Discriminatory Value of the Risk Analysis Index Versus the 5-Factor Modified Frailty Index for Major Outcome Measures in Degenerative Cervical Myelopathy DOI Creative Commons
Nithin Gupta, Sina Zoghi, Michael M. Covell

et al.

Global Spine Journal, Journal Year: 2025, Volume and Issue: unknown

Published: April 29, 2025

Study Design Observational Retrospective Cohort Study. Objectives To compare the discriminatory abilities of Revised Risk Analysis Index (RAI-Rev) and 5-Factor Modified Frailty (mFI-5) to predict major postoperative outcomes in DCM patients overall, by anterior (ADF) or posterior (PDF) approaches for decompression fusion. Methods The American College Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried undergoing ADF PDF from 2015-2020. Logistic regression Receiver Operating Characteristic analysis were used predictive value mFI-5 RAI-Rev 30-day outcomes. Results 18,138 included (median age: 61 years). Both predicted outcomes; however, increasing frailty as measured demonstrated greater odds ratios. RAI-rev superior discrimination non-fatal adverse outcomes, notably non-home discharge (NHD) [C-statistic 0.72 (95% CI 0.71-0.73, P < 0.001)], all measures except complications ( 0.05). Sub-analysis approach showed had accuracy compared PDF. Conclusions predicting following when mFI-5, with equivalent mortality prediction. Further, plays a stronger role morbidity frailty’s impact on This finding demonstrates utility preoperative risk stratification an increasingly frail patient population provides initial evidence selecting increases.

Language: Английский

Best practice for wound debridement DOI
Dieter Mayer, William H Tettelbach, Guido Ciprandi

et al.

Journal of Wound Care, Journal Year: 2024, Volume and Issue: 33(Sup6b), P. S1 - S32

Published: June 1, 2024

Language: Английский

Citations

18
Global, regional, and national prevalence of adult overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021 DOI Creative Commons
Marie Ng, Emmanuela Gakidou, Justin Lo

et al.

The Lancet, Journal Year: 2025, Volume and Issue: 405(10481), P. 813 - 838

Published: March 1, 2025

Overweight and obesity is a global epidemic. Forecasting future trajectories of the epidemic crucial for providing an evidence base policy change. In this study, we examine historical trends global, regional, national prevalence adult overweight from 1990 to 2021 forecast 2050. Leveraging established methodology Global Burden Diseases, Injuries, Risk Factors Study, estimated among individuals aged 25 years older by age sex 204 countries territories Retrospective current were derived based on both self-reported measured anthropometric data extracted 1350 unique sources, which include survey microdata reports, as well published literature. Specific adjustment was applied correct self-report bias. Spatiotemporal Gaussian process regression models used synthesise data, leveraging spatial temporal correlation in epidemiological trends, optimise comparability results across time geographies. To generate estimates, forecasts Socio-demographic Index patterns presented annualised rate change inform trajectories. We considered reference scenario assuming continuation trends. Rates increased at regional levels, all nations, between 2021. 2021, 1·00 billion (95% uncertainty interval [UI] 0·989-1·01) males 1·11 (1·10-1·12) females had obesity. China largest population adults with (402 million [397-407] individuals), followed India (180 [167-194]) USA (172 [169-174]). The highest age-standardised observed Oceania north Africa Middle East, many these reporting more than 80% adults. Compared 1990, 155·1% (149·8-160·3) 104·9% UI 100·9-108·8) females. most rapid rise East super-region, where rates tripled doubled. Assuming 2050, that total number living will reach 3·80 3·39-4·04), over half likely time. While China, India, continue constitute large proportion obesity, sub-Saharan super-region forecasted increase 254·8% (234·4-269·5). Nigeria specifically, 141 (121-162) making it country fourth-largest No date has successfully curbed rising Without immediate effective intervention, globally. Particularly Asia Africa, driven growing populations, substantially. These regions face considerable obesity-related disease burden. Merely acknowledging health issue would be negligent part public practitioners; aggressive targeted measures are required address crisis, one foremost avertible risks now poses unparalleled threat premature death local, national, levels. Bill & Melinda Gates Foundation.

Language: Английский

Citations

16
Insights from Autopsy-initiated Pathological Studies of the Pathogenesis and Clinical Manifestations of Atherosclerosis and Ischemic Heart Disease: Part II. Ischemic Heart Disease DOI
L. Maximilian Buja, Michelle M. McDonald, Bihong Zhao

et al.

Cardiovascular Pathology, Journal Year: 2025, Volume and Issue: unknown, P. 107727 - 107727

Published: Feb. 1, 2025

Language: Английский

Citations

2
Elucidating emerging signaling pathways driving endothelial dysfunction in cardiovascular aging DOI

Anna De Bartolo,

Tommaso Angelone, Carmine Rocca

et al.

Vascular Pharmacology, Journal Year: 2025, Volume and Issue: unknown, P. 107462 - 107462

Published: Jan. 1, 2025

Language: Английский

Citations

1
Rewriting the textbook for pharma: how to adapt and thrive in a digital, personalized and collaborative world DOI Creative Commons
Charles H. Jones, Subha Madhavan, Natarajan Kannan

et al.

Drug Discovery Today, Journal Year: 2024, Volume and Issue: 29(9), P. 104112 - 104112

Published: July 23, 2024

The pharmaceutical industry is undergoing a sweeping transformation, driven by technological innovations, demographic shifts, regulatory changes and consumer expectations. For adaptive players in pharma to excel this rapidly changing landscape, which will be markedly different from today 2030 beyond, they require set of skills, capabilities mindsets, as well willingness collaborate co-create value with multiple stakeholders. needs rewrite the textbook for embracing implementing four key dimensions change: digitalization, personalization, collaboration innovation. In article, we examine how these change are reshaping industry, provide practical strategic guidance based on best practices examples. Specifically, companies should embrace use advanced digital technologies, such artificial intelligence machine learning, streamline processes solve challenges rapidly. Personalization, both medicine patient engagement, also success 'digital revolution', collaborative approach involving partnerships tech start-ups, health-care providers bodies essential create an integrated responsive ecosystem. Using ideas rewritten pharma, evolve personalized digitized health-focused organizations that comprehensive solutions go beyond drugs devices.

Language: Английский

Citations

5
The biological roots of the sex-frailty paradox DOI Creative Commons
Beatrice Arosio, Anna Picca

Experimental Gerontology, Journal Year: 2024, Volume and Issue: 198, P. 112619 - 112619

Published: Oct. 29, 2024

Aging is a dynamic process that requires continuous response and adaptation to internal external stimuli over the life course. This eventually results in people aging differently women than men. The "gender paradox" describes how experience greater longevity men, although linked with higher rates of disability poor health status. Recently, concept frailty has been incorporated into this paradox giving rise "sex-frailty which are frailer because they manifest worse status but, at same time, appear less susceptible death men age. However, very little known about biological roots sex-related difference frailty. Inflamm-aging, chronic low-grade inflammatory state associated age, plays key pathophysiological role several age-related diseases/conditions, including Alzheimer's disease (AD), for have lifetime risk Interestingly, inflamm-aging develops different rate compared features could play critical development AD women. According view, continuum between diseases probably lacks clear boundaries can be envisioned shared mechanisms progress pace may lead trajectories It therefore becomes urgent consider holistic approach study aging, declining it from gender medicine perspective also sex-frailty paradox.

Language: Английский

Citations

5
Macrophage Immunometabolism - Emerging Targets for Regrowth in Aging Muscle DOI
Zachary J. Fennel, Ryan M. O’Connell, Micah J. Drummond

et al.

AJP Endocrinology and Metabolism, Journal Year: 2025, Volume and Issue: 328(2), P. E186 - E197

Published: Jan. 7, 2025

The recovery from muscle atrophy is impaired with aging as characterized by improper remodeling and sustained functional deficits. Age-related deficits in regrowth are tightly linked the loss of early pro-inflammatory macrophage responses subsequent cellular dysregulation within skeletal niche. Macrophage inflammatory phenotype regulated at metabolic level, highlighting immunometabolism an emerging strategy to enhance restore regrowth. Accordingly, targets emphasis on glycolytic, hypoxia, redox-related pathways stand out for their role promoting inflammation enhancing aging. Here we highlight promising immuno-metabolic that could be leveraged optimal function following muscular atrophy.

Language: Английский

Citations

0
A Review of Healthcare Challenges in the UK and the US: Medical Errors, Aging, Private Healthcare and Governance DOI Creative Commons

John S. Bolwell

Health Sciences Review, Journal Year: 2025, Volume and Issue: unknown, P. 100211 - 100211

Published: Jan. 1, 2025

Language: Английский

Citations

0
Addressing Note Bloat: Solutions for Effective Clinical Documentation DOI Creative Commons
Nicholas Genes,

Joseph Sills,

Heather A. Heaton

et al.

Journal of the American College of Emergency Physicians Open, Journal Year: 2025, Volume and Issue: 6(1), P. 100031 - 100031

Published: Jan. 13, 2025

Clinical documentation in the United States has grown longer and more difficult to read, a phenomenon described as "note bloat." This issue is especially pronounced emergency medicine, where high diagnostic uncertainty brief evaluations demand focused, efficient chart review inform decision-making. Note bloat arises from multiple factors: efforts enhance billing, mitigate malpractice risk, leverage electronic health record tools that improve speed completeness. We discuss best practices based on available evidence expert opinion note clarity concision. Recent E/M coding reforms aim streamline by prioritizing medical decision-making over details of historical physical examination, though implementation varies. New technologies such generative artificial intelligence present opportunities challenges for practices. Addressing will require ongoing effort clinical leadership, vendors, professional organizations.

Language: Английский

Citations

0
Fine-tuning a local LLaMA-3 large language model for automated privacy-preserving physician letter generation in radiation oncology DOI Creative Commons

Yihao Hou,

Christoph Bert, Ahmed M. Gomaa

et al.

Frontiers in Artificial Intelligence, Journal Year: 2025, Volume and Issue: 7

Published: Jan. 14, 2025

Introduction Generating physician letters is a time-consuming task in daily clinical practice. Methods This study investigates local fine-tuning of large language models (LLMs), specifically LLaMA models, for letter generation privacy-preserving manner within the field radiation oncology. Results Our findings demonstrate that base without fine-tuning, are inadequate effectively generating letters. The QLoRA algorithm provides an efficient method intra-institutional LLMs with limited computational resources (i.e., single 48 GB GPU workstation hospital). fine-tuned LLM successfully learns oncology-specific information and generates institution-specific style. ROUGE scores generated summary reports highlight superiority 8B LLaMA-3 model over 13B LLaMA-2 model. Further multidimensional evaluations 10 cases reveal that, although has capacity to generate content beyond provided input data, it salutations, diagnoses treatment histories, recommendations further treatment, planned schedules. Overall, benefit was rated highly by experts (average score 3.4 on 4-point scale). Discussion With careful review correction, automated LLM-based significant practical value.

Language: Английский

Citations

0