Search Results (160)

Background and Objectives: Nausea and vomiting (NV) are common and distressing adverse effects among cancer patients undergoing treatment. Despite the widespread use of pharmacological antiemetics, these medications are often insufficient for controlling nausea and may cause medication interactions and side effects. Acupuncture has been proposed as a complementary therapy; however, the comprehensive analysis of its effects on NV across all emetogenic cancer treatments remains limited. This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of acupuncture in managing NV in cancer patients undergoing chemotherapy, radiotherapy, or surgery. Materials and Methods: We conducted a comprehensive search across three electronic databases and two clinical registry platforms from inception to December 2024. Randomized controlled trials (RCTs) evaluating acupuncture for NV in cancer patients were included. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Safety outcomes were assessed based on the Common Terminology Criteria for Adverse Events (CTCAE). Results: Seventeen RCTs met the inclusion criteria, with twelve studies included in the meta-analysis. Acupuncture did not demonstrate significant effects on acute nausea (RR: 0.98; 95% CI: 0.84–1.15; p = 0.80) or acute vomiting (RR: 0.93; 95% CI: 0.65–1.32; p = 0.67). However, it significantly reduced delayed vomiting (RR: 0.76; 95% CI: 0.61–0.95; p = 0.02). Subgroup analysis demonstrated significant effects when acupuncture was administered for at least five days (RR: 0.56; 95% CI: 0.39–0.81; p = 0.002). The most frequently used acupoints were PC6, ST36, CV12, LI4, LR3, and ST25. No serious adverse events related to acupuncture treatments were reported, with only minor AEs such as localized bleeding and mild bruising observed. Conclusions: Acupuncture represents a safe and effective complementary therapy for managing delayed vomiting in cancer patients receiving emetogenic treatments. Clinicians can anticipate optimal benefits from at least five days of treatment, particularly using acupoints PC6, ST36, CV12, LI4, LR3, and ST25. Further high-quality studies are needed to establish standardized treatment regimens and explore its comprehensive effects on NV. Full article

This article presents a comprehensive review of assistive devices for synovial joints, addressing their definitions, classifications, and technological advancements. The historical evolution of artificial exoskeletons, orthoses, prostheses, and splints is analyzed, emphasizing their impact on rehabilitation and the enhancement of human mobility. Through a systematic compilation of scientific literature, patents, and medical regulations, the study clarifies terminology and classifications that have often been imprecisely used in scientific discourse. The review examines the biomechanical principles of the musculoskeletal system and the kinematics of synovial joints, providing a reference framework for the optimization and design of these devices. Furthermore, it explores the various types of artificial exoskeletons, and their classification based on structure, mobility, power source, and control system, as well as their applications in medical, industrial, and military domains. Finally, this study highlights the necessity of a systematic approach in the design and categorization of these technologies to facilitate their development, comparison, and effective implementation, ultimately improving users’ quality of life. Full article

Background: China’s rapidly aging population has increased the need for effective community-based eldercare services. However, the lack of standardized, culturally relevant evaluation frameworks hinders consistent service quality assessment and improvement. Objective: This systematic review aims to identify, synthesize, and critically evaluate the existing quality indicators (QIs) currently utilized for home-based community elderly care HCEC in China. It also aims to highlight gaps to inform the development of a more comprehensive and context-appropriate quality framework. Methods: Following PRISMA guidelines, systematic searches were conducted across Web of Science, PubMed, Wiley, and CNKI databases for studies published in English and Chinese from 2008 onward. Extracted QIs from eligible studies were categorized using Donabedian’s structure–process–outcome (SPO) model. Results: Fifteen studies met the inclusion criteria, with QI sets ranging from 5 to 64 indicators. Most studies emphasized structural and procedural aspects, while outcome measures were limited. Key gaps include inconsistent terminology, insufficient medical care integration, narrow stakeholder engagement, and limited cultural adaptation of Western theoretical frameworks. Furthermore, subjective weighting methods predominated, impacting indicator reliability. Conclusions: Currently, there is no formal quality framework to guide service providers in HCEC, and therefore, quality indicators can be described as fragmented and lack cultural specificity, medical integration, and methodological robustness. Future research should prioritize developing culturally anchored and medically comprehensive QI frameworks, standardize indicator terminology, actively involve diverse stakeholders through participatory methods, and adopt hybrid methodological approaches combining subjective expert insights and objective, data-driven techniques. Alignment with established international standards, such as the OECD long-term care quality indicators, is essential to enhance eldercare quality and support evidence-based policymaking. Full article

The Yogācārabhūmi, compiled by Saṅgharakṣa, was first introduced to China by An Shigao’s abridged translation (T607, Daodi jing 道地經), later, in 284 CE, Dharmarakṣa produced a more comprehensive version (T606, Xiuxing daodi jing 修行道地經). Lacking extant Sanskrit or Pali parallels, the text is difficult to interpret literally, and the differences between T607 and T606 add to the analytical challenges. However, a substantial section in both translations describing omens of impending death in the sick exhibits systematic parallels with Indian Āyurvedic texts, such as the Caraka-saṃhitā and Suśruta-saṃhitā. These parallels help clarify the ambiguous passages through comparative analysis. This study explores the translation strategies of An Shigao and Dharmarakṣa in introducing Indian medical concepts to China. An Shigao adopted a localization strategy, replacing foreign terms with analogous Chinese concepts. His terminology, corroborated by usage in Eastern Han or earlier Chinese texts—particularly excavated manuscripts—supports claims in the Chu sanzang ji ji regarding his expertise in medicine and divination. By contrast, Dharmarakṣa’s Xiuxing daodi jing sought greater fidelity to the Indian source material, offering a more detailed and systematic presentation of Āyurvedic knowledge. However, Dharmarakṣa did not entirely abandon An Shigao’s localization approach. He adopted a balanced strategy that combined faithful representation with cultural adaptation, reflecting the broader capacity of his more diverse and sophisticated audience to engage with complex and extensive foreign knowledge. Full article

Background/objectives: This study addresses two questions: what body sizes/shapes do participants believe correspond to the boundaries of the National Child Measurement Programme (NCMP) weight categories for children aged 4–5 and 10–11 years old, and are these judgements altered by using terminology encouraging positive action by parents? Methods: The study used photorealistic computer-generated stimuli based on 388 3D scans of children in a method of adjustment task. We first asked participants to estimate the boundaries between weight status categories as described by the NCMP. To test validity, we asked a second set of participants to estimate the body that represented exemplars of each weight category (the exemplars should fall between the boundary estimates). We then recruited a third set of participants to determine whether substituting positive action terminology for the weight status definitions altered the boundary positions. Results: First, validity was confirmed. Second, we found a compressed response range (lower weights overestimated and higher weights underestimated) for the positioning of both categorical boundaries and exemplars. Finally, the use of alternative weight status terminology resulted in an upward shift in the position of all boundaries in the BMI spectrum but failed to remove the compressive stimulus response effect. Discussion: There is a disconnect between the child size that people perceive to correspond to the different weight categories and the size criteria used by health professionals, and it is likely that this gap can only be bridged by training to recognise the medically based categories. Full article

Coastal health assessment and diagnosis are important tools for decision-making and coastal management. In this paper, the concept of ecosystem health, which uses medical terminology to define the state of coastal health, was applied to examine and diagnose the state of the physical coastal systems of 120 coastal sites along the Moroccan Mediterranean coastline. Based on this assessment approach, five categories are defined: (1) “Good Health”, with two subdivisions: (1a) “Health Warning” and (1b) “Surface Wounds”; (2) “Minor Injury”; (3) “Major Injury”; (4) “On Life Support” and (5) “Deceased”. According to the results obtained, 38 sites (32%) were classified in the “Good Health” category, with 35 sites (29%) in the “Health Warning” and 11 (9%) in the “Surface Wounds” subdivisions; 14 sites (12%) in each of the “Minor Injury” and “Major Injury” categories; no sites (0%) in the “On Life Support” category; and 8 sites (7%) in the “Deceased” category. The considerable percentage of sites in the alert and lower categories highlights the level of degradation and ongoing loss of coastal ecosystems along the Moroccan Mediterranean coast due to the significant impact of anthropogenic processes and inadequate coastal management practices, highlighting the current degradation of its physical state and its capacity to function naturally, i.e., its ability to respond to various present and future environmental changes. The results and proposals presented in this paper offer important perspectives for the governance, preservation, and management of coastal systems and are very useful in limiting and preventing the degradation of coastal systems linked to natural processes and the development of future anthropogenic activities. In addition, they stress the importance of protecting sites classified as “healthy” and restoring those classified as “alert” or “unhealthy”, using sound management strategies based on reliable scientific data. Full article

Background: Pharmacogenetics (PGx) is the science of assessing how genetic variation affects drug efficacy, tolerability, and safety. While PGx is an emerging discipline which is becoming standard of care, many providers have misunderstandings about its utility. This is even more of a problem for patients, who may perceive that there is a single drug that is “right” for them. The primary objective of this study was to evaluate consumer comprehension of a newly developed patient-facing PGx report. Methods: In this study, we adapted a commercial pharmacogenetic test (Genomind Professional PGx) into a report intended to be more comprehensible to the consumer. The initial translation of the clinical terminology used in the PGx report, into lay terminology was conducted by PharmDs and PhDs who have collectively provided over 20,000 PGx consults to date. These reports were then evaluated with readability scoring software to ensure each translation’s complexity remained ≤8th-grade reading level. A total of 107 participants were recruited to conduct the initial analysis with a goal of achieving a 90% comprehension rate using the Genomind consumer comprehension survey. These participants were also given a modified Minnesota Assessment of Pharmacogenomic Literacy (MAPL™) both before and after the Genomind comprehension survey to assess overall PGx literacy. Results: Ninety-eight (98) out of 107 research participants scored one or zero questions incorrectly, translating to >90% comprehension score on the Genomind consumer comprehension survey. These participants also demonstrated a significant increase in overall pharmacogenetic literacy, as assessed by MAPL after viewing the consumer report and survey. Conclusions: This study found that translating pharmacogenetic test results into lay language may provide individuals with a greater understanding of how their DNA may impact prescribed medications. Full article

Large language models (LLMs) are increasingly applied to specialized domains like medical education, necessitating tailored approaches to evaluate structured responses such as SBAR (Situation, Background, Assessment, Recommendation). This study developed an evaluation tool for nursing student responses using LLMs, focusing on word-based learning and assessment methods to align automated scoring with expert evaluations. We propose a three-stage biasing approach: (1) integrating reference answers into the training corpus; (2) incorporating high-scoring student responses; (3) applying domain-critical token weighting through Weighted Noun Embeddings to enhance similarity measurements. By assigning higher weights to critical medical nouns and lower weights to less relevant terms, the embeddings prioritize domain-specific terminology. Employing Word2Vec and FastText models trained on general conversation, medical, and reference answer corpora alongside Sentence-BERT for comparison, our results demonstrate that biasing with reference answers, high-scoring responses, and weighted embeddings improves alignment with human evaluations. Word-based models, particularly after biasing, effectively distinguish high-performing responses from lower ones, as evidenced by increased cosine similarity differences. These findings validate that the proposed methodology enhances the precision and objectivity of evaluating descriptive answers, offering a practical solution for educational settings where fairness and consistency are paramount. Full article

Clinician notes are a rich source of patient information, but often contain inconsistencies due to varied writing styles, abbreviations, medical jargon, grammatical errors, and non-standard formatting. These inconsistencies hinder their direct use in patient care and degrade the performance of downstream computational applications that rely on these notes as input, such as quality improvement, population health analytics, precision medicine, clinical decision support, and research. We present a large-language-model (LLM) approach to the preprocessing of 1618 neurology notes. The LLM corrected spelling and grammatical errors, expanded acronyms, and standardized terminology and formatting, without altering clinical content. Expert review of randomly sampled notes confirmed that no significant information was lost. To evaluate downstream impact, we applied an ontology-based NLP pipeline (Doc2Hpo) to extract biomedical concepts from the notes before and after editing. F1 scores for Human Phenotype Ontology extraction improved from 0.40 to 0.61, confirming our hypothesis that better inputs yielded better outputs. We conclude that LLM-based preprocessing is an effective error correction strategy that improves data quality at the level of free text in clinical notes. This approach may enhance the performance of a broad class of downstream applications that derive their input from unstructured clinical documentation. Full article

The management of medical waste (MW) is a critical global challenge, contributing to toxic effects on humans, environmental degradation, and economic burdens. Despite advancements, gaps remain in adopting sustainable waste disposal practices, with limited bibliometric analysis in this field. The rising volume of MW, exacerbated by global health crises, strains existing systems. This study uses bibliometric analysis of 3025 publications from 1975 to 2024, employing Web of Science data with specific Boolean operators and keywords for efficient searching algorithms. Data visualization and analysis were carried out with software such as VOSviewer version 1.6.20 and Bibliometrix 5.0.0, along with custom Python 3.12.3 thesaurus files to standardize terminology. The results reveal a significant rise in publications post-2000, particularly during the COVID-19 pandemic, with China, India, and the US as major contributors. South Korea stands out for high citation rates. Network analysis identified collaboration patterns, while trend mapping highlighted a shift toward sustainable waste management practices. The evaluation insights revealed a clear transition from incineration-based methods toward sustainable and innovative solutions such as autoclaving, plasma pyrolysis, and advanced oxidation processes, driven by environmental concerns and regulatory frameworks. This study underscores the implications of MW and the importance of analyzing publication trends over time to understand the ongoing need for development, grounded in a legislative policy framework, which is essential for advancing sustainable practices in MW management. Full article

Clinical text classification presents significant challenges in healthcare informatics due to inherent asymmetries in domain-specific terminology, knowledge distribution across specialties, and imbalanced data availability. We introduce MTTL-ClinicalBERT, a symmetrical multi-task transfer learning framework that harmonizes knowledge sharing across diverse medical specialties while maintaining balanced performance. Our approach addresses the fundamental problem of symmetry in knowledge transfer through three innovative components: (1) an adaptive knowledge distillation mechanism that creates symmetrical information flow between related medical domains while preventing negative transfer; (2) a bidirectional hierarchical attention architecture that establishes symmetry between local terminology analysis and global contextual understanding; and (3) a dynamic task-weighting strategy that maintains equilibrium in the learning process across asymmetrically distributed medical specialties. Extensive experiments on the MTSamples dataset demonstrate that our symmetrical approach consistently outperforms asymmetric baselines, achieving average improvements of 7.2% in accuracy and 6.8% in F1-score across five major specialties. The framework’s knowledge transfer patterns reveal a symmetric similarity matrix between specialties, with strongest bidirectional connections between cardiovascular/pulmonary and surgical domains (similarity score 0.83). Our model demonstrates remarkable stability and balance in low-resource scenarios, maintaining over 85% classification accuracy with only 30% of training data. The proposed framework not only advances clinical text classification through its symmetrical design but also provides valuable insights into balanced information sharing between different medical domains, with broader implications for symmetrical knowledge transfer in multi-domain machine learning systems. Full article

In late 2023, the U.S. Food and Drug Administration (FDA) approved two renal denervation (RDN) systems for the treatment of hypertension. Several professional societies, including the Society of Cardiovascular Angiography and Intervention (SCAI), the American Heart Association (AHA), and numerous European associations, have recognized the potential role of RDN in managing hypertension. Despite widespread enthusiasm from clinicians, patients, and the industry, the American Medical Association’s Current Procedural Terminology (CPT) panel rejected the introduction of new codes for renal denervation at its September 2024 meeting. This article analyzes the latest evidence from clinical trials and registries, reviews current challenges in clinical practice, and explores the role of contemporary hypertension treatment from the perspective of interventional cardiologists. Full article

Background: This study investigated whether a health literacy intervention program could improve the health literacy and quality of life among hospital volunteers. The study also explored the impact of health literacy on hospital volunteers’ health and psychological well-being. Methods: Overall, 35 hospital volunteers were recruited and divided into an experimental group (n = 22) and a control group (n = 13). The experimental group participated in an 8-week health literacy intervention program, which covered topics such as medication information, physiological and symptom-related vocabulary, and disease representation. The control group did not receive any intervention. A questionnaire survey was conducted to assess participants’ health literacy and quality of life before and after the intervention, and the comparison between two groups was statistically analyzed. Results: The experimental group showed significant improvements in multiple aspects of health literacy, particularly in medication information, physiology vocabulary, symptom vocabulary, and signs vocabulary (p < 0.05). In terms of quality of life, the experimental group demonstrated significant enhancements in psychological well-being and overall quality of life (p < 0.05). In contrast, the control group exhibited a downward trend in most health literacy dimensions with a significant decline in organ vocabulary (p < 0.05) and no significant changes in quality of life. Conclusions: The health literacy intervention program effectively improved hospital volunteers’ health literacy and quality of life with particularly notable effects on psychological well-being and the understanding of health-related professional terminology. By enhancing hospital volunteers’ health literacy and quality of life, healthcare organizations can foster more effective, sustainable, and satisfactory service quality. Full article

Service learning across medical schools is non-standardized and the skills that they learn can vary. Project HEART, a volunteer-based outreach program focused on teaching cardiovascular health and cardiopulmonary resuscitation (CPR) at public high schools, was implemented to encourage greater community engagement and equilibrate skill acquisition across different service projects. This pilot study characterized the benefits of providing service learning opportunities to first-year medical students. First-year medical students at a single institution were recruited to Project HEART. Following service sessions, all students completed a retrospective pre/post survey. They provided self-reported scores on a five-point Likert-type scale, grading their didactic and communication skills before and after the event. Subjective feelings of community engagement were also queried. Overall, 30 students were recruited across nine different community programs. Following participation, significantly increased confidence was seen in performing hands-only CPR (p < 0.001), public speaking (p = 0.003), teaching effectively (p < 0.001), and explaining medical terminology to laypersons (p < 0.001). Volunteers had an increased sense of community engagement (p < 0.001) and 17/30 students expressed greater consideration towards specializing in cardiology, primary care, or entering academia after participation. The study supported the proposal that service learning may promote self-determined altruism, positively influence perceptions of community stewardship, and have positive subjective benefits on medical student education. Full article

Background/Objectives: This study aimed to enhance the usability of patient monitoring systems by integrating the Early Warning Score (EWS) function and improving user interface elements. The EWS function is expected to enable the early detection of acute deterioration and prompt medical intervention, while the optimized design supports rapid decision-making by nursing staff. Methods: Two formative usability evaluations were conducted to identify user requirements and improve the device design. A simulated usability test involved five ICU medical staff members, followed by a user preference survey with 72 ICU staff members in a real clinical setting. After incorporating feedback, a summative usability test with 23 ICU nurses was performed to evaluate the revised device. Results: Issues related to unfamiliar parameter terminology and alarm message positioning were identified, and the need for the EWS function was emphasized. The summative evaluation showed an increase in task success rate from 86% to 90% and a significant improvement in user satisfaction from 74.85 (SD: 0.88) to 89.55 (SD: 0.75) (p < 0.05). Conclusions: The integration of the EWS function and interface improvements significantly enhanced the usability of patient monitoring system. These advancements are expected to enable rapid detection of patient deterioration and support timely clinical decision-making by ICU staff. Full article