Improvements In Medical Technology Research Articles

Reasons for the increase and ways to reduce the frequency of cesarean sections in modern obstetrics

The progressive increase in the number of cesarean sections, which is not accompanied by a decrease in the perinatal mortality rate, is an urgent problem not only in obstetrics, but in the health care system in general. The frequency of operative delivery is influenced by both medical and non-medical factors. Moreover, the frequency varies across regions of the world and countries with different levels of economic development. At the present stage, the increase in the number of surgical deliveries in developed countries is due to changes in population health indicators (age, morbidity). The attention of WHO and associations of obstetricians and gynecologists is drawn to the development of measures to stabilize and reduce the frequency of cesarean sections. However, the proposed measures to reduce it through administration in obstetric hospitals and non-medical measures do not have an effect. There is evidence of an increase in the incidence of complications for the mother and fetus when indications for cesarean section are limited. A safe reduction in the frequency of caesarean sections is possible only with an integrated approach, including new solutions that improve the quality of medical care in general (social measures to support families, optimization of medical processes, introduction of decision support systems, improvement of medical technologies for pregnancy and childbirth).

A review of enhanced recovery after surgery concept in perioperative radical prostatectomy for prostate cancer.

Radical prostatectomy (RP) is the main treatment for early-stage localized prostate cancer. With the improvement of medical technology, radical prostatectomy is mainly performed under laparoscopy or robot assistance. With the continuous deepening of the Enhanced Recovery After Surgery (ERAS) concept in clinical practice, patients have increasingly high requirements for postoperative recovery. The ERAS concept is of great significance in the perioperative period and has been used in many surgical fields due to its ability to improve prognosis. ERAS has not yet been widely applied in urology and the research progress of other disciplines in ERAS has promoted its development in radical prostatectomy. This review summarizes the key elements of ERAS in the perioperative period of RP, aiming to demonstrate the superiority of ERAS and provide new references and inspirations for urologists.

Combined laparoscopic nephroureterectomy with transurethral approach to the ureter in renal tuberculosis treatment

BACKGROUND: Tuberculosis of the genitourinary system is a common cause of organ removal surgeries. Despite the improvement of medical technologies, kidney and urinary tract surgeries for urogenital tuberculosis are traditionally performed using the open method. AIM: To assess the findings of laparoscopic and open combined nephroureterectomy with transurethral resection of the distal ureter in patients with renal tuberculosis. MATERIALS AND METHODS: The findings of 61 nephroureterectomies with transurethral resection of the distal ureter performed for destructive renal tuberculosis were analyzed. Open nephroureterectomy was performed in 31 patients, and laparoscopic approach was used in 30 patients. Patients in both groups were comparable by gender and age. RESULTS: The surgery duration, volume of intraoperative blood loss, rate and severity of postoperative complications were lower in patients who had laparoscopic interventions. When examined 1 month after surgery, patients in both groups showed the improvement of clinical parameters. The following changes were reported: a significant decrease in the nighttime urination rate, a decrease in IPSS scores, and an increase in the functional bladder capacity without significant differences depending on the surgical approach. After the surgery, a significant improvement in the quality of patients’ life was observed. In patients who had laparoscopic surgery, improvements were detected in all the SF-36 questionnaire domains. However, in patients after open surgery with a positive effect on most of assessed parameters no significant improvement of parameters in section “General Physical Health” was found. CONCLUSIONS: Irrespective of the selected approach, combined nephroureterectomy with transurethral resection of the distal ureter is an effective method of surgical treatment of patients with destructive renal tuberculosis. Moreover, the laparoscopic technique has shown a number of significant advantages over open surgery.

Advances in systemic treatment for recurrent metastatic cervical cancer.

Cervical cancer remains a leading cause of cancer-related mortality among women worldwide, particularly in underdeveloped nations. Despite advances in standard therapies, patients with recurrent metastatic cervical cancer face a poor prognosis and limited treatment options. This study aims to evaluate the efficacy and safety of emerging therapeutic approaches in managing this challenging condition, including immunotherapy, targeted medicines, and chemotherapy. Our review of recent literature and clinical trials highlights the significant progress made in the systematic treatment of metastatic cervical cancer. While each treatment modality has its strengths and limitations, the collective data suggest a trend towards improved patient outcomes with the adoption of these novel therapies. However, the heterogeneity of patient responses underscores the need for personalised treatment strategies. In conclusion, improvements in medical technology and the adoption of tailored treatment approaches have led to promising advancements in the management of recurrent metastatic cervical cancer. To further enhance patient care, there is an urgent need for more extensive clinical trial data and the development of more efficient personalised treatment plans. This study aims to contribute to this effort by comprehensively analysing current therapeutic strategies and identifying areas for future research.

Task-State Functional MRI of Brain Regions with Reduced Activation in Aphasia Patients: A Meta-analysis.

Language is one of the most celebrated hallmarks of human cognition. With the continuous improvement of medical technology, functional MRI (fMRI) has been used in aphasia. Although many related studies have been carried out, most studies have not extensively focused on brain regions with reduced activation in aphasic patients. The aim of this study was to identify brain regions normally activated in healthy controls but with reduced activation in aphasic patients during fMRI language tasks. We collected all previous task-state fMRI studies of secondary aphasia. The brain regions showed normal activation in healthy controls and reduced activation in aphasic patients were conducted activation likelihood estimation (ALE) meta-analysis to obtain the brain regions with consistently reduced activation in aphasic patients. The ALE meta-analysis revealed that the left inferior frontal gyrus, left middle temporal gyrus, left superior temporal gyrus, left fusiform gyrus, left lentiform nucleus and the culmen of the cerebellum were the brain regions with reduced activation in aphasic patients. These findings from the ALE meta-analysis have significant implications for understanding the language network and the potential for recovery of language functions in individuals with aphasia.

Research Progress of Traditional Chinese Medicine in Immune Function of Lung Cancer Patients

Lung cancer is one of the most common malignant tumors in the world, ranking the first cause of death. In recent years, the incidence and mortality of patients with lung cancer have increased significantly. Western medicine generally adopts traditional treatment methods such as surgery, chemotherapy and radiotherapy, but there are inevitable adverse reactions and side effects in all of them, and new treatment methods are urgently needed to control its development. With the continuous improvement of medical technology, immunotherapy has gradually flourished in the medical field. Traditional Chinese medicine can achieve the purpose of tumor treatment by regulating the tumor immune microenvironment. This paper explores the mechanism of traditional Chinese medicine in the treatment of lung cancer from the etiology, pathogenesis and the role of traditional Chinese medicine in lung cancer immunity, and puts forward new ideas to provide reference for clinical practice.

How Will Artificial Intelligence Shape the Future of Decision-Making in Congenital Heart Disease?

Improvements in medical technology have significantly changed the management of congenital heart disease (CHD), offering novel tools to predict outcomes and personalize follow-up care. By using sophisticated imaging modalities, computational models and machine learning algorithms, clinicians can experiment with unprecedented insights into the complex anatomy and physiology of CHD. These tools enable early identification of high-risk patients, thus allowing timely, tailored interventions and improved outcomes. Additionally, the integration of genetic testing offers valuable prognostic information, helping in risk stratification and treatment optimisation. The birth of telemedicine platforms and remote monitoring devices facilitates customised follow-up care, enhancing patient engagement and reducing healthcare disparities. Taking into consideration challenges and ethical issues, clinicians can make the most of the full potential of artificial intelligence (AI) to further refine prognostic models, personalize care and improve long-term outcomes for patients with CHD. This narrative review aims to provide a comprehensive illustration of how AI has been implemented as a new technological method for enhancing the management of CHD.

Parental Involvement in the Transition from Paediatric to Adult Care for Youth with Chronic Illness: A Scoping Review of the North American Literature.

With medical advancements and improvements in medical technology, an increasing number of children with chronic conditions survive into adulthood. There is accordant growing interest toward supporting adolescents throughout the transition from paediatric to adult care. However, there is currently a paucity of research focusing on the role that these patients' parents should play during and after the transition to adult care and if maintained parental involvement is beneficial during this transition within a North American context. Accordingly, this scoping review utilized Arksey and O'Malley's five-step framework to consider parental roles during chronically ill children's transition to adult care. APA PsycInfo, CINAHL, EMBASE, MEDLINE, ProQuest, and Scopus were searched alongside advanced Google searches. Thematic content analysis was conducted on 30 articles meeting the following inclusion criteria: (1) published in English between 2010 and 2022, (2) conducted in Canada or the United States, (3) considered adolescents with chronic conditions transitioning to adult care, (4) family being noted in the title or abstract, and (5) patient populations of study not being defined by delays in cognitive development, nor mental illness. Three themes emerged from the literature: the impacts of maintaining parental involvement during transition to adult care for patients, parents experiencing feeling loss of stability and support surrounding the transition of their child's care, and significant nonmedical life events occurring for youths at the time of transition of care. Parents assuming supportive roles which change alongside their maturing child's needs were reported as being beneficial to young peoples' transition processes, while parents who hover over or micromanage their children during this time were found to hinder successful transitions. Ultimately, the majority of reviewed articles emphasized maintained parental involvement as having a net positive impact on adolescents' transitions to adult care. As such, practice and policies should be structured to engage parents throughout the transition process to best support their chronically ill children during this time of change.

Bioethics as a guarantor of the anthropocentricity of modern scientific and technological development

The relevance of the article is due to the acuteness of the public and scientific debate on the ethics of human cloning experiments: both from the point of view of violating the boundaries of human individuality, and from the standpoint of biological safety. Bioethics in this context becomes a reference point for any scientific research related to the human body, which is especially important in the modern «age of technological dehumanization». The article examines the disciplinary, philosophical, medical, anthropological aspects of bioethics in Russia and abroad, as well as the specifics of the legislative regulation of cloning issues. As a result of the analysis, the conclusion is postulated that ethical norms find themselves in a situation of opposition to the principles of bioeconomics, which implies the reproduction «to order» of a person with specified characteristics. A parallel is drawn with artificial intelligence, which also, in fact, imitates and reproduces individual processes of human thinking. Nevertheless, bioethics should not create barriers to the development of scientific knowledge and the improvement of medical technologies.

Brain Drain among Nigerian Doctors: Country’s Implications and Policy Responses

Over the past two decades, the migration of medical doctors has shown remarkable trends. In Nigeria, the medical profession stands out as one of the most mobile, highly skilled occupations and grapples with severe labor shortages. This study delves into two primary aspects. Firstly, it examines the main theoretical contributions and historical evolution of two phenomena: brain drain and medical brain drain. Secondly, it aims to raise inquiries, provide insights, pinpoint critical concerns, and propose potential solutions to curtail the emigration of medical doctors from Nigeria to developed nations. Secondary data source through desktop research was employed. Descriptive and explanatory research designs were used with mixed method research methodology involving qualitative and quantitative methods. Our results reveal that the attractive remuneration of doctors, a pleasant working environment, and adequate provisions for career advancement in the destination countries are among the pull factors for doctors' brain drain. In like manner, the surge in demand for healthcare services and improvements in medical technology in the receiving country act as driving forces behind the migration of medical doctors from developing nations, such as Nigeria. Keywords: Brain Drain; Migration; Poor Wages; Opportunities; Remuneration

Brain Drain among Nigerian Doctors: Country’s Implications and Policy Responses

Over the past two decades, the migration of medical doctors has shown remarkable trends. In Nigeria, the medical profession stands out as one of the most mobile, highly skilled occupations and grapples with severe labor shortages. This study delves into two primary aspects. Firstly, it examines the main theoretical contributions and historical evolution of two phenomena: brain drain and medical brain drain. Secondly, it aims to raise inquiries, provide insights, pinpoint critical concerns, and propose potential solutions to curtail the emigration of medical doctors from Nigeria to developed nations. Secondary data source through desktop research was employed. Descriptive and explanatory research designs were used with mixed method research methodology involving qualitative and quantitative methods. Our results reveal that the attractive remuneration of doctors, a pleasant working environment, and adequate provisions for career advancement in the destination countries are among the pull factors for doctors' brain drain. In like manner, the surge in demand for healthcare services and improvements in medical technology in the receiving country act as driving forces behind the migration of medical doctors from developing nations, such as Nigeria. Keywords: Brain Drain; Migration; Poor Wages; Opportunities; Remuneration

Deep supervision feature refinement attention network for medical image segmentation

The improvement of medical technology is closely related to the development of computers. Deep learning methods have become an important means for medical image processing, and their accuracy in processing lesions will have a significant impact on the final diagnosis result. Currently, some traditional algorithms and classical deep learning methods are no longer able to meet the increasing demand for higher accuracy in medical image processing. In order to achieve better performance in handling the edge and detail features of lesions, we create the Deep Supervision Feature Refinement Attention Network (DSFRA-Net) through extensive experiments. In DSFRA-Net, the Depth Feature Attention Block is created to enhance the long-range dependency between pixels in deep neural networks. The Feature Refinement Block is developed to enhance the details in shallow features. The Adaptive Feature Extraction Block is created to strengthen the fusion of semantic information and detail information. A deep supervision mechanism is used to supervise each layer of the feature reconstruction process, feeding back the training in the form of a loss function to optimize the training. DSFRA-Net experiments on four datasets, all of which show better performance than the current mainstream networks. It shows superior capabilities in areas such as feature continuity and detailed feature processing.

Epidemiology and antibiogram of listeria species from retail raw frozen atlantic mackerel fish (Scomber scombrus) in Nigeria

This study was undertaken to determine the epidemiology and antibiogram of Listeria species isolated from raw frozen Atlantic Mackerel (Scomber Scombrus) fish sold in Enugu State Southeastern Nigeria. Twentyfive grams each of raw fish gut and skin were collected from 800 raw fish sold in 8 major markets randomly selected from the study area. Isolation of Listeria was done using half and full fraser broths, and polymyxin acriflavine lithium chloride ceftazidime aesculin mannitol (PALCAM) agar. Confirmation of the genus Listeria was done by a polymerase chain reaction. Identification of species was done using an analytic profile index (API) kit specific for Listeria. The antibiotic resistance of the isolates was determined using disc diffusion method. Out of the 800 fish samples, 38 (4.75%) were positive for Listeria species. Enugu North (6.50%) had significantly (P<0.05) higher prevalence than Enugu East (3.0%). Five Listeria species were identified. Listeria innocua (71.1%) predominated, followed by Listeria welshimeri (10.5%), Listeria ivanovii (7.9%), Listeria grayi (5.3%) and Listeria monocytogenes (5.3%). All the isolates were susceptible to the tested antibacterial agents. The occurrence of Listeria species in raw frozen Atlantic mackerel fish, poses a threat, when consumed raw or lightly cooked, to people especially the immunocomprormised persons whose population is increasing as a result of improvement in medical technology. Also, the possibility of cross contamination in the kitchen or food service establishments is also a concern. Since all the Listeria species got in this study showed 100% susceptibility to all the antimicrobials tested, therefore, there is no fear of acquiring and transferring antibiotic resistance genes from raw frozen Atlantic mackerel fish to the general human population.

Effect of xenon on brain injury, neurological outcome, and survival in patients after aneurysmal subarachnoid hemorrhage—study protocol for a randomized clinical trial

BackgroundAneurysmal subarachnoid hemorrhage (aSAH) is a neurological emergency, affecting a younger population than individuals experiencing an ischemic stroke; aSAH is associated with a high risk of mortality and permanent disability. The noble gas xenon has been shown to possess neuroprotective properties as demonstrated in numerous preclinical animal studies. In addition, a recent study demonstrated that xenon could attenuate a white matter injury after out-of-hospital cardiac arrest.MethodsThe study is a prospective, multicenter phase II clinical drug trial. The study design is a single-blind, prospective superiority randomized two-armed parallel follow-up study. The primary objective of the study is to explore the potential neuroprotective effects of inhaled xenon, when administered within 6 h after the onset of symptoms of aSAH. The primary endpoint is the extent of the global white matter injury assessed with magnetic resonance diffusion tensor imaging of the brain.DiscussionDespite improvements in medical technology and advancements in medical science, aSAH mortality and disability rates have remained nearly unchanged for the past 10 years. Therefore, new neuroprotective strategies to attenuate the early and delayed brain injuries after aSAH are needed to reduce morbidity and mortality.Trial registrationClinicalTrials.gov NCT04696523. Registered on 6 January 2021.EudraCT, EudraCT Number: 2019-001542-17. Registered on 8 July 2020.

The role of artificial intelligence in the differential thyroid nodules ultrasound diagnostics

Advances in the development and improvement of medical technologies and methods of processing medical images make it possible to highlight clinically significant characteristics that were not previously available to classical methods of medical imaging. Ultrasound diagnostics of thyroid gland nodules has a huge potential medical images processing. The article presents an overview of the existing ultrasound classification systems for thyroid nodules malignancy and the prospects for the development of intellectual tools TIRADS (Thyroid Imaging Reporting and Data System) classification system.

Chinese patients’ response to doctor–patient relationship stimuli: evidence from an event-related potential study

BackgroundWith improvements in medical technology, the doctor–patient relationship should be further improved. However, disputes between doctors and patients have increased, with the two groups frequently hurting each other. Therefore, we sought to explore the perception of Chinese patients regarding the stimuli of doctor–patient relationships with different valence.MethodsWe used event-related potential (ERP) to explore the brain electrical activity of 19 undergraduate participants who had a clinical experience in the previous 6 months where they perceived negative, neutral, and positive doctor–patient relationships. The ERPs were recorded, and the early ERP components (P2) and late positive potential (LPP) were measured.ResultsCompared with the stimuli of negative doctor–patient relationships, those of positive doctor–patient relationships would attract more attention and have larger P2 amplitude; LPP was larger for the stimuli of negative doctor–patient relationships than neutral ones in the 500–800 ms, while in the 1100–1500 ms, the stimuli of neutral doctor–patient relationships elicited larger LPP amplitude than positive ones.ConclusionPatients paid more attention to the stimuli of positive doctor–patient relationships because they expected to have the same positive relationship. Although threatening elements in negative doctor–patient relationships would catch patients’ attention and make them have implicit emotional regulation, neutral stimuli with poker-faced doctors would cause lasting attention. These results illustrate the patients’ real perception of the different valence of doctor–patient relationship stimuli.

Transcatheter Interventions in Patients With Adult Congenital Heart Disease.

Patients with congenital heart disease now live well into adulthood because of advances in surgical techniques, improvements in medical management, and the development of novel therapeutic agents. As patients grow older into adults with congenital heart disease, many require catheter-based interventions for the treatment of residual defects, sequelae of their initial repair or palliation, or acquired heart disease. The past 3 decades have witnessed an exponential growth in both the type and number of transcatheter interventions in patients with congenital heart disease. With improvements in medical technology and device design, including the use of devices designed for the treatment of acquired valve stenosis or regurgitation, patients who previously would have required open-heart surgery for various conditions can now undergo percutaneous cardiac catheter-based procedures. Many of these procedures are complex and occur in complex patients who are best served by a multidisciplinary team. This review aims to highlight some of the currently available transcatheter interventional procedures for adults with congenital heart disease, the clinical outcomes of each intervention, and any special considerations so that the reader may better understand both the procedure and patients with adult congenital heart disease.

Trend Analysis of Maternal Health Care Services in Nepal

This study attempts to analyze the trend in maternal health care utilization: antenatal care, delivery care, and postnatal care in Nepal. Maternal health remains a major challenge in developing countries despite improvements in medical technology and several efforts to improve maternal health care services. This study is based on Nepal Demographic and Health Survey data from 2006, 2011, and 2016. It covers 4,066 women in 2006, 4,148 in 2011 and 3,998 in 2016 for antenatal care. In the study, this analysis is confined to women aged (15-49) who had a live birth in the five years preceding the survey. Data on delivery care were obtained for all births that occurred in the five or two years preceding the survey. This study comprises 2030 women in 2011 and 1,978 women in 2016 aged 15–49 years who had a live birth in the two years preceding the survey on childbirth, and postnatal care. Especially, the study deals with antenatal, delivery care, and postnatal care. There is a substantial increase in the utilization of antenatal care (ANC) by skilled health providers from, 44 percent in 2006 to 84 percent in 2016 respectively. Still, six percent percentage do not seek even one-time ANC care and the percentage of women who seek 4 or more ANC care from a skilled service provider is low. Still, two fifth percent of delivery take place at home. postnatal service is still very low in Nepal. This study’s results suggest the need for efforts to be addressed to improve the use of maternal health care services in Nepal. There is a need to increase the use of postnatal checkup as well as delivery assisted by skilled attendants.

VASCULAR ACCESS FOR HEMODIALYSIS BY ULNAR-BASILIC-TRANSPOSITION IN AXILLARY LOOP

The population on dialysis is increasing because of multiple factors, including the rise in life expectancy that has taken place during this century and the admission of increasingly younger patients affected by diseases such as diabetes. Further, the life expectancy of the population on dialysis has also grown thanks to improvements in medical technology. Classical native vascular accesses like Brescia-Cimino radiocephalic AVF, the brachiocephalic AVF and transposition of basilic and ulnar veins continue to be the first choice since they present higher patency and lower complication rates as compared to prosthetic materials. Once all conventional access alternatives in the upper limbs have been exhausted, a viable alternative is the creation of an ulnar-basilic AVF in axillary loop. This procedure was performed with good results in four patients with an age range of 30 to 52 with chronic renal insufficiency, receiving dialysis three times a week.

Application Protocol of Standardized Neonatal Parenteral Nutrition Formulations

With the improvements in medical technology, more premature infants and infants with congenital intestinal malformations or other conditions who need parenteral nutrition (PN) support can survive. PN technology has become an important therapeutic strategy in neonatal intensive care units. Due to differences in the qualifications of medical staffs, hospital pharmacy management, hospital level, etc, the composition and preparation methods of PN prescription vary greatly in different regions and hospitals in China. In addition, delays in the starting time of PN, unreasonable formula of nutrition components, poor prescription review, large workload involved in the preparation of PN for nurses, and waste of drugs are prone to happen. In view of these issues, our hospital independently developed standardized formulas of neonatal PN solution, which has been approved in Australia as a patented invention. Herein, we reported the composition and application protocol of this standardized PN solution for newborns.