Madhan Jeyaraman, S. Balaji, Naveen Jeyaraman
et al.
The integration of artificial intelligence (AI) into healthcare promises groundbreaking advancements in patient care, revolutionizing clinical diagnosis, predictive medicine, and decision-making. This transformative technology uses machine learning, natural language processing, and large language models (LLMs) to process and reason like human intelligence. OpenAI's ChatGPT, a sophisticated LLM, holds immense potential in medical practice, research, and education. However, as AI in healthcare gains momentum, it brings forth profound ethical challenges that demand careful consideration. This comprehensive review explores key ethical concerns in the domain, including privacy, transparency, trust, responsibility, bias, and data quality. Protecting patient privacy in data-driven healthcare is crucial, with potential implications for psychological well-being and data sharing. Strategies like homomorphic encryption (HE) and secure multiparty computation (SMPC) are vital to preserving confidentiality. Transparency and trustworthiness of AI systems are essential, particularly in high-risk decision-making scenarios. Explainable AI (XAI) emerges as a critical aspect, ensuring a clear understanding of AI-generated predictions. Cybersecurity becomes a pressing concern as AI's complexity creates vulnerabilities for potential breaches. Determining responsibility in AI-driven outcomes raises important questions, with debates on AI's moral agency and human accountability. Shifting from data ownership to data stewardship enables responsible data management in compliance with regulations. Addressing bias in healthcare data is crucial to avoid AI-driven inequities. Biases present in data collection and algorithm development can perpetuate healthcare disparities. A public-health approach is advocated to address inequalities and promote diversity in AI research and the workforce. Maintaining data quality is imperative in AI applications, with convolutional neural networks showing promise in multi-input/mixed data models, offering a comprehensive patient perspective. In this ever-evolving landscape, it is imperative to adopt a multidimensional approach involving policymakers, developers, healthcare practitioners, and patients to mitigate ethical concerns. By understanding and addressing these challenges, we can harness the full potential of AI in healthcare while ensuring ethical and equitable outcomes.
IntroductionUniversity students constitute a key source of national talent, yet academic and social pressures may cause harm to their physical and psychological health. From a salutogenic perspective, sense of coherence functions as a coping resource that mitigates the effects of demanding environments. This study examines how physical activity relates to sense of coherence, considering the roles of self-esteem and grit.MethodsA cross-sectional survey used stratified cluster sampling (province × university type strata; sampled classrooms as clusters with in-class census of all eligible students). Four hundred and sixty-five valid questionnaires were collected from undergraduates in Hunan, Hubei, and Henan, China. Relationships among physical activity, self-esteem, grit, and sense of coherence were tested using structural equation modeling with maximum likelihood estimation.ResultsPhysical activity was positively associated with self-esteem and with grit. Self-esteem was positively associated with grit. Both self-esteem and grit were positively associated with sense of coherence. In addition, self-esteem and grit jointly mediated the relationship between physical activity and sense of coherence. Participation in physical activity appears to enhance self-esteem and grit, which in turn are linked to a stronger sense of coherence.DiscussionTo promote healthier university lives, governments and universities should expand opportunities for sport and create supportive environments that encourage regular, long-term engagement in physical activity. Students are encouraged to form and maintain stable physical-activity habits.
Ramona Nasr, Abir Abdel Rahman, Chadia Haddad
et al.
The financial crisis has indirectly affected Lebanese university students, leading to economic distress. Accordingly, this study aimed to assess the substantial negative impact of financial stress on the mental health and well-being of Lebanese college students. A quantitative research approach was applied and took place from June 13th to July 25th, 2023, targeting 1272 university students aged 17 and above from private and public universities across Lebanon through convenience sampling. The InCharge Financial Distress/Financial Well-Being scale (IFDFW), Pittsburgh Sleep Quality Index (PSQI), Beirut Distress Scale (BDS-10), Perceived Stress Scale (PSS-10), and Well-Being Index (WHO-5) were used to assess the students’ well-being. Descriptive analyses of the data was performed using SPSS software version 25. 1272 university students participated in this study, mostly females, with a mean age of 21.64 (± 4.43) years. Participants reported a lack of financial independence, unemployment, and no income. Positive associations were obtained between the BDS total scale as well as the PSS total and PSQI scores, while there was a significant negative relationship between IFDFW and PSQI scores. Those with a higher GPA, majoring in science/health and medicine, living in rural areas, and graduate students were linked to lower PSQI and BDS-10 scores. Financial aid and financial independence were associated with lower PSQI and BDS-10 scores. PSS-10 scores were higher among students majoring in science/health and medicine. Higher scores on the IFDFW scale correlated with lower BDS-10 and PSS-10 scores. In contrast, females had higher BDS-10 and PSS-10 scores. Scoring higher on the PSS-10 and PSQI scales, living off campus, or majoring in science/health and medicine, were associated with higher on the WHO-5 scale. A significant impact of financial stress on college students in Lebanon was obtained, affecting their well-being and mental health aspects. Marital status, gender, academic major, region of living, and financial independence also influences students’ experiences. Tailored support and further research are needed to address these multifaceted challenges.
Abstract Introduction The number of postmenopausal women is expected to grow dramatically in the coming decades in Iran. Adopting a health-promoting lifestyle (HPL) is essential for improving health and quality of life of this population. This study pursues two objectives: (1) to assess the HPL levels among Iranian postmenopausal women and (2) to investigate the socio-demographic and psychological variables including self-efficacy and self-esteem associated with HPL. Methods In this cross-sectional study with correlational design, 400 married postmenopausal women in Shiraz (southwestern Iran) were selected via stratified random sampling. The data collection tools were the Health-Promoting Lifestyle Profile-II (HPLP-II), General Self-Efficacy Scale (GSE), the Rosenberg Self-Esteem Scale, and a sociodemographic information questionnaire. Pearson’s correlation coefficient test, independent samples t-tests, and stepwise multiple linear regression were used for analyzing the data in SPSS v. 22. Results The average age of natural menopause among participants was 49.33 ± 3.43 years, and they had relatively good HPLP (136.52 ± 21.46). The results highlighted that among all the HPLP subscales, the highest mean score was observed for health responsibility (33.62 ± 6.98), whereas the lowest scores were observed for stress management (12.26 ± 3.13) and physical activity (17.64 ± 6.52). Both self-efficacy (r = 0.445, p < 0.01) and self-esteem (r = 0.425, p < 0.01) demonstrated significant, moderate positive correlations with the total HPL score. Also, there was a significant association between the total HPLP score and two demographic variables: women’s education (r = 0.17, p < 0.01) and husband’s educational level (r = 0.113, p < 0.05). In addition, the HPLP total score had a significant negative relationship with the number of children (r=-0.114, p < 0.05). The stepwise multiple linear regression analysis revealed that the variables independently associated with the HPL of participants were self-efficacy (β = 0.32, p < 0.001), self-esteem (β = 0.27, p < 0.001), and occupation (β = 0.144, p < 0.001). Conclusion It is suggested that health care professionals implement comprehensive planning to enhance the HPL of postmenopausal women. Interventions aimed at improving HPL in this population should prioritize strategies to enhance self-efficacy and self-esteem. Particular attention should be paid to women with lower education, unemployment, and a higher number of children.
Gynecology and obstetrics, Public aspects of medicine
Alma Tursynbek, Dilnaz Zhaksylykova, J. Cruz
et al.
BACKGROUND Artificial intelligence integration into healthcare has gained significant attention in recent years, with its use ranging from disease diagnosis to surgical assistance. While artificial intelligence's potential to improve patient outcomes and optimise patient care is undeniable, concerns regarding privacy, transparency, and the potential for medical errors persist. To take full advantage of artificial intelligence's transformative abilities, understanding patient perceptions and attitudes towards its integration into medicine is crucial for ethical considerations and health outcomes. PURPOSE This study aimed to describe patients' perceptions of medical artificial intelligence and its integration into the healthcare system, drawing attention to a crucial yet understudied aspect of artificial intelligence adoption in Kazakhstan. DESIGN Descriptive qualitative design. METHOD From February to March 2024, the researchers conducted semi-structured interviews amongst 13 patients. The interviews were audio-recorded, transcribed, translated, and then analysed using a thematic analysis approach. The study adhered to the COREQ guidelines. RESULT Five themes emerged from 13 interviews: the benefits of artificial intelligence on patient care, the importance of human factors on patient care over artificial intelligence, revolutionising patient care delivery through artificial intelligence, patient education and artificial intelligence, and balancing technology and human interaction in artificial intelligence-driven intervention. CONCLUSION Patient perceptions of artificial intelligence integration into healthcare were primarily positive. Nevertheless, patients prefer artificial intelligence as a supplementary tool under human supervision due to risks such as possible medical errors and violations of patient privacy. PATIENT OR PUBLIC CONTRIBUTION Patients provided the data for this study. The researchers interviewed them about their perceptions of medical artificial intelligence and its integration into the healthcare system. The patients or the public contributed nothing to the other aspects of the study.
Abstract Background Inadequate surgical interventions can lead to serious complications such as tubo-ovarian abscesses in the upper female genital system, often resulting from untreated pelvic inflammatory disease. Pelvic inflammatory disease, caused by infections like Chlamydia trachomatis and Neisseria gonorrhoeae, leads to scarring and adhesions in the reproductive organs, with common risk factors including intrauterine device use and multiple sexual partners. Pelvic inflammatory disease primarily affects sexually active young women and can manifest with varied symptoms, potentially leading to complications like ectopic pregnancy, infertility, and chronic pelvic pain if untreated. Case presentation This case report presents a unique scenario involving a 17-year-old sexually inactive female who experienced concurrent tubo-ovarian abscess, acute cystitis, and pancolitis following laparoscopic ovarian cystectomy. Pelvic inflammatory disease and its complications are well-documented, but the simultaneous occurrence of acute cystitis and pancolitis in this context is unprecedented in the medical literature. The patient’s presentation, clinical course, and management are detailed, highlighting the importance of considering diverse and severe complications in individuals with a history of gynecological surgeries. Conclusions Our case report highlights the need for healthcare professionals to remain vigilant for atypical presentations of gynecological complications and emphasizes the value of interdisciplinary collaboration for optimal patient care. We encourage further research and awareness to enhance understanding and recognition of complex clinical scenarios associated with gynecological procedures.
Gynecology and obstetrics, Public aspects of medicine
Since the start of the COVID-19 pandemic in early 2020, governments around the world have adopted an array of measures intended to control the transmission of the SARS-CoV-2 virus, using both pharmaceutical and non-pharmaceutical interventions (NPIs). NPIs are public health interventions that do not rely on vaccines or medicines and include policies such as lockdowns, stay-at-home orders, school closures, and travel restrictions. Although the intention was to slow viral transmission, emerging research indicates that these NPIs have also had unintended consequences for other aspects of public health. Hence, we conducted a narrative review of studies investigating these unintended consequences of NPIs, with a particular emphasis on mental health and on lifestyle risk factors for non-communicable diseases (NCD): physical activity (PA), overweight and obesity, alcohol consumption, and tobacco smoking. We reviewed the scientific literature using combinations of search terms such as ‘COVID-19′, ‘pandemic’, ‘lockdowns’, ‘mental health’, ‘physical activity’, and ‘obesity’. NPIs were found to have considerable adverse consequences for mental health, physical activity, and overweight and obesity. The impacts on alcohol and tobacco consumption varied greatly within and between studies. The variability in consequences for different groups implies increased health inequalities by age, sex/gender, socioeconomic status, pre-existing lifestyle, and place of residence. In conclusion, a proper assessment of the use of NPIs in attempts to control the spread of the pandemic should be weighed against the potential adverse impacts on other aspects of public health. Our findings should also be of relevance for future pandemic preparedness and pandemic response teams.
The aims of this review are to provide a comprehensive overview of the definition and scope of pharmacoepidemiology, to summarize the study designs and methodologies used in the field, to discuss the future trends in the field and new methodologies to address bias and confounding, and finally to give some recommendations to clinicians interested in pharmacoepidemiologic research. Because drug efficacy and safety from randomized clinical trials do not reflect the real-world situation, pharmacoepidemiological studies on drug safety monitoring and drug effectiveness in large numbers of people are needed by healthcare professionals and regulatory institutions. We aim to highlight the importance of pharmacoepidemiologic research in informing evidence-based medicine and public health policy. The development of new designs and methodologies for the generation of valid evidence, as well as new initiatives to provide guidance and recommendations on how to incorporate real-world evidence into the drug development process, are reported on. In addition, we have touched on the implication of artificial intelligence in the management of real-world data. This overview aims to summarize all important aspects to consider when conducting or interpreting a pharmacoepidemiologic study.
Sébastien Varrette, P. Bouvry, Hyacinthe Cartiaux
et al.
The intensive growth of processing power, data storage and transmission capabilities has revolutionized many aspects of science. These resources are essential to achieve high-quality results in many application areas. In this context, the University of Luxembourg (UL) operates since 2007 an High Performance Computing (HPC) facility and the related storage by a very small team. The aspect of bridging computing and storage is a requirement of UL service - the reasons are both legal (certain data may not move) and performance related. Nowadays, people from the three faculties and/or the two Interdisciplinary centers within the UL, are users of this facility. More specifically, key research priorities such as Systems Bio-medicine (by LCSB) and Security, Reliability & Trust (by SnT) require access to such HPC facilities in order to function in an adequate environment. The management of HPC solutions is a complex enterprise and a constant area for discussion and improvement. The UL HPC facility and the derived deployed services is a complex computing system to manage by its scale: at the moment of writing, it consists of 150 servers, 368 nodes (3880 computing cores) and 1996 TB of shared storage which are all configured, monitored and operated by only three persons using advanced IT automation solutions based on Puppet [1], FAI [2] and Capistrano [3]. This paper covers all the aspects in relation to the management of such a complex infrastructure, whether technical or administrative. Most design choices or implemented approaches have been motivated by several years of experience in addressing research needs, mainly in the HPC area but also in complementary services (typically Web-based). In this context, we tried to answer in a flexible and convenient way many technological issues. This experience report may be of interest for other research centers and universities belonging either to the public or the private sector looking for good if not best practices in cluster architecture and management.
Kofi Awuviry-Newton, Mary Amponsah, Dinah Amoah
et al.
Knowledge about how physical activity levels relate to functional disability is essential for health promotion and planning older adults' care or rehabilitation. The risk of living with one or more chronic health conditions increases with increasing age in lower and higher income countries-many of which are associated with physical inactivity. We conducted a cross-sectional study to examine the moderating role of multimorbidity on physical activity and its measures on functional disability among older adults in Ghana. Data from WHO's Study on global AGEing and adult health Ghana Wave 2 with a sample of 4,446 people aged 50+ years was used for this study. Functional disability was assessed using the 12-item WHO Disability Assessment Schedule 2.0. Three categories of physical activity levels were used: vigorous intensity, moderate intensity, and walking. Past month diagnosis by a doctor was used to assess the presence of a chronic condition, and the presence of two or more conditions was used to define multi-morbidity. Logistic regressions with a post hoc interactional tests were used to examine the associations. Overall, physical activity had a significant association with functional disability (OR = 0.25, 95%CI; 0.12, 0.32). A similar relationship was found for vigorous-intensity (OR = 0.19, 95%CI: 0.12, 0.29), moderate-intensity (OR = 0.19, 95%CI: 0.15, 0.25) and walking (OR = 0.41, 95%CI: 0.33, 0.51). Older adults living with one condition and physically active were 47% less likely to experience functional disability compared with the less active counterparts living with at least two chronic conditions. Among the three measures of physical activity, multimorbidity moderated the relationship between walking and functional disability. Future strategies for meeting the health and long-term care needs of older adults, particularly those living with only one chronic condition in Ghana should consider encouraging walking. Policies, financial assistance, family, and community level interventions aimed to promote and sustain physical activity among older adults should be a priority for stakeholders in Ghana.
Luísa Cruz Lopes, Ana Lopes, Maria Escudeiro
et al.
Introdução: A Doença de Alzheimer é uma patologia neurodegenerativa primária, de etiologia desconhecida e influenciada por vários fatores com aspetos neuropatológicos e neuroquímicos característicos. Atualmente, os fármacos aprovados para o tratamento desta doença apenas permitem aliviar os sintomas sendo acompanhados por diversos efeitos secundários. A nanotecnologia aparece como alternativa para o tratamento do Alzheimer, por oferecer muitas vantagens para a medicina contemporânea permitindo um diagnóstico e tratamento não invasivos e direcionados, reduzindo as reações adversas e os efeitos sistémicos.
Objetivo: Reconhecer as potencialidades do uso de nanopartículas no tratamento da Doença de Alzheimer, identificando os tratamentos mais promissores e quais os seus possíveis efeitos secundários.
Métodos: Revisão bibliográfica narrativa a partir de consulta a bases de dados como Science Direct, Web of Science, PubMed e Scielo.
Resultados: As nanopartículas de ouro mostram-se capazes de atravessar a barreira hematoencefálica (BHE), carregando fármacos essenciais para a inibição da agregação dos péptidos Aβ, bem como dissolver fibrilhas pré-existentes. Polímeros biodegradáveis e biocompatíveis, como o polilactídeo poliglicólico (PLGA), constituem uma abordagem promissora e segura, tendo sido muito utilizados. As melhores técnicas são aquelas que garantem que as nanopartículas são capazes de atravessar a barreira hematoencefálica (BHE), atingir o seu alvo terapêutico, bem como garantir que estas partículas não induzem efeitos tóxicos no organismo. Apesar das nanopartículas serem capazes de tratar algumas doenças de forma eficiente, pouco se conhece sobre os seus efeitos secundários, estes poderão ou não ser mais danosos para o organismo do que a doença que pretenderam tratar.
Conclusão: Existem várias abordagens terapêuticas promissoras, porém nenhuma ainda aprovada, uma vez que é difícil manter concentrações adequadas de fármaco no espaço intraneuronal. Estabelecer a dose tóxica é necessário para o uso aprovado de uma nanopartícula num tratamento, porém é quase impossível prever os seus efeitos citotóxicos em regiões extra-neuronais.
Special aspects of education, Public aspects of medicine
Background: Lack of collaborative capacity results in provision of fragmented health services that do not meet the needs of patients. Collaborative capacity refers to the extent to which providers have influence over other healthcare workers’ decision-making, and can be assessed by measuring perceptions of task interdependence, quality of interaction and collaborative influence. However, each healthcare worker may present differing perceptions that can influence their ability to collaborate effectively during provision of care. No studies that specifically assessed healthcare workers’ perception of collaborative capacity in Malawi were identified.
Aim: To assess the perceptions of healthcare workers regarding collaborative capacity in Malawi.
Setting: The study was conducted at a tertiary public hospital in Blantyre city, Malawi.
Methods: The study employed a quantitative cross-sectional correlational design. The instrument used was a Care Coordination survey that had been used previously in similar studies in the United States of America. Descriptive statistics as well as univariate and multivariate analysis were computed using Statistical Package for Social Science (SPSS) program version 21.0 (IBM, Armonk, NY, USA).
Results: A total of 384 healthcare workers participated in the study, with a response rate of 100%. There were differences in perceptions of collaborative capacity based on the cadre of the respondent (p 0.005). Medical staff reported higher mean scores on quality of interaction (2.94) and collaborative influence (2.65), whereas technical support staff reported the lowest mean scores across all three measures of collaborative capacity (≤ 2.4).
Conclusion: Differences in perceptions about collaborative capacity suggest the need for interventions to enhance interprofessional collaboration.
Contribution: The study will inform strategies to promote interprofessional collaboration.
Abdulaziz Mushi,1 Yara Yassin,1 Anas Khan,1,2 Saber Yezli,1 Yasir Almuzaini1 1The Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia; 2Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Abdulaziz MushiPublic Health Directorate, Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi ArabiaTel +966506830492Email abhmashi@moh.gov.saPurpose: To investigate knowledge, attitude, and perceived risks towards COVID-19 pandemic among healthcare workers (HCWs) in Saudi Arabia. Besides, the impact of risk communication strategy on the attitude and practice of HCWs was investigated.Patients and Methods: We conducted a cross-sectional study that targeted HCWs from various Saudi health facilities. We utilized a self-administrated, online-based questionnaire designed to assess basic knowledge of COVID-19, attitude and disease perception, and the impact of risk communication messages among HCWs.Results: A total of 1691 responses were received in the study. The HCWs exhibited good levels of knowledge (total maximum score is 1) of COVID-19 concerning the modes of transportation of COVID-19 (0.82± 0.16), sample collection method for COVID-19 diagnosis (0.98± 0.08), transmission of infection from asymptomatic individuals (0.99± 0.11), and that antibiotics are not effective against the new COVID-19 (0.83± 0.38). Nearly one-third of the participants considered a high/very high possibility of acquiring COVID-19 infection. HCWs had good attitude scores concerning their willingness to deal with new COVID-19 patients (0.87± 0.33) and their beliefs in being educated on COVID-19 (0.99± 0.11). Almost all participants strongly agree/agree that it is important to take action to prevent the spread of COVID-19 within healthcare facilities and received health information messages. Notably, 93.4% of the participants stated that the received messages changed their attitude towards COVID-19 and its preventive measures. Good knowledge scores were significantly associated with age > 49 years old, higher educational level, and physician occupation. Similarly, good attitude scores were higher among males, HCWs aged 40– 49 years old, non-Saudi nationals, and physician and nurse occupations.Conclusion: HCWs have fair knowledge and attitude towards the COVID-19 pandemic. The risk communication is an effective strategy to improve the attitude and practice of HCWs towards COVID-19 in Saudi Arabia.Keywords: COVID-19 pandemic, knowledge, attitude, risk communication, perceived benefits, Saudi Arabia
Luis Alberto Corona Martínez, Mercedes Fonseca Hernández
The title of a scientific article, a research project or the thesis final report is intended to provide guiding information about the content of the study. Based on the research problem-objective-title relationship, an analysis is made of one of the title´s most marked qualities: its extension. Derived from this analysis, it is concluded that in assessing the title of a research work´s quality, the priority, what is truly relevant is its precision and not its extension.
Resumo Objetivo: descrever o perfil das notificações e internações de lesões autoprovocadas envolvendo adolescentes no Brasil. Métodos: estudo descritivo, com dados do Sistema de Informação de Agravos de Notificação (Sinan) (2011-2014) e do Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH/SUS) (2007-2016) sobre lesões autoprovocadas. Resultados: houve 15.702 notificações, predominando o grupo etário de 15-19 anos (76,4%) do sexo feminino (71,6%), e raça/cor da pele branca (58,3%); a residência foi o local mais frequente dessas ocorrências (88,5% de 10-14 anos; 89,9% de 15-19 anos); o meio mais utilizado foi envenenamento/intoxicação (76,6% e 78,0%, respectivamente nas idades de 10-14 e 15-19); houve 12.060 internações, com predominância do sexo feminino (58,1%) e maior ocorrência na região Sudeste (2,7 e 7,0 notificações/100 mil habitantes, nos grupos de 10-14 e 15-19 anos, respectivamente). Conclusão: os resultados reforçam a necessidade de os serviços de saúde estarem sensíveis ao registro, atenção e cuidado desses adolescentes.
Abstract Background Health of the population of post-socialist Central and Eastern European (CEE) countries lags behind the European Union average. Our aim in this paper is to analyse the link between transition shocks and health two-three decades later. Methods We use retrospective data from the Survey of Health, Ageing and Retirement in Europe. We estimate the implications of stressful periods, financial hardships and job loss occurring around the transition (1987–1993) on subjective and objective measures of health in 2017. We compare these implications across groups of CEE countries and with the health implications of similar difficulties reported by individuals from Western Europe. We also compare the health implications of difficulties occurring around the transition to difficulties occurring before or after the transition. Results In the CEE region there is a peak in the timing of difficulties around the transition. Stressful periods, financial difficulties and job loss around the period of transition are generally associated with worse subjective and objective health at older ages in all groups of CEE countries, even after netting out the effect of childhood health and demographic factors. However, the consequences of hardships due to the transition are not specific, health implications of these difficulties seem to be similar to the implications of other shocks possibly unrelated to the transition. Conclusions The high fraction of individuals experiencing stress, financial difficulties and job loss around the transition contributed to the current health disadvantage in the CEE region. As similar shocks in the West and before or after the transition had similar health implications, our results draw the attention to the long-lasting impacts of psychosocial stress and financial hardship during adulthood on later health over the life course.