Search

Background: Weakness of the shoulder girdle muscles has been reported in patients with chronic lateral elbow tendinopathy. The aim of this study was to assess the short- and long-term effects of a conventional treatment plus scapular exercises program in patients with chronic lateral elbow tendinopathy. Methods: A single-group prestudy and poststudy were conducted. The primary outcome was the Patient-Rated Tennis Elbow Evaluation questionnaire score. Secondary outcomes were grip strength; Disabilities of the Arm, Shoulder, and Hand questionnaire score; Visual Analogue Scale score at rest and at grip, and presence of scapular dyskinesis. Results: A total of 65 patients (72.3% females), with a mean age of 41.8 years, were analyzed. At the end of 6 weeks, the results showed clinically and statistically significant differences (P< .05). At 1-year follow-up, the differences were: Patient-Rated Tennis Elbow Evaluation -31 points (P<.001); grip strength +33.6% (P<.001); Disabilities of the Arm, Shoulder, and Hand -34.2 points (P < .001); Visual Analogue Scale at rest -2.5 cm (P < .001); and Visual Analogue Scale at grip -2.3 cm (P < .001). Conclusion: At the end of 6 weeks and at 1-year follow-up, conventional treatment plus scapular exercises program showed statistically and clinically significant differences in all functional outcomes assessed in patients with lateral elbow tendinopathy. [ABSTRACT FROM AUTHOR]

L'Essai sur quelques problèmes concernant le normal et le pathologique , thèse de médecine soutenue en 1943 par Georges Canguilhem (1904–1995), est certainement le texte français d'épistémologie de la médecine le plus connu. L'auteur alors jeune philosophe, étudiant en médecine et résistant, y défend l'autodétermination du vivant, capable de juger de ce qui est normal ou pathologique, catégories dont se saisissent ensuite la médecine et la physiologie ; ainsi qu'une conception de la clinique ajustée à la rencontre singulière. Son argumentation s'appuie largement sur les thèses de psychiatres mais exclut pourtant la psychopathologie de son champ d'application. C'est à ce paradoxe, peu étudié jusqu'ici, que nous tâchons de répondre dans cet article. Nous avons étudié de manière approfondie les textes portant sur la psychologie et le soin psychique dans les archives de G. Canguilhem, ses œuvres complètes, récemment publiées, et les travaux universitaires menés actuellement. Nous proposons de revenir aux deux problèmes qui initient l' Essai : « celui des rapports entre sciences et techniques, celui des normes et du normal ». À ce dernier, Canguilhem répond en proposant le concept de normativité vitale qui s'inscrit dans la continuité de travaux précédents consacrés à la psychologie, présentés lors de cours donnés au lycée dans les années trente et dans un Traité de psychologie , demeuré inédit, qui déjà promouvaient un sujet capable de valoriser, de s'engager, et par-là de se soustraire au déterminisme de son environnement et de son organisme. Concernant les rapports entre science et technique, qu'il commence à conceptualiser à la toute fin des années trente, il propose dans l' Essai un trajet inverse à celui du positivisme, partant de la clinique vers la science qui en retour l'éclaire ; or, la psychologie scientifique ne saurait jouer un rôle équivalent à la physiologie dans le soin psychique. Canguilhem considère en effet la revendication d'objectivité de la psychologie incompatible avec le respect de la subjectivité, que défend au contraire sa psychologie réflexive. Nous étudions pour finir les textes de Canguilhem évoquant la psychothérapie ainsi que ceux mentionnant la psychopharmacologie. Nous discutons les conséquences cliniques de l'impossibilité pour la psychologie scientifique de jouer pour la psychothérapie un rôle analogue à celui de physiologie en médecine. La conception du soin psychique qu'ébauche Canguilhem consiste essentiellement en une défense de la dignité humaine, fondée sur une théorie philosophique et non scientifique de l'individu. L'Essai sur quelques problèmes concernant le normal et le pathologique , a medical thesis defended in 1943 by Georges Canguilhem (1905–1995), is certainly the best-known French text on the epistemology of medicine. Canguilhem, then a young philosopher, medical student, and member of the French Resistance, defends the self-determination of the living individual, capable of judging what is normal or pathological – categories subsequently adopted by medicine and physiology – as well as a conception of the medical practice tailored to the singular situation. His argumentation is largely based on the theories of psychiatrists, yet excludes psychopathology from its scope. It is this paradox, little studied until now, that I attempt to resolve in this article. I have conducted an extensive study of the texts on psychology and mental care in G. Canguilhem's archives, his recently published complete works, and current academic research. I propose to return to the two problems presented at the beginning of the Essai : "that of the relationship between science and technology, and that of norms and the normal". Canguilhem responds to the latter by proposing the concept of vital normativity, which follows on from earlier work on psychology, presented in high school courses in the 1930s and in a Traité de psychologie , never published, which already promoted a subject able to value, to commit, and thus to escape from the determinism of his environment and organism. Regarding the relationship between science and technology, which Canguilhem began to conceptualize at the very end of the 1930s, in his Essai , he proposes a path that reverses that of positivism, moving from clinical practice to science, in which the former is clarified by the latter; however, scientific psychology cannot play a role equivalent to physiology in psychological care. Indeed, Canguilhem considers psychology's claim to objectivity incompatible with the respect for subjectivity that his psychologie réflexive , on the contrary, defends. To conclude, I examine Canguilhem's few writings on psychotherapy, as well as those on psychopharmacology. I discuss the clinical consequences of the inability of scientific psychology to play a role in psychotherapy similar to that of physiology in medicine. Canguilhem's conception of psychological care is essentially a defense of human dignity, based on a philosophical, not a scientific, theory of the individual. [ABSTRACT FROM AUTHOR]

Large language models (LLMs) are a type of machine learning model that learn statistical patterns over text, such as predicting the next words in a sequence of text. Both general purpose and task‐specific LLMs have demonstrated potential across diverse applications. Science and medicine have many data types that are highly suitable for LLMs, such as scientific texts (publications, patents and textbooks), electronic medical records, large databases of DNA and protein sequences and chemical compounds. Carefully validated systems that can understand and reason across all these modalities may maximize benefits. Despite the inevitable limitations and caveats of any new technology and some uncertainties specific to LLMs, LLMs have the potential to be transformative in science and medicine. [ABSTRACT FROM AUTHOR]

The article offers news briefs related to diabetic medicine. Climate change poses challenges for people with diabetes, affecting their health and access to care. Teplizumab and baricitinib show potential in delaying the progression of type 1 diabetes. Quitting smoking reduces the risk of type 2 diabetes and improves management and outcomes.

Microbial life is not restricted to any particular setting. Over the past several decades, it has been evident that microbial populations can exist in a wide range of environments, including those with extremes in temperature, pressure, salinity, and pH. Bacteria and Archaea are the two most reported types of microbes that can sustain in extreme environments, such as hot springs, ice caves, acid drainage, and salt marshes. Some can even grow in toxic waste, organic solvents, and heavy metals. These microbes are called extremophiles. There exist certain microorganisms that are found capable of thriving in two or more extreme physiological conditions simultaneously, and are regarded as polyextremophiles. Extremophiles possess several physiological and molecular adaptations including production of extremolytes, ice nucleating proteins, pigments, extremozymes and exopolysaccharides. These metabolites are used in many biotechnological industries for making biofuels, developing new medicines, food additives, cryoprotective agents etc. Further, the study of extremophiles holds great significance in astrobiology. The current review summarizes the diversity of microorganisms inhabiting challenging environments and the biotechnological and therapeutic applications of the active metabolites obtained as a response to stress conditions. Bioprospection of extremophiles provides a progressive direction with significant enhancement in economy. Moreover, the introduction to omics approach including whole genome sequencing, single cell genomics, proteomics, metagenomics etc., has made it possible to find many unique microbial communities that could be otherwise difficult to cultivate using traditional methods. These findings might be capable enough to state that discovery of extremophiles can bring evolution to biotechnology. [ABSTRACT FROM AUTHOR]

This commentary explores historical efforts to diagnose the present and project the future through the specific example of medical manpower planning. To situate this, it draws on work within and across geography exploring the concept of anticipation and considers the discipline's failure to adequately engage with healthcare workers, despite the vibrancy of health geography as a subdiscipline. As it explores, ensuring adequate numbers of staff in a healthcare system has been an issue for as long as there have been healthcare systems. Planning for healthcare system needs is thus a particularly fraught form of anticipation that seeks to project future needs from a contested and often incalculable present as a basis for political decision‐making and resource allocation. As this commentary explores, it is a problem that is global in scope, historically deep and thus rich in analytical possibility. [ABSTRACT FROM AUTHOR]

The match rate of medical schools in the U.S. has been extensively studied from the perspective of applicants and influential factors. A method to objectively estimate the efficiency of a medical school's match rate has not been described in the literature. Such a method constitutes a significant improvement opportunity for medical schools via benchmarking best practices. This research fills the gap and proposes a bootstrap data envelopment analysis (DEA) framework to assess the residency match rate efficiency of medical schools. The efficacy of the proposed method is confirmed when benchmarking the Texas allopathic medical schools to representative samples of allopathic medical schools in the United States. The model allows to determine the statistical significance of differences in the residency match rate efficiency between groups of medical schools. The proposed bootstrap DEA approach is used to estimate the real efficiency's density function of 40 medical schools in the U.S. over the 2018–2020 period. The aggregate efficiency estimation showed that the medical schools are performing at a high competitive level; they have experienced a slight decline in scale efficiencies and have preserved high managerial performance. The study measured four groups: Texas medical schools, top ten ranked, middle ten ranked, and bottom ten ranked U.S. medical schools. The overall major improvement opportunity for medical schools is the scale of operations. Results confirm that medical schools are shown to be efficient in training future physicians. [ABSTRACT FROM AUTHOR]

In recent decades, polyelectrolytes (PELs) have attracted significant interest owing to a surge in research dedicated to the development of new technologies and applications at the biological level. Polyelectrolytes are macromolecules of which a substantial portion of the constituent units contains ionizable or ionic groups. These macromolecules demonstrate varied behaviors across different pH ranges, ionic strengths, and concentrations, making them fascinating subjects within the scientific community. The aim of this review is to present a comprehensive survey of the progress in the application studies of polyelectrolytes and their derivatives in various fields that are vital for the advancement, conservation, and technological progress of the planet, including agriculture, environmental science, and medicine. Through this bibliographic review, we seek to highlight the significance of these materials and their extensive range of applications in modern times. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions We aimed to clarify the characteristics of the Kampo specialists' gaze during Kampo abdominal examinations on simulated patients and obtain suggestions for improving medical students' gaze during Kampo medicine abdominal examinations.We recorded and quantitatively evaluated the gazes of eight Kampo specialists and six medical students using a wearable eye tracker during abdominal examinations of simulated patients.When specific sites were observed during abdominal examinations, the Kampo specialists' gaze toward the simulated patient's face was significantly higher than that of the medical students (mean = 1.019, 95% highest density interval: 0.159–2.050). A significant difference was also observed between the two populations regarding the specific sites observed. The medical students' gaze durations toward the simulated patient's eyes (mean = −2.696; 95% highest density interval: −4.961 to −0.744), face (mean = −1.881; 95% highest density interval: −3.353 to −0.691), upper limbs (mean = −1.707; 95% highest density interval: −2.932 to −0.500), and lower limbs (mean = −2.555; 95% highest density interval: −4.730 to −0.654) were significantly longer than those of Kampo specialists.The medical students' gazes were dispersed; those of Kampo specialists were focused and of short durations. These findings suggest that Kampo specialists quickly collect essential diagnostic information and look away from the patient's face to concentrate on considering the Kampo medicine diagnosis. Teaching Kampo specialists' gaze techniques in Kampo medicine education could lead to improvements in the gaze of medical students during abdominal examinations. [ABSTRACT FROM AUTHOR]

The objective of the ASPIRE award programme of the International Association for Health Professions Education is to go beyond traditional accreditation processes. Working in partnership with the ASPIRE Academy, the programme aims to encourage and support excellence in health professions education, in part by showcasing and exemplifying best practices. Each year ASPIRE award applications received from institutions across the globe describe their greatest achievements in a variety of areas, one of which is curriculum development, where evaluation of applications is carried out using a framework of six domains. These are described in this paper as key elements of excellence, specifically, Organisational Structure and Curriculum Management; Underlying Educational Strategy; Content Specification and Pedagogy; Teaching and Learning Methods and Environment; Assessment, Monitoring and Evaluation; Scholarship. Using examples from the content of submissions of three medical schools from very different settings that have been successful in the past few years, achievements in education processes and outcomes of institutions around the world are highlighted in ways that are relevant to their local and societal contexts. [ABSTRACT FROM AUTHOR]

Making a career choice is a multifaceted process and support for medical students on career choice is pivotal. Not all medical schools have programs or guidelines to support having meaningful conversations with medical students. However, medical students have questions and are seeking answers. This article presents twelve tips for having meaningful conversations with medical students for educators, mentors and internship tutors. The twelve tips have been grouped into three categories: the conversation, the reflection and the actions students can take in the process of their specialty career choice. [ABSTRACT FROM AUTHOR]

Background: Ideas about Artificial intelligence appeared about half a century ago, but only now is it becoming an essential element of everyday life. The data provided are becoming a bigger pool and we need artificial intelligence that will help us with its superhuman powers. Its interaction with medicine is improving more and more, with medicine being a domain that continues to be perfected. Materials and Methods: The most important databases were used to perform this detailed search that addresses artificial intelligence in the medical and surgical fields. Discussion: Machine learning, deep learning, neural networks and computer vision are some of the mechanisms that are becoming a trend in healthcare worldwide. Developed countries such as Japan, France and Germany have already implemented artificial intelligence in their medical systems. The help it gives is in medical diagnosis, patient monitoring, personalized therapy and workflow optimization. Artificial intelligence will help surgeons to perfect their skills, to standardize techniques and to choose the best surgical techniques. Conclusions: The goal is to predict complications, reduce diagnostic times, diagnose complex pathologies, guide surgeons intraoperatively and reduce medical errors. We are at the beginning of this, and the potential is enormous, but we must not forget the impediments that may appear and slow down its implementation. [ABSTRACT FROM AUTHOR]

As previous research has observed, medical students and physicians alike confront vast amounts of knowledge in their education and practice, such that no one clinician can know everything there is to know about biomedicine. Even before clerkships, medical students learn to cope with this impossibility by prioritizing certain information based on its perceived utility for exams and clinical practice. Many factors can shape this process, including teamwork, wherein individual medical students rely on one another to address gaps in knowledge at the level of the group. This paper will draw on qualitative data from two allopathic medical schools in the American Midwest to demonstrate that peer-to-peer learning, a widely utilized pedagogical modality in North American medical schools, is amongst the earliest places where future physicians learn how to rely on their peers in the profession as they make choices about what to know and what not to know about biomedicine: cultivating a culture of "intraprofessionalism" between students with different knowledges and values, as they prepare to enter the same profession. The paper will also consider how differences in the student populations at two field sites impact intraprofessional development. Drawing on scholarship of peer-based learning strategies and the sociology and anthropology of medical education, the authors argue that peer-to-peer learning is a key site in the professional socialization of medical students toward the effective management of medical knowledge. [ABSTRACT FROM AUTHOR]

Objectives Autoantibody-negative RA differs from autoantibody-positive RA in several clinical aspects, possibly underpinned by pathogenetic differences. At present, the role of adaptive immune responses in autoantibody-negative RA remains unclear. Here, we investigated the synovial and serum immunophenotype indicative of B lymphocyte involvement across the spectrum of autoantibody-positive and -negative chronic arthritides. Methods Ultrasound-guided synovial biopsies were retrieved from 131 patients: 43 autoantibody-positive RA, 35 autoantibody-negative RA, 25 polyarticular PsA and 28 oligoarticular PsA. Samples were analysed for the degree of histological inflammation, B lymphocyte infiltration and the distribution of different pathotypes (lympho-myeloid, myeloid, pauci-immune). Serum levels of the B cell chemoattractant CXCL13 were compared among groups. Results Synovitis scores and CD68+ sublining macrophage infiltration were comparable irrespective of clinical diagnosis and disease subtype. In contrast, the degree of B lymphocyte infiltration and the frequency of lympho-myeloid synovitis in autoantibody-negative RA were lower than those of autoantibody-positive RA (mean [ s. d.] 1.8 [1] vs 2.4 [0.6], P  = 0.03, and 38.2% vs 62.9%, P  = 0.07, respectively), and similar to polyarticular PsA. Oligoarticular PsA had the lowest B cell scores. Serum CXCL13 was associated with lympho-myeloid synovitis and followed a similar gradient, with the highest levels in autoantibody-positive RA, intermediate and comparable levels in autoantibody-negative RA and polyarticular PsA, and low levels in oligoarticular PsA. Conclusions The synovial and serum immunophenotype indicative of B lymphocyte involvement in autoantibody-negative RA differs from that of autoantibody-positive RA and more closely resembles that observed in polyarticular PsA. The pathobiological stratification of chronic inflammatory arthritides beyond clinical diagnosis may fuel personalized treatment strategies. [ABSTRACT FROM AUTHOR]

We might expect chiromancy in the modern period to be analysed best within the well-known late nineteenth-century occult revival. The specific practice of palmistry, as it happens, is minimally examined in that historiographical context. Yet the purpose here is not to reinstate palmistry into our already extensive understanding of an Anglo-American modern occult, but to show how other readers of hands, including those trained in biomedical sciences, exceeded occultism altogether, and often enough repudiated it. This article considers modern palmistry in the first instance through an intellectual and social historiography of mind–body knowledges and practices. It shows not only how various 'psychic' practices turned into 'psy' practices, but also how reading signs of the hand morphed into clinical diagnostics, into primatology, comparative anatomy and eventually into early medical genetics, especially through the so-called 'simian line' correlated with Down syndrome. Through analysis of a suite of London-based hand experts, this twentieth-century history of palm-reading argues for a plain 'disenchantment' of chiromancy, qualifying historians' common commitment to theses of re-enchantment. One strand of palm-reading's recent past turns out to be part of the history of scientific naturalism, not super-naturalism at all. [ABSTRACT FROM AUTHOR]

* Context.--Social media (SM) use in pathology and medicine today is widespread, receives active advocacy, and is said to bring a host of benefits. In latter days, the harmful effects of SM have received attention, but they have yet been followed by greater encouragement of professionalized SM usage. SM use in medicine has seen adoption in parallel to its general ascendancy, even though the platforms are products with purposes misaligned with the practice of medicine. Objective.--To (1) characterize premises and forces that propel professional SM platform adoption and use, and (2) examine wide-ranging literature, both medical and nonmedical, that substantiates the premises and to find counteracting perspectives and evidence. Data Sources.--Review of the literature using relevant keyword searches in PubMed, Google Scholar, Dimensions, and Web of Science for articles that study/describe professional SM use in pathology and medicine. Additionally, we examined business, technology, and social sciences literature and high-quality gray literature (newspapers, books, blogs) that addressed questions in relation to the topic of professional SM adoption. Conclusions.--We identified 6 major premises as motivators of professional SM use and highlight significant counteracting factors. We conclude that the harms of professionalized SM use have not been fully considered in the medical literature and that a change in direction and the creation of new communication platforms would be beneficial. [ABSTRACT FROM AUTHOR]

Physicians generally recommend that patients resuscitated with naloxone after opioid overdose stay in the emergency department for a period of observation in order to prevent harm from delayed sequelae of opioid toxicity. Patients frequently refuse this period of observation despiteenefit to risk. Healthcare providers are thus confronted with the challenge of how best to protect the patient's interests while also respecting autonomy, including assessing whether the patient is making an autonomous choice to refuse care. Previous studies have shown that physicians have widely divergent approaches to navigating these conflicts. This paper reviews what is known about the effects of opioid use disorder on decision-making, and argues that some subset of these refusals are non-autonomous choices, even when patients appear to have decision making capacity. This conclusion has several implications for how physicians assess and respond to patients refusing medical recommendations after naloxone resuscitation. [ABSTRACT FROM AUTHOR]

Current attempts to understand unusually high rates of psychiatric illness in complex, chronic illnesses can be guilty of operating within an explanatory framework whereby there are two options. Either (a) that the psychiatric predicaments are secondary to the bodily condition, and (b) that they are primary. In this paper, I draw upon philosophical work on affect, contemporary empirical work, and qualitative first-person patient data to illustrate a much messier reality. I argue that affective experience is generally more complex in such conditions, and that a variety of pre- and post-morbid causal factors dynamically interact such that the resultant psychiatric predicaments do not permit to classification as strictly primary or secondary to the bodily condition. Affective scaffolding, in my view, provides an apt theoretical framework for capturing this nuance. [ABSTRACT FROM AUTHOR]

AbstractA novel advantage of the use of machine learning (ML) systems in medicine is their potential to continue learning from new data after implementation in clinical practice. To date, considerations of the ethical questions raised by the design and use of adaptive machine learning systems in medicine have, for the most part, been confined to discussion of the so-called “update problem,” which concerns how regulators should approach systems whose performance and parameters continue to change even after they have received regulatory approval. In this paper, we draw attention to a prior ethical question: whether the continuous learning that will occur in such systems after their initial deployment should be classified, and regulated, as medical research? We argue that there is a strong prima facie case that the use of continuous learning in medical ML systems should be categorized, and regulated, as research and that individuals whose treatment involves such systems should be treated as research subjects. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusionsStudent study behaviours that prioritise the UKMLA content map over the local curriculum are a significant risk for UK medical education. To mitigate this, we describe a student-centred faculty process to improve local curriculum guidance based on an evaluation of student study behaviours, concerns and needs. Responses informed the build of an online curriculum map.A mixed methods approach was adopted, including an online anonymous survey exploring student study behaviours and preferences for curricular guidance. This was followed by student-led focus groups to explore emergent themes further. Qualitative data underwent reflexive thematic analysis.121 students responded to the survey, of which 12 consented to participate in two student-led focus groups. Five key themes emerged, including motivation for learning, student use of the intended curriculum, student experience of the enacted curriculum, the hidden curriculum, and expectations of an online curriculum map.A participatory framework enabled shared aims and responsive outcomes for curricular development in the run up to the UKMLA. Student responses led to clarification of guidance, reorganisation of learning resources and optimal design of an online curriculum map which linked all content in a visible, UKMLA aligned framework, accessible to all students and teachers. [ABSTRACT FROM AUTHOR]

AbstractAn anthropocentric scope for clinical medical ethics (CME) has largely separated this area of bioethics from environmental concerns. In this article, we first identify and reconcile the ethical issues imposed on CME by climate change including the dispersion of related causes and effects, the transdisciplinary and transhuman nature of climate change, and the historic divorce of CME from the environment. We then establish how several moral theories undergirding modern CME, such as virtue ethics, feminist ethics, and several theories of justice, promote both a flourishing of human medical practice and the environment. We conclude by defining an expanded the scope of CME as inclusive of not only patients, families, physicians, and other health professionals but other humans, non-humans, and their shared environment. We then apply this scope and theory to a widely used framework for applying CME, the Four Topics model, to construct a climate conscious approach to CME. [ABSTRACT FROM AUTHOR]

Polymers stand out as promising materials extensively employed in biomedicine and biotechnology. Their versatile applications owe much to the field of tissue engineering, which seamlessly integrates materials engineering with medical science. In medicine, biomaterials serve as prototypes for organ development and as implants or scaffolds to facilitate body regeneration. With the growing demand for innovative solutions, synthetic and hybrid polymer materials, such as polyethersulfone, are gaining traction. This article offers a concise characterization of polyethersulfone followed by an exploration of its diverse applications in medical and biotechnological realms. It concludes by summarizing the significant roles of polyethersulfone in advancing both medicine and biotechnology, as outlined in the accompanying table. [ABSTRACT FROM AUTHOR]

Background: Abstract review is a time and labor-consuming step in the systematic and scoping literature review in medicine. Text mining methods, typically natural language processing (NLP), may efficiently replace manual abstract screening. This study applies NLP to a deliberately selected literature review problem, the trend of using NLP in medical research, to demonstrate the performance of this automated abstract review model. Methods: Scanning PubMed, Embase, PsycINFO, and CINAHL databases, we identified 22,294 with a final selection of 12,817 English abstracts published between 2000 and 2021. We invented a manual classification of medical fields, three variables, i.e., the context of use (COU), text source (TS), and primary research field (PRF). A training dataset was developed after reviewing 485 abstracts. We used a language model called Bidirectional Encoder Representations from Transformers to classify the abstracts. To evaluate the performance of the trained models, we report a micro f1-score and accuracy. Results: The trained models' micro f1-score for classifying abstracts, into three variables were 77.35% for COU, 76.24% for TS, and 85.64% for PRF. The average annual growth rate (AAGR) of the publications was 20.99% between 2000 and 2020 (72.01 articles (95% CI: 56.80–78.30) yearly increase), with 81.76% of the abstracts published between 2010 and 2020. Studies on neoplasms constituted 27.66% of the entire corpus with an AAGR of 42.41%, followed by studies on mental conditions (AAGR = 39.28%). While electronic health or medical records comprised the highest proportion of text sources (57.12%), omics databases had the highest growth among all text sources with an AAGR of 65.08%. The most common NLP application was clinical decision support (25.45%). Conclusions: BioBERT showed an acceptable performance in the abstract review. If future research shows the high performance of this language model, it can reliably replace manual abstract reviews. [ABSTRACT FROM AUTHOR]

Digital transformation in education and relevant calls for action are recognised global priorities aimed to support education and training in the digital age. The experiences from the emergency remote teaching during the COVID‐19 pandemic and recent research findings reveal relevant advantages, challenges, as well as different students and teaching staff perspectives which should be carefully considered and integrated into institutional strategies and policies to improve and enrich students’ learning experience. The present study aimed to explore health sciences students' perspectives on online teaching and learning (T&L) in four domains—Satisfaction, Motivation, Interaction and Challenges, and to identify the preferred T&L models or tools. A total of 1,041 responses were collected, including 476 dental medicine (45.7%), 399 pharmacy (38.3%), and 166 medical students (15.9%). Overall Satisfaction was quite high (4.0 ± 1.2; out of 5), followed by satisfactory Interaction (3.4 ± 1.4), whereas Motivation was quite low on average (3.0 ± 1.5). Challenges in online T&L were not markedly expressed (3.0 ± 1.6). The majority of students (46.6%) opted for the blended model as the preferred T&L model. Moodle lessons were perceived as the most useful online T&L tool (45.5% of students), followed by video materials (32.2%). Other T&L tools which require more active student's role, such as short test/quiz, and group or team assignment were declared as less favourable. The findings from the current study may contribute to raising the awareness of academic staff and higher institutions management about the student attitudes and needs related to online T&L and inform institutional planning, decision‐making and policy development. [ABSTRACT FROM AUTHOR]

Introduction: The emergence of artificial intelligence (AI) chat programs has opened two distinct paths, one enhancing interaction and another potentially replacing personal understanding. Ethical and legal concerns arise due to the rapid development of these programs. This paper investigates academic discussions on AI in medicine, analyzing the context, frequency, and reasons behind these conversations. Methods: The study collected data from the Web of Science database on articles containing the keyword "ChatGPT" published from January to September 2023, resulting in 786 medically related journal articles. The inclusion criteria were peer-reviewed articles in English related to medicine. Results: The United States led in publications (38.1%), followed by India (15.5%) and China (7.0%). Keywords such as "patient" (16.7%), "research" (12%), and "performance" (10.6%) were prevalent. The Cureus Journal of Medical Science (11.8%) had the most publications, followed by the Annals of Biomedical Engineering (8.3%). August 2023 had the highest number of publications (29.3%), with significant growth between February to March and April to May. Medical General Internal (21.0%) was the most common category, followed by Surgery (15.4%) and Radiology (7.9%). Discussion: The prominence of India in ChatGPT research, despite lower research funding, indicates the platform's popularity and highlights the importance of monitoring its use for potential medical misinformation. China's interest in ChatGPT research suggests a focus on Natural Language Processing (NLP) AI applications, despite public bans on the platform. Cureus' success in publishing ChatGPT articles can be attributed to its open-access, rapid publication model. The study identifies research trends in plastic surgery, radiology, and obstetric gynecology, emphasizing the need for ethical considerations and reliability assessments in the application of ChatGPT in medical practice. Conclusion: ChatGPT's presence in medical literature is growing rapidly across various specialties, but concerns related to safety, privacy, and accuracy persist. More research is needed to assess its suitability for patient care and implications for non-medical use. Skepticism and thorough review of research are essential, as current studies may face retraction as more information emerges. [ABSTRACT FROM AUTHOR]

The Swiss natural philosopher, physician, and radical reformer Theophrastus of Hohenheim (1493–1541), known as Paracelsus, endeavoured to reconcile his various perspectives in his extensive biblical exegeses. Symbolizing this effort were the two lights of nature and the Holy Spirit, which, on one hand, explored worldly and mortal aspects of nature and, on the other hand, led to eternal life. In response to the prevailing dispute between Luther and Zwingli over the interpretation of the Eucharist, Paracelsus developed his own viewpoint, introducing the concept of the new human with a renewed corporeal body. His comprehensive interpretations of the Gospel of Matthew not only addressed theology but also engaged with the perspectives of a natural philosopher, physician, and advocate of natural magic. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to explore how health science faculty publication patterns at a large public research university have changed over time and examine how productivity relates to their information-seeking behavior and perception of the academic library. Methods: Two datasets were utilized: one consisted of publication records of health sciences faculty spanning a 15-year period, while the other was from a faculty survey exploring faculty's perception of and satisfaction with library resources and services related to their research. Results: Health sciences faculty publication patterns have changed over time, characterized by greater productivity, collaboration, and use of literature in their publications. Faculty's literature use correlates with productivity, as evidenced by both datasets. The survey revealed that faculty with more publications tend to rely more on online journals and Interlibrary Loan (ILL). Similarly, the publication data indicated that less productive faculty tended to use fewer references in their publications. Discussion: The publication data and survey results offer valuable insights into the health sciences faculty's informationseeking behavior and productivity. Online access to information has been effective in facilitating use of information, as indicated by the greater incorporation of references in publications. Conclusion: The study highlights the changing publication patterns and productivity of health sciences faculty, as well as the role academic libraries play in supporting their research and publishing activities. Although multiple variables influence faculty access to and use of information, faculty attitudes towards the library and use of the library are related to faculty research and productivity. [ABSTRACT FROM AUTHOR]

What changes in the conceptualization of God, the ultimate healer, once God himself becomes the object of healing? This article examines the delicate tensions between divine and human agency in the Lurianic kabbalah, focusing on its grammar of action, and the complex relations between the subjects and the objects of this action. Rather than analyzing the relations between the kabbalists and their God through their conscious perceptions, the article explores how these relations emerge from the Lurianic discursive configurations and describes the role of medical discourse in their shaping. I claim that in order to perceive the transformation in the image of God in this early modern kabbalistic corpus, we should place at the heart of our inquiry the questions of who the patient is in the Lurianic medical clinic and how the relations between the human and the divine protagonists of the Lurianic drama are woven in this clinic. [ABSTRACT FROM AUTHOR]

This paper explores physicians' responses to the suicide of a female surgeon colleague in order to detail the cultural patterning of the problem of suicide within biomedicine. More broadly, it argues that suicide provides an exemplary case of reckoning with uncertainty. Data sources include 124 hours of person-centered and semistructured interviews with 65 individuals, including 54 physicians, 28 of whom are female surgeons. I argue that the cultural model of suicide articulated by physicians reflects an ultimately ineffective strategy for managing suicide's multisource uncertainty, with the suicide of a colleague exposing the moral and affective entailments of a limit case of prognostication. Examining patterns in physician responses to suicide, I define "bewilderment" as a state of having no means of getting to know, and I detail the ways in which physicians' aversive reaction to bewilderment undermine knowledge acquisition. I describe suicide's distinct challenges to biomedicine's social power, including suicide's contestation of narratives about the future. Finally, I raise questions about the degree to which biomedical framings of suicide may undermine the ability of biomedical actors to develop effective interventions to address it. Exploring responses to suicide as a form of cultural production can illustrate fundamental tensions about uncertainty and causality. [ABSTRACT FROM AUTHOR]

Virtual reality (VR) is a technology that is seeing increasing use in medical education as a means to complement or prepare students for clinical practice in a safe space. Whilst effective for learning, it can be difficult to use effectively and requires significant planning to avoid the technological tail wagging the educational dog. We have run educational sessions using the technology to teach anatomy and clinical reasoning that have been well received by students at Queen Mary, University of London. In this article, we share 12 practical tips from our experiences on how to create and deliver learning using VR. [ABSTRACT FROM AUTHOR]

This article highlights the continuing relevance of a classic bioethical text, "Bioethics as a Discipline," published by the Hastings Center's cofounder Daniel Callahan in 1973. Connecting the text's programmatic recommendations with later reflections and interventions Callahan wrote about the development of bioethics illuminates how the vision Callahan established and the reality this vision helped create were interrelated—just not in the way Callahan had hoped for. Although this portrait relies on an individual perception of the development of bioethics, it might nevertheless, through its unique linkage of different bioethical temporalities, contribute to a broader reassessment of what bioethics became and why. [ABSTRACT FROM AUTHOR]

This paper introduces Mahāyāna Buddhist medicine into the contemporary international relations (IR) literature. In this paper, we will elucidate the perception towards subjectivity and relationality based upon the non-binary relationality of Mahāyāna Buddhist medicine, and strive to provide a refreshing understanding of the world. In order to achieve this goal, we start this article by focussing upon the way in which the essentialised subjectivity became the norm of contemporary IR even in non-Western regions. Second, we will provide a general introduction to Mahāyāna Buddhism. Here, we will explain the fluid subjectivity of this particular philosophical tradition, particularly its assumptions of subjectivity, relationality and temporality. Third, we will shift our focus to a practical application of this line of thought, Mahāyāna Buddhist medicine. We argue that Mahāyāna Buddhist medicine is extremely suggestive to contemporary colonial/postcolonial relations in the sense that it provides a practical way to cure those who are suffering from fear and anxiety generated by the assumptions of autonomy and independence. Last, we will return to the discourses of IR, in particular a recent discussion on temporality, relationality and ethics, to consider the possible contributions of Mahāyāna Buddhist medicine to IR. [ABSTRACT FROM AUTHOR]

This article focuses on the manuscript diary of a Scottish doctor, Jonathan Troup, who during a truncated fifteen-month period, from 1789 to 1790, practised medicine on the island of Dominica, part of the climatic 'torrid zone' in the British West Indies. While the relevant textual contents of his diary are already familiar to scholars of medical humanities, the analysis seeks to complement and extend these existing discussions by addressing an aspect of the illustrated and inscribed pages of Troup's diary that has not been previously discussed, namely his diurnal account of race-making. The article argues that Troup was a product of Scottish enlightenment medical training, with its blended curricula of medicine, natural history and moral philosophy. The diary in turn, is shown to be a product of the diagnostic tools of that education, which equipped practitioners with the skills to classify human diversity through careful observation in the 'colonial field'. In his diurnal sketches, Troup employs a tiered racial system or calculus of colour to differentiate between peoples of different races, based on the visual proximity of their skin to either European whiteness or shades of blackness associated with African descent. In the textual descriptions that variously accompany, envelope, elucidate and ignore the drawings, Troup's race-making schema is shown to be informed by factors other than the gradations of skin complexion, including social temper and moral temperament. Such factors are given particular prominence in his discussion of multi-racial women, making gender an innate constituent of his race-making schema. The article is framed by the concept of business, which for most professionals in the Caribbean involved more than one economic occupation. It offers a prognosis as to the significance of Troup's diary for a range of academic disciplines, historical, literary and visual, and their discreet historiographies which pertain to his imperial careering. [ABSTRACT FROM AUTHOR]

The article focuses on reexamining the traditional cell doctrine in biology, highlighting the historical and conceptual shifts in understanding the nature of living organisms. Topics discussed include the historical background of the cell doctrine versus the fluid body perspective, the role of molecules in cellular organization and function, and the implications of molecular dynamics for understanding physiological processes and boundaries of the body.

L'analyse du rôle du médecin relatif aux maladies dites vénériennes, d'une part, aux remèdes aphrodisiaques, de l'autre, est révélatrice de la tension existante entre le traitement du corps social et le soin du corps humain, entre la santé publique et la santé individuelle. Est significative à cet égard l'évolution des dispositions du droit médical érotique, c'est-à-dire relatifs aux amours charnelles. En encadrant les activités iatriques, autrement dit celles qui ressortissent de l'art du médecin, la loi interroge la définition même de la médecine. Analyse the doctor's role relative to diseases formerly qualified as venereal on the one hand, to aphrodisiac remedies on the other, reveals the existing tension between the care of the social body and the human body, between public and individual health. The evolution of the medical law relating to carnal love demonstrates a significant evolution in this area. By redefining iatric activities, in other words those that come under the art of the doctor, it questions the definition of medicine itself. [ABSTRACT FROM AUTHOR]

Religion and spirituality are powerful social forces in contemporary South Africa. Traditional Health Practitioners (THPs) are commonly consulted for both spiritual and medical ailments as a first line of care. Many studies have assessed African traditional health seeking behaviors but few have examined beliefs, practices, and behaviors of THPs themselves. This study sought to explore spiritual worldviews among South African THPs. Semi-structured in-depth interviews were conducted with 18 THPs in Johannesburg, South Africa between January and May, 2022. Interviews were transcribed and translated into English. Data were managed using NVivo 12 software and thematically analyzed. The majority of THPs interviewed indicated that initiation as a THP was almost always preceded by a sickness accompanied by dreams/visions that represented an "ancestral calling" to become a healer. Most THPs also trained as both sangomas—who healed according to traditional beliefs—and prophets—who healed according to Christian beliefs. This reflects a syncretic relationship between traditional African beliefs and Christianity. However, not all churches are accepting of traditional beliefs and subsequently these THPs are members only at non-Pentecostal AIC churches who blend both African and Christian practices. Similar to these forms of religious pluralism melding Christianity and traditional beliefs, many THPs also often practice medical pluralism, mixing Western treatments with traditional practices/medicines. THPs are able to adapt elements of Western and African beliefs into healing practices that span multiple religious and medical fields. Thus, collaborative and decentralized healthcare services may be highly acceptable among such a pluralistic community. [ABSTRACT FROM AUTHOR]

Summary: Many people like to perceive themselves as better than previous generations: more knowledgeable, moral, tolerant and humane. Values associated with these aspects of ourselves may affect how we understand our professional forebears. In the early 20th century, some psychiatrists adopted new biomedical theories, including focal sepsis and eugenics, which resulted in inestimable harm. Detrimental clinical practices arose and were perpetuated in the context of societal values, medical ethics and other forces within and outside the medical profession. Historical understanding of the processes by which these things took place may help inform debate concerning current and future challenges of providing psychiatric care. The methods by which psychiatrists consider their predecessors may also have a bearing on how psychiatrists of the future will perceive us, the psychiatrists of the 2020s. [ABSTRACT FROM AUTHOR]

This study presents and explains the phenomenon of indexjacking, which involves the systematic infiltration of hijacked journals into international indexing databases, with Scopus being one of the most infiltrated among these databases. Through an analysis of known lists of hijacked journals, the study identified at least 67 hijacked journals that have penetrated Scopus since 2013. Of these, 33 journals indexed unauthorized content in Scopus and 23 compromised the homepage link in the journal's profile, while 11 did both. As of September 2023, 41 hijacked journals are still compromising the data of legitimate journals in Scopus. The presence of hijacked journals in Scopus is a challenge for scientific integrity due to the legitimization of unreliable papers that have not undergone peer review and compromises the quality of the Scopus database. The presence of hijacked journals in Scopus has far‐reaching effects. Papers published in these journals may be cited, and unauthorized content from these journals in Scopus is thus imported into other databases, including ORCID and the WHO COVID‐19 Research Database. This poses a particular challenge for research evaluation in those countries, where cloned versions of approved journals may be used to acquire publications and verifying their authenticity can be difficult. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the reliability and validity of the Artificial Intelligence Performance Instrument (AIPI). Methods: Medical records of patients consulting in otolaryngology were evaluated by physicians and ChatGPT for differential diagnosis, management, and treatment. The ChatGPT performance was rated twice using AIPI within a 7-day period to assess test–retest reliability. Internal consistency was evaluated using Cronbach's α. Internal validity was evaluated by comparing the AIPI scores of the clinical cases rated by ChatGPT and 2 blinded practitioners. Convergent validity was measured by comparing the AIPI score with a modified version of the Ottawa Clinical Assessment Tool (OCAT). Interrater reliability was assessed using Kendall's tau. Results: Forty-five patients completed the evaluations (28 females). The AIPI Cronbach's alpha analysis suggested an adequate internal consistency (α = 0.754). The test–retest reliability was moderate-to-strong for items and the total score of AIPI (rs = 0.486, p = 0.001). The mean AIPI score of the senior otolaryngologist was significantly higher compared to the score of ChatGPT, supporting adequate internal validity (p = 0.001). Convergent validity reported a moderate and significant correlation between AIPI and modified OCAT (rs = 0.319; p = 0.044). The interrater reliability reported significant positive concordance between both otolaryngologists for the patient feature, diagnostic, additional examination, and treatment subscores as well as for the AIPI total score. Conclusions: AIPI is a valid and reliable instrument in assessing the performance of ChatGPT in ear, nose and throat conditions. Future studies are needed to investigate the usefulness of AIPI in medicine and surgery, and to evaluate the psychometric properties in these fields. [ABSTRACT FROM AUTHOR]

Exercise is becoming more integrated into the management of multiple sclerosis (MS) and is promoted to manage impairments and symptoms. Whereas extensive research outlines factors impacting participation, less is known regarding how medicalized exercise promotion might impact views of exercise and self. We conducted a secondary data analysis to understand how medicalized exercise-promotion paradigms impact the meaning and roles of exercise among those with MS. Twenty-two interviews were selected for reanalysis with an interpretative phenomenological analysis methodology and a critical disability studies lens. Three themes were identified: Constant Vigilance (worry about exercise), Productivity and Social Engagement (exercise to feel productive, engage socially, and enhance self-worth), and Exercise as Medicine/Self-Care (exercise to manage MS, relax, improve mental well-being, prevent/reverse disability, and stay healthy). This research underscores that exercise occupies many contradictory roles reflecting a medicalized exercise-promotion paradigm for those with MS, and this should inform exercise promotion practices. [ABSTRACT FROM AUTHOR]

Simple Summary: In the past decades, the survival of ovarian malignant tumors has been largely unchanged. Treatment usually consists of a combination of systemic and surgical therapy. However, when recurrence occurs, treatment options are limited. When repeated surgery is no longer possible and chemotherapy is no longer effective, theranostics, a newly developing approach, might be of value. Theranostics will diagnose and destroy malignant tissue by binding radioactive isotopes to targets on malignant cells. To develop this approach, selection and validation of a target is necessary. For the selection of a target in ovarian tumors, the follicle-stimulating hormone (FSH) receptor appears to be suitable because it is primarily expressed in ovarian tissue, and expression is reported in malignant tumors. This review seeks to determine whether the follicle-stimulating hormone receptor is expressed in ovarian tumor types and, therefore, is suitable as a target in a future theranostic approach. Ovarian cancer mortality rates have not decreased significantly in the past years. As most women are still diagnosed in an advanced stage, there is a need for new treatment strategies for recurrent disease. A potentially new developing targeted approach, theranostics, combines diagnostics and treatment using radiopharmaceuticals. Through target receptors, imaging and treatment of malignant tissue can be achieved. For ovarian malignancy, the follicle-stimulating hormone (FSH) receptor may serve as a possible target since expression appears to be limited to ovarian cells. In this systematic review, we aim to gather all available literature on the expression of the FSH receptor in ovarian tumors. Pubmed, Embase and the Cochrane databases were searched until December 2023 for eligible studies. The search yielded 41 studies, mostly regarding serous carcinomas, sex cord–stromal tumors (SCSTs) and cell lines of serous and SCSTs. Various techniques were used to analyze the expression of the FSH receptor. For serous carcinomas, conflicting results on the expression of the FSH receptor were found. Studies on SCSTs, mainly studying the subtype of granulosa cell tumors, all showed positive expression of the FSH receptor. In the cell lines studies, the KGN cell line derived from a granulosa cell tumor shows positive expression in all studies. Available studies show that SCSTs express the FSH receptor. A theranostic approach targeting the FSH receptor may, therefore, provide a useful new approach for this malignancy with limited therapeutic options in recurrent disease. [ABSTRACT FROM AUTHOR]

AbstractReflective writing (RW) is a popular tool in medical education, but it is being used in ways that fail to maximize its potential. Literature in the field focuses on why RW is used – that is to develop, assess, and remediate learner competencies – but less so on how to use it effectively. The emerging literature on how to integrate RW in medical education is haphazard, scattered and, at times, reductionist. We need a synthesis to translate this literature into cohesive strategies for medical educators using RW in a variety of contexts. These 12 tips offer guidelines for the principles and practices of using RW in medical education. This synthesis aims to support more strategic and meaningful integration of RW in medical education. [ABSTRACT FROM AUTHOR]

OBJECTIVE: We, therefore, aim to conduct a systematic review to assess the academic potential of ChatGPT-3.5, along with its strengths and limitations when giving medical exams. METHOD: Following PRISMA guidelines, a systemic search of the literature was performed using electronic databases PUBMED/MEDLINE, Google Scholar, and Cochrane. Articles from their inception till April 4, 2023, were queried. A formal narrative analysis was conducted by systematically arranging similarities and differences between individual findings together. RESULTS: After rigorous screening, 12 articles underwent this review. All the selected papers assessed the academic performance of ChatGPT-3.5. One study compared the performance of ChatGPT-3.5 with the performance of ChatGPT-4 when giving a medical exam. Overall, ChatGPT performed well in 4 tests, averaged in 4 tests, and performed badly in 4 tests. ChatGPT's performance was directly proportional to the level of the questions' difficulty but was unremarkable on whether the questions were binary, descriptive, or MCQ-based. ChatGPT's explanation, reasoning, memory, and accuracy were remarkably good, whereas it failed to understand image-based questions, and lacked insight and critical thinking. CONCLUSION: ChatGPT-3.5 performed satisfactorily in the exams it took as an examinee. However, there is a need for future related studies to fully explore the potential of ChatGPT in medical education. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the rates and causality of patient-reported adverse events (AEs) associated with concomitant Chinese Herbal Medicine (CHM) and Western Medicine prescription drug (WMPD) consumption through active surveillance in Singapore's Traditional Chinese Medicine (TCM) clinics. Methods: A cross-sectional study was conducted at five TCM clinics across Singapore from 8th May till 8th July 2023. Patients were screened to determine rates of CHM and WMPD consumption, and then interviewed if an AE was reported. An expert committee assessed the AE reports to determine causality. Along with descriptive statistics, odds ratios were calculated to determine AE occurrence likelihoods for patients who consumed both CHM and WMPD compared to CHM consumption alone. Results: 1028 patients were screened and 62.65% of them reported concurrent CHM-WMPD consumption. Patients who consumed CHM and WMPD were 3.65 times more likely to experience an AE as compared to CHM consumption alone. 18 AE reports were adjudicated, with most AEs deemed unlikely due to CHM consumption. Conclusions: A large proportion of patients consumed CHM and WMPD concurrently, thus increasing their risk of experiencing AEs compared to those consuming CHM only. Active surveillance is applicable for detecting AEs, collecting data for causality assessment, and analysis. [ABSTRACT FROM AUTHOR]