Advances In Medical Technology Research Articles

Increased prevalence of recurrence in squamous cell carcinoma arising from buccal mucosa: A pervasive threat requiring multidimensional perspectives

Perspective goalSquamous cell carcinoma (SCC) of the buccal mucosa is at a higher risk of local recurrence. Surgery in this area is complex and frequently results in close or positive margins, which increases the risk of recurrence. A margin distance of less than 1 mm from the tumour is linked to a higher rate of recurrence. DiscussionAnatomic, genetic, environmental, and lifestyle factors contribute to its resurgence. Effective prevention strategies, early detection, and treatment require a multidimensional approach. Understanding genetic, environmental, and socio-cultural factors can help develop effective prevention strategies, improve early detection, and enhance treatment outcomes. ConclusionDespite advancements in medical technology and awareness campaigns, the aggressive nature of SCC and its adverse impact on patient's quality of life necessitates a comprehensive understanding of its factors. A comprehensive and multidimensional approach is crucial for combating this pervasive public health threat. By integrating this knowledge into prevention strategies, healthcare professionals can work towards reducing the burden of SCC and enhancing patients' quality of life.

The role of ventricular assist device in the management of advanced heart failure: a literature review

The ventricular assist device has become a reliable and enduring therapy for patients with end-stage heart failure, with over 22,000 implantations to date. Initially designed as a bridge-to-transplant option but now it has become permanent cure for patients with acute heart failure. VAD has significant advancements in medical management and technology, particularly with the introduction of newer-generation devices, have greatly enhanced patient outcomes. This progress has led to an increasing use of ventricular assist devices as a destination therapy. Nonetheless, the substantial burden of adverse events remains a critical challenge in the current state of ventricular assist device therapy, despite this, its viable alternative of heart transplantation as it has solved the complications of donor heart and proved significant success among patient with acute heart failure.

Advances in undergraduate and postgraduate education- bedside, simulation and E-learning

Clinical bedside teaching the cornerstone of medical education in the 19th century has been shaped and developed by changes in healthcare delivery and work practices. Developing skilled clinicians to work and thrive in these complex environments requires innovative and adaptive strategies. In this rapidly changing environment compounded by a shorter duration of training, there is an increasing focus on the student learner, team-based working and the development of professionalism. The continuum of medical education from undergraduate through postgraduate to continued professional development has been greatly enhanced by the adoption of new strategies and technologies. Simulation is long established in medical education and its benefits well recognised. Technological developments including Artificial Intelligence have supported and enhanced the quality of simulation in medical education. There is a broad range of simulation available with varying degrees of fidelity, as required, culminating in immersive virtual reality. The challenges for medical educators of the Covid-19 pandemic, with closure or restricted access to clinical patients, wards and classrooms, resulted in rapid restructuring of teaching programs and for many to move “on-line”. This resulted in widespread rapid adoption of technologically driven medical education, with E-learning, blended learning and innovative strategies to increase student engagement. The seismic changes in medical education necessitated by the Covid-19 pandemic coupled with the upskilling of medical educators and technological advances, should result in an exciting period of continued innovation in medical education, a second “Golden Era” and enhance medical education for many years to come.

Optimizing ventilatory support in ARDS: A comprehensive guide for ICU nurses on patient care

The emergence of COVID-19 as a global pandemic has placed an unprecedented strain on healthcare systems worldwide, highlighting a critical shortage of trained healthcare professionals equipped to manage such a crisis. This deficit poses a significant challenge to the delivery of healthcare services, particularly in the context of intensive care units (ICUs) where the use of advanced medical technologies, such as ventilators, is paramount. For nurses with limited experience in ICU settings, navigating the complexities of invasive positive pressure ventilation (IPPV), a principal method of mechanical ventilation for critically ill patients can be daunting. This article aims to serve as a comprehensive guide for nurses less familiar with the intricacies of managing patients on IPPV, offering insights and strategies to enhance their competence and confidence in this critical aspect of patient care.

Seasonal Variation in Short-Term Ambient Air Pollutants and ST-Elevation Myocardial Infarction Admissions: An Innovative Exploration of Air Pollution’s Health Consequences

Seasonal Variation in Short-Term Ambient Air Pollutants and ST-Elevation Myocardial Infarction Admissions: An Innovative Exploration of Air Pollution’s Health Consequences

Assessing the Robot-Assisted Surgical Systems between Developed and Developing Economies

Robot-assisted surgery (RAS) is a revolutionary technology for the surgeons, doctors and physicians. Although RAS deployment is rapid since 2019, despite decades of successful robotic assisted surgeries in the developed economies that have positively impacted millions of patients, RAS was barely explored by the developing countries compared to the developed countries whereby capabilities to enhance and improve the levels of expertise is limited besides acquisition and operating costs. This paper aims to raise awareness and compare what is the future of RAS in selected developing countries given its multitude of needs and challenges? Is RAS still in early days and too expensive to be put to general use in these developing economies today? We applied indicators to test the adoption of RAS using the economic consideration of robotic surgery in health economics. We examine the likelihood of acquiring and using RAS with different market characteristics from 2000 to 2022. We used data on traditional and robot-assisted surgical interventions and transform it into an improved version on Quality-Adjusted Life Year (QALY) and Willingness-to-Pay for Robot-Assisted Surgery (WTPR). Asia growth was spectacular. China’s participation resulted in closing the gap much faster in advanced medical technology and treatment such as RAS between developing and developed economies beside knowledge diffusion. South Koreans had catch up with the Europeans i.e., Italy, Germany, France and UK. China’s total patents had explosive growth and the robot density was among the highest among the selected economies compared in this study.

Advanced tumor electric fields therapy: A review of innovative research and development and prospect of application in glioblastoma.

Glioblastoma multiforme (GBM) is an aggressive malignant tumor with a high mortality rate and is the most prevalent primary intracranial tumor that remains incurable. The current standard treatment, which involves surgery along with concurrent radiotherapy and chemotherapy, only yields a survival time of 14-16 months. However, the introduction of tumor electric fields therapy (TEFT) has provided a glimmer of hope for patients with newly diagnosed and recurrent GBM, as it has been shown to extend the median survival time to 20 months. The combination of TEFT and other advanced therapies is a promising trend in the field of GBM, facilitated by advancements in medical technology. In this review, we provide a concise overview of the mechanism and efficacy of TEFT. In addition, we mainly discussed the innovation of TEFT and our proposed blueprint for TEFT implementation. Tumor electric fields therapy is an effective and highly promising treatment modality for GBM. The full therapeutic potential of TEFT can be exploited by combined with other innovative technologies and treatments.

Evolving Challenges in the Implementation of China's "Four Frees and One Care" Policy for HIV/AIDS.

In response to the HIV/AIDS epidemic, China initiated the "Four Frees and One Care" policy in late 2003. This policy provided free counseling, testing, and antiretroviral treatment for people living with HIV, while also offering support to affected families. While instrumental in advancing HIV/AIDS prevention, the policy faces evolving challenges. This study aims to analyze this challenge from multiple dimensions and, based on this analysis, provide effective recommendations for the Chinese government to address it, promoting the sustainable development of the "Four Frees and One Care" policy. The research found that reduced government funding has led to the decline of grassroots organizations, creating a disconnect between administrative and treatment systems. Additionally, advancements in medical technology introduce new antiretroviral drugs, complicating their integration into the healthcare system. In the current healthcare reform, updating the list of free antiretroviral drugs proves challenging. Adapting the policy to contemporary HIV/AIDS prevention should be a priority for the Chinese government. Balancing financial constraints, organizational sustainability, and evolving medical technologies will be pivotal for the ongoing transformation of the "Four Frees and One Care" initiative.

Efficacy of a Single Day Extracorporeal Membrane Oxygenation Training Course for Critical Care Air Transport Team Eligible Personnel.

Extracorporeal membrane oxygenation (ECMO) is an advanced medical technology that is used to treat respiratory and heart failure. The U.S. military has used ECMO in the care of combat casualties during Operation Enduring Freedom and Operation Iraqi Freedom as well as in the treatment of patients during the recent Coronavirus Disease 2019 pandemic. However, few Military Health System personnel have training and experience in the use of ECMO therapy. To address this dearth of expertise, we developed and evaluated an accelerated ECMO course for military medical personnel. To compare the efficacy of an accelerated ECMO course for Military Health System critical care teams. Seventeen teams, each consisting of a physician and nurse, underwent a 5-h accelerated ECMO course. Similar to our previous live-tissue ECMO training program (phases I and II), each team watched prerecorded ECMO training lectures. Subjects then practiced priming the ECMO circuit, cannulating ECMO, initiating ECMO, and correcting common complications on an ECMO simulation model. An added component to this phase III project included transportation and telemedicine consultation availability. Training success was evaluated via knowledge and confidence assessments, and observation of each team attempting to initiate ECMO on a Yorkshire swine patient model, transport the patient model, and troubleshoot complications with the support of telemedicine consultation when desired. Seventeen teams successfully completed the course. All seventeen teams (100%) successfully placed the swine on veno-arterial ECMO. Of those, 15 teams successfully transitioned to veno-arterial-venous ECMO. The knowledge assessments of physicians and nurses increased by 12.2% from pretest (mean of 62.1%, SD 10.4%) to posttest (mean of 74.4%, SD 8.2%), P < .0001; their confidence assessments increased by 41.1% from pretest (mean of 20.1%, SD 11.8%) to posttest (mean of 61.2%, SD 18.6%). An abbreviated 1-day lecture and hands-on task-trainer-based ECMO course resulted in a high rate of successful skill demonstration and improvement of physicians' and nurses' knowledge assessments and confidence levels, similar to our previous live-tissue training program. When compared to our previous studies, the addition of telemedicine and patient transportation to this study did not affect the duration or performance of procedures.

Epidemiology and current management of cardiovascular disease in China.

The Annual Report on Cardiovascular Health and Diseases in China (2022) intricate landscape of cardiovascular health in China. This is the fourth section of the report with a specific focus on epidemiology and current management of cardiovascular disease (CVD) in China. This section of the report highlights the epidemiological trends of CVD in China. It reveal a concerning rise in prevalence, with approximately 330 million affected individuals, including significant numbers with stroke, coronary artery disease (CAD), heart failure, and other conditions. CVD stands as the primary cause of mortality among both urban and rural populations, accounting for nearly half of all deaths in 2020. Mortality rates are notably higher in rural areas compared to urban centers since 2009. While age-standardized mortality rates have decreased, the absolute number of CVD deaths has increased, primarily due to population aging. Ischemic heart disease, hemorrhagic and ischemic strokes are the leading causes of CVD-related deaths. Notably, the burden of atherosclerotic cardiovascular disease has risen substantially, with atherosclerotic cardiovascular disease-related deaths increasing from 1990 to 2016. The incidence of ischemic stroke and ischemic heart disease has shown similar increasing trends over the past three decades. CAD mortality, particularly acute myocardial infarction, has been on the rise, with higher mortality rates observed in rural areas since 2016. The prevalence of CAD has increased significantly, with over 11 million patients identified in 2013. Studies assessing hospital performance in managing acute coronary syndrome reveal gaps in adherence to guideline-recommended strategies, with disparities in care quality across hospitals. However, initiatives like the China Patient-centered Evaluative Assessment of Cardiac Events (PEACE)-Retrospective AMI Study and the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome (CCC-ACS) project aim to improve patient outcomes through enhanced care protocols. Moreover, advancements in medical technology, such as quantitative flow ratio-guided lesion selection during percutaneous coronary intervention, show promise in improving clinical outcomes for patients undergoing intervention.

A biomechanical analysis of novel endovascular implants for aortic valve replacement and ascending aortic repair

Advances in medical technology have enabled minimally invasive treatment of type A aortic dissection with accompanying aortic regurgitation. Implants include endovascular stent grafts (ESG) and heart valve substitute (HVS) modules. Traditional implants can be divided into two types based on the assembly relationship between ESG and HVS: separated z-shaped implants (SZ) and separated diamond-shaped implants (SD). This study proposes a novel linked diamond-shaped implant (LD). To evaluate the safety and effectiveness of this new implant, finite element simulation models were created to assess the risks of endoleak, migration, and vascular wall rupture under annulus displacement load. After the SZ, SD, and LD implants were grafted in virtual release method, all the implants can cover tear-entry located in the ascending aorta, but space distance (δ) which exposed to blood was 14.5, 13.1, and 7.4 mm, respectively; the maximum areas of contact gap was 76.5, 51.5 and 6.3 mm2; the maximum migration distance (ΔL1) were 1.27, 1.06, and 0.1 mm; the maximum stress on ascending aorta was 0.19, 0.24, and 0.51 MPa, which were lower than failure stress (0.9 MPa). This study showed that both SZ and SD implants had minimal effects on the ascending aorta; however, higher risks were associated with implant migration and proximal endoleak. In contrast, the LD implant can simplify the surgical procedure, has a lower risk of endoleak and migration, and limited stress stimulation of the aorta. This study validated the feasibility and effectiveness of this novel implant using the finite element method, indicating its potential as a secure and reliable treatment option.

Analysis of the Association between Protein Intake and Disability-Adjusted Life Year Rates for Alzheimer's Disease in Japanese Aged over 60.

With advancements in medical technology, the structure of disease is shifting from acute illnesses to chronic conditions, such as Alzheimer's disease (AD). Consequently, there is an escalating need for evaluations that discourse on the potential effects on healthy life years, as well as disease onset. We aimed to evaluate the associations with AD disability-adjusted life year (AD-DALY) rates and protein intake by sex and age group. For the analysis, we used representative values for males and females in their 60s and aged over 70, extracted from the public dataset of the Global Burden of Disease Study and the National Health and Nutrition Survey in Japan, covering the years 1990 to 2019. In order to evaluate the association between AD-DALY rates and protein intake, we analyzed correlations and stratified multiple regression models. Additionally, we simulated alterations in AD-DALY rates associated with changes in protein intake by utilizing stratified multiple regression models. AD-DALY rates and protein intake indicated significant negative correlations across all sex and age groups. In stratified multiple regression models, significant associations were found between higher protein intake and lower AD-DALY rates in females. In the simulation, when protein intake was increased to 1.5 g/kg/day, AD-DALY rates decreased by 5-9 percent compared with 2019. However, the association between intake of animal and plant protein and AD-DALY rates were found to vary based on sex and age group. The present study suggests the possibility to improve AD-DALY rates by increasing population average protein intake levels in a recommended range.

Enhancing lung cancer diagnosis with data fusion and mobile edge computing using DenseNet and CNN

The recent advancements in automated lung cancer diagnosis through the application of Convolutional Neural Networks (CNN) on Computed Tomography (CT) scans have marked a significant leap in medical imaging and diagnostics. The precision of these CNN-based classifiers in detecting and analyzing lung cancer symptoms has opened new avenues in early detection and treatment planning. However, despite these technological strides, there are critical areas that require further exploration and development. In this landscape, computer-aided diagnostic systems and artificial intelligence, particularly deep learning methods like the region proposal network, the dual path network, and local binary patterns, have become pivotal. However, these methods face challenges such as limited interpretability, data variability handling issues, and insufficient generalization. Addressing these challenges is key to enhancing early detection and accurate diagnosis, fundamental for effective treatment planning and improving patient outcomes. This study introduces an advanced approach that combines a Convolutional Neural Network (CNN) with DenseNet, leveraging data fusion and mobile edge computing for lung cancer identification and classification. The integration of data fusion techniques enables the system to amalgamate information from multiple sources, enhancing the robustness and accuracy of the model. Mobile edge computing facilitates faster processing and analysis of CT scan images by bringing computational resources closer to the data source, crucial for real-time applications. The images undergo preprocessing, including resizing and rescaling, to optimize feature extraction. The DenseNet-CNN model, strengthened by data fusion and edge computing capabilities, excels in extracting and learning features from these CT scans, effectively distinguishing between healthy and cancerous lung tissues. The classification categories include Normal, Benign, and Malignant, with the latter further sub-categorized into adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. In controlled experiments, this approach outperformed existing state-of-the-art methods, achieving an impressive accuracy of 99%. This indicates its potential as a powerful tool in the early detection and classification of lung cancer, a significant advancement in medical imaging and diagnostic technology.

Challenges and Strategies for Medical Education in the New Era: An Analysis

Medical education, serving as the cornerstone for cultivating future healthcare talent, directly impacts the efficiency and quality of medical services. With the rapid advancement of medical technology and the growing demand for public health, medical education is facing unprecedented challenges and pressures. Optimizing resource allocation, updating educational content and methods, and strengthening soft skills training have become focal points for reform in medical education. This paper aims to explore key issues within medical education and propose effective improvement strategies, providing references and guidance for the development of medical education.

Poland’s Breast Self-Exams: Empowering Awareness

Introduction and purpose: Breast cancer poses a significant global health challenge, especially in Poland, where it is the most prevalent cancer among women. Despite advancements in medical technology, individual awareness and proactive health practices, such as Breast Self-Examination (BSE), are crucial for early detection. This study focuses on BSE practices in the Tarnów district of Poland, a small city facing unique healthcare challenges, to understand the prevalence, knowledge, and attitudes toward BSE. The aim of study was to comprehensively investigate BSE practices among women in the Tarnów district, considering socio-demographic factors.&#x0D; Material and Methods: Anonymous questionnaires assessed socio-demographic characteristics, attitudes toward BSE, frequency of BSE performance, knowledge on BSE, and sources of information. The survey involved 100 Polish women in gynecologist and general practitioner offices in Tarnów County. Results were analyzed in relation to age, education, and place of residence.&#x0D; Results: While 90% of women were familiar with BSE, 10% had never heard of it. While 29% performed BSE monthly, 18% never conducted the examination. Knowledge gaps were identified, particularly regarding optimal BSE practices. Information sources included the Internet (44%) and gynecologists (28%). Notably, 65% expressed a willingness to participate in BSE training.&#x0D; Conclusions: In conclusion, the study provides valuable insights into BSE practices among women in the Tarnów district, emphasizing the need for targeted interventions to encourage regular BSE. Knowledge gaps and the willingness of women to participate in training present opportunities for healthcare initiatives. The study also highlights the need for broader health education campaigns to dispel myths and enhance awareness, particularly regarding breast cancer affecting both genders. Limitations include a small sample size and geographic specificity to Tarnów district.

Elevated ADH5 expression suggested better prognosis in kidney renal clear cell carcinoma (KIRC) and related to immunity through single-cell and bulk RNA-sequencing

BackgroundDespite the rapid advances in modern medical technology, kidney renal clear cell carcinoma (KIRC) remains a challenging clinical problem in urology. Researchers urgently search for useful markers to break through the therapeutic conundrum due to its high lethality. Therefore, the study explores the value of ADH5 on overall survival (OS) and the immunology of KIRC.MethodsThe gene expression matrix and clinical information on ADH5 in the TCGA database were validated using external databases and qRT-PCR. To confirm the correlation between ADH5 and KIRC prognosis, univariate/multivariate Cox regression analysis was used. We also explored the signaling pathways associated with ADH5 in KIRC and investigated its association with immunity.ResultsThe mRNA and protein levels showed an apparent downregulation of ADH5 in KIRC. Correlation analysis revealed that ADH5 was directly related to histological grade, clinical stage, and TMN stage (p < 0.05). Univariate and multivariate Cox regression analysis identified ADH5 as an independent factor affecting the prognosis of KIRC. Enrichment analysis looked into five ADH5-related signaling pathways. The results showed no correlation between ADH5 and TMB, TNB, and MSI. From an immunological perspective, ADH5 was found to be associated with the tumor microenvironment, immune cell infiltration, and immune checkpoints. Lower ADH5 expression was associated with greater responsiveness to immunotherapy. Single-cell sequencing revealed that ADH5 is highly expressed in immune cells.ConclusionADH5 could be a promising prognostic biomarker and a potential therapeutic target for KIRC. Besides, it was found that KIRC patients with low ADH5 expression were more sensitive to immunotherapy.

Unraveling the Enigma of Aortic Dissection: From Genetics to Innovative Therapies.

Aortic dissection (AD) presents a critical medical emergency characterized by a tear in the aortic wall, necessitating prompt recognition and management to mitigate catastrophic complications. Despite advancements in medical technology and therapeutic interventions, AD remains a formidable challenge, often resulting in severe morbidity and mortality. This narrative review provides a comprehensive overview of AD, encompassing its clinical presentation, diagnostic modalities, and management strategies, while also exploring emerging trends and innovations in its management. Genetic predispositions significantly influence AD pathogenesis, with over 30 contributory genes identified, emphasizing the importance of genetic screening and counseling. Classification systems such as Stanford and DeBakey, alongside their revised counterparts, aid in categorizing AD and guiding treatment decisions. Advancements in diagnostic imaging, including transesophageal echocardiography and computed tomography angiography, have enhanced diagnostic precision, augmented by artificial intelligence and machine learning algorithms. Pharmacological innovations focus on optimizing medical therapy, while surgical and endovascular approaches offer minimally invasive treatment options. Hybrid procedures and aortic valve-sparing techniques broaden treatment avenues, while bioresorbable stent grafts hold promise for tissue regeneration. Collaborative efforts and ongoing research are essential to address remaining challenges and improve outcomes in managing AD. This review contributes to the understanding of AD's complexity and facilitates informed decision-making in clinical practice, underscoring the imperative for continued innovation and research in AD management.

Renal Pathological Image Classification Based on Contrastive and Transfer Learning

Following recent advancements in medical laboratory technology, the analysis of high-resolution renal pathological images has become increasingly important in the diagnosis and prognosis prediction of chronic nephritis. In particular, deep learning has been widely applied to computer-aided diagnosis, with an increasing number of models being used for the analysis of renal pathological images. The diversity of renal pathological images and the imbalance between data acquisition and annotation have placed a significant burden on pathologists trying to perform reliable and timely analysis. Transfer learning based on contrastive pretraining is emerging as a viable solution to this dilemma. By incorporating unlabeled positive pretraining images and a small number of labeled target images, a transfer learning model is proposed for high-accuracy renal pathological image classification tasks. The pretraining dataset used in this study includes 5000 mouse kidney pathological images from the Open TG-GATEs pathological image dataset (produced by the Toxicogenomics Informatics Project of the National Institutes of Biomedical Innovation, Health, and Nutrition in Japan). The transfer training dataset comprises 313 human immunoglobulin A (IgA) chronic nephritis images collected at Fukushima Medical University Hospital. The self-supervised contrastive learning algorithm “Bootstrap Your Own Latent” was adopted for pretraining a residual-network (ResNet)-50 backbone network to extract glomerulus feature expressions from the mouse kidney pathological images. The self-supervised pretrained weights were then used for transfer training on the labeled images of human IgA chronic nephritis pathology, culminating in a binary classification model for supervised learning. In four cross-validation experiments, the proposed model achieved an average classification accuracy of 92.2%, surpassing the 86.8% accuracy of the original RenNet-50 model. In conclusion, this approach successfully applied transfer learning through mouse renal pathological images to achieve high classification performance with human IgA renal pathological images.

PRAGMALINGUISTIC STUDY OF INNOVATIVE PROCESSES IN MEDICAL TERMINOLOGY

This article examines the pragmatic and linguistic aspects of everyday processes in medical terminology, providing detailed information on pragma linguistics, which is considered a very relevant field in linguistics. Medical terminology is a highly specialized field that is constantly evolving to keep up with advances in medical science and technology. The study of innovative processes in medical terminology includes the analysis of how new terms are created, adopted, and integrated into the medical lexicon. This article examines the role of pragmatics in shaping the use and understanding of medical terminology, as well as the linguistic strategies used to create and disseminate new terms within the medical community.

Application of vibration analysis for medical diagnosis

The ability to interpret vibration signals in the biomedical field offers a promising path toward continuous improvement of medical devices. By examining the revolutions per minute profile, analysts can identify any deviations or anomalies in the vibration patterns at different speeds. This information can help identify potential faults or imbalances within the rotating machinery. With a comprehensive understanding of the revolutions per minute profile, analysts can make informed decisions regarding maintenance and repairs. Besides, the analysis of the order of vibration signals represents an essential pillar of biomedical engineering, bringing an innovative and in-depth perspective to the development of medical devices, and contributing to the continued advancement of medical technology and healthcare. Integrating vibration analysis into preventive maintenance practices can help ensure the reliability of medical equipment, reduce potential risks to patients, and contribute to the advancement of healthcare quality.