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Traumatic brain injury: progress and challenges in prevention, clinical care, and research.

Traumatic brain injury (TBI) has the highest incidence of all common neurological disorders, and poses a substantial public health burden. TBI is increasingly documented not only as an acute condition but also as a chronic disease with long-term consequences, including an increased risk of late-onset neurodegeneration. The first Lancet Neurology Commission on TBI, published in 2017, called for a concerted effort to tackle the global health problem posed by TBI. Since then, funding agencies have supported research both in high-income countries (HICs) and in low-income and middle-income countrie

Barriers and Facilitators to Interest-Holder Engagement in Health Guideline Development: A Qualitative Evidence Synthesis.

BACKGROUND: Health guidelines are important resources for informing decisions made by health practitioners, patients, caregivers, policymakers, and other interest-holders. Interest-holder engagement in health guideline development can improve the relevance of recommendations, promote considerations of equity, and support implementation. To facilitate efficient and effective health guideline development, there is a need for a comprehensive, global, evidence-based guidance for interest-holder engagement in guideline development. This paper synthesises the barriers and facilitators to interest-ho

Rehabilitation interventions for oropharyngeal dysphagia in people with Parkinson's disease.

RATIONALE: Oropharyngeal dysphagia is a common and disabling symptom in people with Parkinson's disease, affecting the safety and efficiency of swallowing and increasing the risk of malnutrition and aspiration pneumonia. Despite its clinical relevance, the effectiveness of rehabilitation interventions for managing dysphagia in this population remains uncertain. OBJECTIVES: To assess the effectiveness of rehabilitation interventions for oropharyngeal dysphagia in improving swallowing safety and efficiency in people with Parkinson's disease. SEARCH METHODS: We searched the Cochrane Central Reg

How Does ChatGPT Use Source Information Compared With Google? A Text Network Analysis of Online Health Information.

BACKGROUND: The lay public is increasingly using ChatGPT (a large language model) as a source of medical information. Traditional search engines such as Google provide several distinct responses to each search query and indicate the source for each response, but ChatGPT provides responses in paragraph form in prose without providing the sources used, which makes it difficult or impossible to ascertain whether those sources are reliable. One practical method to infer the sources used by ChatGPT is text network analysis. By understanding how ChatGPT uses source information in relation to traditi

Chronic Pain, Cannabis Legalization and Cannabis Use Disorder in Veterans Health Administration Patients, 2005 to 2019.

BACKGROUND: The risk for cannabis use disorder (CUD) is elevated among U.S. adults with chronic pain, and CUD rates are disproportionately increasing in this group. Little is known about the role of medical cannabis laws (MCL) and recreational cannabis laws (RCL) in these increases. Among U.S. Veterans Health Administration (VHA) patients, we examined whether MCL and RCL effects on CUD prevalence differed between patients with and without chronic pain. METHODS: Patients with ≥1 primary care, emergency, or mental health visit to the VHA and no hospice/palliative care within a given calendar ye

Musical and vocal interventions to improve neurodevelopmental outcomes for preterm infants.

BACKGROUND: Preterm birth interferes with brain maturation, and subsequent clinical events and interventions may have additional deleterious effects. Music as therapy is offered increasingly in neonatal intensive care units aiming to improve health outcomes and quality of life for both preterm infants and the well-being of their parents. Systematic reviews of mixed methodological quality have demonstrated ambiguous results for the efficacy of various types of auditory stimulation of preterm infants. A more comprehensive and rigorous systematic review is needed to address controversies arising

Rapid, point-of-care antigen and molecular-based tests for diagnosis of SARS-CoV-2 infection.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the resulting COVID-19 pandemic present important diagnostic challenges. Several diagnostic strategies are available to identify or rule out current infection, identify people in need of care escalation, or to test for past infection and immune response. Point-of-care antigen and molecular tests to detect current SARS-CoV-2 infection have the potential to allow earlier detection and isolation of confirmed cases compared to laboratory-based diagnostic methods, with the aim of reducing household and community transmissi

Endometrial injection of embryo culture supernatant for subfertile women in assisted reproduction.

BACKGROUND: Despite substantial improvements in the success of assisted reproduction techniques (ART), live birth rates may remain consistently low, and practitioners may look for innovative treatments to improve the outcomes. The injection of embryo culture supernatant in the endometrial cavity can be undertaken at various time intervals before embryo transfer. It provides an altered endometrial environment through the secretion of factors considered to facilitate implantation. It is proposed that injection of the supernatant into the endometrial cavity prior to embryo transfer will stimulate

Pharmacological therapies for the prevention of fractures in men.

RATIONALE: Pharmacological therapies for fracture prevention usually target osteoporosis, a skeletal disorder characterised by compromised bone mass or quality (or both). As most participants in osteoporosis trials are women, a review of pharmacological therapies for fracture prevention in men was warranted. OBJECTIVES: To determine the benefits and harms of bisphosphonates, parathyroid (PTH) or parathyroid-related protein (PTHrP) analogues, denosumab, and romosozumab therapy for the prevention of fractures in men. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, and two trial registrie

Nonsteroidal anti-inflammatory drugs (NSAIDs) for acute renal colic.

BACKGROUND: Urolithiasis (urinary stones) is a common disease with an increasing incidence globally. It often presents with renal colic, which is characterised by acute and intense abdominal pain. The first step in the management of renal colic is pain control. Various medications, including narcotics, nonsteroidal anti-inflammatory drugs (NSAIDs), antispasmodics, and others, have been used for this condition. NSAIDs are amongst the most commonly used drugs for renal colic. They act by reducing inflammation and lowering the pressure inside the urinary collecting system. This review updates a p

Bariatric surgery: an evidence-based analysis.

OBJECTIVE: To conduct an evidence-based analysis of the effectiveness and cost-effectiveness of bariatric surgery. BACKGROUND: Obesity is defined as a body mass index (BMI) of at last 30 kg/m(2).() Morbid obesity is defined as a BMI of at least 40 kg/m(2) or at least 35 kg/m(2) with comorbid conditions. Comorbid conditions associated with obesity include diabetes, hypertension, dyslipidemias, obstructive sleep apnea, weight-related arthropathies, and stress urinary incontinence. It is also associated with depression, and cancers of the breast, uterus, prostate, and colon, and is an independen

Prostate-specific antigen (PSA) test for prostate cancer screening.

RATIONALE: Prostate cancer screening remains controversial. A 2013 update of this Cochrane review concluded that prostate cancer screening does not significantly reduce disease-specific or overall mortality. Since then, results from two new, large trials have become available, alongside extended follow-up data from previously included trials. Thus, an update was warranted. OBJECTIVES: To assess the effects of prostate cancer screening compared to no screening in men with no prior diagnosis of prostate cancer. SEARCH METHODS: We searched the Cochrane Library, MEDLINE, Embase, five other datab

Non-Chinese herbal medicines for functional dyspepsia.

BACKGROUND: One-third of people with gastrointestinal disorders, including functional dyspepsia, use some form of complementary and alternative medicine, including herbal medicines. OBJECTIVES: The primary objective is to assess the effects of non-Chinese herbal medicines for the treatment of people with functional dyspepsia. SEARCH METHODS: We searched the following electronic databases on 22 December 2022: Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Allied and Complementary Medicine Database, Latin American and Caribbean Health Sciences Literature, among other sources,

Bariatric surgery for people with diabetes and morbid obesity: an evidence-based analysis.

UNLABELLED: In June 2008, the Medical Advisory Secretariat began work on the Diabetes Strategy Evidence Project, an evidence-based review of the literature surrounding strategies for successful management and treatment of diabetes. This project came about when the Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the Ministry's newly released Diabetes Strategy.After an initial review of the strategy and consultation with experts, the secretariat identified five key areas in which evidence was n

Human genome meeting 2016 : Houston, TX, USA. 28 February - 2 March 2016.

O1 The metabolomics approach to autism: identification of biomarkers for early detection of autism spectrum disorder A. K. Srivastava, Y. Wang, R. Huang, C. Skinner, T. Thompson, L. Pollard, T. Wood, F. Luo, R. Stevenson O2 Phenome-wide association study for smoking- and drinking-associated genes in 26,394 American women with African, Asian, European, and Hispanic descents R. Polimanti, J. Gelernter O3 Effects of prenatal environment, genotype and DNA methylation on birth weight and subsequent postnatal outcomes: findings from GUSTO, an Asian birth cohort X. Lin, I. Y. Lim, Y. Wu, A. L. Teh, L

Treatment for women with postpartum iron deficiency anaemia.

RATIONALE: Postpartum iron deficiency anaemia is caused by antenatal iron deficiency or excessive blood loss at delivery and might affect up to 50% of labouring women in low- and middle-income countries. Effective and safe treatment during early motherhood is important for maternal well-being and newborn care. Treatment options include oral iron supplementation, intravenous iron, erythropoietin, and red blood cell transfusion. OBJECTIVES: To assess the benefits and harms of the available treatment modalities for women with postpartum iron deficiency anaemia. These include intravenous iron, or

Artificial Intelligence Resources for the Screening of Titles and Abstracts in Systematic Reviews: A Scoping Review.

IntroductionArtificial intelligence (AI) is a branch of technology enabling machines to emulate complex human skills; it can also entail problem-solving using bioinspired methods. It is used for automating systematic literature reviews (SLR), that is, defining a clinical question, locating relevant literature, preliminary screening, study evaluation, data extraction and analysis. Title and abstract screening is one of the most time-consuming and error-prone phases involved in developing a systematic review. While AI promises to expedite this process, adopting it faces challenges due to concern

Translation approaches to support systemic anti-cancer therapy consent for individuals with limited English proficiency.

PurposeLimited English proficiency (LEP) is associated with poor cancer outcomes, and written information about systemic anticancer treatment (SACT) is often provided in English only. Unsupervised machine translation of medical information is common, but its effectiveness and accuracy are unclear. This study aimed to (a) compare professional and machine translation of written SACT information and (b) investigate whether providing a bilingual SACT consent form altered comprehension of key information during an interpreted SACT consent consultation.MethodsThis randomised study included healthy,

Predicting which patients with cancer will see a psychiatrist or counsellor from their initial oncology consultation document using natural language processing.

BackgroundPatients with cancer often have unmet psychosocial needs. Early detection of who requires referral to a counsellor or psychiatrist may improve their care. This work used natural language processing to predict which patients will see a counsellor or psychiatrist from a patient's initial oncology consultation document. We believe this is the first use of artificial intelligence to predict psychiatric outcomes from non-psychiatric medical documents.MethodsThis retrospective prognostic study used data from 47,625 patients at BC Cancer. We analyzed initial oncology consultation documents

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… Our relatively large dataset, drawn from over 50,000 patients with cancer, allows us to investigate more advanced NLP tools, including those using large language models and other neural networks, which have rarely been used in medical applications. … BERTopic does so using modern transformer-based large-language models (LLM) to form embeddings of the documents separate from the topic representations, and allows customization of its modular steps. We used the “Best Practice” values, as of August 17, 2023, for these steps. …

Artificial intelligence across the cancer care continuum.

Artificial intelligence (AI) holds significant potential to enhance various aspects of oncology, spanning the cancer care continuum. This review provides an overview of current and emerging AI applications, from risk assessment and early detection to treatment and supportive care. AI-driven tools are being developed to integrate diverse data sources, including multi-omics and electronic health records, to improve cancer risk stratification and personalize prevention strategies. In screening and diagnosis, AI algorithms show promise in augmenting the accuracy and efficiency of medical image ana

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… Using large language models to create patient centered consent forms . Int J Radiat Oncol Biol Phys . 2024 ; 120 ( 2 ): e612 . doi: 10.1016/j.ijrobp.2024.07.1346 98 Shi Q , Luzuriaga K , Allison JJ , et al. Transforming informed consent generation using large language models: mixed methods study . … A comprehensive survey of large language models and multimodal large language models in medicine . Inf Fusion . 2024 ; 117 : 102888 . doi: 10.1016/j.inffus.2024.102888 116 Jung J , Kim H , Bae S , Park JY . …