate ratio) hold promise for diagnosing malignancies and assessing early anti-tumor treatment responses. Tracers can be administered orally, intravenously, or intraperitoneally, either through bolus administration or continuous infusion. For metabolic quantification, both serial time point methods (including kinetic analysis and calculation of area under the curves) and single time point quantifications are viable. However, insufficient spatial resolution remains a major challenge in DMI (e.g., 3.3-mL spatial resolution with 10-min acquisition at 3 T).
CONCLUSIONS
Enhancing spatial resolution can facilitate the clinical translation of DMI. Furthermore, optimizing tracer synthesis, administration protocols, and quantification methodologies will further enhance their clinical applicability.
RELEVANCE STATEMENT
Deuterium metabolic imaging, a promising non-invasive technique, is systematically discussed in this review for its current progression, limitations, and future directions in studying in vivo energetic metabolism, displaying a relevant clinical potential.
KEY POINTS
• Deuterium metabolic imaging (DMI) shows promise for studying in vivo energetic metabolism. • This review explores DMI's current state, limits, and future research directions comprehensively. • The clinical translation of DMI is mainly impeded by limitations in spatial resolution.
Topics: Humans; Deuterium; Animals
PubMed: 38825658
DOI: 10.1186/s41747-024-00464-y -
Dental Materials : Official Publication... Jun 2024Root canal irrigation endodontic solutions have effects on the chemistry of dentin. Infrared spectroscopy is a non-destructive chemical characterization method where the... (Review)
Review
BACKGROUND
Root canal irrigation endodontic solutions have effects on the chemistry of dentin. Infrared spectroscopy is a non-destructive chemical characterization method where the strength of absorption often correlates with mineral or organic composition.
OBJECTIVES
To survey effects of commonly used irrigation solutions on the composition of root dentin as detected by widely-available Fourier transform infrared spectroscopy (FTIR) methods.
METHODS
Electronic databases were searched for articles published between 1983 to 2023. After risk of bias assessments (OHAT), studies were grouped according to effects per irrigation solution. Inclusion criteria comprised in vitro studies that used extracted human or bovine teeth, treated by irrigation solutions characterized using FTIR spectroscopy and presenting spectral data. Publications that did not share FTIR spectra were excluded.
RESULTS
A wide range of concentrations, durations, and methodologies have been tested but only 30 out of 3452 studies met our inclusion criteria. Different FTIR methods were used with the Attenuated Total Reflection (ATR) variant being the most common (21 studies). Investigated solutions included sodium hypochlorite (NaOCl), ethylenediaminetetraacetic-acid (EDTA), 1-hydroxyethylidene-1-1-diphosphonic-acid (HEDP), peracetic-acid (PAA), glycolic-acid (GA), and citric-acid (CA) though most focused on NaOCl and EDTA. All solutions had detectable effects on the FTIR signature of dentin. NaOCl mainly affects the organic signatures, revealing reduced amide/phosphate ratios with increasing concentrations. EDTA mainly effects the inorganic component, increasing with time and concentration, yet glycolic acid has stronger effects than EDTA on dentin. Beyond the type of irrigant and dentin exposure durations, concentration and protocol of application had strong effects. There is a lack of studies comparing similar irrigants under conditions that mimic clinical scenarios analyzing bulk sample because FTIR of powder dentin differs from bulk measurements.
SIGNIFICANCE
The ideal root-canal irrigant should combine local disinfection properties with minimal compositional effects on healthy dentin. FTIR methods appear reliable to identify important changes in root dentin chemical composition. Such information can help understand when endodontic irrigation might lead to root degradation or possibly contribute to long term failures such as vertical fractures. Awareness of chemical damage from irrigation procedures may help clinicians select procedures that reduce deleterious effects on the root canal structures.
PubMed: 38825554
DOI: 10.1016/j.dental.2024.05.014 -
Journal of Endodontics May 2024Automated segmentation of three-dimensional pulp space on cone-beam computed tomography (CBCT) images presents a significant opportunity for enhancing diagnosis,... (Review)
Review
INTRODUCTION
Automated segmentation of three-dimensional pulp space on cone-beam computed tomography (CBCT) images presents a significant opportunity for enhancing diagnosis, treatment planning, and clinical education in endodontics. The aim of this systematic review was to investigate the performance of AI-driven automated pulp space segmentation on CBCT images.
METHODS
A comprehensive electronic search was performed using PubMed, Web of Science, and Cochrane databases, up until February 2024. Two independent reviewers participated in the selection of studies, data extraction, and evaluation of the included studies. Any disagreements were resolved by a third reviewer. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the risk of bias.
RESULTS
Thirteen studies that met the eligibility criteria were included. Most studies demonstrated high accuracy in their respective segmentation methods, although there was some variation across different structures (pulp chamber, root canal) and tooth types (single-rooted, multi-rooted). Automated segmentation showed slightly superior performance for segmenting the pulp chamber compared to the root canal and single-rooted teeth compared to multi-rooted ones. Furthermore, second mesiobuccal (MB2) canal segmentation also demonstrated high performance. In terms of time efficiency, the minimum time required for segmentation was 13 seconds.
CONCLUSION
AI-driven models demonstrated outstanding performance in pulp space segmentation. Nevertheless, these findings warrant careful interpretation, and their generalizability is limited due to the potential risk and low evidence level arising from inadequately detailed methodologies and inconsistent assessment techniques. In addition, there is room for further improvement, specifically for root canal segmentation and testing of AI performance in artifact-induced images.
PubMed: 38821262
DOI: 10.1016/j.joen.2024.05.012 -
Journal of Medical Internet Research May 2024Mobile health (mHealth) uses mobile technologies to promote wellness and help disease management. Although mHealth solutions used in the clinical setting have typically... (Review)
Review
BACKGROUND
Mobile health (mHealth) uses mobile technologies to promote wellness and help disease management. Although mHealth solutions used in the clinical setting have typically been medical-grade devices, passive and active sensing capabilities of consumer-grade devices like smartphones and activity trackers have the potential to bridge information gaps regarding patients' behaviors, environment, lifestyle, and other ubiquitous data. Individuals are increasingly adopting mHealth solutions, which facilitate the collection of patient-generated health data (PGHD). Health care professionals (HCPs) could potentially use these data to support care of chronic conditions. However, there is limited research on real-life experiences of HPCs using PGHD from consumer-grade mHealth solutions in the clinical context.
OBJECTIVE
This systematic review aims to analyze existing literature to identify how HCPs have used PGHD from consumer-grade mobile devices in the clinical setting. The objectives are to determine the types of PGHD used by HCPs, in which health conditions they use them, and to understand the motivations behind their willingness to use them.
METHODS
A systematic literature review was the main research method to synthesize prior research. Eligible studies were identified through comprehensive searches in health, biomedicine, and computer science databases, and a complementary hand search was performed. The search strategy was constructed iteratively based on key topics related to PGHD, HCPs, and mobile technologies. The screening process involved 2 stages. Data extraction was performed using a predefined form. The extracted data were summarized using a combination of descriptive and narrative syntheses.
RESULTS
The review included 16 studies. The studies spanned from 2015 to 2021, with a majority published in 2019 or later. Studies showed that HCPs have been reviewing PGHD through various channels, including solutions portals and patients' devices. PGHD about patients' behavior seem particularly useful for HCPs. Our findings suggest that PGHD are more commonly used by HCPs to treat conditions related to lifestyle, such as diabetes and obesity. Physicians were the most frequently reported users of PGHD, participating in more than 80% of the studies.
CONCLUSIONS
PGHD collection through mHealth solutions has proven beneficial for patients and can also support HCPs. PGHD have been particularly useful to treat conditions related to lifestyle, such as diabetes, cardiovascular diseases, and obesity, or in domains with high levels of uncertainty, such as infertility. Integrating PGHD into clinical care poses challenges related to privacy and accessibility. Some HCPs have identified that though PGHD from consumer devices might not be perfect or completely accurate, their perceived clinical value outweighs the alternative of having no data. Despite their perceived value, our findings reveal their use in clinical practice is still scarce.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
RR2-10.2196/39389.
Topics: Humans; Telemedicine; Health Personnel; Patient Generated Health Data; Smartphone
PubMed: 38820580
DOI: 10.2196/49320 -
Journal of Medical Internet Research May 2024Health care organizations worldwide are faced with an increasing number of cyberattacks and threats to their critical infrastructure. These cyberattacks cause... (Review)
Review
BACKGROUND
Health care organizations worldwide are faced with an increasing number of cyberattacks and threats to their critical infrastructure. These cyberattacks cause significant data breaches in digital health information systems, which threaten patient safety and privacy.
OBJECTIVE
From a sociotechnical perspective, this paper explores why digital health care systems are vulnerable to cyberattacks and provides sociotechnical solutions through a systematic literature review (SLR).
METHODS
An SLR using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was conducted by searching 6 databases (PubMed, Web of Science, ScienceDirect, Scopus, Institute of Electrical and Electronics Engineers, and Springer) and a journal (Management Information Systems Quarterly) for articles published between 2012 and 2022 and indexed using the following keywords: "(cybersecurity OR cybercrime OR ransomware) AND (healthcare) OR (cybersecurity in healthcare)." Reports, review articles, and industry white papers that focused on cybersecurity and health care challenges and solutions were included. Only articles published in English were selected for the review.
RESULTS
In total, 5 themes were identified: human error, lack of investment, complex network-connected end-point devices, old legacy systems, and technology advancement (digitalization). We also found that knowledge applications for solving vulnerabilities in health care systems between 2012 to 2022 were inconsistent.
CONCLUSIONS
This SLR provides a clear understanding of why health care systems are vulnerable to cyberattacks and proposes interventions from a new sociotechnical perspective. These solutions can serve as a guide for health care organizations in their efforts to prevent breaches and address vulnerabilities. To bridge the gap, we recommend that health care organizations, in partnership with educational institutions, develop and implement a cybersecurity curriculum for health care and intelligence information sharing through collaborations; training; awareness campaigns; and knowledge application areas such as secure design processes, phase-out of legacy systems, and improved investment. Additional studies are needed to create a sociotechnical framework that will support cybersecurity in health care systems and connect technology, people, and processes in an integrated manner.
Topics: Computer Security; Humans; Delivery of Health Care; Patient Safety
PubMed: 38820579
DOI: 10.2196/46904 -
Journal of Robotic Surgery May 2024Subretinal injection (SI) is a novel drug delivery method, directly to retina for treatment of various eye disease. However, manual injection requires surgical... (Review)
Review
Subretinal injection (SI) is a novel drug delivery method, directly to retina for treatment of various eye disease. However, manual injection requires surgical experience and precision due to physiological factors. Robots offer solution to this issue, by reducing hand tremor and increased accuracy. This systematic review analyzes current status on robot-assisted SI compared to conventional techniques. Systematic search across 5 databases was conducted to identify studies comparing manual and robot-assisted SI procedures. Extracted data included robotic systems, complications, and success rates. Four studies, including one human trial, two ex vivo porcine eye studies, and one artificial eye model study were included in the synthesis. The findings show early advantages of robot-assisted SI. Compared to traditional interventions, robot procedures result in reduced tremor, what potentially lowers the risk of complications, including retinal tears and reflux. The first in-human randomized trial showed encouraging results, with no significant differences in surgical times or complications between robot-assisted and manual SI. However, major limitation of robot-assisted procedures is longer procedure time. Robot-assisted SI holds promise by offering increased precision and stability, reducing human error and potentially improving clinical outcomes. Challenges include cost, availability, and learning curve. Overall, early stage of robot-assisted SI suggests advantages in precision, complication reduction, and potentially improved drug delivery. Further research in human randomized trials is needed to fully assess its full-scale clinical application.
Topics: Humans; Animals; Retina; Drug Delivery Systems; Robotic Surgical Procedures; Swine; Injections, Intraocular
PubMed: 38819533
DOI: 10.1007/s11701-024-01991-x -
Digital Health 2024Electronic patient-reported outcome (ePRO) systems hold promise for revolutionizing communication between cancer patients and healthcare providers across various care... (Review)
Review
OBJECTIVE
Electronic patient-reported outcome (ePRO) systems hold promise for revolutionizing communication between cancer patients and healthcare providers across various care settings. This systematic review explores the multifaceted landscape of ePROs in cancer care, encompassing their advantages, disadvantages, potential risks, and opportunities for improvement.
METHODS
In our systematic review, we conducted a rigorous search in Scopus, Web of Science, and PubMed, employing comprehensive medical subject heading terms for ePRO and cancer, with no date limitations up to 2024. Studies were critically appraised and thematically analyzed based on inclusion and exclusion criteria, including considerations of advantages, disadvantages, opportunities, and threats.
FINDINGS
Analyzing 85 articles revealed 69 themes categorized into four key areas. Advantages ( = 14) were dominated by themes like "improved quality of life and care." Disadvantages ( = 26) included "limited access and technical issues." Security concerns and lack of technical skills were prominent threats ( = 10). Opportunities ( = 19) highlighted advancements in symptom management and potential solutions for technical challenges.
CONCLUSION
This review emphasizes the crucial role of continuous exploration, integration, and innovation in ePRO systems for optimizing patient outcomes in cancer care. Beyond traditional clinical settings, ePROs hold promise for applications in survivorship, palliative care, and remote monitoring. By addressing existing limitations and capitalizing on opportunities, ePROs can empower patients, enhance communication, and ultimately improve care delivery across the entire cancer care spectrum.
PubMed: 38812853
DOI: 10.1177/20552076241257146 -
Frontiers in Human Neuroscience 2024This study conducts a bibliometric analysis on neurofeedback research to assess its current state and potential future developments.
INTRODUCTION
This study conducts a bibliometric analysis on neurofeedback research to assess its current state and potential future developments.
METHODS
It examined 3,626 journal articles from the Web of Science (WoS) using co-citation and co-word methods.
RESULTS
The co-citation analysis identified three major clusters: "Real-Time fMRI Neurofeedback and Self-Regulation of Brain Activity," "EEG Neurofeedback and Cognitive Performance Enhancement," and "Treatment of ADHD Using Neurofeedback." The co-word analysis highlighted four key clusters: "Neurofeedback in Mental Health Research," "Brain-Computer Interfaces for Stroke Rehabilitation," "Neurofeedback for ADHD in Youth," and "Neural Mechanisms of Emotion and Self-Regulation with Advanced Neuroimaging.
DISCUSSION
This in-depth bibliometric study significantly enhances our understanding of the dynamic field of neurofeedback, indicating its potential in treating ADHD and improving performance. It offers non-invasive, ethical alternatives to conventional psychopharmacology and aligns with the trend toward personalized medicine, suggesting specialized solutions for mental health and rehabilitation as a growing focus in medical practice.
PubMed: 38799297
DOI: 10.3389/fnhum.2024.1339444 -
Journal of Gynecology Obstetrics and... May 2024Outpatient surgery in gynaecology may offer advantages including cost reduction, patient convenience and hospital bed optimisation without compromising patient safety... (Review)
Review
BACKGROUND
Outpatient surgery in gynaecology may offer advantages including cost reduction, patient convenience and hospital bed optimisation without compromising patient safety and satisfaction. With the continual rise in health costs since 2000, outpatient surgery could be a line of action to improve financial resource utilisation and a solution for continuing to treat patients during crises such as the coronavirus disease 2019 pandemic.
OBJECTIVE
This systematic review provides an overview of the literature on minimally invasive outpatient hysterectomy for benign indications.
METHOD
A focused systematic review of the medical literature between 2018 and 2022 on outpatient gynaecological surgery for a benign indication was conducted using the PubMed and Google Scholar search engines. We then narrowed our selection to articles that referred to hysterectomy. Successful same-day discharge (SDD) was defined as the patient's return home on the day of the procedure without an overnight stay.
RESULTS
Fifteen articles that focused on minimally invasive surgery were included in this review. Most of the studies (n = 11) were conducted in the United States. Outpatient surgery had a mean success rate of 60 % and a mean readmission rate of 3 %. The main reasons for SDD failure were patient choice, failed voiding, the need for pain management, nausea or vomiting, or both and the late timing of surgery. SDD was not associated with more complications and readmissions compared with inpatient care. The three main attribute predictors of SDD were young age, early timing of surgery and short total operative time. Patient satisfaction with SDD was high in absolute terms and relative to satisfaction with hospitalisation.
CONCLUSION
Minimally invasive outpatient hysterectomy for a benign indication is feasible and safe but is associated with a notable risk of failure. To increase the success rate of outpatient management, patients must be well selected and surgery pathways must be planned in advance. The implementation of enhanced recovery protocols may help promote outpatient hysterectomy for a benign indication.
PubMed: 38797369
DOI: 10.1016/j.jogoh.2024.102804 -
Biomedicine & Pharmacotherapy =... Jul 2024Central nervous system (CNS) disorders exhibit exceedingly intricate pathogenic mechanisms. Pragmatic and effective solutions remain elusive, significantly compromising... (Review)
Review
Central nervous system (CNS) disorders exhibit exceedingly intricate pathogenic mechanisms. Pragmatic and effective solutions remain elusive, significantly compromising human life and health. Activating transcription factor 4 (ATF4) participates in the regulation of multiple pathophysiological processes, including CNS disorders. Considering the widespread involvement of ATF4 in the pathological process of CNS disorders, the targeted regulation of ATF4 by plant-derived bioactive compounds (PDBCs) may become a viable strategy for the treatment of CNS disorders. However, the regulatory relationship between PDBCs and ATF4 remains incompletely understood. Here, we aimed to comprehensively review the studies on PDBCs targeting ATF4 to ameliorate CNS disorders, thereby offering novel directions and insights for the treatment of CNS disorders. A computerized search was conducted on PubMed, Embase, Web of Science, and Google Scholar databases to identify preclinical experiments related to PDBCs targeting ATF4 for the treatment of CNS disorders. The search timeframe was from the inception of the databases to December 2023. Two assessors conducted searches using the keywords "ATF4," "Central Nervous System," "Neurological," "Alzheimer's disease," "Parkinson's Disease," "Stroke," "Spinal Cord Injury," "Glioblastoma," "Traumatic Brain Injury," and "Spinal Cord Injury." Overall, 31 studies were included, encompassing assessments of 27 PDBCs. Combining results from in vivo and in vitro studies, we observed that these PDBCs, via ATF4 modulation, prevent the deposition of amyloid-like fibers such as Aβ, tau, and α-synuclein. They regulate ERS, reduce the release of inflammatory factors, restore mitochondrial membrane integrity to prevent oxidative stress, regulate synaptic plasticity, modulate autophagy, and engage anti-apoptotic mechanisms. Consequently, they exert neuroprotective effects in CNS disorders. Numerous PDBCs targeting ATF4 have shown potential in facilitating the restoration of CNS functionality, thereby presenting expansive prospects for the treatment of such disorders. However, future endeavors necessitate high-quality, large-scale, and comprehensive preclinical and clinical studies to further validate this therapeutic potential.
Topics: Activating Transcription Factor 4; Humans; Central Nervous System Diseases; Animals; Phytochemicals; Neuroprotective Agents
PubMed: 38795641
DOI: 10.1016/j.biopha.2024.116811