BACKGROUND: The inability of paramedics to perform accurate calculations may result in a compromise of patient safety which may result from under or over dosing of drugs, incorrect joules for defibrillation, or a majo...BACKGROUND: The inability of paramedics to perform accurate calculations may result in a compromise of patient safety which may result from under or over dosing of drugs, incorrect joules for defibrillation, or a major adverse event such as death. The objective of this study was to identify the drug calculation and mathematical ability of qualified operational paramedics.METHODS: The study used a cross-sectional design with a paper-based calculation questionnaire. Twenty paramedics enrolled in an intensive care paramedic course were eligible to participate in the study. The questionnaire consisted of demographic, drug calculation(seven questions), and mathematical(five) questions. Students were given no notice of the impending study and use of a calculator was not permitted.RESULTS: All eligible students participated in the study. The average time employed as a paramedic was 7.25 years, SD 2.5 years, range four years to twelve years. Four(20%) students got all 12 questions correct, and five(41.6%) got 50% or less. The average score was 8.6(71.7%) correct, SD 2.8 correct, range 3 to 12 correct questions. There were eight(40%) conceptual errors, 12(60%) arithmetical errors, and five(25%) computational errors.CONCLUSION: The results from this study supports similar international studies where paramedic's ability to undertake mathematical and drug calculations without a calculator varies, with some results highlighting the paramedics mathematical skills as a potential risk to patient safety. These results highlight the need for regular continuing mathematical and drug calculation practice and education to ensure a lower error rate.展开更多
Background:Snakebites can lead to lifelong consequences and is one of the main causes of death among military troops worldwide.However,few Chinese military medics know the proper first aid procedures for snakebites.Th...Background:Snakebites can lead to lifelong consequences and is one of the main causes of death among military troops worldwide.However,few Chinese military medics know the proper first aid procedures for snakebites.Therefore,this study aimed to explore the impact of the Standard Operation Procedure(SOP)and checklist on Chinese military medics’ability to manage snakebite first aid.Methods:This study was a prospective single-blind randomized controlled trial conducted in a military medical university of China from May to June 2017.A questionnaire-based survey was performed to collect the participants’socio-demographic profiles before the baseline measurement.During the baseline measurement,participants were requested to provide corresponding first aid that was responsive to the simulative situation portrayed by the standardized patients(SPs)and the evaluators then scored their performances according to a checklist for snakebite first aid scoring table.After the baseline measurement,they were randomly assigned to one of three intervention groups after stratification according to their baseline performance scores:group A received a self-learning course with textbooks(n=27),group B received a self-learning training on the SOP and checklist(n=27)and group C was engaged in an interactive discussion panel regarding the SOP and checklist(n=26).After the interventions,participants received outcome measurements about snakebite first aid key points capability from the same evaluator and SP for each group to avoid observational error.The reviewers were blinded about the grouping in the trial.Results:The baseline measurement yielded no significant difference(H=1.647,P=0.439)among the three groups.The post-intervention scores were higher than the pre-intervention scores for all three(A,B and C)groups(P=0.008,P<0.001 and P<0.001,respectively).There was significant difference of the post-intervention scores among the three groups(F=8.841,P<0.001).Both post-intervention scores of group B and group C were higher than that of group A(P<0.001 and P=0.001,respectively),but no difference was found between group B and C(P=0.695).The acceptance questionnaire score of SOP and checklist was mostly very satisfied,as the final scores of group B and group C were 4.62±0.61 and 4.82±0.45,respectively.Conclusions:In this study,the implementation of an SOP and checklist for snakebite first aid was shown to update and improve first aid treatment concepts in military medics.These intervention methods played an important role in improving the medics’cognition and understanding of snakebite first aid.Therefore,this finding suggests that SOP and checklist training should be further implemented in Chinese troops for snakebite care.展开更多
Background:Drama therapy as a discipline in clinical and public health areas dates back to movements in the Netherlands,Great Britain and the United States of America in the 1960s.Today,drama therapy comprises a huge ...Background:Drama therapy as a discipline in clinical and public health areas dates back to movements in the Netherlands,Great Britain and the United States of America in the 1960s.Today,drama therapy comprises a huge variety of methods and is applied in numerous medical domains such as psychiatry,pediatrics and neurogeriatrics.Nonetheless,historical and philosophical considerations suggest that at all times dramatic arts have encompassed curative potential and helped to promote mental health.Regarding this perspective,the present article aims to explore the spirit of drama therapy in ancient Chinese and Greek cultures.Methods:Involving cross-cultural psychiatry and medical anthropology,comparative research centred around salutary momentums inhering in drama and dramatic practices in Ancient China and Greece.The entire research process consisted of three phases:(i)screening of ancient Chinese and Greek dramatic rituals and arts to select phenomena and genres with pathological,therapeutic and mental health relevance;(ii)medical ontological processing,in particular from a psychopathological,psychiatric,psychotherapeutic and mental health scientific point of view,to explore and elucidate their curative and preventative features;(iii)transdisciplinary considerations about the evolution of drama therapy,as well as their diverse modes of artistic and medical reasoning.Results:The research process resulted in the identification of five(functional)roots of drama therapy,as well as public health benefits of dramatic arts:(i)dramatic rituals,stage-trance settings and spiritual immersion,(ii)mise-en-scène of divine spheres and alternative worlds,as well as scenic imagination and creative fusion of reality and fantasy,desire and satisfaction,(iii)anthropologic ontology,search of meaning and self-actualisation‘beyond codes and conventions’,(iv)personality traits and differential psychological symbolism,aesthetic self-exploration and auxiliary egos,(v)introjection and role-identity,inventive ways to tackle life problems,‘working through’and catharsis.Conclusion:Interdisciplinary constructivist reasoning suggests that dramatic arts and drama therapy share similar health promoting potential and innate therapeutic power.This calls for further research(i)to explore the entire spectrum of curative factors inhering in dramatic entities,(ii)to explain how drama-based interventions may alleviate mental-health issues alongside culturally sensitive differential diagnostic guidelines,and(iii)to optimise beneficial effects through advanced drama therapeutic settings.The present study suggests that dramatic arts shall also be studied with regard to public health challenges,self-regulation and self-care,mental resilience,well-being and quality of life,and emphatically advocates intensified collaboration between drama theory and drama therapy.展开更多
BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as exp...BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as expanding treatment indications,which affect the fair distribution of medical resources.There is limited research on ethical issues in the field of digestive endoscopy.AIM To investigate the level of ethical awareness among gastrointestinal endoscopy practitioners and analyze the ethical issues involved in gastrointestinal endoscopy technology.METHODS A questionnaire survey was performed to collect relevant data(gender,age,degree of education,professional title,personnel category,the level of understanding medical ethical principles,ethics training and its learning pathways)from gastrointestinal endoscopy practitioners at the Second Hospital of Dalian Medical University and Dalian Friendship Hospital,including licensed physicians and nurses(including trainees and graduate students).RESULTS The majority of gastrointestinal endoscopy practitioners have received training on ethics,but there is still considerable room for improvement in their ethical awareness.Different learning pathways may affect the mastery of ethical principles, and understanding of ethical principles is more easily achieved through hospital ethics institutions.CONCLUSIONTo address the ethical issues in gastrointestinal endoscopy technology, it is necessary to enhance the humanisticeducation of gastrointestinal endoscopy practitioners, incorporate ethical standards into the technology assessmentprocess, and establish a patient-centered diagnostic and treatment model to improve the ethical awareness of practitionersand achieve a balance between technology and ethics.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
The integration of machine learning(ML)technology with Internet of Things(IoT)systems produces essential changes in healthcare operations.Healthcare personnel can track patients around the clock thanks to healthcare I...The integration of machine learning(ML)technology with Internet of Things(IoT)systems produces essential changes in healthcare operations.Healthcare personnel can track patients around the clock thanks to healthcare IoT(H-IoT)technology,which also provides proactive statistical findings and precise medical diagnoses that enhance healthcare performance.This study examines how ML might support IoT-based health care systems,namely in the areas of prognostic systems,disease detection,patient tracking,and healthcare operations control.The study looks at the benefits and drawbacks of several machine learning techniques for H-IoT applications.It also examines the fundamental problems,such as data security and cyberthreats,as well as the high processing demands that these systems face.Alongside this,the essay discusses the advantages of all the technologies,including machine learning,deep learning,and the Internet of Things,as well as the significant difficulties and problems that arise when integrating the technology into healthcare forecasts.展开更多
Brain tumors require precise segmentation for diagnosis and treatment plans due to their complex morphology and heterogeneous characteristics.While MRI-based automatic brain tumor segmentation technology reduces the b...Brain tumors require precise segmentation for diagnosis and treatment plans due to their complex morphology and heterogeneous characteristics.While MRI-based automatic brain tumor segmentation technology reduces the burden on medical staff and provides quantitative information,existing methodologies and recent models still struggle to accurately capture and classify the fine boundaries and diverse morphologies of tumors.In order to address these challenges and maximize the performance of brain tumor segmentation,this research introduces a novel SwinUNETR-based model by integrating a new decoder block,the Hierarchical Channel-wise Attention Decoder(HCAD),into a powerful SwinUNETR encoder.The HCAD decoder block utilizes hierarchical features and channelspecific attention mechanisms to further fuse information at different scales transmitted from the encoder and preserve spatial details throughout the reconstruction phase.Rigorous evaluations on the recent BraTS GLI datasets demonstrate that the proposed SwinHCAD model achieved superior and improved segmentation accuracy on both the Dice score and HD95 metrics across all tumor subregions(WT,TC,and ET)compared to baseline models.In particular,the rationale and contribution of the model design were clarified through ablation studies to verify the effectiveness of the proposed HCAD decoder block.The results of this study are expected to greatly contribute to enhancing the efficiency of clinical diagnosis and treatment planning by increasing the precision of automated brain tumor segmentation.展开更多
With the industrialization of agriculture and the advancement of medical care,human life expectancy has increased considerably and continues to rise steadily.This results in novel and unprecedented challenges,namely o...With the industrialization of agriculture and the advancement of medical care,human life expectancy has increased considerably and continues to rise steadily.This results in novel and unprecedented challenges,namely obesity and neurodegeneration.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
Medical Data Mining published an article entitled Mapping the global research trends and hotspots on hypertensive nephropathy:A novel bibliometrics overview on 10 October 2025.The author confirmed this article’s proo...Medical Data Mining published an article entitled Mapping the global research trends and hotspots on hypertensive nephropathy:A novel bibliometrics overview on 10 October 2025.The author confirmed this article’s proof on 28 September 2025 without any questions.However,on 13 November 2025,the Editorial Office of Medical Data Mining noticed an inconsistency between the data presented in the main text and Figure 1.Specifically,erroneous Figure 1 states“a total of 56,691 literatures were obtained through database search”,while the main text in the Search results section states“According to the search term,a total of 59,220 publications were retrieved from the database.”The authors acknowledge that the original version of Figure 1 was incorrect and have provided the revised,correct version in this corrigendum.The authors would like to assert that there is no change in the body text of the article.展开更多
Background:With the rapid development of modern emerging technologies,the ethical dilemmas and social controversies triggered by scientific and technological activities have become increasingly prominent.How to guide ...Background:With the rapid development of modern emerging technologies,the ethical dilemmas and social controversies triggered by scientific and technological activities have become increasingly prominent.How to guide technology for good and prevent and control technological risks has become an important issue of global concern.Research on science and technology ethics is dedicated to integrating ethical theories into governance practices and constructing ethical models that adapt to the development of the times.Methods:This article systematically reviews the six core approaches of scientific and technological ethics thought,including technological autonomy and political philosophy criticism,responsibility ethics and intergenerational obligations,technological intermediation and the integration of life and the world,ethical principles and normative frameworks,participatory governance and ethical practice innovation,as well as domain-specific ethical norms,thereby constructing an ethical analysis framework applicable to medical technology risks.And cross-analysis was conducted by taking medical events such as gene editing and xenotransplantation as examples.Results:Research shows that a single ethical approach has limitations in addressing complex medical ethical challenges,while the six approaches are complementary and synergistic.By criticizing technological autonomy,establishing a responsibility ethics orientation,setting the bottom line of ethical principles,promoting participatory governance,formulating domain norms,and continuously reflecting on the intermediary nature of technology,a multi-level and dynamically adaptive governance system for scientific and technological ethics can be constructed.Conclusion:The key to addressing contemporary medical ethics challenges lies in the comprehensive application of science and technology ethics theories and the integration of ethical considerations throughout the entire process of scientific and technological research and development.In the future,a governance framework that adapts to the development of new technologies should be established to promote cross-cultural and cross-disciplinary ethical dialogue and public participation,ensuring that scientific and technological innovation always serves the dignity of human life and overall well-being.展开更多
Parkinson’s disease(PD)is a debilitating neurological disorder affecting over 10 million people worldwide.PD classification models using voice signals as input are common in the literature.It is believed that using d...Parkinson’s disease(PD)is a debilitating neurological disorder affecting over 10 million people worldwide.PD classification models using voice signals as input are common in the literature.It is believed that using deep learning algorithms further enhances performance;nevertheless,it is challenging due to the nature of small-scale and imbalanced PD datasets.This paper proposed a convolutional neural network-based deep support vector machine(CNN-DSVM)to automate the feature extraction process using CNN and extend the conventional SVM to a DSVM for better classification performance in small-scale PD datasets.A customized kernel function reduces the impact of biased classification towards the majority class(healthy candidates in our consideration).An improved generative adversarial network(IGAN)was designed to generate additional training data to enhance the model’s performance.For performance evaluation,the proposed algorithm achieves a sensitivity of 97.6%and a specificity of 97.3%.The performance comparison is evaluated from five perspectives,including comparisons with different data generation algorithms,feature extraction techniques,kernel functions,and existing works.Results reveal the effectiveness of the IGAN algorithm,which improves the sensitivity and specificity by 4.05%–4.72%and 4.96%–5.86%,respectively;and the effectiveness of the CNN-DSVM algorithm,which improves the sensitivity by 1.24%–57.4%and specificity by 1.04%–163%and reduces biased detection towards the majority class.The ablation experiments confirm the effectiveness of individual components.Two future research directions have also been suggested.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
Objectives Diabetes remains a major global health challenge in China.Artificial intelligence(AI)has demonstrated considerable potential in improving diabetes management.This study aimed to assess healthcare providers...Objectives Diabetes remains a major global health challenge in China.Artificial intelligence(AI)has demonstrated considerable potential in improving diabetes management.This study aimed to assess healthcare providers’perceptions regarding AI in diabetes care across China.Methods A cross-sectional survey was conducted using snowball sampling from November 12 to November 24,2024.We selected 514 physicians and nurses by a snowball sampling method from healthcare providers across 30 cities or provinces in China.The self-developed questionnaire comprised five sections with 19 questions assessing medical workers’demographic characteristics,AI-related experience and interest,awareness,attitudes,and concerns regarding AI in diabetes care.Statistical analysis was performed using t-test,analysis of variance(ANOVA),and linear regression.Results Among them,20.0%and 48.1%of respondents had participated in AI-related research and training,while 85.4%expressed moderate to high interest in AI training for diabetes care.Most respondents reported partial awareness of AI in diabetes care,and only 12.6%exhibited a comprehensive or substantial understanding.Attitudes toward AI in diabetes care were generally positive,with a mean score of 24.50±3.38.Nurses demonstrated significantly higher scores than physicians(P<0.05).Greater awareness,prior AI training experience,and higher interest in AI training in diabetes care were strongly associated with more positive attitudes(P<0.05).Key concerns regarding AI included trust issues from AI-clinician inconsistencies(77.2%),increased workload and clinical workflow disruptions(63.4%),and incomplete legal and regulatory frameworks(60.3%).Only 34.2%of respondents expressed concerns about job displacement,indicating general confidence in their professional roles.Conclusions While Chinese healthcare providers show moderate awareness of AI in diabetes care,their attitudes are generally positive,and they are considerably interested in future training.Tailored,role-specific AI training is essential for equitable and effective integration into clinical practice.Additionally,transparent,reliable,ethical AI models must be prioritized to alleviate practitioners’concerns.展开更多
Objective:To compare the clinical efficacy of mifepristone-misoprostol medical management versus surgical curettage for first-trimester missed miscarriage,and to establish evidence-based sonographic cutoff values pred...Objective:To compare the clinical efficacy of mifepristone-misoprostol medical management versus surgical curettage for first-trimester missed miscarriage,and to establish evidence-based sonographic cutoff values predictive of incomplete abortion requiring surgical intervention.Methods:We retrospectively analyzed a cohort of 702 women diagnosed with first-trimester missed miscarriage between January 2020 and May 2023.Demographic characteristics and ultrasound parameters were systematically recorded.Receiver operating characteristic(ROC)curve analysis was performed to establish optimal sonographic cutoff values for predicting incomplete abortion requiring surgical intervention.Results:146 patients received medical treatment(mifepristone and misoprostol)and 556 underwent surgical curettage.At the 1-month follow-up,the medical group showed significantly greater endometrial thickness and longer postoperative bleeding duration than the surgical group(P<0.05).The menstrual volume reduction rate(23.56%)was significantly lower in the medical group than in the surgical group.The incomplete abortion rate was higher in the medical group(17.12%,25/146)than in the surgical group(2.88%,16/556).Among the medical group,14 patients(9.59%)required curettage due to incomplete abortion,while 11 cases resolved spontaneously after prolonged medication.ROC curve analysis identified two cut-off values indicating the need for surgical intervention:endometrial thickness>1.21 cm at 24 h post-medical abortion,and residual mass diameter>0.95 cm at 7 days post-medical abortion.Conclusions:Medical management of first-trimester missed miscarriage using mifepristone-misoprostol demonstrates comparable efficacy to surgical curettage.An endometrial thickness>1.21 cm at 24 h or residual tissue diameter>0.95 cm at 7 days post-medical abortion should prompt consideration of incomplete abortion.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
The trajectory of human history is characterized by a persistent battle against disease.Over time,the field of medicine has transitioned from enigmatic witch doctors and herbal remedies to a sophisticated realm of con...The trajectory of human history is characterized by a persistent battle against disease.Over time,the field of medicine has transitioned from enigmatic witch doctors and herbal remedies to a sophisticated realm of contemporary medicine that includes fundamental medical and health sciences,clinical medicine,and public health.Nevertheless,the present phase of medical advancement encounters significant challenges,particularly in effectively translating basic research findings into practical applications in clinical and public health settings.Scientists increasingly collaborate with clinical experts to overcome these obstacles and address specific clinical issues by delving deeper into fundamental mechanisms.This collaborative effort has created a new interdisciplinary field:engineering medicine(EngMed),which focuses on addressing clinical and public health needs by integrating various scientific disciplines.This article discusses the definition,key tasks,significance,educational implications,and future trends in EngMed.展开更多
Traditional medicine in Myanmar has a long history,combining the local natural environment,culture,and religious beliefs to form a unique medical system.This article adopts the method of literature research,focusing o...Traditional medicine in Myanmar has a long history,combining the local natural environment,culture,and religious beliefs to form a unique medical system.This article adopts the method of literature research,focusing on the existing book“Milestones of Traditional Medicine in Myanmar”,and reviewing existing literature to analyze historical and contemporary sources.Elaborate on the question of how the history of traditional medicine in Myanmar originated and has continued to develop until now.These histories have proven that traditional medicine in Myanmar,despite facing numerous obstacles,has always been used by the people of Myanmar and has unique value,which deserves our continued attention and inheritance.展开更多
文摘BACKGROUND: The inability of paramedics to perform accurate calculations may result in a compromise of patient safety which may result from under or over dosing of drugs, incorrect joules for defibrillation, or a major adverse event such as death. The objective of this study was to identify the drug calculation and mathematical ability of qualified operational paramedics.METHODS: The study used a cross-sectional design with a paper-based calculation questionnaire. Twenty paramedics enrolled in an intensive care paramedic course were eligible to participate in the study. The questionnaire consisted of demographic, drug calculation(seven questions), and mathematical(five) questions. Students were given no notice of the impending study and use of a calculator was not permitted.RESULTS: All eligible students participated in the study. The average time employed as a paramedic was 7.25 years, SD 2.5 years, range four years to twelve years. Four(20%) students got all 12 questions correct, and five(41.6%) got 50% or less. The average score was 8.6(71.7%) correct, SD 2.8 correct, range 3 to 12 correct questions. There were eight(40%) conceptual errors, 12(60%) arithmetical errors, and five(25%) computational errors.CONCLUSION: The results from this study supports similar international studies where paramedic's ability to undertake mathematical and drug calculations without a calculator varies, with some results highlighting the paramedics mathematical skills as a potential risk to patient safety. These results highlight the need for regular continuing mathematical and drug calculation practice and education to ensure a lower error rate.
基金supported by the Clinical Support program of General Hospital of PLA(No.2018FC-WJFWZX-2-19)Military Medical Innovation Program(18CXZ009)。
文摘Background:Snakebites can lead to lifelong consequences and is one of the main causes of death among military troops worldwide.However,few Chinese military medics know the proper first aid procedures for snakebites.Therefore,this study aimed to explore the impact of the Standard Operation Procedure(SOP)and checklist on Chinese military medics’ability to manage snakebite first aid.Methods:This study was a prospective single-blind randomized controlled trial conducted in a military medical university of China from May to June 2017.A questionnaire-based survey was performed to collect the participants’socio-demographic profiles before the baseline measurement.During the baseline measurement,participants were requested to provide corresponding first aid that was responsive to the simulative situation portrayed by the standardized patients(SPs)and the evaluators then scored their performances according to a checklist for snakebite first aid scoring table.After the baseline measurement,they were randomly assigned to one of three intervention groups after stratification according to their baseline performance scores:group A received a self-learning course with textbooks(n=27),group B received a self-learning training on the SOP and checklist(n=27)and group C was engaged in an interactive discussion panel regarding the SOP and checklist(n=26).After the interventions,participants received outcome measurements about snakebite first aid key points capability from the same evaluator and SP for each group to avoid observational error.The reviewers were blinded about the grouping in the trial.Results:The baseline measurement yielded no significant difference(H=1.647,P=0.439)among the three groups.The post-intervention scores were higher than the pre-intervention scores for all three(A,B and C)groups(P=0.008,P<0.001 and P<0.001,respectively).There was significant difference of the post-intervention scores among the three groups(F=8.841,P<0.001).Both post-intervention scores of group B and group C were higher than that of group A(P<0.001 and P=0.001,respectively),but no difference was found between group B and C(P=0.695).The acceptance questionnaire score of SOP and checklist was mostly very satisfied,as the final scores of group B and group C were 4.62±0.61 and 4.82±0.45,respectively.Conclusions:In this study,the implementation of an SOP and checklist for snakebite first aid was shown to update and improve first aid treatment concepts in military medics.These intervention methods played an important role in improving the medics’cognition and understanding of snakebite first aid.Therefore,this finding suggests that SOP and checklist training should be further implemented in Chinese troops for snakebite care.
文摘Background:Drama therapy as a discipline in clinical and public health areas dates back to movements in the Netherlands,Great Britain and the United States of America in the 1960s.Today,drama therapy comprises a huge variety of methods and is applied in numerous medical domains such as psychiatry,pediatrics and neurogeriatrics.Nonetheless,historical and philosophical considerations suggest that at all times dramatic arts have encompassed curative potential and helped to promote mental health.Regarding this perspective,the present article aims to explore the spirit of drama therapy in ancient Chinese and Greek cultures.Methods:Involving cross-cultural psychiatry and medical anthropology,comparative research centred around salutary momentums inhering in drama and dramatic practices in Ancient China and Greece.The entire research process consisted of three phases:(i)screening of ancient Chinese and Greek dramatic rituals and arts to select phenomena and genres with pathological,therapeutic and mental health relevance;(ii)medical ontological processing,in particular from a psychopathological,psychiatric,psychotherapeutic and mental health scientific point of view,to explore and elucidate their curative and preventative features;(iii)transdisciplinary considerations about the evolution of drama therapy,as well as their diverse modes of artistic and medical reasoning.Results:The research process resulted in the identification of five(functional)roots of drama therapy,as well as public health benefits of dramatic arts:(i)dramatic rituals,stage-trance settings and spiritual immersion,(ii)mise-en-scène of divine spheres and alternative worlds,as well as scenic imagination and creative fusion of reality and fantasy,desire and satisfaction,(iii)anthropologic ontology,search of meaning and self-actualisation‘beyond codes and conventions’,(iv)personality traits and differential psychological symbolism,aesthetic self-exploration and auxiliary egos,(v)introjection and role-identity,inventive ways to tackle life problems,‘working through’and catharsis.Conclusion:Interdisciplinary constructivist reasoning suggests that dramatic arts and drama therapy share similar health promoting potential and innate therapeutic power.This calls for further research(i)to explore the entire spectrum of curative factors inhering in dramatic entities,(ii)to explain how drama-based interventions may alleviate mental-health issues alongside culturally sensitive differential diagnostic guidelines,and(iii)to optimise beneficial effects through advanced drama therapeutic settings.The present study suggests that dramatic arts shall also be studied with regard to public health challenges,self-regulation and self-care,mental resilience,well-being and quality of life,and emphatically advocates intensified collaboration between drama theory and drama therapy.
文摘BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as expanding treatment indications,which affect the fair distribution of medical resources.There is limited research on ethical issues in the field of digestive endoscopy.AIM To investigate the level of ethical awareness among gastrointestinal endoscopy practitioners and analyze the ethical issues involved in gastrointestinal endoscopy technology.METHODS A questionnaire survey was performed to collect relevant data(gender,age,degree of education,professional title,personnel category,the level of understanding medical ethical principles,ethics training and its learning pathways)from gastrointestinal endoscopy practitioners at the Second Hospital of Dalian Medical University and Dalian Friendship Hospital,including licensed physicians and nurses(including trainees and graduate students).RESULTS The majority of gastrointestinal endoscopy practitioners have received training on ethics,but there is still considerable room for improvement in their ethical awareness.Different learning pathways may affect the mastery of ethical principles, and understanding of ethical principles is more easily achieved through hospital ethics institutions.CONCLUSIONTo address the ethical issues in gastrointestinal endoscopy technology, it is necessary to enhance the humanisticeducation of gastrointestinal endoscopy practitioners, incorporate ethical standards into the technology assessmentprocess, and establish a patient-centered diagnostic and treatment model to improve the ethical awareness of practitionersand achieve a balance between technology and ethics.
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.
文摘The integration of machine learning(ML)technology with Internet of Things(IoT)systems produces essential changes in healthcare operations.Healthcare personnel can track patients around the clock thanks to healthcare IoT(H-IoT)technology,which also provides proactive statistical findings and precise medical diagnoses that enhance healthcare performance.This study examines how ML might support IoT-based health care systems,namely in the areas of prognostic systems,disease detection,patient tracking,and healthcare operations control.The study looks at the benefits and drawbacks of several machine learning techniques for H-IoT applications.It also examines the fundamental problems,such as data security and cyberthreats,as well as the high processing demands that these systems face.Alongside this,the essay discusses the advantages of all the technologies,including machine learning,deep learning,and the Internet of Things,as well as the significant difficulties and problems that arise when integrating the technology into healthcare forecasts.
基金supported by Institute of Information&Communications Technology Planning&Evaluation(IITP)under the Metaverse Support Program to Nurture the Best Talents(IITP-2024-RS-2023-00254529)grant funded by the Korea government(MSIT).
文摘Brain tumors require precise segmentation for diagnosis and treatment plans due to their complex morphology and heterogeneous characteristics.While MRI-based automatic brain tumor segmentation technology reduces the burden on medical staff and provides quantitative information,existing methodologies and recent models still struggle to accurately capture and classify the fine boundaries and diverse morphologies of tumors.In order to address these challenges and maximize the performance of brain tumor segmentation,this research introduces a novel SwinUNETR-based model by integrating a new decoder block,the Hierarchical Channel-wise Attention Decoder(HCAD),into a powerful SwinUNETR encoder.The HCAD decoder block utilizes hierarchical features and channelspecific attention mechanisms to further fuse information at different scales transmitted from the encoder and preserve spatial details throughout the reconstruction phase.Rigorous evaluations on the recent BraTS GLI datasets demonstrate that the proposed SwinHCAD model achieved superior and improved segmentation accuracy on both the Dice score and HD95 metrics across all tumor subregions(WT,TC,and ET)compared to baseline models.In particular,the rationale and contribution of the model design were clarified through ablation studies to verify the effectiveness of the proposed HCAD decoder block.The results of this study are expected to greatly contribute to enhancing the efficiency of clinical diagnosis and treatment planning by increasing the precision of automated brain tumor segmentation.
文摘With the industrialization of agriculture and the advancement of medical care,human life expectancy has increased considerably and continues to rise steadily.This results in novel and unprecedented challenges,namely obesity and neurodegeneration.
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.
文摘Medical Data Mining published an article entitled Mapping the global research trends and hotspots on hypertensive nephropathy:A novel bibliometrics overview on 10 October 2025.The author confirmed this article’s proof on 28 September 2025 without any questions.However,on 13 November 2025,the Editorial Office of Medical Data Mining noticed an inconsistency between the data presented in the main text and Figure 1.Specifically,erroneous Figure 1 states“a total of 56,691 literatures were obtained through database search”,while the main text in the Search results section states“According to the search term,a total of 59,220 publications were retrieved from the database.”The authors acknowledge that the original version of Figure 1 was incorrect and have provided the revised,correct version in this corrigendum.The authors would like to assert that there is no change in the body text of the article.
基金supported by the National Key Research and Development Program(Grant No.2024YFA0917200)the Projects of the Chinese Center for Disease Control and Prevention(Grant No.BB2110240093)World Medical History under the Education Innovation Plan of the University of Science and Technology of China(Grant No.2024YCHX07).
文摘Background:With the rapid development of modern emerging technologies,the ethical dilemmas and social controversies triggered by scientific and technological activities have become increasingly prominent.How to guide technology for good and prevent and control technological risks has become an important issue of global concern.Research on science and technology ethics is dedicated to integrating ethical theories into governance practices and constructing ethical models that adapt to the development of the times.Methods:This article systematically reviews the six core approaches of scientific and technological ethics thought,including technological autonomy and political philosophy criticism,responsibility ethics and intergenerational obligations,technological intermediation and the integration of life and the world,ethical principles and normative frameworks,participatory governance and ethical practice innovation,as well as domain-specific ethical norms,thereby constructing an ethical analysis framework applicable to medical technology risks.And cross-analysis was conducted by taking medical events such as gene editing and xenotransplantation as examples.Results:Research shows that a single ethical approach has limitations in addressing complex medical ethical challenges,while the six approaches are complementary and synergistic.By criticizing technological autonomy,establishing a responsibility ethics orientation,setting the bottom line of ethical principles,promoting participatory governance,formulating domain norms,and continuously reflecting on the intermediary nature of technology,a multi-level and dynamically adaptive governance system for scientific and technological ethics can be constructed.Conclusion:The key to addressing contemporary medical ethics challenges lies in the comprehensive application of science and technology ethics theories and the integration of ethical considerations throughout the entire process of scientific and technological research and development.In the future,a governance framework that adapts to the development of new technologies should be established to promote cross-cultural and cross-disciplinary ethical dialogue and public participation,ensuring that scientific and technological innovation always serves the dignity of human life and overall well-being.
基金The work described in this paper was fully supported by a grant from Hong Kong Metropolitan University(RIF/2021/05).
文摘Parkinson’s disease(PD)is a debilitating neurological disorder affecting over 10 million people worldwide.PD classification models using voice signals as input are common in the literature.It is believed that using deep learning algorithms further enhances performance;nevertheless,it is challenging due to the nature of small-scale and imbalanced PD datasets.This paper proposed a convolutional neural network-based deep support vector machine(CNN-DSVM)to automate the feature extraction process using CNN and extend the conventional SVM to a DSVM for better classification performance in small-scale PD datasets.A customized kernel function reduces the impact of biased classification towards the majority class(healthy candidates in our consideration).An improved generative adversarial network(IGAN)was designed to generate additional training data to enhance the model’s performance.For performance evaluation,the proposed algorithm achieves a sensitivity of 97.6%and a specificity of 97.3%.The performance comparison is evaluated from five perspectives,including comparisons with different data generation algorithms,feature extraction techniques,kernel functions,and existing works.Results reveal the effectiveness of the IGAN algorithm,which improves the sensitivity and specificity by 4.05%–4.72%and 4.96%–5.86%,respectively;and the effectiveness of the CNN-DSVM algorithm,which improves the sensitivity by 1.24%–57.4%and specificity by 1.04%–163%and reduces biased detection towards the majority class.The ablation experiments confirm the effectiveness of individual components.Two future research directions have also been suggested.
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supported by the Jiangsu Provincial Department of Science and Technology Social Development Project(No.BE2020787)。
文摘Objectives Diabetes remains a major global health challenge in China.Artificial intelligence(AI)has demonstrated considerable potential in improving diabetes management.This study aimed to assess healthcare providers’perceptions regarding AI in diabetes care across China.Methods A cross-sectional survey was conducted using snowball sampling from November 12 to November 24,2024.We selected 514 physicians and nurses by a snowball sampling method from healthcare providers across 30 cities or provinces in China.The self-developed questionnaire comprised five sections with 19 questions assessing medical workers’demographic characteristics,AI-related experience and interest,awareness,attitudes,and concerns regarding AI in diabetes care.Statistical analysis was performed using t-test,analysis of variance(ANOVA),and linear regression.Results Among them,20.0%and 48.1%of respondents had participated in AI-related research and training,while 85.4%expressed moderate to high interest in AI training for diabetes care.Most respondents reported partial awareness of AI in diabetes care,and only 12.6%exhibited a comprehensive or substantial understanding.Attitudes toward AI in diabetes care were generally positive,with a mean score of 24.50±3.38.Nurses demonstrated significantly higher scores than physicians(P<0.05).Greater awareness,prior AI training experience,and higher interest in AI training in diabetes care were strongly associated with more positive attitudes(P<0.05).Key concerns regarding AI included trust issues from AI-clinician inconsistencies(77.2%),increased workload and clinical workflow disruptions(63.4%),and incomplete legal and regulatory frameworks(60.3%).Only 34.2%of respondents expressed concerns about job displacement,indicating general confidence in their professional roles.Conclusions While Chinese healthcare providers show moderate awareness of AI in diabetes care,their attitudes are generally positive,and they are considerably interested in future training.Tailored,role-specific AI training is essential for equitable and effective integration into clinical practice.Additionally,transparent,reliable,ethical AI models must be prioritized to alleviate practitioners’concerns.
基金supported by National Natural Science Foundation of China(Project approval number 82201825).
文摘Objective:To compare the clinical efficacy of mifepristone-misoprostol medical management versus surgical curettage for first-trimester missed miscarriage,and to establish evidence-based sonographic cutoff values predictive of incomplete abortion requiring surgical intervention.Methods:We retrospectively analyzed a cohort of 702 women diagnosed with first-trimester missed miscarriage between January 2020 and May 2023.Demographic characteristics and ultrasound parameters were systematically recorded.Receiver operating characteristic(ROC)curve analysis was performed to establish optimal sonographic cutoff values for predicting incomplete abortion requiring surgical intervention.Results:146 patients received medical treatment(mifepristone and misoprostol)and 556 underwent surgical curettage.At the 1-month follow-up,the medical group showed significantly greater endometrial thickness and longer postoperative bleeding duration than the surgical group(P<0.05).The menstrual volume reduction rate(23.56%)was significantly lower in the medical group than in the surgical group.The incomplete abortion rate was higher in the medical group(17.12%,25/146)than in the surgical group(2.88%,16/556).Among the medical group,14 patients(9.59%)required curettage due to incomplete abortion,while 11 cases resolved spontaneously after prolonged medication.ROC curve analysis identified two cut-off values indicating the need for surgical intervention:endometrial thickness>1.21 cm at 24 h post-medical abortion,and residual mass diameter>0.95 cm at 7 days post-medical abortion.Conclusions:Medical management of first-trimester missed miscarriage using mifepristone-misoprostol demonstrates comparable efficacy to surgical curettage.An endometrial thickness>1.21 cm at 24 h or residual tissue diameter>0.95 cm at 7 days post-medical abortion should prompt consideration of incomplete abortion.
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 National Natural Science Innovative Research Group Project(61821002)the Frontier Funda-mental Research Program of Jiangsu Province for Leading Technology(BK20222002).
文摘The trajectory of human history is characterized by a persistent battle against disease.Over time,the field of medicine has transitioned from enigmatic witch doctors and herbal remedies to a sophisticated realm of contemporary medicine that includes fundamental medical and health sciences,clinical medicine,and public health.Nevertheless,the present phase of medical advancement encounters significant challenges,particularly in effectively translating basic research findings into practical applications in clinical and public health settings.Scientists increasingly collaborate with clinical experts to overcome these obstacles and address specific clinical issues by delving deeper into fundamental mechanisms.This collaborative effort has created a new interdisciplinary field:engineering medicine(EngMed),which focuses on addressing clinical and public health needs by integrating various scientific disciplines.This article discusses the definition,key tasks,significance,educational implications,and future trends in EngMed.
基金2020 Yunnan Province International Commissioner(Individual)Recognition Work Project(202003AK140041)2024 Yunnan Provincial Philosophy and Social Science Innovation Team:Research on the Exchange and Integration of Traditional Medicine in Yunnan(2024CX09)2023 Hospital-level Project of School of Basic Medical Sciences,Yunnan University of Traditional Chinese Medicine,“Comparison and Research on Traditional Medicine Treatment Methods in China and Burma”(2023CBMS009).
文摘Traditional medicine in Myanmar has a long history,combining the local natural environment,culture,and religious beliefs to form a unique medical system.This article adopts the method of literature research,focusing on the existing book“Milestones of Traditional Medicine in Myanmar”,and reviewing existing literature to analyze historical and contemporary sources.Elaborate on the question of how the history of traditional medicine in Myanmar originated and has continued to develop until now.These histories have proven that traditional medicine in Myanmar,despite facing numerous obstacles,has always been used by the people of Myanmar and has unique value,which deserves our continued attention and inheritance.
