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This paper aims to interpret the role of the soul as ontological, intellectual or cognitive and as the moral principle within the frame of the holistic conception of human psychosomatic health that emerges from the context of Zalmoxian medicine in the proemium of Plato's Charmides. It examines what the ontological status of the soul is in relation to the body and the body–soul complex of man considered as a psychosomatic whole. By comparing the presentation of the soul as principle in the Charmides and the Phaedrus, the paper defends the thesis that in the former dialogue, Plato develops his own anthropological ontology, which paves the way for the salvation of human existence and health. The soul is bestowed with an ontological primacy that determines the philosophical and medical presuppositions for treating human illness under a holistic view. The interpretation of the ontological relation of the soul to the body and the entire human being in the context of Zalmoxian holistic medicine is based on Hermias Alexandrinus' exegesis of the conception of the soul as principle in the Phaedrus. This paper demonstrates that, from both the medical holistic viewpoint and the anthropological philosophical perspective, the soul is the principle and πρῶτον with regard to the body and the body–soul complex without being the whole that the corresponding medical epistemology must apprehend. [ABSTRACT FROM AUTHOR]

Tumors have a huge impact on human life and are now the main cause of disease-related deaths. The main means of treatment are surgery and radiotherapy, but they are more damaging to the organism and have a poor postoperative prognosis. Therefore, we urgently need safe and effective drugs to treat tumors. In recent years, Chinese herbal medicines have been widely used in tumor therapy as complementary and alternative therapies. Medicinal and edible herbs are popular and have become a hot topic of research, which not only have excellent pharmacological effects and activities, but also have almost no side effects. Therefore, as a typical medicine and food homology, some components of Paeoniae Radix Alba (PRA, called Baishao in China) have been shown to have good efficacy and safety against cancer. Numerous studies have also shown that Paeoniae Radix Alba and its active ingredients treat cancer through various pathways and are also one of the important components of many antitumor herbal compound formulas. In this paper, we reviewed the literature on the intervention of Paeoniae Radix Alba in tumors and its mechanism of action in recent years and found that there is a large amount of literature on its effect on total glucosides of paeony (TGP) and paeoniflorin (PF), as well as an in-depth discussion of the mechanism of action of Paeoniae Radix Alba and its main constituents, with a view to promote the clinical development and application of Paeoniae Radix Alba in the field of antitumor management.

Home health care companies provide health care services to patients in their homes. Due to increasing demand, the provision of home health care services requires effective management of operational costs while satisfying both patients and caregivers. In practice, uncertain service times might lead to considerable delays that adversely affect service quality. To this end, this paper proposes a new bi-objective optimization problem to model the routing and scheduling problems under uncertainty in home health care, considering the qualification and workload of caregivers. A mixed-integer linear programming formulation is developed. Motivated by the challenge of computational time, we propose the Adaptive Large Neighborhood Search embedded in an Enhanced Multi-Directional Local Search framework (ALNS-EMDLS). A stochastic ALNS-EMDLS is introduced to handle uncertain service times for patients. Three kinds of metrics for evaluating the Pareto fronts highlight the efficiency of our proposed method. The sensitivity analysis validates the robustness of the proposed model and method. Finally, we apply the method to a real-life case and provide managerial recommendations.

Background/Objectives: Temporomandibular disorder (TMD) is the term used to describe a pathology (dysfunction and pain) in the masticatory muscles and temporomandibular joint (TMJ). There is an apparent upward trend in the publication of dental research and a need to continually improve the quality of research. Therefore, this study was conducted to analyse the use of sample size and effect size calculations in a TMD randomised controlled trial. Methods: The period was restricted to the full 5 years, i.e., papers published in 2019, 2020, 2021, 2022, and 2023. The filter article type—"Randomized Controlled Trial" was used. The studies were graded on a two-level scale: 0–1. In the case of 1, sample size (SS) and effect size (ES) were calculated. Results: In the entire study sample, SS was used in 58% of studies, while ES was used in 15% of studies. Conclusions: Quality should improve as research increases. One factor that influences quality is the level of statistics. SS and ES calculations provide a basis for understanding the results obtained by the authors. Access to formulas, online calculators and software facilitates these analyses. High-quality trials provide a solid foundation for medical progress, fostering the development of personalized therapies that provide more precise and effective treatment and increase patients' chances of recovery. Improving the quality of TMD research, and medical research in general, helps to increase public confidence in medical advances and raises the standard of patient care. [ABSTRACT FROM AUTHOR]

Background: Anticoagulation therapy plays a crucial role in the management of atrial fibrillation (AF) by significantly reducing the risk of stroke. Direct oral anticoagulants (DOAC) became preferred over warfarin due to their superior safety and efficacy profile. Assessing adherence to anticoagulation therapy is necessary in clinical practice for optimising patient outcomes and treatment efficacy, thus emphasising its significance. Methods: A retrospective study utilised the Latvian National Health Service reimbursement prescriptions database, covering prescriptions for AF and flutter from January 2012 to December 2022. The proportion of days covered method was selected for adherence assessment, categorising it into three groups: (1) below 80%, (2) between 80% and 90%, and (3) above 90%. Results: A total of 1,646,648 prescriptions were analysed. Dabigatran prescriptions started declining after 2020, coinciding with a decrease in warfarin prescriptions since 2018. The total adherence levels to DOAC therapy were 69.4%. Only 44.2% of users achieved an adherence level exceeding 80%. The rate of paper prescriptions decreased from 98.5% in 2017 to 1.3% in 2022. Additionally, the utilisation of international non-proprietary names reached 79.7% in 2022. Specifically, 16.7% of patients selected a single pharmacy, whereas 27.7% visited one or two pharmacies. Meanwhile, other patients obtained medicines from multiple pharmacies. Conclusions: The total adherence level to DOAC therapy is evaluated as low and there was no significant difference in age, gender, or "switcher" status among adherence groups. Physicians' prescribing habits have changed over a decade. [ABSTRACT FROM AUTHOR]

Biomedicine is constantly evolving to ensure a significant and positive impact on healthcare, which has resulted in innovative and distinct requisites such as hydrogels. Chitosan-based formulations stand out for their versatile utilization in drug encapsulation, transport, and controlled release, which is complemented by their biocompatibility, biodegradability, and non-immunogenic nature. Stimuli-responsive hydrogels, also known as smart hydrogels, have strictly regulated release patterns since they respond and adapt based on various external stimuli. Moreover, they can imitate the intrinsic tissues' mechanical, biological, and physicochemical properties. These characteristics allow stimuli-responsive hydrogels to provide cutting-edge, effective, and safe treatment. Constant progress in the field necessitates an up-to-date summary of current trends and breakthroughs in the biomedical application of stimuli-responsive chitosan-based hydrogels, which was the aim of this review. General data about hydrogels sensitive to ions, pH, redox potential, light, electric field, temperature, and magnetic field are recapitulated. Additionally, formulations responsive to multiple stimuli are mentioned. Focusing on chitosan-based smart hydrogels, their multifaceted utilization was thoroughly described. The vast application spectrum encompasses neurological disorders, tumors, wound healing, and dermal infections. Available data on smart chitosan hydrogels strongly support the idea that current approaches and developing novel solutions are worth improving. The present paper constitutes a valuable resource for researchers and practitioners in the currently evolving field. [ABSTRACT FROM AUTHOR]

Traumatic Brain Injury (TBI) represents a significant health concern, necessitating advanced therapeutic interventions. This detailed review explores the critical roles of astrocytes, key cellular constituents of the central nervous system (CNS), in both the pathophysiology and possible rehabilitation of TBI. Following injury, astrocytes exhibit reactive transformations, differentiating into pro-inflammatory (A1) and neuroprotective (A2) phenotypes. This paper elucidates the interactions of astrocytes with neurons, their role in neuroinflammation, and the potential for their therapeutic exploitation. Emphasized strategies encompass the utilization of endocannabinoid and calcium signaling pathways, hormone-based treatments like 17β-estradiol, biological therapies employing anti-HBGB1 monoclonal antibodies, gene therapy targeting Connexin 43, and the innovative technique of astrocyte transplantation as a means to repair damaged neural tissues.

Artificial intelligence (AI) has emerged as a transformative force in various sectors, including medicine and healthcare. Large language models like ChatGPT showcase AI's potential by generating human-like text through prompts. ChatGPT's adaptability holds promise for reshaping medical practices, improving patient care, and enhancing interactions among healthcare professionals, patients, and data. In pandemic management, ChatGPT rapidly disseminates vital information. It serves as a virtual assistant in surgical consultations, aids dental practices, simplifies medical education, and aids in disease diagnosis. A total of 82 papers were categorised into eight major areas, which are G1: treatment and medicine, G2: buildings and equipment, G3: parts of the human body and areas of the disease, G4: patients, G5: citizens, G6: cellular imaging, radiology, pulse and medical images, G7: doctors and nurses, and G8: tools, devices and administration. Balancing AI's role with human judgment remains a challenge. A systematic literature review using the PRISMA approach explored AI's transformative potential in healthcare, highlighting ChatGPT's versatile applications, limitations, motivation, and challenges. In conclusion, ChatGPT's diverse medical applications demonstrate its potential for innovation, serving as a valuable resource for students, academics, and researchers in healthcare. Additionally, this study serves as a guide, assisting students, academics, and researchers in the field of medicine and healthcare alike. [ABSTRACT FROM AUTHOR]

3D printing has been adopted into routine use for certain medical applications, but more widespread usage has been hindered by, among other things, unclear legislation. We performed an analysis, using legal doctrinal study and legal informatics, of relevant EU legislation and case law in four issues relevant to medical 3D printing (excluding bioprinting or pharmacoprinting): pre-market approval, post-market liability, intellectual property rights, and data protection. Several gaps and uncertainties in the current legislation and interpretations were identified. In particular, we regard the current EU regulatory framework to be quite limiting and inflexible, exemplifying a cautionary approach common in EU law. Though the need to establish high safety standards in order to protect patients as a disadvantaged population is understood, both legal uncertainties and overregulation are seen as harmful to innovation. Hence, more adaptive legislation is called for to ensure continuous innovation efforts and enhanced patient outcomes. [ABSTRACT FROM AUTHOR]

Cellulose hydrogels, formed either through physical or chemical cross-linking into a three-dimensional network from cellulose or its derivatives, are renowned for their exceptional water absorption capacities and biocompatibility. Rising demands for sustainable materials have spurred interest in cellulose hydrogels, attributed to their abundant supply, biodegradability, and non-toxic nature. These properties highlight their extensive potential across various sectors including biomedicine, the food industry, and environmental protection. Cellulose hydrogels are particularly advantageous in applications such as drug delivery, wound dressing, and water treatment. Recent large-scale studies have advanced our understanding of cellulose preparation and its applications. This review delves into the fundamental concepts, preparation techniques, and current applications of cellulose hydrogels in diverse fields. It also discusses the latest advances in nano-lignin-based hydrogels, providing a comprehensive overview of this promising material and offering insights and guidance for future research and development. [ABSTRACT FROM AUTHOR]

Adherence is vital for medicine to have an effect, yet adherence is considered to be low, with approximately half of the patients not fully adherent. However, research into adherence tends to focus on quantitative analysis of performance, which fails to perceive how people are adherent in their many different environments. As a contribution to gaining a deeper understanding, interviews were held with thirty individuals in the UK, Egypt, Kazakhstan, and six countries in sub-Saharan Africa to understand their perceptions on adherence to a range of drugs, and these were compared with an existing well-regarded list. New or undocumented reasons for non-adherence were discovered. Reasons for non-adherence were consistent across both developing and developed worlds. A new viewpoint on adherence is suggested, which considers adherence to be a single act and therefore as an individual opportunity to be adherent, permitting greater focus on the enablers and inhibitors of adherence at any given point in time. [ABSTRACT FROM AUTHOR]

Skin plays an important role as a defense mechanism against environmental pathogens in organisms such as humans or animals. Once the skin integrity is disturbed by a wound, pathogens can penetrate easily into a deeper part of the body to induce disease. By this means, it is important for the skin to regenerate quickly upon injury to regain its protective barrier function. Traditionally, scientists use rodents or mammals as experimental animals to study skin wound healing. However, due to concerns about animal welfare and increasing costs of laboratory animals, such as rodents, scientists have considered alternative methods of implementing replace, reduce, and refine (3Rs) in experimentation. Moreover, several previous studies on skin wound healing in fish used relatively expensive medical-grade lasers with a low calculation efficiency of the wound area, which led to human judgment errors. Thus, this study aimed to develop a new alternative model for skin wound healing by utilizing zebrafish together with a new rapid and efficient method as an alternative in investigating skin wound healing. First, in order to fulfill the 3Rs concept, the pain in the tested zebrafish was evaluated by using a 3D locomotion assay. Afterward, the obtained behavior data were analyzed using the Kruskal–Wallis test, followed by Dunn's multiple comparisons tests; later, 3 watts was chosen as the power for the laser, since the wound caused by the laser at this power did not significantly alter zebrafish swimming behaviors. Furthermore, we also optimized the experimental conditions of zebrafish skin wound healing using a laser engraving machine, which can create skin wounds with a high reproducibility in size and depth. The wound closure of the tested zebrafish was then analyzed by using a two-way ANOVA, and presented in 25%, 50%, and 75% of wound-closure percentages. After imparting wounds to the skin of the zebrafish, wound images were collected and used for deep-learning training by convolutional neural networks (CNNs), either the Mask-RCNN or U-Net, so that the computer could calculate the area of the skin wounds in an automatic manner. Using ImageJ manual counting as a gold standard, we found that the U-Net performance was better than the Mask RCNN for zebrafish skin wound judgment. For proof-of-concept validation, a U-Net trained model was applied to study and determine the effect of different temperatures and the administration of antioxidants on the skin wound-healing kinetics. Results showed a significant positive correlation between the speed of wound closure and the exposure to different temperatures and administration of antioxidants. Taken together, the laser-based skin ablation and deep learning-based wound-size measurement methods reported in this study provide a faster, reliable, and reduced suffering protocol to conduct skin wound healing in zebrafish for the first time. [ABSTRACT FROM AUTHOR]

Simple Summary: In the past decades, the survival of ovarian malignant tumors has been largely unchanged. Treatment usually consists of a combination of systemic and surgical therapy. However, when recurrence occurs, treatment options are limited. When repeated surgery is no longer possible and chemotherapy is no longer effective, theranostics, a newly developing approach, might be of value. Theranostics will diagnose and destroy malignant tissue by binding radioactive isotopes to targets on malignant cells. To develop this approach, selection and validation of a target is necessary. For the selection of a target in ovarian tumors, the follicle-stimulating hormone (FSH) receptor appears to be suitable because it is primarily expressed in ovarian tissue, and expression is reported in malignant tumors. This review seeks to determine whether the follicle-stimulating hormone receptor is expressed in ovarian tumor types and, therefore, is suitable as a target in a future theranostic approach. Ovarian cancer mortality rates have not decreased significantly in the past years. As most women are still diagnosed in an advanced stage, there is a need for new treatment strategies for recurrent disease. A potentially new developing targeted approach, theranostics, combines diagnostics and treatment using radiopharmaceuticals. Through target receptors, imaging and treatment of malignant tissue can be achieved. For ovarian malignancy, the follicle-stimulating hormone (FSH) receptor may serve as a possible target since expression appears to be limited to ovarian cells. In this systematic review, we aim to gather all available literature on the expression of the FSH receptor in ovarian tumors. Pubmed, Embase and the Cochrane databases were searched until December 2023 for eligible studies. The search yielded 41 studies, mostly regarding serous carcinomas, sex cord–stromal tumors (SCSTs) and cell lines of serous and SCSTs. Various techniques were used to analyze the expression of the FSH receptor. For serous carcinomas, conflicting results on the expression of the FSH receptor were found. Studies on SCSTs, mainly studying the subtype of granulosa cell tumors, all showed positive expression of the FSH receptor. In the cell lines studies, the KGN cell line derived from a granulosa cell tumor shows positive expression in all studies. Available studies show that SCSTs express the FSH receptor. A theranostic approach targeting the FSH receptor may, therefore, provide a useful new approach for this malignancy with limited therapeutic options in recurrent disease. [ABSTRACT FROM AUTHOR]

For thousands of years, nature has been a source of medical substances, and an astounding numeral of contemporary remedies have been identified from natural origins. Plants have long been used as folk herbal medicines to treat various disorders, and their different natural products have inspired the design, discovery, and development of new drugs. With the invention of recent molecular targets based on proteins, there is a growing need for fresh chemical diversification in screening. Natural products will play a vital part in supplying this need via the continuous exploration of global biodiversity, the majority of which remains unexplored. Even though drug discovery from medicinal plants remains an important source of novel therapeutic leads, various hurdles exist, including identifying and executing suitable high-throughput screening bioassays, scaling up the supply of bioactive molecules, and acquiring plant materials. Investigating these natural resources takes multi-disciplinary, nationwide, and global partnerships in design, synthesis, discovery, and drug development techniques. This review article discusses current advancements and future approaches for discovering natural items such as health- and wellness-promoting remedies. It also summarizes strategies to unify the therapeutic use of plant-derived natural products worldwide to support future drug discoveries derived from plant sources. [ABSTRACT FROM AUTHOR]

Background: Our study aimed to explore the way artificial intelligence (AI) utilization is perceived in pediatric medicine, examining its acceptance among patients (in this case represented by their adult parents), and identify the challenges it presents in order to understand the factors influencing its adoption in clinical settings. Methods: A structured questionnaire was applied to caregivers (parents or grandparents) of children who presented in tertiary pediatric clinics. Results: The most significant differentiations were identified in relation to the level of education (e.g., aversion to AI involvement was 22.2% among those with postgraduate degrees, 43.9% among those with university degrees, and 54.5% among those who only completed high school). The greatest fear among respondents regarding the medical use of AI was related to the possibility of errors occurring (70.1%). Conclusions: The general attitude toward the use of AI can be considered positive, provided that it remains human-supervised, and that the technology used is explained in detail by the physician. However, there were large differences among groups (mainly defined by education level) in the way AI is perceived and accepted. [ABSTRACT FROM AUTHOR]

Focusing on the Protestant mission hospitals in Iran during the reign of Reza Pahlavi, this article analyzes the concepts and ideas referred to as medical care in missionary narratives as well as reactions of the Iranians to the missionary medical initiatives. Trying to situate mission hospitals in the context of the rapid social and cultural changes that the Iranians faced because of the implementation of the monarch's reforms and the policies of centralization, statism, and social uniformity, the article puts emphasis on the fact that mission hospitals introduced a processual and negotiable type of medical modernity different from what was launched by the state at that time. Creating the healthcare networks in Iran, the Protestant hospitals produced the ideal—in the missionaries' eyes—types of medical modernity that might be presented as the social and cultural roles played by patients, converts, and nurses. [ABSTRACT FROM AUTHOR]

Fuzzy Cognitive Maps (FCMs) have become an invaluable tool for healthcare providers because they can capture intricate associations among variables and generate precise predictions. FCMs have demonstrated their utility in diverse medical applications, from disease diagnosis to treatment planning and prognosis prediction. Their ability to model complex relationships between symptoms, biomarkers, risk factors, and treatments has enabled healthcare providers to make informed decisions, leading to better patient outcomes. This review article provides a thorough synopsis of using FCMs within the medical domain. A systematic examination of pertinent literature spanning the last two decades forms the basis of this overview, specifically delineating the diverse applications of FCMs in medical realms, including decision-making, diagnosis, prognosis, treatment optimisation, risk assessment, and pharmacovigilance. The limitations inherent in FCMs are also scrutinised, and avenues for potential future research and application are explored. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) has emerged as a crucial tool in healthcare with the primary aim of improving patient outcomes and optimizing healthcare delivery. By harnessing machine learning algorithms, natural language processing, and computer vision, AI enables the analysis of complex medical data. The integration of AI into healthcare systems aims to support clinicians, personalize patient care, and enhance population health, all while addressing the challenges posed by rising costs and limited resources. As a subdivision of computer science, AI focuses on the development of advanced algorithms capable of performing complex tasks that were once reliant on human intelligence. The ultimate goal is to achieve human-level performance with improved efficiency and accuracy in problem-solving and task execution, thereby reducing the need for human intervention. Various industries, including engineering, media/entertainment, finance, and education, have already reaped significant benefits by incorporating AI systems into their operations. Notably, the healthcare sector has witnessed rapid growth in the utilization of AI technology. Nevertheless, there remains untapped potential for AI to truly revolutionize the industry. It is important to note that despite concerns about job displacement, AI in healthcare should not be viewed as a threat to human workers. Instead, AI systems are designed to augment and support healthcare professionals, freeing up their time to focus on more complex and critical tasks. By automating routine and repetitive tasks, AI can alleviate the burden on healthcare professionals, allowing them to dedicate more attention to patient care and meaningful interactions. However, legal and ethical challenges must be addressed when embracing AI technology in medicine, alongside comprehensive public education to ensure widespread acceptance. [ABSTRACT FROM AUTHOR]

The health/salvation nexus can be better understood if analyzed through the transformations that have affected the social relationship with the sacred in Western society. These changes have caused relevant implications concerning the sphere of "ultimate meaning", in the words of Peter Berger. Today, we are witnessing a weakening of legitimized "theodicies" capable of promising—according to Max Weber—salvation and guaranteeing "just equalization", that is, compensation or metaphysical condemnation for worldly conduct. However, this occurs to different extents depending on whether we are in the field of Western religions or new forms of spirituality. Medicine deserves a separate discussion. The hypothesis is that the health/salvation nexus leans towards salvation in the case of Western religions; towards health in the case of medicine; and, in the case of new forms of spirituality it leans neither exactly towards health nor exactly towards salvation: new forms of spirituality promise more than the achievement of health, but less than the achievement of salvation. Ultimately, the health/salvation nexus is structured differently depending on how much Western religions, new forms of spirituality and medicine are able to respond, more or less effectively, to the questions of "theodicy" and of "ultimate meaning". I use the term of "theodicy" in the way Max Weber and Peter Berger conceived it: therefore, this concept can also be usefully applied to non-theistic and secular worldviews. [ABSTRACT FROM AUTHOR]