Medical Research Articles

Hygienic quality of food from animal origin and antibiotic resistance of Escherichia coli in a border region of Algeria

Food of animal origin such as milk and meat have a high nutritional value and form an important part of the human and animal diet, but are difficult to produce and are highly perishable. Additionally significant socio–economic loss will result if production and/or storage conditions are neglected, whether through loss of the food or illnesses caused by consumption and treatment. It was in this context that we carried out this study, to assess the hygienic quality of cow’s milk and meat produced and consumed in a border region of Algeria. A total of 130 samples were taken from animal foodstuffs (raw cow’s milk, sheep carcasses, chicken and turkey meat) at farm, abattoir and butchery levels. Mesophilic aerobic flora, total coliforms, thermotolerant coliforms and Escherichia coli were enumerated, and the sensitivity of the E. coli to certain antibiotics most commonly used in human and veterinary medicine was assessed. High levels of contamination and bacterial loads ranging from 5.36×102 CFU·mL–1 for milk, to 1.56×105 CFU·cm–2 for sheep meat, some of this foodstuffs are acceptable but represent a food hazard, and others are not acceptable according to regulations. A high percentage of multiresistant strains and worrying resistance rates were detected, and if the necessary measures are not taken as a matter of urgency in the context of “One Health”, the situation is likely to worsen and human and animal health will be affected.

THE PREDICTION OF HEART DISEASE USING MACHINE LEARNING ALGORITHMS

Heart disease threatens the lives of around one individual per minute, establishing it as the foremost cause of mortality in the contemporary era. A wide range of individuals over the globe has encountered the intricacies associated with cardiovascular illness. Various factors, such as hypertension, elevated levels of cholesterol, and an irregular pulse rhythm hinder the early identification of a cardiovascular disease. In cardiology, similar to other branches of Medicine, timely and precise identification of cardiac diseases is of utmost importance. Anticipating the onset of heart failure at the appropriate moment can provide challenges, particularly for cardiologists and surgeons. Fortunately, categorisation and forecasting models can assist the medical business and provide real applications for medical data. Regarding this, Machine Learning (ML) algorithms and techniques have benefited from the automated analysis of several medical datasets and complex data to aid the medical community in diagnosing heart-related diseases. Predicting if the patient has early-stage cardiac disease is the primary goal of this paper. A prior study that worked on the Erbil Heart Disease dataset has proved that Naïve Bayes (NB) got an accuracy of 65%, which is the worst classifier, while Decision Tree (DT) obtained the highest accuracy of 98%. In this article, a comparison study has been applied using the same dataset (i.e., Erbil Heart Disease dataset) between multiple ML algorithms, for instance, LR (Logistic Regression), KNN (K-Nearest Neighbours), SVM (Support Vector Machine), DT (Decision Tree), MLP (Multi-Layer Perceptron), NB (Naïve Bayes) and RF (Random Forest). Surprisingly, we obtained an accuracy of 98% after applying LR, MLP, and RF, which was the best outcome. Furthermore, the accuracy obtained by the NB classifier differed incredibly from the one received in the prior work.

Two years of innovative dermatological care: the first public health consultation service for the transgender and gender diverse community in Argentina

BackgroundThe LGBTQI + community encounters distinct healthcare challenges due to discrimination and inadequate understanding of their needs. Dermatologists play a crucial role in addressing this by fostering inclusiveness, recognizing individual concerns, and adopting tailored approaches, thereby promoting a more equitable healthcare system. ObjectiveTo address the need for an inclusive healthcare space, the authors established the first dermatological practice exclusively for transgender and non-binary patients. This article presents a comprehensive two-year experience in a public hospital. MethodsThe authors conducted a retrospective and descriptive study, analyzing the medical records of 114 patients evaluated at a specialized dermatological practice between June 2021 and May 2023. Key variables assessed included self-identified gender, age, residence, access to private healthcare, human immunodeficiency virus status, hormonal treatment, surgical interventions, consultation motives, employment stability, and family support during gender expression transition. ResultsThe present study included 114 patients, 49.1% trans men, 39.5% trans women, and 8.8% non-binary individuals. Trans men, on average younger than trans women (p < 0.001), predominantly sought care for body modification-related concerns, particularly acne and androgenetic alopecia. In contrast, trans women exhibited a more diverse range of consultation motives typically unrelated to hormonal or surgical procedures. Study limitationsThis study is retrospective and limited in geographic scope. Additionally, the patient population lacked diversity in terms of Black ethnicity. ConclusionsThe pioneering dermatological practice for transgender and non-binary patients exemplifies healthcare equity and cultural competence. Effective LGBTQI + healthcare requires addressing unique dermatological concerns while fostering inclusiveness and continuous learning within the medical community.

Sodium glucose transporter 2 inhibitors: Will these drugs benefit non-diabetic veterinary patients with cardiac and kidney diseases?

Sodium glucose transporter type 2 (SGLT2) inhibitors have been introduced into human medicine where their beneficial effects go beyond the expected improvement in blood glucose control. These drugs appear to prevent progression of both cardiovascular and kidney diseases, not only in diabetic but also in non-diabetic human patients. As these drugs have received conditional approval for use in diabetic cats and are being used in other veterinary species, the intriguing question as to whether they will have similar cardioprotective and nephroprotective effects in dogs and cats is being asked. The primary mechanism(s) by which SGLT2 inhibitors are cardio- and nephroprotective remain to be fully characterized. This paper reviews these suggested mechanisms in the context of the pathophysiology of progressive cardiovascular and kidney diseases in dogs and cats with the goal of predicting which categories of non-diabetic veterinary patients these drugs might be of most benefit.

Quality Control in Human Adipose-Derived Stromal/Stem Cells and Tissue Engineering Fat Models for Aging Studies.

Adipose tissue is recognized not only as an endocrine organ but also as a reservoir for adipose-derived stromal/stem cells (ASCs). ASCs have stimulated the interest of both the scientific and medical communities due to their therapeutic potential and applications in tissue engineering and regenerative medicine. ASCs are leveraged for their multipotency and their paracrine function. ASC behavior is highly variable and donor dependent. Donor age, body mass index, disease status, sex, and ethnicity can lead to differential overall function and quality. The impact of donor age and passage on ASC behavior has been well documented, impacting cell proliferation and differentiation potential and thus must be taken into careful consideration when conducting in vitro studies. Pooling of ASCs from different donors reduces heterogeneity among individual donors and produces ASCs with a consistent differentiation and paracrine profiles, an advantage for studies in biological aging. This chapter provides a detailed overview for studies related to quality control for ASC pools considering biological and chronological aging in ASCs. There are hallmarks of biological aging and specific assays associated with the evaluation of each hallmark. Nevertheless, here we present the assays that provide a standardized characterization and qualification of donor pools for their regenerative potential, considering chronological and biological age of the pool. The assays included in this chapter are considered quality control standards to evaluate cell proliferation, differentiation, colony-forming units, and cellular senescence from different donor age and cell passage cohorts.

Multiplex PCR-based genotyping of Salmonella Enteritidis and Salmonella Typhimurium from food sources and assessment of their antimicrobial resistance profiles in Egypt.

Salmonellosis is a widespread zoonotic disease that poses a significant threat to livestock and public health. This study aimed to serotype 20 Salmonella isolates obtained from sixty retail chicken meats, assess Salmonella contamination from eggs, and evaluate antibiotic resistance profiles. Twenty eggs were randomly collected in the new Borg El Arab market. Bacterial isolation was carried out utilizing both traditional culture, biochemical, and PCR methods. Among the twenty eggs analyzed, three (15%) tested positive for Salmonella, while the remaining seventeen (85%) were confirmed as negative. Genotyping through multiplex PCR revealed the presence of two S. Enteritidis and other serovar, with the use of three specific gene sets: a random sequence for Salmonella spp., sdfI gene for S. Enteritidis, and flagellin (fliC gene) for S. Typhimurium. Out of the 20 isolates obtained from chicken meat, five (25%) were identified as S. Typhimurium, and three (15%) were classified as S. Enteritidis. All isolates sourced from chicken meat exhibited resistance to Rifampicin and Amoxicillin, with 90% displaying sensitivity to cefotaxime, gemifloxacin, and Erythromycin. Importantly, S. Blegdam, identified via serological methods, displayed resistance to all tested antibiotics. For the three isolates obtained from eggs, 66.6% showed sensitivity to cefotaxime, erythromycin, cefuraxime, and cefaclor, while displaying complete resistance (100%) to Amoxicillin, rifampicin, clarithromycin, and cefadroxil. Notably, one serovar exhibited absolute resistance to all tested drugs. Stakeholders must implement strict control measures and rationalize antibiotic use in veterinary and human medicine due to the rise of antibiotic-resistant strains.

MedPodGPT: A multilingual audio-augmented large language model for medical research and education.

The proliferation of medical podcasts has generated an extensive repository of audio content, rich in specialized terminology, diverse medical topics, and expert dialogues. Here we introduce a computational framework designed to enhance large language models (LLMs) by leveraging the informational content of publicly accessible medical podcast data. This dataset, comprising over 4, 300 hours of audio content, was transcribed to generate over 39 million text tokens. Our model, MedPodGPT, integrates the varied di-alogue found in medical podcasts to improve understanding of natural language nuances, cultural contexts, and medical knowledge. Evaluated across multiple benchmarks, MedPodGPT demonstrated an average improvement of 2.31% over standard open-source benchmarks and showcased an improvement of 2.58% in its zero-shot multilingual transfer ability, effectively generalizing to different linguistic contexts. By harnessing the untapped potential of podcast content, MedPodGPT advances natural language processing, offering enhanced capabilities for various applications in medical research and education.

Eye Gaze Guided Cross-Modal Alignment Network for Radiology Report Generation.

The potential benefits of automatic radiology report generation, such as reducing misdiagnosis rates and enhancing clinical diagnosis efficiency, are significant. However, existing data-driven methods lack essential medical prior knowledge, which hampers their performance. Moreover, establishing global correspondences between radiology images and related reports, while achieving local alignments between images correlated with prior knowledge and text, remains a challenging task. To address these shortcomings, we introduce a novel Eye Gaze Guided Cross-modal Alignment Network (EGGCA-Net) for generating accurate medical reports. Our approach incorporates prior knowledge from radiologists' Eye Gaze Region (EGR) to refine the fidelity and comprehensibility of report generation. Specifically, we design a Dual Fine-Grained Branch (DFGB) and a Multi-Task Branch (MTB) to collaboratively ensure the alignment of visual and textual semantics across multiple levels. To establish fine-grained alignment between EGR-related images and sentences, we introduce the Sentence Fine-grained Prototype Module (SFPM) within DFGB to capture cross-modal information at different levels. Additionally, to learn the alignment of EGR-related image topics, we introduce the Multi-task Feature Fusion Module (MFFM) within MTB to refine the encoder output information. Finally, a specifically designed label matching mechanism is designed to generate reports that are consistent with the anticipated disease states. The experimental outcomes indicate that the introduced methodology surpasses previous advanced techniques, yielding enhanced performance on two extensively used benchmark datasets: Open-i and MIMIC-CXR.

"When does human life begin?" Teaching human embryology in the context of the American abortion debate

The Dobbs decision of the United States Supreme Court and the actions of several state legislatures have made it risky, if not outright dangerous, to teach factual material concerning human embryology. At Idaho’s public universities, for instance, if a professor's lecture is felt to teach or discuss abortion (as it might when teaching about tubal pregnancies, hydatidiform moles, or eneuploidy), that instructor risks imprisonment for up to 14 years (Gyori 2023). The state's new censorship rules have thus caused professors to drop modules on abortion from numerous science and humanities courses. In most states, instructors can still teach about human embryonic development and not risk putting their careers or livelihoods in jeopardy. However, even in many of these institutions, students can bring a professor to a disciplinary hearing by claiming that the instructor failed to provide ample trigger warnings on such issues. This essay attempts to provide some strategies wherein human embryology and the ethical issues surrounding it might be taught and students may be given resources to counter unscientific falsehoods about fertilization and human development. This essay provides evidence for teaching the following propositions:•There is no consensus among biologists as to what embryonic stage represents the time when independent human life begins. Different groups of biologists have championed individual human life beginning at fertilization, gastrulation, the emergence of the electroencephalogram pattern, and viability/birth.•The genome is not the essence of the person. While the genome can set limits on the possibilities, behavioral phenotypes arise from other environmental sources. Identity of genotype does not mean identity of behavior, beliefs, or details of anatomy.•Fertilization is not ensoulment. Although popular culture often conflates DNA with "soul", biology does not. Similarly, "conception" is not the same as fertilization.•Birth is not merely a "delivery, " but constitutes a perilous process involving gene expression changes in the lung, heart, and brain wherein breathing is activated and the circulatory system is remodeled to go to and from the lungs rather than to and from the placenta.•.Most human embryos die before coming to term.Mis-information about human biology and medicine is rampant on the internet, and there are skills that can be taught to students that will help them determine which sites should trusted. This is a skill that needs to be taught as part of science courses.

Associations between Chronic Medical Conditions and Persistent Dietary Supplement Use: The US Military Dietary Supplement Use Study

This longitudinal study examined associations between chronic medical conditions (CMCs) and persistent dietary supplement (DS) use. On two separate occasions, 1.3 ± 0.2 years apart, military service members (SMs) (n = 5778) completed identical questionnaires concerning their DS use in the past 6 months and their demographic and lifestyle characteristics. Medical conditions were obtained from a medical surveillance system six months before the first questionnaire and during the period between questionnaires. Diagnoses were grouped into 19 major (largely systemic) and 9 specific CMCs. Conditions diagnosed in both periods (CMCs) were examined in relation to DS use reported on both questionnaires (persistent DS use). After adjustment for demographic and lifestyle factors, higher odds of persistent DS use were found in 7 of the 19 major CMCs and 5 of the 9 specific CMCs. SMs with a CMC had 1.25 (95% confidence interval [95%CI] = 1.10–1.41) higher adjusted odds of persistent DS use. The three specific CMCs with the highest adjusted odds of persistent DS use were anxiety (odds ratio [OR] = 2.30, 95%CI = 1.36–3.89), depression (OR = 2.12, 95%CI = 1.20–3.73), and gastroesophageal reflux disease (OR = 2.02, 95%CI = 1.02–4.04). Among DS categories, participants with a CMC had higher adjusted odds of persistent vitamins or mineral use (OR = 1.31, 95% CI = 1.12–1.53). Participants with CMCs had a higher prevalence of persistent DS use, especially individual vitamin and mineral use.

Combined traditional Chinese medicine therapy for the treatment of infertility with polycystic ovary syndrome: A network meta-analysis of randomized controlled trials.

Polycystic ovary syndrome (PCOS) infertility has attracted great attention from researchers due to its high incidence. Numerous studies have shown that Chinese medicine is effective in treating this disease, but there is a wide variety of Chinese medicine therapies available, and there is a lack of comparative evaluation of the efficacy of various Chinese medicine combination therapies in the clinic, which requires further in-depth exploration. This study aims to evaluate the efficacy of a combined traditional Chinese medicine (TCM) therapy for the treatment of infertility with PCOS using network meta-analysis (NMA). In PubMed, web of Science, Cochrane Library, Embase, China Knowledge Network, Wanfang Data, VIP Database, China Biomedical Literature Database (SinoMed) databases, searchs were conducted for information about the randomized controlled trials (RCTs) of combined TCM therapy for the treatment of infertility with PCOS. Quality evaluation was performed using the Cochrane 5.3 risk of bias assessment tool, and NMA using Stata 16.0. This study comprised 28 RCTs using 8 combined TCM therapies in total. The results of the NMA showed that moxibustion + herbal, fire acupuncture + herbal, acupuncture + herbal, electroacupuncture + herbal, and acupoint application + herbal improved the clinical pregnancy rate better than acupuncture, herbal, and western medicines monotherapy (P < .05). Additionally, ear point pressure + herbal enema + herbal, acupuncture and moxibustion + herbal, fire acupuncture + herbal, and acupuncture + herbal improved the ovulation rate better than acupuncture, herbal, and western medicines monotherapy (P < .05). Moxibustion + herbal, fire acupuncture + herbal, and acupuncture + herbal are the 3 most effective therapies for improving the clinical pregnancy rate. Fire acupuncture + herbal, acupuncture + herbal, and ear point pressure + herbal enema + herbal are the 3 most effective therapies for improving the ovulation rate. The combined TCM therapy demonstrated better efficacy for the treatment of infertility with PCOS compared to acupuncture, herbal, and western medicines monotherapy. However, the optimal treatment therapy varied depending on the outcome indicators. Further large sample, high-quality, and standardized RCTs are needed to verify these findings.

Spermatogonial stem cell technologies: applications from human medicine to wildlife conservation.

Spermatogonial stem cell (SSC) technologies that are currently under clinical development to reverse human infertility hold the potential to be adapted and applied for the conservation of endangered and vulnerable wildlife species. The biobanking of testis tissue containing SSCs from wildlife species, aligned with that occurring in pediatric human patients, could facilitate strategies to improve the genetic diversity and fitness of endangered populations. Approaches to utilize these SSCs could include spermatogonial transplantation or testis tissue grafting into a donor animal of the same or a closely related species, or in vitro spermatogenesis paired with assisted reproduction approaches. The primary roadblock to progress in this field is a lack of fundamental knowledge of SSC biology in non-model species. Herein, we review the current understanding of molecular mechanisms controlling SSC function in laboratory rodents and humans, and given our particular interest in the conservation of Australian marsupials, use a subset of these species as a case-study to demonstrate gaps-in-knowledge that are common to wildlife. Additionally, we review progress in the development and application of SSC technologies in fertility clinics and consider the translation potential of these techniques for species conservation pipelines.

Vaccinating the Frontlines: A Qualitative Exploration of Hospital Healthcare Worker Perspectives on Influenza and COVID-19 Immunization.

Although they face higher occupational risk of contracting viral respiratory infections, hospital healthcare worker vaccine hesitancy persists. While most studies have used survey methods to quantify the prevalence of and reasons for healthcare worker vaccine hesitancy, this study employs a qualitative approach to understand their attitudes and beliefs associated with influenza and COVID-19 vaccination. To understand frontline healthcare worker experiences and perspectives on influenza and COVID-19 vaccination, 30 semi-structured interviews were conducted in summer/fall 2022 with staff recruited from two Johns Hopkins hospitals in Maryland. An in-depth, key informant interview was conducted with an expert in public health audience engagement. Interviews were audio recorded and transcribed for thematic and Framework analysis using NVivo software (QSR International, Melbourne, Australia). Healthcare workers engaged in little influenza vaccine information seeking due to their familiarity with the disease and low perceived disease severity. Approximately half (n=16) of healthcare workers reported no vaccine hesitancy towards influenza or COVID-19 vaccines. No physicians or physician assistants expressed any vaccine hesitancy, while most nurses expressed some (n=10). More than half of the women (n=14) expressed COVID-19 vaccine hesitancy compared to none of the men. Structural factors including hospital tier, unit assignment, and professional role influenced perceived risk of disease exposure and subsequent healthcare worker vaccination decisions. Institutional policies, including mandates and a pro-vaccine environment encouraged vaccination uptake. Healthcare workers reported being more receptive to vaccine messaging that focused on protection from disease, scientific and public health data and their heightened occupational exposure to pathogens. Despite their medical knowledge, healthcare workers are susceptible to vaccine hesitancy. Strategies to address specific concerns are needed and can be informed by our findings. A flexible and multi-pronged approach that considers individual anxieties, workplace structures, and the need for open communication with tailored messaging is necessary to promote vaccine acceptance in healthcare settings. What is already known on this topic: Healthcare worker vaccine hesitancy has been associated with many factors including race, gender, age and concerns about vaccine safety.What this study adds: Much of the research on healthcare worker vaccine hesitancy has used surveys and questionnaires giving a broad description of the prevalence and patterns of vaccine hesitancy in the healthcare workforce. This qualitative study examines vaccine behavior (rather than merely intent) through a cross comparison of healthcare workers' experiences and attitudes towards influenza and COVID-19 vaccination.How this study might affect research, practice or policy: Study findings can be used to help tailor vaccine messaging to hospital healthcare workers which could offset concerns regarding vaccine efficacy and risk, to promote vaccine uptake.

Can ultra-widefield optical coherence tomography angiography replace traditional fundus angiography

Fundus imaging plays a pivotal role in diagnosing retinal and choroidal diseases. Optical coherence tomography angiography (OCTA), by capturing signals to reconstruct vascular structures, offers a clear depiction of retinal vasculature with notable advantages such as rapid scanning and non-invasiveness. Although OCTA, due to its underlying principles, cannot dynamically assess vascular function, exploring its future applications and potential to eventually replace traditional fundus angiography remains a key focus in the medical community. OCTA provides multiple parameters that conventional fundus angiography cannot obtain. With the expanding coverage area of OCTA scans and improvements in artifact elimination, the detection rate of various retinal and choroidal diseases has significantly increased, making the widespread clinical application of OCTA an inevitable trend. Although ultra-widefield OCTA cannot yet fully replace angiography in clinical practice, with continued clinical practice, expanded clinical research, and ongoing technological innovation, OCTA is expected to gradually replace fundus angiography in the future.

Demarcating scientific medicine

Scientific medicine and homeopathy are interesting case studies for the ongoing project of demarcating science from pseudoscience. Much of the demarcation literature formulates abstract criteria for demarcating science from pseudoscience generally. In service of a more localist approach to the demarcation problem, I reconstruct a specific demarcating difference, the like comparison criterion, invoked by nineteenth century adherents to an early model of scientific medicine. If it is to remain relevant today, I argue that the like comparison criterion must be updated in our current era of epidemiological, evidence-based medicine to recognize the importance of assessing study bias and mechanistic implausibility in contemporary medical science.

Human post-implantation blastocyst-like characteristics of Muse cells isolated from human umbilical cord

Muse cells, identified as cells positive for the pluripotent surface marker SSEA-3, are pluripotent-like endogenous stem cells located in the bone marrow (BM), peripheral blood, and organ connective tissues. The detailed characteristics of SSEA-3(+) cells in extraembryonic tissue, however, are unknown. Here, we demonstrated that similar to human-adult tissue-Muse cells collected from the BM, adipose tissue, and dermis as SSEA-3(+), human-umbilical cord (UC)-SSEA-3(+) cells express pluripotency markers, differentiate into triploblastic-lineage cells at a single cell level, migrate to damaged tissue, and exhibit low telomerase activity and non-tumorigenicity. Notably, ~ 20% of human-UC-SSEA-3(+) cells were negative for X-inactive specific transcript (XIST), a naïve pluripotent stem cell characteristic, whereas all human adult tissue-Muse cells are XIST-positive. Single-cell RNA sequencing revealed that the gene expression profile of human-UC-SSEA-3(+) cells was more similar to that of human post-implantation blastocysts than human-adult tissue-Muse cells. The DNA methylation level showed the same trend, and notably, the methylation levels in genes particularly related to differentiation were lower in human-UC-SSEA-3(+) cells than in human-adult tissue-Muse cells. Furthermore, human-UC-SSEA-3(+) cells newly express markers specific to extraembryonic-, germline-, and hematopoietic-lineages after differentiation induction in vitro whereas human-adult tissue-Muse cells respond only partially to the induction. Among various stem/progenitor cells in living bodies, those that exhibit properties similar to post-implantation blastocysts in a naïve state have not yet been found in humans. Easily accessible human-UC-SSEA-3(+) cells may be a valuable tool for studying early-stage human development and human reproductive medicine.

Medicinal plants used by minority ethnic groups in China: Taxonomic diversity and conservation needs

Ethnopharmacological relevanceIndigenous communities have long relied on medicinal plants (MPs) for primary healthcare. The ethnomedicinal knowledge are different among ethnic groups since the local flora and people's health beliefs generally vary among biocultural backgrounds. China with its diverse biocultural environment is rich in culturally important plant species including MPs. They are also essential in the context of conservation of plant resources and the related traditional medical knowledge, requiring an integrated perspective on these MPs. Aim of the studyFocusing on the MPs used by the minority ethnic groups, this study assesses the diversity of MPs in China used in local indigenous traditions, as well as their conservation needs. Materials and methodsThe MPs used by the 18 selected minority ethnic groups were extracted from an ethnic MP dictionary. After standardizing, the names then were compiled as an inventory. Next, following statistics were computed: the number of species in each order and family, species used by each ethnic group, species documented in the national herbal resource dataset, species adopted in drug standards, and species at different levels of conservation lists. The overall similarity of the MPs used by the ethnic groups included was achieved using a cluster and principal component analysis. ResultsIn total 5886 vascular plant species are reported as medicines in the 18 ethnic groups, which belong to 1657 genera and 243 families. It is found that 3195 species are used exclusively by one ethnic group, indicating their cultural salience and potential restrictedness in ecological terms. Moreover, 1159 species are included in national/regional drug standards, indicating their importance in the national medical flora. However, only 3541 species of them are documented in the national herbal resource dataset, and 761 species are at different levels of threatened status, highlighting the conservation needs of Chinese MPs and the related traditional medical knowledge. ConclusionsUsing a quantitative approach, for the first time the present study reveals the high level of taxonomic diversity of MPs used by minority ethnic groups of China. However, of these species, 40% are still not inventoried in the national herbal resource dataset, and more than half are used exclusively by one ethnic group, and around 13% are included in the conservation lists of different levels. These together urge the conservation of MP resources and related traditional medical knowledge. Additionally, we recommend fostering the cross-cultural communication the regional ethnomedicinal knowledge, for the purpose of maximizing the benefits of regional plants to human.

Evaluating the application of ChatGPT in China’s residency training education: An exploratory study

Objective The purpose of this study was to assess the utility of information generated by ChatGPT for residency education in China. Methods We designed a three-step survey to evaluate the performance of ChatGPT in China’s residency training education including residency final examination questions, patient cases, and resident satisfaction scores. First, 204 questions from the residency final exam were input into ChatGPT's interface to obtain the percentage of correct answers. Next, ChatGPT was asked to generate 20 clinical cases, which were subsequently evaluated by three instructors using a pre-designed Likert scale with 5 points. The quality of the cases was assessed based on criteria including clarity, relevance, logicality, credibility, and comprehensiveness. Finally, interaction sessions between 31 third-year residents and ChatGPT were conducted. Residents’ perceptions of ChatGPT's feedback were assessed using a Likert scale, focusing on aspects such as ease of use, accuracy and completeness of responses, and its effectiveness in enhancing understanding of medical knowledge. Results Our results showed ChatGPT-3.5 correctly answered 45.1% of exam questions. In the virtual patient cases, ChatGPT received mean ratings of 4.57 ± 0.50, 4.68 ± 0.47, 4.77 ± 0.46, 4.60 ± 0.53, and 3.95 ± 0.59 points for clarity, relevance, logicality, credibility, and comprehensiveness from clinical instructors, respectively. Among training residents, ChatGPT scored 4.48 ± 0.70, 4.00 ± 0.82 and 4.61 ± 0.50 points for ease of use, accuracy and completeness, and usefulness, respectively. Conclusion Our findings demonstrate ChatGPT's immense potential for personalized Chinese medical education.

MFS-DBF: A trustworthy multichannel feature sieve and decision boundary formulation system for Obstructive Sleep Apnea detection

The fine identification of sleep apnea events is instrumental in Obstructive Sleep Apnea (OSA) diagnosis. The development of sleep apnea event detection algorithms based on polysomnography is becoming a research hotspot in medical signal processing. In this paper, we propose an Inverse-Projection based Visualization System (IPVS) for sleep apnea event detection algorithms. The IPVS consists of a feature dimensionality reduction module and a feature reconstruction module. First, features of blood oxygen saturation and nasal airflow are extracted and used as input data for event analysis. Then, visual analysis is conducted on the feature distribution for apnea events. Next, dimensionality reduction and reconstruction methods are combined to achieve the dynamic visualization of sleep apnea event feature sets and the visual analysis of classifier decision boundaries. Moreover, the decision-making consistency is explored for various sleep apnea event detection classifiers, which provides researchers and users with an intuitive understanding of the detection algorithm. We applied the IPVS to an OSA detection algorithm with an accuracy of 84% and a diagnostic accuracy of 92% on a publicly available dataset. The experimental results show that the consistency between our visualization results and prior medical knowledge provides strong evidence for the practicality of the proposed system. For clinical practice, the IPVS can guide users to focus on samples with higher uncertainty presented by the OSA detection algorithm, reducing the workload and improving the efficiency of clinical diagnosis, which in turn increases the value of trust.

Comprehensive Systematic Review of Breast Implant Illness: Symptoms, Management, and Long-Term Outcomes.

Breast augmentation using silicone implants is common, with over 300,000 annual US surgeries. It was initially approved in 1962, there were safety concerns with the use of silicone implants, leading to a 1992-2006 FDA moratorium. Recently, Breast Implant Illness (BII) was described as a cluster of symptoms associated with silicone implants, with a lack of diagnostic criteria, which increased the likelihood of implant removal and a variety of treatment options. This comprehensive review aims to shed light on the extent, symptoms, management, and outcomes of BII. Multiple electronic databases were systematically searched in May 2023 for studies on Breast Implant Illness utilizing terms related to BII and its symptoms, diagnosis, and treatment. Out of 1204 studies, 20 met the inclusion criteria and were included in the systematic review. The Newcastle-Ottawa Scale for the included cohort prospective and retrospective studies, and the tool for evaluating the methodological quality of case reports and case series were utilized during quality assessment. There were 20 papers on Breast Implant Illness published between 1995 and 2022, including a peak of papers published in 2020 and 2022. The majority of the studies came from the USA, with a variety of research methods, including case reports. Reports of arthralgia and fatigue were common findings. These symptoms were frequently alleviated by surgical procedures such as en bloc explantation and capsulectomy, highlighting the intricacy of the problem and the need for individualized treatment plans. The review underscores the critical need for further research into BII, advocating for a multidisciplinary strategy that prioritizes patient safety, informed decision-making, and comprehensive care. As the medical community progresses in understanding and managing BII, emphasizing evidence-based practices and patient-provider communication will be essential in addressing this complex condition effectively. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .