Background: Nursing students are at risk for committing medication administration errors (MAEs), which significantly alter the delivery of safe and effective healthcare. Purpose: To identify the medications most frequ...Background: Nursing students are at risk for committing medication administration errors (MAEs), which significantly alter the delivery of safe and effective healthcare. Purpose: To identify the medications most frequently involved in medication errors as reported by Jordanian nursing students, as well as to identify the level of nursing students’ adherence to best-practice when administering high-risk medications. Methods: A cross-sectional design was used among a convenience sample of 74 nurses. Results: A total of 74 of 110 (67.3%) questionnaires were returned. The most frequent medications subjected to MAEs were Dopamine, Dobutamine, and Insulin continuous intravenous infusion (17.2%, 16.0% and 13.5% respectively). Regarding the adherence to best-practice, nursing students adhered the most to the following best-practices: checking the patient armband prior to medication administration with a mean of 3.81 (±0.6) and bringing the MAR sheet with them when preparing a medication with a mean of 3.46 (±1.1). Conclusion: Developing an effective medication training programs in all undergraduate nursing programs in Jordanis is vital to ensure patient safety. Nursing educators in clinical and academic settings need to reinforce the importance of adherence to medication management best-practice in all courses. Close and effective supervision of students needs to be maintained throughout nursing students’ clinical training, especially during medication preparation and administration.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
In today’s fast-paced world,many elderly individuals struggle to adhere to their medication schedules,especially those with memory-related conditions like Alzheimer’s disease,leading to serious health risks,hospital...In today’s fast-paced world,many elderly individuals struggle to adhere to their medication schedules,especially those with memory-related conditions like Alzheimer’s disease,leading to serious health risks,hospital-izations,and increased healthcare costs.Traditional reminder systems often fail due to a lack of personalization and real-time intervention.To address this critical challenge,we introduce MediServe,an advanced IoT-enabled medication management system that seamlessly integrates deep learning techniques to provide a personalized,secure,and adaptive solution.MediServe features a smart medication box equipped with biometric authentication,such as fingerprint recognition,ensuring authorized access to prescribed medication while preventing misuse.A user-friendly mobile application complements the system,offering real-time notifications,adherence tracking,and emergency alerts for caregivers and healthcare providers.The system employs predictive deep learning models,achieving an impressive classification accuracy of 98%,to analyze user behavior,detect anomalies in medication adherence,and optimize scheduling based on an individual’s habits and health conditions.Furthermore,MediServe enhances accessibility by employing natural language processing(NLP)models for voice-activated interactions and text-to-speech capabilities,making it especially beneficial for visually impaired users and those with cognitive impairments.Cloud-based data analytics and wireless connectivity facilitate remote monitoring,ensuring that caregivers receive instant alerts in case of missed doses or medication mismanagement.Additionally,machine learning-based clustering and anomaly detection refine medication reminders by adapting to users’changing health patterns.By combining IoT,deep learning,and advanced security protocols,MediServe delivers a comprehensive,intelligent,and inclusive solution for medication adherence.This innovative approach not only improves the quality of life for elderly individuals but also reduces the burden on caregivers and healthcare systems,ultimately fostering independent and efficient health management.展开更多
The aim of this study is to explore and summarize the development trajectory,current research landscape,and emerging trends of medication consultation in China,providing a valuable reference for future investigations ...The aim of this study is to explore and summarize the development trajectory,current research landscape,and emerging trends of medication consultation in China,providing a valuable reference for future investigations in this domain.Relevant articles on medication consultation were systematically collected,and bibliometric software such as CiteSpace 6.4R1 was employed to analyze author and institutional collaborations,keyword co-occurrence,clustering,and emerging trends.This approach helped elucidate key themes and hot topics in the field.A total of 1267 articles were included,with the peak number of publications recorded in 2011,followed by a steady decline in subsequent years.The most prolific author was Zhen Jiancun,contributing eight publications,while the First Affiliated Hospital of Sun Yat-sen University emerged as the leading institution with 11 publications.High-frequency identified keywords included medication consultation,rational drug use,pharmaceutical services,clinical pharmacists,and outpatient pharmacies.Cluster analysis revealed 12 significant themes,while emergent analysis highlighted that recent research hotspots centered on the Pareto chart,pregnancy,and traditional Chinese patent medicine.As a critical aspect of pharmaceutical services,the practice of medication consultation in China requires further advancement,with a particular need for enhanced collaboration among researchers and institutions.Moving forward,expanding the scope of medication consultation,improving the quality of related research,and fostering cross-regional collaboration among teams with diverse research focuses will be essential in deepening and broadening this field of study.展开更多
Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and ...Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and healthy lifestyle index (HLI)with BP control among hypertension patients is seldom reported,which needs to provide more evidence by prospective intervention studies.We examined the association of antihypertensive medication use and HLI with BP control among employees with hypertension in China based on a workplace-based multicomponent intervention program.Methods Between January 2013 and December 2014,a cluster randomized clinical trial of a workplace-based multicomponent intervention program was conducted in 60 workplaces across 20 urban areas in China.Workplaces were randomly divided into intervention (n=40) and control (n=20) groups.Basic information on employees at each workplace was collected by trained professionals,including sociodemographic characteristics,medical history,family history,lifestyle behaviors,medication status and physical measurements.After baseline,the intervention group received a 2-year intervention to achieve BP control,which included:(1) a workplace wellness program for all employees;(2) a guidelines-oriented hypertension management protocol.HLI including nonsmoking,nondrinking,adequate physical activity,weight within reference range and balanced diet,were coded on a 5-point scale (range:0-5,with higher score indicating a healthier lifestyle).Antihypertensive medication use was defined as taking drug within the last 2 weeks.Changes in HLI,antihypertensive medication use and BP control from baseline to 24 months were measured after the intervention.Results Overall,4655 employees were included (age:46.3±7.6 years,men:3547 (82.3%)).After 24 months of the intervention,there was a significant improvement in lifestyle[smoking (OR=0.65,95%CI:0.43-0.99;P=0.045),drinking (OR=0.52,95%CI:0.40-0.68;P<0.001),regular exercise (OR=3.10,95%CI:2.53-3.78;P<0.001),excessive intake of fatty food (OR=0.17,95%CI:0.06-0.52;P=0.002),restrictive use of salt (OR=0.26,95%CI:0.12-0.56;P=0.001)].Compare to employees with a deteriorating lifestyle after the intervention,those with an improved lifestyle had a higher BP control.In the intervention group,compared with employees not using antihypertensive medication,those who consistent used (OR=2.34;95%CI:1.16-4.72;P=0.017) or changed from not using to using antihypertensive medication (OR=2.24;95%CI:1.08-4.62;P=0.030) had higher BP control.Compared with those having lower HLI,participants with a same (OR=1.38;95%CI:0.99-1.93;P=0.056) or high (OR=1.79;95%CI:1.27~2.53;P<0.001) HLI had higher BP control.Those who used antihypertensive medication and had a high HLI had the highest BP control (OR=1.88;95%CI:1.32-2.67,P<0.001).Subgroup analysis also showed the consistent effect as the above.Conclusion These findings suggest that adherence to antihypertensive medication treatment and healthy lifestyle were associated with a significant improvement in BP control among employees with hypertension.展开更多
Background:Patient participation is crucial for medication safety among older adults with chronic diseases transitioning from hospital to home,yet evidence on its levels and influencing factors remains limited.This st...Background:Patient participation is crucial for medication safety among older adults with chronic diseases transitioning from hospital to home,yet evidence on its levels and influencing factors remains limited.This study investigated the current state and predictors of such participation during this critical period.Methods:A cross-sectional study was conducted among older adults discharged from two tertiary hospitals in Fujian,China(October-December 2023).Data were collected using a general information questionnaire,a self-developed behavior scale,the Health Literacy Management Scale,General Self-Efficacy Scale,Facilitation of Patient Involvement Scale,and Family Support Scale.Analyses included ANOVA,Pearson correlation,and multiple stepwise regression.Results:Among 302 valid responses,the mean score for participation in medication safety behaviors was 68.59±11.62,indicating a moderate level.Health literacy,self-efficacy,healthcare worker support,and family support were positively correlated with participation(all P<0.01).Multiple regression identified daily medication frequency,health literacy,self-efficacy,and healthcare worker support as significant predictors,explaining 18.3%of the variance.Conclusion:Participation in medication safety among older chronic disease patients during care transitions requires improvement.Enhancing health literacy,self-efficacy,and healthcare worker support,while considering medication frequency,can promote patient involvement and medication safety.展开更多
[Objectives]This study was conducted to analyze the medication laws of traditional Chinese medicine prescriptions for the treatment of spleen-deficiency irritable bowel syndrome in Guanling Autonomous County Hospital ...[Objectives]This study was conducted to analyze the medication laws of traditional Chinese medicine prescriptions for the treatment of spleen-deficiency irritable bowel syndrome in Guanling Autonomous County Hospital of Traditional Chinese Medicine.[Methods]Prescriptions for the treatment of spleen-deficiency irritable bowel syndrome(IBS)were retrieved from the TCM family of the hospital,traditional Chinese medical doctor Wu Zhongli,in the period from November 2023 to April 2024.Microsoft Excel 2007 was employed to set up an information table of TCM prescriptions,and the age,gender,herbal properties,efficacy categories and the frequency of use were analyzed to explore the medication laws of TCM in the hospital for the treatment of spleen-deficiency irritable bowel syndrome.[Results]Among the 259 TCM prescriptions included,152 kinds of TCM decoction pieces were used.The decoction pieces were mainly warm in nature,and decoction pieces cold in nature took the second place.The flavors of the herbs were mostly sweet,bitter and pungent.Most of them were attributive to the spleen,stomach meridian and lung meridians,and the herbs were mainly used for tonifying deficiency and regulating qi.The herbs with higher frequency of use included Radix Glycyrrhiza,Pericarpium Citri Reticulatae,poria,and Angelicae Sinensis Radix,the main effects of which are replenishing qi to invigorate the spleen,activating qi and eliminating phlegm,clearing damp and promoting diuresis,and relaxing bowel.[Conclusions]Chinese medicine treatment of IBS with spleen deficiency in hospitals is mainly based on replenishing qi to invigorate the spleen,activating qi and eliminating phlegm,clearing damp and promoting diuresis,and relaxing bowel,and Xiangsha Liujunzi Decoction is commonly used in clinical treatment based on syndrome differentiation with modifications.展开更多
Background:Patients are particularly vulnerable to adverse drug events during the transition from hospital to home.This risk is significantly amplified for older adults with chronic diseases,who often manage complex m...Background:Patients are particularly vulnerable to adverse drug events during the transition from hospital to home.This risk is significantly amplified for older adults with chronic diseases,who often manage complex medication regimens involving multiple drugs.Although active patient participation is recognized as a crucial component in safeguarding medication safety,there is currently a lack of a standardized,validated tool specifically designed to assess the level of such participation among this vulnerable population during this critical transition.Therefore,this study aimed to develop and validate a questionnaire for assessing the level of participation in medication safety behaviors among older adults with chronic diseases during the transition from hospital to home.Methods:Guided by the Interactive Patient Participation in Patient Safety theory,the initial questionnaire was developed through literature analysis,qualitative interviews,expert consultation,and pre-testing from April to December 2023.A total of 582 older adults with chronic diseases discharged from two tertiary hospitals in Fuzhou,China were recruited using convenience sampling.Construct validity,content validity,internal consistency,and test-retest reliability were assessed.Results:The final questionnaire comprised 20 items across three dimensions:Participation in Decision-Making,Participation in Care,Participation in Appeals.Exploratory factor analysis showed a cumulative variance contribution of 51.478%.The overall Cronbach’s a coefficient was 0.875,the scale-level content validity index was 0.930,and the test-retest reliability was 0.715.Confirmatory factor analysis indicated an acceptable model fit.Conclusion:The developed questionnaire exhibits good reliability and validity,supporting its use to evaluate participation in medication safety behaviors among Chinese older adults with chronic diseases during the hospital-to-home transition period.展开更多
Patients with cardiovascular disease rely on medication to achieve favorable longterm clinical results.Poor adherence has been linked to a relative increase in mortality of 50%-80%as well as higher health care costs.T...Patients with cardiovascular disease rely on medication to achieve favorable longterm clinical results.Poor adherence has been linked to a relative increase in mortality of 50%-80%as well as higher health care costs.This scoping review thus aimed to explore the evidence of the effects of mobile health care apps on medication adherence in patients with cardiovascular diseases.A comprehensive data search and extraction was done in line with the updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist.A total of 10 studies were included for the review.The mean pooled improvement in adherence was found to be 18%and the most effective tool was the digital therapeutics app discussed in Li et al’s study.Smartphones and apps enhance coronary artery disease management by promoting medication compliance.Challenges include data security and smartphone usage among the elderly.Tailored apps or voice assistants offer potential solutions.展开更多
BACKGROUND Patients who undergo cardiac surgery often face postoperative pain and potential cognitive issues.Multimodal analgesia may address these problems.We hypothesized that multimodal analgesia can reduce opioid ...BACKGROUND Patients who undergo cardiac surgery often face postoperative pain and potential cognitive issues.Multimodal analgesia may address these problems.We hypothesized that multimodal analgesia can reduce opioid use and improve cognitive recovery.AIM To investigate the effects of multimodal analgesia on postoperative opioid consumption and cognitive recovery in patients who underwent cardiac surgery.METHODS A prospective,randomized controlled trial at General Hospital from January 2020 to April 2023 recruited a total of 150 adult patients who underwent elective cardiac surgery.The patients were randomly divided into two groups.Group A had patient-controlled intravenous analgesia with sufentanil and flurbiprofen axil.Group B had flurbiprofen axil and paravertebral nerve block.Data were analyzed with appropriate statistical methods.RESULTS Group B had lower postoperative patient-controlled intravenous analgesia drug consumption(2.21 mL/hour vs 4.26 mL/hour,P<0.001),shorter extubation time(2.32 hours vs 3.81 hours,P<0.001),and intensive care unit stay(15.32 h vs 28.63 h,P<0.001).Visual Analogue Scale pain scores were lower in group B(P<0.001).Group B had fewer postoperative complications(no respiratory depression vs 37.9%in group A,P<0.05),a lower postoperative cognitive dysfunction incidence(16.0%vs 28.0%,P<0.05),and higher Barthel Index scores(P<0.05).CONCLUSION Multimodal analgesia with paravertebral nerve block and flurbiprofen axil reduces opioid use and improves cognitive outcomes in patients who underwent cardiac surgery.展开更多
Medication adherence in patients with schizophrenia is essential for managing symptoms,improving prognosis,and enhancing the quality of life.Despite the importance of adherence,it remains a global challenge.It is infl...Medication adherence in patients with schizophrenia is essential for managing symptoms,improving prognosis,and enhancing the quality of life.Despite the importance of adherence,it remains a global challenge.It is influenced by various factors,including symptom severity(e.g.,excitement and impulse control disorders),attitudes towards medication(e.g.,pharmacophobia),lack of social support,and the communication efficacy of healthcare teams.Regarding assessment tools,self-report questionnaires,such as the Morisky Scale,are common but subject to recall bias.Electronic monitoring devices(e.g.,Medication Event Monitoring System)and pharmacy refill data offer more objective measures of adherence,whereas biomarkers,such as blood drug concentration monitoring,show promise under specific conditions but require further validation.Long-acting injectable antipsychotic medications have shown greater adherence benefits than oral medications.Psychological interventions such as motivational interviewing and mindfulness training,along with multidisciplinary team efforts,including psychiatrists,pharmacists,and psychotherapists,can significantly improve patient outcomes.Future research should integrate innovative drug formulations(e.g.,long-acting,low-side-effect medications),digital health technologies(e.g.,medication reminder apps and wearable devices),and supportive policies(e.g.,community-based free medication services)as well as patient education to enhance disease awareness.However,the ethical and legal dilemmas(e.g.,balancing patient autonomy with involuntary medication)and privacy concerns in technological applications require further exploration.In conclusion,enhancing medication adherence in patients with schizophrenia requires a personalized,multifaceted approach,and collaborative efforts across various sectors to achieve optimal clinical results and social functioning.展开更多
Treatment adherence among people living with human immunodeficiency virus(PLWH)is a critical determinant of viral suppression and improved quality of life.Medication literacy,as a key factor influencing adherence,is i...Treatment adherence among people living with human immunodeficiency virus(PLWH)is a critical determinant of viral suppression and improved quality of life.Medication literacy,as a key factor influencing adherence,is itself shaped by various psychosocial variables.Existing studies suggest that human immunodeficiency virus(HIV)-related stigma,self-efficacy,and trust in healthcare providers serve as significant mediators in the relationship between health literacy and treatment adherence.This review systematically explores how medication literacy affects treatment adherence in PLWH through intermediary psychosocial mechanisms such as depression,anxiety,and social support.By synthesizing current evidence,we aim to inform the development of targeted psychosocial interventions to enhance treatment outcomes and quality of life for this population.Our findings provide an evidence-based foundation for nursing practice and support innovative strategies in comprehensive HIV care.展开更多
Objective To explore the medication patterns of Professor Zulong Wang in treating sleep-related painful erection(SRPE)through data mining,aiming to discover new therapeutic strategies for traditional Chinese medicine ...Objective To explore the medication patterns of Professor Zulong Wang in treating sleep-related painful erection(SRPE)through data mining,aiming to discover new therapeutic strategies for traditional Chinese medicine in managing this condition.Methods Medical records of SRPE patients treated by Professor Zulong Wang at the First Affiliated Hospital of Henan University of Chinese Medicine from February 2021 to December 2024 were collected to establish a database.Frequency analysis,association rule analysis,and cluster analysis were employed to examine the frequency of herb use,four properties and five flavors,channel tropisms,and herb combinations.Results A total of 59 prescriptions meeting the criteria were included,involving 81 Chinese herbs,among which 27 herbs were used 10 or more times.The primary herb properties were cold,warm,and neutral,with bitter,sweet,and pungent flavors being most common.The herbs predominantly entered the liver,heart,spleen,and kidney channels.Forty-three commonly used herb combinations were identified,and cluster analysis revealed six core herb groups.Conclusion Professor Zulong Wang primarily treats SRPE with modified Huoluo Xiaoling Dan,focusing on unblocking collaterals and relieving pain,supplemented by soothing the liver and regulating qi,resolving stasis and phlegm,nourishing yin and reducing fire,and tonifying the kidney and activating blood circulation.展开更多
Generative Adversarial Networks(GANs)have become valuable tools in medical imaging,enabling realistic image synthesis for enhancement,augmentation,and restoration.However,their integration into clinical workflows rais...Generative Adversarial Networks(GANs)have become valuable tools in medical imaging,enabling realistic image synthesis for enhancement,augmentation,and restoration.However,their integration into clinical workflows raises concerns,particularly the risk of subtle distortions or hallucinations that may undermine diagnostic accuracy and weaken trust in AI-assisted decision-making.To address this challenge,we propose a hybrid deep learning framework designed to detect GAN-induced artifacts in medical images,thereby reinforcing the reliability of AI-driven diagnostics.The framework integrates low-level statistical descriptors,including high-frequency residuals and Gray-Level Co-occurrence Matrix(GLCM)texture features,with high-level semantic representations extracted from a pre-trained ResNet18.This dual-stream approach enables detection of both pixel-level anomalies and structural inconsistencies introduced by GAN-based manipulation.We validated the framework on a curated dataset of 10,000 medical images,evenly split between authentic and GAN-generated samples across four modalities:MRI,CT,X-ray,and fundus photography.To improve generalizability to real-world clinical settings,we incorporated domain adaptation strategies such as adversarial training and style transfer,reducing domain shift by 15%.Experimental results demonstrate robust performance,achieving 92.6%accuracy and an F1-score of 0.91 on synthetic test data,and maintaining strong performance on real-world GAN-modified images with 87.3%accuracy and an F1-score of 0.85.Additionally,the model attained an AUC of 0.96 and an average precision of 0.92,outperforming conventional GAN detection pipelines and baseline Convolutional Neural Network(CNN)architectures.These findings establish the proposed framework as an effective and reliable solution for detecting GAN-induced hallucinations in medical imaging,representing an important step toward building trustworthy and clinically deployable AI systems.展开更多
The emergence of Medical Large Language Models has significantly transformed healthcare.Medical Large Language Models(Med-LLMs)serve as transformative tools that enhance clinical practice through applications in decis...The emergence of Medical Large Language Models has significantly transformed healthcare.Medical Large Language Models(Med-LLMs)serve as transformative tools that enhance clinical practice through applications in decision support,documentation,and diagnostics.This evaluation examines the performance of leading Med-LLMs,including GPT-4Med,Med-PaLM,MEDITRON,PubMedGPT,and MedAlpaca,across diverse medical datasets.It provides graphical comparisons of their effectiveness in distinct healthcare domains.The study introduces a domain-specific categorization system that aligns these models with optimal applications in clinical decision-making,documentation,drug discovery,research,patient interaction,and public health.The paper addresses deployment challenges of Medical-LLMs,emphasizing trustworthiness and explainability as essential requirements for healthcare AI.It presents current evaluation techniques that improve model transparency in high-stakes medical contexts and analyzes regulatory frameworks using benchmarking datasets such asMedQA,MedMCQA,PubMedQA,and MIMIC.By identifying ongoing challenges in biasmitigation,reliability,and ethical compliance,thiswork serves as a resource for selecting appropriate Med-LLMs and outlines future directions in the field.This analysis offers a roadmap for developing Med-LLMs that balance technological innovation with the trust and transparency required for clinical integration,a perspective often overlooked in existing literature.展开更多
Over the years,Generative Adversarial Networks(GANs)have revolutionized the medical imaging industry for applications such as image synthesis,denoising,super resolution,data augmentation,and cross-modality translation...Over the years,Generative Adversarial Networks(GANs)have revolutionized the medical imaging industry for applications such as image synthesis,denoising,super resolution,data augmentation,and cross-modality translation.The objective of this review is to evaluate the advances,relevances,and limitations of GANs in medical imaging.An organised literature review was conducted following the guidelines of PRISMA(Preferred Reporting Items for Systematic Reviews and Meta-Analyses).The literature considered included peer-reviewed papers published between 2020 and 2025 across databases including PubMed,IEEE Xplore,and Scopus.The studies related to applications of GAN architectures in medical imaging with reported experimental outcomes and published in English in reputable journals and conferences were considered for the review.Thesis,white papers,communication letters,and non-English articles were not included for the same.CLAIM based quality assessment criteria were applied to the included studies to assess the quality.The study classifies diverse GAN architectures,summarizing their clinical applications,technical performances,and their implementation hardships.Key findings reveal the increasing applications of GANs for enhancing diagnostic accuracy,reducing data scarcity through synthetic data generation,and supporting modality translation.However,concerns such as limited generalizability,lack of clinical validation,and regulatory constraints persist.This review provides a comprehensive study of the prevailing scenario of GANs in medical imaging and highlights crucial research gaps and future directions.Though GANs hold transformative capability for medical imaging,their integration into clinical use demands further validation,interpretability,and regulatory alignment.展开更多
Large language models(LLMs)show considerable potential to revolutionize healthcare through their performance across diverse clinical applications.Given the inherent constraints of LLMs and the critical nature of medic...Large language models(LLMs)show considerable potential to revolutionize healthcare through their performance across diverse clinical applications.Given the inherent constraints of LLMs and the critical nature of medical practice,a rigorous and systematic evaluation of their medical competence is imperative.This study presents a comprehensive review of the established methodologies and benchmarks for evaluating the medical competence of LLMs,encompassing a thorough analysis of current assessment practices across medical knowledge,clinical practice competence,and ethical-safety considerations.By integrating clinician competency assessment frameworks into LLMs evaluation,we propose a structured tri-dimensional framework that systematically organizes existing evaluation approaches according to medical theoretical knowledge,clinical practice ability,and ethical-safety considerations.Furthermore,this research provides critical insights into future developmental trajectories while establishing foundational frameworks and standardization protocols for the integration of LLMs into medical practice.展开更多
Mongolian medicine posits that disruptions to the natural balance of the three roots and seven elements within the human body may lead to ocular disorders,vision impairment,and ultimately myopia.China’s children and ...Mongolian medicine posits that disruptions to the natural balance of the three roots and seven elements within the human body may lead to ocular disorders,vision impairment,and ultimately myopia.China’s children and adolescents not only exhibit high myopia rates but also face increasingly prominent issues of younger onset and severe progression,which critically impact the nation’s future and require urgent attention.Myopia prevention constitutes a systematic project.Traditional Mongolian moxibustion therapy works by applying heat stimulation to specific acupoints to warm meridians,harmonize Qi-blood circulation,regulate elemental balance,thereby enhancing immunity for disease prevention.This holistic approach features non-invasive application with minimal side effects.However,current interventions in myopia management through this method still face challenges including inconsistent operational protocols and insufficiently systematic collaborative research.This paper reviews recent advancements in early intervention using Mongolian moxibustion therapy for myopia,providing insights to optimize myopia prevention strategies.展开更多
In recent years,the rising incidence of gastrointestinal(GI)cancer has triggered an urgent need for effective early intervention strategies.Traditional endoscopic techniques often cause patient discomfort,and it is di...In recent years,the rising incidence of gastrointestinal(GI)cancer has triggered an urgent need for effective early intervention strategies.Traditional endoscopic techniques often cause patient discomfort,and it is difficult to navigate deep regions of complex organ structures.This work proposes a kind of bio-inspired magnetic soft robot(BMSR)to address these challenges.The design of the BMSRs is inspired by the rolling motion of the golden wheel spider.Two six-degree-of-freedom(6-DOF)robotic arms are used,where one arm is responsible for real-time manipulation of the BMSRs,and the other is dedicated to monitoring their status.Under the actuation of an external rotating magnetic field,the BMSRs can flexibly climb on inclined surfaces at any angle,involving the inverted surface.Through the powerful output force,the BMSRs can overcome the mobility barrier induced by different human organs,including mucus,folds,and height differences of up to 8 cm.Such an exceptional mobility enables the BMSRs to deliver drugs in the targeted complex GI environment.Moreover,in combination with an endoscope,it provides real-time visual feedback for precise navigation.In vitro animal experiments validate the feasibility of BMSRs,paving a way for their usage in minimally invasive GI treatment.This work advances the potential applications of magnetic soft robots in the biomedical field.展开更多
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
文摘Background: Nursing students are at risk for committing medication administration errors (MAEs), which significantly alter the delivery of safe and effective healthcare. Purpose: To identify the medications most frequently involved in medication errors as reported by Jordanian nursing students, as well as to identify the level of nursing students’ adherence to best-practice when administering high-risk medications. Methods: A cross-sectional design was used among a convenience sample of 74 nurses. Results: A total of 74 of 110 (67.3%) questionnaires were returned. The most frequent medications subjected to MAEs were Dopamine, Dobutamine, and Insulin continuous intravenous infusion (17.2%, 16.0% and 13.5% respectively). Regarding the adherence to best-practice, nursing students adhered the most to the following best-practices: checking the patient armband prior to medication administration with a mean of 3.81 (±0.6) and bringing the MAR sheet with them when preparing a medication with a mean of 3.46 (±1.1). Conclusion: Developing an effective medication training programs in all undergraduate nursing programs in Jordanis is vital to ensure patient safety. Nursing educators in clinical and academic settings need to reinforce the importance of adherence to medication management best-practice in all courses. Close and effective supervision of students needs to be maintained throughout nursing students’ clinical training, especially during medication preparation and administration.
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In today’s fast-paced world,many elderly individuals struggle to adhere to their medication schedules,especially those with memory-related conditions like Alzheimer’s disease,leading to serious health risks,hospital-izations,and increased healthcare costs.Traditional reminder systems often fail due to a lack of personalization and real-time intervention.To address this critical challenge,we introduce MediServe,an advanced IoT-enabled medication management system that seamlessly integrates deep learning techniques to provide a personalized,secure,and adaptive solution.MediServe features a smart medication box equipped with biometric authentication,such as fingerprint recognition,ensuring authorized access to prescribed medication while preventing misuse.A user-friendly mobile application complements the system,offering real-time notifications,adherence tracking,and emergency alerts for caregivers and healthcare providers.The system employs predictive deep learning models,achieving an impressive classification accuracy of 98%,to analyze user behavior,detect anomalies in medication adherence,and optimize scheduling based on an individual’s habits and health conditions.Furthermore,MediServe enhances accessibility by employing natural language processing(NLP)models for voice-activated interactions and text-to-speech capabilities,making it especially beneficial for visually impaired users and those with cognitive impairments.Cloud-based data analytics and wireless connectivity facilitate remote monitoring,ensuring that caregivers receive instant alerts in case of missed doses or medication mismanagement.Additionally,machine learning-based clustering and anomaly detection refine medication reminders by adapting to users’changing health patterns.By combining IoT,deep learning,and advanced security protocols,MediServe delivers a comprehensive,intelligent,and inclusive solution for medication adherence.This innovative approach not only improves the quality of life for elderly individuals but also reduces the burden on caregivers and healthcare systems,ultimately fostering independent and efficient health management.
文摘The aim of this study is to explore and summarize the development trajectory,current research landscape,and emerging trends of medication consultation in China,providing a valuable reference for future investigations in this domain.Relevant articles on medication consultation were systematically collected,and bibliometric software such as CiteSpace 6.4R1 was employed to analyze author and institutional collaborations,keyword co-occurrence,clustering,and emerging trends.This approach helped elucidate key themes and hot topics in the field.A total of 1267 articles were included,with the peak number of publications recorded in 2011,followed by a steady decline in subsequent years.The most prolific author was Zhen Jiancun,contributing eight publications,while the First Affiliated Hospital of Sun Yat-sen University emerged as the leading institution with 11 publications.High-frequency identified keywords included medication consultation,rational drug use,pharmaceutical services,clinical pharmacists,and outpatient pharmacies.Cluster analysis revealed 12 significant themes,while emergent analysis highlighted that recent research hotspots centered on the Pareto chart,pregnancy,and traditional Chinese patent medicine.As a critical aspect of pharmaceutical services,the practice of medication consultation in China requires further advancement,with a particular need for enhanced collaboration among researchers and institutions.Moving forward,expanding the scope of medication consultation,improving the quality of related research,and fostering cross-regional collaboration among teams with diverse research focuses will be essential in deepening and broadening this field of study.
基金supported by grant 2011BAI11B01 from the Projects in the Chinese National Science and Technology Pillar Program during the 12th Five-year Plan Periodby grant 2017-I2M-1-004 from the Chinese Academy of Medical Science Innovation Fund for Medical Sciencesby the Major science and technology special plan project of Yunnan Province (202302AA310045)。
文摘Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and healthy lifestyle index (HLI)with BP control among hypertension patients is seldom reported,which needs to provide more evidence by prospective intervention studies.We examined the association of antihypertensive medication use and HLI with BP control among employees with hypertension in China based on a workplace-based multicomponent intervention program.Methods Between January 2013 and December 2014,a cluster randomized clinical trial of a workplace-based multicomponent intervention program was conducted in 60 workplaces across 20 urban areas in China.Workplaces were randomly divided into intervention (n=40) and control (n=20) groups.Basic information on employees at each workplace was collected by trained professionals,including sociodemographic characteristics,medical history,family history,lifestyle behaviors,medication status and physical measurements.After baseline,the intervention group received a 2-year intervention to achieve BP control,which included:(1) a workplace wellness program for all employees;(2) a guidelines-oriented hypertension management protocol.HLI including nonsmoking,nondrinking,adequate physical activity,weight within reference range and balanced diet,were coded on a 5-point scale (range:0-5,with higher score indicating a healthier lifestyle).Antihypertensive medication use was defined as taking drug within the last 2 weeks.Changes in HLI,antihypertensive medication use and BP control from baseline to 24 months were measured after the intervention.Results Overall,4655 employees were included (age:46.3±7.6 years,men:3547 (82.3%)).After 24 months of the intervention,there was a significant improvement in lifestyle[smoking (OR=0.65,95%CI:0.43-0.99;P=0.045),drinking (OR=0.52,95%CI:0.40-0.68;P<0.001),regular exercise (OR=3.10,95%CI:2.53-3.78;P<0.001),excessive intake of fatty food (OR=0.17,95%CI:0.06-0.52;P=0.002),restrictive use of salt (OR=0.26,95%CI:0.12-0.56;P=0.001)].Compare to employees with a deteriorating lifestyle after the intervention,those with an improved lifestyle had a higher BP control.In the intervention group,compared with employees not using antihypertensive medication,those who consistent used (OR=2.34;95%CI:1.16-4.72;P=0.017) or changed from not using to using antihypertensive medication (OR=2.24;95%CI:1.08-4.62;P=0.030) had higher BP control.Compared with those having lower HLI,participants with a same (OR=1.38;95%CI:0.99-1.93;P=0.056) or high (OR=1.79;95%CI:1.27~2.53;P<0.001) HLI had higher BP control.Those who used antihypertensive medication and had a high HLI had the highest BP control (OR=1.88;95%CI:1.32-2.67,P<0.001).Subgroup analysis also showed the consistent effect as the above.Conclusion These findings suggest that adherence to antihypertensive medication treatment and healthy lifestyle were associated with a significant improvement in BP control among employees with hypertension.
基金supported by the Natural Science Foundation of Fujian Province,China(Grant No.2023J01133509)by The Key Projects on Civil Affairs Policy and Theory Research in Fujian Province(Grant No.FMZD202402).
文摘Background:Patient participation is crucial for medication safety among older adults with chronic diseases transitioning from hospital to home,yet evidence on its levels and influencing factors remains limited.This study investigated the current state and predictors of such participation during this critical period.Methods:A cross-sectional study was conducted among older adults discharged from two tertiary hospitals in Fujian,China(October-December 2023).Data were collected using a general information questionnaire,a self-developed behavior scale,the Health Literacy Management Scale,General Self-Efficacy Scale,Facilitation of Patient Involvement Scale,and Family Support Scale.Analyses included ANOVA,Pearson correlation,and multiple stepwise regression.Results:Among 302 valid responses,the mean score for participation in medication safety behaviors was 68.59±11.62,indicating a moderate level.Health literacy,self-efficacy,healthcare worker support,and family support were positively correlated with participation(all P<0.01).Multiple regression identified daily medication frequency,health literacy,self-efficacy,and healthcare worker support as significant predictors,explaining 18.3%of the variance.Conclusion:Participation in medication safety among older chronic disease patients during care transitions requires improvement.Enhancing health literacy,self-efficacy,and healthcare worker support,while considering medication frequency,can promote patient involvement and medication safety.
文摘[Objectives]This study was conducted to analyze the medication laws of traditional Chinese medicine prescriptions for the treatment of spleen-deficiency irritable bowel syndrome in Guanling Autonomous County Hospital of Traditional Chinese Medicine.[Methods]Prescriptions for the treatment of spleen-deficiency irritable bowel syndrome(IBS)were retrieved from the TCM family of the hospital,traditional Chinese medical doctor Wu Zhongli,in the period from November 2023 to April 2024.Microsoft Excel 2007 was employed to set up an information table of TCM prescriptions,and the age,gender,herbal properties,efficacy categories and the frequency of use were analyzed to explore the medication laws of TCM in the hospital for the treatment of spleen-deficiency irritable bowel syndrome.[Results]Among the 259 TCM prescriptions included,152 kinds of TCM decoction pieces were used.The decoction pieces were mainly warm in nature,and decoction pieces cold in nature took the second place.The flavors of the herbs were mostly sweet,bitter and pungent.Most of them were attributive to the spleen,stomach meridian and lung meridians,and the herbs were mainly used for tonifying deficiency and regulating qi.The herbs with higher frequency of use included Radix Glycyrrhiza,Pericarpium Citri Reticulatae,poria,and Angelicae Sinensis Radix,the main effects of which are replenishing qi to invigorate the spleen,activating qi and eliminating phlegm,clearing damp and promoting diuresis,and relaxing bowel.[Conclusions]Chinese medicine treatment of IBS with spleen deficiency in hospitals is mainly based on replenishing qi to invigorate the spleen,activating qi and eliminating phlegm,clearing damp and promoting diuresis,and relaxing bowel,and Xiangsha Liujunzi Decoction is commonly used in clinical treatment based on syndrome differentiation with modifications.
基金supported by the Natural Science Foundation of Fujian Province,China(Grant No.2023J01133509)by The Key Projects on Civil Affairs Policy and Theory Research in Fujian Province(Grant No.FMZD202402).
文摘Background:Patients are particularly vulnerable to adverse drug events during the transition from hospital to home.This risk is significantly amplified for older adults with chronic diseases,who often manage complex medication regimens involving multiple drugs.Although active patient participation is recognized as a crucial component in safeguarding medication safety,there is currently a lack of a standardized,validated tool specifically designed to assess the level of such participation among this vulnerable population during this critical transition.Therefore,this study aimed to develop and validate a questionnaire for assessing the level of participation in medication safety behaviors among older adults with chronic diseases during the transition from hospital to home.Methods:Guided by the Interactive Patient Participation in Patient Safety theory,the initial questionnaire was developed through literature analysis,qualitative interviews,expert consultation,and pre-testing from April to December 2023.A total of 582 older adults with chronic diseases discharged from two tertiary hospitals in Fuzhou,China were recruited using convenience sampling.Construct validity,content validity,internal consistency,and test-retest reliability were assessed.Results:The final questionnaire comprised 20 items across three dimensions:Participation in Decision-Making,Participation in Care,Participation in Appeals.Exploratory factor analysis showed a cumulative variance contribution of 51.478%.The overall Cronbach’s a coefficient was 0.875,the scale-level content validity index was 0.930,and the test-retest reliability was 0.715.Confirmatory factor analysis indicated an acceptable model fit.Conclusion:The developed questionnaire exhibits good reliability and validity,supporting its use to evaluate participation in medication safety behaviors among Chinese older adults with chronic diseases during the hospital-to-home transition period.
文摘Patients with cardiovascular disease rely on medication to achieve favorable longterm clinical results.Poor adherence has been linked to a relative increase in mortality of 50%-80%as well as higher health care costs.This scoping review thus aimed to explore the evidence of the effects of mobile health care apps on medication adherence in patients with cardiovascular diseases.A comprehensive data search and extraction was done in line with the updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist.A total of 10 studies were included for the review.The mean pooled improvement in adherence was found to be 18%and the most effective tool was the digital therapeutics app discussed in Li et al’s study.Smartphones and apps enhance coronary artery disease management by promoting medication compliance.Challenges include data security and smartphone usage among the elderly.Tailored apps or voice assistants offer potential solutions.
文摘BACKGROUND Patients who undergo cardiac surgery often face postoperative pain and potential cognitive issues.Multimodal analgesia may address these problems.We hypothesized that multimodal analgesia can reduce opioid use and improve cognitive recovery.AIM To investigate the effects of multimodal analgesia on postoperative opioid consumption and cognitive recovery in patients who underwent cardiac surgery.METHODS A prospective,randomized controlled trial at General Hospital from January 2020 to April 2023 recruited a total of 150 adult patients who underwent elective cardiac surgery.The patients were randomly divided into two groups.Group A had patient-controlled intravenous analgesia with sufentanil and flurbiprofen axil.Group B had flurbiprofen axil and paravertebral nerve block.Data were analyzed with appropriate statistical methods.RESULTS Group B had lower postoperative patient-controlled intravenous analgesia drug consumption(2.21 mL/hour vs 4.26 mL/hour,P<0.001),shorter extubation time(2.32 hours vs 3.81 hours,P<0.001),and intensive care unit stay(15.32 h vs 28.63 h,P<0.001).Visual Analogue Scale pain scores were lower in group B(P<0.001).Group B had fewer postoperative complications(no respiratory depression vs 37.9%in group A,P<0.05),a lower postoperative cognitive dysfunction incidence(16.0%vs 28.0%,P<0.05),and higher Barthel Index scores(P<0.05).CONCLUSION Multimodal analgesia with paravertebral nerve block and flurbiprofen axil reduces opioid use and improves cognitive outcomes in patients who underwent cardiac surgery.
文摘Medication adherence in patients with schizophrenia is essential for managing symptoms,improving prognosis,and enhancing the quality of life.Despite the importance of adherence,it remains a global challenge.It is influenced by various factors,including symptom severity(e.g.,excitement and impulse control disorders),attitudes towards medication(e.g.,pharmacophobia),lack of social support,and the communication efficacy of healthcare teams.Regarding assessment tools,self-report questionnaires,such as the Morisky Scale,are common but subject to recall bias.Electronic monitoring devices(e.g.,Medication Event Monitoring System)and pharmacy refill data offer more objective measures of adherence,whereas biomarkers,such as blood drug concentration monitoring,show promise under specific conditions but require further validation.Long-acting injectable antipsychotic medications have shown greater adherence benefits than oral medications.Psychological interventions such as motivational interviewing and mindfulness training,along with multidisciplinary team efforts,including psychiatrists,pharmacists,and psychotherapists,can significantly improve patient outcomes.Future research should integrate innovative drug formulations(e.g.,long-acting,low-side-effect medications),digital health technologies(e.g.,medication reminder apps and wearable devices),and supportive policies(e.g.,community-based free medication services)as well as patient education to enhance disease awareness.However,the ethical and legal dilemmas(e.g.,balancing patient autonomy with involuntary medication)and privacy concerns in technological applications require further exploration.In conclusion,enhancing medication adherence in patients with schizophrenia requires a personalized,multifaceted approach,and collaborative efforts across various sectors to achieve optimal clinical results and social functioning.
基金Supported by Taizhou Municipal Hospital,No.2025JK317 and No.2025JK318.
文摘Treatment adherence among people living with human immunodeficiency virus(PLWH)is a critical determinant of viral suppression and improved quality of life.Medication literacy,as a key factor influencing adherence,is itself shaped by various psychosocial variables.Existing studies suggest that human immunodeficiency virus(HIV)-related stigma,self-efficacy,and trust in healthcare providers serve as significant mediators in the relationship between health literacy and treatment adherence.This review systematically explores how medication literacy affects treatment adherence in PLWH through intermediary psychosocial mechanisms such as depression,anxiety,and social support.By synthesizing current evidence,we aim to inform the development of targeted psychosocial interventions to enhance treatment outcomes and quality of life for this population.Our findings provide an evidence-based foundation for nursing practice and support innovative strategies in comprehensive HIV care.
基金supported by the National Natural Science Foundation of China General Program(82174377)National Traditional Chinese Medicine Advantageous Specialty Construction Project(GZY-ZY[2024]90).
文摘Objective To explore the medication patterns of Professor Zulong Wang in treating sleep-related painful erection(SRPE)through data mining,aiming to discover new therapeutic strategies for traditional Chinese medicine in managing this condition.Methods Medical records of SRPE patients treated by Professor Zulong Wang at the First Affiliated Hospital of Henan University of Chinese Medicine from February 2021 to December 2024 were collected to establish a database.Frequency analysis,association rule analysis,and cluster analysis were employed to examine the frequency of herb use,four properties and five flavors,channel tropisms,and herb combinations.Results A total of 59 prescriptions meeting the criteria were included,involving 81 Chinese herbs,among which 27 herbs were used 10 or more times.The primary herb properties were cold,warm,and neutral,with bitter,sweet,and pungent flavors being most common.The herbs predominantly entered the liver,heart,spleen,and kidney channels.Forty-three commonly used herb combinations were identified,and cluster analysis revealed six core herb groups.Conclusion Professor Zulong Wang primarily treats SRPE with modified Huoluo Xiaoling Dan,focusing on unblocking collaterals and relieving pain,supplemented by soothing the liver and regulating qi,resolving stasis and phlegm,nourishing yin and reducing fire,and tonifying the kidney and activating blood circulation.
基金supported and funded by the Deanship of Scientific Research at Imam Mohammad Ibn Saud Islamic University(IMSIU)(grant number IMSIU-DDRSP2601).
文摘Generative Adversarial Networks(GANs)have become valuable tools in medical imaging,enabling realistic image synthesis for enhancement,augmentation,and restoration.However,their integration into clinical workflows raises concerns,particularly the risk of subtle distortions or hallucinations that may undermine diagnostic accuracy and weaken trust in AI-assisted decision-making.To address this challenge,we propose a hybrid deep learning framework designed to detect GAN-induced artifacts in medical images,thereby reinforcing the reliability of AI-driven diagnostics.The framework integrates low-level statistical descriptors,including high-frequency residuals and Gray-Level Co-occurrence Matrix(GLCM)texture features,with high-level semantic representations extracted from a pre-trained ResNet18.This dual-stream approach enables detection of both pixel-level anomalies and structural inconsistencies introduced by GAN-based manipulation.We validated the framework on a curated dataset of 10,000 medical images,evenly split between authentic and GAN-generated samples across four modalities:MRI,CT,X-ray,and fundus photography.To improve generalizability to real-world clinical settings,we incorporated domain adaptation strategies such as adversarial training and style transfer,reducing domain shift by 15%.Experimental results demonstrate robust performance,achieving 92.6%accuracy and an F1-score of 0.91 on synthetic test data,and maintaining strong performance on real-world GAN-modified images with 87.3%accuracy and an F1-score of 0.85.Additionally,the model attained an AUC of 0.96 and an average precision of 0.92,outperforming conventional GAN detection pipelines and baseline Convolutional Neural Network(CNN)architectures.These findings establish the proposed framework as an effective and reliable solution for detecting GAN-induced hallucinations in medical imaging,representing an important step toward building trustworthy and clinically deployable AI systems.
文摘The emergence of Medical Large Language Models has significantly transformed healthcare.Medical Large Language Models(Med-LLMs)serve as transformative tools that enhance clinical practice through applications in decision support,documentation,and diagnostics.This evaluation examines the performance of leading Med-LLMs,including GPT-4Med,Med-PaLM,MEDITRON,PubMedGPT,and MedAlpaca,across diverse medical datasets.It provides graphical comparisons of their effectiveness in distinct healthcare domains.The study introduces a domain-specific categorization system that aligns these models with optimal applications in clinical decision-making,documentation,drug discovery,research,patient interaction,and public health.The paper addresses deployment challenges of Medical-LLMs,emphasizing trustworthiness and explainability as essential requirements for healthcare AI.It presents current evaluation techniques that improve model transparency in high-stakes medical contexts and analyzes regulatory frameworks using benchmarking datasets such asMedQA,MedMCQA,PubMedQA,and MIMIC.By identifying ongoing challenges in biasmitigation,reliability,and ethical compliance,thiswork serves as a resource for selecting appropriate Med-LLMs and outlines future directions in the field.This analysis offers a roadmap for developing Med-LLMs that balance technological innovation with the trust and transparency required for clinical integration,a perspective often overlooked in existing literature.
基金supported by Deanship of Research and Graduate Studies at King Khalid University for funding this work through Large Research Project under grant number RGP2/540/46.
文摘Over the years,Generative Adversarial Networks(GANs)have revolutionized the medical imaging industry for applications such as image synthesis,denoising,super resolution,data augmentation,and cross-modality translation.The objective of this review is to evaluate the advances,relevances,and limitations of GANs in medical imaging.An organised literature review was conducted following the guidelines of PRISMA(Preferred Reporting Items for Systematic Reviews and Meta-Analyses).The literature considered included peer-reviewed papers published between 2020 and 2025 across databases including PubMed,IEEE Xplore,and Scopus.The studies related to applications of GAN architectures in medical imaging with reported experimental outcomes and published in English in reputable journals and conferences were considered for the review.Thesis,white papers,communication letters,and non-English articles were not included for the same.CLAIM based quality assessment criteria were applied to the included studies to assess the quality.The study classifies diverse GAN architectures,summarizing their clinical applications,technical performances,and their implementation hardships.Key findings reveal the increasing applications of GANs for enhancing diagnostic accuracy,reducing data scarcity through synthetic data generation,and supporting modality translation.However,concerns such as limited generalizability,lack of clinical validation,and regulatory constraints persist.This review provides a comprehensive study of the prevailing scenario of GANs in medical imaging and highlights crucial research gaps and future directions.Though GANs hold transformative capability for medical imaging,their integration into clinical use demands further validation,interpretability,and regulatory alignment.
基金Guangzhou Science and Technology Program,Grant/Award Numbers:2025B03J0110,2024A03J1074,2024A03J0927。
文摘Large language models(LLMs)show considerable potential to revolutionize healthcare through their performance across diverse clinical applications.Given the inherent constraints of LLMs and the critical nature of medical practice,a rigorous and systematic evaluation of their medical competence is imperative.This study presents a comprehensive review of the established methodologies and benchmarks for evaluating the medical competence of LLMs,encompassing a thorough analysis of current assessment practices across medical knowledge,clinical practice competence,and ethical-safety considerations.By integrating clinician competency assessment frameworks into LLMs evaluation,we propose a structured tri-dimensional framework that systematically organizes existing evaluation approaches according to medical theoretical knowledge,clinical practice ability,and ethical-safety considerations.Furthermore,this research provides critical insights into future developmental trajectories while establishing foundational frameworks and standardization protocols for the integration of LLMs into medical practice.
文摘Mongolian medicine posits that disruptions to the natural balance of the three roots and seven elements within the human body may lead to ocular disorders,vision impairment,and ultimately myopia.China’s children and adolescents not only exhibit high myopia rates but also face increasingly prominent issues of younger onset and severe progression,which critically impact the nation’s future and require urgent attention.Myopia prevention constitutes a systematic project.Traditional Mongolian moxibustion therapy works by applying heat stimulation to specific acupoints to warm meridians,harmonize Qi-blood circulation,regulate elemental balance,thereby enhancing immunity for disease prevention.This holistic approach features non-invasive application with minimal side effects.However,current interventions in myopia management through this method still face challenges including inconsistent operational protocols and insufficiently systematic collaborative research.This paper reviews recent advancements in early intervention using Mongolian moxibustion therapy for myopia,providing insights to optimize myopia prevention strategies.
基金supported in part by the National Natural Science Foundation of China under grant 52175556the Macao Science and Technology Development Fund under grant 0004/2022/AKP,0102/2022/A2,and 0078/2023/RIB3+1 种基金the Research Committee of the University of Macao under grants MYRG2022-00068-FST and MYRG-CRG202200004-FST-ICIthe Guangdong Basic and Applied Basic Research Foundation under grant 2023A1515011178。
文摘In recent years,the rising incidence of gastrointestinal(GI)cancer has triggered an urgent need for effective early intervention strategies.Traditional endoscopic techniques often cause patient discomfort,and it is difficult to navigate deep regions of complex organ structures.This work proposes a kind of bio-inspired magnetic soft robot(BMSR)to address these challenges.The design of the BMSRs is inspired by the rolling motion of the golden wheel spider.Two six-degree-of-freedom(6-DOF)robotic arms are used,where one arm is responsible for real-time manipulation of the BMSRs,and the other is dedicated to monitoring their status.Under the actuation of an external rotating magnetic field,the BMSRs can flexibly climb on inclined surfaces at any angle,involving the inverted surface.Through the powerful output force,the BMSRs can overcome the mobility barrier induced by different human organs,including mucus,folds,and height differences of up to 8 cm.Such an exceptional mobility enables the BMSRs to deliver drugs in the targeted complex GI environment.Moreover,in combination with an endoscope,it provides real-time visual feedback for precise navigation.In vitro animal experiments validate the feasibility of BMSRs,paving a way for their usage in minimally invasive GI treatment.This work advances the potential applications of magnetic soft robots in the biomedical field.
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.
