Handbook

手册
  • 文章类型: Journal Article
    大型语言模型(LLM)已经成为人工智能中的强大工具,在自然语言处理和生成方面表现出卓越的能力。在这篇文章中,我们探讨了LLM在加强心血管护理和研究方面的潜在应用。我们讨论了如何利用LLM来简化复杂的医疗信息,改善患者与医生的沟通,和自动化任务,如总结医学文章和提取关键信息。此外,我们强调了LLM在分类和分析非结构化数据中的作用,如医疗记录和测试结果,这可能会彻底改变心血管研究中的数据处理和解释。然而,我们还强调了与LLM相关的局限性和挑战,包括潜在的偏见,推理不透明,以及在医疗环境中进行严格验证的必要性。本文为心血管专业人员提供了实用指南,以了解和利用LLM的功能,同时了解其局限性。最后,我们讨论了LLM在改变心血管护理和研究方面的未来方向和意义。
    Large language models (LLMs) have emerged as powerful tools in artificial intelligence, demonstrating remarkable capabilities in natural language processing and generation. In this article, we explore the potential applications of LLMs in enhancing cardiovascular care and research. We discuss how LLMs can be used to simplify complex medical information, improve patient-physician communication, and automate tasks such as summarising medical articles and extracting key information. In addition, we highlight the role of LLMs in categorising and analysing unstructured data, such as medical notes and test results, which could revolutionise data handling and interpretation in cardiovascular research. However, we also emphasise the limitations and challenges associated with LLMs, including potential biases, reasoning opacity, and the need for rigourous validation in medical contexts. This review provides a practical guide for cardiovascular professionals to understand and harness the power of LLMs while navigating their limitations. We conclude by discussing the future directions and implications of LLMs in transforming cardiovascular care and research.
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  • 文章类型: Journal Article
    RNA-RNA相互作用(RRI)的计算预测是用于特异性研究非编码RNA(如真核微RNA或原核小RNA)的分子间RNA相互作用和调节作用的核心方法。可用的方法可以根据其基础预测策略进行分类,每个都暗示特定的能力和限制通常对非专家用户不透明。在这项工作中,我们回顾了七类RRI预测策略,并讨论了各自工具的优势和局限性,因为这些知识对于选择正确的工具至关重要。在RRI预测策略中,基于可达性的方法已被证明可以提供最可靠的预测。这里,我们描述了IntaRNA,作为最先进的基于可访问性的工具之一,可以应用于计算RRI预测任务的各种用例中。提供了各个RRI预测以及大规模目标预测场景的详细实践示例。我们通过实例说明了IntaRNA的灵活性和能力。每个实施例都是使用来自文献的真实数据设计的,并附有解释来自IntaRNA输出的相应结果的说明。我们的用例驱动指令使非专家用户能够全面理解和利用IntaRNA的功能进行有效的RRI预测。
    Computational prediction of RNA-RNA interactions (RRI) is a central methodology for the specific investigation of inter-molecular RNA interactions and regulatory effects of non-coding RNAs like eukaryotic microRNAs or prokaryotic small RNAs. Available methods can be classified according to their underlying prediction strategies, each implicating specific capabilities and restrictions often not transparent to the non-expert user. Within this work, we review seven classes of RRI prediction strategies and discuss the advantages and limitations of respective tools, since such knowledge is essential for selecting the right tool in the first place.Among the RRI prediction strategies, accessibility-based approaches have been shown to provide the most reliable predictions. Here, we describe how IntaRNA, as one of the state-of-the-art accessibility-based tools, can be applied in various use cases for the task of computational RRI prediction. Detailed hands-on examples for individual RRI predictions as well as large-scale target prediction scenarios are provided. We illustrate the flexibility and capabilities of IntaRNA through the examples. Each example is designed using real-life data from the literature and is accompanied by instructions on interpreting the respective results from IntaRNA output. Our use-case driven instructions enable non-expert users to comprehensively understand and utilize IntaRNA\'s features for effective RRI predictions.
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  • 文章类型: Journal Article
    尽管它们被列为许多慢性疾病的一线治疗,生活方式干预在医学教育中往往不被重视,并且未能将其纳入非生活方式医学培训的临床医生的目录.我们试图通过创建简洁的生活方式医学袖珍指南来解决医学教育中的这一差距,该指南适合在面对面的临床环境中使用。根据生活方式医学专家的意见,该指南是由医学生为医学生以及其他医疗保健专业人员创建的,用于各种临床环境。在本文中,我们分享了创建指南的过程,初始反馈,和未来的方向。
    Despite their inclusion as first-line therapy for many chronic diseases, lifestyle interventions are often de-emphasized in medical education and fail to make it into the repertoire of non-lifestyle medicine trained clinicians. We sought to address this gap in medical education by creating a concise pocket guide to lifestyle medicine that lends itself to use in the face-to-face clinical setting. With input from lifestyle medicine experts, the guide was created by medical students for medical students as well as other healthcare professionals for use in a variety of clinical settings. In this article we share our process of creating the guide, initial feedback, and future directions.
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  • 文章类型: Review
    背景:在过去的几十年里,患者报告结果(PRO)已被用于更好地了解患者的健康状况.因此,已经制定了许多PRO措施(问卷)和准则或指南。然而,从许多可用的指导中选择目标指导并理解所选择的指导是具有挑战性的。这项研究全面收集了现有的PRO临床试验或研究和实践指南,以支持学术界的新手PRO用户,工业,临床实践,以及监管和报销决策。
    方法:对于范围审查,我们搜索了MEDLINE,Embase,谷歌图书,WorldCat,以及2009年至2023年的国家医学图书馆(NLM)书架数据库。资格标准是临床试验的PRO指导,临床实践,或卫生技术评估等应用。这些指南涵盖了生活质量(QOL)、PRO,与健康相关的QOL,健康国家公用事业,心理测量要求,实施方法,分析和解释,或临床实践应用。经过系统的搜索,三名研究人员分别审查了收集的数据,审查的文章和书籍使用相同的标准进行审查。
    结果:我们收集了2009年至2023年之间在文章和书籍中发布的PRO指南。从数据库搜索,确定了1455篇文章和387本书,其中一本书和33篇文章最终被选中。收集的PRO指南被归类为采用PRO措施,使用PRO设计和报告试验或研究,在临床试验或研究或临床实践中实施PRO评估,PROs的分析和解释,和PRO评估的应用。基于这种分类,对于新手,我们建议如下:在选择指南时,新手应该澄清将使用指南的“地点”和“目的”。此外,他们应该知道,与PRO相关的术语以及PRO的范围和期望因“地点”和“目的”而异。
    结论:从对现有PRO指南的范围审查中,我们提供了摘要和警告,以帮助新手选择适合其目的的指南并理解它。
    BACKGROUND: Over the past few decades, patient-reported outcomes (PROs) have been used to understand patient health conditions better. Therefore, numerous PRO measures (questionnaires) and guidelines or guidance have been developed. However, it is challenging to select target guidance from among the many available guidance and to understand the chosen guidance. This study comprehensively collected the existing PRO guidance for clinical trials or studies and practices to support novice PRO users in academia, industry, clinical practice, and regulatory and reimbursement decision-making.
    METHODS: For the scoping review, we searched the MEDLINE, Embase, Google Books, WorldCat, and the National Library of Medicine (NLM) Bookshelf databases from 2009 to 2023. The eligibility criteria were PRO guidance for clinical trials, clinical practice, or application such as health technology assessment. Those guidance cover aspects such as quality of life (QOL), PRO, health-related QOL, health state utilities, psychometric requirements, implementation methods, analysis and interpretation, or clinical practice applications. After the systematic search, three researchers individually reviewed the collected data, and the reviewed articles and books were scrutinized using the same criteria.
    RESULTS: We collected the PRO guidance published in articles and books between 2009 and 2023. From the database searches, 1,455 articles and 387 books were identified, of which one book and 33 articles were finally selected. The collected PRO guidance was categorized into the adoption of PRO measures, design and reporting of trials or studies using PROs, implementation of PRO evaluation in clinical trials or studies or clinical practice, analysis and interpretation of PROs, and application of PRO evaluation. Based on this categorization, we suggest the following for novices: When selecting guidance, novices should clarify the \"place\" and \"purpose\" where the guidance will be used. Additionally, they should know that the terminology related to PRO and the scope and expectations of PROs vary by \"places\" and \"purposes\".
    CONCLUSIONS: From this scoping review of existing PRO guidance, we provided summaries and caveats to assist novices in selecting guidance that fits their purpose and understanding it.
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  • 文章类型: Journal Article
    未经证实:化脓性汗腺炎(HS)是一种慢性,复发性炎症性皮肤病的特点是严重的,痛性结节,脓肿,和瘘管,最常见于腋下的皮肤褶皱,腹股沟,臀肌,和肛周区域。这种疾病是许多研究人员感兴趣的,然而,患者的验证信息仍然有限。
    UNASSIGNED:评估患有痤疮的患者对痤疮的基线知识,以及评估作为手册的教育干预是否可以提高患者对其疾病的认识。
    UNASSIGNED:这项研究是对HSFacebook支持小组进行的横断面调查。受访者完成了一份匿名问卷,评估了他们对痤疮的知识状况。一个月后,他们收到了手册。此后,患者在阅读手册后完成了几乎相同的匿名问卷,以评估知识状况。
    UNASSIGNED:我们在教育干预前(A组)招募了102名参与者,在教育干预后(B组)招募了30名参与者。绝大多数参与者(83.3%)认为编写手册的想法是10分。在这两组中,了解疾病严重程度的受访者的结果明显优于未了解疾病严重程度的参与者.在广泛阅读手册后,与以前相比,更多的患者评估他们的一般HS知识状态为“良好”。
    UASSIGNED:我们的研究表明,患者对HS的了解仍然不足。手册等工具可能有助于传播专业知识并帮助患者了解自己的疾病。
    UNASSIGNED: Hidradenitis suppurativa (HS) is a chronic, recurrent inflammatory skin disease characterized by the occurrence of severe, painful nodules, abscesses, and fistulas, most commonly found in the skin folds of the axilla, groin, gluteal, and perianal areas. The disease is of interest to many researchers, however, verified information for patients is still limited.
    UNASSIGNED: To evaluate the baseline knowledge about acne inversa among patients suffering from the disease as well as to assess whether an educational intervention as a handbook can improve patients\' knowledge of their illness.
    UNASSIGNED: This research study was a cross-sectional survey conducted on HS Facebook support group. The respondents completed an anonymized questionnaire assessing their state of knowledge about acne inversa. After 1 month they were presented with a handbook. Thereafter the patients completed nearly the same anonymized questionnaire assessing the state of knowledge after reading the handbook.
    UNASSIGNED: We enrolled 102 participants before (group A) and 30 participants after (group B) the educational intervention. The vast majority of the participants (83.3%) appraised the idea of preparing a handbook as 10 points. In both groups, respondents who were aware of their disease severity had significantly superior results than the participants who were not. After reading the handbook extensively, more patients assessed the state of their general HS knowledge as \'good\' than before.
    UNASSIGNED: Our study demonstrated that knowledge about HS among patients is still insufficient. Tools such as handbooks may prove useful in disseminating expertise and helping patients to understand their disease.
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  • 文章类型: Journal Article
    UNASSIGNED:从一个临床轮换过渡到下一个临床轮换可能对试图与新的教师导师和新患者一起驾驭新的工作环境的骨科住院医师特别有压力。此质量改进(QI)项目的目的是确定是否可以通过使用手册在季度轮换过渡期内传播关键的轮换数据来改善居民压力。
    UNASSIGNED:居民创建了一本全面的电子手册,以以下方式描述我们骨科培训计划中的每个轮换:(1)教职员工联系数据,(2)每日门诊和手术时间表,(3)居民责任和教师期望,(4)关键资源和文件。在旋转过渡时,学术时间表中的一个会议专门供即将离任的居民更新手册并向即将到来的居民签名。实施手册前和手册后问卷,以评估居民对压力或焦虑的看法,准备,在开始新的轮换之前,还有信心。使用符号检验分析来自调查的非参数数据,对于双尾检验,选择p<0.05作为统计显著性水平。
    未经评估:大多数居民认为压力/焦虑有所改善,准备,和信心理解手册实施后的轮换预期。这三个结果参数的变化具有统计学意义。
    UASSIGNED:此轮换过渡QI计划由居民撰写,轮换专用电子手册和专门的口头签出会议通过减轻压力来增强居民健康,加强准备,并提高居民的信心,开始新的轮换。类似的在线资源可能对其他专业的学员有用。
    UNASSIGNED: Transitioning from one clinical rotation to the next may be particularly stressful for orthopaedic residents attempting to navigate new work environments with new faculty mentors and new patients. The purpose of this quality improvement (QI) project was to determine if resident stress could be improved by using a handbook to disseminate key rotation-specific data during quarterly rotation transition periods.
    UNASSIGNED: A comprehensive electronic handbook was created by residents to describe each rotation in our orthopaedic training program in terms of: (1) faculty and staff contact data, (2) daily clinic and surgery schedules, (3) resident responsibilities and faculty expectations, and (4) key resources and documents. At rotation transition, a session in the academic schedule was dedicated for outgoing residents to update the handbook and to sign-out to incoming residents. Pre- and post-handbook questionnaires were administered to assess resident perceptions of stress or anxiety, preparedness, and confidence before commencing the new rotation. Nonparametric data derived from the surveys were analyzed using the sign test choosing p < 0.05 for a two-tailed test as the level of statistical significance.
    UNASSIGNED: Most residents perceived improvements in stress/anxiety, preparedness, and confidence understanding rotation expectations after the handbook was implemented. Changes in these three outcome parameters were statistically significant.
    UNASSIGNED: This rotation transition QI initiative consisting of a resident-authored, rotation-specific electronic handbook and dedicated verbal sign-out session enhanced resident wellness by decreasing stress, increasing preparedness, and improving confidence among residents starting a new rotation. Similar online resources may be useful for trainees in other specialties.
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  • 文章类型: Published Erratum
    暂无摘要。
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  • 文章类型: Journal Article
    在最近对植物根系功能及其对环境的影响的研究大量增加的背景下,根系生态学家目前面临着许多重要的挑战,有意义的综合知识。近几十年来,人们一直呼吁在植物和生态系统研究中考虑地下组成部分,但是方法论是不同的,有时是不合适的。这本手册,基于一个庞大的专家团队的集体努力,通过提供标准化的方法和受控的词汇,将改善跨研究的特征比较和跨数据库的信息集成。它不仅被希望在地下生态系统中工作的学生和科学家用作起点,但也由专家巩固和扩大他们对根系生态学的多个方面的观点。除了测量协议的经典汇编之外,我们从文献中综合了一些建议,以提供有用的关键背景知识:(1)定义地下植物实体并为其有意义的解剖提供关键,分类和命名超越经典细根与粗根方法;(2)考虑根研究的特异性,以产生良好的实验室和现场数据;(3)描述典型的,但忽略了研究根的步骤(例如根处理,清理和存储);以及(4)收集解释结果及其重用所需的元数据。最重要的是,所有的根性状都引入了一定程度的生态环境,这将是理解其生态含义的基础,它们的典型用途和不确定性,以及未来研究的一些方法论和概念观点。考虑到这一切,我们敦促读者不要仅仅从这项工作中提取用于特征测量的协议建议,但花一点时间阅读和反思这份更广泛的根系生态学指南中包含的广泛信息,包括第I-VII节以及每个节的许多介绍和根性状描述。最后,重要的是要明白,本指南的主要目的是帮助打破根生态学和生态生理学的许多分支学科之间的障碍,扩大研究人员对根系研究的多个方面的看法,并为开始关于根系在植物和生态系统功能中的作用的综合实验创造有利条件。
    In the context of a recent massive increase in research on plant root functions and their impact on the environment, root ecologists currently face many important challenges to keep on generating cutting-edge, meaningful and integrated knowledge. Consideration of the below-ground components in plant and ecosystem studies has been consistently called for in recent decades, but methodology is disparate and sometimes inappropriate. This handbook, based on the collective effort of a large team of experts, will improve trait comparisons across studies and integration of information across databases by providing standardised methods and controlled vocabularies. It is meant to be used not only as starting point by students and scientists who desire working on below-ground ecosystems, but also by experts for consolidating and broadening their views on multiple aspects of root ecology. Beyond the classical compilation of measurement protocols, we have synthesised recommendations from the literature to provide key background knowledge useful for: (1) defining below-ground plant entities and giving keys for their meaningful dissection, classification and naming beyond the classical fine-root vs coarse-root approach; (2) considering the specificity of root research to produce sound laboratory and field data; (3) describing typical, but overlooked steps for studying roots (e.g. root handling, cleaning and storage); and (4) gathering metadata necessary for the interpretation of results and their reuse. Most importantly, all root traits have been introduced with some degree of ecological context that will be a foundation for understanding their ecological meaning, their typical use and uncertainties, and some methodological and conceptual perspectives for future research. Considering all of this, we urge readers not to solely extract protocol recommendations for trait measurements from this work, but to take a moment to read and reflect on the extensive information contained in this broader guide to root ecology, including sections I-VII and the many introductions to each section and root trait description. Finally, it is critical to understand that a major aim of this guide is to help break down barriers between the many subdisciplines of root ecology and ecophysiology, broaden researchers\' views on the multiple aspects of root study and create favourable conditions for the inception of comprehensive experiments on the role of roots in plant and ecosystem functioning.
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  • 文章类型: Journal Article
    BACKGROUND: Paediatric cardiology fellows, tasked with studying a large and dynamic field, may benefit from a quick-access digital resource that reflects contemporary practice. The objective of this study was to evaluate the effectiveness of a paediatric cardiology handbook smartphone app in enhancing the accessibility of information such as guidelines and recommendations for paediatric cardiology fellows.
    METHODS: The Peds Cardiology Handbook app (iOS) was designed using XCode and Swift programming. A pre-app survey and download instructions were sent to the US paediatric cardiology fellows, followed by a post-app survey. Fellows were asked to rate the ease of rapid access to various types of information. Responses were compared pre- and post-app using McNemar\'s test and Wilcoxon signed-rank test.
    RESULTS: Two-hundred and thirty paediatric cardiology fellows were contacted; 23% (n = 53) completed both the pre- and post-app surveys and were included for analysis. After using the app, fellows found it easier to quickly access information in eight out of nine domains evaluated (p < 0.05). All fellows found the app easy to use (100%), most felt that the app was well-organised (98%), contained reliable information (92%), and was useful for finding quick answers to clinical questions (87%).
    CONCLUSIONS: The Peds Cardiology Handbook iPhone app is a useful, reliable tool that provides quick access to high-yield information, including guidelines and references. Overall, paediatric cardiology fellows found it easier to rapidly access clinically relevant information after using the app. Future studies may be necessary to evaluate long-term use and impact on evidence-based practice.
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  • 文章类型: English Abstract
    In 1573, Georg Henisch published a short pharmaceutical handbook, Enchiridion medicinae, which contains remedies for individual health problems, without making any further comments on the effects and method of use. However, this manual had a predecessor which was published in Paris in 1571 without mentioning the author. The text of both editions is practically identical, there are only minimal differences, but the second edition has been expanded to a foreword and final sections with some recipes. A comparison of the work with contemporary medical literature revealed that Enchiridion medicinae is a compilation of three works by other authors, De materia medicinali et compositione medicamentorum by G. Rondelet from 1556, a commentary by the French author Sebastien Coquillat Scipio on Galen\'s work Quos, quibus, quando purgare oporteat from 1553 and the book Lilium medicinae by Bernard de Gordon from 1550. Henisch probably acquired this compilation from 1571 as a young student in France, added some passages by Rendelet and passages from two others books, wrote a foreword which he signed with his name and published in Basel in 1573.
    UNASSIGNED: Im Jahr 1573 veröffentlichte Georg Henisch ein pharmazeutisches Kurzhandbuch, Enchiridion medicinae. Es enthält Heilmittel gegen gesundheitliche Beschwerden, ohne weitere Angaben zur Wirkung oder die Art der Anwendung. Dieses Handbuch basiert auf einer Vorstufe, die 1571 in Paris ohne Angabe eines Autors veröffentlicht wurde. Der Text beider Ausgaben ist nahezu identisch. Die zweite Ausgabe ist um ein Vorwort und abschließende Abschnitte mit einigen Rezepten erweitert. Ein Vergleich dieser Arbeit mit der zeitgenössischen medizinischen Literatur ergibt, dass das Enchiridion medicinae eine Zusammenstellung dreier Werke anderer Autoren ist: De materia medicinali et compositione medicamentorum von Guillaume Rondelet aus dem Jahr 1556; ein Kommentar des französischen Autors Sebastien Coquillat Scipio zu Galens Werk Quos, quibus, quando purgare oporteat von 1553; und das Lilium medicinae von Bernard de Gordon von 1550. Vermutlich hat Henisch als junger Student in Frankreich diese Kompilation aus dem Jahr 1571 erworben. Er ergänzte ein wenig um Passagen von Rendelet, fügte weitere Passagen aus zwei anderen Büchern hinzu und verfasste ein Vorwort, das er mit seinem Namen unterschrieb. So veröffentliche er 1573 in Basel das Enchiridion medicinae.
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