Journal of Medicine, Surgery, and Public Health最新文献

This paper explores the transformative impact of artificial intelligence (AI), particularly machine learning (ML), on diagnosing and treating hearing loss, which affects over 5% of the global population across all ages and demographics. AI encompasses various applications, from natural language processing models like ChatGPT to image recognition systems; however, this paper focuses on ML, a subfield of AI that can revolutionize audiology by enhancing early detection, formulating personalized rehabilitation plans, and integrating electronic health records for streamlined patient care. The integration of ML into audiometry, termed "computational audiology," allows for automated, accurate hearing tests. AI algorithms can process vast data sets, provide detailed audiograms, and facilitate early detection of hearing impairments. Research shows ML's effectiveness in classifying audiograms, conducting automated audiometry, and predicting hearing loss based on noise exposure and genetics. These advancements suggest that AI can make audiological diagnostics and treatment more accessible and efficient. The future of audiology lies in the seamless integration of AI technologies. Collaborative efforts between audiologists, AI experts, and individuals with hearing loss are essential to overcome challenges and leverage AI's full potential. Continued research and development will enhance AI applications in audiology, improving patient outcomes and quality of life worldwide.

Chronic kidney disease (CKD) is defined as the presence of kidney damage persisting for 3 months or more. Kidney transplantation stands as a vital intervention for individuals grappling with end-stage renal disease (ESRD) in Africa, offering the promise of extended life and improved quality of life. However, numerous challenges hinder its widespread implementation across the continent. This paper explored kidney transplantation in Africa, aiming to illuminate key strategies for bridging gaps and building pathways to enhanced renal care. There is a disproportionate burden of CKD on the region's population. Therefore, there is a critical need for early diagnosis and intervention. This paper outlines comprehensive strategies for improving kidney transplantation in Africa. Results indicate that financial support systems, infrastructure enhancement, public awareness campaigns, and legal frameworks are essential for addressing renal care barriers. Active measures such as government subsidy programs, international funding collaboration, and engagement with community leaders are highlighted as effective approaches. Drawing from global standards and best practices, the paper shows the importance of tailored approaches that address Africa's unique socio-economic and healthcare landscape. By leveraging collaborative efforts, regulatory frameworks, and public engagement, African nations can overcome barriers to kidney transplantation and pave the way for equitable access to life-saving treatment.

Post-COVID Conditions (PCC) involve persistent symptoms associated with COVID-19 that continue beyond four weeks of initial infection. Sex has been shown to be related with COVID-19 severity and symptoms. The purpose of this study is to assess the loss of taste (ageusia) or smell (anosmia) among U.S. residents who had PCC and examine its specific association with sex. The data source for this cross-sectional study was 2022 Behavioral Risk Factor Surveillance System (BRFSS), a U.S. national dataset. Participants were included if they had COVID-19, reported experiencing PCC, and identified their primary PCC symptom. Overall, 23,824 participants were included in the study. In multivariable logistic regression analysis, adjusted odds ratio for males compared to females was 1.18 (95 % CI: 1.03–1.35; p=0.0165). Participants who were aged <50 years as compared with those who were aged ≥50 years, non-Hispanic white as compared with non-Hispanic black, had BMI ≤ 25 as compared with BMI ≥ 30, had no reported chronic condition as compared with those who did report a chronic condition, and had ≤high school education as compared with those who had > high school education had higher odds of reporting PCC-related ageusia/anosmia in this multivariable model. Among people with PCC, males had an 18 % higher odds of reporting PCC-related ageusia/anosmia as their primary symptom of PCC compared to females. Findings from our study can help identify patients affected by PCC-related ageusia/anosmia who would benefit from early referral for supportive care, such as counseling or interventions that can alleviate this dysfunction.

Stress is prevalent in the lives of college students, which may manifest into anxiety and depression, especially after life-altering events, such as the COVID-19 pandemic. The goal of this study was to assess the post-pandemic presence and severities of anxiety and depression among the current population of college students at a minority-serving institution using a psychometrically valid 37-item questionnaire. The Generalized Anxiety Disorder 7 Scale (GAD-7) and the Center for Epidemiological Studies Depression Scale (CES-D) were used to assess anxiety and depression, respectively. Univariate and bivariate statistical tests were utilized to analyze the data. A total of 41 students completed the survey, of which 29 (70.8 %) demonstrated minimal to mild anxiety and 12 (29.2 %) demonstrated moderate to severe anxiety. Among respondents, 26 (63.4 %) demonstrated depressive symptoms, and 15 (36.6 %) did not demonstrate any depressive symptoms. There were significantly higher anxiety scores among undergraduate students (p = 0.013) and those who have encountered barriers to identifying mental health resources (p = 0.03). In addition, marginally significant anxiety scores were found among students who have used mental health resources (p = 0.05). There were also significantly higher depression scores among undergraduate students (p = 0.005), those who have encountered barriers to identifying mental health resources (p = 0.02), and 18–22-year-olds (p = 0.01). As time has progressed since the height of the COVID-19 pandemic, further research is needed to discern whether anxiety and depression symptoms have improved or worsened in college students.

Background

Africa has the highest burden of HIV/AIDS globally, with young people being the most affected. This study aimed to assess HIV knowledge and practices among undergraduate students in Africa.

Methods

An analytical cross-sectional study was conducted in ten African countries using an online, self-administered, pre-validated questionnaire. The study was conducted in 10 African countries, located in 5 different regions across Africa including Kenya, Algeria, Botswana, Burkina Faso, Ethiopia, Nigeria, Rwanda, Sudan, Tanzania, and Uganda, during the academic year 2022–2023. A convenience sampling approach was utilized to collect the data. African undergraduates who were 18 years and older, enrolled in universities across ten African countries and were willing to participate and gave an e-informed consent were included.

Shapiro-Wilk test was utilized to check the data normality. Student’s t-test and Chi-square test were used for continuous and categorical variables in independent samples. Mann-Whitney U and Kruskal-Wallis tests were used for nonparametric comparisons. Logistic regression was used for identifying the predictors for the knowledge regarding HIV. Significance level was set at p < 0.05.

Results

A total of 3727 undergraduate students responded to the questionnaire. Most students were medical students (68.1 %), single (94.9 %), and living in urban areas (78.7 %). The overall median HIV knowledge score was 14, and medical students had significantly higher knowledge than non-medical students (p < 0.001). While the students had a strong understanding of HIV transmission, some aspects of their knowledge were inadequate. Most students relied on academic curricula for HIV information (72.3 %) and their institutions provided formal HIV prevention strategies (57.8 %). A low percentage engaged in risky sexual behaviors. The results indicated that being male (AOR (95 % CI) = 4 (1.2–13.2)), pursuing medical education (AOR (95 % CI) = 2.4 (2–2.8)), being in the final years of study (i.e. fourth, fifth, and sixth years) (AOR (95 % CI) = 1.3 (1.02–1.6), 1.6 (1.2–2.1), 2.4 (1.6–3.8), ever testing for HIV (AOR (95 % CI) = 2.3 (1.9–2.8), and ever engaging in sexual activity (AOR (95 % CI) = 2.6 (2.3–3) were independent predictors of good knowledge of HIV.

Conclusion

The findings of this study reveal a notable proficiency in HIV knowledge among African undergraduate students, particularly those enrolled in medical programs. However, there remains scope for enhancing their HIV-related practices, particularly in the areas of routine HIV testing and the establishment of Voluntary Counseling and Testing (VCT) services.

Ancient humans evaded lethal, tropical infections by migrating away from pathogen reservoirs to colder regions where the climate served as a physiological barrier to growth of pathogenic microorganisms. In the contemporary world, aversion of bacterial infections is being dominantly governed by a plethora of antimicrobial drugs which are deemed to be a boon to the society owning to their instant effectiveness, fewer stringent containment and transportation requirements, wider accessibility and economic feasibility. Nonetheless, antibiotic effectivity gradually declined as more microbes began evolving tolerance mechanisms (drug inactivation, drug efflux, drug target modification and more) against them. Invention of sensitive technologies paved way for fresh revelations including how conjugative plasmids in tandem with other mobile genetic elements (MGEs) contribute to the expansion of AMR gene pool. In this commentary, we revise the multifaceted processes associated with the origin (in microbial and human populations), advancement (antibiotic misuse, excessive use of antimicrobial resistance genes as selective markers in cloning pursuits) and dissemination of AMR, thereby, resolving confusions, unveiling new facts and targets that could lay the groundwork for novel therapies.

Adverse perinatal outcomes (APOs) constitute a significant concern for public health in most developing countries. APOs significantly affect perinatal and neonatal survival, with the risk of developing complications such as developmental disability and ill health throughout their lives. This review aimed to identify adverse perinatal outcomes and their associated determinants in Sub-Saharan Africa (SSA). The study conducted an electronic database search from PubMed, Embase, Medline, and African Online Journals to identify relevant literature. Studies were included if they were published in English on adverse perinatal outcomes and their determinants between 1st January 2013 and 31st March 2024. The studies’ quality was assessed by adhering to the guidelines and recommendations for reporting scoping reviews. Two authors independently screened the included studies’ titles, abstracts, and full texts. Out of the 120 studies identified through the database search, 50 met the eligibility criteria and were included in the review. The findings reveal that there were an estimated number of 2.6 million third-trimester stillbirths globally, with 41 % occurring in SSA in 2015. Most studies attributed stillbirth to lack of ANC attendance, delayed or less than four ANC attendance, maternal age, level of education, malaria, HDP, and grand multiparity. Globally, there is an estimated annual delivery of 30 million babies weighing below 2500 g, with half of these deliveries occurring in SSA. Most studies found LBW to be significantly associated with maternal age (especially adolescent pregnancies), maternal nutrition, education, and the number of ANC attendance. According to the WHO, 15 million babies are born preterm annually, with 81 % occurring in South Asia and SSA. Most studies cited maternal age and diseases such as hypertensive disorders in pregnancy (HDP) as significant predictors of preterm birth. Neonatal death was found to be one of the significant burdens faced by SSA; the region has the highest neonatal death rate of 27 per 1000 live births, making it a significant contributor to under-five mortality in the sub-region. Most studies found poor ANC attendance, HDP, and delayed obstetric emergency care significant predictors of neonatal death. The review established that the several APOs in SSA are associated with maternal age, less than four antenatal care follow-ups or non-utilization, maternal education, medical conditions, parity, rural residence, distance travel, and women’s participation in decision-making. This suggests that efforts should be geared towards improving access to healthcare and women’s empowerment.

Measles remains a critical public health threat in Nigeria, with high incidence rates and low vaccination coverage, particularly in the northern zones. This study identifies the drivers of measles outbreaks in Nigeria and proposes short-term and long-term strategies to combat recurrent measles outbreaks. This study was conducted using a review of existing literature and data on measles outbreaks, vaccination coverage, and healthcare infrastructure in Nigeria. Low vaccination coverage, vaccine hesitancy, inadequate healthcare infrastructure, and socioeconomic determinants are key drivers of measles outbreaks in Nigeria. Short-term strategies include enhancing public awareness and community engagement, improving surveillance and case management, ensuring the availability of medications and medical supplies, and strengthening laboratory diagnostic capacity. Long-term strategies include strengthening routine immunization services, addressing vaccine hesitancy, improving disease surveillance and reporting systems, addressing socioeconomic determinants of health, and fostering multisectoral collaboration and coordination. Measles outbreaks in Nigeria can be combated through a combination of short-term and long-term strategies that address the root causes of the problem. Policy implications include improving measles vaccination coverage, strengthening healthcare infrastructure, and building public and government trust.

This letter addresses the hazards that public health of Pakistan faces from heatwaves and global warming. Pakistan's geographical and economic constraints make it particularly vulnerable to climate change effects. The most vulnerable demographics include outdoor laborers, women, kids, and the elderly. Heatwaves are made considerably more deadly when there is no access to electricity. The letter suggests recommendations such as early warning systems, medical professional training, tree planting, and teaching programs in schools.

Breast cancer's global impact and high mortality rates drive interest in Artificial intelligence (AI) applications. AI's pattern recognition and decision-making abilities offer promise in detection, diagnosis, personalized treatment, risk assessment, and prevention. Screening and early detection are improved by AI-enhanced mammography. AI aids radiologists in lesion detection and diagnosis, though concerns about false positives persist. In addition, AI revolutionizes breast imaging, assisting in reading mammograms, biomarker assessment, lymph node detection, and outcome prediction. Genetic insights into risk and treatment response are advanced by AI, particularly through deep learning algorithms. Collaborative treatment approaches benefit from AI-guided radiotherapy planning. However, challenges of AI include data privacy, ethics, and regulatory issues that must be navigated to ensure successful AI implementation while upholding healthcare trust. Therefore, this commentary provided an overview of implication of AI in breast cancer.