This paper presents an overview of tomography and different tomographic imaging modalities. The goal of this paper is to provide an understanding of various imaging modalities; in particular, how the imaging is performed, working principles, and applications. It was not intended to provide the in-depth mathematical principles of these imaging modalities, rather this paper focuses on providing the knowledge in an easy-to-grasp manner for the readers' benefit. Imaging modalities are categorized based on the physics behind image generation. First, the paper explains the general tomography principle. Then explains Ultrasound Imaging, Electrical Impedance Tomography, Computed Tomography, Magnetic Resonance Imaging (MRI), Photoacoustic Tomography (PAT), and Positron Emission Tomography (PET). In the end, the paper provides the fundamentals and review of two relatively new imagining modalities, Diffuse Optical Tomography (DOT) and functional Near-infrared Spectroscopy (fNIRS).

.Abstract: Indonesia, one of the Asia Pacific LMICs, has suffered from a chronic medical workforce shortage. However, there are limited published studies describing the approaches implemented by the Indonesian government regarding the recruitment and retention of the medical workforce. This case study aimed to understand the current practices for recruitment and retention of the medical workforce in Indonesian rural and remote provinces. We conducted a case study of the Maluku Province of Indonesia with document analysis and key informant interviews with officials responsible for medical workforce recruitment and retention. We used the WHO’s guidelines as an analytical matrix to examine the recruitment and retention practices under four domains, i) educational, ii) regulatory, iii) financial, and iv) professional and personal development, and classified them into University/Medical School level and Government/Non-government level. Our findings suggest that Indonesia has implemented most of the WHO-recommended medical workforce recruitment and retention strategies. However, implementation is still problematic; hence, the aim of establishing an adequate, sustainable medical workforce has not been reached. Nationwide government intervention in educational aspects is important to magnify the impact of the regional medical school initiatives. Relevant programs must be re-evaluated and re-enforced concerning significance, comprehensiveness and effectiveness for sustainable rural and remote medical workforce.

Convolutional neural network architectures have become increasingly complex, which has improved the performance slowly on well-known benchmark datasets in the recent years. In this research, we have analyzed the true need for such complexity. We have introduced G-Net light, a lightweight modified GoogleNet with improved filter count per layer to reduce feature overlaps and complexity. Additionally, by limiting the amount of pooling layers in the proposed architecture, we have exploited the skip connections to minimize the spatial information loss. The investigations on the proposed architecture are evaluated on three retinal vessel segmentation publicly available datasets. The proposed G-Net light outperforms other vessel segmentation architectures by reducing the number of trainable parameters..

Background: Citicoline, a medical food, lacks proven efficacy for ischemic stroke and has uncertainties around its harms. The continued prescription should be reevaluated given the more robust, high-quality Evidence against that medical food. This essay is based on a recent Cochrane review and uses only one all-cause mortality as the primary outcome. Therefore, the essay should be considered as something other than an updated Cochrane review but like a reflection based on Evidence-based Medicine and Philosophy of Science analysis. Question Research: Why citicoline (a medical food) should not be prescribed to treat people with acute ischemic stroke: The certainty of the Evidence.? Objective: Demonstrate from evidence-based medicine and philosophy of science perspective that citicoline should not be prescribed for acute ischemic stroke due to lack of efficacy and harm uncertainties. Search publications: We searched in PubMed and Cochrane Library from 2020 until 30 October 2023. We, furthermore, used engineering machines Bing and Google Scholar to detect additional papers. Additionally, we also reviewed reference lists of the retrieved publications and review articles and searched the websites of the U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA). Selection criteria: We included systematic reviews, meta-analyses, randomized clinical trials, clinical guidelines focused on acute ischemic stroke and comparing citicoline versus placebo or no intervention. We excluded narrative reviews, observational studies and ongoing trials. Data collection and analysis: We identified only new randomized clinical trials and assessed the risk of bias in seven domains. The other eight trials were already included in the mentioned Cochrane review. The systematic reviews with or without meta-analyses were assessed using McMaster University guidelines. We estimated risk ratios (RRs) for that outcome. We measured statistical heterogeneity using the I² statistic. We conducted our analyses using the fixed effect model. We did not use the GRADE approach due to what is shown in a Cochrane review published in 2020 by Martí-Carvajal et al. We used the RevMan 5.4 software from Cochrane Collaboration to conduct the forest plot. We used a Trial Sequential Analysis with Copenhagen Trial Unit Software. We estimated a Bayes factor from the relative risk and 95% confidence interval. Results: We identified only one new RCT (N = 99) reported mortality data and three clinical guidelines. We conducted a new meta-analysis with nine trials (N = 4461) having a high risk of bias and showing little to no difference in mortality between citicoline and placebo (17.1% vs 18.4%; RR 0.94, 95% CI 0.82 to 1.06; I2 = 0%). The Bayes factor was 0.7, indicating weak Evidence for the null over the alternative hypothesis. Trial sequential analysis suggested sufficiency of Evidence for mortality. No guidelines recommend citicoline. Conclusions: This essay reassessed citicoline for acute ischemic stroke after the 2020 Cochrane review. Adding a new RCT further supported the lack of mortality benefit with citicoline. The overall evidence quality could be better. Analyses using evidence-based medicine and philosophy of science approaches do not support prescribing citicoline due to a lack of efficacy substantiation and potential harms.

This study examines the psychological repercussions of the COVID-19 pandemic on a medical team in an Israeli general hospital. The research explores the professional quality of life, burnout symptoms, secondary traumatic stress, and mindfulness among team members across three distinct phases of the pandemic. Analysis was conducted for different subgroups based on job roles and seniority, allowing for an evaluation of the phase-specific effects on the ProQOL (Professional Quality of Life) and mindfulness. Results align with established crisis trajectories, encompassing honeymoon/heroic phases, inventory, disillusionment, and recovery. The findings demonstrate a negative correlation between compassion satisfaction and burnout, as well as between mindfulness and burnout/secondary traumatic stress. Remarkably, male doctors exhibit a more pronounced negative impact on mindfulness compared to their female counterparts, primarily comprising healthcare workers. Temporal analysis reveals significant differences in compassion satisfaction and mindfulness, with baseline measurements being notably higher. Furthermore, the study sheds light on the vulnerability of male doctors, emphasizing the crucial role of hospital management in conveying the message and implementing effective measures to support professional quality of life. These findings underscore the necessity of prioritizing the well-being of medical professionals, particularly male doctors who face unique challenges in seeking assistance.

Background: Community-based medical education (CBME) is an essential component of medical education, where primary healthcare physicians (PHPs) play a crucial role. This study explores PHPs' awareness and engagement in CBME and investigates the factors influencing their participation. Methods: This mixed study was conducted in two phases. In the first phase, a qual-itative study was conducted using semi-structured interviews with PHPs, and thematic analysis related to their awareness and engagement in CBME. In the second phase, a quantitative survey was conducted among 72 PHPs pre- and post-training programs. Results: Primary healthcare physicians had a positive attitude toward community-based medical education. The participants have an acceptable level of awareness and engagement, which increased substantially (p-value = 0.03) and (p-value = 0.003), respectively. Logistic analysis indicated that non-Saudi physicians were likelier to participate in the CBME (p-value=0.001). Professions and academic experiences influence their willingness and engagement to participate in CBME (OR= 7.5, p-value=0.001) and (OR=0.21, p-value=0.001), respectively. Conclusion: The study findings highlighted the importance of increased awareness and the factors that enhance PHPs' engagement in CBME. This positive perspective of the PHPs helps build effective partnerships and facilitates the extension of the curriculum to apply CBME.

Recent advancements in surgical and anti-cancer therapies have provided significant hope of long survival in patients with pancreatic cancer (PC). To realize this hope, routine medical checkups of asymptomatic people should be performed to identify operable PCs. In this study, we evaluated the efficacy of medical checkups using abdominal ultrasonography (US). We retrospectively analyzed 374 patients with PC at our institute between 2010 and 2021. We divided these patients into several groups according to the diagnostic approach and compared their background and prognosis. These groups comprised PCs diagnosed through (a) symptoms, 242 cases; (b) US during medical checkup for asymptomatic individuals, 17; and other means. Of the 375 patients, 192 were men (51.3%), and the median age was 74 years (34–105). Tumors were located in the pancreatic tail in 67 patients (17.9%). Excision ratio and 5-year survival rate were significantly better in group (b) than in (a) (58.8% vs. 23.1%, P<0.01 and 42.2% vs. 9.4%, P<0.001, respectively). The prognosis of patients diagnosed using US during medical checkup was better than that of patients identified through symptomatic presentation of PC. US for asymptomatic individuals with PC might be useful for promoting better prognosis of PCs.

The National Occupational Competency Profile (NOCP) – the competency framework for paramedics in Canada – is presently undergoing revision. Since the NOCP was published in 2011, paramedic practice, healthcare and society have changed dramatically. To inform the revision, we sought to identify emerging concepts in the literature that would inform the development of competencies for paramedics. We conducted a restricted literature review and content analysis of all published and grey literature pertaining to or informing Canadian paramedicine from 2011 to 2022. Three authors performed a title and abstract, and full-text review to identify and label concepts informed by existing findings. A total of 302 articles were categorized into eleven emerging concepts related to competencies: Inclusion, Diversity, Equity, and Accessibility (IDEA) in paramedicine; Social responsiveness, justice, equity and access; Anti-racism; Healthy Professionals; Evidence Informed Practice and Systems; Complex Adaptive Systems; Learning Environment; Virtual Care; Clinical Reasoning; Adaptive Expertise; and Planetary Health. This review identified emerging concepts to inform the development of the 2023 National Occupational Standard for Paramedics (NOSP). These concepts will inform data analysis, development group discussions, and competency identification.

Currently, the number of lightning casualties and casualty rates have significantly reduced in developed countries, but there has been no significant reduction in developing countries. On the one hand, this is due to the high frequency of lightning; on the other hand, the vulnerability of people in developing countries is also an influencing factor. Through case analysis and summary, this paper expounds on lightning injury’s mechanism and clinical manifestations. It points out that lightning injury is mainly related to heart problems and the impact on the nervous system, rather than burns, which usually cause fewer consequences. Medical treatment needs to pay attention to the order and principles of treatment. Implementing CPR and auxiliary AED is the most effective way to save lives. Attention should be paid to the practical and effective treatment and nursing of lightning stroke sequelae. Finally, combined with the situation of lightning casualties in china, the existing problems are put forward during the process of early treatment, post-hospital treatment, and nursing observation, which provides an objective basis for the cognition of the scientific nature of the lightning injury.

Recently, Artificial Intelligence (AI)-based algorithms have revolutionized the medical image segmentation processes. Thus, the precise segmentation of organs and their lesions may contribute to an efficient diagnostics process and a more effective selection of targeted therapies as well as increasing the effectiveness of the training process. Thus, AI may contribute to the automatization of the image scan segmentation process and increase the quality of the resulting 3D objects, which may lead to the generation of more realistic virtual objects. In this paper, we focus on the AI-based solutions applied in the medical image scan segmentation, and intelligent visual-content generation, i.e. computer-generated three-dimensional (3D) images in the context of Extended Reality (XR). We consider different types of neural networks used with a special emphasis on the learning rules applied, taking into account algorithm accuracy and performance, as well as open data availability. This paper also attempts to summarize the current development of AI-based segmentation methods in medical imaging and intelligent visual content generation that are applied in XR. Finally, this paper concludes with possible developments and open challenges in AI application in Extended Reality-based solutions. Finally, the future lines of research and development directions of Artificial Intelligence applications both in medical image segmentation and Extended reality-based medical solutions are discussed.

The COVID19 pandemic had a major impact on emergency medical communication centres (EMCC). A live video facility was made available to second-line physicians in an EMCC with a first-line paramedic to receive emergency calls. The objective of this study was to measure the contribution of live video to remote medical triage. The single-centre retrospective study included all telephone assessments of patients with suspected COVID19 symptoms from 01.04.2020 to 30.04.2021 in Geneva, Switzerland. The organisation of the EMCC and the characteristics of patients who called the two emergency lines (official emergency number and COVID19 number) with suspected COVID19 symptoms were described. A prospective web-based survey of physicians was conducted during the same period to measure the indications, limitations and impact of live video on their decisions. 8,957 patients were included. 2,157 (48.0%) of the 4,493 patients assessed on the official emergency number had dyspnoea. 4,045 (90.6%) of 4,464 patients assessed on the COVID19 number had flu-like symptoms. 1,798 (20.1%) patients were reassessed remotely by a physician, including 405 (22.5%) with live video, successfully in 315 (77.8%) attempts. The web-based survey (107 forms) showed that physicians used live video to assess mainly the breathing (81.3%) and general condition (78.5%) of patients. They felt that their decision was modified in 75.7% (n=81) of cases, and caught 7 (7.7%) patients in life-threatening emergency. Medical triage decisions for suspected COVID19 patients are strongly influenced by the use of live video.

Machine learning (ML) offers potential opportunities to enhance the learning, teaching and assessments within veterinary medical education including but not limited to assisting with admissions processes as well as student progress evaluations. The purpose of this primer is to assist veterinary educators in appraising and potentially adopting these rapid upcoming advances in data science and technology. In the first section, we introduce ML concepts and highlight similarities/differences between ML and classical statistics. In the second section, we provide a step-by-step worked example using simulated veterinary student data to answer a hypothesis driven question. Python syntax with explanations is provided within the text to create a random forest ML prediction model and within each step, specific considerations such as how to manage incomplete student records are highlighted when applying ML algorithms within the veterinary education field. The results from the simulated data demonstrate how decisions by the veterinary educator during ML model creation may impact the most important features contributing to the model. These results highlight the need for the veterinary educator to be fully transparent during the creation of ML models and future research is needed to establish guidelines for handling data not missing at random in medical education, and preferred methods for model evaluation.

The fast and reliable processing of medical images is of paramount importance to adequately generate data to feed machine learning algorithms that can prevent and diagnose health issues. Here we benchmark different compressed sensing techniques applied to magnetic resonance imaging as a means to reduce the acquisition time spent in the collection of data and signals that form the image. We show that by using these techniques, it is possible to reduce the number of signals needed and, therefore, substantially decrease the time to acquire the measurements. To this end, we have considered and compared different algorithms: the Iterative Re-Weighted Least Squares, the Iterative Soft Thresholding Algorithm, the Iterative Hard Thresholding Algorithm, the Primal Dual Algorithm and the Log-Barrier Algorithm. We have implemented such algorithms in different analysis programs that have been used to perform the reconstruction of the images and found that the Iterative Soft Thresholding Algorithm gives the optimal results. We found that the images obtained with this algorithm have less quality than the original ones, but the quality is good enough to distinguish each body structure and detect any health problems.

This study examines demographic factors which may influence opinions concerning medical students’ self-care and substance use behaviors as a means of providing insights into how future doctors view these issues compared to Australian doctors and members of the public. We conducted national, multicenter, prospective, on-line cross-sectional surveys using hypothetical scenarios to three cohorts- Australian medical students, medical doctors, and the public. Participants’ responses were compared for the different contextual variables within the scenarios and the participants’ demographic characteristics. In total 2,602 medical students, 809 doctors and 503 members of the public participated. Compared with doctors and the public, medical students were least tolerant of alcohol intoxication, and most tolerant of using stimulants to assist with study, and cannabis for anxiety. Doctor respondents more often aligned with the public’s opinions on the acceptability of the medical students’ behaviors. Although opinions are not equivalent to behaviour, Australian students’ views on the acceptability for cannabis to help manage anxiety, and inappropriate use of prescription-only drugs are concerning; these future doctors will be responsible for prescribing drugs and managing patients with substance abuse problems. However, if current Australian medical student’s opinions on alcohol misuse persist, one of the commonest substance addictions amongst doctors may decrease in future.

The emergence of Internet of Things (IoT) devices is revolutionizing healthcare. This dynamic healthcare environment relies on Internet of Healthcare Things (IoHT) and Internet of Medical Things (IoMT) technologies. Economic, social, and technological opportunities from the IoHT are transforming healthcare systems. This article covers the history, present condition, and future prospects of IoHT, as well as its topologies, platforms, services, applications, market trends, and solution types. It examines security issues, requirements, and a threat taxonomy, studying smart healthcare privacy and security. It explores future research and the challenges IoHT-based solutions face. International health rules and regulations based on the IoT and their social and economic effects on long-term development are also examined. Integrating IoMT into healthcare infrastructures enhances scalability, efficiency, reliability, and accuracy. Through communication networks and data-processing algorithms, IoMT creates smart hardware and software platforms that enhance decision-making. IoMT devices' low resources raise privacy and security concerns. Security and privacy issues are organised by healthcare IoMT adoption in this study. We give an extensive attack taxonomy against the IoMT infrastructure, encompassing devices, security mechanisms, and their pros and cons. Furthermore, it describes the privacy and security requirements for any unique security solutions against IoMT's multiple attack vectors. This article explains the complicated difficulties, security concerns, and future research pathways needed to safeguard and ensure the long-term expansion of these game-changing technologies in the healthcare ecosystem.

The growing dependence on large language models (LLM)s highlights the urgent need to deepen trust in these technologies. Regular, rigorous validation of their expertise, especially in nuanced and intricate scenarios, is essential to ensure their readiness for clinical applications. Our study pioneers the exploration of LLM utility in the field of cardiology. We stand at the cusp of a transformative era where mature AI and LLMs, notably ChatGPT, GPT-4, and Google Bard, are poised to influence healthcare significantly. Recently, we put three available LLMs, OpenAI's ChatGPT-3.5, GPT-4.0, and Google's Bard, to the test against a significant Polish medical special-ization licensing exam (PES). The exams cover the scope of completed specialist training, focusing on diagnostic and therapeutic procedures, excluding invasive medical procedures and interven-tions. In our analysis, GPT-4 consistently outperformed the others, ranking first, with and Google Bard and ChatGPT- 3.5 following, respectively. The performance metrics underscore GPT-4's no-table potential in medical applications. Given a score improvement of over 23.5 % between two AI models released just four months apart, clinicians must stay informed and up-to-date about these rapidly evolving tools and their potential applications to clinical practice. Our results provide a snapshot of the current capabilities of these models, highlighting the nuanced performance dif-ferences when confronted with identical questions

During the creation and integration of a health care system based on medical knowledge graphs, it is necessary to review and select the vocabularies and definitions that best fit the information requirements of the system being developed. This implies the reuse of medical knowledge graphs; however, full importation of knowledge graphs is not a tractable solution in terms of memory requirements. In this paper we present a modularization-based method for knowledge graph reuse. A case study of graph reuse is presented by transforming the original model into a lighter one.

The United States is plagued with the highest rates of preventable metabolic diseases it has ever seen, and while poor nutrition is increasingly recognized as a critical contributing factor, good nutrition has been shown to be a potent factor in prevention and management of these illnesses. Notably, nutrition is inextricably intertwined with farming practices and the stewardship of our environment – particularly its soil. In this proposal, we propose a method to expose medical students to basic agricultural and environmental knowledge regarding the production of food, as well as educate them in practical nutrition education within the interactive, case-based, and longitudinal preclinical curriculum at Case Western Reserve University School of Medicine (CWRU SOM). We propose a two-part approach; first: integrating relevant topics in nutrition, culinary medicine, and farming practices into the preclinical blocks through Official Learning Objectives, and second: an optional 8-week, zero credit elective for students interested in pursuing a deeper understanding of these topics. Through these interventions, we believe courses like this will support a generation of physicians able to understand health from soil to plate with a consideration for the environment in addition to exemplifying healthful lifestyles themselves. We believe these kinds of future physicians will be the most effective in treating (and ideally reversing) the chronic disease epidemic.

In recent years, antibacterial coatings have become a significant approach in the global fight against bacterial pathogens. Developments in materials science, chemistry and biochemistry have led to a plethora of materials and chemical compounds that have potential for creating antibacterial coatings. Nonetheless, there has been insufficient consideration given to the analysis of the techniques and technologies used to apply these coatings. Among the various inorganic coating techniques, Atomic Layer Deposition (ALD) is noteworthy. It enables the successful synthesis of high-purity inorganic nanocoatings on surfaces of complex shape and topography, while also providing precise control over their thickness and composition. ALD has various industrial applications, but its practical application in medicine is still limited. In recent years, a substantial number of papers have been published on the suggested implementation of thin films and coatings produced through ALD in medicine, notably those with antibacterial properties. The aim of this paper is to carefully evaluate and analyse the relevant literature on this subject. Simple oxide coatings, including TiO2, ZnO, Fe2O3, MgO, and ZrO2, were examined, as well as coatings containing metal nanoparticles such as Ag, Cu, Pt, and Au, and mixed systems such as TiO2-ZnO, TiO2-ZrO2, ZnO-Al2O3, TiO2-Ag, and ZnO-Ag. Through comparative analysis, we have been able to draw conclusions on the effectiveness of various antibacterial coatings of different compositions, including key characteristics such as thickness, morphology, and crystal structure. ALD has been analysed in its use for developing antibacterial coatings for various applications. Furthermore, assumptions regarding the most promising development areas have been presented.

This paper introduces the AltumView Sentinare smart activity sensor for senior care and patient monitoring. The sensor uses an AI chip and deep learning algorithms to monitor the activity of people, collect activity statistics, and notify caregivers when emergencies such as falls are detected. To protect privacy, only skeleton (stick figure) animations are transmitted instead of videos. The sensor is highly affordable, accessible, and versatile. It was a CES 2021 Innovation Award Honoree, and has been selected by Amazon as one of only three fall detection devices integrated into its Alexa Together urgent response service, and has received very positive reviews from Amazon customers. It has also been used in different senior care settings in about ten different countries. The paper presents the main features of the system, the evidences and lessons learned from its practical applications, and future directions.

Violence against paramedics is increasingly recognized as an important occupational health problem, but pervasive and institutionalized underreporting hinders efforts at risk mitigation. Earlier research has shown that the organizational culture within paramedicine may contribute to underreporting and researchers have recommended involving paramedics in the development of violence prevention policies, including reporting systems. Eighteen months after the launch of a new comprehensive violence reporting system in Peel Region, Ontario, Canada, we surveyed paramedics about their willingness to report violent encounters. A total of 204 (33% of eligible) paramedics chose to participate, of whom 67% (N=137) had experienced violence since the launch of the new reporting process, with 83% (N=114) reporting the incidents at least some of the time. In choosing to report, participants cited the accessibility of the new reporting process and the desire to promote accountability among perpetrators while contributing to a safer workplace as motivating factors. Their decisions to file a report, however, could be influenced by the perceived ‘volitionality’ and severity of the violent encounters, particularly in the context of (un)supportive co-workers and supervisors. Ultimately, the participants’ belief that the report would lead to meaningful change within the service was a key driver of reporting behavior.

The contemporary landscape of eHealth is characterized by major concerns related to electronic medical records (EMRs). In an EMR, critical patient health information gets its own repository, which is the core of the eHealth system. Notably, the EMR not only retrieves health information generated in ambulatory clinical settings but also includes court-generated records. These overlapping records assume the role of a foundational data source for a comprehensive electronic health record (EHR). This scholarly review sheds light on recent trends in medical records and associated challenges, while at the same time providing insights into Saudi Arabia’s targeted approaches to healthcare delivery. Additionally, the talk expands to include a description of blockchain technology and its underlying conceptual framework. This demonstration positions blockchain technology as a promising approach that requires consideration for future use in the healthcare system.

The integration of artificial intelligence (AI) into medical imaging has guided in an era of transformation in healthcare. This literature review explores the latest innovations and applications of AI in the field, highlighting its profound impact on medical diagnosis and patient care. The innovation segment explores into cutting-edge developments in AI, such as deep learning algorithms, convolutional neural networks, and generative adversarial networks, which have significantly improved the accuracy and efficiency of medical image analysis. These innovations have enabled rapid and accurate detection of abnormalities, from identifying tumors during radiological examinations to detecting early signs of eye disease in retinal images. The article also highlights various applications of AI in medical imaging, including radiology, pathology, cardiology, and more. AI-based diagnostic tools not only speed up the interpretation of complex images but also improve early detection of disease, ultimately delivering better outcomes for patients. Additionally, AI-based image processing facilitates personalized treatment plans, thereby optimizing healthcare delivery. This literature review highlights the paradigm shift that AI has brought to medical imaging, highlighting its role in revolutionizing diagnosis and patient care. By combining cutting-edge AI techniques and their practical applications, it is clear that AI will continue shaping the future of healthcare in profound and positive ways.

Accurate medical image segmentation is paramount for precise diagnosis and treatment in modern healthcare. This research presents a comprehensive study on the efficacy of Particle Swarm Optimization (PSO) combined with Histogram Equalization (HE) preprocessing for medical image segmentation, focusing on Lung CT-Scan and Chest X-ray datasets. Best Cost values reveal the PSO algorithm’s performance, with HE preprocessing demonstrating significant stabilization and enhanced convergence, particularly in complex Lung CT-Scan images. Evaluation metrics, including Accuracy, Precision, Recall, F-Score, Specificity, Dice, and Jaccard, show substantial improvements with HE preprocessing, emphasizing its impact on segmentation accuracy. Comparative analyses against alternative methods, such as Otsu, Watershed, and K-means, confirm the competitiveness of the PSO-HE approach, especially in Chest X-ray images. The study also underscores the positive influence of preprocessing on image clarity and precision. These findings highlight the promise of the PSO-HE approach in advancing the accuracy and reliability of medical image segmentation, paving the way for further research and method integration to enhance this critical healthcare application.

The universal health insurance system in Taiwan was formed with good intentions to help vulnerable groups. However, the possibility of bankrupting the system due to wasted medical resources. In this study, using the medical expenditures of the Taiwanese Government and gross domestic product (GDP) as variables, the wavelet analysis method was used to empirically study the correlations and leading-lagging relationships in quarterly data in the period from 1996 to 2016. In addition, the dependent population of the insured was used as the control variable. This population had no income and had high medical demands. Results: After the dependent population was included as a control variable, there was a period of low-frequency (one to four years short-term) linkage correlation, as well as a period of high-frequency (four to eight years long-term) linkage correlation. In addition, for more than eight years, there was also a high degree of linkage correlation, indicating that the linkage between medical expenditures and GDP occurred over the long term. Moreover, since medical expenditures positively affected GDP, one-way causality was observed. However, after 2008, regardless of whether a long or short term was examined, there was almost no linkage correlation. Before 2008, the medical expenditures of the government were positively correlated with economic growth; i.e., they enhanced economic growth. But, after 2008, this effect had already disappeared. The universal health insurance system has long been denounced as a waste of medical resources, and the waste must be immediately stopped. The government urgently needs to find a new solution.

Introduction: In an era of increasing public awareness regarding the pivotal role of nutrition in the onset and progression of chronic degenerative diseases, there is a growing demand for information and assistance pertaining to the intricate relationship between diet and disease. Nutritional practices, therefore, emerge as a fundamental element in the prevention and management of these maladies, necessitating a proactive response from healthcare professionals (HCP). This study sought to evaluate the impact of participation in a Culinary Medicine (CM) program on Mediterranean diet adherence, food management skills, culinary proficiency, and counseling confidence among HCP. Methods: A mixed-methods pilot implementation program (PIP) was meticulously designed and executed, engaging a cohort of 20 HCP recruited from Hospital Clinic Barcelona. The program unfolded at the Alícia Foundation kitchen-lab and encompassed a series of interactive, hands-on sessions that delved into the realms of gastronomy, food management, culinary skills, and culinary diet therapy, with a specific focus on prevalent diseases and their prevention, treatment, and care. Tailored questionnaires were administered to all participants both before and after the PIP. Results: Of the 20 participants, 14 successfully completed the study, comprising 86% women, 86% aged above 40, 71% nurses, and 7% medical doctors. Interestingly, 86% of the participants had previously received nutrition training, whereas only 14% had received culinary training. Following the completion of the program, there was a remarkable improvement in adherence to the Mediterranean diet (p < 0.01). However, no statistically significant improvements were observed in food management and culinary skills or counseling confidence (p > 0.5). Despite the absence of statistical significance, there was a noteworthy trend towards greater advocacy for dietary changes before resorting to medication, along with enhanced confidence in providing nutritional and culinary guidance to patients. Conclusion: The findings from this study underscore the potential of hands-on CM training as a vital component of nutrition education for HCP. While statistically significant improvements in certain domains were not observed, the program did demonstrate its ability to influence attitudes, knowledge, and behaviors related to healthy cooking and eating for both HCP themselves and their patients. Given these promising trends, future studies with a larger sample size must be performed to further elucidate the impact of CM training on HCP and its potential benefits for public health.

Burden of diseases measured as disability-adjusted life years per 100,000 people can be mined from public domain data, when they are made available by population health surveillance systems. This can be analysed to allow insightful comparisons with the national average, and to understand differences in trends between the sexes, age groups, time periods, geographic regions and sub-regions. In this illustrative case study, we have analysed the Scottish burden of disease database to understand what ailed the population of the Grampian region before the COVID-19 pandemic. We have identified selected cancers, ischaemic heart disease, Alzheimer’s disease and other dementias amongst the highest contributors to the burden; that drug use disorders and colorectal cancer are showing worsening trends and require health promotion and disease prevention measures from ages 15 and 25 respectively, especially in Aberdeen City; and that males are more vulnerable to atrial fibrillation and flutter, diabetes mellitus and oesophageal cancer, while females are to cerebrovascular disease. We demonstrate the usefulness of our analysis and methodology for the wider health system, allowing targeted medical research investments and coordinated response from public health and health service delivery. We also show the need for up-to-date surveillance data, forecasts and evidence on the impact of interventions to be made available widely.

Depression and anxiety in cardiovascular disease worsen the prognosis of patients. Treatments for these disorders often provide limited improvement. The present study aimed to test, for the first time, the impact of educational technology on anxiety and depressive symptoms in patients participating in a cardiac rehabilitation program. A 12-month randomized controlled trial was conducted, in which 207 patients were randomly assigned to either the experimental (n=76) or control (n=69) groups. The intervention involved a structured patient education program provided by medical students who had undergone specially designed training in cardiac rehabilitation. The primary outcomes were death, hospitalization, heart failure, and recurrent myocardial infarction. The study also assessed anxiety and depression. A year later, the experimental group showed a statistically significant decrease in anxiety and depression on the HADS scale, with reductions of 2.0 and 1.9 points respectively (p&lt;0.05). The control group showed reductions of 1.5 and 1.2 points (p&lt;0.05). The difference in depression (HRDS) between the groups at 12 months was -1.29 in favor of the main group (95% CI, -0.7 to -1.88), and the standardized effect size (SMD) was 0.36 (95% CI, 0.03 to 0.69). No treatment-related adverse events were observed. The results suggest that educational interventions can have a positive impact on mental health. The study's strengths include a structured intervention, randomization, and long-term follow-up. Limitations include the lack of blinding of study participants and a relatively small sample size.

This study aimed to investigate Romanian physicians' awareness, recommendation practices, and opinions regarding using Foods for Special Medical Purposes (FSMPs) products. A total of ten physicians were interviewed using a structured questionnaire, and their responses were analysed using thematic content analysis. The study found that physicians were aware of FSMPs and recommended them to their patients based on nutritional deficits, weight loss, or deglutition impairments. In addition, disease stage, treatment scheme, taste, affordability, and availability were identified as factors influencing the recommendation and use of FSMPs. While physicians generally did not consult clinical trials, clinical experience was deemed essential for recommending FSMPs to patients. Patients' feedback regarding the usage and sourcing of FSMPs was generally positive, with some expressing concerns about the availability of different flavours and the costs of purchasing the products. The study concludes that physicians play a vital role in recommending FSMPs to patients and ensuring they have the necessary nutritional support during treatment. However, more patient education materials and collaboration with nutritionists may be required to improve patient outcomes and reduce patient financial burden.

This study investigates the pivotal areas where Artificial Intelligence (AI) integration in healthcare warrants further exploration, leveraging insights from Boston Specialists, a forefront healthcare provider in AI adoption. Employing a qualitative case study approach, enriched by in-depth interviews and comprehensive literature reviews, we identify three main domains for potential AI expansion: scheduling efficiency, clinical documentation, and AI-driven medical research. Our results underscore the substantial enhancements AI brings to operational workflows and patient care, notably through improved scheduling systems, accuracy in medical documentation, and the facilitation of data-driven research methodologies. These findings suggest a critical need for healthcare institutions to further invest in AI technologies, focusing on these key areas to harness AI's full potential in personalizing care, optimizing efficiency, and advancing medical knowledge. The study concludes with a call for continued investigation into AI's integration within healthcare settings, emphasizing the importance of a supportive organizational infrastructure, ethical considerations, and data security in realizing AI's transformative impact on healthcare delivery and patient outcomes.

This comprehensive review unfolds a detailed narrative of Artificial Intelligence (AI) making its foray into radiology, a move that is catalysing transformational shifts in the healthcare landscape. It sheds light on the journey of radiology, from the pioneering discovery of X-rays to today’s intricate imaging technologies, infused with machine learning and deep learning in medical image analysis. At the crux of this review lies an in-depth study of AI applications in radiology, elucidating its seminal roles in image segmentation, computer-aided diagnosis, predictive analytics, and workflow optimisation. A spotlight is cast on the profound impact of AI on diagnostic processes, personalised medicine, and clinical workflows, with empirical evidence derived from a series of case studies across multiple medical disciplines. However, the integration of AI in radiology is not devoid of challenges. The review ventures into the labyrinth of obstacles that are inherent to AI-driven radiology — data quality, the ’black box’ enigma, infrastructural and technical complexities, as well as ethical implications. Peering into the future, the review contends that the road ahead for AI in radiology is paved with promising opportunities. It advocates for continuous research, embracing avant-garde imaging technologies, and fostering robust collaborations between radiologists and AI developers. It concludes by firmly cementing the role of AI as a catalyst for change in radiology, a stance that is firmly rooted in sustained innovation, dynamic partnerships, and a steadfast commitment to ethical responsibility.

With the popularization of intelligent sensing and the improvement of modern medical technology, intelligent medical sensing technology has emerged as the times require. This technology combines basic disciplines such as physics, mathematics, and materials with modern technologies such as semiconductors, integrated circuits, and artificial intelligence, and has become one of the most promising focuses in the medical field. The core of intelligent medical sensor technology is to make existing medical sensors intelligent, portable, and wearable with full consideration of ergonomics and sensor power consumption issues, for conforming to the current trends in cloud medicine, personalized medicine, and health monitoring. With the development of automation and intelligence in measurement and control systems, it is required that sensors have high accuracy, reliability, stability, as well as certain data processing capabilities, self-checking, self-calibration, and self-compensation，while traditional medical sensors cannot meet such requirements. In addition, in order to manufacture high-performance sensors, it is also difficult to improve the material process alone, and it is necessary to combine computer technology with sensor technology to make up for its performance shortcomings. Intelligent medical sensing technology combines medical sensors with microprocessors to produce powerful intelligent medical sensors. On the basis of the original sensor functions, intelligent medical sensors also have functions such as self-compensation, self-calibration, self-diagnosis, numerical processing, two-way communication, information storage, and digital output. This review focuses on the application of intelligent medical sensing technology in biomedical sensing detection from three aspects: physical sensor, chemical sensor, and biosensor.

The present study aimed to evaluate the psychometric properties of the Greek version of the Jefferson Scale of Empathy—Student version (JSE-S) and its association with potential predictors among Greek-speaking undergraduate medical students. This study adopted a cross-sectional, comparative–descriptive research design. The study was conducted during October and November 2023. Cronbach’s α for the JSE-S was 0.846. Cronbach’s α values for the factors “perspective taking”, “compassionate care”, and “standing in the patient’s shoes” were 0.800, 0.715, and 0.748, respectively. The intraclass correlation coefficient for the JSE-S score in the test–retest study was 0.827 (95% CI = 0.647 to 0.915, p-value &lt; 0.001), indicating a high level of reliability. The participants showed moderate empathy levels. Females scored higher than males on the Greek version of the JSE-S (108.8 vs. 102.8, p-value &lt; 0.001). Moreover, students enrolled in the fourth academic year showed higher empathy mean scores than those enrolled in the first year (108.6 vs. 103.6, p-value = 0.012). Statistically significant empathy differences by specialty preferences or faith in God/supreme power were not found. The present study provided satisfactory evidence that the Greek JSE-S is a psychometrically sound measurement instrument. Empathy differences by gender were found in line with prior literature.

Violence against paramedics has been described as a ‘serious public health problem’ but one that remains ‘vastly underreported’, owing to an organizational culture that stigmatizes reporting – hindering efforts at risk mitigation in addition to creating a gap in research. Leveraging a novel reporting process developed after extensive stakeholder consultation and embedded within the electronic patient care record, our objective was to provide a descriptive profile of violence against paramedics in a single paramedic service in Ontario, Canada. Between February 1, 2021, through January 31, 2023, a total of 374 paramedics in Peel Region (48% of the workforce) generated 941 violence reports, of which 40% documented physical (n=364) or sexual (n=19) assault. The violence was typically perpetrated by patients (78%) and primarily took place at the scene of the 9-1-1 call (47%); however, violent behavior frequently persisted or recurred while in transit to hospital and after arrival. Collectively, mental health, alcohol, or drug use were listed as contributing circumstances in 83% of violence reports. In all, 81 paramedics were physically harmed because of an assault. On average, our data correspond to a paramedic filing a violence report every 18 hours, being physically assaulted every 46 hours, and injured every 9 days.

A medical entity (hospital, nursing home, rest home, revalidation center, etc.) usually includes a multitude of information systems that allow for quick decision-making close to the medical sensors. The Internet of Medical Things (IoMT) is an area of IoT that generates a lot of data of different natures (radio, CT scan, medical reports, medical sensor data). However, these systems need to share and exchange medical information in a seamless, timely, and efficient manner with systems that are either located within the same entity or located in other healthcare entities. The lack of inter and intra entity interoperability causes major problems in the analysis of patient records and leads to additional financial costs (e.g., redone examinations). In order to develop a medical data interoperability architecture model that will allow providers and different actors in the medical community to exchange patient summary information with other caregivers and partners in order to improve the quality of care, the level of data security, and the efficiency of care, we take stock of the state of knowledge.

In February 2004, the Food and Drug Administration (FDA) was the first to approve the combination of cisplatin (CDDP) and pemetrexed (PEM) as standard first-line chemotherapy for untreated, unresectable malignant pleural mesothelioma (MPM). However, after that approval, no progress was made in the standard first-line treatment of MPM for almost 15 years. Positive results from a phase 3 study (Mesothelioma Avastin Cisplatin Pemetrexed Study: MAPS) verifying the effect of bevacizumab, an anti-angiogenesis agent added to CDDP/PEM for unresectable MPM, were published in The Lancet in December 2015; however, this did not lead to approval by national drug regulatory agencies. Furthermore, no second-line treatment was established for cases refractory to CDDP/PEM. In August 2018, the Pharmaceuticals and Medical Devices Agency of Japan was the first in the world to approve monotherapy with nivolumab, an immune checkpoint inhibitor (ICI), for previously unresectable, advanced, or recurrent MPM. Following Japan, in October 2020, the FDA approved the combination of nivolumab and ipilimumab for the treatment of previously untreated, unresectable MPM. In this article, we review the transition of drug treatment for MPM, in light of the historical background, focusing on the benefits of ICIs.

We evaluated the usefulness of the novel cholesterol-triglyceride subgroup (CTS) indices that potentially reflect the metabolic status regarding risk of coronary heart disease (CHD) using a retrospective longitudinal study of the Japanese general population. We recruited 12,373 individuals from the annual users of our healthcare center. Among them, the first onset of CHD was recorded in 131 individuals between April, 2014 and March, 2020. The multivariate Cox proportional hazards regression analyses for all normalized lipid indices revealed that the CTSqnt index showed a comparable hazard ratio for the CHD outcome to non-high-density lipoprotein cholesterol (nonHDL-c) and triglycerides. The HR of the CTSqlt index was significantly lower than for CTSqnt, but still comparable to that for low-density lipoprotein cholesterol (LDL-c). In comparison with the other indices, CTSqlt is more sensitive to risk increment while the index value increases. Linear regression analyses for the CTS indices and previously known lipid indices suggest that the CTSqnt and CTSqlt indices reflect the quantity of atherogenic lipoproteins and size of smaller and denser LDLs, respectively. Furthermore, the CTSqnt/HDL-c index can be used as a comprehensive risk indicator that may represent the status of lipid metabolism determined by the CTSqlt and CTSqnt indices and thus may be useful for screening. The CTS indices can be used to evaluate the metabolic status of individuals, which may increase the risk of future CHD.

Respiratory viral infections (RVI) are common reasons for healthcare consultations. The inpatient management of RVI consumes significant resources. From 2009-2014, we assessed the costs of RVI management in 4776 hospitalized chil-dren aged 0-18 years participating in a quality improvement program, where all ILI patients underwent virologic testing at the National Reference Centre followed by de-tailed recording of their clinical course. The direct (medical or non-medical) and indirect costs of inpatient management outside the ICU (“non-ICU”) versus management requiring ICU-care (“ICU”) added up to 2,767.14€ (non-ICU) vs. 29,941.71€ (ICU) for Influenza, 2,713.14€ (non-ICU) vs. 16,951.06€ (ICU) for RSV infections, and 2,767.33€ (non-ICU) vs. 14,394.02€ (ICU) for human rhinovirus (hRV) infections, respectively. Non-ICU inpatient costs were similar for all 8 RVI studied: Influenza, RSV, hRV, ade-novirus (hAdV), metapneumovirus (hMPV), parainfluenzavirus (hPIV), bocavirus (hBoV) and seasonal coronavirus (hCoV) infections. ICU-costs for Influenza however, ex-ceeded all other RVI. At the time of the study, Influenza was the only RVI with antivi-ral treatment options available for children, but only 9.8% of Influenza patients (non-ICU) and 1.5% of ICU-patients with Influenza received antivirals; only 2.9% were vac-cinated. Future studies should investigate the economic impact of treatment and pre-vention of Influenza-, COVID-19-, and RSV post vaccine introduction.

Recently, there has been remarkable progress in the development of smart textiles, especially knitted strain sensors, to achieve reliable sensor signals. Stable and reliable electro-mechanical properties of sensors are essential for using textile-based sensors in medical applications. How-ever, challenges associated with significant hysteresis and low gauge factor (GF) values remain for using strain sensors for motion capture. To evaluate these issues, a comprehensive investiga-tion of the cyclic electro-mechanical properties of weft-knitted strain sensors was conducted in the present study to develop a drift-free elastic strain sensor with a robust sensor signal for mo-tion capture for medical devices. Several variables were considered in the study, including the variation of the basic knit pattern, the incorporation of the electrically conductive yarn, and the size of the strain sensor. The effectiveness and feasibility of the developed knitted strain sensors are demonstrated through experimental evaluation, by determining the gauge factor, its non-linearity, hysteresis and drift. The developed knitted piezoresistive strain sensors have a GF of 2.4, a calculated drift of 50 %, 12,5 % hysteresis, and 0.3 % nonlinearity in parts.

There are four categories of medical waste that cannot be mixed as this will cause serious problems such as environmental pollution or infection. In the past, the classification of medical waste often involved a lot of human and material resources to process, with workers at risk of exposure to infectious substances. Therefore, an augmented reality (AR) and artificial intelligence (AI) medical waste classification system and method were developed. This innovative medical waste classification system and method combines AR and AI identification technology to reduce the risk of manual judgment errors by clinical staff when handling medical waste.

A substantial spike in the need for quality healthcare has resulted from people being more cognizant of health issues. With blockchain, healthcare providers may safely share patient information electronically, which is especially important given the sensitive nature of the data contained inside them. However, flaws in the current blockchain design have surfaced since the dawn of quantum computing systems. The study proposes a novel quantum inspired blockchain system (Qchain) and constructs a unique entangled quantum medical record (EQMR)system with an emphasis on privacy and security. This Qchain relies on entangled states to connect its blocks. Automated production of the chronology indicator reduces storage capacity requirements by connecting entangled BloQ (blocks with quantum properties) with controlled activities. One qubit is used to store the hash value of each block. A lot of information regarding quantum internet is included in the protocol for the entangled quantum medical record (EQMR). EQMR can be accessed in Medical Internet of Things (M-IoT) systems may be kept private and secure, and their where-abouts can be monitored in the event of an emergency. The protocol also uses quantum authentication in place of more conventional methods like encryption and digital signatures. Mathematical research shows that the quantum converged blockchain (QCB) is highly safe against attacks such as the External attack, Intercept-Measure-Repeat attack, and Entanglement-Measure attack. The reliability and auditability evaluations of the entangled BloQ, as well as the quantum circuit design for computing the hash value, are presented. There's also a comparison between the suggested approach and several other quantum blockchain designs.

Understanding the genetic architecture of a disease is crucial for development of valid diagnostic and therapeutic interventions. The analysis of genomic variations associated with pathological conditions is the starting point for uncovering disease-causing pathways (candidate processes). However, the complexity of intergenic and genetic-environmental interactions hinders the identification of pathogenic values of genomic changes. Furthermore, heredity, epigenetics and somatic mosaicism make the interpretation of genomic data even more sophisticated. To succeed, a variety of bioinformatic techniques are applied. Here, reviewing own and literature data, knowledge-based prioritization of genomic variations is described. Theoretical basis of the knowledge-based prioritization is given with a special regard to gene ontology, heuristics, hermeneutics (genomic hermeneutics) and analytics. Practical and methodological issues of prioritization using ontology- or pathway-based systems analysis are considered in the light of optimistic and realistic scenarios of cumulative phenotypic effects of the variome (the whole set of genomic variations in an individual or specific set of genomic variations for a phenotypic outcome). In the present communication, copy number variants (CNVs) in children with neurodevelopmental diseases are used as a practical foundation for the prioritization, inasmuch as these genome variations are systematically overlooked in the so-called NGS era. Nonetheless, it is highly likely that the prioritization is applicable to almost all types of genomic variations (e.g. chromosome abnormalities, gene mutations, functional synonymous variants etc.). The present methodology seems to be a valuable addition to current biomedical science widening the opportunities for medical genomics and genetics.

Aims: Medical Nutritional Treatment (MNT) can be complex and associated to potential meta-bolic complications, which has been recently described as Nutritrauma. There is no data on the effect of applying this strategy in clinical practice. The aim of our work is to describe if applica-tion of Nutritrauma concept in real live is useful to detect metabolic complications associated to the prescription of MNT in critically ill patients. Methods: In this descriptive prospective study at a single center, we enrolled 30 consecutive crit-ical ill patients of a 14 beds medical – surgical Intensive Care Unit. The Nutritrauma strategy implementation was based in four M steps: Metabolic screening, MNT prescription, Biochemical Monitoring and Nutritional Management. The primary endpoint was to describe the metabolic complications of the MNT detected with Nutritrauma strategy. Secondary endpoint was to de-scribe the most frequent causes of inappropriate prescription. Results: We analysed 28 patients (mean age 69,7 ± 11,3 years; APACHE II 18,1 ± 8,1, SOFA 7,5 ± 3,7; Nutric Score modified 4,3 ± 2,01 and mean BMI 27,2 ± 3,8). The most frequent disease on admission was sepsis (46,4%). Length of ICU stay was 20,6 ± 15,1 days and 39,3% died during the ICU stay. Enteral nutrition (82,1%) was more frequent than parenteral nutrition (17,9%). During nutritional monitoring 54 specific analytical determinations were made. Hyperglycemia was the most frequent metabolic alteration (83,3% of the determinations). Electrolyte disturbance were hypocalcemia (50%), hypophosphatemia (29,6%) and hypokalemia (27,8%). The most frequent lipid profile abnormality were hypocholesterolemia (64,8%) and hypertriglyceridemia (27,8%). Furthermore, nutritional prescription was modified in the 53,6% of patients: increase protein dosage (25%), increase caloric dosage (21,4%) and change to an organ-specific diet (17,8%). Conclusions: The application of Nutritrauma strategy facilitate the detection of metabolic com-plications and the evaluation of the appropiate prescription of the MNT.

The optical properties and physiology of biological tissue, as well as how near-infrared (NIR) light interacts with the tissue, both play a significant role in interpreting the tissue probing optical measurements, and in solving the inverse problem of near-infrared spectroscopy (NIRS)-based medical imaging modalities such as diffuse optical tomography and functional near-infrared spectroscopy. This paper discusses the optical properties of tissue, specifically in the NIR wavelength range, which influence NIRS measurements in NIRS-based medical imaging. There is an easy-to-understand explanation given in this paper of the NIR light-tissue interaction phenomenon. The mathematical explanation, the processes involved in the interaction, and the rationale for a few approximations are described. Various types of chromophores present in the tissue, their composition in the tissue, and how these chromophores overall affect the scattering and absorption of NIR light are presented. The absorption spectra of these chromophores are shown. Finally, the paper concludes with the author’s perspective on two NIRS-based medical imaging modalities, diffuse optical tomography, and functional near-infrared spectroscopy.

In this paper we introduce the concept of Nano Beta Closure, Nano Beta Interior and study the relationship between them also study some of their properties. Based on these notions we introduced the topological Approach to Decision Making and Its Application in the Medical Field" which describes the use of topological methods in decision-making, specifically through the utilization of nano beta closure and nano beta interior. These mathematical tools are applied in the medical field to improve diagnostic accuracy and aid in treatment planning. The authors demonstrate the effectiveness of this approach through a case study on the diagnosis of Chronic Kidney. The results show that the topological approach using nano beta closure and nano beta interior provides a reliable and accurate method for medical decision-making. Finally, we introduce a medical application for disease groups patients of with chronic kidney. To identify the main causative agent of kidney disease. where using this approach, the medical team can identify the specific areas of the kidney that are affected by the infection, as well as the extent of damage and any potential complications. This information is used to create an individualized treatment strategy that is customized to meet the specific requirements of the patient. and medical history. We write an algorithm that can be a helpful tool for doctors to utilize in diagnosing infection disease Chronic Kidney infections. By utilizing this approach, clinicians can provide accurate diagnoses, develop effective treatment plans, and ultimately improve patient outcomes. finally, we show that fractals hold significant importance in future nano topological generation of the human factor. Their unique properties and self-similar patterns offer insights into the complex organization of biological systems and provide a foundation for designing advanced Nanosystems.

The ankle is a complex joint with a high injury incidence. Rehabilitation Robotics applied to the ankle is a very active research field. We present cable-driven reconfigurable robot kinematics and statics. We studied how the tendons pull mid-foot bones around the talocrural and subtalar axes. Likewise, we propose a hybrid serial-parallel mechanism analogous to the ankle. Then, using screw theory, we synthesized a cable-driven robot with the human ankle in the closed-loop kinematics. We incorporate a draw-wire sensor to measure the axes’ pose and compute the product of exponentials. We reconfigure the cables to balance the tension and pressure forces using the axis projection on the base and platform planes. Likewise, we also computed the workspace to show that the reconfigurable design fits several sizes. The data used is from anthropometry and statistics. Finally, we validated the robot’s statics with MuJoCo for various cable length groups corresponding to the axes’ range of motion. We suggested a platform adjusting system and an alignment method. The design is lightweight, and the cable-driven robot has advantages over rigid parallel robots, such as Stewart platforms. We will use compliant actuators.

Exoskeletons designed to assist patients with activities of daily living are becoming increasingly popular, but still are subject to research. In order to gather requirements for the design of such systems, long-term gait observation of the patients over the course of multiple days in an environment of daily living are required. In this paper a wearable all-in-one data acquisition system for collecting and storing biomechanical data in everyday life is proposed. The system is designed to be cost efficient and easy to use, using off-the-shelf components and a cloud server system for centralized data storage. The measurement accuracy of the system was verified, by measuring the angle of the human knee joint at walking speeds between 3 and 12 km/h in reference to an optical motion analysis system. The acquired data was uploaded to a cloud database via a smartphone application. Verification results showed that the proposed toolchain works as desired. The system reached an RMSE from 2.9° to 8°, which is below most of the comparable system. The system provides a powerful, scalable platform for collecting and processing biomechanical data, which can help to automize the generation of an extensive database for human kinematics.

This paper describes the design and development of an active device that was applied to shoulder rotation rehabilitation. It implements a force control in a similar way to the haptic devices that reflect a force on the user’s hand according to the rehabilitation parameters. This device was tested with patients, combining clinician manipulation and programmed exercises. The results were excellent, given that the range of movement of the shoulder increased in most of the pa-tients. The results of the Usability Scale questionnaire were also promising.

This study evaluates the accessibility of primary care physicians (PCPs) in Eastern Quebec using an enhanced two-step floating catchment area (E2SFCA) methodology. The E2SFCA methodology considers both the population supply of PCPs and the travel time between PCPs and dissemination areas, and was found to be effective in identifying possibly underserved areas. The availability of primary care services is contingent upon the presence of adequate road infrastructure, and populations residing in areas with limited access to main road networks may experience compromised access to primary care. The study concludes that the E2SFCA methodology can facilitate the identification of areas experiencing a shortage of PCPs, and this information can be used to inform the development of regional medical workforce programs and support the establishment of rural residency initiatives.

Cosmetic surgery is the subfield of plastic surgery that enhances appearance mainly for aesthetic reasons. Currently, cosmetic surgery interventions are highly considered appealing and popular all around the world. Several factors have contributed in this rapidly evolving field such as scientific and economic development, breaking down barriers and cultural norms, globalization, social media and mental disorders. Nowadays, the morality of cosmetic surgery is facing many dilemmas due to its benefits and drawbacks. It is proven that the advantages of cosmetic surgery include improved body confidence, mental health, and function. Additionally, aesthetic corrections can upscale the quality of life and create career opportunities for special targeted groups. Also, cosmetic surgery has a major impact in gender affirmation procedures. Although, herein we also describe the disadvantages of this widely developing field such as minor and major medical complications, potential postoperative risks and addiction in plastic surgeries associated with damaging economic issues. Lack in self-confidence, altered mental health status and ethical crisis consist another negative aspects of aesthetic surgery’s impact.

Introduction. Covid-19 faced the world with serious health and socioeconomic issues. At the very beginning of the pandemics, the vaccine was considered by health authorities and the medical community the only way to curb the spread of the virus. One of the measures that have been proposed to increase vaccinations was the mandatory policy. The purpose of this study was to compare determinants of voluntary and mandatory vaccination among students of Albanian University. Methodology: This cross-sectional study by means of an online survey, was conducted among students enrolled in the private University “Albanian University”, Tirana, Albania during the last week of winter semester 7-14 Feb 2022. Results: 878 students participated in this study, among them 612 (69.7%) were females, 266 (30%) were males. 506 (57%) of the participants were enrolled in Medical Sciences (MS), 372(42.3%) were Non-Medical Science (Non-MS) group. 773 (88%) was vaccinated against Covid-19, 105 (11.8%) were not vaccinated. 466 (53%) reported voluntary vaccination, 412 (46.9%) reported mandatory vaccination. Among students that vaccinated voluntary 266 (57%) were from MS group, 200(42.9%) from Non-MS group. 237(57.5%) of students in mandatory vaccination group were from MS group, 175 (42.4%) from Non-MS. Conlusion. Vaccine safety and efficacy were hindering factors of vaccination. Also, based on the results of this study, the students felt encouraged to vaccinate by the academic staff. This clearly demonstrates that the staff does not lack the skills to enhance stu-dents' knowledge about the risk of infectious diseases and the importance of vaccination. Therefore, to influence as much as possible students’ attitude toward vaccination, comprehensive educational programs including modification of existing curricula should be considered.

Deep Neutral Networks (DNNs) were initially proposed towards the midst of the 20th century, motivated by the neural structure and mechanism of the human brain. Thanks to major ad-vancements in computational resources, during the past decade DNN-based systems have demonstrated unprecedented performance in terms of accuracy and speed. However, recent work has shown that such models may not be sufficiently robust during the inference process. Furthermore, due to the data-driven learning nature of DNNs, designing interpretable and gen-eralizable networks is a major challenge, especially in critical applications, such as medical Computer Aided Diagnostics (CAD) and other medical imaging tasks, including classification, regression and reconstruction. Within this context, a line of physics-driven approaches for deep learning has recently emerged, aimed at improving the stability and generalization capacity of DNNs for medical imaging applications. In this paper, we review recent work focused on phys-ics-driven or prior-information learning for a variety of imaging modalities and medical applica-tions. We discuss how the inclusion of domain-related knowledge into the learning process and networks’ design supports their stability and generalization capability. In addition, we highlight current and future challenges within this scope.

Electrical storm (ES) is defined as the presence of at least three episodes of sustained ventricular tachycardia or ventricular fibrillation within 24 hours. This patient had a previously known arterial hypertension, type II diabetes mellitus, and chronic kidney disease and has presented to the Emergency Department (ED) with symptoms of retrosternal chest pain lasting for several hours prior. The initial 12-lead electrocardiogram revealed ST segment elevation in the anterior leads (V1-V6). Emergent coronary angiography revealed an acute occlusion of the proximal left anterior descending artery (pLAD) and percutaneous coronary intervention was performed with successful implantation of one drug-eluting stent in the pLAD. On the day 8 of hospitalization, patient developed a refractory ES for which he received 50 DC shocks and did not respond to multiple lines of antiarrhythmic medications. Due to a failure of medical therapy, we decided to implant a temporary pacemaker and initiate ventricular overdrive pacing (VOP) that was successful in terminating ES. Following electrical stabilization, the patient underwent a successful ICD implantation. This case demonstrates that VOP can contribute to hemodynamic and electrical stabilization of a patient that suffers from refractory ES and this treatment modality might serve as a temporary bridge to ICD implantation.

Fractional flow reserve (FFR) is well recognized as a gold standard measure for the estimation of functional coronary stenosis. Technological progressions in image processing have empowered the reconstruction of three-dimensional models of the coronary arteries via both non-invasive imaging modalities, such as Coronary Computed Tomography Angiography (CCTA), and invasive coronary angiography or intravascular imaging. The application of computational fluid dynamics (CFD) techniques to coronary 3D anatomical models allows the virtual evaluation of the hemodynamic significance of a coronary lesion with high diagnostic accuracy in comparison to the invasive FFR using pressure wires. These opportunities providing hemodynamic information based on anatomy have given rise to a new era of functional angiography and coronary imaging. However, further validations are needed to overcome several scientific and computational challenges before these methods are applied in everyday clinical practice. This review aims to present all the data on the studies and methodologies that have been presented for the virtual estimation of FFR, and the diagnostic execution of the virtual tools for the hemodynamic assessment of coronary lesions compared to the invasive FFR.

The patient's satisfaction level concerning hospitalization has certain particularities, related to the geographical area, medical/non-medical assistance, the age, incomes, morbidity and mortality of the population. The objective of this study is to emphasize the degree of patients' satisfaction, depending on the specialty of the hospitalization department: surgical, medical, oncological, psychiatry, and to evidence the factors influencing the reliability and accuracy of patients' answers, such as: the patient's health condition upon admission, the duration of the admission, the level of physical pain and the emotional state. Patients and methods: The research was conducted between April and December 2021 on patients hospitalized in two public hospitals from the north-west of Romania, both of them being independent Legal Entities: the Municipal Clinical Hospital of Oradea (MCHO) and the County Clinical Emergency Hospital of Oradea (CCEHO). Results: The lowest score of PSS recorded in these two analyzed public hospitals from the north-western of Romania was appointed for the Pharmaceutical availability of patients medical treatment (2.24), attitude of the staff (2.56) and the quality of nursing care offered (2.58). Conclusions: The hospital management’s focus has been set to improve the communication skills among medical staff, to evidence their compassion, politeness, and to ensure the availability of essential drugs.

Paramedics are increasingly being subjected to violence, creating the potential for significant physical and psychological harm. Where a patient has a history of violent behavior, hazard flags - applied either to the individual, their residential address, or phone number - can alert paramedics to the possibility of violence, potentially reducing the risk of injury. Leveraging a novel violence reporting process embedded in the electronic patient care record, we reviewed violence reports filed over a thirteen-month period since its inception in February 2021to assess the effectiveness of hazard flagging as a potential risk mitigation strategy. Upon reviewing a report, paramedic-supervisors can generate a hazard flag if recurrent violent behavior from the patient is anticipated. In all, 502 violence reports were filed, for which paramedic-supervisors generated hazard flags in 20% of cases (n=99). In general, cases were not flagged either because the incident occurred at a location not amenable to flagging, or because the supervisors felt that a hazard flag was not warranted based on the details in the report. Hazard flagging was associated with an increased risk of violence during subsequent paramedic attendance (Odds Ratio [OR] 6.21, p

Introduction: At the end of 2019 the Covid-19 pandemic caused a huge amount of restrictions across the world which affected teaching around the world as it was not prepared to move from traditional face-to-face to an online conversion overnight, so the aim of this paper is to determine the changes in undergraduate anatomy teaching strategies post-pandemic compared to pre-pandemic. Methods: A systematic review was conducted based on the PRISMA statement. Data were retrieved from the searches conducted in the different databases, and the articles to be retrieved were selected with the help of the Rayyan platform. Using the OPMER and JBI tools, the quality of evidence was assessed for the selection of the articles included in the review. Results: The teaching of medicine, specifically anatomy, presented serious problems due to the fact that throughout history it has been taught in the classroom by means of cadaveric dissection and when this ceased to be available, new methods arose through the use of digital resources to try to make up for the needs of the lack of dissection laboratories which lost a great deal of content in this restructuring, which have been improving with the passing of the courses taught and the development of new material that has been better adapted to the needs of the students. Discussion: The authors agree that in the future the best way to teach anatomy will continue to be face-to-face dissection without neglecting the strategies developed during this pandemic and to be taken if necessary to restructure curricula in the future to improve teaching.

Post-menopausal women are at risk of osteoporotic vertebral fractures (OVFs), which if undetected and untreated, can lead to significant pain and morbidity. However, OVFs are often not reported by radiologists on routine chest radiographs. Artificial Intelligence (AI) is increasingly used in medical applications with improvements in detection and diagnosis. This study aims to investigate the clinical value of a newly developed AI tool, Ofeye 1.0 for automated detection of OVFs on lateral chest radiographs in post-menopausal women (&gt;60 years) who were referred to undergo chest x-rays for other reasons. A total of 510 de-identified lateral chest radiographs from three clinical sites were retrieved and analysed by Ofeye1.0 tool. These images were then reviewed by a consultant radiologist to decide whether there is any fracture present or not with findings served as the reference standard for determining the diagnostic performance of the AI tool. The percentage of radiologist reports which included the OVF was analysed by comparing diagnostic reports with AI findings, while the accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) of the AI tool were calculated. Out of all the original radiologist reports, missed OVFs were found in 14% images but were detected by the AI tool. The AI tool demonstrated a relatively high specificity 92.8% (95% CI: 89.6, 95.2%), moderate accuracy 80.3% (95% CI: 76,3, 80.4%), PPV 73.7% (95% CI: 65.2, 80.8%) and NPV 81.5% (95%CI: 79, 83.8%), but low sensitivity 49% (95%CI: 40.7, 57.3%). The high false negative results were mainly due to mild OVFs with &lt;20% vertebral height loss. The new AI software tool has high specificity with a low false positive rate of 5.1%, showing that it can be used as a complimentary tool to the routine diagnostic reports for reduction of missed OVF in elderly women. The low sensitivity with high false negative rates indicate the necessity of radiologist’s in identifying and reporting early OVFs.

This study delves into the dynamic field of medical education research, emphasizing the integration of research training within medical curricula. It seeks to understand the impact of such integration on the competencies of future medical professionals. The primary aim is to systematically categorize and analyze the current trends and future directions in medical education research. This involves assessing the influence of research training on medical students' skills and the methodologies used in such research. Methods: The research employs an extensive bibliographic literature review across multiple databases. It classifies studies into categories like experiential or case studies, editorials, and original research articles. This classification is based on criteria such as geographical location, research objectives, theoretical frameworks, and methodologies. Results: Findings reveal a diverse landscape in medical education research, with a significant emphasis on research training. The research showcases varying methodologies and approaches used globally, highlighting the thematic focus and geographical distribution of these studies. Conclusion: Medical education research is a globally expansive and evolving field. It underscores the importance of continuous investigation, particularly focusing on integrating research elements at curricular levels and exploring innovative educational strategies. The study also points out potential gaps in research, especially in underrepresented regions, indicating directions for future research efforts.

Unexpected preoperative surgery cancellations are one of the important problems in daily anesthesia practice. It's an even bigger problem if these cancellations happen in the operating room. Our aim was to draw attention to this issue and reveal the reasons. This prospective, cross-sectional study aimed to assess the prevalence and causes of elective surgery cancellations once patients are in the operating room. The study sample consisted of 7482 adult patients scheduled for elective surgeries and taken to the operating room. Sixty-seven patients whose surgeries were canceled were grouped into Group 1, while the remaining 7415 whose surgeries were completed were in Group 2. Patients were divided into two groups based on whether their surgeries were completed or canceled. Factors such as age, American Society of Anesthesiologists physical status, and surgical department were analyzed. Metrics involved comparisons between the two groups regarding age, American Society of Anesthesiologists physical status classification, surgical department, and timing of the surgery. The prevalence of elective surgery cancellations after patients were in the operating room was 0.9%. Group 1 was significantly older than Group 2 (p&lt;0.001). The proportion of patients classified as American Society of Anesthesiologists physical status III was higher in Group 1 (p&lt;0.001). The department with the highest cancellation rate was ophthalmology(2.5%), followed by general surgery(2.1%), urology(1.5%), and ear, nose, and throat(1.4%). Approximately 59.7% of cancellations were deemed potentially avoidable. The study suggests that many of these cancellations are potentially avoidable, underscoring the need for optimized surgical scheduling and patient assessment protocols.

Breast cancer is a global health concern, necessitating continuous advancements in diagnostic medical imaging technologies for early detection and improvement of treatment. This paper presents an overview of the past, present and future of breast cancer imaging using light and some results from the current studies. The paper specifically presents the role of Diffuse Optical Tomography (DOT) in breast cancer imaging. Conventional methods, such as X-ray mammography, face limitations. Diffuse Optical Tomography, a non-invasive light-based imaging modality can provide quantitative descriptive and architectural information about breast tissue. The paper discusses the key challenges and recent developments in breast cancer imaging using DOT to overcome some key challenges. This paper aims to contribute to the understanding of the evolving technological landscape in breast cancer imaging using light for improving early detection and patient outcomes.

Keywords: Marine Coasts; Protected Areas; Defense and Conservation; Asbestos Cement Materials; Wastes; Contamination; Human Health Risk; Medical Geology.

Medical tests' cost-effectiveness analysis reveals a strong correlation between their accuracy and analysis results. Theoretically, we provide two lower bounds that medical tests' accuracy must exceed to be considered cost-effective. Theoretically, we provide two lower bounds that the accuracy of medical tests meeting cost-effectiveness must exceed. First, medical tests' accuracy should surpass the lower bound of matching requirements for each patient to receive the most appropriate intervention based on their test results. Second, the overall lower limit should be exceeded for the medical testing to be cost-effective for the patients as a whole. Furthermore, the conclusions from this model also provide an economic explanation for the under-diagnosis of rare diseases and the challenges faced in implementing precision medicine for minority patients. A numerical simulation example validates the conclusions of this paper.

Currently, Pythagorean fuzzy sets (PFSs) have been widely applied in various fields due to their substantial advantages in expressing and dealing with uncertainty. However, measuring the similarity and difference between PFSs effectively remains an unresolved issue. Inspired by Tanimoto similarity, we propose a novel set of similarity and distance measures for PFSs. We delve into the theoretical properties of the proposed measures and compare it with existing PFSs measures. Numerous numerical examples validate their rationality and effectiveness. Furthermore, our experimental findings suggest that in contrast to existing measures, the introduced measures successfully circumvent various counter-intuitive issues encountered by current measures, and yield more pronounced outcomes in the discrimination of different fuzzy sets. This enhances the uniqueness and superiority of our measures. Finally, we developed two decision models based on the proposed measures and validated their applicability in three applications.

Background The workload of nurses in the intensive care unit (ICU) can affect the quality of nursing services. Aim This study aimed to determine the relationship between the nursing activity score and missed care in patients hospitalized in the ICU in Zanjan, Iran. Methods This observational and prospective study was conducted from April 3 to September 18 in 2021. In this study, the tools used included a patient and nurses' profile questionnaire, Nursing Activity Score (NAS). Missed care was observed in the 301 patients for whom the NAS was calculated. Analysis of variance (ANOVA) was used to investigate the differences in mean levels of missed care. Logistic regression models were used to assess the association between factors and missed nursing care. Results Results show that the Medical ICU's mean NAS was 76.31 (95% CI: -13.06 -14.89). In 9 dimensions of care, the extent of missed care was 40.7%. In the care dimensions of assessment, hand hygiene, and infection control, the mean NAS had a statistically significant increase at higher levels of missed care (P<.5). Furthermore, work experience was identified as a protective factor for missed care (OR =.59, 95% CI: .37–.94, χ2= =4.97, p =.026). Conclusion The study revealed a high incidence of missed care. The study revealed that the mean workload was high in certain dimensions of care such as assessment, hand hygiene, and infection control. The increase in workload for nurses results in lost care. Nonetheless, the utilization of experienced nurses can help mitigate this problem. However, utilizing experienced nurses can help reduce this problem.

Background: Gender stereotypes and biases can influence perceptions of competence and suitability for certain medical specialties. Empathy is an important component of an optimal doctor-patient relationship. The scope of our study is to verify the correlation between “empathetic" behavioral style with attention and sensibility to the gender differences of patients of the medical students. Methods: An online survey was conducted using the Jefferson Scale for Empathy (JSE), to measure empathy in the context of health professions education and patient care; and the Nijmegen Gender Awareness in Medicine Scale (N-GAMS), which measures attitudes and assumptions about gender. A total of 234 students (52.1% M; mean age: 22.68±2.48) from Medicine and Surgery at the University of Salerno (Italy) participated, of whom n° 175 were third-year students and n° 59 were fifth-year students. Results: The JSE score shows that male students have higher scores (77.29±12.38) than females (75.91±10.39). Conversely, female students have higher perspective-taking (JSE Factor 1: Male= 51.26±11.84; Female= 52.72±11.88). In addition, third-year students are much more empathetic than their fifth-year colleagues (JSE Score: 3°ys= 77.35±11.46; 5°ys= 74.49±11.33). With reference to the GS, we found that male students have greater sensitivity than their female colleagues (GS: Male= 2.67±0.68; Female= 2.37±0.48); conversely, they have higher scores of gender stereotype towards patients (GRIP: Male= 2±0.88; Female= 1.59±0.61) and doctors (GRID: Male= 1.88±0.89; Female= 1.64±0.63). Also, the third-year students compared to their fifth-year colleagues are characterized by greater gender sensitivity (GS: 3°ys= 2.57±0.62; 5°ys= 2.42±0.57), less bias with respect to patients (GRIP: 3°ys= 1.77±0.79; 5°ys= 1.90±0.78) but, on the other hand, show more stereotypes and prejudices towards doctors (GRID: 3°ys= 1.77±0.81; 5°ys= 1.75±0.74). Conclusions: Humanistic attitudes, including empathy, should be instilled, and evaluated among trainees as an essential part of their postgraduate medical education.

Background: Advances in additive manufacturing and the development of antimicrobial biopolymers facilitate the production of critical medical devices with strong and safe biocidal properties. The purpose of this study was to assess the antimicrobial efficacy, safety, and longevity of a polylactic acid-based biopolymer supplemented with a copper-based composite additive. Methods: An antimicrobial polylactic acid-based biopolymer was tested against several inoculants including Staphylococcus Aureus, MRSA, E. coli, Listeria, HCoV-229E (a SARS-CoV-2 surrogate), and HIV-1. Material safety was evaluated according to international testing standards for in vitro cytotoxicity. Results: The main findings of the present investigation showed a strong and long-lasting biocidal effect of a polylactic acid-based biopolymer embedded with a copper-based composite additive against Staphylococcus Aureus, MRSA, E. coli, Listeria, HCoV-229E (a SARS-CoV-2 surrogate), and HIV-1. Furthermore, the cytotoxicity and safety assessment of the antimicrobial biopolymer was found to be “non-toxic” and safe for human skin contact. Conclusions: The present investigation showed that the antimicrobial biopolymer exhibits strong and long-lasting biocidal properties against an array of viral and bacterial inoculants.

The Work Ability Index (WAI) is the most widely used questionnaire for the self-assessment of working ability. Because of its different applications, shorter versions, and widespread use in healthcare activities, it is worthwhile assessing its characteristics. The WAI was distributed online among the workers of a healthcare company; the results were compared with data contained in the workers' personal health records and with absence registers. 340 out of 575 workers (59.1%) participated; 6.5% of them reported poor work ability. Exploratory factor analysis indicated that the one-factor version best described the characteristics of the WAI. The scores of the complete WAI, the shorter form without the list of diseases, and the minimal one-item version (WAS) had equal distribution and were significantly correlated. The WAI score was inversely related to age and significantly lower in women than in men, but it was higher in night workers than in colleagues due to the probable effect of selective factors. The WAI score was also correlated with absenteeism, but no differences were found between males and females in the average number of absences, suggesting that cultural or emotional factors influence the self-rating of the WAI. Workers tended to overreport illnesses in the online survey compared to data collected during occupational health checks. Musculoskeletal disorders were the most frequently reported illnesses (53%). Psychiatric illnesses affected 21% of workers and had the greatest impact on work ability. Multilevel ergonomic and human factor intervention seems to be needed to recover the working capacity of healthcare workers.

Ceruminous gland tumours are rare injuries of the external auditory canal (EAC). This tumor, even if considered a slow-growing carcinoma, has high rate of perineural invasion and metastasis. For this reason, it must be promptly diagnosed, then it must be treated with aggressive surgery combined with postoperative radiation. The present case report is about a case of an adenoid cystic carcinoma arising the external auditory canal of 46 years old female patient, who complained hypoacusis and pain. The profile of medical liability is substantiated on the delayed diagnosis when the lately observed tumor progression by the invasion of both surrounding bone and vascular structures.

Alzheimer's disease (AD) is a progressive and evolving neurodegenerative disease with an insidious onset that can lead to memory loss and cognitive impairment. There is no effective treatment for this disease. However, early diagnosis plays an important role in treatment planning to slow down its progression, as treatment has the greatest impact in the early stages of the disease. Neurological images obtained through different imaging techniques provide powerful information and help diagnose the disease. With the wide application of deep learning techniques in disease diagnosis, especially the prominence of Convolutional Neural Networks (CNNs) in computer vision and image processing, more and more studies are proposing the use of this algorithm for the diagnosis of AD. In this paper, we first systematically introduce the impact of AD on people, detailing the biomarkers, early clinical symptoms, and risk factors of this disease. Secondly, it goes on to detail the development of CNNs, their form, and methods to help diagnose AD. It is proposed that CNNs can help diagnose AD by analyzing medical imaging data, particularly structural brain scans such as magnetic resonance imaging (MRI) and functional scans such as positron emission tomography (PET). Finally, it is concluded that CNNs are of great importance for the diagnosis of AD and that they are likely to play an increasingly important role in the early detection of the disease, the understanding of disease mechanisms, and ultimately, in the development of effective AD therapies and interventions. CNNs are playing an increasingly important role in the Their potential impact on healthcare emphasizes the importance of continued research and innovation in neural networks and medical imaging.

Peritoneal fluid is an ovarian exudate from the growing follicle or corpus luteum. Therefore, the free concentrations of estrogens and progesterone are always much higher than in plasma, especially after ovulation. The peritoneum is not vascularised, and peritoneal implants and the superficial portion of deep endometriosis are likely influenced mainly by peritoneal fluid. Follicular phase progesterone concentrations are as high as during the luteal phase in plasma. This explains that most peritoneal implants are rarely proliferative and out of phase with the endometrium. From some 5 mm of depth onwards, endometriosis is rather influenced by plasma hormone concentra-tions, and the deeper parts can be proliferative as the endometrium. Because of these progesterone concentrations, progesterone resistance has to be postulated, permitting endometriosis lesions to initiate and develop. This opens the discussion of whether endometriosis is similar to the basal endometrium. These peritoneal fluid concentrations are important to understand the natural history and medical therapy of endometriosis. Most medical therapies decrease ovarian function and affect peritoneal fluid steroid hormone concentrations. It is suggested that the efficacy of medical therapy for endometriosis-associated pain is a consequence of the decreased estrogen concentrations in the peritoneal cavity and that the local effect of progestins may not be determinant for pain relief. If this is true, a history of endometriosis should not be considered a contraindication for hormone re-placement therapy.

This review summarizes available data on invasive procedures applied with questionable indications in Russia in the recent past: mastectomy with the removal of muscles, gastrectomy for peptic ulcers, spleno-renal anastomosis for diabetes mellitus, thoracic surgery for bronchial asthma, overuse of surgery in tuberculosis, excessive and compulsory treatments of alcohol-dependent patients, etc. Among factors contributing to the use of invasive procedures with unproven efficiency have been the partial isolation from international scientific community, insufficient consideration of the principles of professional autonomy, informed consent and scientific polemics, training of medical personnel. It is known that invasive procedures can exert a placebo effect, which might have contributed to reported efficiency of some methods discussed here. However, by definition, placebo must be free of risks.

Multimodal medical image fusion is a fundamental but challenging problem in the fields of brain science research and brain disease diagnosis, and it is challenging for sparse representation (SR)-based fusion to characterize activity level with single measurement and no loss of effective information. In this paper, the Kronecker-criterion-based SR framework is applied for medical image fusion with a patch-based activity level integrating salient features of multiple domains. Inspired by the formation process of vision system, the spatial saliency is characterized by textural contrast (TC), which is composed of luminance and orientation contrasts to promote more highlighted texture information to participate in the fusion process. As substitution of the conventional l1-norm-based sparse saliency, a metric of sum of sparse salient features (SSSF) is used for promoting more significant coefficients to participate in the composition of activity level measure. The designed activity level measure is verified to be more conducive to maintain the integrity and sharpness of detailed information. Various experiments on multiple groups of clinical medical images verify the effectiveness of the proposed fusion method on both visual quality and objective assessment. Furthermore, the research work of this paper is helpful for further detection and segmentation of medical images.

The paper aims to develop and test an algorithm for classifying Russian-language text reviews of patients’ experiences with medical facilities and physicians, extracted from social media. This is motivated by the limitations of conventional methods of surveying consumers to assess their satisfaction with the quality of services, which are being replaced by automatic processing of text data from social media. This approach enables to get more objective results due to the increased representativeness and independence of the sample of service consumers. The authors have tested machine learning methods using various neural network architectures. A hybrid method was developed to classify text reviews of medical facilities posted by patients on the two most popular physician review websites in Russia. Overall, more than 60,000 reviews were analysed. The main results are as follows: 1) the classification algorithm developed by the authors has a high efficiency, the best result being achieved by the GRU-based architecture (val_accuracy = 0.9271); 2) applying the named entity search method to text messages following their partitioning improved the classification efficiency for each of the classifiers based on artificial neural networks. To further enhance the classification quality, reviews need to be semantically partitioned by target and sentiment and the resulting fragments need to be analysed separately.

This review explores the integration of Virtual and Mixed Reality in medical training. The advent of immersive technologies has revolutionized traditional methodologies, offering immersive, interactive, and flexible learning environments. This study aims to assess the impact, efficacy, and potential of Extended Reality (XR) in medical education. Methods included a comprehensive analysis of current Metaverse’s applications in various medical fields, including surgery, diagnostics, and patient care. Results indicate a significant enhancement in learning outcomes, practical skills, and student engagement. Conclusions suggest that Virtual Reality is a valuable tool for medical training, providing realistic simulations and improving both theoretical knowledge and practical skills. The intersection of virtual reality and cognitive neuroscience presents an exciting frontier for understanding the human brain's response to immersive environments. This review explores how VR impacts learning, with a particular focus on the activation and engagement of the prefrontal cortex during immersive experiences. It delves into various studies that highlight the transformative potential of VR in educational settings and therapeutic applications, demonstrating how VR can facilitate deeper and more effective learning experiences. The review will present a dedicated section on the current methodologies used to analyze the brain's response while immersed in a virtual environment.

Wildfires are a rising environmental threat which health impact remains poorly documented, in particular beyond the fire period. This ecological study investigates changes in health conditions before, during, and after two consecutive wildfires that occurred in France´s Gironde district in the summer 2022. Electronic records from the district´s emergency medical communication centre were used to identify calls with respiratory and cardiovascular diseases, and two specific subgroups of those, asthma (all ages and 0-5 years) and cardiac arrest, respectively. Compared to before the fires, respiratory disease cases were fewer during each fire (OR = 0.85, 95% CI: 0.79, 0.90 and OR = 0.62, 95% CI: 0.58, 0.67, respectively), cardiovascular disease cases, more common during the second fire, and asthma cases, higher following the fires (ORall ages= 1.85, 95% CI: 1.56, 2.21 and ORchildren= 3.52, 95% CI: 2.62, 4.80). Asthma cases also rose during the same calendar time in 2021, but to a lesser extent. In sum, except for asthma, emergency calls data in Gironde reveal few significant potentially smoke-related symptoms around fire periods, apart from post-fire asthma. Whether the effects are smoke- or season-related remains to be determined, preferably using additional data sources.

Violence against paramedics is widely recognized as a serious, but underreported, problem. While injurious physical attacks on paramedics are generally reported, non-physical violence is less likely to be documented. Verbal abuse can be very distressing, particularly if the harassment targets personal or cultural identities, such as race, ethnicity, gender, or sexual orientation. Leveraging a novel, point-of-event reporting process, our objective was to estimate the prevalence of harassment on identity grounds against paramedics in a single paramedic service in Ontario, Canada, and assess its potentially differential impact on emotional distress. In an analysis of 502 reports filed between February 1, 2021, through February 28, 2022, two paramedic-supervisors independently coded the free-text narrative descriptions of violent encounters for themes suggestive of sexism, racism, and homophobia. We achieved high interrater agreement across the dimensions (k=0.73-0.83), and after resolving discrepant cases, we found that 1 in 4 violent reports documented abuse on at least one of the identity grounds. In these cases, paramedics were 60% more likely to indicate being emotionally distressed than for other forms of violence. Our findings offer unique insight into the type of vitriol paramedics experience in the course of their work and its potential for psychological harm.

Dermal injections of hyaluronic acid gel for aesthetic skin rejuvenation are increasingly popular nowadays. Although these products are classified as medical devices, the regulations on their administration by licensed practitioners are still weak, whereas their manufacturers increasingly highlight and advertise the cellular effects that underpin the efficacy of these injections. In this re-view, we discuss all current knowledge on the mode of action of dermally injected hyaluronic acid and the potential toxicological implications especially from crosslinked gels in conjunction with the current global regulations. We conclude that dermal injections of hyaluronic acid have several therapeutic implications that warrant further research, and that strict regulations must be applied on their manufacture/quality control and the required qualifications of licensed aesthetic injectors.

We review the literature on medical discourse and attempt to build a computational model of it. Medical discourse sheds a light on communication structure of patient-doctor and other communication scenarios in healthcare and should be leveraged to facilitate and automate this communication when it is possible and practical. We propose a unified framework to represent communication discourse at the meta-level, where the subject of the communication is expressed in a language object. So far, the broad range of work on medical discourse is detached from computational discourse analysis, and we explore the possibilities of filling this gap and computationally treat the peculiarities of how information is passed between the agents in a hospital setting. We select the domain of question answering (QA) against a corpus of medical documents of diverse nature to evaluate our computational model of medical discourse. It turns out that applying specific structures obtained in medical discourse studies improves the relevance and efficiency of question answering.

Fractures of the talar neck and body are associated with spine fractures and scoliosis deformity, which affect cosmetic appearance and cause difficulty in ambulation. The implant design for talus surgery is thriving as a functional alternative in case of severe talar destruction, focusing on segmentation and reconstruction of the talus’s shape. However, manual segmentation of the talus is time-consuming and subjective. In this study we exploited the automatic segmentation framework to efficiently train a deep learning-based model to accurately segment the talus based on computed tomography imaging. We developed three model configurations with nnU-Net and investigated their Dice similarity coefficients (DSC) and 95% Hausdorff distances (HD95) for talus segmentation on a CT image dataset. The three configurations performed well (DSC > 0.95, HD95 < 0.6). When tested on the same samples, one of the configurations was more efficient while ensuring higher accuracy. We propose to focus on talus anatomic variations with increasing age based on this framework and apply it to clinical trials at the next stage.

One of the challenges in the healthcare sector is making accurate forecasts across insurance years for claims reserve. The state-of-the-art envisages various methods for estimating the claims reserve but without being applied to systems that do not present huge variability and heterogeneity, such as the healthcare sector. The methodology is based on generalized linear models using the Overdispersed Poisson distribution as shown in the state-of-the-art. In this context, we developed a method to estimate the parameters of the quasi-likelihood function using a Gauss-Newton algorithm optimized through a genetic algorithm. The genetic algorithm plays a crucial role in glimpsing the position of the global minimum to ensure a correct convergence of the Gauss-Newton method, where the choice of the initial guess is fundamental. The proposed methodology has been entirely developed using MATLAB and has been applied to estimate the claims reserve in the healthcare system of the Tuscany Region in Italy, as case study. The results obtained were validated by comparing them with the state-of-the-art by measuring the confidence intervals of the Overdispersed Poisson distribution parameters. Therefore local healthcare authorities could use the proposed and improved methodology to allocate the resources dedicated to healthcare and global management.

This study introduces a specialized Automatic Speech Recognition (ASR) system, leveraging the Whisper Large-v2 model, specifically adapted for radiological applications in French language. Our methodology focused on adapting the model to accurately transcribe medical terminology and diverse accents within the French language context, achieving a notable Word Error Rate (WER) of 17.121%. The research involved extensive data collection and preprocessing, utilizing a wide range of French medical audio content. The results demonstrate the system's effectiveness in transcribing complex radiological data, underscoring its potential to enhance medical documentation efficiency in French-speaking clinical settings. The discussion extends to the broader implications of this technology in healthcare, including its potential integration with Electronic Health Records (EHRs) and its utility in medical education. The study also explores future research directions, such as tailoring ASR systems to specific medical specialties and languages. Overall, this research contributes significantly to the field of medical ASR systems, presenting a robust tool for radiological transcription in the French language and paving the way for advanced technology-enhanced healthcare solutions.

During the pandemic, educational digitization experienced a significant increase. In Mexico, social service is a crucial component of technical and professional training, a phase during which individuals apply the knowledge gained throughout their university education. The aim of this study is to standardize a digital model for the management of social service in the health care sector within health care units. This study employed an analytical, observational, retrospective, and longitudinal approach, involving two groups of trainees: Group A (n=133), utilizing a Non-Digital Model, and Group B (n=50), employing a Digital Model. In Stage I. the model design underwent validation through the Delphi method with a panel of three experts. The model was implemented on a Classroom® digital platform with the integration of the elements 1) a monthly rotation rubric 2) care services rubric 3) clinical cases or nursing process rubric, and 4) innovation project rubric. The validation of the model achieved 100% agreement (K=1). The variables measured for each group included the school of origin, career, unit of assignment, timely enrolment, and timely delivery of rubrics on the platform. The difference between the two groups was measured using Chi-Square. To measure the impact, the difference in the timeliness of the products was considered. From the University of Quintana Roo, the difference was 20.3 vs 34%. According to the Unit of Attachment the most frequent was HGR No. 17 with Group A at 22.5 vs 52%. According to the product the least delivered was Product 4, with 69% vs 81%. Timely enrollment was observed in Group A at 89% vs Group B at 80% p=0.001. Overall timely delivery in Group A was 81% vs Group B at 91% p=0.001 in the first 6 months post-implementation. Demonstrating that the implementation of the digital platform was effective, representing a significant advance in the adaptation of medical education to the circumstances imposed by the pandemic, highlighting the feasibility and effectiveness of digital teaching methods in the training of health professionals.

Continuum robots play the role of end-effector in various surgical robots and endoscopic devices. The robots may be categorized as rigid or soft continuum robots (SCRs). While the SCRs have proven advantages such as safety and compliance, more research and development are required to enhance their capability for specific medical scenarios. This research aims at designing a soft robot considering concepts of geometric and kinematic similarities. The chosen application is a semi-invasive medical application known as Transesophageal Echocardiography (TEE), but the methodology can be implemented in other similar applications. Since established rigid carrier construction make use of principles we find as well embodied in vertebral spines, the paragon for soft robot solution can be the phylogenetic precursor of the spine, the Chorda dorsalis. The feasibility of fabrication of a soft endoscopic device derived from that paragon within a robotics laboratory was shown empirically by producing a three-segment pneumatic SCR. The kinematic model was proposed based on the method of transformation matrices, and an algorithm based on a self-organizing map (SOM) was proposed and applied to realize kinematic similarity. The simulation results indicate that the algorithm acting as an open-loop controller forces the soft robot tip to follow the desired path which in this case is the path of the rigid probe. It is concluded that the solution provides a soft robot that can surrogate and succeed the traditional rigid counterpart owing to size, workspace, and kinematics.

Bipolar disorder is a severe mood disorder and is one of the top 20 reasons of disability in the world. It causes a huge burden on society. In this study, the prediction models of bipolar disorder were constructed based on the concept of knowledge distillation. The input data consisted of patients of bipolar disorder and matched controls, all of which were selected from the open database MIMIC. The method of kernel density estimation (KDE) was exploited to generate probability density functions (PDF) which identify distributions of input data. The PDF values referred to as the soft labels were combined with the input data to construct the prediction models of bipolar disorder using decision tree and artificial neural network respectively. According to the evaluation results, indicators for identifying positive samples of bipolar disorder were improved. Meanwhile, the indicators for identifying negative samples have also been advanced. In addition, the branching attributes selected by the decision trees can be mapped back to specific disease diagnoses, which are all associated with bipolar disorder. In conclusion, using KDE to generate the soft label information of the input data can make knowledge distillation work and has improved the performances of prediction models for bipolar disorder.

Exudative-pleural-effusion (ePE) is a common presentation in pulmonology clinics. Pleural biopsy is indicated for identifying the aetiology in undiagnosed ePE especially the ones with low adenosine-deaminase levels. The access to rigid and semi-rigid medical thoracoscopy is scarce and heterogeneous in a resource limited country like India. In such circumstances, using flexible bronchoscope via intercostal-chest-tube for visualization of parietal pleura and pleural biopsy offers a way out. Here, in this retrospective study, we have presented our experience of such practice on 25 cases. Mean age was 52.4±1 years. Adhesions were present in 40% of the subjects. Most common finding was presence of nodules. On an average 6.8 passes were taken with maximum of 10. In 32% cases only tiny tissue was obtained, hence requiring multiple passes. Large tissue could be obtained in 44% of the subjects. Mean duration of the procedure was 35.6±9.0 minutes. Tissue diagnosis was established in 80% with most common being malignancy (48%) followed by tuberculosis (20%). In 3 cases, the final diagnosis was made by exclusion. No major complications were recorded. In conclusion, medical thoracoscopy using flexible video bronchoscope via intercostal-chest-tube was a feasible alternative for the diagnosis of ePE effusion in resource limited settings.

This research employs a spatial optimization approach customized for addressing equitable emergency medical facility location problems, through the p-dispersed-median problem (p-DIME). The p-DIME integrates two conflicting classes of spatial optimization problems, dispersion, and median problems, aiming to identify the optimal locations for emergency medical facilities to achieve a balanced spatial distribution of emergency medical services (EMS) while effectively serving demands. To demonstrate the utility of the p-DIME model, we selected Gyeongsangbuk-do in South Korea, recognized as one of the most challenging areas for providing EMS to the elderly population (aged 65 and over). This challenge arises from the significant spatial disparity in the distribution of emergency medical facilities. The results of the model assessment gauge the spatial disparity of EMS, provide significantly enhanced solutions for a more equitable EMS distribution in terms of service coverage, and offer policy implications for future EMS location planning. In addition, to address the computational challenges posed by p-DIME's inherent complexity, involving mixed-integer programming, this study introduces a solution technique through constraint formulations aimed at tightening the lower bounds of the problem's solution space. The computational results confirm the effectiveness of this approach in ensuring reliable computational performance, with significant reductions in solution times, while still producing optimal solutions.

In this paper we report on the use of an in-house developed solid-state hybrid microwave and radiofrequency generator operating at frequencies of 2.45 GHz and/or 480 kHz for cancer ablation in various tissues. The generator has demonstrated increased accuracy due to its custom-designed hardware, which incorporates the latest technologies and algorithms to control the emitted power versus temperature profile of the treated sample. In particular, the hybrid generator incorporates control systems based on impedance or reflected power measurements that allow controlled ablation without causing unwanted carbonisation and without including areas where tissue damage is not desired. Tests performed ex-vivo on chicken breast and bovine liver show that radiofrequency ablation (RFA) is very effective for performing controlled ablations with minimally invasive probes, such as cardiac pathologies, small lesions, tissues with particular composition, while microwave ablation (MWA) is optimal for performing large ablations in highly vascularised tissues, such as liver cancer, where it is necessary to achieve higher temperatures.

Since the emergence of convolutional neural networks (CNNs), and later vision transformers (ViTs), the standard paradigm for model development has been using a set of identical block types with varying parameters/hyper-parameters. To leverage the benefits of different architectural designs (e.g., CNNs and ViTs), we propose alternating structurally different types of blocks to generate a new architecture, mimicking how Lego blocks can be assembled. Using two CNN-based and one SwinViT-based blocks, we investigate three variations to the so-called LegoNet that apply the new block alternation concept for the segmentation task in medical imaging. We also study a new clinical problem that has not been investigated before – the right internal mammary artery (RIMA) and perivascular space segmentation from computed tomography angiography (CTA). It was proven to demonstrate a prognostic value to primary cardiovascular outcomes. We compare the model performance against popular CNN and ViT architectures using two large datasets (achieving 0.749 dice similarity coefficient (DSC) on the larger dataset). We also evaluate the model’s performance on three external testing cohorts, where an expert clinician corrected model-segmented results (DSC>0.90 for the three cohorts). To assess our proposed model for suitability in clinical use, we perform intra- and inter-observer variability analysis. Finally, we investigate a joint self-supervised learning approach to determine its impact on model performance.

Despite the efforts to deliver the best evidence-based care, in-hospital death is an inevitable event among some patients hospitalized in cardiology departments. We retrospectively evaluated mortality events from inpatient admissions to Cardiology Department between 2010-2019. Data were collected from morbidity &amp; mortality meeting presentations which evaluated comorbidities, medical history, treatments, and causes of death for the overall cohort and according to age group and sex. There were 1,182 registered deaths. The most common causes of death among patients were acute myocardial infarction (AMI) (53.0%), heart failure (HF, 11.7%), cardiac arrest (CA, 6.6%), HF with complication/defined cardiomyopathy (6.3%) and sepsis (4.4%). We observed a decline in deaths from AMI from 61.9% in 2010 to 46.7% in 2019 while there was an apparent increase in deaths from HF (11.1% in 2010 to 25.9% in 2019). Compared to patients ≥65 years, younger patients were more likely to have died from CA (15.7% vs. 4.3%, p&lt;0.001) and other cardiac reasons (3.0% vs. 0.4%, p&lt;0.001). The majority of deaths were due to AMI, HF, and CA. We observed a significant decline in the proportion of deaths due to AMI in recent years with an increase in deaths due to HF.

Cancer is the second major cause of disease-related dead worldwide, and its accurate early diagnosis and therapeutic intervention are fundamental for saving the patient’s life. Cancer, as a complex and heterogeneous disorder, results from disruption and alteration of a wide variety of biological entities, including genes, proteins, mRNAs, miRNAs, and metabolites that eventually emerge as clinical symptoms. Traditionally, diagnosis is based on clinical examination, blood tests for biomarkers, histopathology of biopsy, and imaging (MRI, CT, PET, US). Additionally, omics biotechnologies help to further characterize the genome, metabolome, microbiome traits of the patient that could have an impact on the prognosis and patient’s response to the therapy. The integration of all these data relies on gathering of several experts and may require considerable time, and, unfortunately, it is not without the risk of error in the interpretation and therefore in the decision. Systems biology algorithms exploit Artificial Intelligence (AI) combined with omics technologies to perform a rapid and accurate analysis and integration of patient’s big data and support the physician in making diagnosis and tailoring the most appropriate therapeutic intervention. However, AI is not free from possible diagnostic and prognostic errors in the interpretation of images or biochemical-clinical data. Here, we first describe the methods used by systems biology for combining AI with omics and then discuss the potential, challenges, limitations, and critical issues in using AI in cancer research.

Diabetic retinopathy (DR) is the primary factor leading to vision impairment and blindness in diabetic people. Uncontrolled diabetes can damage the retinal blood vessels. Initial detection and prompt medical intervention are vital in preventing progressive vision impairment. Today's growing medical field poses more significant workload and diagnostic demands on medical professionals. In the proposed study, a convolutional neural network (CNN) is employed to detect the stages of DR. This research is crucial for studying DR because of its innovative methodology incorporating two different public datasets. This strategy enhances the model's capacity to generalize unseen DR images, as each dataset encompasses unique demographics and clinical circumstances. The network can learn and capture complicated hierarchical image features with asymmetric weights. Each image undergoes preprocessing using contrast-limited adaptive histogram equalization (CLAHE) and the discrete wavelet transform (DWT). The model is trained and validated using the combined datasets of Dataset for Diabetic Retinopathy (DDR) and the Asia Pacific Tele-Ophthalmology Society (APTOS). The CNN model is tuned with different learning rates and optimizers. The CNN model with Adam optimizer achieved 70% accuracy and an area under curve (AUC) score of 0.82. The recommended study results may reduce diabetes-related vision impairment by early DR severity identification.

The study aimed to assess the prevalence of the frailty syndrome in older patients hospitalized in the geriatric ward depending on the diagnostic criteria used, the feasibility of particular diagnostic scales in hospitalized patients, and their compatibility. Material and methods: Patients admitted to the Department of Geriatrics of Hospital of the Ministry of the Interior and Administration in Bialystok within eight months were included in the study. Four diagnostic scales were used to identify the frailty syndrome: Fried criteria, 7-point Clinical Frailty Scale (CFS), 40-item Frailty Index (FI), and FRAIL Scale. The compatibility of the scales was determined using Cohen's Kappa statistics. Results: 416 patients (mean age 81.2 ± 6.91 years, 77.4% women) were included in the study. Depending on the scale, the prevalence of frailty syndrome varied from 26.8% ( FRAIL Scale), 52.3% (Clinical Frailty Scale), and 58.1% (Fried criteria) up to 62.9% (Frailty Index). We observed the highest feasibility for CFS (100%), intermediate for Frailty Index (95.2%), FRAIL Scale (89.7%), and the lowest for Fried scale (79.8%). The highest level of agreement was found between the CFS and Fried scale, with 70.2% consistent ratings (Cohen Kappa 0.49). Conclusions: Patients in the geriatric ward are characterized by a high prevalence of frailty, although it differs depending on the criteria. The Frailty Index found the highest prevalence and the lowest in the case of the FRAIL scale. The feasibility of scales and their comparability differed; the most difficult to use in daily practice was the Fried scale, while the Clinical Frailty Scale was determined feasible in all patients. The highest agreement was observed between the Fried criteria and the Clinical Frailty Scale and the lowest between the FRAIL scale and the remaining ones.

Early treatment is the mainstay of sepsis therapy. We suspected that early recognition of sepsis by prehospital healthcare providers may shorten time to antibiotic administration in the Emergency Department. We retrospectively evaluated all patients above 18 years of age that were diagnosed with sepsis or severe infection in our Emergency Department between 2018 and 2020. We recorded the suspected diagnosis at time of presentation, type of referring healthcare provider and time until initiation of antibiotic treatment. Differences between groups were calculated using Kruskal-Wallis rank sum test. Of the 277 patients that were diagnosed with severe infection or sepsis in the emergency department, an infection was suspected in 124 (44.8%) patients and sepsis was suspected in 31 (11.2%) patients by referring healthcare providers. Time to initiation of antibiotic treatment was shorter in patients where sepsis or infection had been suspected prior to arrival for both patients with severe infections (p = 0.022) and sepsis (p = 0.004). Given the well described outcome benefits to early sepsis therapy, recognition of sepsis needs to be improved. Appropriate scores should be used as part of routine patient assessment to reduce time to antibiotic administration and improve patient outcomes.

Medical Self-service Terminals (MST) offer potential for process optimization and enhanced patient convenience in hospitals, including the elderly. However, the behavioral inclination (BI) of elderly Chinese individuals towards MST adoption remains suboptimal. This study aims to elucidate BI determinants for MST among the aging demographic, focusing on User Interface (UI) attributes within the extended Unified Technology Acceptance and Use Theory (UTAUT) Model. The empirical inquiry examines seven factors, comprising three key UI attributes and four fundamental UTAUT factors. Results reveal significant positive associations of Performance Expectancy (β=0.40, p&lt;0.001), Effort Expectancy (β=0.50, p&lt;0.001), and Social Influence (β=0.25, p&lt;0.05) with BI. Notably, User Interface Design positively correlates with Performance Expectancy (β=0.89, p&lt;0.001) and Effort Expectancy (β=0.81, p&lt;0.001). These findings emphasize the interplay between objective UI attributes and subjective UTAUT determinants. This research enhances understanding of UI's impact on MST BI and acceptance, particularly within the Chinese elderly population, urging MST researchers to prioritize elderly attitudes for effective technological integration in healthcare.

The primary goal of picture compression is to reduce the amount of unused image data while still storing or transmitting it in a format that is appropriate. The compression of raw binary data is quite different from the compression of a picture, and these differences may be rather substantial. In light of this, compression is often regarded as an essential technique for the purposes of both data storage an d transmission in order to mitigate the excessive amounts of data that are generated by these images. In order to transmit enormous datasets, particularly for the purposes of telemedicine and teleradiology, one needs a significant amount of storage capacity as well as an expansive network. As a result, compression is an important aspect of medical imaging. In addition to the importance of compression, the quality of the photos themselves is also an essential factor in the success of analysis. In addition to this, the amount of time necessary to compress the photographs before sending them should be reduced.

INTRODUCTION: With an increase in the aging population, the application of evidence-based practice in geriatric education can strengthen knowledge, skills, and clinical experience for healthcare students caring for older adults. Age Friendly Health Systems (AFHS) is one of the frameworks founded on providing evidence-based and low-risk care centered on what matters most to older adults, their families, and caregivers. Virtual Reality (VR) platforms are gaining popularity due to their ability to provide an immersive, hands-on learning experience resembling an actual medical practice or care setting. Immersive learning enhances students’ sensory perceptions, promoting an innovative and engaging way of acquiring concepts that are difficult to teach in real life. This study aimed to design, develop, implement, and evaluate a case-based training module highlighting AFHS and educating medical students on the 4Ms approach in geriatric care (What Matters, Medication, Mentation, and Mobility). METHODOLOGY: The project was a feasibility study completed in two phases. Phase one included planning and development of a case-based scenario incorporating 4Ms of AFHS. Phase two included implementing and evaluating the VR training module into the geriatric curriculum for medical students. RESULTS: The final VR case displays a hospital and post-acute setting where an elderly patient is admitted for a hip fracture. Students learn how to triage and treat patients from admission to discharge while demonstrating their knowledge of AFHS. Approximately 10% of students completed the evaluation survey, and preliminary results indicate significant knowledge change in pre-post scenario-based training on AFHS. CONCLUSION: The VR education platform and embedded scenario promise an innovative adaptation of technology in learning the concepts of the 4Ms of AFHS. However, future studies should explore VR education with clinical assessment evaluation to ensure competence in providing Age-Friendly care.

Culture signifies the customs, language, ceremonies, Indigenous Medical Knowledge (IMK) and other material objects of a tribe. These and many other features are a representation of identity for many Zambian communities. IMK practices are skills inherent by certain individuals in a tribal grouping who are chosen by the spirits (gods) or trained by those who practice. This intrinsic skill is in danger of diminishing as a result of modern medication. This article attempts to understand the role of traditional healers (also known as asing’anga in local language) in preservation of IMK in Chibombo District of Zambia. In so doing, the paper examined methods of preservation used by asing’anga and the challenges faced. Using hermeneutic phenomenology and linear snowball sampling, findings revealed that preservation was done through training. The study found unwillingness, expiration, and spirituality as challenges in the process of preserving IMK. The study recommended that the Lenje Cultural Association consider documenting and disseminating information to the local people by showcasing what is available in the Mukuni Culture Village Museum and Library. This was seen as a way through which many youths would be encouraged to appreciate the indigenous values in their culture.

Historically, admission of hematological patients in the ICU shortly after the start of a critical illness is associated with better survival rates. Early intensive interventions administered by MET could have a role in the management of hematological critically ill patients, eventually reducing ICU admission rate. In this retrospective and monocentric study, we evaluate the safety and effectiveness of intensive treatments administered by the MET in a medical ward frame. The administered interventions were mainly helmet CPAP and pharmacological cardiovascular support. Frequent reassessment by the MET at least every 8 to 12 hours was guaranteed. We analyze data from 133 hematological patients that required MET intervention. In hospital mortality was 38%; mortality doesn’t increase in patients not immediately transferred to the ICU. Only 3 patients died without a former admission in ICU; in these cases, mortality was not related to the acute illness. Moreover, 37% of patients overcame the critical episode in the hematological ward. Higher SOFA and MEWS scores were associated with a worst survival rate, while neutropenia and pharmacological immunosuppression were not. The MET approach seems to be safe and effective. SOFA and MEWS confirmed to be effective tools for prognostication.

The German health authorities' guidelines for medical devices in 2012 highlighted the importance of cleaning ultrasound probes, emphasizing their validation and reliability. In addition to automated and validated options, alternative manual methods such as wipe disinfection have gained traction due to their independence from additional hardware. The study examines the effectiveness of manual disinfection methods, specifically the cleaning process, addressing concerns raised by the Robert Koch Institute regarding the lack of validation for wipe disinfection of semi-critical devices. The EQUINOS colored wipe disinfection kit identified wetting gaps in all cleanings across four probes tested. The results indicate significant challenges in ensuring complete surface wetting, particularly in complex body parts such as clip-on areas and shapes for additional biopsy attachments, suggesting that manual methods alone may not adequately mitigate the risk of infection transmission (p value .001). The study concludes that while manual disinfection methods are a viable alternative to automated reprocessing, there is a critical need for enhanced training and potentially the development of more effective manual disinfection techniques or colored wipes to ensure patient safety and compliance with healthcare hygiene standards.