-
Non-coding RNA May 2024Chronic kidney disease (CKD) represents an increasing health burden. Evidence suggests the importance of miRNA in diagnosing CKD, yet the reports are inconsistent. This... (Review)
Review
Chronic kidney disease (CKD) represents an increasing health burden. Evidence suggests the importance of miRNA in diagnosing CKD, yet the reports are inconsistent. This study aimed to determine novel miRNA biomarkers and potential therapeutic targets from hypothesis-free miRNA profiling studies in human and murine CKDs. Comprehensive literature searches were conducted on five databases. Subgroup analyses of kidney diseases, sample types, disease stages, and species were conducted. A total of 38 human and 12 murine eligible studies were analyzed using Robust Rank Aggregation (RRA) and vote-counting analyses. Gene set enrichment analyses of miRNA signatures in each kidney disease were conducted using DIANA-miRPath v4.0 and MIENTURNET. As a result, top target genes, Gene Ontology terms, the interaction network between miRNA and target genes, and molecular pathways in each kidney disease were identified. According to vote-counting analysis, 145 miRNAs were dysregulated in human kidney diseases, and 32 were dysregulated in murine CKD models. By RRA, miR-26a-5p was significantly reduced in the kidney tissue of Lupus nephritis (LN), while miR-107 was decreased in LN patients' blood samples. In both species, epithelial-mesenchymal transition, Notch, mTOR signaling, apoptosis, G2/M checkpoint, and hypoxia were the most enriched pathways. These miRNA signatures and their target genes must be validated in large patient cohort studies.
PubMed: 38804362
DOI: 10.3390/ncrna10030030 -
Alimentary Pharmacology & Therapeutics Jul 2024Interest in large language models (LLMs), such as OpenAI's ChatGPT, across multiple specialties has grown as a source of patient-facing medical advice and... (Review)
Review
BACKGROUND
Interest in large language models (LLMs), such as OpenAI's ChatGPT, across multiple specialties has grown as a source of patient-facing medical advice and provider-facing clinical decision support. The accuracy of LLM responses for gastroenterology and hepatology-related questions is unknown.
AIMS
To evaluate the accuracy and potential safety implications for LLMs for the diagnosis, management and treatment of questions related to gastroenterology and hepatology.
METHODS
We conducted a systematic literature search including Cochrane Library, Google Scholar, Ovid Embase, Ovid MEDLINE, PubMed, Scopus and the Web of Science Core Collection to identify relevant articles published from inception until January 28, 2024, using a combination of keywords and controlled vocabulary for LLMs and gastroenterology or hepatology. Accuracy was defined as the percentage of entirely correct answers.
RESULTS
Among the 1671 reports screened, we identified 33 full-text articles on using LLMs in gastroenterology and hepatology and included 18 in the final analysis. The accuracy of question-responding varied across different model versions. For example, accuracy ranged from 6.4% to 45.5% with ChatGPT-3.5 and was between 40% and 91.4% with ChatGPT-4. In addition, the absence of standardised methodology and reporting metrics for studies involving LLMs places all the studies at a high risk of bias and does not allow for the generalisation of single-study results.
CONCLUSIONS
Current general-purpose LLMs have unacceptably low accuracy on clinical gastroenterology and hepatology tasks, which may lead to adverse patient safety events through incorrect information or triage recommendations, which might overburden healthcare systems or delay necessary care.
Topics: Humans; Gastroenterology; Digestive System Diseases; Decision Support Systems, Clinical; Language
PubMed: 38798194
DOI: 10.1111/apt.18058 -
Cancers May 2024: Total hysterectomy with bilateral salpingo-oophorectomy via minimally invasive surgery (MIS) has emerged as the standard of care for early-stage endometrial cancer... (Review)
Review
: Total hysterectomy with bilateral salpingo-oophorectomy via minimally invasive surgery (MIS) has emerged as the standard of care for early-stage endometrial cancer (EC). Prior systematic reviews and meta-analyses have focused on outcomes reported solely from randomised controlled trials (RCTs), overlooking valuable data from non-randomised studies. This inaugural systematic review and network meta-analysis comprehensively compares clinical and oncological outcomes between MIS and open surgery for early-stage EC, incorporating evidence from randomised and non-randomised studies. : This study was prospectively registered on PROSPERO (CRD42020186959). All original research of any experimental design reporting clinical and oncological outcomes of surgical treatment for endometrial cancer was included. Study selection was restricted to English-language peer-reviewed journal articles published 1 January 1995-31 December 2021. A Bayesian network meta-analysis was conducted. : A total of 99 studies were included in the network meta-analysis, comprising 181,716 women and 14 outcomes. Compared with open surgery, laparoscopic and robotic-assisted surgery demonstrated reduced and but increased . Compared with laparoscopic surgery, robotic-assisted surgery was associated with a significant reduction in (OR = 0.40, 95% CrI: 0.17-0.87) and (OR = 0.38, 95% CrI: 0.17-0.75) as well as a higher (OR = 2.45, 95% CrI: 1.04-6.34). : For treating early endometrial cancer, minimal-access surgery via robotic-assisted or laparoscopic techniques appears safer and more efficacious than open surgery. Robotic-assisted surgery is associated with fewer complications and favourable oncological outcomes.
PubMed: 38791939
DOI: 10.3390/cancers16101860 -
Animals : An Open Access Journal From... May 2024Q fever is a disease caused by that affects many animal species and humans. In ruminants, the disease is responsible for several reproductive disorders (such as... (Review)
Review
Q fever is a disease caused by that affects many animal species and humans. In ruminants, the disease is responsible for several reproductive disorders (such as abortions, stillbirths, premature births, weak offspring, retained foetal membranes and infertility). An inactivated vaccine based on a phase I antigen of is available for cattle, goats and sheep. This review aims to summarise the scientific literature regarding the efficacy and safety of this vaccine to control the infection in these three domestic ruminant species. Forty-five publications and one experimental veterinary thesis reporting on experimental studies, case reports, mathematical modelling and intervention studies were selected according to the PRISMA guidelines. Although some studies lack control groups or statistical analyses, for all three species, published data show that vaccination often results in a reduction in abortions and an improvement in reproductive performance in comparison with absence of vaccination. There is also evidence, including in infected herds and animals, that vaccination is associated with a reduction in bacterial shedding, both in intensity and duration in comparison with absence of vaccination. For these reasons, in case of human outbreaks, vaccination is one of the pillars of control measures. Vaccination is generally well tolerated, despite the rare occurrence of mild, transient side-effects, such as hyperthermia and reduction in milk yield.
PubMed: 38791700
DOI: 10.3390/ani14101484 -
Scandinavian Journal of Gastroenterology May 2024Adenoma detection rate (ADR) is higher after a positive fecal immunochemical test (FIT) compared to direct screening colonoscopy. (Review)
Review
BACKGROUND
Adenoma detection rate (ADR) is higher after a positive fecal immunochemical test (FIT) compared to direct screening colonoscopy.
OBJECTIVE
This meta-analysis evaluated how ADR, the rates of advanced adenoma detection (AADR), colorectal cancer detection (CDR), and sessile serrated lesion detection (SSLDR) are affected by different FIT positivity thresholds.
METHODS
We searched MEDLINE, EMBASE, CINAHL, and EBM Reviews databases for studies reporting ADR, AADR, CDR, and SSLDR according to different FIT cut-off values in asymptomatic average-risk individuals aged 50-74 years old. Data were stratified according to sex, age, time to colonoscopy, publication year, continent, and FIT kit type. Study quality, heterogeneity, and publication bias were assessed.
RESULTS
Overall, 4280 articles were retrieved and fifty-eight studies were included (277,661 FIT-positive colonoscopies; mean cecal intubation 96.3%; mean age 60.8 years; male 52.1%). Mean ADR was 56.1% (95% CI 53.4 - 58.7%), while mean AADR, CDR, and SSLDR were 27.2% (95% CI 24.4 - 30.1%), 5.3% (95% CI 4.7 - 6.0%), and 3.0% (95% CI 1.7 - 4.6%), respectively. For each 20 μg Hb/g increase in FIT cut-off level, ADR increased by 1.54% (95% CI 0.52 - 2.56%, < 0.01), AADR by 3.90% (95% CI 2.76 - 5.05%, < 0.01) and CDR by 1.46% (95% CI 0.66 - 2.24%, < 0.01). Many detection rates were greater amongst males and Europeans.
CONCLUSIONS
ADRs in FIT-positive colonoscopies are influenced by the adopted FIT positivity threshold, and identified targets, importantly, proved to be higher than most current societal recommendations.
PubMed: 38775234
DOI: 10.1080/00365521.2024.2356649 -
Journal of Medical Imaging and... May 2024The intrinsic stochasticity of patients' response to treatment is a major consideration for clinical decision-making in radiation therapy. Markov models are powerful... (Review)
Review
The intrinsic stochasticity of patients' response to treatment is a major consideration for clinical decision-making in radiation therapy. Markov models are powerful tools to capture this stochasticity and render effective treatment decisions. This paper provides an overview of the Markov models for clinical decision analysis in radiation oncology. A comprehensive literature search was conducted within MEDLINE using PubMed, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only studies published from 2000 to 2023 were considered. Selected publications were summarized in two categories: (i) studies that compare two (or more) fixed treatment policies using Monte Carlo simulation and (ii) studies that seek an optimal treatment policy through Markov Decision Processes (MDPs). Relevant to the scope of this study, 61 publications were selected for detailed review. The majority of these publications (n = 56) focused on comparative analysis of two or more fixed treatment policies using Monte Carlo simulation. Classifications based on cancer site, utility measures and the type of sensitivity analysis are presented. Five publications considered MDPs with the aim of computing an optimal treatment policy; a detailed statement of the analysis and results is provided for each work. As an extension of Markov model-based simulation analysis, MDP offers a flexible framework to identify an optimal treatment policy among a possibly large set of treatment policies. However, the applications of MDPs to oncological decision-making have been understudied, and the full capacity of this framework to render complex optimal treatment decisions warrants further consideration.
PubMed: 38766899
DOI: 10.1111/1754-9485.13656 -
Food Research International (Ottawa,... Jul 2024Vitamins are responsible for providing biological properties to the human body; however, their instability under certain environmental conditions limits their... (Meta-Analysis)
Meta-Analysis Review
Vitamins are responsible for providing biological properties to the human body; however, their instability under certain environmental conditions limits their utilization in the food industry. The objective was to conduct a systematic review on the use of biopolymers and lipid bases in microencapsulation processes, assessing their impact on the stability, controlled release, and viability of fortified foods with microencapsulated vitamins. The literature search was conducted between the years 2013-2023, gathering information from databases such as Scopus, PubMed, Web of Science and publishers including Taylor & Francis, Elsevier, Springer and MDPI; a total of 49 articles were compiled The results were classified according to the microencapsulation method, considering the following information: core, coating material, solvent, formulation, process conditions, particle size, efficiency, yield, bioavailability, bioaccessibility, in vitro release, correlation coefficient and references. It has been evidenced that gums are the most frequently employed coatings in the protection of vitamins (14.04%), followed by alginate (10.53%), modified chitosan (9.65%), whey protein (8.77%), lipid bases (8.77%), chitosan (7.89%), modified starch (7.89%), starch (7.02%), gelatin (6.14%), maltodextrin (5.26%), zein (3.51%), pectin (2.63%) and other materials (7.89%). The factors influencing the release of vitamins include pH, modification of the coating material and crosslinking agents; additionally, it was determined that the most fitting mathematical model for release values is Weibull, followed by Zero Order, Higuchi and Korsmeyer-Peppas; finally, foods commonly fortified with microencapsulated vitamins were described, with yogurt, bakery products and gummy candies being notable examples.
Topics: Food, Fortified; Vitamins; Drug Compounding; Chitosan; Biological Availability; Humans; Biopolymers; Alginates; Whey Proteins
PubMed: 38763670
DOI: 10.1016/j.foodres.2024.114420 -
Journal of Bodywork and Movement... Apr 2024Low back pain is a painful disorder that prevents normal mobilization, increases muscle tension and whose first-line treatment is usually non-steroidal anti-inflammatory... (Review)
Review
Low back pain is a painful disorder that prevents normal mobilization, increases muscle tension and whose first-line treatment is usually non-steroidal anti-inflammatory drugs, together with non-invasive manual therapies, such as deep oscillation therapy. This systematic review aims to investigate and examine the scientific evidence of the effectiveness of deep oscillation therapy in reducing pain and clinical symptomatology in patients with low back pain, through the use of motion capture technology. To carry out this systematic review, the guidelines of the PRISMA guide were followed. A literature search was performed from 2013 to March 2022 in the PubMed, Elsevier, Science Director, Cochrane Library, and Springer Link databases to collect information on low back pain, deep oscillation, and motion capture. The risk of bias of the articles was assessed using the Cochrane risk of bias tool. Finally, they were included 16 articles and 5 clinical trials which met the eligibility criteria. These articles discussed the effectiveness of deep oscillation therapy in reducing pain, eliminating inflammation, and increasing lumbar range of motion, as well as analyzing the use of motion capture systems in the analysis, diagnosis, and evaluation of a patient with low back pain before, during and after medical treatment. There is no strong scientific evidence that demonstrates the high effectiveness of deep oscillation therapy in patients with low back pain, using motion capture systems. This review outlines the background for future research directed at the use of deep oscillation therapy as a treatment for other types of musculoskeletal injuries.
Topics: Humans; Low Back Pain; Range of Motion, Articular; Physical Therapy Modalities; Motion Capture
PubMed: 38763561
DOI: 10.1016/j.jbmt.2024.01.010 -
Clinical & Translational Oncology :... May 2024Treating aggressive superficial squamous cell carcinoma (SCC) poses challenges due to invasiveness. Palliative care is recommended for inoperable cases with extensive...
OBJECTIVE
Treating aggressive superficial squamous cell carcinoma (SCC) poses challenges due to invasiveness. Palliative care is recommended for inoperable cases with extensive tumors near vital organs, risking disfigurement or functional impairment. Electrochemotherapy (ECT) is an emerging cutaneous tumor treatment, but its efficacy against superficial SCC remains uncertain. This study conducts a systematic review and single-arm meta-analysis to evaluate ECT's effectiveness against superficial SCC and provide current evidence for clinical practice.
METHODS
Embase, PubMed and Cochrane Library were searched for studies up to May 2023. The random effects model analyzed complete response (CR) and partial response (PR), with subgroup assessment based on drug dosage, treatment response evaluation, tumor size, primary/recurrent status, and tumor location.
RESULTS
Ten studies involving 162 patients and 208 tumors were included. Pooled CR and PR rates for ECT-treated superficial SCC were 66.5% (95% CI 48.4%-82.5%; I = 84%) and 20.3% (95% CI 10.5%-32.3%; I = 70%), respectively. Subgroup analysis indicated ECT's superiority in treating primary tumors (PR: 70%, CR: 30%) and tumors ≤ 3 cm (PR: 81.3%, CR: 10.1%) compared to recurrent tumors (PR: 56.7%, CR: 36.5%) and tumors > 3 cm (PR: 45.2%, CR: 34.4%).
CONCLUSION
This single-arm meta-analysis confirms ECT's efficacy against superficial SCC, especially in primary tumors and those ≤ 3 cm in diameter. The study highlights the impact of tumor location and response evaluation on ECT's benefits, warranting further investigation through additional research.
PubMed: 38758386
DOI: 10.1007/s12094-024-03522-4 -
Hernia : the Journal of Hernias and... May 2024
PubMed: 38753063
DOI: 10.1007/s10029-024-03071-3