innovation

创新
  • 文章类型: Journal Article
    这篇文献综述总结了子宫内膜异位症手术治疗中使用吲哚菁绿(ICG)的研究,重点介绍其在深子宫内膜异位症(DE)中的应用。这项研究回顾了发展,荧光特性,以及ICG在提高术中识别子宫内膜病变的准确性方面的临床应用。强调该技术对改善病变可视化的贡献,本文讨论了ICG如何提高诊断准确性,可能降低复发率和后续干预的必要性。此外,它探讨了ICG在最大限度地降低医源性损伤风险方面的作用,尤其是输尿管子宫内膜异位症,及其通过评估肠灌注在直肠乙状结肠子宫内膜异位症手术决策中的实用性。最后,同时承认ICG整合在子宫内膜异位症手术中的明显益处,摘要要求进行更广泛的研究,以验证其在更广泛的子宫内膜异位症治疗背景下的疗效和成本效益.
    This literature review summarises the investigation into using Indocyanine Green (ICG) in the surgical management of endometriosis, focusing mainly on its application in Deep Endometriosis (DE). The study reviews the development, fluorescence characteristics, and clinical usage of ICG in enhancing the precision of identifying endometrial lesions during surgery. Emphasizing the technology\'s contribution to improved lesion visualisation, the paper discusses how ICG facilitates increased diagnostic accuracy, potentially reducing recurrence rates and the necessity for subsequent interventions. Additionally, it explores ICG\'s role in minimizing the risk of iatrogenic injuries, especially in ureteral endometriosis, and its utility in surgical decision-making for rectosigmoid endometriosis by evaluating bowel perfusion. Conclusively, while acknowledging the clear benefits of ICG integration in endometriosis surgical procedures, the abstract calls for more extensive research to validate its efficacy and cost-efficiency in the broader context of endometriosis treatment.
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  • 文章类型: Journal Article
    学术研究在药物发现中的参与一直在增长。然而,学术项目很少推进临床试验。这里,我们评估了瑞士国家科学基金会发起的国家研究能力中心(NCCR)TransCure内的药物发现状况,以促进膜转运蛋白的基础研究和早期药物发现。这包括中枢神经系统(CNS)疾病中的转运蛋白,这代表了巨大的未满足的医疗需求。而创意冠军,可持续资金,学术界和工业界的学科之间的合作对于转化研究很重要,Popperian可伪造性,强大的知识产权和积极的创业团队是创新的关键要素。NCCRTransCure分拆公司SynendosTherapeutics就是例证,一家临床阶段的生物技术公司正在开发第一种选择性内源性大麻素再摄取抑制剂(SERIs)作为神经精神疾病的新型治疗方法。我们提供了一个关于进入一个未知的可吸毒空间和弥合经常提到的“死亡谷”的挑战的观点。学术界中枢神经系统领域药物发现项目的高流失率通常是由于缺乏有意义的动物模型,可以在最早阶段为潜在的破坏性技术提供药理学概念验证。缺乏坚实的知识产权。
    The involvement of academic research in drug discovery is consistently growing. However, academic projects seldom advance to clinical trials. Here, we assess the landscape of drug discovery within the National Centre of Competence in Research (NCCR) TransCure launched by the Swiss National Science Foundation to foster basic research and early-stage drug discovery on membrane transporters. This included transporters in central nervous system (CNS) disorders, which represent a huge unmet medical need. While idea championship, sustainable funding, collaborations between disciplines at the interface of academia and industry are important for translational research, Popperian falsifiability, strong intellectual property and a motivated startup team are key elements for innovation. This is exemplified by the NCCR TransCure spin-off company Synendos Therapeutics, a clinical stage biotech company developing the first selective endocannabinoid reuptake inhibitors (SERIs) as novel treatment for neuropsychiatric disorders. We provide a perspective on the challenges related to entering an uncharted druggable space and bridging the often mentioned \"valley of death\". The high attrition rate of drug discovery projects in the CNS field within academia is often due to the lack of meaningful animal models that can provide pharmacological proof-of-concept for potentially disruptive technologies at the earliest stages, and the absence of solid intellectual property.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    介绍和研究的目的。酸性浓缩物的集中制备和分配系统代表了血液透析的真正创新,与酸袋相比,在便利性和生态可持续性方面。这项研究的目的是比较使用传统的酸袋与酸性浓缩物的集中分配系统,特别关注生态可持续性和便利性方面的差异。方法。在摩德纳大学医院的肾脏科透析和肾脏移植部门安装了Granumix系统®(FreseniusMedicalCare,坏Homburg,德国)。在引入Granumix®系统之前收集的数据(包括用过的酸袋,用于包装的盒子和托盘,使用的酸溶液和木材产生的废物的公斤数,塑料,纸板和残留酸溶液)与实施Granumix®系统后收集的比较。材料消耗等因素,产生的废物量,未使用和浪费的产品,透析会议准备所需的时间和护士的满意度进行了分析,以记录哪种系统更具环境可持续性。结果。2019年在我们的透析中心收集的数据显示,消耗了30,000个酸袋,从木材中产生了超过20,000公斤的废物,塑料和纸板,和大约12,000升的残余酸溶液要处理,操作员的处理重量达到近160,000公斤。使用酸性浓缩物的集中分配系统导致产生的废物大幅减少(2,642千克对13,617千克),待处理的残余酸溶液(2,351升vs12,100升)和操作人员处理的重量(71,522公斤vs158,117公斤)。Conclusions.酸性浓缩物似乎更适合当今透析必须面临的可持续性挑战。特别是由于患者数量的显著增加,这导致了更多的治疗,因此,对生态可持续产品的需求不断增长。
    Introduction and aim of the study. The centralized preparation and distribution system of acidic concentrate represents a true innovation in hemodialysis, when compared to acid bags, in terms of convenience and eco-sustainability. The aim of this study is to compare the use of traditional acid bags with the centralized distribution system of acidic concentrate, with particular attention to differences in terms of eco-sustainability and convenience. Methods. At the Nephrology Dialysis and Renal Transplantation Unit of the University Hospital of Modena was installed the Granumix system® (Fresenius Medical Care, Bad Homburg, Germany). Data collected before the introduction of the Granumix® system (including the used acid bags, boxes and pallets used for their packaging, liters of acid solution used and kilograms of waste generated from wood, plastic, cardboard and residual acid solution) were compared with those collected after the implementation of the Granumix® system. Factors such as material consumption, volume of waste generated, unused and wasted products, time required for dialysis session preparation and nurses\' satisfaction were analyzed to document which system was more environmentally sustainable. Results. Data collected in 2019 at our Dialysis Center showed a consumption of 30,000 acid bags, which generated over 20,000 kg of waste from wood, plastic and cardboard, and approximately 12,000 liters of residual acid solution to be disposed of, with a handling weight by operators reaching nearly 160,000 kg. The use of the centralized distribution system of acidic concentrate resulted in a significant reduction in waste generated (2,642 kg vs 13,617 kg), residual acid solution to be disposed of (2,351 liters vs 12,100 liters) and weights handled by operators (71,522 kg vs 158,117 kg). Conclusions. The acidic concentrate appears to be better suited to the sustainability challenge that dialysis must faces today, particularly due to the significant increase in the number of patients, which leads to a higher number of treatments and, therefore, a growing demand for eco-sustainable products.
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  • 文章类型: Journal Article
    为罕见疾病重新使用药物是一种创造性且具有成本效益的方法,可以为某些疾病创造新的治疗选择。该技术需要通过利用有关药理学特征的既定信息,将现有药物重新用于新用途。操作模式,安全概况,以及与生物系统的相互作用。由于包括小患者群体在内的因素,为罕见疾病创造新的治疗方法通常很困难。疾病错综复杂,和疾病病理生物学知识不足。与从头开始开发新药物相比,药物再利用是一种更有效和更具成本效益的方法。它通常需要学术界之间的合作,制药公司,和患者倡导团体。
    Repurposing drugs for rare diseases is a creative and cost-efficient method for creating new treatment options for certain conditions. This technique entails repurposing existing pharmaceuticals for new uses by utilizing established information regarding pharmacological characteristics, modes of operation, safety profiles, and interactions with biological systems. Creating new treatments for uncommon diseases is frequently difficult because of factors including small patient groups, disease intricacy, and insufficient knowledge of disease pathobiology. Drug repurposing is a more efficient and cost-effective approach compared to developing new drugs from scratch. It typically requires collaboration among academia, pharmaceutical firms, and patient advocacy groups.
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  • 文章类型: Journal Article
    哥伦比亚是一个拉丁美洲国家,社会和政治背景非常复杂,不允许在科学领域分配足够的资源,技术,创新(STI)。这对于卫生领域尤其令人担忧,因为没有为公共卫生分配足够的资源,研究,或教育。
    所谓的“2019年健康大调查”通过SurveyMonkey平台在线管理了该国不同地区的5298人,代表公众,私人,和学术部门。问卷包括46个开放式和封闭式问题,包括人口调查。数据分析涉及文本分析和情感分析。
    总的来说,56%的受访者是处于成年生命周期的女性。大多数受访者接受过研究生教育。在东方观察到更多的参与,波哥大,和安蒂奥基亚州,这也为科技创新集中了最大数量的资源。在结果得出的主要建议中,优先事项包括投资研究,个性化医疗,促进知识的社会占有,解决心理健康问题,通过法规来规范研究,促进本科生研究,建立重新认证考试以追求卓越。
    这项原始研究的结果是促进和加强生命科学和健康领域的性传播感染过程的基本投入。它们是制定公共政策和行动的指南,以保证哥伦比亚人民更好的健康和福祉,战略性地提出了未来20年的清晰路线图。
    UNASSIGNED: Colombia is a Latin American country with a very complex social and political context that has not allowed the allocation of sufficient resources to the fields of science, technology, and innovation (STI). This is particularly worrying for the area of health since not enough resources are allocated for public health, research, or education.
    UNASSIGNED: The so-called \"Great Survey in Health 2019\" was administered online through the SurveyMonkey platform to 5298 people in different regions of the country, representing the public, private, and academic sectors. The questionnaire consisted of 46 open and closed questions, including demographic inquiries. Data analysis involved textual analytics and sentiment analysis.
    UNASSIGNED: Overall, 56% of those surveyed were women within the adult life cycle. Most respondents had a postgraduate education. Greater participation was observed in the Oriental, Bogotá, and Antioquia regions, which also concentrate the largest number of resources for STI. Among the main recommendations derived from the results, priorities include investing in research, personalised medicine, promoting the social appropriation of knowledge, addressing mental health, regulating research through a statute, promoting undergraduate research, and establishing recertification exams to pursue excellence.
    UNASSIGNED: The results of this original study serve as a fundamental input to promote and strengthen the STI processes in life sciences and health. They serve as a guide to generate public policies and actions that guarantee better health and well-being for the Colombian population, strategically proposing a clear roadmap for the next 20 years.
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  • 文章类型: Journal Article
    像联合国清洁发展机制(CDM)这样的碳抵消框架在很大程度上忽视了涉及粮食的干预措施,健康,和护理系统,包括母乳喂养。创新的绿色喂养气候行动工具(GFT)评估商业牛奶配方(CMF)使用对环境的影响。和倡导母乳喂养支持干预措施作为合法的碳补偿。本文概述了GFT的发展,主要功能,和潜在的用途。离线和在线GFT是使用DMADV方法开发的(定义,Measure,分析,设计,验证)。GFT显示,6个月以下婴儿生产和使用CMF导致全球温室气体(GHG)年排放量在59亿至75亿千克二氧化碳当量之间。消耗了25625亿升的水。作为一个国家的例子,在印度,世界上人口最多的国家之一,CMF消耗需要2506亿公升的水,导致温室气体排放量为5.79亿至7.37亿千克二氧化碳当量。每年,尽管该国6个月以下婴儿的母乳喂养率很高。GFT主要利用低收入和中等收入国家(LMICs)的数据,因为许多高收入国家(HIC)没有收集合适的数据进行此类计算。尽管关于HIC母乳喂养做法的官方数据不佳,GFT用户可以从小规模调查或最佳估计中输入自己的数据。GFT还提供了估计和比较基线与反事实情景的能力,例如改善母乳喂养做法的干预措施或政策变化。总之,GFT是一项重要的创新,旨在量化CMF对环境的影响,并强调母乳喂养对地球和人类健康的重要性。应承认妇女通过母乳喂养对环境保护的贡献,母乳喂养干预措施和政策应作为合法的碳抵消措施提供资金。GFT量化CMF的碳和水足迹,并促进资助母乳喂养支持作为CDM资助机制下的碳抵消倡议。
    Carbon offset frameworks like the UN Clean Development Mechanism (CDM) have largely overlooked interventions involving food, health, and care systems, including breastfeeding. The innovative Green Feeding Climate Action Tool (GFT) assesses the environmental impact of commercial milk formula (CMF) use, and advocates for breastfeeding support interventions as legitimate carbon offsets. This paper provides an overview of the GFT\'s development, key features, and potential uses. The offline and online GFT were developed using the DMADV methodology (Define, Measure, Analyze, Design, Verify). The GFT reveals that the production and use of CMF by infants under 6 months results in annual global greenhouse gas (GHG) emissions of between 5.9 and 7.5 billion kg CO2 eq. and consumes 2,562.5 billion liters of water. As a national example, in India, one of the world\'s most populous countries, CMF consumption requires 250.6 billion liters of water and results in GHG emissions ranging from 579 to 737 million kg CO2 eq. annually, despite the country\'s high breastfeeding prevalence among infants under 6 months. The GFT mainly draws on data for low- and middle-income countries (LMICs), as many high-income countries (HICs) do not collect suitable data for such calculations. Despite poor official data on breastfeeding practices in HICs, GFT users can input their own data from smaller-scale surveys or their best estimates. The GFT also offers the capability to estimate and compare baseline with counterfactual scenarios, such as for interventions or policy changes that improve breastfeeding practices. In conclusion, the GFT is an important innovation to quantify CMF\'s environmental impact and highlight the significance of breastfeeding for planetary as well as human health. Women\'s contributions to environmental preservation through breastfeeding should be recognized, and breastfeeding interventions and policies should be funded as legitimate carbon offsets. The GFT quantifies CMF\'s carbon and water footprints and facilitates financing breastfeeding support as a carbon offset initiative under CDM funding facilities.
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  • 文章类型: Journal Article
    背景:随机对照试验(RCT)是评估干预效果的严格科学研究设计。然而,在现实世界中实施RCT是具有挑战性的。制定改善其应用的策略,了解这种设计的优势和挑战是至关重要的。因此,本研究旨在探索其优势,挑战,以及改进务实多中心实施的战略,prospective,两臂RCT评估个性化公民援助对社会参与的影响(Acccompnement-citoyenPersonnaliséd\'IntegrationCommunautaire:APIC;由训练有素的志愿者在12个月内每周提供3小时个性化刺激课程)对老年人健康的影响,社会参与,和生活满意度。
    方法:对14名参与者进行了多案例研究,由一名研究助理组成,七位协调员以及为老年人服务的六个社区组织的六名经理,在RCT的背景下实施APIC。2017年至2023年,从24次小组会议中提取了定性数据,七个半定向采访,与研究团队交换的电子邮件,和一份后续文件。
    结果:年龄在30至60岁之间(中位数±SIQR:44.0±6.3),大多数参与者是已经为老年人提供社会参与干预措施并与公共部门合作的组织的妇女。该RCT的报告优势是其在评估支持健康衰老的创新干预措施方面的相关性。以及共同目标的共享,专业知识,以及与社区组织的策略。挑战包括招募老年人的困难,对潜在对照组分配的抵抗力,设计复杂性,以及动员和参与志愿者的努力。COVID-19大流行的封锁和卫生措施加剧了与招募老年人和动员志愿者以及复杂的干预措施交付有关的挑战。主要克服招募老年人困难的策略是减少样本量,简化招聘程序,强调健康随访,扩大伙伴关系,更好地认识和支持志愿者。由于封锁和物理距离措施,干预措施也适用于远程交付,包括通过电话或视频会议。
    结论:了解实用RCT的优势和挑战可以有助于制定策略,以促进实施研究并更好地评估在现实生活条件下提供的健康和社会参与干预措施。
    背景:NCT03161860;预结果。2017年5月22日注册
    BACKGROUND: Randomized controlled trials (RCTs) are rigorous scientific research designs for evaluating intervention effectiveness. However, implementing RCTs in a real-world context is challenging. To develop strategies to improve its application, it is essential to understand the strengths and challenges of this design. This study thus aimed to explore the strengths, challenges, and strategies for improving the implementation of a pragmatic multicenter, prospective, two-arm RCT evaluating the effects of the Personalized Citizen Assistance for Social Participation (Accompagnement-citoyen Personnalisé d\'Intégration Communautaire: APIC; weekly 3-h personalized stimulation sessions given by a trained volunteer over a 12-month period) on older adults\' health, social participation, and life satisfaction.
    METHODS: A multiple case study was conducted with 14 participants, comprising one research assistant, seven coordinators, and six managers of six community organizations serving older adults, who implemented the APIC in the context of a RCT. Between 2017 and 2023, qualitative data were extracted from 24 group meetings, seven semi-directed interviews, emails exchanged with the research team, and one follow-up document.
    RESULTS: Aged between 30 and 60 (median ± SIQR: 44.0 ± 6.3), most participants were women from organizations already offering social participation interventions for older adults and working with the public sector. Reported strengths of this RCT were its relevance in assessing an innovative intervention to support healthy aging, and the sharing of common goals, expertise, and strategies with community organizations. Challenges included difficulties recruiting older adults, resistance to potential control group assignments, design complexity, and efforts to mobilize and engage volunteers. The COVID-19 pandemic lockdown and health measures exacerbated challenges related to recruiting older adults and mobilizing volunteers and complicated delivery of the intervention. The strategies that mostly overcame difficulties in recruiting older adults were reducing sample size, simplifying recruitment procedures, emphasizing the health follow-up, extending partnerships, and recognizing and supporting volunteers better. Because of the lockdown and physical distancing measures, the intervention was also adapted for remote delivery, including via telephone or videoconferencing.
    CONCLUSIONS: Knowledge of the strengths and challenges of pragmatic RCTs can contribute to the development of strategies to facilitate implementation studies and better evaluate health and social participation interventions delivered under real-life conditions.
    BACKGROUND: NCT03161860; Pre-results. Registered on May 22, 2017.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    外科技术在儿科手术中不断发展,特别是在微创手术(MAS)领域,应用的适应症正在扩大。仪器的小型化,使用天然孔口,单切口,或远程控制的机器人辅助程序,承诺增加MAS程序在儿科的好处。许多儿科疾病很少见,和专门的手术和麻醉仪器是必要的管理,定义为“孤立设备”,由于监管标准和限制金融利益冲突,市场上的发展和传播放缓或有时受阻。在儿科手术中,最重要的是以多学科的方式工作,以提供安全和技术进步支持的手术路径。出于这个原因,优化儿科麻醉也是技术进步使监测更加精确的关键因素,从而提高手术室的安全性。定制仪器和技术的开发应得到儿科研究的支持,并应适应小患者的个性。本概述概述了为安全完成儿科MAS程序而开发的专用仪器的重要性。
    Surgical techniques are evolving in Pediatric Surgery, especially in the area of minimal access surgery (MAS) where indications for applications are expanding. Miniaturization of instruments, using natural orifices, single incisions, or remotely controlled robot-assisted procedures, promises to increase the benefits of MAS procedures in pediatrics. Many pediatric pathologies are rare, and specialized surgical and anesthesiologic instruments are necessary to manage them, defined as \"orphan devices\", for which development and dissemination on the market are slowed down or sometimes hindered by regulatory standards and limiting financial conflicts of interest. In pediatric surgery, it is of utmost importance to work in a multidisciplinary way to offer a surgical path that is safe and supported by technological advances. For this reason, optimizing pediatric anesthesia is also a crucial factor where technological advances have made monitoring more precise, thereby enhancing safety in the operative room. The development of customized instruments and technologies should be supported by pediatric research and should be adapted to the individualities of the small patient. This overview outlines the importance of dedicated instruments developed for the safe completion of MAS procedures in pediatrics.
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