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Machine learning applications in stroke medicine:advancements,challenges,and future prospectives

Neural Regeneration Research 2024年第4期19卷 769-773页

作者： Mario Daidone Sergio Ferrantelli Antonino Tuttolomondo Internal Medicine and Stroke Care Ward Department of Health PromotionMother and Child CareInternal Medicine and Medical SpecialtiesUniversity of Palermo Molecular and Clinical Medicine PhD Program University of Palermo

Stroke is a leading cause of disability and mortality worldwide,necessitating the development of advanced technologies to improve its diagnosis,treatment,and patient *** recent years,machine learning techniques have emerged as promising tools in stroke medicine,enabling efficient analysis of large-scale datasets and facilitating personalized and precision medicine *** abstract provides a comprehensive overview of machine learning’s applications,challenges,and future directions in stroke *** introduced machine learning algorithms have been extensively employed in all the fields of stroke *** learning models have demonstrated remarkable accuracy in imaging analysis,diagnosing stroke subtypes,risk stratifications,guiding medical treatment,and predicting patient *** the tremendous potential of machine learning in stroke medicine,several challenges must be *** include the need for standardized and interoperable data collection,robust model validation and generalization,and the ethical considerations surrounding privacy and *** addition,integrating machine learning models into clinical workflows and establishing regulatory frameworks are critical for ensuring their widespread adoption and impact in routine stroke *** learning promises to revolutionize stroke medicine by enabling precise diagnosis,tailored treatment selection,and improved *** research and collaboration among clinicians,researchers,and technologists are essential for overcoming challenges and realizing the full potential of machine learning in stroke care,ultimately leading to enhanced patient outcomes and quality of *** review aims to summarize all the current implications of machine learning in stroke diagnosis,treatment,and prognostic *** the same time,another purpose of this paper is to explore all the future perspectives these techniques can provide in combating this disabling dis

关键词： cerebrovascular disease deep learning machine learning reinforcement learning stroke stroke therapy supervised learning unsupervised learning

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Exploring the wound-healing potential and seasonal chemical variability of the Formosan Callery pear Pyrus calleryana: implications for therapeutic applications

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Pharmaceutical Biology 2024年第1期62卷 621-633页

作者： Peng, Bo-Rong Tang, Xin-Yun Chen, Yun-Shiuan Lai, Kuei-Hung Lee, Mei-Hsien Graduate Institute of Pharmacognosy College of Pharmacy Taipei Medical University PhD Program in Clinical Drug Development of Herbal Medicine College of Pharmacy Taipei Medical University Center for Reproductive Medicine and Sciences Taipei Medical University Hospital

Context: Pyrus calleryana Decne (Rosaceae), renowned for its therapeutic properties, is known to moisturize the lungs (removing dryness;relieving cough), clear heat (acting as an antipyretic;febrifuge) and aid in detoxification (relieving pyogenic inflammation;eliminating toxins). However, scientific evidence supporting its efficacy in wound healing is lacking. Objective: This study investigated *** samples collected over a year to explore metabolite variations and their impact on skin wound-healing activities. Materials and methods: P. calleryana (PC) twigs and leaves were collected from the Matsu Islands, Taiwan, spanning 2018–2020. Extracts were prepared using 95% ethanol or water, and we assessed the chemical composition, total phenolic/triterpenoid contents and antioxidant properties. Metabolites were analysed via LC–MS/MS and molecular networking. Wound healing potential was evaluated on WS-1 cells through MTT and migration assays, and gene expression analyses, with tests including control (DMSO), compounds 1 (3′-hydroxylbenzyl-4-hydroxybenzoate-4′-O-β-glucopyranoside) and 2 (vanilloylcalleryanin) (100 µM), and a positive control (ascorbic acid, 100 µM) for 24 h. Results: Significant variations in extract compositions were observed based on the solvent used, with distinct metabolomic profiles in extracts collected during different months. Notably, compounds 1 and 2 showed no cytotoxic effects on human dermal fibroblast cells and significantly accelerated wound closure at 100 μM. A gene expression analysis indicated upregulation of wound healing-associated genes, including MMP-1 (matrix metalloproteinase-1) and COL1A1 (collagen, type 1, alpha 1). Conclusions: This study reports the first evidence of PC compounds aiding wound healing. Utilizing Global Natural Products Social Molecular Networking (GNPS) and principal component analysis (PCA) approaches, we unveiled metabolomic profiles, suggesting the potential to expedite wound-healing. © 2024 The Autho

关键词： COL1A1 GNPS LC-MS/MS MMP-1

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Unveiling mortality predictors: Exploring phase angle as a prognostic indicator in adult and elderly patients on home enteral nutrition in curitiba

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clinical Nutrition Open Science 2024年 58卷 326-336页

作者： Vicenski, Paola Pasini Naslowski, Janaina Bach Rabito, Estela Iraci Gonzalez, Maria Cristina Madalozzo Schieferdecker, Maria Eliana Postgraduate Program in Food and Nutrition Federal University of Paraná Avenida Prefeito Lothário Meissner 632 Jardim Botânico Paraná Curitiba 80210-170 Brazil PhD program in Medicine São Paulo University Brazil PosDoc in Pennington Biomedical Research Center Louisiana State University United States Permanent Professor of Post-Graduate Program in Health and Behaviour Catholic University of Pelotas RS Brazil Post-Graduate Program in Nutrition and Foods Federal University of Pelotas RS Brazil Phd Program in Clinical Surgery Federal University of Paraná Brazil Permanent Professor of the Postgraduate Program in Food and Nutrition at the Federal University of Paraná Avenida Prefeito Lothário Meissner 632 Jardim Botânico Paraná Curitiba 80210-170 Brazil

Background and Aims: This study investigated the Standardized Phase Angle (SPA) as a prognostic indicator of mortality among individuals undergoing Home Enteral Nutrition (HEN). Methods: We conducted an observational, analytical, longitudinal study involving 108 HEN participants. Body composition was assessed using bioelectrical impedance analysis, with reactance and resistance values utilized to estimate PA. Following adjustments for age and sex, SPA was derived. clinical outcomes such as recurrence or death were ascertained by contacting patients or caregivers via telephone 90 days post initial home visit. We examined the association between SPA, disease, and mortality outcome. Results: The majority of patients were elderly, with a mean age of 68.8 years, predominantly male (56.5%), and afflicted with neurological diseases (70.4%). SPA yielded a negative value in 88.9% of the sample. A high SPA value indicated greater protection (OR 0.50, CI 0.28–0.89, P = 0.0181). Males exhibited lower SPA values compared to females (-2.9 vs. -1.8, P < 0.0001). Patients with cancer had a 492% higher likelihood of mortality compared to those with neurological diseases (OR 5.92, CI 1.23–28.46, P = 0.0263). The ROC curve demonstrated that the optimal SPA cutoff for identifying mortality risk was -2.6°. Conclusions: SPA has emerged as a predictive tool for mortality in patients with HEN. SPA can be used as a complementary tool in the general nutritional assessment of this population. © 2024

关键词： Body composition Enteral nutrition Home enteral nutrition Nutritional evaluation Phase angle

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The landscape of cognitive impairment in superoxide dismutase 1-amyotrophic lateral sclerosis

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Neural Regeneration Research 2023年第7期18卷 1427-1433页

作者： Ilaria Martinelli Elisabetta Zucchi Cecilia Simonini Giulia Gianferrari Giovanna Zamboni Marcello Pinti Jessica Mandrioli Clinical and Experimental Medicine PhD Program University of Modena and Reggio EmiliaModenaItaly Department of Neurosciences Azienda Ospedaliero-Universitaria di ModenaModenaItaly Department of Biomedical Metabolic and Neural SciencesUniversity of Modena and Reggio EmiliaModenaItaly Department of Life Sciences University of Modena and Reggio EmiliaModenaItaly

Although mutations in the superoxide dismutase 1 gene account for only a minority of total amyotrophic lateral sclerosis cases,the discovery of this gene has been crucial for amyotrophic lateral sclerosis *** the identification of superoxide dismutase 1 in 1993,the field of amyotrophic lateral sclerosis genetics has considerably widened,improving our understanding of the diverse pathogenic basis of amyotrophic lateral *** this review,we focus on cognitive impairment in superoxide dismutase 1-amyotrophic lateral sclerosis *** has mostly reported that cognition remains intact in superoxide dismutase 1-amyotrophic lateral sclerosis patients,but recent reports highlight frontal lobe function frailty in patients carrying different superoxide dismutase 1-amyotrophic lateral sclerosis *** thoroughly reviewed all the various mutations reported in the literature to contribute to a comprehensive database of superoxide dismutase 1-amyotrophic lateral sclerosis genotype-phenotype *** a resource could ultimately improve our mechanistic understanding of amyotrophic lateral sclerosis,enabling a more robust assessment of how the amyotrophic lateral sclerosis phenotype responds to different variants across genes,which is important for the therapeutic strategy targeting genetic *** in superoxide dismutase 1-amyotrophic lateral sclerosis deserves further longitudinal research since this peculiar frailty in patients with similar mutations can be conditioned by external factors,including environment and other unidentified agents including modifier genes.

关键词： amyotrophic lateral sclerosis cognitive impairment genotype-phenotype correlation superoxide dismutase 1

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Angiogenesis:the Yin and Yang in intrahepatic cholangiocarcinoma

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Hepatoma Research 2023年第1期9卷 136-148页

作者： Adriana Romanzi Erica Villa Department of Biomedical Metabolic and Neural SciencesClinical and Experimental Medicine PhD ProgramUniversity of Modena and Reggio EmiliaModena 41125Italy Chimomo Department Gastroenterology UnitUniversity of Modena and Reggio Emilia and University Hospital of ModenaModena 41125Italy

The tumor microenvironment(TME)constitutes a complex structure comprising different cell types and soluble factors that surround the tumor and promote its *** for its pivotal role in malignant growth,TME has become a potential therapeutic objective for developing new targeted therapy and a marker for assessing therapeutic *** intrahepatic cholangiocarcinoma(iCCA),the second most common primary liver malignancy,TME has also gained a central role in understanding the mechanisms underlying tumor *** this review,we focused on the role of angiogenic factors and their pathway in iCCA and analyzed possible therapeutic and prognostic implications.

关键词： Intrahepatic cholangiocarcinoma angiogenic factors VEGF angiopoietins thrombospondin 1 endothelins

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Towards a new frontier in wrist rehabilitation:The traction-free posture orthosis

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Medicine in Novel Technology and Devices 2024年第3期23卷 136-138页

作者： Paolo Boccolari Roberto Tedeschi Danilo Donati Azienda Ospedaliero Universitaria di Modena PoliclinicoItaly Department of Biomedical and Neuromotor Sciences Alma Mater StudiorumUniversity of BolognaBolognaItaly Physical Therapy and Rehabilitation Unit Policlinico di ModenaModenaItaly Clinical and Experimental Medicine PhD Program University of Modena and Reggio EmiliaModenaItaly

This study presents the novel Traction-Free Posture Orthosis,designed to address wrist stiffness without the use of traditional traction *** orthosis employs a velcro system to stabilize the position of the wrist in flexion or extension,thereby avoiding the compression and rotational disadvantages associated with non-perpendicular traction ***-shaped cuts in the brace allow for plastic material flexibility,ensuring movement and *** is the absence of a traction strap,which traditionally reduces the support surface and could create pressure points leading to patient discomfort or treatment *** design facilitates a wide contact surface with the hand,optimal load distribution,and the capacity to adjust dual traction straps independently,adapting to the natural wrist *** single-piece base orthosis offers a stable,cost-effective,and patientfriendly alternative to conventional ***,patients with stiffness in both flexion and extension may require two separate orthoses,potentially increasing costs and patient ***,the Traction-Free Posture Orthosis represents an innovative step in wrist rehabilitation,providing a quick-to-construct,easy-to-wear solution with the promise of enhanced patient compliance and comfort.

关键词： Wrist rehabilitation Orthotic devices Hand therapy Occupational therapy

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Surveillance Imaging and GAAD/GALAD Scores for Detection of Hepatocellular Carcinoma in Patients with Chronic Hepatitis

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Journal of clinical and Translational Hepatology 2024年第11期12卷 907-916页

作者： Chung-Feng Huang Konstantin Kroeniger Chih-Wen Wang Tyng-Yuan Jang Ming-Lun Yeh Po-Cheng Liang Yu-Ju Wei Po-Yao Hsu Ching-I Huang Ming-Yen Hsieh Yi-Hung Lin Jee-Fu Huang Chia-Yen Dai Wan-Long Chuang Ashish Sharma Ming-Lung Yu Hepatobiliary Division Department of Internal MedicineKaohsiung Medical University HospitalKaohsiung Medical UniversityKaohsiung PhD Program in Translational Medicine College of MedicineKaohsiung Medical Universityand Academia SinicaKaohsiung Faculty of Internal Medicine School of Medicine and Hepatitis Research CenterCollege of MedicineKaohsiung Medical UniversityKaohsiung Clinical Algorithms&Biomarker Statistics Roche Diagnostics GmbHPenzbergGermany Department of Internal Medicine Kaohsiung Municipal Siaogang HospitalKaohsiung Medical UniversityKaohsiung Department of Internal Medicine Kaohsiung Municipal Ta-Tung HospitalKaohsiung Medical UniversityKaohsiung Clinical Development&Medical Affairs Roche Diagnostics International AGRotkreuzSwitzerland School of Medicine and Doctoral Program of Clinical and Experimental Medicine College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver DiseaseNational Sun Yat-sen UniversityKaohsiung

Background and Aims:Early detection of hepatocellular carcinoma(HCC)is crucial for improving survival in patients with chronic *** GALAD algorithm combines gen-der(biological sex),age,α-fetoprotein(AFP),Lens culinaris agglutinin-reactive fraction of AFP(AFP-L3),and protein in-duced by vitamin K absence or antagonist-II(PIVKA-II)for HCC ***,the GAAD algorithm incorporates gender(biological sex),age,AFP,and *** study aimed to assess the clinical utility of AFP-L3 in the GALAD algorithm and its potential synergies with *** compared the clinical performance of GALAD with GAAD;AFP;AFP-L3;and PIVKA-II,with or without ultrasound,in Taiwan residents ***:A total of 439 serum samples were analyzed using a Cobas®e 601 analyzer(healthy con-trols,n=200;chronic liver disease controls,n=177;HCC cases,n=62).Performance was assessed through receiver operating characteristic curve analyses to calculate the area under the ***:The area under the curve for dif-ferentiating early-stage HCC from patients with chronic liver disease was optimal for PIVKA-II(84.9%),GAAD(79.8%),and GALAD(79.4%),with slightly improved performance for detecting all-stage *** performance was unaffected by disease stage or *** for early-stage HCC was highest for GAAD(57.6%)and GALAD(57.6%).Sen-sitivity for each strategy was further enhanced when com-bined with ultrasound,regardless of disease stage or etiology(P<0.01).Conclusions:These findings indicate that the role of AFP-L3 in the GALAD algorithm is minimal,supporting the use of GAAD for HCC detection.A combination of GAAD,GALAD,or PIVKA-II with ultrasound may improve diagnostic efficiency compared with recommended strategies.

关键词： Algorithm Biomarkers Cirrhosis Diagnosis Detection GAAD GALAD Hepatocellular carcinoma Liver cancer Surveillance Ultrasound

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An expandable chamber for safe brain retraction: new technologies in the field of transcranial endoscopic surgery

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2023年第4期24卷 326-335页

作者： Elena ROCA Anna GOBETTI Giovanna CORNACCHIA Oscar VIVALDI Barbara BUFFOLI Giorgio RAMORINO Head and Neck Department NeurosurgeryIstituto Ospedaliero Fondazione Poliambulanza25124 BresciaItaly Technology for Health PhD Program University of Brescia25124 BresciaItaly Materials Science and Technology at Department of Mechanical and Industrial Engineering University of Brescia25123 BresciaItaly Metallurgy at Department of Mechanical and Industrial Engineering University of Brescia25123 BresciaItaly Anatomy and Physiopathology Division Department of Clinical and Experimental SciencesUniversity of Brescia25123 BresciaItaly

Neurosurgery is a highly specialized field:it often involves surgical manipulation of noble structures and cerebral retraction is frequently necessary to reach deep-seated brain *** are still no reliable methods preventing possible retraction *** objective of this study was to design work chambers well suited for transcranial endoscopic surgery while providing safe retraction of the surrounding brain *** chamber is designed to be inserted close to the intracranial point of interest;once it is best placed it can be *** should guarantee an appreciable workspace similar to that of current neurosurgical *** experimental aspect of this study involved the use of a force sensor to evaluate the pressures exerted on the brain tissue during the retraction *** pterional craniotomy,pressure measurements were made during retraction with the use of a conventional metal spatula with different *** that,although the force values necessary for retraction and exerted on the spatula by the neurosurgeon are the same,the local pressure exerted on the parenchyma at the edge of the spatula at different inclinations varied greatly.A new method of cerebral retraction using a chamber retractor(CR)has been designed to avoid any type of complication due to spatula edge overpressures and to maintain acceptable pressure values exerted on the parenchyma.

关键词： Brain retraction Spatula Brain retractor design Brain retraction injury Retraction complication Transcranial endoscopic surgery

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Potential protective role of ACE-inhibitors and AT1 receptor blockers against levodopa-induced dyskinesias:a retrospective case-control study

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Neural Regeneration Research 2021年第12期16卷 2475-2478页

作者： Elena Contaldi Luca Magistrelli Anna VMilner Marco Cosentino Franca Marino Cristoforo Comi Movement Disorders Centre Neurology UnitDepartment of Translational MedicineUniversity of Piemonte OrientaleNovaraItaly PhD Program in Medical Sciences and Biotechnology University of Piemonte OrientaleNovaraItaly PhD Program in Clinical and Experimental Medicine and Medical Humanities University of InsubriaVareseItaly Center of Research in Medical Pharmacology University of InsubriaVareseItaly Center for Research in Neuroscience University of InsubriaVareseItaly

Growing evidence has highlighted that angiotensin-converting enzyme(ACE)-inhibitors(ACEi)/AT1 receptor blockers(ARBs)may influence the complex interplay between dopamine and the renin-angiotensin system in the nigrostriatal pathway,thus affecting the development of levodopa-induced dyskinesia in Parkinson’s disease(PD).In the present study,we analyzed whether the use of this class of medication was associated with a reduced occurrence of levodopa-induced dyskinesia,using electronically-stored information of idiopathic PD patients enrolled at Novara University Hospital“Maggiore della Carità”.We conducted a retrospective case-control study identifying PD patients with dyskinesias(PwD;n=47)as *** each PwD we selected a non-dyskinetic control(NoD),nearly perfectly matched according to sex,Unified Parkinson’s Disease Rating Scale(UPDRS)part III score,and duration of antiparkinsonian *** logistic regression was used to evaluate whether dyskinesias were associated with ACEi/ARBs ***-four PD patients were included,aged 72.18±9 years,with an average disease duration of 10.20±4.8 years and 9.04±4.9 years of antiparkinsonian *** mean UPDRS part III score was 18.87±7.6 and the median HY stage was *** the NoD group,25(53.2%)were users and 22(46.8%)non-users of ACEi/***,in the PwD group,11(23.4%)were users and 36 non-users(76.6%)of this drug class(Pearson chi-square=8.824,P=0.003).Concerning general medication,there were no other statistically significant differences between *** controlling for tremor dominant phenotype,levodopa equivalent daily dose,HY 3-4,and disease duration,ACEi/ARBs use was a significant predictor of a lower occurrence of dyskinesia(OR=0.226,95%CI:0.080-0.636,P=0.005).Therefore,our study suggests that ACEi/ARBs may reduce levodopa-induced dyskinesia occurrence and,thanks to good tolerability and easy management,represent a feasible choice when dealing with the treatment of hypertension in PD patients.

关键词： angiotensin-converting enzyme inhibitors AT1 receptor blockers dyskinesias hypertension levodopa motor complications neuroinflammation Parkinson’s disease renin-angiotensin system

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A multimodal integrative approach to model transcriptional addiction of thyroid cancer on RUNX2

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Cancer Communications 2022年第9期42卷 892-896页

作者： Emanuele Vitale Elisabetta Sauta Mila Gugnoni Federica Torricelli Veronica Manicardi Alessia Ciarrocchi Laboratory of Translational Research Azienda Unità Sanitaria Locale-IRCCS di Reggio EmiliaReggio Emilia 42123Italy Clinical and Experimental Medicine PhD Program University of Modena and Reggio EmiliaModena 41121Italy Department of Electrical Computer and Biomedical EngineeringUniversity of PaviaPavia 27100Italy

Dear Editor Aberrant gene expression sustains massive proliferation and stress adaptation under the regulation of oncogenic transcription factors(TFs)whose binding across the genome orchestrates in space and time *** dependency defines the addiction of cancer cells to TFs on top of the regulatory hierarchy governing cancer dysregulated programs[1].These factors and their dependent mechanisms are an attractive and unexplored reservoir of potential targets for new anticancer ***,while the transcriptional landscape of many cancer-supportive TFs has been revealed,this information remains purely descriptive and confined to in vitro *** foster transferability,new approaches that integrate clinical data into the transcriptional networks are needed.

关键词： addiction modal reservoir

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