big data

大数据
  • 文章类型: Journal Article
    慢性鼻窦炎(CRS)的病因及发病机制尚未完全明确。目前多组学和大数据以其数据的多样性、易处理性等优势,已被用于探索多种疾病的发病机制和生物标志物等,多种高级机器学习方法也有助于完善CRS的精准诊疗服务,并在CRS的研究中取得了一定进展。然而,多组学数据网络的建设以及其研究成果的临床转化等,仍是制约该技术进一步发展的主要问题。本文对多组学和大数据驱动的CRS研究现状及其面临的机遇与挑战进行了论述。.
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  • 文章类型: Journal Article
    背景:左心室(LV)血栓并不常见,但存在栓塞性卒中或全身性栓塞的重大风险。然而,非缺血性心肌病(NICM)和缺血性心肌病(ICM)栓塞风险的区别尚不清楚.
    结果:总计,纳入了来自JROAD-DPC(日本注册所有心脏和血管疾病诊断程序组合)数据库的2738名LV血栓患者。在这些患者中,对1037例患者进行了分析,其中826人(79.7%)拥有ICM,211人拥有NICM(20.3%)。在NICM组中,分布如下:扩张型心肌病(DCM;41.2%),Takotsubo心肌病(27.0%),肥厚型心肌病(18.0%),及其他原因(13.8%)。主要结局是住院期间栓塞性中风或全身性栓塞(SSE)的复合结局。ICM和NICM组在主要结局方面没有显着差异(5.8%vs.7.6%,p=0.34)。在NICM中,12.6%的DCM患者发生SSE,7.0%患有takotsubo心肌病,和2.6%的肥厚型心肌病。SSE的多变量逻辑回归分析显示比值比为1.4(95%置信区间[CI],与ICM相比,NICM为0.7-2.7,p=0.37)。然而,与ICM相比,DCM表现出更高的SSE调整后比值比(2.6,95%CI1.2-6.0,p=0.022)。
    结论:这表明,在左心室血栓患者中,ICM和NICM之间的栓塞事件发生率相当,DCM比ICM具有更大的SSE风险。研究结果强调了在NICM中评估心脏病的具体原因的重要性,在LV血栓管理策略中。
    BACKGROUND: Left ventricular (LV) thrombus is not common but poses significant risks of embolic stroke or systemic embolism. However, the distinction in embolic risk between nonischemic cardiomyopathy (NICM) and ischemic cardiomyopathy (ICM) remains unclear.
    RESULTS: In total, 2738 LV thrombus patients from the JROAD-DPC (Japanese Registry of All Cardiac and Vascular Diseases Diagnosis Procedure Combination) database were included. Among these patients, 1037 patients were analyzed, with 826 (79.7%) having ICM and 211 with NICM (20.3%). Within the NICM group, the distribution was as follows: dilated cardiomyopathy (DCM; 41.2%), takotsubo cardiomyopathy (27.0%), hypertrophic cardiomyopathy (18.0%), and other causes (13.8%). The primary outcome was a composite of embolic stroke or systemic embolism (SSE) during hospitalization. The ICM and NICM groups showed no significant difference in the primary outcome (5.8% vs. 7.6%, p = 0.34). Among NICM, SSE occurred in 12.6% of patients with DCM, 7.0% with takotsubo cardiomyopathy, and 2.6% with hypertrophic cardiomyopathy. Multivariate logistic regression analysis for SSE revealed an odds ratio of 1.4 (95% confidence interval [CI], 0.7-2.7, p = 0.37) for NICM compared to ICM. However, DCM exhibited a higher adjusted odds ratio for SSE compared to ICM (2.6, 95% CI 1.2-6.0, p = 0.022).
    CONCLUSIONS: This nationwide shows comparable rates of embolic events between ICM and NICM in LV thrombus patients, with DCM posing a greater risk of SSE than ICM. The findings emphasize the importance of assessing the specific cause of heart disease in NICM, within LV thrombus management strategies.
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  • 文章类型: Journal Article
    目的:本研究的目的是评估绝对淋巴细胞计数(ALC)动态对重症监护病房(ICU)脓毒症患者90天全因死亡率的临床预测价值。
    方法:使用大数据的回顾性队列研究。
    方法:本研究使用医学信息集市重症监护IV数据库V.2.0数据库进行。
    方法:主要结局是90天全因死亡率。
    方法:如果患者在入住ICU的第一天被诊断为脓毒症,则纳入患者。排除标准为ICU停留24小时以下;第一天没有淋巴细胞计数;淋巴细胞计数极高(>10×109/L);血淋巴肿瘤病史,骨髓或实体器官移植;72小时以下的存活时间和以前的ICU入院时间。分析最终包括17329例脓毒症患者。
    结果:非幸存者组的ALC在入院后第1、3、5和7天降低(p<0.001)。第7天的ALC具有用于预测90天死亡率的最高曲线下面积(AUC)值。第7天ALC的截断值为1.0×109/L。在受限三次样条图中,经过多变量调整后,淋巴细胞计数较高的患者预后较好.校正后,在序贯器官衰竭评估评分≥6或年龄≥60岁的亚组中,第7天的ALC具有最低的HR值(分别为0.79和0.81)。在训练和测试集上,在第7天添加ALC改善了所有预测模型的AUC和平均精度值。
    结论:脓毒症患者ALC的动态变化与90天全因死亡率密切相关。此外,入院后第7天的ALC是脓毒症患者90天死亡率的更好的独立预测因子,尤其是在重症或年轻的败血症患者中。
    OBJECTIVE: The objective of the study was to assess the clinical predictive value of the dynamics of absolute lymphocyte count (ALC) for 90-day all-cause mortality in sepsis patients in intensive care unit (ICU).
    METHODS: Retrospective cohort study using big data.
    METHODS: This study was conducted using the Medical Information Mart for Intensive Care IV database V.2.0 database.
    METHODS: The primary outcome was 90-day all-cause mortality.
    METHODS: Patients were included if they were diagnosed with sepsis on the first day of ICU admission. Exclusion criteria were ICU stay under 24 hours; the absence of lymphocyte count on the first day; extremely high lymphocyte count (>10×109/L); history of haematolymphatic tumours, bone marrow or solid organ transplants; survival time under 72 hours and previous ICU admissions. The analysis ultimately included 17 329 sepsis patients.
    RESULTS: The ALC in the non-survivors group was lower on days 1, 3, 5 and 7 after admission (p<0.001). The ALC on day 7 had the highest area under the curve (AUC) value for predicting 90-day mortality. The cut-off value of ALC on day 7 was 1.0×109/L. In the restricted cubic spline plot, after multivariate adjustments, patients with higher lymphocyte counts had a better prognosis. After correction, in the subgroups with Sequential Organ Failure Assessment score ≥6 or age ≥60 years, ALC on day 7 had the lowest HR value (0.79 and 0.81, respectively). On the training and testing set, adding the ALC on day 7 improved all prediction models\' AUC and average precision values.
    CONCLUSIONS: Dynamic changes of ALC are closely associated with 90-day all-cause mortality in sepsis patients. Furthermore, the ALC on day 7 after admission is a better independent predictor of 90-day mortality in sepsis patients, especially in severely ill or young sepsis patients.
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  • 文章类型: Journal Article
    背景:直接口服抗凝药(DOAC)对成人静脉血栓栓塞(VTE)的管理产生了重大影响,但这些药物直到2021年才被批准用于儿科患者.我们的目的是分析在美国食品药品监督管理局(FDA)批准儿童之前和之后接受DOAC治疗的儿科患者的特征,并评估其对医院预后的影响。
    方法:我们使用了EpicCosmos数据集(Cosmos),超过2.2亿患者的数据集,确定在2017年1月1日至2023年6月30日期间首次诊断为VTE的1-18岁患者.患者按接受的抗凝治疗进行分组(普通肝素,低分子量肝素,和/或DOAC)。
    结果:在5138名符合条件的患者中,18.1%接受DOAC作为全部或部分抗凝治疗,而81.9%仅接受肝素治疗.接受DOAC治疗的患者在17.4和13.0岁时比接受肝素单药治疗的患者年龄大,分别。非DOAC患者更有可能患有慢性疾病,并且不太可能患有肺栓塞。接受DOAC治疗的患者的总住院时间和重症监护病房(ICU)入院时间较短。
    结论:DOAC在儿科患者中很少使用,尤其是13岁以下的人。开始肝素治疗和过渡到DOAC仍然很常见,80.6%的DOAC患者在住院期间接受肝素治疗。虽然DOAC单药治疗目前未被认可为儿童DVT或PE的一线治疗,它正在临床上使用。需要进一步的研究来阐明使用DOAC对患者依从性的影响。VTE复发,和医疗费用。
    BACKGROUND: Direct oral anticoagulants (DOACs) have had significant impact on the management of venous thromboembolism (VTE) in adults, but these agents were not approved for use in pediatric patients until 2021. Our objective was to analyze the characteristics of pediatric patients treated with DOACs prior to and following U.S. Food and Drug Administration (FDA) approval for children and evaluate their impact on hospital outcomes.
    METHODS: We utilized the Epic Cosmos dataset (Cosmos), a de-identified dataset of over 220 million patients, to identify patients aged 1-18 years admitted with a first-occurrence diagnosis of VTE between January 1, 2017 and June 30, 2023. Patients were grouped by anticoagulation received (unfractionated heparin, low molecular weight heparin, and/or DOACs).
    RESULTS: Among 5138 eligible patients, 18.1% received DOACs as all or part of their anticoagulation treatment, while 81.9% received heparin therapies alone. Patients treated with DOACs were older than patients treated with heparin monotherapy at 17.4 and 13.0 years, respectively. Non-DOAC patients were more likely to have chronic conditions and were less likely to have pulmonary embolism. Patients treated with DOACs demonstrated shorter overall length of stay and duration of intensive care unit (ICU) admission.
    CONCLUSIONS: DOACs remain infrequently utilized in pediatric patients, especially in those under 13 years old. Initiation on heparin therapy and transition to DOACs remains common, with 80.6% of DOAC patients receiving heparin during their hospitalization. While DOAC monotherapy is not currently endorsed as first-line therapy for DVT or PE in children, it is being used clinically. Further research is needed to clarify the impact of DOAC use on patient adherence, VTE recurrence, and healthcare cost.
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  • 文章类型: Journal Article
    Dictyostelium代表了一个简化的模型,用于理解细胞在发育过程中如何做出决定。完整的生命周期大约需要一天,完全分化的结构仅由两种主要的细胞类型组成。随着复杂性的明显减少,“单细胞转录组学已被证明是定义发育转变和细胞命运分离事件特征的有价值的工具,甚至提供基因表达机制如何为细胞决策提供因果信息。这些科学成果已通过非破坏性单细胞分离的简易性得到了极大的促进-允许获得更多的转录物水平的生理测量。此外,在开发过程中有限数量的单元状态允许使用更直接的分析工具来处理随后的大型数据集,这增强了对数据推断的信心。在这一章中,我们将概述我们用于处理网菌属单细胞转录组数据的方法,说明这些方法如何有助于我们理解细胞在发育过程中的决策。
    Dictyostelium represents a stripped-down model for understanding how cells make decisions during development. The complete life cycle takes around a day and the fully differentiated structure is composed of only two major cell types. With this apparent reduction in \"complexity,\" single cell transcriptomics has proven to be a valuable tool in defining the features of developmental transitions and cell fate separation events, even providing causal information on how mechanisms of gene expression can feed into cell decision-making. These scientific outputs have been strongly facilitated by the ease of non-disruptive single cell isolation-allowing access to more physiological measures of transcript levels. In addition, the limited number of cell states during development allows the use of more straightforward analysis tools for handling the ensuing large datasets, which provides enhanced confidence in inferences made from the data. In this chapter, we will outline the approaches we have used for handling Dictyostelium single cell transcriptomic data, illustrating how these approaches have contributed to our understanding of cell decision-making during development.
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  • 文章类型: Journal Article
    医疗保健4.0。是指先进技术的集成,例如人工智能(AI)和大数据分析,进入医疗保健部门。认识到Healthcare4.0技术在实验室医学(LM)中的影响,我们试图评估韩国实验室医学学会(KSLM)成员对Healthcare4.0的整体认识和实施情况.
    使用匿名问卷进行了基于网络的调查。调查包括36个问题,涵盖人口统计信息(七个问题),大数据(10个问题)和AI(19个问题)。
    总共,1017名KSLM成员中有182名(17.9%)参加了调查。32%的受访者认为AI是医疗保健4.0时代LM中最重要的技术,紧随其后的是31%的受访者支持大数据。大约80%的受访者熟悉大数据,但没有使用它进行研究。71%的人愿意参与KSLM未来的大数据研究。受访者认为AI是不同部门分子遗传学中最有价值的工具。超过一半的受访者对使用人工智能作为辅助而不是完全替代他们的角色持开放态度。
    这项调查强调了KSLM成员对大数据和AI的潜在应用和影响的认识。我们强调医疗保健中人工智能集成的复杂性,引用技术和道德挑战,导致对其对就业和培训的影响的不同意见。这凸显了采用新技术的整体方法的必要性。
    UNASSIGNED: Healthcare 4.0. refers to the integration of advanced technologies, such as artificial intelligence (AI) and big data analysis, into the healthcare sector. Recognizing the impact of Healthcare 4.0 technologies in laboratory medicine (LM), we seek to assess the overall awareness and implementation of Healthcare 4.0 among members of the Korean Society for Laboratory Medicine (KSLM).
    UNASSIGNED: A web-based survey was conducted using an anonymous questionnaire. The survey comprised 36 questions covering demographic information (seven questions), big data (10 questions), and AI (19 questions).
    UNASSIGNED: In total, 182 (17.9%) of 1,017 KSLM members participated in the survey. Thirty-two percent of respondents considered AI to be the most important technology in LM in the era of Healthcare 4.0, closely followed by 31% who favored big data. Approximately 80% of respondents were familiar with big data but had not conducted research using it, and 71% were willing to participate in future big data research conducted by the KSLM. Respondents viewed AI as the most valuable tool in molecular genetics within various divisions. More than half of the respondents were open to the notion of using AI as assistance rather than a complete replacement for their roles.
    UNASSIGNED: This survey highlighted KSLM members\' awareness of the potential applications and implications of big data and AI. We emphasize the complexity of AI integration in healthcare, citing technical and ethical challenges leading to diverse opinions on its impact on employment and training. This highlights the need for a holistic approach to adopting new technologies.
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  • 文章类型: Journal Article
    评估COVID-19大流行对西班牙75岁以上人群及其家庭护理人员健康状况的影响。
    多中心,混合方法并行研究。
    这项工作,这将在西班牙11个行政区的初级保健环境中进行,将包括三个不同方法的协调研究。首先是一项基于人群的队列研究,该研究将使用现实生活数据来分析健康需求的速率和演变,护理提供,和服务利用之前,during,在大流行之后。第二个是前瞻性队列研究,随访18个月,评估COVID-19疾病对死亡率的影响,脆弱,功能和认知能力,以及参与者的生活质量。最后,第三项将是一项定性研究,采用批判性的社会方法来理解和解释社会,政治,以及与大流行期间使用卫生服务相关的经济层面。我们遵循了精神清单来解决试验方案和相关文件。这项研究自2021年以来由SaludCarlosIII研究所资助,并获得其伦理委员会的批准(2022年6月)。
    研究结果将揭示COVID-19大流行对老年人及其照顾者的长期影响。这些信息将有助于决策者在最大压力的情况下调整卫生政策以适应该人群的需求,例如COVID-19大流行产生的。
    标识符:NCT05249868[ClinicalTrials.gov]。
    UNASSIGNED: To assess the impact of the COVID-19 pandemic on the health condition of people ≥75 years of age and on their family caregivers in Spain.
    UNASSIGNED: Multicentric, mixed method concurrent study.
    UNASSIGNED: This work, which will be conducted within the primary care setting in 11 administrative regions of Spain, will include three coordinated studies with different methodologies. The first is a population-based cohort study that will use real-life data to analyze the rates and evolution of health needs, care provision, and services utilization before, during, and after the pandemic. The second is a prospective cohort study with 18 months of follow-up that will evaluate the impact of COVID-19 disease on mortality, frailty, functional and cognitive capacity, and quality of life of the participants. Finally, the third will be a qualitative study with a critical social approach to understand and interpret the social, political, and economic dimensions associated with the use of health services during the pandemic. We have followed the SPIRIT Checklist to address trial protocol and related documents. This research is being funded by the Instituto de Salud Carlos III since 2021 and was approved by its ethics committee (June 2022).
    UNASSIGNED: The study findings will reveal the long-term impact of the COVID-19 pandemic on the older adults and their caregivers. This information will serve policymakers to adapt health policies to the needs of this population in situations of maximum stress, such as that produced by the COVID-19 pandemic.
    UNASSIGNED: Identifier: NCT05249868 [ClinicalTrials.gov].
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  • 文章类型: Journal Article
    使用理发店干预措施的基于社区的参与式研究(CBPR)是解决健康差异和促进健康公平的新兴方法。理发店是值得信赖的健康教育社区环境,筛选服务,和转介。这篇叙述性小型评论概述了有关使用理发店干预措施的CBPR的当前知识状态,并探讨了大数据参与增强这种方法在抗击慢性病方面的影响和影响的潜力。使用理发店干预的CBPR在降低黑人男性的血压和提高糖尿病意识和自我管理方面显示出可喜的结果。通过提高检测率和促进预防行为,理发店的干预措施已经成功地解决了传染病,包括HIV和COVID-19。理发店在促进癌症筛查和提高对癌症风险的认识方面也发挥了作用,即前列腺癌和结直肠癌。Further,利用理发师和客户之间的信任关系,理发店的心理健康促进和预防工作取得了成功。大数据参与理发店慢性病管理干预的潜力为有针对性的计划提供了新的机会,实时监控,和个性化的方法。然而,关于隐私的伦理考虑,保密性,和数据所有权需要小心处理。为了最大限度地发挥理发店干预的影响,挑战,如理发师的培训和资源提供,干预的文化适宜性,可持续性和可扩展性必须解决。需要进一步的研究来评估长期影响,成本效益,和实施的最佳实践。总的来说,理发店有潜力成为解决长期健康差距和促进健康公平的关键合作伙伴。
    Community-based participatory research (CBPR) using barbershop interventions is an emerging approach to address health disparities and promote health equity. Barbershops serve as trusted community settings for health education, screening services, and referrals. This narrative mini-review provides an overview of the current state of knowledge regarding CBPR employing barbershop interventions and explores the potential for big data involvement to enhance the impact and reach of this approach in combating chronic disease. CBPR using barbershop interventions has shown promising results in reducing blood pressure among Black men and improving diabetes awareness and self-management. By increasing testing rates and promoting preventive behaviors, barbershop interventions have been successful in addressing infectious diseases, including HIV and COVID-19. Barbershops have also played roles in promoting cancer screening and increasing awareness of cancer risks, namely prostate cancer and colorectal cancer. Further, leveraging the trusted relationships between barbers and their clients, mental health promotion and prevention efforts have been successful in barbershops. The potential for big data involvement in barbershop interventions for chronic disease management offers new opportunities for targeted programs, real-time monitoring, and personalized approaches. However, ethical considerations regarding privacy, confidentiality, and data ownership need to be carefully addressed. To maximize the impact of barbershop interventions, challenges such as training and resource provision for barbers, cultural appropriateness of interventions, sustainability, and scalability must be addressed. Further research is needed to evaluate long-term impact, cost-effectiveness, and best practices for implementation. Overall, barbershops have the potential to serve as key partners in addressing chronic health disparities and promoting health equity.
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  • 文章类型: Journal Article
    目的:放疗指南的依从性对于维持治疗质量和一致性至关重要,特别是在大多数治疗发生的非试验患者环境中。该研究旨在评估指南更改对治疗计划实践的影响,并将手动注册数据的准确性与治疗计划数据进行比较。
    方法:这项研究利用了DBCGRTNation队列,丹麦的乳腺癌放射治疗数据集,评估2008年至2016年对指南的遵守情况。该队列包括7448例高危乳腺癌患者。国家准则的变化包括,分馏,引入呼吸门控,乳腺内淋巴结的照射,在描绘实践中使用同时集成的增强技术和左前下降冠状动脉的纳入。结构名称映射的方法,侧向性检测,检测人群平均肺容积的时间变化,和剂量评估进行了介绍和应用。从丹麦乳腺癌数据库获得手动登记的治疗特征数据用于比较。
    结果:研究发现,丹麦放疗中心立即且一致地遵守指南变更。指南实施之前的治疗实践已记录在案,并显示各中心之间存在差异。对于某些措施,手动注册数据与实际治疗计划数据之间的差异高达10%。
    结论:可以在常规治疗数据中检测到国家指南的变化,具有高度的合规性和较短的实施时间。与医疗登记数据相比,从治疗计划数据文件提取的数据提供了更准确和详细的治疗和指南依从性表征。
    OBJECTIVE: Guideline adherence in radiotherapy is crucial for maintaining treatment quality and consistency, particularly in non-trial patient settings where most treatments occur. The study aimed to assess the impact of guideline changes on treatment planning practices and compare manual registry data accuracy with treatment planning data.
    METHODS: This study utilised the DBCG RT Nation cohort, a collection of breast cancer radiotherapy data in Denmark, to evaluate adherence to guidelines from 2008 to 2016. The cohort included 7448 high-risk breast cancer patients. National guideline changes included, fractionation, introduction of respiratory gating, irradiation of the internal mammary lymph nodes, use of the simultaneous integrated boost technique and inclusion of the Left Anterior Descending coronary artery in delineation practice. Methods for structure name mapping, laterality detection, detection of temporal changes in population mean lung volume, and dose evaluation were presented and applied. Manually registered treatment characteristic data was obtained from the Danish Breast Cancer Database for comparison.
    RESULTS: The study found immediate and consistent adherence to guideline changes across Danish radiotherapy centres. Treatment practices before guideline implementation were documented and showed a variation among centres. Discrepancies between manual registry data and actual treatment planning data were as high as 10% for some measures.
    CONCLUSIONS: National guideline changes could be detected in the routine treatment data, with a high degree of compliance and short implementation time. Data extracted from treatment planning data files provides a more accurate and detailed characterisation of treatments and guideline adherence than medical register data.
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  • 文章类型: Journal Article
    正在收集越来越多的关于一个人的日常功能的数据,它拥有信息来彻底改变以人为本的医疗保健。然而,关于日常运作的数据的全部潜力还不能被利用,因为它大多以非结构化和不可访问的方式存储。这些数据的整合,从而加快了知识发现,通过引入功能组学作为补充“组学”倡议是可能的,拥抱数据科学的进步。功能组学是研究一个人的日常功能的高通量数据,可以通过国际功能分类来实施,残疾与健康(ICF)。使功能组学具有可操作性的先决条件是FAIR(Findable,可访问,互操作,和可重用)原则。本文说明了FAIR原理的逐步应用,使功能组学数据机器可读和可访问,在严格认证的条件下,在一个实际的例子中。建立更多的FAIR功能组学数据存储库,使用联合数据基础设施进行分析,使新一代知识能够改善健康和以人为中心的医疗保健。一起,作为一个联合健康和医疗保健研究社区,我们需要考虑采用这里提出的方法。
    An ever-increasing amount of data on a person\'s daily functioning is being collected, which holds information to revolutionize person-centered healthcare. However, the full potential of data on daily functioning cannot yet be exploited as it is mostly stored in an unstructured and inaccessible manner. The integration of these data, and thereby expedited knowledge discovery, is possible by the introduction of functionomics as a complementary \'omics\' initiative, embracing the advances in data science. Functionomics is the study of high-throughput data on a person\'s daily functioning, that can be operationalized with the International Classification of Functioning, Disability and Health (ICF).A prerequisite for making functionomics operational are the FAIR (Findable, Accessible, Interoperable, and Reusable) principles. This paper illustrates a step by step application of the FAIR principles for making functionomics data machine readable and accessible, under strictly certified conditions, in a practical example. Establishing more FAIR functionomics data repositories, analyzed using a federated data infrastructure, enables new knowledge generation to improve health and person-centered healthcare. Together, as one allied health and healthcare research community, we need to consider to take up the here proposed methods.
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