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5,565 results for “medical”
Analysis of factors influencing the network teaching effect of college students in a medical school during the COVID-19 epidemic
<p><strong>Analysis of factors influencing the network teaching effect of college students in a medical school during the COVID-19 epidemic</strong></p>
Publicly available medical text data with authentic quality
<p>This dataset is the public medical text record (progress notes) written in Japanese.</p> <p>Any researchers can use this dataset without privacy issues. </p> <p>CC BY-NC 4.0</p> <p>crowd.zip: 9,756 pseudo progress notes written by crowd workers</p> <p>crowd_evaluated.zip: 83 pseudo progress notes with authentic quality written by crowd workers</p> <p>MD.zip: 19 pseudo progress notes written by medical doctors</p> <p> </p> <p>Reference:</p> <p>Kagawa, R., Baba, Y., & Tsurushima, H. (2021, December). A practical and universal framework for generating publicly available medical notes of authentic quality via the power of crowds. In <em>2021 IEEE International Conference on Big Data (Big Data)</em> (pp. 3534-3543). IEEE.</p> <p><a href="http://hdl.handle.net/2241/0002002333">http://hdl.handle.net/2241/0002002333</a></p> <p>The supplemental files of the paper are here: <a href="https://github.com/rinabouk/HMData2021">https://github.com/rinabouk/HMData2021</a></p>
Professional burnout of medical professionals according to specialties and generations
<p>The problem of professional burnout of medical workers around the world is acute and is directly related to the quality of medical care.</p> <p>The aim of the study is to determine the prevalence, severity and risk factors of professional burnout syndrome of medical workers in Tomsk region according to generations to develop preventive measures.</p> <p>Materials and methods. As part of the study, a questionnaire was developed that consisted of 41 questions aimed at assessing the life factors of medical professionals. Also it included an abbreviated version of the MBI questionnaire (Maslach Burnout Inventory) in the Russian-language adaptation by N. E. Vodopyanova and E. S. Starchenkova (2005). The study population was divided into age groups based on the generational theory. Participation in the survey was anonymous and voluntary.</p> <p>Expected results of the study. The study will determine the factors of development professional burnout syndrome of medical workers in Tomsk region according to generations and identify possible correlations with socio-economic status, as well as suggest corrective measures to modernize the personnel policy aimed at preventing this syndrome.</p>
Study on the correlation of prevalence of ocular disease to different demographic variables, medical history and concomitant diseases.
<p>Random blood sugar, cholesterol, and triglycerides were analyzed by taking the blood sample from each patient. The average of the parameters was recorded, and the standard deviation (SD) was calculated. The parameters have been presented in the study as mean± SD. Blood sample analysis revealed that the average random blood glucose level (mg/dl) was 113.3±26.9 (Mean ±SD). The average cholesterol level was 189.35± 49.7 mg/dl, and the average triglycerides level was 124.25±50.0 mg/dl. Average systolic and diastolic blood pressure was found to be 126.0 ± 15.5 mmHg and 81.43 ± 8.0 mmHg, respectively. The patients were examined by the dermatologist. The dermatologists observed the signs, and the patients were asked about the presence of the symptoms to evaluate the severity of psoriasis and psoriatic arthropathy. The patients were asked about the duration for which they had been suffering from psoriasis. On average, a patient was found to be suffering from psoriasis for 11.4 ±9.9 years (the duration ranged from a minimum of 1 year to a maximum of 45 years). The doctor screened the patients for the number of sites involved and evaluated the severity of psoriasis via psoriasis area and severity index (PASI) score. Average Psoriasis Area and Severity Index (PASI) for the patients, as recorded by the dermatologists, was found to be 5.94 ± 6.8. </p>
Toxin or medication? Immunotherapeutic effects of nicotine on a specialist caterpillar
<p>1. A core tenant in the field of ecological immunology is that immune responses trade off with other physiological functions due to resource-allocation costs. Caterpillars, for example, tend to exhibit reduced immune responses when reared on more toxic food plants due to a cost from detoxifying or sequestering secondary metabolites, also known as the "vulnerable host hypothesis". However, support for this hypothesis is mixed, and studies have not yet mechanistically isolated the relative contributions of total plant defenses, specific metabolites, or macro-nutritional quality. </p> <p>2. We used the tobacco hornworm (Manduca sexta), a specialist herbivore on plants in the nightshade family (Solanaceae), to investigate tradeoffs in immune response. This system is ideal given the availability of solanaceous plant lines varying in general (i.e., jasmonate-induced) and specific (i.e., nicotine) resistance traits. We also applied a geometric diet stoichiometry approach to examine how phytochemical toxicity and nutritional quality interactively impact insect immunity and performance. We predicted that as plant toxicity increased immune activity and herbivore performance would decrease.</p> <p>3. Increasing food plant toxicity reduced insect growth and development, as predicted, but contrary to our hypothesis, plant toxicity did not trade off with immune parameters. Surprisingly, specific plant chemicals, in this case nicotine, appeared immunotherapeutic, stimulating the phenoloxidase (PO) immune response of M. sexta. Available nutrients in artificial diets, mainly protein, also strongly impacted insect growth, but did not affect PO activity, while diets supplemented with nicotine enhanced the PO and melanization response.</p> <p>4. This work highlights how specific secondary metabolites, and not overall plant toxicity, impact the immune response. Importantly, our data also suggest an alternative mechanism (i.e., immune enhancement) for reduced parasitoid performance when reared from hosts on toxic plants via tri-trophic interactions.</p>
The impact of the program for medical male circumcision on HIV in South Africa: analysis using three epidemiological models
<p class="Body"><b>Background</b>: South Africa began offering medical male circumcision (MMC) in 2010. We evaluated the current and future impact of this program to see if it is effective in preventing new HIV infections.</p> <p class="Body"><b>Methods</b>: The Thembisa, Goals and EMOD HIV transmission models were calibrated to South Africa's HIV epidemic, fitting to household survey data on HIV prevalence, risk behaviors, and proportions of men circumcised, and to programmatic data on intervention roll-out including program-reported MMCs over 2009-2017. We compared the actual program accomplishments through 2017 and program targets through 2021 with a counterfactual scenario of no MMC program.</p> <p class="Body"><strong>Results:</strong> The MMC program averted 71,000-83,000 new HIV infections from 2010 to 2017. The future benefit of the circumcision already conducted will grow to 496,000-518,000 infections (6-7% of all new infections) by 2030. If program targets are met by 2021 the benefits will increase to 723,000-760,000 infections averted by 2030. The cost would be $1,070-1,220 per infection averted relative to no MMC. The savings from averted treatment needs would become larger than the costs of the MMC program around 2034-2039. In the Thembisa model, when modelling South Africa's 9 provinces individually, the 9-provinces-aggregate results were similar to those of the single national model. Across provinces, projected long-term impacts were largest in Free State, KwaZulu-Natal and Mpumalanga (23-27% reduction over 2017-2030), reflecting these provinces' greater MMC scale-up.</p> <p class="Body"><b>Conclusions</b>: MMC has already had a modest impact on HIV incidence in South Africa and can substantially impact South Africa's HIV epidemic in the coming years.</p>
Data from: Medical-device recalls in the UK and the device-regulation process: retrospective review of safety notices and alerts
Background: Medical devices are used widely for virtually every disease and condition. Although devices are subject to regulation, the number of recalls, the clinical data requirements for regulation and the impact on patient safety are poorly understood. Methods: The authors defined a device using European directives and used publicly available information on the Medicines and Health Regulatory Authority website to determine the number of devices recalled from January 2006 to December 2010. Two reviewers independently assessed Field Safety Notices and Medical Device Alerts. The authors wrote to manufacturers to obtain further information and clinical data, and summarised data by year, Conformité Européenne classification, indication, and Food and Drug Administration recall system of severity. Results: In total, 2124 field safety notices were issued over the 5-year period, an increase of 1220% (62 in 2006 to 757 in 2010). 447 Medical Device Alerts were issued in the same period, and 44% were assessed as a reasonable probability of causing serious adverse health consequences or death. The authors wrote to 192 manufacturers of withdrawn devices and received 101 (53%) replies; only four (2.1%) provided the clinical data the authors requested. A lack of available transparent data prevented full analyses of the safety impact. Of the highest-risk recalled devices, more than half were related to the cardiovascular system (25%) or musculoskeletal system (33%), and 88% (95% CI 80% to 97%) were assessed as a reasonable probability of causing serious adverse health consequences or death. For low-risk devices, the figure was 34% (95% CI 26% to 42%). Conclusion: The number of medical devices subject to recalls or warnings in the UK has risen dramatically. A substantial number of these devices may have caused serious adverse effects in patients and contributed to healthcare costs. Significant problems exist in the UK with a lack of access to transparent data and a registry of the highest-risk devices.
Data from: What influence do courses at medical school and personal experience have on interest in practicing family medicine? – results of a student survey in Hessia
Aim: Against the background of an impending shortage of family practitioners, it is important to investigate the factors influencing the choice to become one. The aim of this study was to identify factors that encourage medical students to choose to practice family medicine. Method: Using a questionnaire, students in the fourth and fifth years of their studies in the Federal State of Hesse were asked about the factors that had influenced their choice of medical specialty and their experience of courses in family medicine. Predictors of an interest in practicing family medicine were calculated using multiple logistic regression. Results: 361 questionnaires were returned, representing a response rate of 70.9%. Confirmation of personal strengths, an interest in the field, and practical experience of the subject generally turned out to be important factors influencing the choice of medical specialty. 49.3% of students expressed an interest in practicing family medicine. A link existed between an interest in working as a family doctor and the opportunity to take over an existing practice, experience of medicine in rural areas, and an appreciation of the conditions of work. With regard to education at medical school, positive experiences during a clinical traineeship in family medicine and positive role models among teachers of general practice were identified as predictors. Conclusion: Almost half the medical students were open to the idea of practicing family medicine. Experience of medicine in rural areas and positive experiences of courses in general practice were linked to an increased interest in working as a family doctor. To promote this interest, it may be a promising approach to increase opportunities to collect experience of medicine in rural areas, and to encourage highly motivated teaching practices.
Data from: Cost-effectiveness of a specialist geriatric medical intervention for frail older people discharged from acute medical units: economic evaluation in a two-centre randomised controlled trial (AMIGOS)
Background: Poor outcomes and high resource-use are observed for frail older people discharged from acute medical units. A specialist geriatric medical intervention, to facilitate Comprehensive Geriatric Assessment, was developed to reduce the incidence of adverse outcomes and associated high resource-use in this group in the post-discharge period. Objective: To examine the costs and cost-effectiveness of a specialist geriatric medical intervention for frail older people in the 90 days following discharge from an acute medical unit, compared with standard care. Methods: Economic evaluation was conducted alongside a two-centre randomised controlled trial (AMIGOS). 433 patients (aged 70 or over) at risk of future health problems, discharged from acute medical units within 72 hours of attending hospital, were recruited in two general hospitals in Nottingham and Leicester, UK. Participants were randomised to the intervention, comprising geriatrician assessment in acute units and further specialist management, or to control where patients received no additional intervention over and above standard care. Primary outcome was incremental cost per quality adjusted life year (QALY) gained. Results: We undertook cost-effectiveness analysis for 417 patients (intervention: 205). The difference in mean adjusted QALYs gained between groups at 3 months was -0.001 (95% confidence interval [CI]: -0.009, 0.007). Total adjusted secondary and social care costs, including direct costs of the intervention, at 3 months were £4412 (€5624, $6878) and £4110 (€5239, $6408) for the intervention and standard care groups, the incremental cost was £302 (95% CI: 193, 410) [€385, $471]. The intervention was dominated by standard care with probability of 62%, and with 0% probability of cost-effectiveness (at £20,000/QALY threshold). Conclusions: The specialist geriatric medical intervention for frail older people discharged from acute medical unit was not cost-effective. Further research on designing effective and cost-effective specialist service for frail older people discharged from acute medical units is needed.
Interprofessional education in geriatric medicine: towards best practice. A controlled before-after study of medical and nursing student attitudes
<p>Objectives To investigate nursing and medical students' readiness for interprofessional learning before and after implementing geriatric Interprofessional education (IPE), based on interactive case scenarios Problem Based Learning (PBL). To determine optimal number of geriatric IPE sessions, the size and the ratio of participants in the learner groups, the outcomes related to the Kirkpatrick four-level typology of learning evaluation, students' concerns about joint learning, perception of roles of the "other" profession and students choice of topic.</p> <p>The strength:</p> <p>• This is a novel evidence regarding good practice for geriatric undergraduate Interprofessional education derived from a large unselected (inclusive) cohort of medical and nursing students</p> <p>• A controlled before-after study, with students randomly assigned to the intervention and control groups</p> <p>The limitations:</p> <p>• The overall number of nursing students was smaller, so the control group consisted of only medical students</p> <p>• The nursing students had more clinical experience than the medical students at the time of the geriatric IPE</p> <p>• Not all students returned the feedback forms, complaining that completing both questionnaires was time-consuming</p>
Data from: Reducing early infant mortality in India: results of a prospective cohort of pregnant women utilizing emergency medical services
Objectives: To describe the demographic characteristics and clinical outcomes of neonates born within 7 days of public ambulance transport to hospitals across five states in India. Design: Prospective observational study. Setting: Five Indian states using a centralised EMS agency that transported 3.1 million pregnant women in 2014. Participants: Over 6 weeks in 2014, this study followed a convenience sample of 1,431 neonates born to women utilizing a public-private ambulance service for a 'pregnancy related' problem. Initial calls were deemed 'pregnancy related' if categorised by EMS dispatchers as 'pregnancy', 'childbirth', 'miscarriage' or 'labour pains'. Interfacility transfers, patients absent on ambulance arrival, refusal of care, and neonates born to women beyond 7 days of using the service were excluded. Main outcome measures: Death at 2, 7 and 42 days after delivery. Results: Among 1,684 women, 1,411 gave birth to 1,431 newborns within 7 days of initial ambulance transport. Median maternal age at delivery was 23 years (IQR: 21-25). Most mothers were from rural/tribal areas (92.5%) and lower social (79.9%) and economic status (69.9%). Follow-up rates at 2, 7 and 42 days were 99.8%, 99.3% and 94.1%, respectively. Cumulative mortality rates at 2, 7 and 42-days follow-up were 41, 53 and 62 per 1000 births, respectively. The perinatal mortality rate (PMR) was 53 per 1000. Preterm birth [OR: 2.89, 95% CI: 1.67-5.00], twin deliveries (OR: 2.80, 95% CI: 1.10-7.15), and cesarean section (2.21, 95% CI: 1.15-4.23) were the strongest predictors of mortality. Conclusions: The perinatal mortality rate associated with this cohort of patients with high-acuity conditions of pregnancy was nearly two times the most recent rate for India as a whole (28 per 1000 births). EMS data has the potential to provide more robust estimates of PMR, reduce inequities in timely access to healthcare, and increase facility-based care through service of marginalized populations.
Data from: Medically important differences in snake venom composition are dictated by distinct postgenomic mechanisms
Variation in venom composition is a ubiquitous phenomenon in snakes and occurs both interspecifically and intraspecifically. Venom variation can have severe outcomes for snakebite victims by rendering the specific antibodies found in antivenoms ineffective against heterologous toxins found in different venoms. The rapid evolutionary expansion of different toxin-encoding gene families in different snake lineages is widely perceived as the main cause of venom variation. However, this view is simplistic and disregards the understudied influence that processes acting on gene transcription and translation may have on the production of the venom proteome. Here, we assess the venom composition of six related viperid snakes and compare interspecific changes in the number of toxin genes, their transcription in the venom gland, and their translation into proteins secreted in venom. Our results reveal that multiple levels of regulation are responsible for generating variation in venom composition between related snake species. We demonstrate that differential levels of toxin transcription, translation, and their posttranslational modification have a substantial impact upon the resulting venom protein mixture. Notably, these processes act to varying extents on different toxin paralogs found in different snakes and are therefore likely to be as important as ancestral gene duplication events for generating compositionally distinct venom proteomes. Our results suggest that these processes may also contribute to altering the toxicity of snake venoms, and we demonstrate how this variability can undermine the treatment of a neglected tropical disease, snakebite.
Data from: Is computer-assisted instruction more effective than other educational methods in achieving ECG competence amongst medical students and residents? A systematic review and meta-analysis.
Objectives It remains unclear whether computer-assisted instruction (CAI) is more effective than other teaching methods in acquiring and retaining ECG competence amongst medical students and residents. Design This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data sources Electronic literature searches of PubMed, databases via EBSCOhost, Scopus, Web of Science, Google Scholar and grey literature were conducted on 28 November 2017. We subsequently reviewed the citation indexes of articles identified by the search. Eligibility criteria Studies were included if a comparative research design was used to evaluate the efficacy of CAI versus other methods of ECG instruction, as determined by the acquisition and/or retention of ECG competence of medical students and/or residents. Data extraction and synthesis Two reviewers independently extracted data from all eligible studies and assessed the risk of bias. After duplicates were removed, 559 papers were screened. Thirteen studies met the eligibility criteria. Eight studies reported sufficient data to be included in the meta-analysis. Results In all studies, CAI was compared to face-to-face ECG instruction. There was a wide range of computer-assisted and face-to-face teaching methods. Overall, the meta-analysis found no significant difference in acquired ECG competence between those who received computer-assisted or face-to-face instruction. However, sub-analyses showed that CAI in a blended learning context was better than face-to-face teaching alone, especially if trainees had unlimited access to teaching materials and/or deliberate practice with feedback. There was no conclusive evidence that CAI was better than face-to-face teaching for longer-term retention of ECG competence. Conclusion CAI was not better than face-to-face ECG teaching. However, this meta-analysis was constrained by significant heterogeneity amongst studies. Nevertheless, the finding that blended learning is more effective than face-to-face ECG teaching is important in the era of increased implementation of e-learning. PROSPERO registration number CRD42017067054
A Positive/Unlabeled Approach for the Segmentation of Medical Sequences using Point-Wise Supervision
<p>Description<br> ------------</p> <p>This archive contains data and results (model checkpoint, segmentation results, ...)<br> used and obtained in paper:</p> <p>Laurent Lejeune, Raphael Sznitman,<br> A Positive/Unlabeled Approach for the Segmentation of Medical Sequences using Point-Wise Supervision,<br> Medical Image Analysis,<br> 2021 (in preparation)</p> <p>Details<br> ------------</p> <p>Each directory is named DatasetXY, where X denotes the type (surgical instrument, cochlea,<br> slitlamp, and brain), and Y denotes the index of the sequences (from 0 to 3).</p> <p>For the data.zip archive, we provide a CSV file that contains the 2d locations used in our experiments.</p> <p>For the results.zip archive, the checkpoint of our models are in PyTorch format.</p> <p> </p>
Data from: Trial-results reporting and academic medical centers.
To the Editor: Reporting of aggregate results helps mitigate disclosure biases affecting medical research. Although the reporting of summary results is currently mandated by the Food and Drug Administration Amendments Act of 2007 (FDAAA), published findings suggest underreporting. Two recent proposals are aimed at improving public reporting of aggregate results. These are a Notice of Proposed Rulemaking (NPRM) to expand FDAAA requirements to include the results of trials of unapproved products, and a draft policy requiring the results of all National Institutes of Health (NIH)-funded trials, including those not subject to the FDAAA.
Data from: Medical school selection criteria as predictors of medical student empathy: a cross-sectional study of medical students, Ireland
Objectives: To determine whether performance in any of the HPAT sections, most specifically the interpersonal understanding section, correlates with self-reported empathy levels in medical students. Setting: The study was conducted in University College Cork, Ireland. Participants: 290 students participated in the study. Matching HPAT scores were available for 263 students. All male and female undergraduate students were invited to participate. Post graduate and international students were excluded. Primary and secondary outcome measures: HPAT-Ireland and JSPE scores were compared including subsection analysis. Comparisons were made between groups such as gender and year of programme. Results : A total of 290 students participated. Males scored significantly higher than females for total HPAT-Ireland [U = 7329, z = -2.04, p < 0.05], HPAT-Ireland Section 1 [U = 5382, z = -5.21, p < 0.0001], and Section 3 scores [U = 6833, z = -2.85, p < 0.01]. In contrast, females scored significantly higher than males on HPAT-Ireland Section 2 [U = 5844, z = -4.46, p < 0.0001]. Females demonstrated significantly higher total JSPE scores relative to males [mean score ± SEM: 113.33 ± 1.05 vs 109.21 ± 0.95; U = 8450, z = -2.83, p < 0.01]. No significant association was observed between JSPE scores and any of the HPAT-Ireland measures [all p > 0.05]. There was no effect of programme year on JSPE scores [all p >0.05]. Conclusion : The introduction of the HPAT–Ireland test was partly designed to identify students with strong interpersonal skills. A significant finding of this study is that JSPE values did not correlate with HPAT-Ireland scores. This study suggests no clear link between scores on a selection test, the HPAT-Ireland, which is designed to assess several skill domains including interpersonal skills, and scores on a psychometric measure of empathy, at any point during medical education.
Data from: Diagnostic pathways and direct medical costs incurred by new adult pulmonary tuberculosis patients prior to anti-tuberculosis treatment – Tamil Nadu, India
Background: Tuberculosis (TB) patients face substantial delays prior to treatment initiation, and out of pocket (OOP) expenditures often surpass the economic productivity of the household. We evaluated the pre-diagnostic cost and health seeking behaviour of new adult pulmonary TB patients registered at Primary Health Centres (PHCs) in Vellore district, Tamil Nadu, India. Methods: This descriptive study, part of a randomised controlled trial conducted in three rural Tuberculosis Units from Dec 2012 to Dec 2015, collected data on number of health facilities, dates of visits prior to the initiation of anti-tuberculosis treatment, and direct OOP medical costs associated with TB diagnosis. Logistic regression analysis examined the factors associated with delays in treatment initiation and OOP expenditures. Results: Of 880 TB patients interviewed, 34.7% presented to public health facilities and 65% patients sought private health facilities as their first point of care. The average monthly individual income was $77.79 (SD 57.14). About 69% incurred some pre-treatment costs at an average of $39.74. Overall, patients experienced a median of 6 days (3-11 IQR) of time to treatment initiation and 21 days (10-30 IQR) of health systems delay. Age ≤ 40 years (aOR: 1.73; CI: 1.22 - 2.44), diabetes (aOR: 1.63; CI: 1.08 - 2.44) and first visit to a private health facility (aOR: 17.2; CI: 11.1 - 26.4) were associated with higher direct OOP medical costs, while age ≤ 40 years (aOR: 0.64; CI: 0.48 - 0.85) and first visit to private health facility (aOR: 1.79, CI: 1.34 - 2.39) were associated with health systems delay. Conclusion: The majority of rural TB patients registering at PHCs visited private health facilities first and incurred substantial direct OOP medical costs and delays prior to diagnosis and anti-tuberculosis treatment initiation. This study highlights the need for PHCs to be made as the preferred choice for first point of contact, to combat TB more efficiently.
Time-sensitive inventory of medical terminology
<p>This inventory contains a set of terms that are relevant to the study of medical history.</p> <p>The inventory is organised as a set of "heading terms", belonging to one of seven different semantic categories, each of which is accompanied by a set of semantically-related terms. There are around 175,000 heading terms.</p> <p>The nature of the semantic relationship holding between the heading term and each related term varies. A pair of related terms may, for example be synonyms of each other, one term may be more or less specific than the other, one may be a part of the other, one may be used in the treatment of the other, etc.</p> <p>The unique feature of our terminological inventory is that the sematically-related terms may correspond to terms used within different periods of time, and which may not be in common usage today.</p>
Figure 3 The mean hours of self medical English learning per week.
<p>Figure 3 for <strong>Mind Mapping improved the Effect of Medical English Learning for non-Native English Speakers in non Target Language Environment：A Randomized Controlled Trial</strong></p>
Appendix 2 Self-medication study questionnaire
<p>Appendix 2 Self-medication study questionnaire</p>
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OpenNeuro
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