As a practicing anatomic pathologist specialized in urologic pathology,a vast difference may be observed between what pathologists designate as neuroendocrine(or small cell)carcinoma of the prostate,and what clinician...As a practicing anatomic pathologist specialized in urologic pathology,a vast difference may be observed between what pathologists designate as neuroendocrine(or small cell)carcinoma of the prostate,and what clinicians or basic scientists define as such.展开更多
Introduction In all branches of healthcare,clinicians are seen to be making professional judgements based on objective facts and assessments.However,in our daily lives,we recognise and celebrate individual differences...Introduction In all branches of healthcare,clinicians are seen to be making professional judgements based on objective facts and assessments.However,in our daily lives,we recognise and celebrate individual differences in interests,beliefs and personalities.展开更多
Summary： Chinese herbal medicine （CHM）, as the largest application category of traditional Chinese medicine （TCM）, is widely accepted among cancer patients in China. Herbal slice （HS） and Chinese patent drug （...Summary： Chinese herbal medicine （CHM）, as the largest application category of traditional Chinese medicine （TCM）, is widely accepted among cancer patients in China. Herbal slice （HS） and Chinese patent drug （CPD） are commonly used CHM in China. This study aimed to investigate the utilization of CHM among clinicians and cancer patients in central China. Five hundred and twenty-five patients and 165 clinicians in 35 comprehensive hospitals in central China were asked to complete an anonymous questionnaire that was designed to evaluate the use of CHM. The results showed that 90.74% clinicians and 72.24% cancer patients used CHM during cancer treatment. The educational backgrounds of the clinicians and the age, education level, annual income, and cancer stage of the cancer patients were re- lated to use of CHM. More than 90% clinicians and cancer patients had used CPD. Comparatively, the percentage of HS use was 10% lower than that of CPD use among clinicians and cancer patients. More clinicians preferred to use CHM after surgery than cancer patients did （20.41% vs. 5.37%）. Enhancing physical fitness and improving performance status were regarded as the most potential effect of CHM on cancer treatment （85.71% among clinicians and 94.07% among cancer patients）, in comparison with directly killing tumor cells （24.49% among clinicians and 31.36% among patients）. As for refusal rea- sons, imprecise efficacy was the unanimous （100%） reason for clinicians＇ rejection of CHM, and 95.58% patients objected to using CHM also for this reason. Furthermore, the side effects of CHM were more concerned by clinicians than by patients （33.33% vs. 15.81%）. In conclusion, our survey revealed that CHM was popularly accepted by clinicians and cancer patients in central China. The reasons of use and rejection of CHM were different between clinicians and cancer patients.展开更多
On March 15,2019,in order to study and implement General Secretary Xi Jinping's speech on deepening reform and cultivating worldclass scientific and technological journals,the eighth working meeting of serial peri...On March 15,2019,in order to study and implement General Secretary Xi Jinping's speech on deepening reform and cultivating worldclass scientific and technological journals,the eighth working meeting of serial periodicals of the People's Medical Publishing House (PMPH),meeting of the ninth editorial board of the Chinese Journal for Clinicians,and the second editorial board of the Global Health Journal were held in Beijing.展开更多
How to select a research topic that is appropriate for a clinician and that can lead to a peer-reviewed publication?In this essay,I will provide 5 tips:keep it interesting,keep it relevant,keep it inclusive,keep it si...How to select a research topic that is appropriate for a clinician and that can lead to a peer-reviewed publication?In this essay,I will provide 5 tips:keep it interesting,keep it relevant,keep it inclusive,keep it simple,and keep it trying.Keep it展开更多
Working in prehospital emergency medical services(EMS)can be unpredictable and emotionally demanding for ambulance clinicians(ACs).Burnout,stress,poor sleep quality,fatigue,and psychological health issues increase the...Working in prehospital emergency medical services(EMS)can be unpredictable and emotionally demanding for ambulance clinicians(ACs).Burnout,stress,poor sleep quality,fatigue,and psychological health issues increase the risk of accidents and adverse events re-lated to occupational and patient safety.This scoping review aimed to identify and map the existing literature on the current state of the effect of ACs’well-being on occupational or patient safety risks in prehospital emergency medical services settings.The methodologies of the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines were used.The databases searched included CINAHL Plus,PubMed,Scopus,Web of Science,and MedNar on March 8,2024.Peer-reviewed and nonpeer-reviewed scientific and nonscientific sources were searched.The reference lists of the selected sources were screened for further papers.Participants who were ACs working in prehospital EMS and reported their physical,psychological,and social well-being related to adverse events in occupational or patient safety were eligible for inclusion.Quantitative,qualitative,and mixed-method studies;reviews;text,opinion,and discussion papers;and gray literature were included.Two reviewers independently reviewed the titles,abstracts,and full texts and assessed the quality of the sources.Data were extracted from the 2 reviewers by using an extraction tool.Data were analyzed using numerical and thematic methods.In total,35 sources were included.Four themes were identified from the heterogeneous data:Deficiencies in psychological well-being,Deficiencies in physical well-being,Deficiencies in psychophysical well-being,and Deficiencies in social well-being.Fatigue and stress experienced by ACs are the most important factors that negatively affect patient and occupational safety.Deficiencies in psychophysical well-being have a clear effect on both patient and occupational safety.There is limited evidence on the effect of ACs’well-being on patient and occupational safety in prehospital EMS.展开更多
Deep learning has undeniably sharpened our ability to forecast risk in neuropsychiatry[1].Yet the very success of prediction has exposed a deeper limitation:we are still remarkably uncertain about which levers to pull...Deep learning has undeniably sharpened our ability to forecast risk in neuropsychiatry[1].Yet the very success of prediction has exposed a deeper limitation:we are still remarkably uncertain about which levers to pull to change patient trajectories[2].Accurate risk scores that cannot be translated into credible actions leave clinicians where they began,testing symptomatic fixes and hoping for the best.If we want to move beyond this impasse,the next step is not simply to train larger models,but to rethink what we ask of them.展开更多
Background:China has more cases of Alzheimer’s disease(AD)than any other country in the world.As training to recognize and manage dementia is in its early stage,it is important to study clinicians’current prescripti...Background:China has more cases of Alzheimer’s disease(AD)than any other country in the world.As training to recognize and manage dementia is in its early stage,it is important to study clinicians’current prescription preferences for treating patients with AD.Methods:This study surveyed neurologists,psychiatrists,and general physicians(GPs)in Shanghai who had outpatients with AD,using a questionnaire asking about their prescription preferences for these patients.Results:Among the 148 clinicians in the study,26.4%were psychiatrists,44.6%were neurologists,and 29.1%were GPs.The groups did not differ significantly in age,gender,or their monthly cases of new patients with mild or moderate AD(P>0.05).Most clinicians prescribed Cholinesterase inhibitors(ChEIs),including Huperzine A,but there were significant group-differences in prescribing specific ChEIs(P<0.05).The daily dosages of ChEI and Memantine prescribed by all three groups were small(P>0.05),and all three groups prescribed piracetam,ergot,and ginkgo biloba drugs.All three groups also tended to treat AD patients with a combination of antidepressants and anxiolytics,although psychiatrists were significantly more likely than neurologists to combine antipsychotics with other drugs(P<0.05).Conclusion:Clinicians in Shanghai prescribed low doses of ChEIs and Memantine for patients with AD.A relatively high proportion also prescribed cognitive enhancers,which lack evidence-based support of their use,and antipsychotics.There is a need for more training about treating patients with AD and for clinicians to standardize their clinical practice.展开更多
Graduation requirements for students often mandate publications,and the promotion of scientists and clinicians in academic radiology hinges significantly on their publication achievements.1 In light of these challenge...Graduation requirements for students often mandate publications,and the promotion of scientists and clinicians in academic radiology hinges significantly on their publication achievements.1 In light of these challenges,we introduce Ankyrons,a potentially transformative entity poised to become a“gold mine”for publications.If successful,this proposal has the potential to characterize thousands of protein targets,opening avenues for new discoveries in target identification,disease diagnosis,and therapy,particularly in the realm of translational science in molecular imaging.Our analysis positions Ankyrons as an innovative solution addressing the challenges associated with publishing and discovery in translational science within molecular imaging.Ankyrons stand out as a promising avenue for impactful publications,emphasizing strong and selective ligand binding coupled with rapid circulation clearance,facilitating high-contrast in vivo imaging.The introduction of Ankyrons signifies a noteworthy development,poised to make a substantial contribution to scientific literature.It has the potential to advance our understanding and application of cutting-edge technologies in the fields of molecular imaging and therapeutic interventions for various diseases.展开更多
Psychiatric advance directives(PADs)represent a significant stride towards self-determination in mental healthcare.These legal documents allow individuals with mental illness to articulate their treatment preferences ...Psychiatric advance directives(PADs)represent a significant stride towards self-determination in mental healthcare.These legal documents allow individuals with mental illness to articulate their treatment preferences for future psychiatric crises when decision-making capacity may be impaired.Designed to empower individuals and reduce coercive interventions,PADs hold the poten-tial to transform patient-clinician dynamics.展开更多
Inflammatory bowel disease(IBD)is an increasing global health issue that poses specific challenges in Nigeria.Although awareness of IBD is growing in the country,research and resources remain limited.This review aims ...Inflammatory bowel disease(IBD)is an increasing global health issue that poses specific challenges in Nigeria.Although awareness of IBD is growing in the country,research and resources remain limited.This review aims to address this significant gap.To identify key gaps in IBD research within Nigeria and highlight opportunities for advancing future investigations to improve patient outcomes.A comprehensive review of the existing literature was conducted to evaluate current trends in IBD research,healthcare barriers,and potential areas for investigation specific to the Nigerian context.The analysis highlights significant deficiencies,including scarce epidemiological data,low levels of awareness among clinicians and patients,limited access to healthcare,and inadequate diagnostic and treatment resources.Additionally,there is a profound lack of localized research addressing genetic,environmental,and dietary factors relevant to the Nigerian population.Future investigations should prioritize epidemiological studies to assess IBD prevalence in Nigeria,establish specialized care centers for diagnosis and management,and launch public health initiatives to promote awareness and education.Strengthening collaboration between researchers,healthcare providers,and policymakers is imperative to achieving these goals.Bridging these research gaps presents an invaluable opportunity to enhance IBD healthcare delivery and patient outcomes in Nigeria.Collaborative,multidisciplinary efforts are essential for advancing knowledge,improving resources,and ultimately elevating the quality of life for individuals living with IBD in the country.展开更多
The concept of evidence-based practice has persisted over several years and remains a cornerstone in clinical practice,representing the gold standard for optimal patient care.However,despite widespread recognition of ...The concept of evidence-based practice has persisted over several years and remains a cornerstone in clinical practice,representing the gold standard for optimal patient care.However,despite widespread recognition of its significance,practical application faces various challenges and barriers,including a lack of skills in interpreting studies,limited resources,time constraints,linguistic competencies,and more.Recently,we have witnessed the emergence of a groundbreaking technological revolution known as artificial intelligence.Although artificial intelligence has become increasingly integrated into our daily lives,some reluctance persists among certain segments of the public.This article explores the potential of artificial intelligence as a solution to some of the main barriers encountered in the application of evidence-based practice.It highlights how artificial intelligence can assist in staying updated with the latest evidence,enhancing clinical decision-making,addressing patient misinformation,and mitigating time constraints in clinical practice.The integration of artificial intelligence into evidence-based practice has the potential to revolutionize healthcare,leading to more precise diagnoses,personalized treatment plans,and improved doctor-patient interactions.This proposed synergy between evidencebased practice and artificial intelligence may necessitate adjustments to its core concept,heralding a new era in healthcare.展开更多
With the surge of genetic tests and technologies, genetic counsellors are faced with the challenge of translating emerging scientific knowledge into practical information for patients, clinicians and public health pol...With the surge of genetic tests and technologies, genetic counsellors are faced with the challenge of translating emerging scientific knowledge into practical information for patients, clinicians and public health policy makers. The new tests and technologies also are associated with new psychosocial and ethical considerations. New guidelines are needed for each new discovery of the genomic impact on phenotype, pathology and disease while "old" syndromes and "old" pathology, continue to require attention. In the new postHuman Genome Project era, genetic counsellors will be an integral part of translating genomic discoveries into beneficial impact on human disease, health care, and medical benefits. The needs for genetic counselling should be designed into genomic research at the onset. Genetic counsellors need to handle old while rapidly assimilating new information and the principal challenge is to be up to date and updated.展开更多
文摘As a practicing anatomic pathologist specialized in urologic pathology,a vast difference may be observed between what pathologists designate as neuroendocrine(or small cell)carcinoma of the prostate,and what clinicians or basic scientists define as such.
文摘Introduction In all branches of healthcare,clinicians are seen to be making professional judgements based on objective facts and assessments.However,in our daily lives,we recognise and celebrate individual differences in interests,beliefs and personalities.
基金supported by Hubei Provincial Health Department Research Fund Project of China(No.2012Z-Y10)
文摘Summary： Chinese herbal medicine （CHM）, as the largest application category of traditional Chinese medicine （TCM）, is widely accepted among cancer patients in China. Herbal slice （HS） and Chinese patent drug （CPD） are commonly used CHM in China. This study aimed to investigate the utilization of CHM among clinicians and cancer patients in central China. Five hundred and twenty-five patients and 165 clinicians in 35 comprehensive hospitals in central China were asked to complete an anonymous questionnaire that was designed to evaluate the use of CHM. The results showed that 90.74% clinicians and 72.24% cancer patients used CHM during cancer treatment. The educational backgrounds of the clinicians and the age, education level, annual income, and cancer stage of the cancer patients were re- lated to use of CHM. More than 90% clinicians and cancer patients had used CPD. Comparatively, the percentage of HS use was 10% lower than that of CPD use among clinicians and cancer patients. More clinicians preferred to use CHM after surgery than cancer patients did （20.41% vs. 5.37%）. Enhancing physical fitness and improving performance status were regarded as the most potential effect of CHM on cancer treatment （85.71% among clinicians and 94.07% among cancer patients）, in comparison with directly killing tumor cells （24.49% among clinicians and 31.36% among patients）. As for refusal rea- sons, imprecise efficacy was the unanimous （100%） reason for clinicians＇ rejection of CHM, and 95.58% patients objected to using CHM also for this reason. Furthermore, the side effects of CHM were more concerned by clinicians than by patients （33.33% vs. 15.81%）. In conclusion, our survey revealed that CHM was popularly accepted by clinicians and cancer patients in central China. The reasons of use and rejection of CHM were different between clinicians and cancer patients.
文摘On March 15,2019,in order to study and implement General Secretary Xi Jinping's speech on deepening reform and cultivating worldclass scientific and technological journals,the eighth working meeting of serial periodicals of the People's Medical Publishing House (PMPH),meeting of the ninth editorial board of the Chinese Journal for Clinicians,and the second editorial board of the Global Health Journal were held in Beijing.
文摘How to select a research topic that is appropriate for a clinician and that can lead to a peer-reviewed publication?In this essay,I will provide 5 tips:keep it interesting,keep it relevant,keep it inclusive,keep it simple,and keep it trying.Keep it
文摘Working in prehospital emergency medical services(EMS)can be unpredictable and emotionally demanding for ambulance clinicians(ACs).Burnout,stress,poor sleep quality,fatigue,and psychological health issues increase the risk of accidents and adverse events re-lated to occupational and patient safety.This scoping review aimed to identify and map the existing literature on the current state of the effect of ACs’well-being on occupational or patient safety risks in prehospital emergency medical services settings.The methodologies of the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines were used.The databases searched included CINAHL Plus,PubMed,Scopus,Web of Science,and MedNar on March 8,2024.Peer-reviewed and nonpeer-reviewed scientific and nonscientific sources were searched.The reference lists of the selected sources were screened for further papers.Participants who were ACs working in prehospital EMS and reported their physical,psychological,and social well-being related to adverse events in occupational or patient safety were eligible for inclusion.Quantitative,qualitative,and mixed-method studies;reviews;text,opinion,and discussion papers;and gray literature were included.Two reviewers independently reviewed the titles,abstracts,and full texts and assessed the quality of the sources.Data were extracted from the 2 reviewers by using an extraction tool.Data were analyzed using numerical and thematic methods.In total,35 sources were included.Four themes were identified from the heterogeneous data:Deficiencies in psychological well-being,Deficiencies in physical well-being,Deficiencies in psychophysical well-being,and Deficiencies in social well-being.Fatigue and stress experienced by ACs are the most important factors that negatively affect patient and occupational safety.Deficiencies in psychophysical well-being have a clear effect on both patient and occupational safety.There is limited evidence on the effect of ACs’well-being on patient and occupational safety in prehospital EMS.
文摘Deep learning has undeniably sharpened our ability to forecast risk in neuropsychiatry[1].Yet the very success of prediction has exposed a deeper limitation:we are still remarkably uncertain about which levers to pull to change patient trajectories[2].Accurate risk scores that cannot be translated into credible actions leave clinicians where they began,testing symptomatic fixes and hoping for the best.If we want to move beyond this impasse,the next step is not simply to train larger models,but to rethink what we ask of them.
基金This study was supported by grants for National Key Clinical Disciplines to the Shanghai Mental Health Center(Office of Medical Affairs,Ministry of Health,2011–873,OMA-MH,2011–873)the Shanghai Clinical Center for Mental Disorders(2014),Shanghai Science&Technology Committee(No.15411961400).
文摘Background:China has more cases of Alzheimer’s disease(AD)than any other country in the world.As training to recognize and manage dementia is in its early stage,it is important to study clinicians’current prescription preferences for treating patients with AD.Methods:This study surveyed neurologists,psychiatrists,and general physicians(GPs)in Shanghai who had outpatients with AD,using a questionnaire asking about their prescription preferences for these patients.Results:Among the 148 clinicians in the study,26.4%were psychiatrists,44.6%were neurologists,and 29.1%were GPs.The groups did not differ significantly in age,gender,or their monthly cases of new patients with mild or moderate AD(P>0.05).Most clinicians prescribed Cholinesterase inhibitors(ChEIs),including Huperzine A,but there were significant group-differences in prescribing specific ChEIs(P<0.05).The daily dosages of ChEI and Memantine prescribed by all three groups were small(P>0.05),and all three groups prescribed piracetam,ergot,and ginkgo biloba drugs.All three groups also tended to treat AD patients with a combination of antidepressants and anxiolytics,although psychiatrists were significantly more likely than neurologists to combine antipsychotics with other drugs(P<0.05).Conclusion:Clinicians in Shanghai prescribed low doses of ChEIs and Memantine for patients with AD.A relatively high proportion also prescribed cognitive enhancers,which lack evidence-based support of their use,and antipsychotics.There is a need for more training about treating patients with AD and for clinicians to standardize their clinical practice.
文摘Graduation requirements for students often mandate publications,and the promotion of scientists and clinicians in academic radiology hinges significantly on their publication achievements.1 In light of these challenges,we introduce Ankyrons,a potentially transformative entity poised to become a“gold mine”for publications.If successful,this proposal has the potential to characterize thousands of protein targets,opening avenues for new discoveries in target identification,disease diagnosis,and therapy,particularly in the realm of translational science in molecular imaging.Our analysis positions Ankyrons as an innovative solution addressing the challenges associated with publishing and discovery in translational science within molecular imaging.Ankyrons stand out as a promising avenue for impactful publications,emphasizing strong and selective ligand binding coupled with rapid circulation clearance,facilitating high-contrast in vivo imaging.The introduction of Ankyrons signifies a noteworthy development,poised to make a substantial contribution to scientific literature.It has the potential to advance our understanding and application of cutting-edge technologies in the fields of molecular imaging and therapeutic interventions for various diseases.
文摘Psychiatric advance directives(PADs)represent a significant stride towards self-determination in mental healthcare.These legal documents allow individuals with mental illness to articulate their treatment preferences for future psychiatric crises when decision-making capacity may be impaired.Designed to empower individuals and reduce coercive interventions,PADs hold the poten-tial to transform patient-clinician dynamics.
文摘Inflammatory bowel disease(IBD)is an increasing global health issue that poses specific challenges in Nigeria.Although awareness of IBD is growing in the country,research and resources remain limited.This review aims to address this significant gap.To identify key gaps in IBD research within Nigeria and highlight opportunities for advancing future investigations to improve patient outcomes.A comprehensive review of the existing literature was conducted to evaluate current trends in IBD research,healthcare barriers,and potential areas for investigation specific to the Nigerian context.The analysis highlights significant deficiencies,including scarce epidemiological data,low levels of awareness among clinicians and patients,limited access to healthcare,and inadequate diagnostic and treatment resources.Additionally,there is a profound lack of localized research addressing genetic,environmental,and dietary factors relevant to the Nigerian population.Future investigations should prioritize epidemiological studies to assess IBD prevalence in Nigeria,establish specialized care centers for diagnosis and management,and launch public health initiatives to promote awareness and education.Strengthening collaboration between researchers,healthcare providers,and policymakers is imperative to achieving these goals.Bridging these research gaps presents an invaluable opportunity to enhance IBD healthcare delivery and patient outcomes in Nigeria.Collaborative,multidisciplinary efforts are essential for advancing knowledge,improving resources,and ultimately elevating the quality of life for individuals living with IBD in the country.
文摘The concept of evidence-based practice has persisted over several years and remains a cornerstone in clinical practice,representing the gold standard for optimal patient care.However,despite widespread recognition of its significance,practical application faces various challenges and barriers,including a lack of skills in interpreting studies,limited resources,time constraints,linguistic competencies,and more.Recently,we have witnessed the emergence of a groundbreaking technological revolution known as artificial intelligence.Although artificial intelligence has become increasingly integrated into our daily lives,some reluctance persists among certain segments of the public.This article explores the potential of artificial intelligence as a solution to some of the main barriers encountered in the application of evidence-based practice.It highlights how artificial intelligence can assist in staying updated with the latest evidence,enhancing clinical decision-making,addressing patient misinformation,and mitigating time constraints in clinical practice.The integration of artificial intelligence into evidence-based practice has the potential to revolutionize healthcare,leading to more precise diagnoses,personalized treatment plans,and improved doctor-patient interactions.This proposed synergy between evidencebased practice and artificial intelligence may necessitate adjustments to its core concept,heralding a new era in healthcare.
文摘With the surge of genetic tests and technologies, genetic counsellors are faced with the challenge of translating emerging scientific knowledge into practical information for patients, clinicians and public health policy makers. The new tests and technologies also are associated with new psychosocial and ethical considerations. New guidelines are needed for each new discovery of the genomic impact on phenotype, pathology and disease while "old" syndromes and "old" pathology, continue to require attention. In the new postHuman Genome Project era, genetic counsellors will be an integral part of translating genomic discoveries into beneficial impact on human disease, health care, and medical benefits. The needs for genetic counselling should be designed into genomic research at the onset. Genetic counsellors need to handle old while rapidly assimilating new information and the principal challenge is to be up to date and updated.
