Practice Of Medicine Research Articles

Homogenization Construction of Three-Level Teaching Bases for General Practice Medicine Under the Internet+ Model

With the continuous expansion of medical student enrollment, the number of clinical teaching bases is gradually increasing. However, there are significant differences in clinical teaching management models and teaching levels among different bases. Most clinical teaching bases have incomplete teaching management systems, inadequate teaching management institutions, insufficient teaching personnel, and inadequate implementation of teaching rules and regulations. This article combines the construction practice of three-level clinical teaching base of the General Medicine College and the First Affiliated Hospital of Xi’an Medical University. We establish a standardized management system for the three-level clinical teaching base; implement a teaching supervision system and strengthen the monitoring of teaching quality; adopt multiple evaluations to test the effectiveness of clinical teaching implementation; explore the path of homogenization construction of teaching bases in terms of unified teacher training, promoting the development of teacher teaching abilities with equal quality and excellence, and providing a reference for improving the quality of medical talent training.

#1377 Evaluation of state-wide health system implementation of renal supportive care shows substantial net benefits

Abstract Background and Aims In 2016, the New South Wales (NSW) Health system implemented a service to make the principles and practice of palliative medicine comprehensively available to patients receiving chronic kidney disease (CKD) care across NSW. Summative evaluation of the economic value that this multi-disciplinary State-wide RSC service provided following implementation was prospectively planned in the domains of patient experience and economic value. This abstract reports the first cost-benefit analysis of a RSC service. Method De-identified patient-level data was extracted from the NSW Renal Supportive Care Register (a linked dataset comprising admitted patient, non-admitted patient, emergency department episodes and death registrations). Data was compared between 2015/16, prior to implementation of the State-wide RSC service; and 2018/19, following settled operation of the service. A cost-benefit analysis model was constructed to estimate the economic value of the RSC service between 2015/16 and 2018/19; and the projected value to 2029/30 under different scenarios. Multivariate Cox regressions were estimated to measure survival benefits, and a polynomial regression model was employed to estimate the impact of RSC on the share of patients receiving dialysis. Results Considering the actual impact of the NSW RSC service; in 2015/16, 5% (n = 443) of all ESKD patients, (defined as receiving dialysis >3 months, non-dialysis conservative care or in receipt of a functioning transplant) received any RSC service. By 2018/19, 16% (n = 1460) of all ESKD patients had received RSC within NSW. The proportion of patients receiving RSC from a non-dialysis conservative care or dialysis context remained stable between 2015/16 and 2018/19 at 41% and 29% respectively. Patients receiving RSC were estimated to have increased survival by 3-21 weeks, depending on patient characteristics, compared to the scenario of no RSC service. Considering the projected value of ongoing RSC services; scenarios with different assumptions were modelled. Assuming that the proportion of patients receiving different ESKD modalities and the costs of care remained stable, the RSC service would deliver a net financial benefit to the commissioning health system (avoided costs of service minus RSC costs) of ${\$}$109 million Australian Dollars (AUD), with a return on investment of 212%, compared to the scenario of no RSC service. When the economic value for the whole NSW community from increased survival benefit was included, the projected value was ${\$}$275 million AUD, with return on investment of 535%. The projected economic value of RSC was modelled under scenarios of increasing access to the service by ESKD patients (Figure). Increasing RSC access from the achieved 16% to 20% of ESKD patients was projected to deliver maximal economic value, with a 3% fall in ESKD patients receiving dialysis, increasing survival benefit (${\$}$221 million AUD) and economic value ${\$}$94 million AUD. As access to RSC expands further, modelling indicates that additional dialysis substitution becomes less likely but benefits still accrue from survival up to a maximum viable rollout of 50% of the ESKD population receiving RSC, when survival benefits plateau. Conclusion Economic evaluation of this implementation of the Statewide RSC service across NSW Health shows it has been associated with both a net economic benefit and survival benefits four years after implementation. It is projected to provide an economic value of ${\$}$275 million AUD over ten years, which would increase with greater participation of ESKD patients suitable for RSC.

#2067 Prediction of gastrointestinal bleeding hospitalization risk in hemodialysis using machine learning techniques

Abstract Background and Aims INitiativeS on advancing Patients’ outcomes In REnal disease (INSPIRE) is an academia and industry collaboration set forth to identify critical investigations needed to advance the practice of medicine in nephrology. Gastrointestinal bleeding (GIB) is one of the most common types of bleeding events in the kidney dialysis population [1]. We aimed to develop a model to predict GIB hospitalization risk in a hemodialysis (HD) patient within 180 days. We evaluated advanced machine learning algorithm (XGBoost) and compared it to traditional machine learning algorithm (logistic regression) modeling techniques. Method We used data from a kidney care network from 2017 through 2020. We included data from adult dialysis patients (age ≥18 years). GIB related hospitalization was defined based on international classification of diseases (ICD) diagnosis codes recorded as the primary, secondary, or tertiary discharge reason for hospitalization. Two distinct models were created using XGBoost and logistic regression algorithms and using the same dataset. Both models were evaluated using metrics such as area under the receiver operating curve (AUROC), accuracy, sensitivity, and specificity. Missing data was imputed using mean for quantitative data and mode for qualitative data. The dataset then was randomly divided into 60% training, 20% validation and 20% test dataset. The test data, comprising unseen patients and data was used to evaluate the performance of the model. This means that the model had never encountered the test data during its learning phase, which included training the model and then validating the model. Results The incidence of 180-day GIB hospitalization was 1.12% in the HD population (n = 5 116 with GIB hospitalization/ n = 451 653 without GIB hospitalization), and consistent in the unseen test dataset (n = 465 with GIB hospitalization/ n = 38586 without GIB hospitalization). The XGBoost model showed higher predictive performance compared to logistic regression (Table). The AUROC was 0.72 (95% confidence interval (CI) 0.69, 0.74) for the XGBoost model. In comparison, the AUROC was 0.615 (95% CI 0.60, 0.64) for the logistic regression model. Specificity was 67% versus 58% for the XGBoost model versus logistic regression model respectively. However, sensitivity for both the models was 65%. The top predictors for major GIB were consistent in both models for many factors, yet some factors showed different importance on outcome prediction (Fig. 1). Higher risk of GIB hospitalization was associated with older age, lower ferritin levels, and recent all-cause hospitalizations in both models. The XGBoost showed high importance on outcome prediction for lower hemoglobin and higher serum 25 hydroxy (25OH) vitamin D values, and the logistic regression model showed high importance for higher amounts of saline delivered during an HD treatment and lower intact parathyroid hormone (iPTH) levels. Conclusion We found advanced machine learning prediction modeling (XGBoost) appears suitable for identifying a HD patient at risk for a GIB hospitalization in the next 180 days, and outperforms traditional machine learning (logistic regression) modeling techniques. Although both models showed identical sensitivity, the XGBoost model had higher specificity. Prospective testing is needed to confirm the model's performance. The association between bone mineral metabolism markers and GIB hospitalization risk is unexpected and warrants further investigation.

Phytochemical and Antioxidant Investigations of Extracts from the Leaves of Macaranga heterophylla (Müll. Arg.) (Euphorbiaceae), A Medicinal Species used in Côte d'Ivoire

Aims: This work aims to investigate the phytochemical composition and antioxidant potential of the leaves of Macaranga heterophylla. Methodology: For this purpose, phytochemical screening by detection tests and thin layer chromatography (TLC), determination of total phenols content, total flavonoids content and condensed tannins content, and assessment of antioxidant potential by DPPH and reducing power tests were carried out on aqueous crude extracts, ethanolic crude extracts and selective extracts of the leaves of M. heterophylla. Results: The percentage yields obtained with ethanol (70%) (28.90 and 24.70% for the ethanolic decoction and ethanolic macerate respectively) are higher than those obtained with water (24.30 and 21.10% for the aqueous decoction and aqueous macerate respectively). The phytochemical screening highlighted the presence of several phytochemical families such as phenolic compounds (coumarins, flavones, tannins), quinones, sterols and polyterpenes, saponosides, glycosides, cardiotonic glycosides and oligosaccharides. Quantitative analysis of total phenolics, total flavonoids and proanthocyanidols showed that their respective levels in the leaves of M. heterophylla varied depending on the solvent and the extraction technique. Concerning total phenolics, the aqueous decoction and ethanolic macerate gave the best total phenol contents (129.04 ± 9.53 and 119.82 ± 2.63 mg EAG/g DM respectively); for total flavonoids, the aqueous decoction gave the best content (33.03 ± 1.61 mg EQ/g DM), while for condensed tannins, the aqueous macerate gave the best content (0.87 ± 0.02 mg ECT/g DM). With regard to DPPH antioxidant activity, the results showed that the ethanolic decoction has more pronounced antioxidant activity than the aqueous decoction, while the aqueous macerate showed better antioxidant activity than the ethanolic macerate. Concerning the reducing power test, the opposite trend was observed. Conclusion: The present study demonstrated that M. heterophylla is a concentrate of secondary metabolites with antioxidant properties, which would explain its use in traditional medicinal practice.

Anti-coronavirus and anti-pulmonary inflammation effects of iridoids, the common component from Chinese herbal medicines for the treatment of COVID-19.

The practice of Chinese herbal medicines for the treatment of COVID-19 in China played an essential role for the control of mortality rate and reduction of recovery time. The iridoids is one of the main constituents of many heat-clearing and detoxifying Chinese medicines that were largely planted and frequently used in clinical practice. Twenty-three representative high content iridoids from several staple Chinese medicines were obtained and tested by a SARS-CoV-2 pseudo-virus entry-inhibition assay on HEK-293T/ACE2 cells, a live HCoV-OC43 virus infection assay on HRT-18 cells, and a SARS-CoV-2 3CL protease inhibitory FRET assay followed by molecular docking simulation. The anti-pulmonary inflammation activities were further evaluated on a TNF-α induced inflammation model in A549 cells and preliminary SARs were concluded. The results showed that specnuezhenide (7), cornuside (12), neonuezhenide (15), and picroside III (21) exhibited promising antiviral activities, and neonuezhenide (15) could inhibit 3CL protease with an IC50 of 14.3μM. Docking computation showed that compound 15 could bind to 3CL protease through a variety of hydrogen bonding and hydrophobic interactions. In the anti-pulmonary inflammation test, cornuside (12), aucubin (16), monotropein (17), and shanzhiside methyl ester (18) could strongly decrease the content of IL-1β and IL-8 at 10μM. Compound 17 could also upregulate the expression of the anti-inflammatory cytokine IL-10 significantly. The iridoids exhibited both anti-coronavirus and anti-pulmonary inflammation activities for their significance of existence in Chinese herbal medicines, which also provided a theoretical basis for their potential utilization in the pharmaceutical and food industries.

Structural and mechanistic insights into the transport of aristolochic acids and their active metabolites by human serum albumin

Aristolochic acids I and II (AA-I/II) are carcinogenic principles of Aristolochia plants, which have been employed in traditional medicinal practices and discovered as food contaminants. While the deleterious effects of AAs are broadly acknowledged, there is a dearth of information to define the mechanisms underlying their carcinogenicity. Following bioactivation in the liver, N-hydroxyaristolactam and N-sulfonyloxyaristolactam metabolites are transported via circulation and elicit carcinogenic effects by reacting with cellular DNA. In this study, we apply DNA adduct analysis, X-ray crystallography, isothermal titration calorimetry (ITC) and fluorescence quenching to investigate the role of human serum albumin (HSA) in modulating AA carcinogenicity. We find that HSA extends the half-life and reactivity of N-sulfonyloxyaristolactam-I with DNA, thereby protecting activated AAs from heterolysis. Applying novel pooled plasma HSA crystallization methods, we report high-resolution structures of myristic acid-enriched HSA (HSAMYR) and its AA complexes (HSAMYR/AA-I and HSAMYR/AA-II) at 1.9 Å resolution. Whereas AA-I is located within HSA subdomain IB, AA-II occupies subdomains IIA and IB. ITC binding profiles reveal two distinct AA sites in both complexes with association constants of 1.5 and 0.5 · 106 M-1 for HSA/AA-I versus 8.4 and 9.0 · 105 M-1 for HSA/AA-II. Fluorescence quenching of the HSA Trp214 suggests variable impacts of fatty acids on ligand binding affinities. Collectively, our structural and thermodynamic characterizations yield significant insights into AA binding, transport, toxicity, and potential allostery, critical determinants for elucidating the mechanistic roles of HSA in modulating AA carcinogenicity.

Education and training in neurology: developments and future challenges.

Training and education is essential for best practice medicine and is especially important in a rapidly evolving field such as neurology. Due to improved imaging techniques and laboratory testing, there is a better understanding of the pathophysiology of diseases. As a result more treatments have become available. The most important developments in neurology over the last two decades and their effect on training and education are described. In addition, how future training should be aware of the challenges ahead of us is described. This is a narrative review describing developments and challenges based on personal experience and the literature. Due to major developments in radiological and immunological testing, major changes have been seen in different subspecialties of neurology, including but not limited to, the treatment of ischaemic stroke, the development of new entities in the field of demyelinating diseases and auto-immune encephalitis, and diffuse glioma. These developments challenge the education and training in neurology with, ahead of us, technological developments, an aging population, and potentially more superspecialization. Although there are differences in the training curricula between European countries, the developments and future challenges within the field of neurology are very similar. In the development of future curricula it is important to face these developments and challenges and to adapt to them.

MACRO- AND MICROELEMENT COMPOSITION OF THE HERB AND ROOTS OF HAPLOPHYLLUM DAURICUM (L.) G. DON.

Haplophyllum dauricum is a rich source of lignans with antitumor activity. It has been actively used in the practice of Traditional medicine. In addition to lignans, the chemical composition of the species is represented by coumarins, flavonoids, alkaloids and essential oils. However, the composition of the elements of the species, which are necessary for the development of quality criteria of medicinal plants, has not been studied before. In this regard, the purpose of the work was to study the content of macro- and microelements in the aboveground and underground parts of Haplophyllum dauricum of the flora of Buryatia and Transbaikal territory. The content of the following elements was determined by inductively coupled plasma atomic emission spectrometry: Li, Be, Na, Mg, Al, P, K, Ca, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Se, Sr, Zr, Mo, Cd, Sb, Te, Ba and Pb. The content of Hg was determined by the "cold steam" method using an atomic absorption analyzer. According to the obtained data, Haplophyllum dauricum is a rich source of calcium, potassium, magnesium and phosphorus, which were dominant. Among the microelements, iron and titanium were in highest concentration, which were accumulated mainly in the underground part of the plant. The content of heavy metals did not exceed the maximum permissible concentration established by the State Pharmacopoeia of the Russian Federation.

Cubeb (Piper cubeba L.): nutritional value, phytochemical profiling and dermacosmeceutical properties.

Cubeb, Piper cubeba L., has been used for centuries in traditional medicine and culinary practices, with a wide range of biological and pharmacological activities. Herein, we determined the phytochemical profile, mineral, fatty acids, and amino acid contents of P. cubeba berries and assessed the dermacosmeceutical properties of their water extract and essential oil (EO). These included assessing their antioxidant and antibacterial activities as well as their in vitro inhibitory activities against tyrosinase and elastase enzymes. In addition, molecular docking and molecular dynamics studies were performed on the major identified compounds of the EO. A total of forty-three compounds belonging to organic acids, phenolic acids and flavonoids were found in the water extract, while 36 volatile compounds were identified in the EO with Z-isoeugenol, dihydroeugenol, β-pinene, E-caryophyllene, and 1,8-cineole as major constituents. The berries were found to be rich in sodium and iron, have moderate zinc content along with low contents of total nitrogen, phosphorus, and potassium. Amino acid analysis revealed a considerable concentration of isoleucine and phenylalanine, whereas 11,14,17-eicosatrienoic acid and linoleic acid were identified as the major fatty acids. In the DPPH and FRAP assays, the water extract elicited considerable antioxidant activity compared to the reference compounds. Enzyme inhibitory assays revealed that the EO had a potential to inhibit tyrosinase and elastase enzymes with IC50 values of 340.56 and 86.04 μg/mL, respectively. The water extract and EO completely inhibited the bacterial growth at MIC of 50 mg/mL and 20%, respectively. At sub-MIC concentrations, the extract and the EO substantially reduced the biofilm formation by up to 26.63 and 77.77%, respectively, as well as the swimming and swarming motilities in a dose-dependent manner. Molecular docking and molecular dynamics showed that the five main components of P. cubeba EO could be the major contributors to the elastase and tyrosinase inhibitory effect. This study emphasizes the promising potential of P. cubeba as a valuable source of natural compounds that can be utilized for the development of innovative pharmaceuticals, dietary supplements, and dermacosmeceutical agents.

Knowledge, attitude, and practice of Iranian adults toward Persian Medicine: a national survey

BackgroundPrevious researches conducted in both developed and developing countries have demonstrated a rising trend in the utilization of complementary and alternative medicine. The World Health Organization has underscored the importance of studying the prevalence and determinants of such alternative practices. This study delves into the knowledge, attitudes, and practices of Iranian adults towards Persian medicine, a distinct form of complementary and alternative medicine, through a national survey for the first time.MethodsA total of 2882 Iranian adults (aged ≥ 15 years) were randomly chosen from all regions. Data were gathered through structured door-to-door interviews using a survey questionnaire, wherein cases were selected randomly based on postal codes, and interviewers completed the forms at the participants’ residences.ResultsApproximately 46% of the subjects exhibited familiarity with Persian Medicine. The study revealed that the primary sources of knowledge about Persian Medicine were family, relatives, and friends, with only 2.9% indicating medical staff as their source of information. Furthermore, the study indicated that 21% of participants expressed a strong interest in using Persian Medicine, while 30.3% did not. When comparing Persian medicine to modern medicine, respondents indicated that Persian medicine is more cost-effective and has fewer side effects, yet modern medicine is more widely used globally; although, the majority responded “I don’t know” to other questions. The results also demonstrated that approximately 37% of the participants had a history of Persian Medicine utilization in their lifetime.ConclusionThis study revealed that Iranian adults have low reliable knowledge (from medical staff, Persian medicine books and other publications) and limited familiarity with Persian medicine, with about one third of the participants expressing disinterest (attitude) and over half of them having not utilized this form of medicine (practice).

Telehealth and Telemedicine: Regulatory and Medicolegal Landscape.

Telehealth and telemedicine experienced remarkable growth during and after the recent COVID-19 pandemic. Telehealth is generally defined as nonclinical services that employ telecommunication technology. Telemedicine refers more specifically to remote clinical services including diagnosis, monitoring, and treatment. Nuclear medicine is no exception in employing telemedicine increasingly in clinical practice for image interpretation and treatment consultation and care delivery supervision. There is no doubt that soon, the use of tele-nuclear medicine will increase, comparable to the employment of telecommunication in other fields of medicine. We review the medicolegal and regulatory aspects of the evolution in the clinical practice of medicine through telehealth and telemedicine.

The prospect of social medicine in South Africa

The term “médecine sociale” (social medicine in English) was first coined in 1848 during the French Revolution by Dr. Jules Guérin. It is a branch of medicine that focuses on the impact of social and economic conditions on health, disease, and the practice of medicine, with the intention of creating a healthier society. It is an interdisciplinary program between medicine and social sciences, expected to equip medicine with the knowledge and skills needed for analyzing the social causes of health and illness, akin to how the alliance between medicine and laboratory sciences provided insights into the biological, chemical, and physical bases of diseases. Social medicine is also interconnected with social determinants of health. While social determinants of health specifically target social and environmental conditions that affect health, social medicine has a broader scope, encompassing the entire social context of health, including societal structures and cultural factors. In the post-apartheid era, social medicine could play an important role in transforming the healthcare system to ensure equity and inclusivity, leading to improved health outcomes. This would require re-engineering the education of health professionals in South Africa at both undergraduate and postgraduate levels, as practiced in many parts of the world. This will assist South Africa in joining the global movement of social medicine for the promotion of human rights and social justice in medicine, and a better understanding of the impact of social factors on the aetiology and management of medical disorders in the 21st century.

Evaluation of In-Vitro Studies of the Shalmali Extract on Human Endometrial Stromal Cells.

The utilization of herbal formulations for the management of reproductive tract disorders has been a longstanding practice in traditional medicine. In this study, we investigated the efficacy of a herbal extract, Shalmali (Bombax ceiba), in addressing uterine bleeding, a common concern in gynecological health. Through gene expression analysis, this study examined the impact of Shalmali extract on key genes associated with uterine bleeding, namely ESR1, CD56, and SDF-1, in the human endometrial stromal cell line (T HESC). Our findings revealed a dose-dependent decrease in ESR1 and CD56 gene expression levels following treatment with Shalmali extract, suggesting its potential to modulate hormonal and cellular processes involved in uterine bleeding. Notably, an increase in SDF-1 gene expression was observed, indicating a possible role of Shalmali extract in promoting tissue repair and regeneration. Comparison with the standard drug tranexamic acid demonstrated similar effects on gene expression levels, further validating the therapeutic potential of Shalmali extract. Agarose gel electrophoresis images supported these findings, showing reduced gene expression in cells treated with Shalmali extract comparable to those treated with tranexamic acid. These results underscore the promising efficacy of Shalmali extract as a natural alternative for managing uterine bleeding, potentially offering a safe and effective treatment option for individuals seeking traditional remedies for gynecological concerns. Further research is warranted to elucidate the underlying mechanisms of action and assess the long-term safety and efficacy of Shalmali extract in clinical settings.

New Strategies In The Treatment Of Hip Fractures In Patients With Combined Injuries

This article is a study aimed at analyzing and improving the results of surgical treatment of patients with hip fractures in concomitant injuries using modern technologies. Within the framework of the study, the results of treatment of 233 patients with concomitant hip injuries were analyzed, a surgical method - osteosynthesis was used. early period of a traumatic disease. The results of the study made it possible to determine the optimal methods of fixation depending on the patient's condition. The findings of this study are important for improving the results of surgical treatment of patients with concomitant hip injuries and can be used in practical medicine to optimize treatment tactics and reduce complications

Education and diversity in cytopathology: Past, present, and future.

Diversity, equity, and inclusion is a powerful goal which many of us strive toward in medicine, both in patient care and administrative leadership. As the world evolves, the practice of medicine must evolve with it. We are cognizant of the importance of the history of our medical specialties. If we do not acknowledge all parts of our history, we are doomed to repeat it. This special issue is unique and unlike anything that has previously been published in Diagnostic Cytopathology. This issue looks at some of the history of cytopathology. This historical review is followed by some of the present state of cytopathology. There are insights into global cytopathology. The final portion of this issue examines the critical need for cytotechnology schools in the United States. All of these areas are critical to the past, present, and future of cytopathology.

The maintenance of mexican traditional medicine practices among mexicans in southern Arizona

Mexicans in the United States have been reported to maintain practices of Mexican traditional medicine at comparably higher rates than most other populations, including other Latino sub-groups. In this cross-sectional study, we examined the pre- and post-migration traditional medicine practices of first-generation immigrants from Mexico living in southern Arizona. Our objective was to assess how migration affected Mexican immigrants' ethnomedical practices and to better understand the mechanisms and motivating factors for the post-migration maintenance of practice. We designed a survey instrument based off prior qualitative data on traditional medicine practices and translated it into Spanish. The survey measured the rates and frequency of six domains of lay healing practices: herbal medicine, healing foods, self-medication with over-the-counter medicine, and three types of specialty healers (curandero/a, and sobador/a, or partero/a), and asked questions about knowledge sources, reasons for maintaining practice post-migration, and to what extent participants believed the remedies were effective. The research team fielded the telephone-based survey from April 2022 to February 2023 to 300 first-generation adult Mexican immigrants residing in southern Arizona. A series of proportions tests were conducted to examine differences in reliance on lay healing pre- and post-migration as well as to assess differences between women's and men's lay practices. The data indicate a general, but moderated decline in lay medical practices post-migration, with the usage of expert healers declining at much higher rates than the three self-care domains. Women tend to use herbal medicine and healing foods at higher rates than men post-migration. This cross-sectional quantitative study confirms prior research indicating that traditional medicine practices are heavily relied upon by Mexican origin people both pre- and post-migration. These findings suggest that public health messaging and medical providers should better address and harness Mexican immigrants' lay medical practices in order to optimize health in this population.

The study of the influence of <i>Thlaspi arvense</i> L. on the characteristics of the reproductive system of male rats

Introduction. The development of new effective and safe herbal medicines capable of having a positive effect on reproductive status is an urgent task of domestic pharmacy. Medicinal plants are considered as alternative therapies aimed at increasing testosterone levels and fertility in men. The arsenal of medicinal plants used in traditional medicine for the treatment of diseases in men is mainly represented by phytoadaptogens, most of which have a small resource potential in Russia, therefore, it is relevant to search for plants with a sufficient raw material base and with the potential for cultivation. Thlaspi arvense L. is a promising medicinal plant, as it is widely used in folk medicine as a diuretic, anti-inflammatory, diaphoretic, antihistamine, hemostatic, astringent, has a positive effect on the processes of spermatogenesis and is widely distributed in our country. However, information on the chemical composition and biological activity of Thlaspi arvense L. they are insufficient, which shows the relevance of its further more detailed study in order to substantiate the possibility of application in practical medicine and solutions to the issues of standardization of medicinal plant raw materials.Aim. The study of the influence of Thlaspi arvense L. on the characteristics of the reproductive system of male rats.Materials and methods. The object of the study was an infusion of herbа Thlaspi arvense L. The features of the reproductive behavior of male rats after 21-day administration of the infusion of grass yarutka field were studied using tests that allow quantifying the severity of sexual motivation and sexual activity of males. The viability of spermatozoa in the ejaculate of rats was assessed, the total number of spermatozoa (ACS, million), degenerative and immobile forms (%) was calculated. Morphophysiological parameters of spermatogenesis of rats of control and experimental groups of animals were studied using classical histological methods. The concentration of testosterone in the blood serum of experimental groups of animals was determined by the enzyme immunoassay.Results and discussion. The results obtained allow us to conclude that the fertility of rats has increased against the background of the course administration of the infusion of herbа Thlaspi arvense L., as evidenced by an increase in the testosterone content in the blood, improvement of spermogram indicators and morphophysiological characteristics of spermatogenesis in the testicles of rats. The use of the infusion of herbа Thlaspi arvense L. has a protective effect on spermatogenesis. An increase in the thickness of the spermatogenic epithelium, the diameter of the cross-section of the convoluted seminal tubules and the index of spermatogenesis compared with the control group of animals was revealed. The positive effect of Thlaspi arvense L. on indicators of sexual motivation and sexual activity of male rats is shown.Conclusion. Thlaspi arvense L. is a promising medicinal plant, as it is able to have a positive effect on libido, the number and mobility of spermatozoa, the production of sex hormones, spermatogenesis, as well as on the pituitary-gonadal axis, which is associated with the content of a complex of biologically active substances in it.

Flexible endoscopic intubation in emergency medicine: A mixed-methods needs assessment.

This needs assessment aimed to improve understanding of flexible endoscopic intubation training and practice in emergency medicine (EM), providing insights to educators and practice leaders seeking to improve education and practices. We conducted a multicenter, mixed-methods needs assessment of emergency physicians (EPs) incorporating focus groups and a survey. Focus groups comprised community EPs, academic EPs, and resident EPs. We analyzed focus group transcripts using grounded theory, qualitatively describing EM endoscopic intubation. The qualitative analysis shaped our survey instrument, which we deployed in cross-sectional fashion. We report survey data with descriptive statistics. Focus groups with 13 EPs identified three themes: indications for use of endoscopic intubation, factors impacting a physician's decision to endoscopically intubate, and attaining and maintaining endoscopic intubation competency. Of 257 surveyed EPs (33% response rate), 79% had received endoscopic intubation training during residency, though 82% had performed this procedure 10 or fewer times in their career. Despite 97% acknowledging the necessity of competency, only 23% felt highly confident in their ability to perform endoscopic intubation. Participants (93%) reported scarce opportunities to perform the procedure and identified factors believed to facilitate competency acquisition and maintenance, including opportunities to perform endoscopic intubation in practice (98%), local champions (93%), and performing nasopharyngoscopy (87%). While most EPs acknowledged the importance of competency in endoscopic intubation, they reported scarce procedural opportunities and commonly expressed low confidence. Further research is needed on this topic, and we propose avenues to enhance education and practices related to endoscopic intubation. These include development of robust procedural curricula, support of local champions, and incorporating nasopharyngoscopy into EM practice.

Understanding the root of healing and beyond: Exploring the way forward for Alternative Medicine in Nigeria

Complementary and alternative medicine involves medical practices rooted in traditional methods such as herbal remedies and spiritual beliefs. Historical factors influence the practice of alternative medicine in Nigeria. This study examines cultural perceptions, practices, challenges, and integration strategies for alternative medicine in the Nigerian healthcare system. Nigeria, with a population of over 200 million, faces significant health challenges, necessitating robust healthcare systems. Despite having over 80,000 registered doctors, there is a low doctor-to-population ratio of 4,000 to 5,000 people per doctor. Traditional healers practicing under partial regulation significantly contribute to healthcare delivery by using indigenous herbal and spiritual therapies. Challenges in integrating alternative medicine include standardization, limited scientific evidence, stigma, funding constraints, and barriers to access of services . Integration efforts involve creating inclusive healthcare systems that combine traditional and modern approaches, prioritize equitable access, and respect for cultural diversity, developing standardized training, generating scientific evidence, and increasing public awareness. Collaboration among stakeholders, such as healers, healthcare providers, policymakers, researchers, and communities, is essential for successful integration and improved healthcare outcomes. The Nigerian healthcare system can benefit from integrating alternative medicine and promoting holistic and culturally sensitive practices. Overcoming these challenges requires cooperation, evidence-based strategies, and investments in research, leading to more effective healthcare delivery, improved health outcomes, and reduced disparities nationwide. Countries on integration journeys should prioritize collaboration, establish clear regulations, raise public awareness, and invest in research to support the effectiveness and safety of alternative medicine.

Biodiversity and Utilization Patterns of Medicinal and Aromatic Plants in Africa

Medicinal and aromatic plants (MAPs) constitute a diverse array of botanical taxa cultivated or harvested primarily for their therapeutic properties and, or aromatic compounds. This study describes the biodiversity and usage patterns of medicinal and aromatic plants in Africa, offering a comprehensive exploration of the continent's rich natural resources. Through a meticulous examination of the diverse flora, the research sheds light on the historical, cultural, and ecological significance of these plants in traditional medicine and local practices. The objectives of the study include the evaluation of the diversity of medicinal and aromatic plants present in Africa, as well as the examination of their utilization, encompassing both traditional methodologies and modern applications. The findings of this study contribute to the ongoing discourse on sustainable biodiversity management and underscore the significance of these plants in both traditional and modern contexts.