Medical Environment Research Articles

Rural residents’ willingness to utilize primary care and its influencing factors in the context of graded diagnosis and treatment: a study in Deqing, China

BackgroundGraded diagnosis and treatment is a key component in advancing healthcare system reforms and establishing a foundational healthcare framework. Primary care serves as the cornerstone of this system. Understanding the willingness to seek primary care and the factors influencing it can enhance primary care utilization and address the challenges of “difficult access to healthcare” and “high medical costs.”MethodsThis study, based on data from 415 rural residents in Deqing County, Zhejiang Province, analyzes their willingness to seek primary care and the factors influencing it using the Theory of Planned Behavior and structural equation modeling.ResultsThe results of the study show the following: ① Attitude toward behavioral, subjective norm, and perceived behavior control significantly affect willingness to seek primary care, with attitude toward behavior having the greatest influence. ② Regarding attitude toward behavior, residents’ evaluation of treatment costs in primary care, the medical environment, and trust in doctors significantly impact their willingness to seek primary care. ③ In terms of subjective norms, the level of support from others, as well as the recognition of graded diagnosis and treatment systems and family doctor contracting services, positively influence the willingness to use primary care. ④ For perceived behavioral control, residents’ perception of personal and environmental factors affects their willingness to make a first visit to primary care facilities.ConclusionThe study recommends strengthening the awareness of the necessity of primary care among rural residents, improving the experience at the primary level, stimulating the desire for primary care, and increasing the frequency of primary care utilization.

Investigation of Gamma Ray Shielding Characteristics of Binary Composites Containing Polyester Resin and Lead Oxide

Ionizing radiation plays an essential role across various fields but also poses significant health risks, requiring effective shielding solutions. This study focuses on the photon shielding properties of PbO-reinforced composites, specifically PbO-0, PbO-2, PbO-4, PbO-6, PbO-8, and PbO-10, through experimental measurements of photon energies ranging from 59.5 keV to 1408.0 keV. The measurements were taken using an HPGe detector. Experimental results were compared to theoretical calculations. Among the tested composites, PbO-10, which contains the highest concentration of lead oxide (PbO), provided the most effective radiation shielding. This sample demonstrated superior mass and linear attenuation coefficients, offering excellent protection at low photon energies. Furthermore, PbO-10 exhibited the lowest half-value layer (HVL) and tenth-value layer (TVL) values, indicating its efficiency in reducing radiation intensity with thinner material layers. It was determined that the experimental TVL results for PbO-O, PbO-2, PbO-4, PbO-6, PbO-8, and PbO-10 at 59.5 keV photon energy were 9.95, 5.98, 4.77, 3.67, 3.22, and 2.71 cm, respectively. With these outstanding attenuation capabilities, PbO-10 is deemed highly suitable for use in medical, industrial, and radiation-heavy environments. In summary, this research emphasizes the effectiveness of PbO-reinforced composites in gamma-ray shielding, with PbO-10 emerging as the top performer, demonstrating great potential for applications that require durable and efficient radiation protection.

Research on the Rehabilitation Medical Space Design Update Based on the Needs of Children with Autism

Abstract: This study aims to explore and summarize the relationship between the psychological development of children with autism and the redesign of modern public medical environments, from the perspectives of their basic characteristics and needs, interior functional spaces, and interior design strategies. The research employs methods including literature analysis, field investigations, interdisciplinary studies, and comparative analysis, focusing on the logical relationship of identifying, analyzing, and solving problems. Taking the current state of rehabilitation medical environments as the starting point, the study conducts an analysis of environmental redesign. The findings indicate that updating the design of environments in autism rehabilitation institutions is of significant importance to the psychological development and therapeutic intervention for children with autism, playing a substantial role in treatment enhancement. The study also summarizes relevant design ideas and methods, providing reference and evidence for similar project research.

The Practical Pathways of Enhancing Nursing Education in Medical Schools

The advancement of society and continuous improvements in the healthcare system have heightened the demands on professional nursing training, necessitating that nursing education better meet practical needs in an increasingly diversified medical environment. To address these requirements, the teaching approaches and assessment methods in nursing education should be reformed and updated. This study conducted a comprehensive analysis of the current state of nursing education and proposed potential pathways to enhance nursing education in medical schools. These pathways include implementing a student-centered teaching approach, incorporating various teaching activities, emphasizing the development of students’ practical skills, and reforming assessment methods to cultivate well-rounded professionals. The application of these strategies will help improve the effectiveness of classroom teaching, deepen students’ understanding of theoretical knowledge and practical skills, and thereby contribute to the improvement of nursing education quality.

Stress, Anxiety, and Depression in the First-year Students of Medical Education: A Prospective Cohort Study from a Women's Medical College in South India.

Medical students around the world have been found to have high rates of depression and anxiety as compared to the general population. This study aimed to assess these in medical students immediately after they joined medical school and six months later. This study also aimed to assess if there was any association with stress, anxiety, and depression scores at six months follow-up with coping styles, self-esteem, personality, family functioning, and academic performance. We enrolled 154 first-year undergraduate medical students in this study with a baseline assessment including sociodemographic factors and Depression, Anxiety, Stress Scale 21 (DASS 21). They were followed up at six months with assessments of DASS 21, family functioning using the Family Adaptability, Partnership, Growth, Affection, and Resolve Scale (APGAR), coping styles using the Brief Coping Orientation to Problems Experienced (Brief COPE) scale, personality factors using the Big Five Inventory (BFI-10) and self-esteem using Rosenberg Self-Esteem Inventory (RSES). Change in scores in DASS 21 was measured. The DASS 21 scores at six months were correlated with other scale scores using appropriate statistical tools. Logistic regression analysis was done to study the effect of different variables on the outcomes. Mean DASS scores at baseline fell within the normal range. There was a significant increase in mean DASS scores six months after joining. Despite this, only three students reported receiving treatment for mental health problems. DASS scores showed positive correlations with neuroticism and emotion-focused coping styles. About 36.6% of students reported failing in at least one subject. Academic performance did not show any association with levels of psychological distress. Students showed a striking rise in psychological distress six months after joining medical school. This suggests that the medical school environment could play a role. To meet students' needs, a change in medical school culture and the provision of accessible and flexible mental health services are required.

Multiple criteria qualitative value-based pricing framework “MARIE” for new drugs

ObjectivesValue-based pricing (VBP) could improve allocation of healthcare resources. We created and evaluated a simple VBP method that qualitatively considers broad values for drugs. MethodFirst, we established the value elements that determine the value of drugs. Then, we decided on the criteria for scoring the value elements, constructed a method for estimating daily drug prices from the value elements and the maximum number of patients, and used this framework to estimate daily drug prices. ResultsFour base value elements and 8 additional elements were identified. We applied our scoring criteria to calculate scores for 39 drugs already listed in Japan and estimated the daily drug price of each drug by creating a conversion table of base drug prices according to base points and maximum number of patients and adding points for additional elements. For all hepatitis C drugs, the estimated daily drug prices were lower than the actual prices, whereas for the other drugs, they were higher or, in some cases, lower. ConclusionOur VBP framework comprises 4 steps: 1. gathering information on value elements; 2. scoring value elements; 3. calculating the base drug price from the base points and the maximum number of patients by using the conversion table; and 4. calculating the daily drug price by adding points for additional value elements. Our framework, which we refer to as MARIE (multiple criteria qualitative value-based pricing framework), is a versatile, practical, and simple option for pricing new drugs that can be easily adapted to different healthcare environments. Public Interest SummaryDrug prices do not necessarily reflect the values provided by drugs in Japanese current drug pricing system. It is not fully discussed how to quantify the value of drugs for prices by considering a broad range of value elements. We created and evaluated VBP method for drug pricing that would be applicable in Japan considering the current pharmaceutical regulations, medical environment, and availability of data at the timing of pricing negotiation process for new drugs. The study summarizes the value elements to be considered in determining drug prices and proposed VBP framework. It also revealed that qualitative factors can be used for drug pricing. Our proposed approach for drug pricing system enables to capture and reflect broader values of new drug.

Delphi Consensus Recommendations for the Development of the Emergency Medicine Point of Care Ultrasound (POCUS) Curriculum in Nepal.

Introduction: Emergency Medicine Point of Care Ultrasound (EM-POCUS) is a diagnostic bedside tool for quick and accurate clinical decision-making. Comprehensive training in POCUS is a mandatory part of EM training in developed countries. In Nepal, we need to build an educational curriculum based on the local medical system, available resources, and educational environment. We used the modified Delphi method to develop a EM-POCUS curriculum. Methods: We formed an EM-POCUS core working group based on expertise in key identified areas. The core working group developed criteria for expert panelist selection and synthesized the data for panelists after each Delphi round. We recruited 46 expert panelists to participate in a series of electronic surveys. The literature review and the results of the first Delphi round identified a set of competencies. Quantitative methodology was performed for subsequent surveys. Data analysis of the frequency, percentage, median, and interquartile range of the 9-point Likert scale was performed. We deemed a minimum threshold of 80% agreement to retain items across Delphi rounds. The result of every round was disseminated before subsequent rounds for the expert panelists to review responses in light of the group's response. Results: We identified 10 specific global competency categories and 132 objectives (Round 1, response rate 85%). Rounds 2 and 3 (response rates 78% and 81% respectively) developed consensus on 45 core objectives (34%). The list of EM-POCUS competencies with the median (IQR) was finalized. Conclusion: This expert, consensus-generated EM-POCUS curriculum provides detailed guidance for EM-POCUS education and applications in clinical practice in Nepal.

Completion Rate and Satisfaction With Online Computer-Assisted History Taking Questionnaires in Orthopedics: Multicenter Implementation Report.

Collecting the medical history during a first outpatient consultation plays an important role in making a diagnosis. However, it is a time-consuming process, and time is scarce in today's health care environment. The computer-assisted history taking (CAHT) systems allow patients to share their medical history electronically before their visit. Although multiple advantages of CAHT have been demonstrated, adoption in everyday medical practice remains low, which has been attributed to various barriers. This study aimed to implement a CAHT questionnaire for orthopedic patients in preparation for their first outpatient consultation and analyze its completion rate and added value. A multicenter implementation study was conducted in which all patients who were referred to the orthopedic department were invited to self-complete the CAHT questionnaire. The primary outcome of the study is the completion rate of the questionnaire. Secondary outcomes included patient and physician satisfaction. These were assessed via surveys and semistructured interviews. In total, 5321 patients were invited, and 4932 (92.7%) fully completed the CAHT questionnaire between April 2022 and July 2022. On average, participants (n=224) rated the easiness of completing the questionnaire at 8.0 (SD 1.9; 0-10 scale) and the satisfaction of the consult at 8.0 (SD 1.7; 0-10 scale). Satisfaction with the outpatient consultation was higher in cases where the given answers were used by the orthopedic surgeon during this consultation (median 8.3, IQR 8.0-9.1 vs median 8.0, IQR 7.0-8.5; P<.001). Physicians (n=15) scored the average added value as 7.8 (SD 1.7; 0-10 scale) and unanimously recognized increased efficiency, better patient engagement, and better medical record completeness. Implementing the patient's answers into the electronic health record was deemed necessary. In this study, we have shown that previously recognized barriers to implementing and adapting CAHT can now be effectively overcome. We demonstrated that almost all patients completed the CAHT questionnaire. This results in reported improvements in both the efficiency and personalization of outpatient consultations. Given the pressing need for personalized health care delivery in today's time-constrained medical environment, we recommend implementing CAHT systems in routine medical practice.

Abstract 4136566: Primary Pericardial Mesothelioma: Diagnostic dilemma and rapid decline

Description of case: A 33-year-old man with no medical history or environment exposures, presented with dyspnea, nausea, and vomiting. He was tachycardic, with jugular venous distension, pulsus paradoxus, low voltage QRS and echocardiogram (TTE) showed a large pericardial effusion with ventricular interdependence. He underwent pericardiocentesis with negative fluid studies, including cytology. Two months later he represented with dyspnea and pleuritic chest pain, was diagnosed with pericarditis, and found to have recurrent pericardial effusion without tamponade. He was treated with aspirin and colchicine and discharged, with surveillance TTE showing a stable pericardial effusion but with significant adhesions and constrictive physiology (confirmed on right heart catheterization). Negative QuantiFERON was obtained and Anakinra started. Two months later he remained symptomatic with new pleural effusions and was sent for positron emission tomography scan which revealed diffuse intensely hypermetabolic pericardial thickening/fluid, up to 3.8 cm in maximal thickness and increased uptake in mediastinal nodes. Next, a cardiac MRI showed extensive circumferential thickening of the pericardial space approximately 2.5 cm in thickness. Both the visceral and parietal pericardium exhibited extensive scattered delayed hyperenhancement. Subsequent pericardial biopsy showed markedly fibrotic pericardium and pathology showed biphasic malignant pericardial mesothelioma. Immunosuppressive medications were stopped, and he underwent thoracentesis. After multidisciplinary discussions, he was started on nivolumab every two weeks and ipilimumab with a plan for surgery based on response to therapy. However, progressive symptoms and worsening constriction physiology led to palliative consultation and comfort care transition, with him dying shortly after. Discussion: Recurrent pericarditis and pericardial effusion, along with negative typical pericardial fluid studies, raised suspicion for a non-benign etiology. Multimodality imaging was employed and led to a pericardial biopsy. Constrictive pericarditis is an uncommon presentation of primary pericardial mesothelioma. Biphasic mesotheliomas from pleural or peritoneal origins are normally treated with systemic therapy with preference for combined immunotherapy. Primary pericardial mesothelioma is associated with a late presentation and high mortality rate, with surgery, if able to be done early appearing to be the recommended approach.

Does financing for private maternity services improve birth experiences in Poland? A mixed-methods study of the Babies Born Better Survey.

Women in Poland, despite having access to publicly-funded medical care during pregnancy, childbirth and the postpartum period, frequently use private care. Women's experience and satisfaction with childbirth have been considered one of the key indicators of the quality of care. In this study we explore whether and how paying for private childbirth services affects women's experiences and satisfaction with care. The qualitative portion seeks to understand how individual women construct meaning around their childbirth experiences, including their relationships with healthcare personnel, medical interventions, birth environment, and professionalism. This mixed-methods study is based on data from 951 online questionnaires completed by women who gave birth between June 2017 and June 2022, in Poland. This study is part of the international Babies Born Better Survey project. The project used simultaneous quantitative and qualitative data collection, it was exploratory with equivalent status of qualitative and quantitative data. Quantitative data were analyzed descriptively and chi-squared tests were conducted to compare women who used private and public care. Qualitative data were analyzed using inductive thematic analysis. The quantitative and qualitative results were integrated, in accordance with the chosen mixed-methods design. There were no major differences in sociodemographic characteristics (except living standards), health status and satisfaction with labor between women who paid for private services during childbirth and those who used only publicly-funded care. For both groups of women, healthcare personnel and their behavior were the most frequently mentioned aspect shaping childbirth experiences. Other important aspects were: medical interventions, birth environment, and staff professionalism. Although accessing private perinatal services care did not provide women with care consistent with their expectations, women put a lot of trust into private services as a means to receive more attentive care. Further research investigating the interplay between private and public services is needed to explore the question how private services may impact the care women receive and why women put so much trust in these services.

Evaluation of Medical College Learning Environment: A students' Perception of University College of Medicine &amp; Dentistry, University of Lahore

Background: The educational setting in medical schools influences education quality and student satisfaction. Knowing students' views on learning environment is crucial as more enroll in private medical colleges. This study assesses the learning environment of University College of Medicine &amp; Dentistry, University of Lahore, through students' perspectives using the John Hopkins Learning Environment Scale. The aim is to identify areas for enhancement and improve the educational experience.Objective: The objective of current study was to assess the perception of medical and dental undergraduate students about their learning environment at Medical and Dental College of University of Lahore.Materials and Methods: This analytical Cross-sectional study was conducted in University College of Medicine &amp; Dentistry, University of Lahore. The Study was conducted from 12 April 2022 to 22 October 2022. Sample of the study was 214 medical and dental students. Data was collected using Johns Hopkins Learning Environment Scale (JHLES). Independent sample t test was used to explore the difference of MBBS and BDS students' perception about learning environment.Results: A significant difference was found between the perception of medical and dental students in terms learning environment (t=2.45, P=.015). Perception of medical students about the learning environment of was more positive (92.57±10.03) as compared to dental students (89.22±9.97).Conclusion: Medical students of University College of Medicine &amp; Dentistry, The University of Lahore perceived learning environment more positive as compared to dental students. This is due to the better quality of physical space and facilities available for medical students compared to dental students.Keywords: Community of peers, Dental students, Johns Hopkins Learning Environment Scale (JHLES), Medical students, Physical space,

Prehospital ultrasound constitutes a potential distraction from the observation of critically ill patients: a prospective simulation study

BackgroundPrehospital point-of-care ultrasound allows an unstable patient to be rapidly and accurately assessed. However, we are concerned that an excessive focus on the ultrasound device, in an already demanding emergency medical service environment, may distract from patient care, potentially leading to reduced situational awareness and the neglect of other crucial instruments, such as the patient monitor. Thus, in this study, we examined the influence of prehospital ultrasound on situational awareness, by studying the degree to which physicians were distracted from the patient monitor.MethodsWe observed HEMS physicians in a simulated setting and analysed their gaze behaviour using an eye tracker placed on three areas of interests: the ultrasound device, the patient and the patient monitor. In the course of the experiment, the simulated patient desaturated, which was presented on the patient monitor. The primary outcome was the fraction of gaze distribution across the three areas of interest, while secondary outcomes were different gaze metrics (dwell time, revisits, average duration of visual intake and entry time) on the patient monitor. We then compared the participants who noticed the patient’s deterioration with those who did not.ResultsIn 75% of cases, the severely decreased oxygen saturation went unnoticed during the test. Moreover, the gaze distribution of the two groups differed, with the group that recognised the deterioration focusing longer on the patient monitor (7.8% (95% CI 5–10.7) vs 0.1% (95% CI 0–0.3), p: 0.124).ConclusionsThe task of performing an ultrasound examination appears to overwhelm some participants and distract them from other aspects of the scenario. Efforts to mitigate distractions and optimise the use of prehospital ultrasound, such as education, a focus on human factors aspects and standardisation, are crucial for maximising the potential benefits of prehospital ultrasound.

The impact of artificial intelligence in the diagnosis and management of acoustic neuroma: A systematic review.

Schwann cell sheaths are the source of benign, slowly expanding tumours known as acoustic neuromas (AN). The diagnostic and treatment approaches for AN must be patient-centered, taking into account unique factors and preferences. The purpose of this study is to investigate how machine learning and artificial intelligence (AI) can revolutionise AN management and diagnostic procedures. A thorough systematic review that included peer-reviewed material from public databases was carried out. Publications on AN, AI, and deep learning up until December 2023 were included in the review's purview. Based on our analysis, AI models for volume estimation, segmentation, tumour type differentiation, and separation from healthy tissues have been developed successfully. Developments in computational biology imply that AI can be used effectively in a variety of fields, including quality of life evaluations, monitoring, robotic-assisted surgery, feature extraction, radiomics, image analysis, clinical decision support systems, and treatment planning. For better AN diagnosis and treatment, a variety of imaging modalities require the development of strong, flexible AI models that can handle heterogeneous imaging data. Subsequent investigations ought to concentrate on reproducing findings in order to standardise AI approaches, which could transform their use in medical environments.

Exploring the barriers to the development of organizational health literacy in health institutions to meet the needs of older patients from multiple perspectives: a mixed-methods study

BackgroundThe latest evidence on health literacy in China revealed that only 8% of individuals aged 65–69 years, a segment of the geriatric population, possess adequate health literacy levels, indicating a low level in China. Studies have demonstrated that improving the organizational health literacy of healthcare institutions is a crucial approach to addressing low health literacy among older patients.ObjectiveTo explore the obstacles hindering the advancement of organizational health literacy in healthcare institutions in meeting the needs of older patients.DesignA mixed-methods approach was employed to investigate both the status and barriers to the establishment of organizational health literacy within two healthcare institutions.ParticipantsParticipants included older individuals aged over 60, clinical staff, and managerial personnel from these two health institutions.MethodsThis research utilized the social-ecological model as its theoretical foundation and utilized a mixed-methods approach to examine the current status and challenges in developing organizational health literacy within healthcare institutions. Initially, a survey using a questionnaire (n = 178) was conducted among older patients to evaluate the establishment of organizational health literacy from their perspective. Following this, interviews (n = 22) were carried out with administrators, clinical personnel, and elderly patients to identify the barriers hindering the development of organizational health literacy within healthcare institutions.ResultsQuantitative research indicates that health institutions have been less accommodating to the requirements of older patients, with health information dissemination and communication emerging as the weakest areas. Qualitative investigations revealed three key influencing factors: patient-related factors, including physiological and cognitive decline, as well as low educational attainment among older patients; organizational factors, including inadequate clinical staff numbers, deficient long-term systematic training, and a digital divide resulting from health institutions’ digital advancements; and policy-related factors indicating a lack of regulations governing the establishment of organizational health literacy within healthcare institutions.ConclusionThe two most vulnerable aspects of OHL in medical institutions regarding the needs of older patients are health information and communication. The factors influencing the construction of OHL in medical institutions are multifaceted, encompassing micro, meso, and macro levels. At the macro level, it is essential for medical institutions to enhance leadership awareness of OHL and to incorporate its development into institutional strategic plans. At the meso-level, medical institutions should be made to optimize the medical environment for elderly patients and to prioritize health literacy training for medical staff. At the micro level, attention must be given to the characteristics and needs of elderly patients. Ultimately, by implementing a comprehensive construction of intervention strategies, the response ability of medical institutions to the needs of elderly patients can be enhanced.

Study on the mechanical properties and gamma/neutron radiation shielding performance of SnBi/B4C composite materials

The development of multifunctional shielding materials has become a hot research topic with the increasing requirements for radiation protection materials in terms of performance, weight and non-toxicity. In this study, non-toxic SnBi/B4C composites with different B4C contents (0, 3, 6, 9, 12 and 15 wt%) were successfully prepared by powder metallurgy, and their mass attenuation coefficients, half-value layers, mean free paths, effective atomic numbers, and 0.025 eV thermal neutron shielding performance. The results show that B4C plays a key role in regulating the mechanical properties and thermal neutron shielding properties of SnBi/B4C composites. When the B4C content was 9 wt% (S3), the integrated mechanical properties of the composites were optimal, and the yield strength, tensile strength, and microhardness were enhanced by 31 %, 32 %, and 129 %, respectively, compared with those of the samples without B4C. The radiation shielding effect is remarkable, the gamma-ray shielding performance in the energy range of 0.03–0.08 MeV is better than that of Pb. Meanwhile, the S3 sample with only 3 mm thickness can shield 99.7 % of thermal neutrons, while the shielding rate of the S0 sample without B4C is only 5.2 %. Comprehensive analyses show that the SnBi/B4C composites are superior in terms of environmental protection, mechanical properties, gamma-ray and thermal neutron shielding, with lighter weight and safer use. This finding provides a theoretical basis for the selection of efficient, non-toxic and diverse radiation shielding materials for medical and other special environments.

Workplace violence as a predictor of suicidal ideation in undergraduate internal physicians

The environments in which doctors in training operate have been distinguished by being rigid, hostile and routine. There is scientific evidence that people who are victims of workplace violence are more likely to suffer from depression, a disorder that has been associated with suicidal ideation. To predict suicidal ideation as a function of depressive symptoms and workplace violence in undergraduate internal physicians. The quantitative method was used through a non-experimental, cross-sectional, explanatory design with non-probabilistic convenience sampling. 117 medical students who were doing their internship in health centers in Sonora, Mexico participated. Participants responded to the Workplace Violence Scale (Mobbing), the Beck Depression Inventory, and the Beck Suicidal Ideation Scale. A high perception of workplace violence, moderate levels of depression and low levels of suicidal ideation were identified; Workplace violence was positively and significantly associated with depression and suicidal behavior. Furthermore, it was found that violence provides more explanation for suicidal behavior compared to depression. The predictive role of workplace violence in the suicidal behavior of undergraduate internal physicians is confirmed. Highlights the importance of developing prevention and intervention programs to reduce workplace violence in medical training environments.

Reflections and Practice on the Development of Co-construction between Doctors, Nurses and Patients through Evidence-based Narrative Exploration of Traditional Chinese Medicine

Abstract Traditional Chinese medicine (TCM) is the wisdom crystallization and cultural treasure of the Chinese nation. Establishing a positive relationship among doctors, nurses, and patients is essential for promoting the sustainable development of TCM culture. As an important branch of evidence-based narrative medicine, evidence-based narrative of TCM significantly contributes to the co-construction of doctors, nurses and patients. This paper discusses the necessity and clinical practice value of promoting co-construction of doctors, nurses and patients based on the principles of evidence-based narrative TCM. By working together to select optimal diagnosis and treatment options, we aim to enhance patient compliance, alleviate tensions among the parties involved, and establish equitable collaborative relationships. Creating a harmonious medical environment is crucial for promoting the continuous development of this collaborative model in clinical practice, thereby improving patients' overall health, increasing public recognition of TCM, and supporting its sustainable growth.

A Survey on Emerging Trends and Applications of 5G and 6G to Healthcare Environments

A delay, interruption, or failure in the wireless connection has a significant impact on the performance of wirelessly connected medical equipment. Researchers presented the fastest technological innovations and industrial changes to address these problems and improve the applications of information and communication technology. The development of the 6G communication infrastructure was greatly aided by the use of Block-chain technology, artificial intelligence (AI), virtual reality (VR), and the Internet of Things (IoT). In this paper, we comprehensively discuss 6G technologies enhancement, its fundamental architecture, difficulties, and other issues associated with it. In addition, the outcomes of our research help make 6G technology more applicable to real-world medical environments. The most important thing that this study has contributed is an explanation of the path that future research will take and the current state of the art. This study might serve as a jumping-off point for future researchers in the academic world who are interested in investigating the possibilities of 6G technological developments.

Research and application of heteroskedasticity diagnostic method of matrix factor modeling

Abstract Matrix-type time series data are widely used in the fields of finance, medical environment, etc. Matrix factor models can effectively downscale such data and reveal their underlying structures. Based on the popular matrix factor model, this paper proposes a diagnostic method for its heteroskedasticity and verifies the effectiveness of the method through numerical simulation. Finally, this paper applies the method to Fama-French portfolio data and finds heteroskedasticity, so that a matrix factor model based on heteroskedasticity can be considered for analyzing this data, thus improving the robustness of the analysis results.

Cascaded redundant convolutional encoder-decoder network improved apnea detection performance using tracheal sounds in post anesthesia care unit patients

Objective. Methods of detecting apnea based on acoustic features can be prone to misdiagnosed and missed diagnoses due to the influence of noise. The aim of this paper is to improve the performance of apnea detection algorithms in the Post Anesthesia Care Unit (PACU) using a denoising method that processes tracheal sounds without the need for separate background noise.Approach. Tracheal sound data from laboratory subjects was collected using a microphone. Record a segment of clinical background noise and clean tracheal sound data to synthesize the noisy tracheal sound data according to a specified signal-to-noise ratio. Extract the frequency-domain features of the tracheal sounds using the Short Time Fourier Transform (STFT) and input the Cascaded Redundant Convolutional Encoder-Decoder network (CR-CED) network for training. Patients' tracheal sound data collected in the PACU were then fed into the CR-CED network as test data and inversely transformed by STFT to obtain denoised tracheal sounds. The apnea detection algorithm was used to detect the tracheal sound after denoising.Results. Apnea events were correctly detected 207 times and normal respiratory events 11,305 times using tracheal sounds denoised by the CR-CED network. The sensitivity and specificity of apnea detection were 88% and 98.6%, respectively.Significance. The apnea detection results of tracheal sounds after CR-CED network denoising in the PACU are accurate and reliable. Tracheal sound can be denoised using this approach without separate background noise. It effectively improves the applicability of the tracheal sound denoising method in the medical environment while ensuring its correctness.