BACKGROUND Drug utilization research has an important role in assisting the healthcare administration to know,compute,and refine the prescription whose principal objective is to enable the rational use of drugs.Resear...BACKGROUND Drug utilization research has an important role in assisting the healthcare administration to know,compute,and refine the prescription whose principal objective is to enable the rational use of drugs.Research in developing nations relating to the cost of treatment is scarce when compared with developed countries.Thus,the drug utilization research studies from developing nations are most needed,and their number has been growing.AIM To evaluate patterns of utilization of antipsychotic drugs and direct medical cost analysis in patients newly diagnosed with schizophrenia.METHODS The present study was observational in type and based on a retrospective cohort to evaluate patterns of utilization of antipsychotic drugs using World Health Organization(WHO)core prescribing indicators and anatomical therapeutic chemical/defined daily dose indicators.We also calculated direct medical costs for a period of 6 months.RESULTS This study has found that atypical antipsychotics are the mainstay of treatment for schizophrenia in every age group and subcategories of schizophrenia.The evaluation based on WHO prescribing indicators showed a low average number of drugs per prescription and low prescribing frequency of antipsychotics from the National List of Essential Medicines 2015 and the WHO Essential Medicines List 2019.The total mean drug cost of our study was 1396 Indian rupees.The total mean cost due to the investigation in our study was 1017.34 Indian rupees.Therefore,the total mean direct medical cost incurred on patients in our study was 4337.28 Indian rupees.CONCLUSION The information from the present study can be used for reviewing and updating treatment policy at the institutional level.展开更多
Background:Medical artificial intelligence(MAI)is a synthesis of medical science and artificial intelligence development,serving as a crucial field in the current advancement and application of AI.In the process of de...Background:Medical artificial intelligence(MAI)is a synthesis of medical science and artificial intelligence development,serving as a crucial field in the current advancement and application of AI.In the process of developing medical AI,there may arise not only legal risks such as infringement of privacy rights and health rights but also ethical risks stemming from violations of the principles of beneficence and non-maleficence.Methods:To effectively address the damages caused by MAI in the future,it is necessary to establish a hierarchical governance system with MAI.This paper examines the systematic collection of local practices in China and the induction and integration of legal remedies for the damage of MAI.Results:To effectively address the ethical and legal challenges of medical artificial intelligence,a hierarchical regulatory system should be established,which based on the impact of intervention measures on natural rights and differences in intervention timing.This paper finally obtains a legal hierarchical governance system corresponding to the ethical risks and legal risks of MAI in China.Conclusion:The Chinese government has formed a multi-agent governance system based on the impact of risks on rights and the timing of legal intervention,which provides a reference for other countries to follow up on the research on MAI risk management.展开更多
Brain-computer interfaces(BCIs)represent an emerging technology that facilitates direct communication between the brain and external devices.In recent years,numerous review articles have explored various aspects of BC...Brain-computer interfaces(BCIs)represent an emerging technology that facilitates direct communication between the brain and external devices.In recent years,numerous review articles have explored various aspects of BCIs,including their fundamental principles,technical advancements,and applications in specific domains.However,these reviews often focus on signal processing,hardware development,or limited applications such as motor rehabilitation or communication.This paper aims to offer a comprehensive review of recent electroencephalogram(EEG)-based BCI applications in the medical field across 8 critical areas,encompassing rehabilitation,daily communication,epilepsy,cerebral resuscitation,sleep,neurodegenerative diseases,anesthesiology,and emotion recognition.Moreover,the current challenges and future trends of BCIs were also discussed,including personal privacy and ethical concerns,network security vulnerabilities,safety issues,and biocompatibility.展开更多
Image segmentation is attracting increasing attention in the field of medical image analysis.Since widespread utilization across various medical applications,ensuring and improving segmentation accuracy has become a c...Image segmentation is attracting increasing attention in the field of medical image analysis.Since widespread utilization across various medical applications,ensuring and improving segmentation accuracy has become a crucial topic of research.With advances in deep learning,researchers have developed numerous methods that combine Transformers and convolutional neural networks(CNNs)to create highly accurate models for medical image segmentation.However,efforts to further enhance accuracy by developing larger and more complex models or training with more extensive datasets,significantly increase computational resource consumption.To address this problem,we propose BiCLIP-nnFormer(the prefix"Bi"refers to the use of two distinct CLIP models),a virtual multimodal instrument that leverages CLIP models to enhance the segmentation performance of a medical segmentation model nnFormer.Since two CLIP models(PMC-CLIP and CoCa-CLIP)are pre-trained on large datasets,they do not require additional training,thus conserving computation resources.These models are used offline to extract image and text embeddings from medical images.These embeddings are then processed by the proposed 3D CLIP adapter,which adapts the CLIP knowledge for segmentation tasks by fine-tuning.Finally,the adapted embeddings are fused with feature maps extracted from the nnFormer encoder for generating predicted masks.This process enriches the representation capabilities of the feature maps by integrating global multimodal information,leading to more precise segmentation predictions.We demonstrate the superiority of BiCLIP-nnFormer and the effectiveness of using CLIP models to enhance nnFormer through experiments on two public datasets,namely the Synapse multi-organ segmentation dataset(Synapse)and the Automatic Cardiac Diagnosis Challenge dataset(ACDC),as well as a self-annotated lung multi-category segmentation dataset(LMCS).展开更多
Existing semi-supervisedmedical image segmentation algorithms use copy-paste data augmentation to correct the labeled-unlabeled data distribution mismatch.However,current copy-paste methods have three limitations:(1)t...Existing semi-supervisedmedical image segmentation algorithms use copy-paste data augmentation to correct the labeled-unlabeled data distribution mismatch.However,current copy-paste methods have three limitations:(1)training the model solely with copy-paste mixed pictures from labeled and unlabeled input loses a lot of labeled information;(2)low-quality pseudo-labels can cause confirmation bias in pseudo-supervised learning on unlabeled data;(3)the segmentation performance in low-contrast and local regions is less than optimal.We design a Stochastic Augmentation-Based Dual-Teaching Auxiliary Training Strategy(SADT),which enhances feature diversity and learns high-quality features to overcome these problems.To be more precise,SADT trains the Student Network by using pseudo-label-based training from Teacher Network 1 and supervised learning with labeled data,which prevents the loss of rare labeled data.We introduce a bi-directional copy-pastemask with progressive high-entropy filtering to reduce data distribution disparities and mitigate confirmation bias in pseudo-supervision.For the mixed images,Deep-Shallow Spatial Contrastive Learning(DSSCL)is proposed in the feature spaces of Teacher Network 2 and the Student Network to improve the segmentation capabilities in low-contrast and local areas.In this procedure,the features retrieved by the Student Network are subjected to a random feature perturbation technique.On two openly available datasets,extensive trials show that our proposed SADT performs much better than the state-ofthe-art semi-supervised medical segmentation techniques.Using only 10%of the labeled data for training,SADT was able to acquire a Dice score of 90.10%on the ACDC(Automatic Cardiac Diagnosis Challenge)dataset.展开更多
Multimodal deep learning has emerged as a key paradigm in contemporary medical diagnostics,advancing precision medicine by enabling integration and learning from diverse data sources.The exponential growth of high-dim...Multimodal deep learning has emerged as a key paradigm in contemporary medical diagnostics,advancing precision medicine by enabling integration and learning from diverse data sources.The exponential growth of high-dimensional healthcare data,encompassing genomic,transcriptomic,and other omics profiles,as well as radiological imaging and histopathological slides,makes this approach increasingly important because,when examined separately,these data sources only offer a fragmented picture of intricate disease processes.Multimodal deep learning leverages the complementary properties of multiple data modalities to enable more accurate prognostic modeling,more robust disease characterization,and improved treatment decision-making.This review provides a comprehensive overview of the current state of multimodal deep learning approaches in medical diagnosis.We classify and examine important application domains,such as(1)radiology,where automated report generation and lesion detection are facilitated by image-text integration;(2)histopathology,where fusion models improve tumor classification and grading;and(3)multi-omics,where molecular subtypes and latent biomarkers are revealed through cross-modal learning.We provide an overview of representative research,methodological advancements,and clinical consequences for each domain.Additionally,we critically analyzed the fundamental issues preventing wider adoption,including computational complexity(particularly in training scalable,multi-branch networks),data heterogeneity(resulting from modality-specific noise,resolution variations,and inconsistent annotations),and the challenge of maintaining significant cross-modal correlations during fusion.These problems impede interpretability,which is crucial for clinical trust and use,in addition to performance and generalizability.Lastly,we outline important areas for future research,including the development of standardized protocols for harmonizing data,the creation of lightweight and interpretable fusion architectures,the integration of real-time clinical decision support systems,and the promotion of cooperation for federated multimodal learning.Our goal is to provide researchers and clinicians with a concise overview of the field’s present state,enduring constraints,and exciting directions for further research through this review.展开更多
Convolutional neural networks(CNNs)-based medical image segmentation technologies have been widely used in medical image segmentation because of their strong representation and generalization abilities.However,due to ...Convolutional neural networks(CNNs)-based medical image segmentation technologies have been widely used in medical image segmentation because of their strong representation and generalization abilities.However,due to the inability to effectively capture global information from images,CNNs can easily lead to loss of contours and textures in segmentation results.Notice that the transformer model can effectively capture the properties of long-range dependencies in the image,and furthermore,combining the CNN and the transformer can effectively extract local details and global contextual features of the image.Motivated by this,we propose a multi-branch and multi-scale attention network(M2ANet)for medical image segmentation,whose architecture consists of three components.Specifically,in the first component,we construct an adaptive multi-branch patch module for parallel extraction of image features to reduce information loss caused by downsampling.In the second component,we apply residual block to the well-known convolutional block attention module to enhance the network’s ability to recognize important features of images and alleviate the phenomenon of gradient vanishing.In the third component,we design a multi-scale feature fusion module,in which we adopt adaptive average pooling and position encoding to enhance contextual features,and then multi-head attention is introduced to further enrich feature representation.Finally,we validate the effectiveness and feasibility of the proposed M2ANet method through comparative experiments on four benchmark medical image segmentation datasets,particularly in the context of preserving contours and textures.展开更多
A medical image encryption is proposed based on the Fisher-Yates scrambling,filter diffusion and S-box substitution.First,chaotic sequence associated with the plaintext is generated by logistic-sine-cosine system,whic...A medical image encryption is proposed based on the Fisher-Yates scrambling,filter diffusion and S-box substitution.First,chaotic sequence associated with the plaintext is generated by logistic-sine-cosine system,which is used for the scrambling,substitution and diffusion processes.The three-dimensional Fisher-Yates scrambling,S-box substitution and diffusion are employed for the first round of encryption.The chaotic sequence is adopted for secondary encryption to scramble the ciphertext obtained in the first round.Then,three-dimensional filter is applied to diffusion for further useful information hiding.The key to the algorithm is generated by the combination of hash value of plaintext image and the input parameters.It improves resisting ability of plaintext attacks.The security analysis shows that the algorithm is effective and efficient.It can resist common attacks.In addition,the good diffusion effect shows that the scheme can solve the differential attacks encountered in the transmission of medical images and has positive implications for future research.展开更多
This study presents an innovative approach to enhancing the security of visual medical data in the generative AI environment through the integration of blockchain technology.By combining the strengths of blockchain an...This study presents an innovative approach to enhancing the security of visual medical data in the generative AI environment through the integration of blockchain technology.By combining the strengths of blockchain and generative AI,the research team aimed to address the timely challenge of safeguarding visual medical content.The participating researchers conducted a comprehensive analysis,examining the vulnerabilities of medical AI services,personal information protection issues,and overall security weaknesses.This multi faceted exploration led to an indepth evaluation of the model’s performance and security.Notably,the correlation between accuracy,detection rate,and error rate was scrutinized.This analysis revealed insights into the model’s strengths and limitations,while the consideration of standard deviation shed light on the model’s stability and performance variability.The study proposed practical improvements,emphasizing the reduction of false negatives to enhance detection rate and leveraging blockchain technology to ensure visual data integrity in medical applications.Applying blockchain to generative AI-created medical content addresses key personal information protection issues.By utilizing the distributed ledger system of blockchain,the research team aimed to protect the privacy and integrity of medical data especially medical images.This approach not only enhances security but also enables transparent and tamperproof record-keeping.Additionally,the use of generative AI models ensures the creation of novel medical content without compromising personal information,further safeguarding patient privacy.In conclusion,this study showcases the potential of blockchain-based solutions in the medical field,particularly in securing sensitive medical data and protecting patient privacy.The proposed approach,combining blockchain and generative AI,offers a promising direction toward more robust and secure medical content management.Further research and advancements in this area will undoubtedly contribute to the development of robust and privacy-preserving healthcare systems,and visual diagnostic systems.展开更多
This paper presents a project aimed at developing a trilingual visual dictionary for aircraft maintenance professionals and students.The project addresses the growing demand for accurate communication and technical te...This paper presents a project aimed at developing a trilingual visual dictionary for aircraft maintenance professionals and students.The project addresses the growing demand for accurate communication and technical terminology in the aviation industry,particularly in Brazil and China.The study employs a corpus-driven approach,analyzing a large corpus of aircraft maintenance manuals to extract key technical terms and their collocates.Using specialized subcorpora and a comparative analysis,this paper demonstrates challenges and solutions into the identification of high-frequency keywords and explores their contextual use in aviation documentation,emphasizing the need for clear and accurate technical communication.By incorporating these findings into a trilingual visual dictionary,the project aims to enhance the understanding and usage of aviation terminology.展开更多
Machine learning(ML)is increasingly applied for medical image processing with appropriate learning paradigms.These applications include analyzing images of various organs,such as the brain,lung,eye,etc.,to identify sp...Machine learning(ML)is increasingly applied for medical image processing with appropriate learning paradigms.These applications include analyzing images of various organs,such as the brain,lung,eye,etc.,to identify specific flaws/diseases for diagnosis.The primary concern of ML applications is the precise selection of flexible image features for pattern detection and region classification.Most of the extracted image features are irrelevant and lead to an increase in computation time.Therefore,this article uses an analytical learning paradigm to design a Congruent Feature Selection Method to select the most relevant image features.This process trains the learning paradigm using similarity and correlation-based features over different textural intensities and pixel distributions.The similarity between the pixels over the various distribution patterns with high indexes is recommended for disease diagnosis.Later,the correlation based on intensity and distribution is analyzed to improve the feature selection congruency.Therefore,the more congruent pixels are sorted in the descending order of the selection,which identifies better regions than the distribution.Now,the learning paradigm is trained using intensity and region-based similarity to maximize the chances of selection.Therefore,the probability of feature selection,regardless of the textures and medical image patterns,is improved.This process enhances the performance of ML applications for different medical image processing.The proposed method improves the accuracy,precision,and training rate by 13.19%,10.69%,and 11.06%,respectively,compared to other models for the selected dataset.The mean error and selection time is also reduced by 12.56%and 13.56%,respectively,compared to the same models and dataset.展开更多
In this editorial,I comment on the article by Zhang et al.To emphasize the importance of the topic,I discuss the relationship between the use of smart medical devices and mental health.Smart medical services have the ...In this editorial,I comment on the article by Zhang et al.To emphasize the importance of the topic,I discuss the relationship between the use of smart medical devices and mental health.Smart medical services have the potential to positively influence mental health by providing monitoring,insights,and inter-ventions.However,they also come with challenges that need to be addressed.Understanding the primary purpose for which individuals use these smart tech-nologies is essential to tailoring them to specific mental health needs and prefe-rences.展开更多
Introduction and Problem Statement: Many medication errors occur during the community and hospital transition. Indeed, the World Health Organization launched the international “High 5S” project to implement medicati...Introduction and Problem Statement: Many medication errors occur during the community and hospital transition. Indeed, the World Health Organization launched the international “High 5S” project to implement medication reconciliation in healthcare facilities to reduce them and ensure patients a safe, high-quality healthcare pathway. Objective: This study aimed to detect medication errors by reconciling drug treatments and assess the relevance and feasibility of this standardized practice within the Medical Emergency Unit of the Teaching Pediatric Hospital of Ouagadougou (Burkina Faso). Methods: Patients whose parents gave their consent at their entrance were enrolled. For each patient, the pharmacy team completed a reconciliation form that included the patient’s usual treatment, which was taken and in progress and received upon admission to the medical emergency unit. Patients’ treatments were reviewed to detect and characterize discrepancies. The data of each form were reported and analyzed using KoboCollect, an Android application. Results: 135 records and 412 medication lines were captured over six weeks. The average time of treatment reconciliation per patient was 57 minutes. One thousand one hundred ninety-eight (1198) intentional discrepancies were detected, of which 6.09% were documented. Seventy-one (71) unintentional discrepancies were collected, including 39 omissions, 24 regimen dosing errors, and 8 pharmaceutical form dosage errors. Forty-nine (49) unintentional discrepancies, or 69.01%, were corrected by formulated pharmaceutical interventions toward physicians. Conclusion: Medical treatment reconciliation during hospital admission is critical because discrepancies can compromise the efficacy and/or safety of the patient’s hospital medication.展开更多
Background: Clinical decision support tools provide suggestions to support healthcare providers and clinicians, as they attend to patients. Clinicians use these tools to rapidly consult the evidence at the point of ca...Background: Clinical decision support tools provide suggestions to support healthcare providers and clinicians, as they attend to patients. Clinicians use these tools to rapidly consult the evidence at the point of care, a practice which has been found to reduce the time patients spend in hospitals, promote the quality of care and improve healthcare outcomes. Such tools include Medscape, VisualDx, Clinical Key, DynaMed, BMJ Best Practice and UpToDate. However, use of such tools has not yet been fully embraced in low-resource settings such as Uganda. Objective: This paper intends to collate data on the use and uptake of one such tool, UpToDate, which was provided at no cost to five medical schools in Uganda. Methods: Free access to UpToDate was granted through the IP addresses of five medical schools in Uganda in collaboration with Better Evidence at The Global Health Delivery Project at Harvard and Brigham and Women’s Hospital and Wolters Kluwer Health. Following the donation, medical librarians in the respective institutions conducted training sessions and created awareness of the tool. Usage data was aggregated, based on logins and content views, presented and analyzed using Excel tables and graphs. Results: The data shows similar trends in increased usage over the period of August 2022 to August 2023 across the five medical schools. The most common topics viewed, mode of access (using either the computer or the mobile app), total usage by institution, ratio of uses to eligible users by institution and ratio of uses to students by institution are shared. Conclusion: The study revealed that the tool was used by various user categories across the institutions with similar steady improved usage over the year. These results can inform the librarians as they encourage their respective institutions to continue using the tool to support uptake of point-of-care tools in clinical practice.展开更多
Accurate medical diagnosis,which involves identifying diseases based on patient symptoms,is often hindered by uncertainties in data interpretation and retrieval.Advanced fuzzy set theories have emerged as effective to...Accurate medical diagnosis,which involves identifying diseases based on patient symptoms,is often hindered by uncertainties in data interpretation and retrieval.Advanced fuzzy set theories have emerged as effective tools to address these challenges.In this paper,new mathematical approaches for handling uncertainty in medical diagnosis are introduced using q-rung orthopair fuzzy sets(q-ROFS)and interval-valued q-rung orthopair fuzzy sets(IVq-ROFS).Three aggregation operators are proposed in our methodologies:the q-ROF weighted averaging(q-ROFWA),the q-ROF weighted geometric(q-ROFWG),and the q-ROF weighted neutrality averaging(qROFWNA),which enhance decision-making under uncertainty.These operators are paired with ranking methods such as the similarity measure,score function,and inverse score function to improve the accuracy of disease identification.Additionally,the impact of varying q-rung values is explored through a sensitivity analysis,extending the analysis beyond the typical maximum value of 3.The Basic Uncertain Information(BUI)method is employed to simulate expert opinions,and aggregation operators are used to combine these opinions in a group decisionmaking context.Our results provide a comprehensive comparison of methodologies,highlighting their strengths and limitations in diagnosing diseases based on uncertain patient data.展开更多
The benefits of regular physical activity are well known.Yet,few studies have examined the effectiveness of integrating physical activity(PA)into curricula within a post-secondary setting.To investigate the incorporat...The benefits of regular physical activity are well known.Yet,few studies have examined the effectiveness of integrating physical activity(PA)into curricula within a post-secondary setting.To investigate the incorporation of PA into medical curriculum,we developed a series of optional exercise-based review sessions designed to reinforce musculoskeletal(MSK)anatomy course material.These synchronous sessions were co-taught by a group fitness instructor and an anatomy instructor.The fitness instructor would lead students through both strength and yoga style exercises,while the anatomy instructor asked questions about relevant anatomical structures related to course material previously covered.After the sessions,participants were asked to evaluate the classes on their self-reported exam preparedness in improving MSK anatomy knowledge,PA levels,and mental wellbeing.Thirty participants completed surveys;a majority agreed that the classes increased understanding of MSK concepts(90.0%)and activity levels(97.7%).Many(70.0%)felt that the classes helped reduce stress.The majority of respondents(90.0%)agreed that the classes contributed to increased feelings of social connectedness.Overall,medical students saw benefit in PA based interventions to supplement MSK course concepts.Along with increasing activity levels and promoting health behaviours,integrating PA into medical curriculum may improve comprehension of learning material,alleviate stress and foster social connectivity among medical students.展开更多
On October 18,2017,the 19th National Congress Report called for the implementation of the Healthy China Strategy.The development of biomedical data plays a pivotal role in advancing this strategy.Since the 18th Nation...On October 18,2017,the 19th National Congress Report called for the implementation of the Healthy China Strategy.The development of biomedical data plays a pivotal role in advancing this strategy.Since the 18th National Congress of the Communist Party of China,China has vigorously promoted the integration and implementation of the Healthy China and Digital China strategies.The National Health Commission has prioritized the development of health and medical big data,issuing policies to promote standardized applica-tions and foster innovation in"Internet+Healthcare."Biomedical data has significantly contributed to preci-sion medicine,personalized health management,drug development,disease diagnosis,public health monitor-ing,and epidemic prediction capabilities.展开更多
Objective: This study assesses the quality of artificial intelligence chatbots in responding to standardized obstetrics and gynecology questions. Methods: Using ChatGPT-3.5, ChatGPT-4.0, Bard, and Claude to respond to...Objective: This study assesses the quality of artificial intelligence chatbots in responding to standardized obstetrics and gynecology questions. Methods: Using ChatGPT-3.5, ChatGPT-4.0, Bard, and Claude to respond to 20 standardized multiple choice questions on October 7, 2023, responses and correctness were recorded. A logistic regression model assessed the relationship between question character count and accuracy. For each incorrect question, an independent error analysis was undertaken. Results: ChatGPT-4.0 scored a 100% across both obstetrics and gynecology questions. ChatGPT-3.5 scored a 95% overall, earning an 85.7% in obstetrics and a 100% in gynecology. Claude scored a 90% overall, earning a 100% in obstetrics and an 84.6% in gynecology. Bard scored a 77.8% overall, earning an 83.3% in obstetrics and a 75% in gynecology and would not respond to two questions. There was no statistical significance between character count and accuracy. Conclusions: ChatGPT-3.5 and ChatGPT-4.0 excelled in both obstetrics and gynecology while Claude performed well in obstetrics but possessed minor weaknesses in gynecology. Bard comparatively performed the worst and had the most limitations, leading to our support of the other artificial intelligence chatbots as preferred study tools. Our findings support the use of chatbots as a supplement, not a substitute for clinician-based learning or historically successful educational tools.展开更多
Introduction: The use of radioactive radiations in healthcare facilities must comply with radioprotection safety rules in order to avoid threatening the health of workers and patients. This study aimed to assess the w...Introduction: The use of radioactive radiations in healthcare facilities must comply with radioprotection safety rules in order to avoid threatening the health of workers and patients. This study aimed to assess the working conditions, the protective measures and the medical monitoring of workers directly involved in X-ray work at hospitals in Douala, Cameroon. Materials and Methods: A descriptive cross-sectional study was carried out during the 1st quarter of 2018, across various state and private health facilities of the city of Douala. Sampling was non-random, based on convenience and all the willing participants that fulfilled the inclusion criteria were enrolled. Quantitative analyses were conducted using EPI INFO 7.0 software and the results were presented in both univariate and bivariate forms. Results: The sample consisted of 56 men and 31 women with a mean age of 34.75 ± 8.77 years. X-ray technicians were over-represented (41.38%). Day/night shift work was the main work pattern (68.96%). The distribution of work zones A&B was known by 87.5% of the participants. Hazard warning signs were effective in work zones A and B (75.86%), and the walls of the premises were also reinforced in these work zones (88.51%), but the use of radiation dosimeters was rare (9.20%). Radiation aprons (94.30%) and hand-held dosimeters (63.20%) were the most commonly used personal protective equipment. The majority of the participants did not benefit from medical follow-up by an occupational health specialist (62.1%). Conclusion: The implementation of radiation protection measures remains a significant concern in Douala based health facilities, and requires stricter administrative controls and sanctions to prevent serious health consequences for exposed staff.展开更多
Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major...Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major cause of morbidity and mortality in pediatrics. The aim of our study was to investigate the epidemiological, clinical and therapeutic aspects of respiratory distress in children aged between 1 month and 15 years seen in the emergency department of the Bangui paediatric university hospital. Methodology: This was a 3-month descriptive cross-sectional study, from January 1 to March 31, 2023. All children aged 1 month to less than 15 years presenting with respiratory distress were included. Results: A total of 3021 children were admitted to the emergency medical services of Bangui’s pediatric university hospital. Of these, 164 were included in the study. The predominance was male, with a sex ratio of 1.09. The 0 - 2 age group was the most represented, with 67 patients (42.85%). The majority of patients came from Bangui, accounting for 146 (89.02%) of cases. Respiratory difficulty (59.15%), characterized by dyspnea and cough, associated with fever, vomiting, physical asthenia and diarrhea, were the main reasons for consultation. The main pathologies noted were respiratory 92 (56.10%), followed by cardiac pathologies 21 (12.8%). Antibiotic administration (76.82%) was the most common therapeutic procedure used in the management of respiratory distress. Conclusion: Respiratory distress remains an important cause of infant mortality in our context, with major management problems.展开更多
文摘BACKGROUND Drug utilization research has an important role in assisting the healthcare administration to know,compute,and refine the prescription whose principal objective is to enable the rational use of drugs.Research in developing nations relating to the cost of treatment is scarce when compared with developed countries.Thus,the drug utilization research studies from developing nations are most needed,and their number has been growing.AIM To evaluate patterns of utilization of antipsychotic drugs and direct medical cost analysis in patients newly diagnosed with schizophrenia.METHODS The present study was observational in type and based on a retrospective cohort to evaluate patterns of utilization of antipsychotic drugs using World Health Organization(WHO)core prescribing indicators and anatomical therapeutic chemical/defined daily dose indicators.We also calculated direct medical costs for a period of 6 months.RESULTS This study has found that atypical antipsychotics are the mainstay of treatment for schizophrenia in every age group and subcategories of schizophrenia.The evaluation based on WHO prescribing indicators showed a low average number of drugs per prescription and low prescribing frequency of antipsychotics from the National List of Essential Medicines 2015 and the WHO Essential Medicines List 2019.The total mean drug cost of our study was 1396 Indian rupees.The total mean cost due to the investigation in our study was 1017.34 Indian rupees.Therefore,the total mean direct medical cost incurred on patients in our study was 4337.28 Indian rupees.CONCLUSION The information from the present study can be used for reviewing and updating treatment policy at the institutional level.
基金funded by China Law Society 2025 Annual Legal Research,Project grant number:CLS(2025)Y04.
文摘Background:Medical artificial intelligence(MAI)is a synthesis of medical science and artificial intelligence development,serving as a crucial field in the current advancement and application of AI.In the process of developing medical AI,there may arise not only legal risks such as infringement of privacy rights and health rights but also ethical risks stemming from violations of the principles of beneficence and non-maleficence.Methods:To effectively address the damages caused by MAI in the future,it is necessary to establish a hierarchical governance system with MAI.This paper examines the systematic collection of local practices in China and the induction and integration of legal remedies for the damage of MAI.Results:To effectively address the ethical and legal challenges of medical artificial intelligence,a hierarchical regulatory system should be established,which based on the impact of intervention measures on natural rights and differences in intervention timing.This paper finally obtains a legal hierarchical governance system corresponding to the ethical risks and legal risks of MAI in China.Conclusion:The Chinese government has formed a multi-agent governance system based on the impact of risks on rights and the timing of legal intervention,which provides a reference for other countries to follow up on the research on MAI risk management.
基金supported by the National Key R&D Program of China(2021YFF1200602)the National Science Fund for Excellent Overseas Scholars(0401260011)+3 种基金the National Defense Science and Technology Innovation Fund of Chinese Academy of Sciences(c02022088)the Tianjin Science and Technology Program(20JCZDJC00810)the National Natural Science Foundation of China(82202798)the Shanghai Sailing Program(22YF1404200).
文摘Brain-computer interfaces(BCIs)represent an emerging technology that facilitates direct communication between the brain and external devices.In recent years,numerous review articles have explored various aspects of BCIs,including their fundamental principles,technical advancements,and applications in specific domains.However,these reviews often focus on signal processing,hardware development,or limited applications such as motor rehabilitation or communication.This paper aims to offer a comprehensive review of recent electroencephalogram(EEG)-based BCI applications in the medical field across 8 critical areas,encompassing rehabilitation,daily communication,epilepsy,cerebral resuscitation,sleep,neurodegenerative diseases,anesthesiology,and emotion recognition.Moreover,the current challenges and future trends of BCIs were also discussed,including personal privacy and ethical concerns,network security vulnerabilities,safety issues,and biocompatibility.
基金funded by the National Natural Science Foundation of China(Grant No.6240072655)the Hubei Provincial Key Research and Development Program(Grant No.2023BCB151)+1 种基金the Wuhan Natural Science Foundation Exploration Program(Chenguang Program,Grant No.2024040801020202)the Natural Science Foundation of Hubei Province of China(Grant No.2025AFB148).
文摘Image segmentation is attracting increasing attention in the field of medical image analysis.Since widespread utilization across various medical applications,ensuring and improving segmentation accuracy has become a crucial topic of research.With advances in deep learning,researchers have developed numerous methods that combine Transformers and convolutional neural networks(CNNs)to create highly accurate models for medical image segmentation.However,efforts to further enhance accuracy by developing larger and more complex models or training with more extensive datasets,significantly increase computational resource consumption.To address this problem,we propose BiCLIP-nnFormer(the prefix"Bi"refers to the use of two distinct CLIP models),a virtual multimodal instrument that leverages CLIP models to enhance the segmentation performance of a medical segmentation model nnFormer.Since two CLIP models(PMC-CLIP and CoCa-CLIP)are pre-trained on large datasets,they do not require additional training,thus conserving computation resources.These models are used offline to extract image and text embeddings from medical images.These embeddings are then processed by the proposed 3D CLIP adapter,which adapts the CLIP knowledge for segmentation tasks by fine-tuning.Finally,the adapted embeddings are fused with feature maps extracted from the nnFormer encoder for generating predicted masks.This process enriches the representation capabilities of the feature maps by integrating global multimodal information,leading to more precise segmentation predictions.We demonstrate the superiority of BiCLIP-nnFormer and the effectiveness of using CLIP models to enhance nnFormer through experiments on two public datasets,namely the Synapse multi-organ segmentation dataset(Synapse)and the Automatic Cardiac Diagnosis Challenge dataset(ACDC),as well as a self-annotated lung multi-category segmentation dataset(LMCS).
基金supported by the Natural Science Foundation of China(No.41804112,author:Chengyun Song).
文摘Existing semi-supervisedmedical image segmentation algorithms use copy-paste data augmentation to correct the labeled-unlabeled data distribution mismatch.However,current copy-paste methods have three limitations:(1)training the model solely with copy-paste mixed pictures from labeled and unlabeled input loses a lot of labeled information;(2)low-quality pseudo-labels can cause confirmation bias in pseudo-supervised learning on unlabeled data;(3)the segmentation performance in low-contrast and local regions is less than optimal.We design a Stochastic Augmentation-Based Dual-Teaching Auxiliary Training Strategy(SADT),which enhances feature diversity and learns high-quality features to overcome these problems.To be more precise,SADT trains the Student Network by using pseudo-label-based training from Teacher Network 1 and supervised learning with labeled data,which prevents the loss of rare labeled data.We introduce a bi-directional copy-pastemask with progressive high-entropy filtering to reduce data distribution disparities and mitigate confirmation bias in pseudo-supervision.For the mixed images,Deep-Shallow Spatial Contrastive Learning(DSSCL)is proposed in the feature spaces of Teacher Network 2 and the Student Network to improve the segmentation capabilities in low-contrast and local areas.In this procedure,the features retrieved by the Student Network are subjected to a random feature perturbation technique.On two openly available datasets,extensive trials show that our proposed SADT performs much better than the state-ofthe-art semi-supervised medical segmentation techniques.Using only 10%of the labeled data for training,SADT was able to acquire a Dice score of 90.10%on the ACDC(Automatic Cardiac Diagnosis Challenge)dataset.
文摘Multimodal deep learning has emerged as a key paradigm in contemporary medical diagnostics,advancing precision medicine by enabling integration and learning from diverse data sources.The exponential growth of high-dimensional healthcare data,encompassing genomic,transcriptomic,and other omics profiles,as well as radiological imaging and histopathological slides,makes this approach increasingly important because,when examined separately,these data sources only offer a fragmented picture of intricate disease processes.Multimodal deep learning leverages the complementary properties of multiple data modalities to enable more accurate prognostic modeling,more robust disease characterization,and improved treatment decision-making.This review provides a comprehensive overview of the current state of multimodal deep learning approaches in medical diagnosis.We classify and examine important application domains,such as(1)radiology,where automated report generation and lesion detection are facilitated by image-text integration;(2)histopathology,where fusion models improve tumor classification and grading;and(3)multi-omics,where molecular subtypes and latent biomarkers are revealed through cross-modal learning.We provide an overview of representative research,methodological advancements,and clinical consequences for each domain.Additionally,we critically analyzed the fundamental issues preventing wider adoption,including computational complexity(particularly in training scalable,multi-branch networks),data heterogeneity(resulting from modality-specific noise,resolution variations,and inconsistent annotations),and the challenge of maintaining significant cross-modal correlations during fusion.These problems impede interpretability,which is crucial for clinical trust and use,in addition to performance and generalizability.Lastly,we outline important areas for future research,including the development of standardized protocols for harmonizing data,the creation of lightweight and interpretable fusion architectures,the integration of real-time clinical decision support systems,and the promotion of cooperation for federated multimodal learning.Our goal is to provide researchers and clinicians with a concise overview of the field’s present state,enduring constraints,and exciting directions for further research through this review.
基金supported by the Natural Science Foundation of the Anhui Higher Education Institutions of China(Grant Nos.2023AH040149 and 2024AH051915)the Anhui Provincial Natural Science Foundation(Grant No.2208085MF168)+1 种基金the Science and Technology Innovation Tackle Plan Project of Maanshan(Grant No.2024RGZN001)the Scientific Research Fund Project of Anhui Medical University(Grant No.2023xkj122).
文摘Convolutional neural networks(CNNs)-based medical image segmentation technologies have been widely used in medical image segmentation because of their strong representation and generalization abilities.However,due to the inability to effectively capture global information from images,CNNs can easily lead to loss of contours and textures in segmentation results.Notice that the transformer model can effectively capture the properties of long-range dependencies in the image,and furthermore,combining the CNN and the transformer can effectively extract local details and global contextual features of the image.Motivated by this,we propose a multi-branch and multi-scale attention network(M2ANet)for medical image segmentation,whose architecture consists of three components.Specifically,in the first component,we construct an adaptive multi-branch patch module for parallel extraction of image features to reduce information loss caused by downsampling.In the second component,we apply residual block to the well-known convolutional block attention module to enhance the network’s ability to recognize important features of images and alleviate the phenomenon of gradient vanishing.In the third component,we design a multi-scale feature fusion module,in which we adopt adaptive average pooling and position encoding to enhance contextual features,and then multi-head attention is introduced to further enrich feature representation.Finally,we validate the effectiveness and feasibility of the proposed M2ANet method through comparative experiments on four benchmark medical image segmentation datasets,particularly in the context of preserving contours and textures.
文摘A medical image encryption is proposed based on the Fisher-Yates scrambling,filter diffusion and S-box substitution.First,chaotic sequence associated with the plaintext is generated by logistic-sine-cosine system,which is used for the scrambling,substitution and diffusion processes.The three-dimensional Fisher-Yates scrambling,S-box substitution and diffusion are employed for the first round of encryption.The chaotic sequence is adopted for secondary encryption to scramble the ciphertext obtained in the first round.Then,three-dimensional filter is applied to diffusion for further useful information hiding.The key to the algorithm is generated by the combination of hash value of plaintext image and the input parameters.It improves resisting ability of plaintext attacks.The security analysis shows that the algorithm is effective and efficient.It can resist common attacks.In addition,the good diffusion effect shows that the scheme can solve the differential attacks encountered in the transmission of medical images and has positive implications for future research.
文摘This study presents an innovative approach to enhancing the security of visual medical data in the generative AI environment through the integration of blockchain technology.By combining the strengths of blockchain and generative AI,the research team aimed to address the timely challenge of safeguarding visual medical content.The participating researchers conducted a comprehensive analysis,examining the vulnerabilities of medical AI services,personal information protection issues,and overall security weaknesses.This multi faceted exploration led to an indepth evaluation of the model’s performance and security.Notably,the correlation between accuracy,detection rate,and error rate was scrutinized.This analysis revealed insights into the model’s strengths and limitations,while the consideration of standard deviation shed light on the model’s stability and performance variability.The study proposed practical improvements,emphasizing the reduction of false negatives to enhance detection rate and leveraging blockchain technology to ensure visual data integrity in medical applications.Applying blockchain to generative AI-created medical content addresses key personal information protection issues.By utilizing the distributed ledger system of blockchain,the research team aimed to protect the privacy and integrity of medical data especially medical images.This approach not only enhances security but also enables transparent and tamperproof record-keeping.Additionally,the use of generative AI models ensures the creation of novel medical content without compromising personal information,further safeguarding patient privacy.In conclusion,this study showcases the potential of blockchain-based solutions in the medical field,particularly in securing sensitive medical data and protecting patient privacy.The proposed approach,combining blockchain and generative AI,offers a promising direction toward more robust and secure medical content management.Further research and advancements in this area will undoubtedly contribute to the development of robust and privacy-preserving healthcare systems,and visual diagnostic systems.
文摘This paper presents a project aimed at developing a trilingual visual dictionary for aircraft maintenance professionals and students.The project addresses the growing demand for accurate communication and technical terminology in the aviation industry,particularly in Brazil and China.The study employs a corpus-driven approach,analyzing a large corpus of aircraft maintenance manuals to extract key technical terms and their collocates.Using specialized subcorpora and a comparative analysis,this paper demonstrates challenges and solutions into the identification of high-frequency keywords and explores their contextual use in aviation documentation,emphasizing the need for clear and accurate technical communication.By incorporating these findings into a trilingual visual dictionary,the project aims to enhance the understanding and usage of aviation terminology.
基金the Deanship of Scientifc Research at King Khalid University for funding this work through large group Research Project under grant number RGP2/421/45supported via funding from Prince Sattam bin Abdulaziz University project number(PSAU/2024/R/1446)+1 种基金supported by theResearchers Supporting Project Number(UM-DSR-IG-2023-07)Almaarefa University,Riyadh,Saudi Arabia.supported by the Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Education(No.2021R1F1A1055408).
文摘Machine learning(ML)is increasingly applied for medical image processing with appropriate learning paradigms.These applications include analyzing images of various organs,such as the brain,lung,eye,etc.,to identify specific flaws/diseases for diagnosis.The primary concern of ML applications is the precise selection of flexible image features for pattern detection and region classification.Most of the extracted image features are irrelevant and lead to an increase in computation time.Therefore,this article uses an analytical learning paradigm to design a Congruent Feature Selection Method to select the most relevant image features.This process trains the learning paradigm using similarity and correlation-based features over different textural intensities and pixel distributions.The similarity between the pixels over the various distribution patterns with high indexes is recommended for disease diagnosis.Later,the correlation based on intensity and distribution is analyzed to improve the feature selection congruency.Therefore,the more congruent pixels are sorted in the descending order of the selection,which identifies better regions than the distribution.Now,the learning paradigm is trained using intensity and region-based similarity to maximize the chances of selection.Therefore,the probability of feature selection,regardless of the textures and medical image patterns,is improved.This process enhances the performance of ML applications for different medical image processing.The proposed method improves the accuracy,precision,and training rate by 13.19%,10.69%,and 11.06%,respectively,compared to other models for the selected dataset.The mean error and selection time is also reduced by 12.56%and 13.56%,respectively,compared to the same models and dataset.
文摘In this editorial,I comment on the article by Zhang et al.To emphasize the importance of the topic,I discuss the relationship between the use of smart medical devices and mental health.Smart medical services have the potential to positively influence mental health by providing monitoring,insights,and inter-ventions.However,they also come with challenges that need to be addressed.Understanding the primary purpose for which individuals use these smart tech-nologies is essential to tailoring them to specific mental health needs and prefe-rences.
文摘Introduction and Problem Statement: Many medication errors occur during the community and hospital transition. Indeed, the World Health Organization launched the international “High 5S” project to implement medication reconciliation in healthcare facilities to reduce them and ensure patients a safe, high-quality healthcare pathway. Objective: This study aimed to detect medication errors by reconciling drug treatments and assess the relevance and feasibility of this standardized practice within the Medical Emergency Unit of the Teaching Pediatric Hospital of Ouagadougou (Burkina Faso). Methods: Patients whose parents gave their consent at their entrance were enrolled. For each patient, the pharmacy team completed a reconciliation form that included the patient’s usual treatment, which was taken and in progress and received upon admission to the medical emergency unit. Patients’ treatments were reviewed to detect and characterize discrepancies. The data of each form were reported and analyzed using KoboCollect, an Android application. Results: 135 records and 412 medication lines were captured over six weeks. The average time of treatment reconciliation per patient was 57 minutes. One thousand one hundred ninety-eight (1198) intentional discrepancies were detected, of which 6.09% were documented. Seventy-one (71) unintentional discrepancies were collected, including 39 omissions, 24 regimen dosing errors, and 8 pharmaceutical form dosage errors. Forty-nine (49) unintentional discrepancies, or 69.01%, were corrected by formulated pharmaceutical interventions toward physicians. Conclusion: Medical treatment reconciliation during hospital admission is critical because discrepancies can compromise the efficacy and/or safety of the patient’s hospital medication.
文摘Background: Clinical decision support tools provide suggestions to support healthcare providers and clinicians, as they attend to patients. Clinicians use these tools to rapidly consult the evidence at the point of care, a practice which has been found to reduce the time patients spend in hospitals, promote the quality of care and improve healthcare outcomes. Such tools include Medscape, VisualDx, Clinical Key, DynaMed, BMJ Best Practice and UpToDate. However, use of such tools has not yet been fully embraced in low-resource settings such as Uganda. Objective: This paper intends to collate data on the use and uptake of one such tool, UpToDate, which was provided at no cost to five medical schools in Uganda. Methods: Free access to UpToDate was granted through the IP addresses of five medical schools in Uganda in collaboration with Better Evidence at The Global Health Delivery Project at Harvard and Brigham and Women’s Hospital and Wolters Kluwer Health. Following the donation, medical librarians in the respective institutions conducted training sessions and created awareness of the tool. Usage data was aggregated, based on logins and content views, presented and analyzed using Excel tables and graphs. Results: The data shows similar trends in increased usage over the period of August 2022 to August 2023 across the five medical schools. The most common topics viewed, mode of access (using either the computer or the mobile app), total usage by institution, ratio of uses to eligible users by institution and ratio of uses to students by institution are shared. Conclusion: The study revealed that the tool was used by various user categories across the institutions with similar steady improved usage over the year. These results can inform the librarians as they encourage their respective institutions to continue using the tool to support uptake of point-of-care tools in clinical practice.
文摘Accurate medical diagnosis,which involves identifying diseases based on patient symptoms,is often hindered by uncertainties in data interpretation and retrieval.Advanced fuzzy set theories have emerged as effective tools to address these challenges.In this paper,new mathematical approaches for handling uncertainty in medical diagnosis are introduced using q-rung orthopair fuzzy sets(q-ROFS)and interval-valued q-rung orthopair fuzzy sets(IVq-ROFS).Three aggregation operators are proposed in our methodologies:the q-ROF weighted averaging(q-ROFWA),the q-ROF weighted geometric(q-ROFWG),and the q-ROF weighted neutrality averaging(qROFWNA),which enhance decision-making under uncertainty.These operators are paired with ranking methods such as the similarity measure,score function,and inverse score function to improve the accuracy of disease identification.Additionally,the impact of varying q-rung values is explored through a sensitivity analysis,extending the analysis beyond the typical maximum value of 3.The Basic Uncertain Information(BUI)method is employed to simulate expert opinions,and aggregation operators are used to combine these opinions in a group decisionmaking context.Our results provide a comprehensive comparison of methodologies,highlighting their strengths and limitations in diagnosing diseases based on uncertain patient data.
文摘The benefits of regular physical activity are well known.Yet,few studies have examined the effectiveness of integrating physical activity(PA)into curricula within a post-secondary setting.To investigate the incorporation of PA into medical curriculum,we developed a series of optional exercise-based review sessions designed to reinforce musculoskeletal(MSK)anatomy course material.These synchronous sessions were co-taught by a group fitness instructor and an anatomy instructor.The fitness instructor would lead students through both strength and yoga style exercises,while the anatomy instructor asked questions about relevant anatomical structures related to course material previously covered.After the sessions,participants were asked to evaluate the classes on their self-reported exam preparedness in improving MSK anatomy knowledge,PA levels,and mental wellbeing.Thirty participants completed surveys;a majority agreed that the classes increased understanding of MSK concepts(90.0%)and activity levels(97.7%).Many(70.0%)felt that the classes helped reduce stress.The majority of respondents(90.0%)agreed that the classes contributed to increased feelings of social connectedness.Overall,medical students saw benefit in PA based interventions to supplement MSK course concepts.Along with increasing activity levels and promoting health behaviours,integrating PA into medical curriculum may improve comprehension of learning material,alleviate stress and foster social connectivity among medical students.
文摘On October 18,2017,the 19th National Congress Report called for the implementation of the Healthy China Strategy.The development of biomedical data plays a pivotal role in advancing this strategy.Since the 18th National Congress of the Communist Party of China,China has vigorously promoted the integration and implementation of the Healthy China and Digital China strategies.The National Health Commission has prioritized the development of health and medical big data,issuing policies to promote standardized applica-tions and foster innovation in"Internet+Healthcare."Biomedical data has significantly contributed to preci-sion medicine,personalized health management,drug development,disease diagnosis,public health monitor-ing,and epidemic prediction capabilities.
文摘Objective: This study assesses the quality of artificial intelligence chatbots in responding to standardized obstetrics and gynecology questions. Methods: Using ChatGPT-3.5, ChatGPT-4.0, Bard, and Claude to respond to 20 standardized multiple choice questions on October 7, 2023, responses and correctness were recorded. A logistic regression model assessed the relationship between question character count and accuracy. For each incorrect question, an independent error analysis was undertaken. Results: ChatGPT-4.0 scored a 100% across both obstetrics and gynecology questions. ChatGPT-3.5 scored a 95% overall, earning an 85.7% in obstetrics and a 100% in gynecology. Claude scored a 90% overall, earning a 100% in obstetrics and an 84.6% in gynecology. Bard scored a 77.8% overall, earning an 83.3% in obstetrics and a 75% in gynecology and would not respond to two questions. There was no statistical significance between character count and accuracy. Conclusions: ChatGPT-3.5 and ChatGPT-4.0 excelled in both obstetrics and gynecology while Claude performed well in obstetrics but possessed minor weaknesses in gynecology. Bard comparatively performed the worst and had the most limitations, leading to our support of the other artificial intelligence chatbots as preferred study tools. Our findings support the use of chatbots as a supplement, not a substitute for clinician-based learning or historically successful educational tools.
文摘Introduction: The use of radioactive radiations in healthcare facilities must comply with radioprotection safety rules in order to avoid threatening the health of workers and patients. This study aimed to assess the working conditions, the protective measures and the medical monitoring of workers directly involved in X-ray work at hospitals in Douala, Cameroon. Materials and Methods: A descriptive cross-sectional study was carried out during the 1st quarter of 2018, across various state and private health facilities of the city of Douala. Sampling was non-random, based on convenience and all the willing participants that fulfilled the inclusion criteria were enrolled. Quantitative analyses were conducted using EPI INFO 7.0 software and the results were presented in both univariate and bivariate forms. Results: The sample consisted of 56 men and 31 women with a mean age of 34.75 ± 8.77 years. X-ray technicians were over-represented (41.38%). Day/night shift work was the main work pattern (68.96%). The distribution of work zones A&B was known by 87.5% of the participants. Hazard warning signs were effective in work zones A and B (75.86%), and the walls of the premises were also reinforced in these work zones (88.51%), but the use of radiation dosimeters was rare (9.20%). Radiation aprons (94.30%) and hand-held dosimeters (63.20%) were the most commonly used personal protective equipment. The majority of the participants did not benefit from medical follow-up by an occupational health specialist (62.1%). Conclusion: The implementation of radiation protection measures remains a significant concern in Douala based health facilities, and requires stricter administrative controls and sanctions to prevent serious health consequences for exposed staff.
文摘Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major cause of morbidity and mortality in pediatrics. The aim of our study was to investigate the epidemiological, clinical and therapeutic aspects of respiratory distress in children aged between 1 month and 15 years seen in the emergency department of the Bangui paediatric university hospital. Methodology: This was a 3-month descriptive cross-sectional study, from January 1 to March 31, 2023. All children aged 1 month to less than 15 years presenting with respiratory distress were included. Results: A total of 3021 children were admitted to the emergency medical services of Bangui’s pediatric university hospital. Of these, 164 were included in the study. The predominance was male, with a sex ratio of 1.09. The 0 - 2 age group was the most represented, with 67 patients (42.85%). The majority of patients came from Bangui, accounting for 146 (89.02%) of cases. Respiratory difficulty (59.15%), characterized by dyspnea and cough, associated with fever, vomiting, physical asthenia and diarrhea, were the main reasons for consultation. The main pathologies noted were respiratory 92 (56.10%), followed by cardiac pathologies 21 (12.8%). Antibiotic administration (76.82%) was the most common therapeutic procedure used in the management of respiratory distress. Conclusion: Respiratory distress remains an important cause of infant mortality in our context, with major management problems.
