China held a national day of mourning on April 4,2020 to commemorate 3,335 victims of the COVID-19 outbreak,including medical workers who sacrificed their lives in the battle against the epidemic[1].April 4 was also T...China held a national day of mourning on April 4,2020 to commemorate 3,335 victims of the COVID-19 outbreak,including medical workers who sacrificed their lives in the battle against the epidemic[1].April 4 was also Tomb-sweeping Day in China,known as the Qingming Festival,it is an important occasion for the Chinese to visit cemeteries,clean tombs,and mourn their ancestors[2].According to data from the official website of the State Administration of Traditional Chinese Medicine,as of February 17,60,107 confirmed cases had been treated with traditional medicine,accounting for 85.2%,while nearly 4,400 medical personnel from more than 600 traditional Chinese hospitals were sent to Hubei[3].展开更多
We are writing in response to the article titled“Addressing the needs and rights of sex workers for HIV healthcare services in the Philippines”[1].The article calls for attention on the significant challenges faced ...We are writing in response to the article titled“Addressing the needs and rights of sex workers for HIV healthcare services in the Philippines”[1].The article calls for attention on the significant challenges faced by sex workers in the Philippines in accessing HIV healthcare.We appreciate the article’s effort to examine these issues in depth.We would like to present a constant flow of thoughts in this letter while highlighting the positive aspects,potential obstacles,and additional points that contribute to this ongoing discussion.展开更多
Background A medical content-based image retrieval(CBIR)system is designed to retrieve images from large imaging repositories that are visually similar to a user′s query image.CBIR is widely used in evidence-based di...Background A medical content-based image retrieval(CBIR)system is designed to retrieve images from large imaging repositories that are visually similar to a user′s query image.CBIR is widely used in evidence-based diagnosis,teaching,and research.Although the retrieval accuracy has largely improved,there has been limited development toward visualizing important image features that indicate the similarity of retrieved images.Despite the prevalence of 3D volumetric data in medical imaging such as computed tomography(CT),current CBIR systems still rely on 2D cross-sectional views for the visualization of retrieved images.Such 2D visualization requires users to browse through the image stacks to confirm the similarity of the retrieved images and often involves mental reconstruction of 3D information,including the size,shape,and spatial relations of multiple structures.This process is time-consuming and reliant on users'experience.Methods In this study,we proposed an importance-aware 3D volume visualization method.The rendering parameters were automatically optimized to maximize the visibility of important structures that were detected and prioritized in the retrieval process.We then integrated the proposed visualization into a CBIR system,thereby complementing the 2D cross-sectional views for relevance feedback and further analyses.Results Our preliminary results demonstrate that 3D visualization can provide additional information using multimodal positron emission tomography and computed tomography(PETCT)images of a non-small cell lung cancer dataset.展开更多
The high rates of depression,burnout,and increased risk of suicide among medical students,residents,and physicians in comparison with other careers signal a mental health crisis within our profession.We contend that t...The high rates of depression,burnout,and increased risk of suicide among medical students,residents,and physicians in comparison with other careers signal a mental health crisis within our profession.We contend that this crisis coupled with the inadequate acquisition of interpersonal skills during medical education results from the interaction between a challenging environment and the mental capital of individuals.Additionally,we posit that mindfulness-based practices are instrumental for the development of major components of mental capital,such as resilience,flexibility of mind,and learning skills,while also serving as a pathway to enhance empathy,compassion,self-awareness,conflict resolution,and relational abilities.Importantly,the evidence base supporting the effectiveness of mindfulness-based interventions has been increasing over the years,and a growing number of medical schools have already integrated mindfulness into their curricula.While we acknowledge that mindfulness is not a panacea for all educational and mental health problems in this field,we argue that there is currently an unprecedented opportunity to gather momentum,spread and study mindfulness-based programs in medical schools around the world as a way to address some longstanding shortcomings of the medical profession and the health and educational systems upon which it is rooted.展开更多
Ioannis Solos Ph.D.,M.D.(China),L.Ac.currently serves as President and CEO at the Saint George Clinic and Research Institute,Scottsdale,AZ.,and Associate Editor for Chinese Medicine and Culture.Professor Solos has ear...Ioannis Solos Ph.D.,M.D.(China),L.Ac.currently serves as President and CEO at the Saint George Clinic and Research Institute,Scottsdale,AZ.,and Associate Editor for Chinese Medicine and Culture.Professor Solos has earned his Master of Medicine in Traditional Diagnosis at the Beijing University of Chinese Medicine,and his Medical Ph.D.in Chinese and Western Integrative Medicine at the Jinan University in Guangzhou.He practices and teaches integrative clinical medicine,Jing Fang(经方TCM formulas),martial lineage acupuncture,and his personalized style of“tendon and fascia reconditioning manipulations for bone and joint disease”.展开更多
Background: Hospital Acquired Infections (HAIs) remain a common cause of death, functional disability, emotional suffering and economic burden among hospitalized patients. Knowledge of HAIs is important in its prevent...Background: Hospital Acquired Infections (HAIs) remain a common cause of death, functional disability, emotional suffering and economic burden among hospitalized patients. Knowledge of HAIs is important in its prevention and control. This study seeks to assess the knowledge of Hospital Acquired Infections (HAIs) among medical students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria. Methods: This was a descriptive cross-sectional study done in October 2019 among clinical medical students using a Multistage sampling technique. Data was collected using a self-administered structured questionnaire and analyzed using the IBM SPSS 20 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics Committee, Jos, Plateau State. Results: A total of 219 students in the clinical arm of the College of Medicine and Health Sciences were selected. A higher proportion (97.7%) of respondents knew about Hospital Acquired Infections and 85.4% knew that Hospital Acquired infections occur in the hospital, and (86.3%) considered patients contagious with half (58.9%) considered patients as the most important source of HAIs, followed by care givers (13.2%), then doctors including medical students and interns (10.0%) and lastly nurses (8.7%). The majority of respondents (70.8%) considered Surgical Wound Infections to be the most commonly occurring HAI, followed by UTIs (69.9%), RTIs (61.2%), BSIs (37.0%) and others (0.9%). The clinical thermometer was the instrument that most commonly transmits HAIs (82.6%), then followed by stethoscope (62.1%), white coats (53.9%), and blood pressure cuff (51.1%). Most respondents knew the infectious substances, like blood (96.3%), nasal discharge (82.6%), saliva (85.3%), and faeces (79.4%) transmitted HAIs, 72.6% of the respondents said that they were aware of the recommended hand washing techniques by WHO. Conclusion: The majority of students 91.3% had good knowledge while 8.7% had poor knowledge of HAIs. Lower classes had more respondents with poor knowledge. This finding was statistically significant (p = 0.002, Chi-square 12.819). Students are encouraged to keep up the level of knowledge they have about HAIs. These students can help improve the knowledge of those whose knowledge level is low. Government and NGOs should support sponsorship for capacity-building events targeted at HAIs for healthcare workers and medical students.展开更多
Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of sk...Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.展开更多
This editorial highlights the remarkable advancements in medical treatment strategies for pancreatic neuroendocrine tumors(pan-NETs),emphasizing tailored approaches for specific subtypes.Cytoreductive surgery and soma...This editorial highlights the remarkable advancements in medical treatment strategies for pancreatic neuroendocrine tumors(pan-NETs),emphasizing tailored approaches for specific subtypes.Cytoreductive surgery and somatostatin analogs(SSAs)play pivotal roles in managing tumors,while palliative options such as molecular targeted therapy,peptide receptor radionuclide therapy,and chemotherapy are reserved for SSA-refractory patients.Gastrinomas,insul-inomas,glucagonomas,carcinoid tumors and VIPomas necessitate distinct thera-peutic strategies.Understanding the genetic basis of pan-NETs and exploring immunotherapies could lead to promising avenues for future research.This review underscores the evolving landscape of pan-NET treatment,offering renewed hope and improved outcomes for patients facing this complex disease.展开更多
Feature Subset Selection(FSS)is an NP-hard problem to remove redundant and irrelevant features particularly from medical data,and it can be effectively addressed by metaheuristic algorithms.However,existing binary ver...Feature Subset Selection(FSS)is an NP-hard problem to remove redundant and irrelevant features particularly from medical data,and it can be effectively addressed by metaheuristic algorithms.However,existing binary versions of metaheuristic algorithms have issues with convergence and lack an effective binarization method,resulting in suboptimal solutions that hinder diagnosis and prediction accuracy.This paper aims to propose an Improved Binary Quantum-based Avian Navigation Optimizer Algorithm(IBQANA)for FSS in medical data preprocessing to address the suboptimal solutions arising from binary versions of metaheuristic algorithms.The proposed IBQANA’s contributions include the Hybrid Binary Operator(HBO)and the Distance-based Binary Search Strategy(DBSS).HBO is designed to convert continuous values into binary solutions,even for values outside the[0,1]range,ensuring accurate binary mapping.On the other hand,DBSS is a two-phase search strategy that enhances the performance of inferior search agents and accelerates convergence.By combining exploration and exploitation phases based on an adaptive probability function,DBSS effectively avoids local optima.The effectiveness of applying HBO is compared with five transfer function families and thresholding on 12 medical datasets,with feature numbers ranging from 8 to 10,509.IBQANA's effectiveness is evaluated regarding the accuracy,fitness,and selected features and compared with seven binary metaheuristic algorithms.Furthermore,IBQANA is utilized to detect COVID-19.The results reveal that the proposed IBQANA outperforms all comparative algorithms on COVID-19 and 11 other medical datasets.The proposed method presents a promising solution to the FSS problem in medical data preprocessing.展开更多
Background:Pen-pal clubs(PPC)are used worldwide for students to learn about different cultures and other skillsets without the need for travel.Many medical students are interested in global health opportunities abroad...Background:Pen-pal clubs(PPC)are used worldwide for students to learn about different cultures and other skillsets without the need for travel.Many medical students are interested in global health opportunities abroad but costs,scheduling,and other barriers allow few to participate in such experiences.It is important that medical students have nuanced global medical perspectives and can contribute to the global medical community.Objective:The purpose of this study is to demonstrate that an international medical student PPC improves medical students'perspectives of cultural competency and global health engagement.Methods:In 2021,a novel medical student PPC was established that began between an American and Japanese medical school.Following a shareholders meeting,it was decided that the number of medical schools involved globally be expanded through previous institutional affiliations and online presences.In total,the club connected 50 American medical students and 52 medical students from 17 high-and middle-income countries.The primary form of communication was online;pen-pals were encouraged to communicate monthly using provided topics,although frequency and way of communication was their discretion.In February 2022,American PPC members were emailed a qualitative survey to assess the PPC's impact.Results:The survey was completed by 42%of American PPC members,95%of which were 22-26 years.Participants were preclinical medical students,60%whom were female and the majority either white(47%)or Asian(43%).Overall,the PPC positively influenced American medical students'perception of global medicine,medical education,and their cultural competency after joining the PPC compared to prior(P=0.004).Conclusion:PPCs encourage medical students to think from a global perspective and foster open-mindedness within varying social and cultural contexts.Having a global communication platform for students during medical school education may be an additional way to train aspiring global leaders.展开更多
Objectives: Sex work is not well documented among African men. The aim of this study was to describe the epidemiological profile of men who have sex with men (MSM) and eventually to determine the proportion of sex wor...Objectives: Sex work is not well documented among African men. The aim of this study was to describe the epidemiological profile of men who have sex with men (MSM) and eventually to determine the proportion of sex workers (SW) among them, as well as the proportion of MSM who have been victims of gender-based violence (GBV). Material and Methods: A cross-sectional study coordinated by the Direction de la Médecine du Travail was carried out at the headquarters of the association ALTERNATIVES in Bangui Bangui from July 1 to October 31, 2021. Consenting MSM present during the study period were systematically included. Sociodemographic variables, those relating to the future vision of the activity and to GBV were collected and analyzed using Epi-Info version 7 software. Results: Forty MSM with an average age of 23 years and mainly secondary education (75.0%) were included. The vast majority of MSM were unemployed (85.0%). 45.0% had been victims of GBV and wanted to stop working as an MSM (47.5%), and almost 2/3 (65.0%) would accept another income-generating activity in exchange for the MSM. Violence was sexual (32.5%), economic (22.5%), physical (20.0%), verbal (12.5%) and psychological (12.5%). Conclusion: The MSM were mainly young, poorly educated, unemployed, and almost half were victims of GBV. The desire to change MSM activity to another income-generating activity alongside that of MSM shows that many of them are SW, workers in the informal sector. This must be taken into account in prevention activities, even if the data needs to be confirmed on a much larger sample.展开更多
Introduction: Medical treatment for POAG is continuous and lifelong treatment. The aim of this study was to evaluate the relationship between the cost of this treatment and patients’ income and the impact of this rel...Introduction: Medical treatment for POAG is continuous and lifelong treatment. The aim of this study was to evaluate the relationship between the cost of this treatment and patients’ income and the impact of this relationship on treatment compliance. Materials and Methods: Prospective cross-sectional study with a descriptive aim covering sociodemographic data, average incomes, and direct and indirect costs of treatment of 57 patients followed for POAG during the period from January 1, 2012, to December 31, 2016 (5 years). Results: The patients were aged 25 to 77 years (mean = 54.4 years) with a male predominance (sex ratio = 1.5). Retirees were the most represented (26.32%), followed by workers in the informal sector (14.04%) and housewives (12.28%). Patients who had an annual income less than or equal to 900,000 CFA francs (€1370.83) per year represented 56.14% and those who did not have health coverage represented 57.89%. The treatment was monotherapy (64.91%), dual therapy (31.58%) or triple therapy (3.05%) and the average ratio of “annual cost of treatment to annual income” was 0.56 with for maximum 2.23 and 0.02 as minimum. Patients who considered the cost of treatment unbearable for their income represented 78.95%. Conclusion: Prevention of blindness due to glaucoma requires early detection but also the establishment of health coverage mechanisms to improve compliance with medical treatment. In addition, consideration should be given to the development of glaucoma surgery in our country, the indication of which could be the first intention in certain patients, considering for those patients, the geographical and financial accessibility of medical treatment. .展开更多
Objective To explore the impact of population aging on the expenditures of medical insurance funds against the background that great changes in population structure influences economic development.Methods Through anal...Objective To explore the impact of population aging on the expenditures of medical insurance funds against the background that great changes in population structure influences economic development.Methods Through analyzing the impact of the population aging,the income and accumulated balance of the medical insurance fund,and other related factors on the expenditure of the medical insurance fund,development status of the medical insurance fund for urban employees in China since 2003 was obtained.Stata 16.0 was used to perform multiple linear regression analysis on related factors to determine the correlation between population aging and the change in medical insurance expenditures.Results and Conclusion The factors that have a greater impact on the expenditure of the medical insurance fund are the amount of income from the medical insurance,followed by the number of people over the age of 65 in China and the urban retired employees participating in medical insurance.We should focus on the sustainable development of the urban employee medical insurance fund to deal with the threat of aging.展开更多
Mobile young white-collar workers not only have the characteristics of mobile young people,but also have the characteristics of general white-collar workers.Under the influence of both,their mental health may be suffe...Mobile young white-collar workers not only have the characteristics of mobile young people,but also have the characteristics of general white-collar workers.Under the influence of both,their mental health may be suffering from“double disadvantage”.So,based on an ecological model of the stress process,this paper tries to use the data of the questionnaire on the mental health of mobile young white-collar workers in Zhejiang Province to explore the influence of some factors in the middle workplace and residence place on the mental health of micro individuals.The results show that:(1)The working environment with high control and low freedom and the workplace discrimination against the mobile status will have a negative impact on the mental health of mobile young white-collar workers;(2)Financial anxiety in daily life will lead to a decline in the mental health level of mobile young white-collar workers;(3)Good organizational support and neighborhood social relations can significantly relieve life pressure,so as to effectively improve the mental health of mobile young white-collar workers.It can be seen that we also need to pay more attention to the mental health of mobile young white-collar workers in order to improve their situation.展开更多
Background: Prevention is one of the safe schemes against the high prevalence of viral Hepatitis. Negative perceptions or perceptions about the risks of hepatitis B among medical students and health care workers may i...Background: Prevention is one of the safe schemes against the high prevalence of viral Hepatitis. Negative perceptions or perceptions about the risks of hepatitis B among medical students and health care workers may influence the behavioral pattern and adoption of preventive measures against the virus and can affect the uptake of the Hepatitis B vaccine. This study assesses the perception of medical students towards Hepatitis B virus infection and Hepatitis B Vaccination in a Private Tertiary Hospital in Jos North Local Government, Plateau State, Nigeria. Methods: This was a descriptive cross-sectional study done in August 2021 among 236 clinical medical students using a multistage sampling technique. Data was collected using an interviewer-administered structured questionnaire and analysed using the IBM SPSS 28 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics Committee, Jos, Plateau State. Results: Two-thirds of respondents were of the opinion that they are at risk of contracting HBV. Half were of the opinion that the risk is very much while a third believed the risk is moderate. Among those who think they are not at risk of contracting HBV, the majority felt so because they are vaccinated while 10.3% believe that they are safe. 43.2% of respondents think that HBV Vaccine is very effective in preventing HBV infection while 39.8% think it is slightly effective, and 7.6% think it is not effective. Almost all respondents, 99.2% are of the opinion that HBV Vaccination is important for students while 0.8% think it is not important. The majority of the respondents at 95.8% were willing to be screened for HBV. The majority (85.6%) of respondents are willing to pay for HBV Vaccine as against 14.4% of respondents who are not willing to pay. Conclusion: Summarily, 21 (8.9%) of the students had a negative perception of Hepatitis B Vaccination, and 215 (91.1%) had a positive perception of Hepatitis B Vaccination. Perception-sustaining events like seminars, workshops, road shows, and campaigns should be organized among students and health workers.展开更多
Automatic segmentation of medical images provides a reliable scientific basis for disease diagnosis and analysis.Notably,most existing methods that combine the strengths of convolutional neural networks(CNNs)and Trans...Automatic segmentation of medical images provides a reliable scientific basis for disease diagnosis and analysis.Notably,most existing methods that combine the strengths of convolutional neural networks(CNNs)and Transformers have made significant progress.However,there are some limitations in the current integration of CNN and Transformer technology in two key aspects.Firstly,most methods either overlook or fail to fully incorporate the complementary nature between local and global features.Secondly,the significance of integrating the multiscale encoder features from the dual-branch network to enhance the decoding features is often disregarded in methods that combine CNN and Transformer.To address this issue,we present a groundbreaking dual-branch cross-attention fusion network(DCFNet),which efficiently combines the power of Swin Transformer and CNN to generate complementary global and local features.We then designed the Feature Cross-Fusion(FCF)module to efficiently fuse local and global features.In the FCF,the utilization of the Channel-wise Cross-fusion Transformer(CCT)serves the purpose of aggregatingmulti-scale features,and the Feature FusionModule(FFM)is employed to effectively aggregate dual-branch prominent feature regions from the spatial perspective.Furthermore,within the decoding phase of the dual-branch network,our proposed Channel Attention Block(CAB)aims to emphasize the significance of the channel features between the up-sampled features and the features generated by the FCFmodule to enhance the details of the decoding.Experimental results demonstrate that DCFNet exhibits enhanced accuracy in segmentation performance.Compared to other state-of-the-art(SOTA)methods,our segmentation framework exhibits a superior level of competitiveness.DCFNet’s accurate segmentation of medical images can greatly assist medical professionals in making crucial diagnoses of lesion areas in advance.展开更多
In recent years, semiconductor survey meters have been developed and are in increasing demand worldwide. This study determined if it is possible to use the X-ray system installed in each medical facility to calculate ...In recent years, semiconductor survey meters have been developed and are in increasing demand worldwide. This study determined if it is possible to use the X-ray system installed in each medical facility to calculate the time constant of a semiconductor survey meter and confirm the meter’s function. An additional filter was attached to the medical X-ray system to satisfy the standards of N-60 to N-120, more copper plates were added as needed, and the first and second half-value layers were calculated to enable comparisons of the facility’s X-ray system quality with the N-60 to N-120 quality values. Next, we used a medical X-ray system to measure the leakage dose and calculate the time constant of the survey meter. The functionality of the meter was then checked and compared with the energy characteristics of the meter. The experimental results showed that it was possible to use a medical X-ray system to reproduce the N-60 to N-120 radiation quality values and to calculate the time constant from the measured results, assuming actual leakage dosimetry for that radiation quality. We also found that the calibration factor was equivalent to that of the energy characteristics of the survey meter.展开更多
Ethical principles form a bedrock to medical practice in any specialty,guiding physicians to appropriate attitudes and behaviors.A formal ethics curriculum can be difficult to generate de novo in an ophthalmology trai...Ethical principles form a bedrock to medical practice in any specialty,guiding physicians to appropriate attitudes and behaviors.A formal ethics curriculum can be difficult to generate de novo in an ophthalmology training program.A number of barriers exist in most ophthalmology departments:trainees may think ethics is of secondary importance compared to core basic and clinical science topics;most ophthalmology faculty have no formal degree in medical ethics;there is limited didactic time with competing academic,clinical,and surgical priorities;work-hours regulations may limit the time available to deliver“para-professional”lectures;and there is a belief that the medical ethics lectures during medical school is a sufficient amount of coursework to last through a physician’s career with no need for continuing professional development.The four pillars of medical ethics are beneficence,non-maleficence,autonomy,and justice.In addition,morals,ethics,and professionalism are important aspects of sound medical practice.A curriculum specific to medical ethics in ophthalmology can be developed in any of our sub-specialties and include lectures,curated readings,case rounds,and clinic wrap-up sessions.Ethical considerations are part of everyday clinical practice,and a structured ethics curriculum can be incorporated into ophthalmology training programs.The concept of backward design can be used to structure the curriculum,starting with the expected outcome,then designing authentic assessments,and finally putting together a learning plan that has students actively involved in ethical discussions.This paper will provide a guide to developing an ethics curriculum for an ophthalmology training program utilizing the concept of backwards design and guide the reader through the process of developing expected learning outcomes,authentic assessments,and a unified learning plan.展开更多
文摘China held a national day of mourning on April 4,2020 to commemorate 3,335 victims of the COVID-19 outbreak,including medical workers who sacrificed their lives in the battle against the epidemic[1].April 4 was also Tomb-sweeping Day in China,known as the Qingming Festival,it is an important occasion for the Chinese to visit cemeteries,clean tombs,and mourn their ancestors[2].According to data from the official website of the State Administration of Traditional Chinese Medicine,as of February 17,60,107 confirmed cases had been treated with traditional medicine,accounting for 85.2%,while nearly 4,400 medical personnel from more than 600 traditional Chinese hospitals were sent to Hubei[3].
文摘We are writing in response to the article titled“Addressing the needs and rights of sex workers for HIV healthcare services in the Philippines”[1].The article calls for attention on the significant challenges faced by sex workers in the Philippines in accessing HIV healthcare.We appreciate the article’s effort to examine these issues in depth.We would like to present a constant flow of thoughts in this letter while highlighting the positive aspects,potential obstacles,and additional points that contribute to this ongoing discussion.
文摘Background A medical content-based image retrieval(CBIR)system is designed to retrieve images from large imaging repositories that are visually similar to a user′s query image.CBIR is widely used in evidence-based diagnosis,teaching,and research.Although the retrieval accuracy has largely improved,there has been limited development toward visualizing important image features that indicate the similarity of retrieved images.Despite the prevalence of 3D volumetric data in medical imaging such as computed tomography(CT),current CBIR systems still rely on 2D cross-sectional views for the visualization of retrieved images.Such 2D visualization requires users to browse through the image stacks to confirm the similarity of the retrieved images and often involves mental reconstruction of 3D information,including the size,shape,and spatial relations of multiple structures.This process is time-consuming and reliant on users'experience.Methods In this study,we proposed an importance-aware 3D volume visualization method.The rendering parameters were automatically optimized to maximize the visibility of important structures that were detected and prioritized in the retrieval process.We then integrated the proposed visualization into a CBIR system,thereby complementing the 2D cross-sectional views for relevance feedback and further analyses.Results Our preliminary results demonstrate that 3D visualization can provide additional information using multimodal positron emission tomography and computed tomography(PETCT)images of a non-small cell lung cancer dataset.
基金Supported by the Brazilian National Council for Scientific and Technological Development(CNPq),No.312499/2022-1São Paulo Research Foundation(FAPESP),No.2023/00823-9,and No.2023/01251-9.
文摘The high rates of depression,burnout,and increased risk of suicide among medical students,residents,and physicians in comparison with other careers signal a mental health crisis within our profession.We contend that this crisis coupled with the inadequate acquisition of interpersonal skills during medical education results from the interaction between a challenging environment and the mental capital of individuals.Additionally,we posit that mindfulness-based practices are instrumental for the development of major components of mental capital,such as resilience,flexibility of mind,and learning skills,while also serving as a pathway to enhance empathy,compassion,self-awareness,conflict resolution,and relational abilities.Importantly,the evidence base supporting the effectiveness of mindfulness-based interventions has been increasing over the years,and a growing number of medical schools have already integrated mindfulness into their curricula.While we acknowledge that mindfulness is not a panacea for all educational and mental health problems in this field,we argue that there is currently an unprecedented opportunity to gather momentum,spread and study mindfulness-based programs in medical schools around the world as a way to address some longstanding shortcomings of the medical profession and the health and educational systems upon which it is rooted.
文摘Ioannis Solos Ph.D.,M.D.(China),L.Ac.currently serves as President and CEO at the Saint George Clinic and Research Institute,Scottsdale,AZ.,and Associate Editor for Chinese Medicine and Culture.Professor Solos has earned his Master of Medicine in Traditional Diagnosis at the Beijing University of Chinese Medicine,and his Medical Ph.D.in Chinese and Western Integrative Medicine at the Jinan University in Guangzhou.He practices and teaches integrative clinical medicine,Jing Fang(经方TCM formulas),martial lineage acupuncture,and his personalized style of“tendon and fascia reconditioning manipulations for bone and joint disease”.
文摘Background: Hospital Acquired Infections (HAIs) remain a common cause of death, functional disability, emotional suffering and economic burden among hospitalized patients. Knowledge of HAIs is important in its prevention and control. This study seeks to assess the knowledge of Hospital Acquired Infections (HAIs) among medical students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria. Methods: This was a descriptive cross-sectional study done in October 2019 among clinical medical students using a Multistage sampling technique. Data was collected using a self-administered structured questionnaire and analyzed using the IBM SPSS 20 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics Committee, Jos, Plateau State. Results: A total of 219 students in the clinical arm of the College of Medicine and Health Sciences were selected. A higher proportion (97.7%) of respondents knew about Hospital Acquired Infections and 85.4% knew that Hospital Acquired infections occur in the hospital, and (86.3%) considered patients contagious with half (58.9%) considered patients as the most important source of HAIs, followed by care givers (13.2%), then doctors including medical students and interns (10.0%) and lastly nurses (8.7%). The majority of respondents (70.8%) considered Surgical Wound Infections to be the most commonly occurring HAI, followed by UTIs (69.9%), RTIs (61.2%), BSIs (37.0%) and others (0.9%). The clinical thermometer was the instrument that most commonly transmits HAIs (82.6%), then followed by stethoscope (62.1%), white coats (53.9%), and blood pressure cuff (51.1%). Most respondents knew the infectious substances, like blood (96.3%), nasal discharge (82.6%), saliva (85.3%), and faeces (79.4%) transmitted HAIs, 72.6% of the respondents said that they were aware of the recommended hand washing techniques by WHO. Conclusion: The majority of students 91.3% had good knowledge while 8.7% had poor knowledge of HAIs. Lower classes had more respondents with poor knowledge. This finding was statistically significant (p = 0.002, Chi-square 12.819). Students are encouraged to keep up the level of knowledge they have about HAIs. These students can help improve the knowledge of those whose knowledge level is low. Government and NGOs should support sponsorship for capacity-building events targeted at HAIs for healthcare workers and medical students.
文摘Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.
文摘This editorial highlights the remarkable advancements in medical treatment strategies for pancreatic neuroendocrine tumors(pan-NETs),emphasizing tailored approaches for specific subtypes.Cytoreductive surgery and somatostatin analogs(SSAs)play pivotal roles in managing tumors,while palliative options such as molecular targeted therapy,peptide receptor radionuclide therapy,and chemotherapy are reserved for SSA-refractory patients.Gastrinomas,insul-inomas,glucagonomas,carcinoid tumors and VIPomas necessitate distinct thera-peutic strategies.Understanding the genetic basis of pan-NETs and exploring immunotherapies could lead to promising avenues for future research.This review underscores the evolving landscape of pan-NET treatment,offering renewed hope and improved outcomes for patients facing this complex disease.
文摘Feature Subset Selection(FSS)is an NP-hard problem to remove redundant and irrelevant features particularly from medical data,and it can be effectively addressed by metaheuristic algorithms.However,existing binary versions of metaheuristic algorithms have issues with convergence and lack an effective binarization method,resulting in suboptimal solutions that hinder diagnosis and prediction accuracy.This paper aims to propose an Improved Binary Quantum-based Avian Navigation Optimizer Algorithm(IBQANA)for FSS in medical data preprocessing to address the suboptimal solutions arising from binary versions of metaheuristic algorithms.The proposed IBQANA’s contributions include the Hybrid Binary Operator(HBO)and the Distance-based Binary Search Strategy(DBSS).HBO is designed to convert continuous values into binary solutions,even for values outside the[0,1]range,ensuring accurate binary mapping.On the other hand,DBSS is a two-phase search strategy that enhances the performance of inferior search agents and accelerates convergence.By combining exploration and exploitation phases based on an adaptive probability function,DBSS effectively avoids local optima.The effectiveness of applying HBO is compared with five transfer function families and thresholding on 12 medical datasets,with feature numbers ranging from 8 to 10,509.IBQANA's effectiveness is evaluated regarding the accuracy,fitness,and selected features and compared with seven binary metaheuristic algorithms.Furthermore,IBQANA is utilized to detect COVID-19.The results reveal that the proposed IBQANA outperforms all comparative algorithms on COVID-19 and 11 other medical datasets.The proposed method presents a promising solution to the FSS problem in medical data preprocessing.
文摘Background:Pen-pal clubs(PPC)are used worldwide for students to learn about different cultures and other skillsets without the need for travel.Many medical students are interested in global health opportunities abroad but costs,scheduling,and other barriers allow few to participate in such experiences.It is important that medical students have nuanced global medical perspectives and can contribute to the global medical community.Objective:The purpose of this study is to demonstrate that an international medical student PPC improves medical students'perspectives of cultural competency and global health engagement.Methods:In 2021,a novel medical student PPC was established that began between an American and Japanese medical school.Following a shareholders meeting,it was decided that the number of medical schools involved globally be expanded through previous institutional affiliations and online presences.In total,the club connected 50 American medical students and 52 medical students from 17 high-and middle-income countries.The primary form of communication was online;pen-pals were encouraged to communicate monthly using provided topics,although frequency and way of communication was their discretion.In February 2022,American PPC members were emailed a qualitative survey to assess the PPC's impact.Results:The survey was completed by 42%of American PPC members,95%of which were 22-26 years.Participants were preclinical medical students,60%whom were female and the majority either white(47%)or Asian(43%).Overall,the PPC positively influenced American medical students'perception of global medicine,medical education,and their cultural competency after joining the PPC compared to prior(P=0.004).Conclusion:PPCs encourage medical students to think from a global perspective and foster open-mindedness within varying social and cultural contexts.Having a global communication platform for students during medical school education may be an additional way to train aspiring global leaders.
文摘Objectives: Sex work is not well documented among African men. The aim of this study was to describe the epidemiological profile of men who have sex with men (MSM) and eventually to determine the proportion of sex workers (SW) among them, as well as the proportion of MSM who have been victims of gender-based violence (GBV). Material and Methods: A cross-sectional study coordinated by the Direction de la Médecine du Travail was carried out at the headquarters of the association ALTERNATIVES in Bangui Bangui from July 1 to October 31, 2021. Consenting MSM present during the study period were systematically included. Sociodemographic variables, those relating to the future vision of the activity and to GBV were collected and analyzed using Epi-Info version 7 software. Results: Forty MSM with an average age of 23 years and mainly secondary education (75.0%) were included. The vast majority of MSM were unemployed (85.0%). 45.0% had been victims of GBV and wanted to stop working as an MSM (47.5%), and almost 2/3 (65.0%) would accept another income-generating activity in exchange for the MSM. Violence was sexual (32.5%), economic (22.5%), physical (20.0%), verbal (12.5%) and psychological (12.5%). Conclusion: The MSM were mainly young, poorly educated, unemployed, and almost half were victims of GBV. The desire to change MSM activity to another income-generating activity alongside that of MSM shows that many of them are SW, workers in the informal sector. This must be taken into account in prevention activities, even if the data needs to be confirmed on a much larger sample.
文摘Introduction: Medical treatment for POAG is continuous and lifelong treatment. The aim of this study was to evaluate the relationship between the cost of this treatment and patients’ income and the impact of this relationship on treatment compliance. Materials and Methods: Prospective cross-sectional study with a descriptive aim covering sociodemographic data, average incomes, and direct and indirect costs of treatment of 57 patients followed for POAG during the period from January 1, 2012, to December 31, 2016 (5 years). Results: The patients were aged 25 to 77 years (mean = 54.4 years) with a male predominance (sex ratio = 1.5). Retirees were the most represented (26.32%), followed by workers in the informal sector (14.04%) and housewives (12.28%). Patients who had an annual income less than or equal to 900,000 CFA francs (€1370.83) per year represented 56.14% and those who did not have health coverage represented 57.89%. The treatment was monotherapy (64.91%), dual therapy (31.58%) or triple therapy (3.05%) and the average ratio of “annual cost of treatment to annual income” was 0.56 with for maximum 2.23 and 0.02 as minimum. Patients who considered the cost of treatment unbearable for their income represented 78.95%. Conclusion: Prevention of blindness due to glaucoma requires early detection but also the establishment of health coverage mechanisms to improve compliance with medical treatment. In addition, consideration should be given to the development of glaucoma surgery in our country, the indication of which could be the first intention in certain patients, considering for those patients, the geographical and financial accessibility of medical treatment. .
文摘Objective To explore the impact of population aging on the expenditures of medical insurance funds against the background that great changes in population structure influences economic development.Methods Through analyzing the impact of the population aging,the income and accumulated balance of the medical insurance fund,and other related factors on the expenditure of the medical insurance fund,development status of the medical insurance fund for urban employees in China since 2003 was obtained.Stata 16.0 was used to perform multiple linear regression analysis on related factors to determine the correlation between population aging and the change in medical insurance expenditures.Results and Conclusion The factors that have a greater impact on the expenditure of the medical insurance fund are the amount of income from the medical insurance,followed by the number of people over the age of 65 in China and the urban retired employees participating in medical insurance.We should focus on the sustainable development of the urban employee medical insurance fund to deal with the threat of aging.
基金the National Social Science Fund of China(Grant No.20BTJ005).
文摘Mobile young white-collar workers not only have the characteristics of mobile young people,but also have the characteristics of general white-collar workers.Under the influence of both,their mental health may be suffering from“double disadvantage”.So,based on an ecological model of the stress process,this paper tries to use the data of the questionnaire on the mental health of mobile young white-collar workers in Zhejiang Province to explore the influence of some factors in the middle workplace and residence place on the mental health of micro individuals.The results show that:(1)The working environment with high control and low freedom and the workplace discrimination against the mobile status will have a negative impact on the mental health of mobile young white-collar workers;(2)Financial anxiety in daily life will lead to a decline in the mental health level of mobile young white-collar workers;(3)Good organizational support and neighborhood social relations can significantly relieve life pressure,so as to effectively improve the mental health of mobile young white-collar workers.It can be seen that we also need to pay more attention to the mental health of mobile young white-collar workers in order to improve their situation.
文摘Background: Prevention is one of the safe schemes against the high prevalence of viral Hepatitis. Negative perceptions or perceptions about the risks of hepatitis B among medical students and health care workers may influence the behavioral pattern and adoption of preventive measures against the virus and can affect the uptake of the Hepatitis B vaccine. This study assesses the perception of medical students towards Hepatitis B virus infection and Hepatitis B Vaccination in a Private Tertiary Hospital in Jos North Local Government, Plateau State, Nigeria. Methods: This was a descriptive cross-sectional study done in August 2021 among 236 clinical medical students using a multistage sampling technique. Data was collected using an interviewer-administered structured questionnaire and analysed using the IBM SPSS 28 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics Committee, Jos, Plateau State. Results: Two-thirds of respondents were of the opinion that they are at risk of contracting HBV. Half were of the opinion that the risk is very much while a third believed the risk is moderate. Among those who think they are not at risk of contracting HBV, the majority felt so because they are vaccinated while 10.3% believe that they are safe. 43.2% of respondents think that HBV Vaccine is very effective in preventing HBV infection while 39.8% think it is slightly effective, and 7.6% think it is not effective. Almost all respondents, 99.2% are of the opinion that HBV Vaccination is important for students while 0.8% think it is not important. The majority of the respondents at 95.8% were willing to be screened for HBV. The majority (85.6%) of respondents are willing to pay for HBV Vaccine as against 14.4% of respondents who are not willing to pay. Conclusion: Summarily, 21 (8.9%) of the students had a negative perception of Hepatitis B Vaccination, and 215 (91.1%) had a positive perception of Hepatitis B Vaccination. Perception-sustaining events like seminars, workshops, road shows, and campaigns should be organized among students and health workers.
基金supported by the National Key R&D Program of China(2018AAA0102100)the National Natural Science Foundation of China(No.62376287)+3 种基金the International Science and Technology Innovation Joint Base of Machine Vision and Medical Image Processing in Hunan Province(2021CB1013)the Key Research and Development Program of Hunan Province(2022SK2054)the Natural Science Foundation of Hunan Province(No.2022JJ30762,2023JJ70016)the 111 Project under Grant(No.B18059).
文摘Automatic segmentation of medical images provides a reliable scientific basis for disease diagnosis and analysis.Notably,most existing methods that combine the strengths of convolutional neural networks(CNNs)and Transformers have made significant progress.However,there are some limitations in the current integration of CNN and Transformer technology in two key aspects.Firstly,most methods either overlook or fail to fully incorporate the complementary nature between local and global features.Secondly,the significance of integrating the multiscale encoder features from the dual-branch network to enhance the decoding features is often disregarded in methods that combine CNN and Transformer.To address this issue,we present a groundbreaking dual-branch cross-attention fusion network(DCFNet),which efficiently combines the power of Swin Transformer and CNN to generate complementary global and local features.We then designed the Feature Cross-Fusion(FCF)module to efficiently fuse local and global features.In the FCF,the utilization of the Channel-wise Cross-fusion Transformer(CCT)serves the purpose of aggregatingmulti-scale features,and the Feature FusionModule(FFM)is employed to effectively aggregate dual-branch prominent feature regions from the spatial perspective.Furthermore,within the decoding phase of the dual-branch network,our proposed Channel Attention Block(CAB)aims to emphasize the significance of the channel features between the up-sampled features and the features generated by the FCFmodule to enhance the details of the decoding.Experimental results demonstrate that DCFNet exhibits enhanced accuracy in segmentation performance.Compared to other state-of-the-art(SOTA)methods,our segmentation framework exhibits a superior level of competitiveness.DCFNet’s accurate segmentation of medical images can greatly assist medical professionals in making crucial diagnoses of lesion areas in advance.
文摘In recent years, semiconductor survey meters have been developed and are in increasing demand worldwide. This study determined if it is possible to use the X-ray system installed in each medical facility to calculate the time constant of a semiconductor survey meter and confirm the meter’s function. An additional filter was attached to the medical X-ray system to satisfy the standards of N-60 to N-120, more copper plates were added as needed, and the first and second half-value layers were calculated to enable comparisons of the facility’s X-ray system quality with the N-60 to N-120 quality values. Next, we used a medical X-ray system to measure the leakage dose and calculate the time constant of the survey meter. The functionality of the meter was then checked and compared with the energy characteristics of the meter. The experimental results showed that it was possible to use a medical X-ray system to reproduce the N-60 to N-120 radiation quality values and to calculate the time constant from the measured results, assuming actual leakage dosimetry for that radiation quality. We also found that the calibration factor was equivalent to that of the energy characteristics of the survey meter.
基金supported by an unrestricted Research to Prevent Blindness grant.
文摘Ethical principles form a bedrock to medical practice in any specialty,guiding physicians to appropriate attitudes and behaviors.A formal ethics curriculum can be difficult to generate de novo in an ophthalmology training program.A number of barriers exist in most ophthalmology departments:trainees may think ethics is of secondary importance compared to core basic and clinical science topics;most ophthalmology faculty have no formal degree in medical ethics;there is limited didactic time with competing academic,clinical,and surgical priorities;work-hours regulations may limit the time available to deliver“para-professional”lectures;and there is a belief that the medical ethics lectures during medical school is a sufficient amount of coursework to last through a physician’s career with no need for continuing professional development.The four pillars of medical ethics are beneficence,non-maleficence,autonomy,and justice.In addition,morals,ethics,and professionalism are important aspects of sound medical practice.A curriculum specific to medical ethics in ophthalmology can be developed in any of our sub-specialties and include lectures,curated readings,case rounds,and clinic wrap-up sessions.Ethical considerations are part of everyday clinical practice,and a structured ethics curriculum can be incorporated into ophthalmology training programs.The concept of backward design can be used to structure the curriculum,starting with the expected outcome,then designing authentic assessments,and finally putting together a learning plan that has students actively involved in ethical discussions.This paper will provide a guide to developing an ethics curriculum for an ophthalmology training program utilizing the concept of backwards design and guide the reader through the process of developing expected learning outcomes,authentic assessments,and a unified learning plan.
