Medicine

医学
  • 文章类型: Journal Article
    目的:颞下颌关节紊乱病(TMD)是用于描述咀嚼肌和颞下颌关节(TMJ)的病理(功能障碍和疼痛)的术语。牙科研究的出版有明显的上升趋势,需要不断提高研究质量。因此,本研究旨在分析TMD随机对照试验中样本量和效应量计算的使用.
    方法:期限限制为整整5年,即,2019年、2020年、2021年、2022年和2023年发表的论文。使用过滤器文章类型-“随机对照试验”。这些研究以两级量表进行分级:0-1。在1的情况下,计算样本量(SS)和效应量(ES)。
    结果:在整个研究样本中,58%的研究中使用了SS,而15%的研究使用ES。
    结论:质量应该随着研究的增加而提高。影响质量的一个因素是统计水平。SS和ES计算为理解作者获得的结果提供了基础。访问公式,在线计算器和软件促进了这些分析。高质量的试验为医学进步提供了坚实的基础,促进个性化疗法的发展,提供更精确和有效的治疗,增加患者康复的机会。提高TMD研究的质量,和一般的医学研究,有助于增加公众对医疗进步的信心,并提高病人护理的标准。
    OBJECTIVE: Temporomandibular disorder (TMD) is the term used to describe a pathology (dysfunction and pain) in the masticatory muscles and temporomandibular joint (TMJ). There is an apparent upward trend in the publication of dental research and a need to continually improve the quality of research. Therefore, this study was conducted to analyse the use of sample size and effect size calculations in a TMD randomised controlled trial.
    METHODS: The period was restricted to the full 5 years, i.e., papers published in 2019, 2020, 2021, 2022, and 2023. The filter article type-\"Randomized Controlled Trial\" was used. The studies were graded on a two-level scale: 0-1. In the case of 1, sample size (SS) and effect size (ES) were calculated.
    RESULTS: In the entire study sample, SS was used in 58% of studies, while ES was used in 15% of studies.
    CONCLUSIONS: Quality should improve as research increases. One factor that influences quality is the level of statistics. SS and ES calculations provide a basis for understanding the results obtained by the authors. Access to formulas, online calculators and software facilitates these analyses. High-quality trials provide a solid foundation for medical progress, fostering the development of personalized therapies that provide more precise and effective treatment and increase patients\' chances of recovery. Improving the quality of TMD research, and medical research in general, helps to increase public confidence in medical advances and raises the standard of patient care.
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  • 文章类型: Journal Article
    脑机接口(BCI)实现了大脑与计算机或其他外部设备之间的直接通信。它们可以通过加强或替代人的外围工作能力来扩展人的自由度。此外,它们在医学领域的潜在临床应用包括康复,情感计算,通信,和控制。在过去的十年里,诸如脑电图(EEG)之类的无创BCI系统已经从简单的统计模型发展到深度学习模型,随着时间的推移,性能提高,计算能力增强。然而,与BCI系统的临床使用有关的许多挑战仍然存在,例如,缺乏足够的数据来学习更多可能的特征以进行稳健和可靠的分类。然而,与计算机视觉和语音识别等领域相比,医学BCI领域的训练样本是有限的,因为它们针对的是与健康对照相比难以生成EEG数据的患者。因为深度学习模型包含几个参数,它们比其他传统方法需要更多的数据。因此,深度学习模型尚未在医学BCI中得到彻底利用。本研究总结了BCI系统在过去十年中的最新进展,强调关键挑战和解决方案。
    Brain-computer interfaces (BCI) enable direct communication between the brain and a computer or other external devices. They can extend a person\'s degree of freedom by either strengthening or substituting the human peripheral working capacity. Moreover, their potential clinical applications in medical fields include rehabilitation, affective computing, communication, and control. Over the last decade, noninvasive BCI systems such as electroencephalogram (EEG) have progressed from simple statistical models to deep learning models, with performance improvement over time and enhanced computational power. However, numerous challenges pertaining to the clinical use of BCI systems remain, e.g., the lack of sufficient data to learn more possible features for robust and reliable classification. However, compared with fields such as computer vision and speech recognition, the training samples in the medical BCI field are limited as they target patients who face difficulty generating EEG data compared with healthy control. Because deep learning models incorporate several parameters, they require considerably more data than other conventional methods. Thus, deep learning models have not been thoroughly leveraged in medical BCI. This study summarizes the state-of-the-art progress of the BCI system over the last decade, highlighting critical challenges and solutions.
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  • 文章类型: Journal Article
    牙槽骨移植(ABG)在牙槽增强中的应用是为了防止由于拔牙而导致的过度骨吸收,缺失的牙齿,或影响牙槽骨的其他疾病/状况。已经认为使用自体牙本质衍生的ABG,因为牙本质的组成似乎与骨的组成几乎相似。
    本系统综述旨在通过评估体积增加和组织形态学数据来评估牙本质衍生的ABG对拔牙后牙槽腔或其他牙槽骨缺损的牙槽增强的功效。
    在Pubmed,Scopus,WebofScience,和Embase从数据库开始到2023年10月。该综述包括两项随机对照试验(RCT),试点研究,临床试验,和回顾性研究报告牙本质衍生的ABG用于肺泡扩张。
    总的来说,最初检索获得298篇文章。从这些文章中,21篇文章符合纳入标准,纳入进行描述性分析。所有研究都表明偏倚风险较低。牙本质衍生的ABG的研究,使用骨源性移植物作为对照组,已经显示出明显更高的新骨形成百分比,垂直和水平维度的增益,尺寸减少。
    牙本质衍生的ABG在容量维持方面有效,通过组织形态学和影像学分析表明有希望的结果。
    UNASSIGNED: Application of alveolar bone graft (ABG) in alveolar augmentation is done to prevent excessive bone resorption due to tooth extraction, missing teeth, or other diseases/conditions affecting the alveolar bone. The use of autogenous dentin-derived ABG has been considered as the composition of dentin appears to be nearly analogous to that of bone.
    UNASSIGNED: This systematic review aims to assess the efficacy of dentin-derived ABG for alveolar augmentation of post-extraction sockets or other alveolar bone defects by evaluating volume gain and histomorphometric data.
    UNASSIGNED: A search of systematic literature was conducted in Pubmed, Scopus, Web of Science, and Embase from database inception to October 2023. The review included both randomized controlled trials (RCT), pilot studies, clinical trials, and retrospective studies reporting on dentin-derived ABG use for alveolar augmentation.
    UNASSIGNED: Overall, 298 articles were obtained from the initial search. From these articles, 21 articles met the inclusion criteria and were included for descriptive analysis. All of the studies indicated low risk of bias. Studies of dentin-derived ABG, which used bone-derived grafts as the control group, have shown significantly higher percentages of new bone formation, gain in vertical and horizontal dimensions, and less reduction in dimensions.
    UNASSIGNED: Dentin-derived ABG was effective in volume maintenance, indicating promising results via histomorphometric and radiographic analysis.
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  • 文章类型: Systematic Review
    认知和运动障碍在中风幸存者中很常见。物理疗法通常用于改善中风幸存者的功能能力。然而,有限地坚持康复计划是一个挑战。动机在康复计划的成功中起着至关重要的作用,因为它影响个人对治疗的依从性和整体健康结果。这篇综述旨在确定医疗保健专业人员用于中风幸存者康复的动机策略的当前趋势。
    遵循Arksey和O\'Malley开发的框架,进行了范围审查。我们使用MEDLINE进行了文献检索,CINAHL,Cochrane中央受控试验登记册,护理与联合健康,和MedicLatina数据库。
    共鉴定出906篇论文。在选择和分析文章之后,这篇综述包括17篇论文。卫生专业人员使用各种策略来激励中风幸存者。这些方法包括建立治疗联盟,提高患者的健康素养,定义现实的目标,培养解决问题的能力,个性化康复计划,展示成功的故事,利用有说服力的技术,提供鼓励和赞美,提供情感支持,有效控制症状。
    本综述收集的知识可以指导医疗保健专业人员帮助患者克服康复障碍,提高他们的动机,并最终提高他们的恢复结果。
    UNASSIGNED: Cognitive and motor impairments are common among stroke survivors. Physical therapy is often used to improve the functional capacity of stroke survivors. However, limited adherence to rehabilitation programs is a challenge. Motivation plays a crucial role in the success of rehabilitation programs as it influences individual adherence to treatment and overall health outcomes. This review aims to identify current trends in motivational strategies used by healthcare professionals for stroke survivor rehabilitation.
    UNASSIGNED: Following the framework developed by Arksey and O\'Malley, a scoping review was conducted. We performed a literature search using MEDLINE, CINAHL, the Cochrane Central Register of Controlled Trials, Nursing & Allied Health, and MedicLatina databases.
    UNASSIGNED: A total of 906 papers were identified. After selecting and analyzing the articles, 17 papers were included in this review. Health professionals use various strategies to motivate stroke survivors. These approaches include establishing a therapeutic alliance, improving patients\' health literacy, defining realistic goals, fostering problem-solving skills, personalizing the rehabilitation program, showcasing success stories, utilizing persuasive techniques, offering encouragement and compliments, providing emotional support, and effectively managing symptoms.
    UNASSIGNED: The knowledge gathered in this review can guide healthcare professionals in helping patients overcome barriers to rehabilitation, improve their motivation, and ultimately enhance their recovery outcomes.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    虚拟现实(VR)是一种新兴的方法,可用于许多涉及儿童的场景。VR的研究越来越多,因为它变得越来越便宜。更广泛的可用,和更好的质量。在这篇关于医疗环境中儿童使用VR的荟萃分析的综述中,我们研究了它在5种广泛的环境中的作用,在这些环境中,它被用于缓解疼痛和焦虑,以及在治疗方案中的作用.研究范围有目的地广泛,以突出广泛的病例。我们搜索了ScienceDirect,SpringerLink,科克伦图书馆,PubMed,和PMC数据库,用于医疗环境中儿科人群使用VR进行荟萃分析。使用美国国立卫生研究院质量评估工具和Meta分析报告质量报告清单来验证研究质量。检索到六百五十三篇文章;在应用纳入和排除标准后,11仍然这些荟萃分析包括脑瘫(4个荟萃分析),注意缺陷/多动障碍(2个荟萃分析),烧伤护理(1个荟萃分析),术前焦虑(2个荟萃分析),和涉及针头的程序(2个荟萃分析)。荟萃分析显示出广泛的积极结果,VR在其应用领域非常有用。这项研究有几个局限性。荟萃分析一致强调了高度的异质性,很难得出明确的结论。所有领域的大多数荟萃分析都产生了令人鼓舞的结果。然而,需要进一步的研究来证实这些发现。必须为将来的实验制定指南,以提供标准和统一的程序来减少实验方法的异质性。
    Virtual reality (VR) is an emerging method that can be used in many scenarios involving children. VR has been increasingly studied as it has become cheaper, more widely available, and of better quality. In this review of current meta-analyses on the use of VR in children in the medical setting, we examined its role in 5 broad settings where it is used to alleviate pain and anxiety as well as in therapeutic scenarios. The study scope was purposefully broad to highlight a wide range of cases. We searched the ScienceDirect, SpringerLink, Cochrane Library, PubMed, and PMC databases for meta-analyses using VR in pediatric populations in medical settings. The National Institutes of Health quality assessment tool and Quality of Reporting of Meta-analyses statement checklist were used to verify study quality. Six hundred fifty-three articles were retrieved; after the application of the inclusion and exclusion criteria, 11 remained. These meta-analyses included cerebral palsy (4 meta-analyses), attention deficit/hyperactivity disorder (2 meta-analyses), burn care (1 meta-analysis), preoperative anxiety (2 meta-analyses), and needle-involving procedures (2 meta-analyses). The meta-analyses showed broadly positive results, with VR being useful in the areas in which it was applied. This study had several limitations. The meta-analyses consistently highlighted a high level of heterogeneity, making it challenging to draw clear conclusions. Most meta-analyses across all fields yielded encouraging results. However, further studies are required to confirm these findings. Guidelines must be established for future experiments to provide a standard and uniform procedure for reducing the heterogeneity of experimental methods.
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  • 文章类型: Journal Article
    ChatGPT在医疗领域具有广泛的应用。因此,这篇综述旨在根据ChatGPT在医学中的应用来定义关键问题并提供文献的全面视图。
    这个范围遵循Arksey和O\'Malley的五阶段框架。对出版物进行了全面的文献检索(2022年11月30日至2023年8月16日)。检索了六个数据库,并系统地编目了相关参考文献。注意力集中在文章的一般特征上,他们的应用领域,以及使用ChatGPT的优缺点。采用描述性统计和叙事综合法进行数据分析。
    在3426项研究中,247符合纳入本审查的标准。大多数文章(31.17%)来自美国。社论(43.32%)排名第一,其次是实验研究(11.74%)。ChatGPT在医学上的潜在应用是多种多样的,探索临床实践的研究数量最多(45.75%),包括协助临床决策支持和提供疾病信息和医疗建议。其次是医学教育(27.13%)和科学研究(16.19%)。在学科统计中特别值得注意的是放射学,手术和牙科在列表的顶部。然而,ChatGPT在医学上也面临着数据隐私的问题,不准确和抄袭。
    ChatGPT在医学中的应用侧重于不同的学科和一般的应用场景。ChatGPT具有自相矛盾的性质:它提供了显着的优势,但同时也引起了人们对其在医疗保健环境中的应用的极大关注。因此,必须制定理论框架,不仅解决其在医疗保健中的广泛使用,而且促进全面评估。此外,这些框架应有助于制定严格有效的准则和监管措施。
    UNASSIGNED: ChatGPT has a wide range of applications in the medical field. Therefore, this review aims to define the key issues and provide a comprehensive view of the literature based on the application of ChatGPT in medicine.
    UNASSIGNED: This scope follows Arksey and O\'Malley\'s five-stage framework. A comprehensive literature search of publications (30 November 2022 to 16 August 2023) was conducted. Six databases were searched and relevant references were systematically catalogued. Attention was focused on the general characteristics of the articles, their fields of application, and the advantages and disadvantages of using ChatGPT. Descriptive statistics and narrative synthesis methods were used for data analysis.
    UNASSIGNED: Of the 3426 studies, 247 met the criteria for inclusion in this review. The majority of articles (31.17%) were from the United States. Editorials (43.32%) ranked first, followed by experimental studys (11.74%). The potential applications of ChatGPT in medicine are varied, with the largest number of studies (45.75%) exploring clinical practice, including assisting with clinical decision support and providing disease information and medical advice. This was followed by medical education (27.13%) and scientific research (16.19%). Particularly noteworthy in the discipline statistics were radiology, surgery and dentistry at the top of the list. However, ChatGPT in medicine also faces issues of data privacy, inaccuracy and plagiarism.
    UNASSIGNED: The application of ChatGPT in medicine focuses on different disciplines and general application scenarios. ChatGPT has a paradoxical nature: it offers significant advantages, but at the same time raises great concerns about its application in healthcare settings. Therefore, it is imperative to develop theoretical frameworks that not only address its widespread use in healthcare but also facilitate a comprehensive assessment. In addition, these frameworks should contribute to the development of strict and effective guidelines and regulatory measures.
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  • 文章类型: Journal Article
    在微米和纳米尺度上雕刻硅一直在改变游戏规则,以塑造块状硅的特性并扩展,反过来,硅的应用超越电子,即,在光子学中,传感,医学,和机械师,举几个。电压和金属辅助化学蚀刻(ECE和MaCE,由于其独特的蚀刻特征,酸性电解质中的硅已经超过其他微米和纳米结构技术。ECE和MaCE实现了无法实现的新型结构和器件的制造,用深度反应离子蚀刻(DRIE)技术补充那些可行的技术,在硅加工的黄金标准。这里,提供了对硅微纳米加工的ECE和MaCE的全面审查。剖析了决定硅溶解的化学和物理学,并讨论了ECE和MaCE之间的异同,表明它们是同一枚硬币的两面。分析了控制设计的硅微米和纳米结构的各向异性蚀刻的过程,并讨论了蚀刻轮廓对深度的调制。用定制的光学制备微米和纳米结构,机械,然后解决了热(电)特性,以及它们在光子学中的应用,(生物)传感,(纳米)医学,和微机械系统进行了调查。最终,ECE和MaCE以DRIE为基准,并强调了未来的前景。
    Sculpting silicon at the micro and nano scales has been game-changing to mold bulk silicon properties and expand, in turn, applications of silicon beyond electronics, namely, in photonics, sensing, medicine, and mechanics, to cite a few. Voltage- and metal-assisted chemical etching (ECE and MaCE, respectively) of silicon in acidic electrolytes have emerged over other micro and nanostructuring technologies thanks to their unique etching features. ECE and MaCE have enabled the fabrication of novel structures and devices not achievable otherwise, complementing those feasible with the deep reactive ion etching (DRIE) technology, the gold standard in silicon machining. Here, a comprehensive review of ECE and MaCE for silicon micro and nano machining is provided. The chemistry and physics ruling the dissolution of silicon are dissected and similarities and differences between ECE and MaCE are discussed showing that they are the two sides of the same coin. The processes governing the anisotropic etching of designed silicon micro and nanostructures are analyzed, and the modulation of etching profile over depth is discussed. The preparation of micro- and nanostructures with tailored optical, mechanical, and thermo(electrical) properties is then addressed, and their applications in photonics, (bio)sensing, (nano)medicine, and micromechanical systems are surveyed. Eventually, ECE and MaCE are benchmarked against DRIE, and future perspectives are highlighted.
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  • 文章类型: English Abstract
    该评论考虑了将著名的法国外科医生A.Paré置于十六世纪欧洲文艺复兴的更一般的欧洲背景下以及这一时期巴黎知识生活的当地背景下的方法。讨论了关于中世纪欧洲严格将大学医学与工匠手术分开的医学史上广泛存在的驳斥。
    The review considers the approach placing famous French surgeon A. Paré into more general European context of European Renaissance of XVI century and into local context of intellectual life of Paris of this period. The refutation of widespread in history of medicine opinion about strict separation of university medicine from artisan surgery in Medieval Europe is discussed.
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  • 文章类型: Journal Article
    背景:摘要综述是医学系统和范围界定文献综述中的一个耗时且费力的步骤。文本挖掘方法,通常是自然语言处理(NLP),可以有效地取代手动抽象筛选。本研究将NLP应用于一个刻意选择的文献综述问题,在医学研究中使用NLP的趋势,来演示这种自动抽象评论模型的性能。
    方法:扫描PubMed,Embase,PsycINFO,和CINAHL数据库,我们确定了22,294,最终选择了2000年至2021年之间发表的12,817份英文摘要.我们发明了医学领域的手动分类,三个变量,即,使用上下文(COU),文本源(TS),和主要研究领域(PRF)。在审查了485篇摘要后,开发了一个训练数据集。我们使用了一种称为“来自变形金刚的双向编码器表示”的语言模型来对摘要进行分类。要评估训练模型的性能,我们报告微f1评分和准确性。
    结果:用于分类摘要的训练模型\'microf1-score,分为三个变量,COU为77.35%,TS为76.24%,PRF为85.64%。在2000年至2020年之间,出版物的平均年增长率(AAGR)为20.99%(每年增加72.01篇(95%CI:56.80-78.30)),81.76%的摘要在2010年至2020年之间发表。对肿瘤的研究占整个语料库的27.66%,AAGR为42.41%,其次是关于精神状况的研究(AAGR=39.28%)。虽然电子健康或医疗记录占文本来源的比例最高(57.12%),在所有文本来源中,组学数据库的增长率最高,AAGR为65.08%.最常见的NLP应用是临床决策支持(25.45%)。
    结论:BioBERT在摘要综述中显示出可接受的表现。如果未来的研究表明这种语言模型的高性能,它可以可靠地替代手动摘要评论。
    BACKGROUND: Abstract review is a time and labor-consuming step in the systematic and scoping literature review in medicine. Text mining methods, typically natural language processing (NLP), may efficiently replace manual abstract screening. This study applies NLP to a deliberately selected literature review problem, the trend of using NLP in medical research, to demonstrate the performance of this automated abstract review model.
    METHODS: Scanning PubMed, Embase, PsycINFO, and CINAHL databases, we identified 22,294 with a final selection of 12,817 English abstracts published between 2000 and 2021. We invented a manual classification of medical fields, three variables, i.e., the context of use (COU), text source (TS), and primary research field (PRF). A training dataset was developed after reviewing 485 abstracts. We used a language model called Bidirectional Encoder Representations from Transformers to classify the abstracts. To evaluate the performance of the trained models, we report a micro f1-score and accuracy.
    RESULTS: The trained models\' micro f1-score for classifying abstracts, into three variables were 77.35% for COU, 76.24% for TS, and 85.64% for PRF. The average annual growth rate (AAGR) of the publications was 20.99% between 2000 and 2020 (72.01 articles (95% CI: 56.80-78.30) yearly increase), with 81.76% of the abstracts published between 2010 and 2020. Studies on neoplasms constituted 27.66% of the entire corpus with an AAGR of 42.41%, followed by studies on mental conditions (AAGR = 39.28%). While electronic health or medical records comprised the highest proportion of text sources (57.12%), omics databases had the highest growth among all text sources with an AAGR of 65.08%. The most common NLP application was clinical decision support (25.45%).
    CONCLUSIONS: BioBERT showed an acceptable performance in the abstract review. If future research shows the high performance of this language model, it can reliably replace manual abstract reviews.
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