Medical Practice Research Articles

Addressing the Decline in Clinical Skills: A Call for Comprehensive Educational Reform

Despite technological advances, clinical skills are the foundation of medical practice. Taking a comprehensive clinical history, performing physical examinations, and communicating effectively are crucial for high-quality patient care. Medical students need to focus on developing strong clinical skills to ensure they are well-prepared for their careers and adapt to the evolving field of medicine through continual practice and refinement.1 The medical community is worried about declining essential clinical skills among undergraduate medical students.2,3 This editorial aims to analyze the reasons for the decline and suggest evidence-based methods to address the situation. 05885.0258063. The declining standards of clinical skills among medical students can be attributed to the widespread adoption of technology-based learning, which has the potential to diminish the importance of traditional hands-on bedside teaching.4 Technology should enhance, not replace, practical clinical experiences. Practical training improves the clinical abilities, expertise, and self-assurance of medical students.5 Moreover, the growing magnitude and expansion of medical curricula provide difficulties in the development of educational programs without ample time for bedside practical teaching.6,7 There is frequently an excessive focus on remembering facts rather than on cultivating clinical reasoning abilities.8 The reduced patient interaction during medical school, due to increased reliance on simulations and less time in clinical rotations and bedside teaching, hampers the development of clinical skills.9 External factors such as limited time and extensive paperwork may affect the quality of patient encounters. Efficient communication is crucial for building good relationships with patients, obtaining accurate medical histories, and ensuring patient understanding and adherence to treatment.9 Insufficient training in communication skills can result in less-than-ideal interactions between patients and healthcare providers and can also contribute to errors in diagnosis and medical treatment.10 The provision of trained faculty for teaching medical students is an issue worldwide. Insufficient supervision and feedback during clinical rotations hinder the development of essential clinical skills.11 Larger student cohorts reduce the opportunities for individual students to practice and receive personalized instruction in clinical skills.12 Medical education often prioritizes theoretical testing over practical examinations and undervalues communication skills training. Variability in clinical experiences at different medical schools can lead to inconsistencies in skill acquisition. The scarcity of skilled clinicians as role models impacts students’ learning. Economic constraints and modern healthcare pressures limit opportunities for thorough patient interactions and clinical training.13 THE WAY FORWARD Educational institutions should prioritize hands-on clinical experiences throughout the curriculum to improve students’ diagnostic and communication abilities. These experiences should include simulation-based learning, standardized patients, and longitudinal clerkships. Faculty members need support and resources for effective clinical mentorship and development. Reflective practice should be integrated into the curriculum to enhance self-awareness and critical thinking. Open communication and mentorship programs between students and faculty can strengthen medical training and promote continual learning. To address declining clinical proficiency among medical students, institutions can adopt evidence-based approaches including curriculum changes, faculty training, promoting reflective thinking, collaboration among healthcare professionals, and fostering a culture of ongoing learning. Regulatory bodies should ensure adequate time for bedside teaching and appropriate assessment weightage.

Utilization of Euphemism in Conveying Negative Information: A Mixed-Methods Case Study

While euphemism has been extensively studied, there remains a gap in the literature regarding its use by physicians with critically ill patients during consultations, as well as medical students' perceptions of this practice. This present mixed-methods case study addresses this gap by examining the forms of euphemistic language employed by doctors with critically ill patients and exploring medical student’s perspectives on this use. Findings reveal that physicians utilize euphemisms to emphasize positive aspects, employ softer terminology, and omit frightening details when communicating with critically ill patients. Medical students perceive this practice as valuable for minimizing patient stress and facilitating comprehension of information. of information. These findings have significant implications for medical practice and education. For practitioners, a nuanced understanding of euphemisms language can enhance patient-doctor communication, particularly in sensitive contexts, by mitigating anxiety and fostering a more supportive atmosphere. For medical educators, incorporating training on the effective use of euphemisms into curricula can better equip future physicians to navigate difficult conversations with empathy and clarity. This study also highlights the need for continued research into communication strategies within healthcare to ensure their alignment with both ethical principles and the emotional well-being of patients.

Treatment of Allergies to Fur Animals

Allergy to fur animals is becoming an increasingly common clinical problem in everyday medical practice. Depending on the route of exposure to the allergen, patients present with many, often non-specific symptoms. The most common illnesses among people with allergies to the above-mentioned allergens are as follows: allergic rhinitis, allergic conjunctivitis, atopic bronchial asthma, food allergy, allergic contact dermatitis, and sometimes anaphylactic shock. In recent years, there has been a change in the holistic approach to the treatment of allergy patients. The method of treatment should be tailored to a specific patient, taking into account his or her predispositions, economic possibilities, and therapeutic goals. The article describes the main methods of treating allergies, focusing primarily on allergies to fur animals. Allergy treatment always requires great care, and qualification for specific types of therapy should be preceded by a thorough and accurate diagnosis.

Advancing Community Well-being through innovative Pharmacies: A European Perspective

The project’s goal is to gain knowledge of how European pharmacies integrate technology and personalized healthcare in order provide better health care services to the community. To identify patterns and trends, descriptive statistics were utilized to make assumptions about the data from various trees. The principal finding is that important takeaways underscore the importance of tailored services and technology deployment in current medical practice, indicating that both of them have the greatest influence on improving patient outcomes and community health. The report’s suggestions emphasize techniques for promoting pharmacy practice innovation. The measures also include the promotion of worker training and collaborative efforts to address sector-specific issues.

Crisis resilience in medical practices and clinics

Climate change because of anthropogenic greenhouse gas emissions increasingly triggers extreme weather events. Of all the continents, Europe is warming the fastest. Heat and drought, forest fires and floods will worsen in Europe even in optimistic global warming scenarios, affecting living conditions across the continent. Extreme weather events threaten energy and food security, ecosystems, infrastructure, water resources, financial stability, and people's healthcare. Many of these risks have already reached critical levels and could take on catastrophic proportions without immediate, decisive action. This paper outlines current challenges for medical practices and clinics in the context of climate change and provides examples and guidance for strengthening crisis resilience. Selective literature review on the different requirements for crisis resilience in practices and clinics was performed. Medical practices and clinics achieve crisis resilience by high degrees of adaptability and flexibility. They prepare for climate change-related challenges and are, therefore, able to protect themselves and maintain their function in the healthcare system. Recent weather events in Germany revealed insufficient resilience among the healthcare sector; hence, improvements are necessary. Changing environmental conditions urgently require the healthcare sector to adapt and effectively strengthen crisis resilience in order to ensure that critical infrastructure remains functional and the population has access to healthcare.

Sexual and reproductive health in men with spinal cord injury

Introduction. Sexual health is a fundamental aspect of overall well-being, quality of life, and a sense of fulfillment. A significant percentage of men with spinal cord injury (SCI) experience ejaculatory issues (95%), poor semen quality (75%), and erectile dysfunction (80%), making it impossible for them to conceive without medical assistance. Material and methods. The bibliographic resources were analyzed and selected from databases such as PubMed, SCOPUS, HINARI, and Web of Science to identify studies on the desired topic. Following the initial research, 128 items were identified, and 32 representative articles were selected for this synthesis article. Results. Damage to the spinal cord can result in partial or complete loss of function below the level of the injury. These injuries lead to impaired ejaculatory and erectile function in addition to reproductive issues, which might include abnormal sperm motility, morphology, and viability, as well as reduced spermatogenesis. Challenges such as loss of bladder and bowel function, changes in physical appearance, spasms, lack of communication, and stereotypes can affect sexual life of men with SCI. Conclusions. Studying sexual dysfunction in disabled men is essential for promoting comprehensive healthcare, supporting mental health, fostering healthy relationships, and advocating for the rights and inclusion of individuals with disabilities. Understanding the mechanisms affecting sexual function in people with SCI is of particular practical interest both in medical practice and in subsequent studies on patients.

Predicting Alzheimer's disease CSF core biomarkers: a multimodal Machine Learning approach.

Alzheimer's disease (AD) is a progressive neurodegenerative disorder. Current core cerebrospinal fluid (CSF) AD biomarkers, widely employed for diagnosis, require a lumbar puncture to be performed, making them impractical as screening tools. Considering the role of sleep disturbances in AD, recent research suggests quantitative sleep electroencephalography features as potential non-invasive biomarkers of AD pathology. However, quantitative analysis of comprehensive polysomnography (PSG) signals remains relatively understudied. PSG is a non-invasive test enabling qualitative and quantitative analysis of a wide range of parameters, offering additional insights alongside other biomarkers. Machine Learning (ML) gained interest for its ability to discern intricate patterns within complex datasets, offering promise in AD neuropathology detection. Therefore, this study aims to evaluate the effectiveness of a multimodal ML approach in predicting core AD CSF biomarkers. Mild-moderate AD patients were prospectively recruited for PSG, followed by testing of CSF and blood samples for biomarkers. PSG signals underwent preprocessing to extract non-linear, time domain and frequency domain statistics quantitative features. Multiple ML algorithms were trained using four subsets of input features: clinical variables (CLINVAR), conventional PSG parameters (SLEEPVAR), quantitative PSG signal features (PSGVAR) and a combination of all subsets (ALL). Cross-validation techniques were employed to evaluate model performance and ensure generalizability. Regression models were developed to determine the most effective variable combinations for explaining variance in the biomarkers. On 49 subjects, Gradient Boosting Regressors achieved the best results in estimating biomarkers levels, using different loss functions for each biomarker: least absolute deviation (LAD) for the Aβ42, least squares (LS) for p-tau and Huber for t-tau. The ALL subset demonstrated the lowest training errors for all three biomarkers, albeit with varying test performance. Specifically, the SLEEPVAR subset yielded the best test performance in predicting Aβ42, while the ALL subset most accurately predicted p-tau and t-tau due to the lowest test errors. Multimodal ML can help predict the outcome of CSF biomarkers in early AD by utilizing non-invasive and economically feasible variables. The integration of computational models into medical practice offers a promising tool for the screening of patients at risk of AD, potentially guiding clinical decisions.

Exploring antimicrobial resistance determinants in the Neanderthal microbiome.

The results of our analysis demonstrate the challenges in identifying determinants of antibiotic resistance within the endogenous microbiome of Neanderthals. Despite the comprehensive investigation of multiple studies and the utilization of advanced analytical techniques, the detection of antibiotic resistance determinants in the ancient microbial communities proved to be particularly difficult. However, our analysis did reveal the presence of some authentic ancient conservative genes, indicating the preservation of certain genetic elements over time. These findings raise intriguing questions about the factors influencing the presence or absence of antibiotic resistance in ancient microbial communities. It could be speculated that the spread of current antibiotic resistance, which has reached alarming levels in modern times, is primarily driven by anthropogenic factors such as the widespread use and misuse of antibiotics in medical and agricultural practices.

Simulation in admissions interviews: applicant experiences and programmatic performance prediction

Background: Admissions interviews are frequently used to assess personal and interpersonal attributes required for successful medical practice. Using simulation in interviews to engage applicants in realistic medical scenarios to assess these attributes is novel. This study evaluates applicant perceptions of simulation within multiple mini-interviews (MMI) and reports on subsequent student program performance. Methods: Physician assistant (PA) program applicants were invited to complete an anonymous post-interview survey that included one free-response question about their admissions experience. We chose to qualitatively analyze the free-response question. Additionally, success metrics of students who experienced simulation-based MMI were compared to prior cohorts who were admitted using traditional interviews. Results: Applicants undergoing simulation-based interviews in MMI had decreased incidences of major professionalism events, greater on-time program progression, and similar board pass rates compared to applicants who experienced traditional interviews. Several themes, highlighting the applicants’ varied responses to the simulation-based MMI, emerged including showcasing strengths and passion, feelings of fairness, accessing program faculty, and impacts on certainty. Conclusions: The use of simulation in admissions interviews is a valuable tool for assessing an applicant’s personal attributes in a clinical setting. Applicants admitted using simulation had improved programmatic performance compared to applicants admitted using traditional interviews. Applicants’ perceptions of simulation in interviews are helpful when designing the admissions experience.

What Questions Do Patients Ask About Biologic Therapies for Chronic Sinusitis With Nasal Polyps?

Objective: The objective of this study is to explore the questions commonly asked online about biologic therapies for use in treatment of chronic sinusitis with nasal polyps (CRSwNP) and the quality of the available content. Methods: Most common search terms were identified via Google Trends. People Also Ask (PAA) questions were identified and extracted with their associated website using an online data-scraping program [Search Engine Optimization (SEO) Minion, Keywords Everywhere]. Sources were evaluated using Flesch Kincaid Grade Level (FKGL) and Flesch Reading Ease (FRE, higher number = better) score for readability; Journal of American Medical Association (JAMA) Benchmark criteria for quality assessment (0-4, 4 = all criteria met). Results: A total of 143 unique PAA questions and unique websites were identified. Questions were organized into 3 categories: questions about biologic therapies overall (38.46%), about CRSwNP (37.76%), and about treatment options for CRSwNP (23.78%). Websites answering PAA questions were from commercial (60.14%), medical practice (13.99%), academic (13.29%), and government (12.59%) sources. FKGL scores found the average reading level to be at approximately a 12th grade level (SD = 3.297) alongside a low reading ease FRE score of 37.6 (SD = 16.77). Mean JAMA criteria scores were 0.9895 (SD = 0.848), indicating largely low-quality materials. Conclusion: Biologic therapies are a novel treatment option for CRSwNP, and participants are seeking more information about these treatments and disease state. Online resources regarding biologics should be presented at a lower reading level. Sources with evidence-based information are needed. Physicians should be aware of these limitations in online material and counsel accordingly by curating and directing patients to good sources.Level of Evidence: Step 4.

The interrelation of scientific, ethical, and translational challenges for precision medicine with multimodal biomarkers – A qualitative expert interview study in dermatology research

This qualitative study examines the impact of scientific, ethical, and translational challenges of precision medicine for atopic dermatitis and psoriasis. The study explores how these challenges affect biomarker research for inflammatory skin diseases as identified by stakeholders, including patient board representatives, pharmaceutical industry partners, and postdoctoral and senior researchers from multiple disciplines in biomarker research. We recruited participating experts both within and associated with the international Biomarkers in Atopic Dermatitis and Psoriasis (BIOMAP) consortium to ensure representation of the different organizational units of the consortium. For the study, we followed the COREQ checklist. The interviews were conducted using GDPR-safe online platforms and the pseudonymized transcripts were analyzed using Atlas.ti. We analyzed the interviews from participants' personal experiences, topic-oriented, and group specific to identify the main themes presented in this article. The findings were presented to peers and to the wider BIOMAP audience, discussed, and a draft was circulated within the consortium for feedback. In this study, we identify and discuss the interrelation of challenges that are relevant to improving precision medicine with multimodal biomarkers. We show how scientific challenges can interrelate with ethical and translational issues, and explain these interdependencies and articulate epistemic and social factors of interdisciplinary collaboration. Based on our findings, we suggest that including patient representatives’ perspectives is crucial for highly interrelated and widely diverse research. The proposed integrative perspective is beneficial for all involved stakeholders. Effective communication of science requires reflection on the tension between scientific uncertainty and the goals of precision medicine. Furthermore, we show how changing the perception of the diseases, atopic dermatitis, and psoriasis can benefit patients beyond medical practice.

Features of the use of art therapy in working with members of military families

The article is devoted to the analysis of the peculiarities of the use of art therapy in working with members of military families. The concepts of art therapy, social adaptation, and coping resources are characterized. The concept of grief and its course during war, in particular when a loved one is lost in war, is defined. The results of an empirical study on the severity of anxiety, depression and post-traumatic growth of women who lost relatives in the war are presented. The art therapy technique "Painting grief" is characterized. The purpose of this article is to determine the possibilities of using art therapy in working with military family members. The tasks of the article are to define the concept of grief and its course during war, in particular when a loved one is lost in war; analysis of the results of an empirical study on the severity of anxiety, depression and post-traumatic growth of women who lost relatives in the war, an outline of the possibilities of implementing the art therapy technique "Painting grief". To achieve the goals of the study, we used the following methods: Hospital anxiety and depression scale (HADS) Post-traumatic growth questionnaire (PGI). The hospital scale of anxiety and depression is designed to assess the severity of depression and anxiety in the conditions of general medical practice, contains 14 items, each of which corresponds to 4 options of answers that reflect the degree of increase in the corresponding symptomatology: normal, borderline state, moderately expressed anxiety/depression, severe form of anxiety /depression. Questionnaire of post-traumatic growth (R. Tadeshi and L. Calhoun) contains 21 statements with six possible answer options that form five scales: attitude to others, new opportunities, personal strength, spiritual changes, increased value life, as well as the general index of post-traumatic growth. According to the HADS method, subclinically expressed depression, the so-called borderline state, was detected, however, in the case of the death of a loved one in the war, relatives feel moderately expressed anxiety, while after death from diseases or simply death in civilian life, relatives note the absence of reliably expressed symptoms. Personal growth means the feeling that after a loss a person has become more merciful, tolerant towards himself and others, learned to forgive himself and the people around him, and look optimistically at the future. Although the loss of a loved one is a natural life event experienced by all people, it is also one of the most difficult experiences in a person's life. For many people, the loss of a loved one is accompanied by an intense emotional and devastating period. Experiencing the death of a loved one causes great stress both because of the loss and because of the encounter with mortality. Numerous stressors also occur when a bereaved person attends various events and services that are not normally included in the routine of daily life, including memorial services in a church. Many bereaved people find a path that leads to the restoration of a relatively normal life. However, some people do not cope effectively with loss. They experience grief very emotionally, often denying the fact of loss, trying to avoid reminders of death and helplessly focusing on the nagging waves of painful emotions. One of the effective methods of dealing with grief is art therapy.

Eligibility of sodium-glucose cotransporter-2 inhibitors in heart failure with preserved ejection fraction: Insights from the Colombian heart failure registry (RECOLFACA)

BackgroundThe value of Sodium-glucose cotransporter-2 inhibitors (SGLT-2 inhibitor) therapy in individuals with heart failure with preserved EF (HFpEF) was unknown until the EMPEROR-Preserved trial. We aimed to assess the proportion of patients with HFpEF that are eligible for empagliflozin therapy within the Colombian Heart Failure Registry (RECOLFACA). MethodsRECOLFACA enrolled adult patients with a HF diagnosis during 2017–2019 from 60 medical centers in Colombia. Criteria of the EMPEROR-Preserved Trial were used to recruit participants. The main outcome was individual eligibility with N-terminal pro-B-type natriuretic peptide (NT-proBNP) criteria, while the secondary outcome was eligibility without NT-proBNP data. ResultsRECOLFACA had 799 patients with HFpEF (mean age70.7 ± 13.5; 50.7 % males). According to the major selection criteria of the EMPEROR Preserved Trial, 73.7 % patients would be eligible for empagliflozin therapy initiation when considering the NT-proBNP threshold. The NT-proBNP threshold represented the main determinant of ineligibility in patients with this biomarker measure (13.6 %; n = 16). In patients without NT-proBNP data, the main reasons for exclusion were the diagnosis of symptomatic hypotension or a systolic blood pressure below 100 mmHg (7.5 %), having an eGFR < 20 ml/min/1.73 m2 (4.3 %), and haemoglobin < 9 g/dl (3.1 %). Excluding NT-proBNP criteria increased empagliflozin eligibility to 80.6 %. ConclusionMost patients with HFpEF from RECOLFACA are potential candidates for empagliflozin therapy initiation according to the EMPEROR-Preserved trial criteria. These findings favor the utilization of SGLT-2 inhibitor medications in daily medical practice, which may further decrease morbidity and mortality in HF patients, regardless of their EF classification.

A A arte como um instrumento para combater a psicofobia: relato de experiência sobre a oficina “Jornada da luta Antimanicomial”

The Brazilian anti-asylum movement has been intertwined with art over the decades, influencing the transformation of psychiatric care and psychosocial imaginary. However, the replacement of asylums with freedom-oriented care is jeopardized if there are no professionals who are part of and advocate for humanitarian mental health care. Therefore, it is extremely necessary to incorporate these themes into the education of future doctors. Thus, the report describes the realization of the “Anti-Asylum Movement Journey” at a private medical school, a workshop which took place on May 18th, National Anti-Asylum Day. It included a poetic soirée, an exploration of the history of art related to mental health, and creative proposals to engage users of the psychosocial care network. The event aims to recall the history of the anti-asylum struggle and reaffirm its necessity, utilizing art as the primary tool to explore ethics and policies that ensure visibility, inclusion, and assistance for mental health patients in their environment. As a result, participants learned the importance and methods of using art in healthcare, preparing them for a more sensitive, critical and politically engaged medical practice. The event also destigmatized and humanized the perception of mental illness in a strictly academic environment.

Проблема критериев приемлемости в биомедицинском эксперименте: философско-методологический анализ

Introduction. The formation and development of modern evidence-based medicine is not possible without clinical studies with the participation of humans as subjects. The methodology of such experiments is based on careful selection of subjects based on the so-called eligibility criteria – parameters which form the optimal patient group for studying the therapeutic properties of a particular drug based on the science community’s expectations. The article considers some bioethical aspects of the practical problems of formulating such criteria, and also it examines the question of the possibility of proper application of scientific data obtained in the framework of clinical studies. Theoretical analysis. Based on the example of HIV-positive patients, it is shown that excessive formalization of the process of determining eligibility criteria leads to the formation of fundamental differences between participants in clinical trials and patients in routine medical practice, which put at risk the ability to properly extrapolate the results of such studies outside the experimental field and realization of one of the basic bioethical principles of clinical trials: to be useful for society. Conclusion. The article substantiates the need to revise the methodological and bioethical foundations of the process of formulating eligibility criteria, taking into account the risks faced by patients of experimental therapy and patients in real clinical practice.

Current trends in the medical treatment of neuropathic low back pain: a Swedish registry-based study of 1.7 million people

BackgroundLow back pain, a common problem worldwide, causes more global disability than any other condition and is associated with high costs to society. This observational registry-based study describes the current trends in the medical treatment of neuropathic low back pain in the Swedish region of Västra Götaland, which has a population of 1.7 million. The study aims to; (1) identify the prevalence of neuropathic low back pain within the study population; (2) to explore the patterns of medical treatment utilization, including the prevalence and distribution of opioids (OG) and analgesics specified for neuropathic low back pain (NG) and (3) to evaluate the long-term trends and changes in medical treatment practice for neuropathic low back pain over the study period.MethodsThis study includes a descriptive analysis of aggregated data extracted from the Swedish primary care registry VEGA and the pharmaceutical prescription registry Digitalis between the years 2017 and 2021. The data were stratified by year, age, gender, pharmaceutical code (ATC), and sub-diagnoses and presented as the prevalence of unique patients retrieving prescribed medication within six months before or after a registered diagnosis of neuropathic low back pain. The pharmaceutical codes were furthermore grouped into two groups depending on their mechanism of action; opioid group (OG) and neuropathic group (NG).ResultsIn all four diagnosis groups, more patients used opioid analgesics than neuropathic analgesics. The greatest difference between the opioid group and neuropathic group was in the lumbar spinal stenosis diagnosis group (67.1% vs. 40.6%), followed by the lumbar root canal stenosis diagnosis (65.9% vs. 44.2%), the nerve root and plexus compressions in intervertebral disc disorders diagnosis (57.5% vs. 40.8%), and lumbago with sciatica diagnosis (38.4% vs. 22.7%).ConclusionsThe trends suggest a general increase in the prescription rate and therefore patients’ use of neuropathic analgesics for neuropathic pain associated with the studied diagnoses. However, opioid treatment remains the most common. The results indicate that the treatment for neuropathic low back pain needs to be improved.

Effectiveness of teaching motivational interview technique to third professional year medical students to improve counseling skills – An interventional study

Abstract Background: Effective patient–provider communication was recognized as essential to providing high-quality medical care. In medical practice, motivational interviewing (MI) is a vital communication method. By assisting patients in exploring and resolving ambivalence and resistance to change, this directive the patient-centered counseling approach seeks to elicit behavior change. Health behavior change counseling skills were taught as a learning objective in medical curricula worldwide. However, in many medical colleges, this area of health-care education was frequently unstructured and informal. Objective: This study aimed to find out if teaching medical students how to conduct motivational interviews helped them feel more confident about their ability to advise patients on changing their health-related behaviors, such as their breastfeeding habits in the present study. Methodology: All 200 third-year medical students of a medical college participated in MI sessions for health behavior change. Antenatal and postnatal mothers completed a pre- and posttest questionnaire before and after being educated by trained medical students; later, the students completed a perception questionnaire regarding their confidence. Data were analyzed using SPSS version 17, and student perceptions were presented as percentages. Results: The mean score (knowledge) of posttests (12.53) is higher than the mean score of pretests (9.23) which is statistically significant (P = 0.000). There was a role of health education for behavioral change in improving mothers' knowledge regarding breastfeeding, (antenatal and postnatal). Conclusion: The results of the present study demonstrated that teaching MI methods to third-year medical students could increase student confidence in giving patients advice about changing their health-related behaviors.

Metoda pomiaru temperatury ciała człowieka za pomocą kamery termowizyjnej

Measurement and monitoring of human physiological parameters play an important role in many applications such as health care, sports training and prevention of disease spread. Dynamic changes in physiological parameters can reveal not only changes in a patient’s physiological state and function, but also be used to assess a person’s activity status, fitness and fatigue. Body temperature is among the most important human physiological parameters for assessing basic vital functions, apart from heart rate, blood pressure and respiratory rate. In medical practice, various types of measuring instruments are used to measure temperature, such as liquid thermometers, electronic thermometers, non-contact ear thermometers, non-contact forehead thermometers. Liquid and electronic thermometers require the appropriate sensors to be connected to a person, which may be undesirable or impossible as, for example, in newborns or during sports training. Non-contact thermometers operate over short distances and often force a specific position of the person during the measurement. In addition, the above body temperature measurement techniques require direct supervision by medical personnel, which often reduces the effectiveness and efficiency of screening temperature measurement. In screening temperature measurements of a large number of people, especially those on the move, a measuring thermal imaging camera works well. The article presents a method for measuring human body temperature using a thermal imaging camera. The presented method is characterized by high accuracy of temperature measurement, which allows medical use of the obtained measurements. The measurement method has been tested on a test stand and for a selected test sample of people. The measurements and tests carried out confirmed the possibility of obtaining temperature measurement accuracy with an expanded uncertainty of less than 0.05 K with a resolution of less than 0.1 K.

An Examination of Students’ Perspectives of Medical English Course Quality in Guangdong Medical Universities

Phenomenon: In China, medical English courses are critical to medical education, equipping Chinese students with the linguistic tools necessary for international medical practice and collaboration. However, a disconnect persists between the pedagogical approaches of medical practitioners and language educators, leading to a curriculum that emphasizes grammatical accuracy over practical communication skills. This misalignment results in student disengagement and falls short of addressing the real-world demands of the medical profession. With the growing importance of English proficiency in the global health sector, the need for significant improvements in medical English education is evident. This study delves into the underlying causes of student demotivation and aims to reconcile educational delivery with the evolving expectations of the medical field. Insights gained from this research will inform targeted interventions, promising to enhance medical English courses and support improved educational experiences for Chinese medical undergraduates. Approach: This cross-sectional quantitative study surveyed 3,046 second-year medical students from four medical universities in Guangdong Province, China, leveraging means-analysis and Expectancy-Disconfirmation Theory (EDT) as its foundation. The research was conducted at the end of the 2022–2023 academic year, utilizing a questionnaire to assess students’ perceptions of their medical English courses. Importance-Performance Analysis (IPA) was the primary analytical tool to discern discrepancies between students’ expectations and experiences. Findings: The IPA revealed that course content, classroom environment, and instructor effectiveness were pivotal factors influencing the perceived quality of the medical English courses. Students expressed a need for practical and relevant course material, with current content and textbooks falling short of preparing them for future medical communication demands. Additionally, while learning technologies were acknowledged, there was a discernible preference against their excessive application, suggesting a misalignment between student satisfaction and learning outcomes. Insights: This study highlights the need for innovative staffing models, refined qualifications for part-time instructors, development of collaborative and practical teaching materials, and focused training for medical English instructors. It also emphasizes the judicious integration of e-learning to enhance the learning experience. These insights aim to improve instruction quality by informing potential pedagogical adjustments and resource allocations in medical English education.

Thymoquinone affects hypoxia-inducible factor-1α expression in pancreatic cancer cells via HSP90 and PI3K/AKT/mTOR pathways.

Pancreatic cancer (PC) is associated with some of the worst prognoses of all major cancers. Thymoquinone (TQ) has a long history in traditional medical practice and is known for its anti-cancer, anti-inflammatory, anti-fibrosis and antioxidant pharmacological activities. Recent studies on hypoxia-inducible factor-1α (HIF-1α) and PC have shown that HIF-1α affects the occurrence and development of PC in many aspects. In addition, TQ could inhibit the development of renal cancer by decreasing the expression of HIF-1α. Therefore, we speculate whether TQ affects HIF-1α expression in PC cells and explore the mechanism. To elucidate the effect of TQ in PC cells and the regulatory mechanism of HIF-1α expression. Cell counting kit-8 assay, Transwell assay and flow cytometry were performed to detect the effects of TQ on the proliferative activity, migration and invasion ability and apoptosis of PANC-1 cells and normal pancreatic duct epithelial (hTERT-HPNE) cells. Quantitative real-time polymerase chain reaction and western blot assay were performed to detect the expression of HIF-1α mRNA and protein in PC cells. The effects of TQ on the HIF-1α protein initial expression pathway and ubiquitination degradation in PANC-1 cells were examined by western blot assay and co-immunoprecipitation. TQ significantly inhibited proliferative activity, migration, and invasion ability and promoted apoptosis of PANC-1 cells; however, no significant effects on hTERT-HPNE cells were observed. TQ significantly reduced the mRNA and protein expression levels of HIF-1α in PANC-1, AsPC-1, and BxPC-3 cells. TQ significantly inhibited the expression of the HIF-1α initial expression pathway (PI3K/AKT/mTOR) related proteins, and promoted the ubiquitination degradation of the HIF-1α protein in PANC-1 cells. TQ had no effect on the hydroxylation and von Hippel Lindau protein mediated ubiquitination degradation of the HIF-1α protein but affected the stability of the HIF-1α protein by inhibiting the interaction between HIF-1α and HSP90, thus promoting its ubiquitination degradation. The regulatory mechanism of TQ on HIF-1α protein expression in PC cells was mainly to promote the ubiquitination degradation of the HIF-1α protein by inhibiting the interaction between HIF-1α and HSP90; Secondly, TQ reduced the initial expression of HIF-1α protein by inhibiting the PI3K/AKT/mTOR pathway.