This essay questions, with regard to medicine, the idea of progress as technological development by focusing on people rather than things. It analyzes how the predominance of such an idea of progress converts today\'s societies to techno-fetishism that degrades community life and medical practice, contributing to the medicalization of social life. It is argued that the realization of technological potentialities depends on their forms of use; that the main motive of technological development is unlimited profit and that priority developments are those that enhance the social control that maintains the status quo. The intelligence as an intelligence quotient is criticized by proposing it as an attribute of the human being as a whole, manifested in the ways of thinking and proceeding of people in their circumstances, where affectivity and critical thinking are essential for their development; it is emphasized that its antecedent is the harmonic concert of planetary life that contrasts with the prevailing human disharmony. It is proposed that artificial intelligence is the most recent creation of techno-fetishism that deposits vital attributes in technology and that its forms of use will accentuate the degradation of human and planetary life. Another idea of medical progress is proposed, based on forms of organization conducive to the development of inquisitive, critical and collaborative skills that promote permanent improvement, whose distant horizon is dignifying progress: spiritual, intellectual, moral and convivial sublimation of collectivities in harmony with the planetary ecosystem.
Este ensayo cuestiona, a propósito de la medicina, la idea de progreso como desarrollo tecnológico al centrarlo en las personas y no en las cosas. Se analiza cómo el predominio de tal idea de progreso convierte a las sociedades actuales al tecno-fetichismo que degrada la vida comunitaria y la práctica médica contribuyendo a la medicalización de la vida social. Se argumenta que la realización de las potencialidades tecnológicas depende de sus formas de uso, que el móvil principal del desarrollo tecnológico es el lucro sin límites, y que los desarrollos prioritarios son los que potencian el control social que mantiene el statu quo. Se critica la idea de inteligencia como cociente intelectual al proponerla como atributo del ser humano como un todo, manifiesto en las formas pensar y proceder de las personas en sus circunstancias, donde la afectividad y el pensamiento crítico son imprescindibles para su desarrollo. Se destaca que su antecedente es el concierto armónico de la vida planetaria contrastante con la disarmonía humana imperante. Se plantea que la inteligencia artificial es la más reciente hechura del tecno-fetichismo que deposita en la tecnología atributos vitales, y que sus formas de uso acentuarán la degradación de la vida humana y planetaria. Se propone otra idea de progreso médico basado en formas de organización propicias para el desarrollo de aptitudes inquisitivas, críticas y colaborativas que impulsen la superación permanente, cuyo horizonte lejano es el progreso dignificante: sublimación espiritual, intelectual, moral y convivencial de las colectividades en armonía con el ecosistema planetario.

The generative artificial intelligence (AI) model ChatGPT holds transformative prospects in medicine. The development of such models has signaled the beginning of a new era where complex biological data can be made more accessible and interpretable. ChatGPT is a natural language processing tool that can process, interpret, and summarize vast data sets. It can serve as a digital assistant for physicians and researchers, aiding in integrating medical imaging data with other multiomics data and facilitating the understanding of complex biological systems. The physician\'s and AI\'s viewpoints emphasize the value of such AI models in medicine, providing tangible examples of how this could enhance patient care. The editorial also discusses the rise of generative AI, highlighting its substantial impact in democratizing AI applications for modern medicine. While AI may not supersede health care professionals, practitioners incorporating AI into their practices could potentially have a competitive edge.

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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.

BACKGROUND: This study aimed to characterize dentistry, medicine and pharmacy students in terms of emotional intelligence (EI) and personality traits (PTs). It also sought to identify whether differences existed according to gender and degree program and the relationship between them.
METHODS: Students enrolled in dentistry (115), medicine (85) and pharmacy (57) degree programs participated voluntarily in the research, including 59 men and 198 women. The following questionnaires were used: (1) the Trait Meta-Mood Scale (TMMS-24) to evaluate EI; (2) the NEO Five-Factor Inventory (NEO-FFI) to assess PT. The Qualtrics XM platform was used for data collection.
RESULTS: There were no statistically significant differences between three components of EI, either according to gender or degree program. The only difference in PTs was found in neuroticism, where women scored higher than men. There were statistically significant differences between students on different degree programs in openness to experience and responsibility. The five PTs correlated significantly with the three components of EI, except responsibility and emotional attention. The strongest associations were found between neuroticism and emotional repair (-0.439).
CONCLUSIONS: High percentages of the student population were observed to have weaknesses in emotional clarity and emotional repair. Neuroticism is a personality trait that seems to occur more frequently in women.

Physical inactivity represents a global challenge in public health, being the second most significant factor contributing to mortality. In Latin America, the prevalence of physical inactivity and sedentary behaviour is notable, affecting medical students as well, who play a crucial role as behavioural role models for the population. This study addresses the prevalence of physical activity and sedentary behaviour among medical students in Latin America during the year 2023. A total of 864 participants from 12 institutions across eight countries were surveyed using the Global Physical Activity Questionnaire. Significant variations in physical activity and sedentary behaviour were observed according to sex, age, body mass index, academic year, and country. Notably, Costa Rica exhibited the highest levels of moderate physical activity in leisure time (90 min/day). Strength training was more common among men (60 min/day) and in Argentina (60 min/day). Sedentary behaviour was higher in women (420 min/day) and during the first academic year (485 min/day). Uruguay stood out with high levels of sedentary behaviour (600 min/day). Correlations indicated positive moderate associations between academic year and moderate leisure-time PA (r:0,128, p:0,007). In conclusion, there are associations between the level of physical activity and sedentary behaviour with the variables studied in this research, with the main findings being that the female sex has more time spent in sedentary behaviour (minutes/day) and less time spent in strength training (minutes/day). Additionally, there are higher levels of sedentary behaviour in the early years of medical study compared to the later years of the program.

Background Contemporary medical education emphasizes that postgraduate clinicians should look at their daily experiences as an opportunity to learn and advance their knowledge and practice of medicine. This is the concept of reflective practice. Internal medicine trainees (IMT) in the UK are encouraged to record written reflections in their electronic portfolios but it is not a mandatory requirement. There is literature suggesting that the level of engagement with these written reflections is varied and that when these are produced, they can be superficial. Thus, the aim of this research was to ascertain what percentage of trainees engaged in written reflections and the factors that affected the likelihood they would reflect. There are no studies that have attempted to quantify de novo engagement with reflective practice and to quantify the significance of different theorized barriers to reflection. Methods This study was in the form of a quasi-experimental cross-sectional study. A 15-item survey was sent out to the IMT in the northwest deanery of England (n=592). The survey remained open for approximately three months with periodic reminders sent out to the trainees. The survey was closed to further responses when the number of responses reached the predetermined sample size of 240 (5% margin of error at a confidence interval of 95%). The data were analyzed by chi-square testing and represented using descriptive statistics. Results There were 243 responses to this survey. A total of 81.5% (n=198) wrote reflections in their portfolio and 19.5% (n=45) did not write any reflections. The main content of written reflections were clinical outcomes (positive and negative), teaching, and new learning. Several background factors had a statistically significant influence on the likelihood that trainees would write reflections in their portfolios. These included their stage of training, years practicing medicine, location of primary medical training, first exposure to reflective practice, and whether they have ever been tutored on reflection. Concerns about legal or General Medical Council (GMC) use of reflective notes against trainees also significantly impacted on reflection. The main perceived barriers to written reflections were the fact that trainees felt they had no time to properly reflect and the lack of perceived benefits from reflections. Conclusion Most trainees wrote reflections in their portfolios, but the majority did not perceive any benefits in doing this. The varied backgrounds of trainees seem to have an impact on their likelihood to reflect and strategies to increase engagement would need to address this.

UNASSIGNED: Preterm birth is the leading cause of neonatal morbidity and mortality worldwide. Most cases of preterm birth occur spontaneously and result from preterm labor with intact (spontaneous preterm labor [sPTL]) or ruptured (preterm prelabor rupture of membranes [PPROM]) membranes. The prediction of spontaneous preterm birth (sPTB) remains underpowered due to its syndromic nature and the dearth of independent analyses of the vaginal host immune response. Thus, we conducted the largest longitudinal investigation targeting vaginal immune mediators, referred to herein as the immunoproteome, in a population at high risk for sPTB.
UNASSIGNED: Vaginal swabs were collected across gestation from pregnant women who ultimately underwent term birth, sPTL, or PPROM. Cytokines, chemokines, growth factors, and antimicrobial peptides in the samples were quantified via specific and sensitive immunoassays. Predictive models were constructed from immune mediator concentrations.
UNASSIGNED: Throughout uncomplicated gestation, the vaginal immunoproteome harbors a cytokine network with a homeostatic profile. Yet, the vaginal immunoproteome is skewed toward a pro-inflammatory state in pregnant women who ultimately experience sPTL and PPROM. Such an inflammatory profile includes increased monocyte chemoattractants, cytokines indicative of macrophage and T-cell activation, and reduced antimicrobial proteins/peptides. The vaginal immunoproteome has improved predictive value over maternal characteristics alone for identifying women at risk for early (<34 weeks) sPTB.
UNASSIGNED: The vaginal immunoproteome undergoes homeostatic changes throughout gestation and deviations from this shift are associated with sPTB. Furthermore, the vaginal immunoproteome can be leveraged as a potential biomarker for early sPTB, a subset of sPTB associated with extremely adverse neonatal outcomes.
UNASSIGNED: This research was conducted by the Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS) under contract HHSN275201300006C. ALT, KRT, and NGL were supported by the Wayne State University Perinatal Initiative in Maternal, Perinatal and Child Health.
Human pregnancies last 40 weeks on average. Preterm births, defined as live births before 37 weeks, occur in about one in ten pregnancies. Being born too early is the main cause of a number of diseases and death in newborn babies. Preterm births are further divided into those that happen early – before 34 weeks – and those that happen late – between 34 and 37 weeks. There are also differences between preterm births in which the amniotic sac ruptures before or after the start of labor. Although several factors can lead to spontaneous preterm birth, bacteria getting into the amniotic fluid around the fetus are a well-known trigger. These bacteria usually come from the vagina. In the past, researchers have studied the number and types of bacteria in the vagina of people who had a normal pregnancy and those that had a preterm birth to predict who is more at risk of preterm birth. However, predictions based only on data about bacteria have been less useful so far. Instead, it might be better to investigate a person’s immune response during pregnancy. Shaffer et al. addressed this gap by asking whether measuring the levels of proteins involved in the immune response could help predict preterm births. Shaffer et al. collected vaginal fluids from 739 individuals of predominately African American ethnicity with an average BMI of 28.7 – representing a population at high risk for spontaneous preterm birth. The swabs were taken at multiple points during their pregnancy, and 31 different immune-related proteins in those fluids were measured. The researchers further noted whether these individuals had a normal or a preterm birth. The data showed that, compared to normal births, preterm births are associated with higher levels of proteins that attract white blood cells and promote inflammation, such as IL-6 and IL-1β. Vaginal fluids from individuals who went on to have an early preterm birth where the amniotic sac ruptured before labor, contained lower levels of proteins known as defensins, which defend the body from bacteria. With these new data from vaginal swabs, Shaffer et al. could make better predictions about the likelihood of preterm birth in general and early preterm birth with the amniotic sac ruptured before labor. For the latter scenario, the predictions were not improved when combining immune protein data with other characteristics of the pregnant person, such as age. These findings suggest that clinicians may be able to use measurements of immune-related proteins to help predict preterm births, so that pregnant individuals at high risk can receive extra care. Further research will have to validate the data and determine whether the findings apply more widely.

Proteases, enzymes that hydrolyze peptide bonds, have various applications in medicine, clinical applications, and pharmaceutical development. They are used in cancer treatment, wound debridement, contact lens cleaning, prion degradation, biofilm removal, and fibrinolytic agents. Proteases are also crucial in cardiovascular disease treatment, emphasizing the need for safe, affordable, and effective fibrinolytic drugs. Proteolytic enzymes and protease biosensors are increasingly used in diagnostic and therapeutic applications. Advanced technologies, such as nanomaterials-based sensors, are being developed to enhance the sensitivity, specificity, and versatility of protease biosensors. These biosensors are becoming effective tools for disease detection due to their precision and rapidity. They can detect extracellular and intracellular proteases, as well as fluorescence-based methods for real-time and label-free detection of virus-related proteases. The active utilization of proteolytic enzymatic biosensors is expected to expand significantly in biomedical research, in-vitro model systems, and drug development. We focused on journal articles and books published in English between 1982 and 2024 for this study.

BACKGROUND: Diabetic foot ulcer is a major medical, social, and economic problem, and a leading cause of hospitalisations, increased morbidity, and mortality. Despite a rising occurrence, there is a dearth of data on the incidence and its predictors.
OBJECTIVE: To assess the incidence and predictors of diabetic foot ulcers among patients with diabetes mellitus in a diabetic follow-up clinic in Central Ethiopia.
METHODS: Retrospective follow-up study design.
METHODS: A total of 418 newly diagnosed diabetes mellitus patients from 1 January 2012 to 31 December 2022. A computer-generated simple random sampling method was used to select the study participants. Data were collected using a structured data extraction checklist. The collected data were entered into Epi Info V.7.2 and exported to STATA V.14 for analysis. To estimate survival time, the Kaplan-Meier method was used, and the survival difference was tested using a log-rank test.
METHODS: The Cox proportional hazard model was fitted to identify the predictors of diabetic foot ulcer development. The strength of the association was estimated using an adjusted hazard ratio (AHR) with a 95% confidence interval (CI), and statistical significance was proclaimed at a p<0.05.
RESULTS: The overall incidence of diabetic foot ulcer was 1.51 cases (95% CI 1.03 to 2.22) per 100 person-years of observation. The cumulative incidence was 6.2% (95% CI 4.1% to 8.6%) over 10 years. The median time of follow-up was 45 months (IQR 21-73). Diastolic blood pressure of 90 mm Hg or above (AHR 2.91, 95% CI 1.25 to 6.77), taking combined medication (AHR 3.24, 95% CI 1.14 to 9.19) and having a peripheral arterial disease (AHR 5.26, 95% CI 1.61 to 17.18) were statistically significant predictors of diabetic foot ulcer development.
CONCLUSIONS: The risk of occurrence of diabetic foot ulcer was relatively high. Diastolic blood pressure level, combined medication and peripheral arterial disease were independent predictors of diabetic foot ulcer development. Hence, close monitoring and proper interventions are essential.