Journal of Multidisciplinary Healthcare最新文献

Background: Precision medicine is an innovative approach that integrates genomics, clinical informatics, and proteomics to address both genetic and environmental factors in disease prevention and treatment. This bibliometric study analyzes research trends, collaboration patterns, and the unique characteristics of precision medicine across countries to inform future research directions.

Methods: A comprehensive search was conducted in the Web of Science Core Collection (1999-2022) database to identify publications related to precision medicine. The analysis of publication patterns, collaborations, institutions, authors, and research hotspots was performed utilizing Microsoft PowerPoint 2019 in conjunction with the Bibliometrix package in R.

Results: A total of 30,777 publications on precision medicine were identified. The United States and the United Kingdom were recognized as the primary contributors, while European countries exhibited substantial collaborative efforts. Harvard University and the University of California System have played pivotal roles in advancing the field. The keywords analysis showed that in the early 2000s, "gene expression" and "personalized outcomes" were key themes. Since 2015, there's been a significant shift towards advanced technologies like artificial intelligence, machine learning, liquid biopsy, highlighting their growing importance in precision medicine. Research topics across various countries exhibit certain global similarities. However, different nations exhibit distinct thematic research focuses. China emphasizes "Informatics", "Hepatocellular Carcinoma", "Photothermal Therapy", and "Lung Adenocarcinoma", while the United States prioritizes "Informatics", "Treatment Rules", and "Consortium Guidelines". Germany and France share similar interests in particular research domains.

Conclusion: Precision medicine is rapidly globalizing, with significant contributions from multiple countries and emerging technologies acting as catalysts for further development. Greater international cooperation is essential to elevate the quality and impact of research. These advancements hold great potential for transforming personalized healthcare by integrating cutting-edge scientific disciplines.

Introduction: Mechanical thrombectomy (MTB) is a critical procedure for acute ischemic stroke (AIS) patients. However, the free-text format of MTB surgical records limits the formulation of effective postoperative patient management and rehabilitation plans. This study compares the efficacy of large language models (LLMs) in structuring data from these free-text MTB surgical record.

Methods: This retrospective study collected a total of 382 MTB surgical records from a tertiary hospital. An initial analysis of 30 surgical record from these records provided a guiding prompt for LLMs, focusing on basic and advanced characteristics, such as occlusion locations, thrombectomy maneuvers, reperfusion status, and intraoperative complications. Six LLMs-ChatGPT, GPT-4, GeminiPro, ChatGLM4, Spark3, and QwenMax-were assessed against data extracted by neuroradiologists and a junior physician for comparison. The all 382 surgical records were used to test the performance of LLMs. The performance of the LLMs was quantified using Accuracy, Sensitivity, Specificity, AUC, and MSE as an additional metric for advanced characteristics.

Results: All LLMs showed high performance in characteristic extraction, achieving an average accuracy of 95.09 ± 4.98% across 48 items, and 78.05 ± 4.2% overall. GLM4 and GPT-4 were most accurate in advanced characteristics extraction, with accuracies of 84.03% and 82.20%, respectively. The processing time for LLMs averaged 73.10 ± 10.86 seconds of six models, significantly faster than the 427.88 seconds for manual extraction by physicians.

Conclusion: LLMs, particularly GLM4 and GPT-4, efficiently and accurately structured both general and advanced characteristics from MTB surgical record, outperforming manual extraction methods and demonstrating potential for enhancing clinical data management in AIS treatment.

Background: Hemodialysis-related restless legs syndrome (HD-RLS) is a common sensorial and motor disorder. The diagnosis of this disease is based on clinical criteria, and it has recently been proposed to use physiological parameters of the nerves related to the duration of the F wave as a supplementary diagnostic modality. The aim of the study is to determine the value of these parameters in the diagnosis of HD-RLS by comparing the differences between patients with HD-RLS and hemodialysis patients without RLS (HD-nRLS).

Methods: A total of 20 HD-RLS patients, 33 HD-nRLS patients, and 30 age-and gender-matched healthy controls (HCs) were included in the study. The motor nerve conduction of the median and ulnar nerves in the upper limbs, as well as the tibial and peroneal nerves in the bilateral lower limbs, and the sensory nerve conduction of the sural nerve bilaterally and the superficial peroneal nerve, along with the F waves of the ulnar nerves, median nerve, and bilateral tibial nerve, were assessed.

Results: Both groups of HD patients had variable levels of axonal degeneration and demyelination, with the HD-RLS patients having more severe lower limb involvement. The HD-RLS patients showed an extension of the F-wave duration (FWD) of the bilateral tibial, median, and ulnar nerves, along with an increased ratio between FWD and compound muscle action potential duration (CMAPD).

Conclusion: Peripheral neuropathy occurs in patients with HD-RLS, and the FWD/CMAPD ratio could potentially serve as an adjunctive diagnostic tool for HD-RLS.

Introduction: Alcohol use remains a leading cause of excess mortality and morbidity worldwide, and identifying and following up harmful alcohol use represents a key component of alcohol harm reduction policies. This article explores health professionals' experiences implementing these policies in a Norwegian hospital.

Aim: To explore health professionals' views and experiences of systematic screening and tailored follow-up of harmful and hazardous alcohol use in a Norwegian hospital.

Methods: We conducted semi-structured interviews with 13 specialty registrars and nurses working in the emergency department and observation ward of a hospital in Oslo, Norway. Interviews were carried out between May and December 2022, coded using NVivo v.14 and analyzed thematically.

Results: We identified three themes: (i) standardized and clinical assessment, referring to tensions between standardized and clinical alcohol risk assessment; (ii) formal and informal treatment guidelines, encompassing the informal patient care practices enacted in the emergency department and on the wards, and; (iii) training delivery and barriers to implementation, referring to the training penetration rate and identified need for "clear and simple" alcohol treatment guidelines.

Conclusion: This study highlights tensions between alcohol-related harm and alcohol-related norms as these pertain to screening and following up harmful and hazardous alcohol use in a Norwegian hospital. Results suggest training should focus on zero alcohol recommendations, the use of assessment tools, the acceptability of screening to patients and "clear and simple" patient follow-up procedures.

Background: The utilization of telehealth as an effective means to provide quality services is steadily rising across different tiers of the health system. However, advancing telehealth utilization relies on the current healthcare systems' infrastructure, policies, cultural factors, and utilization requirements can influence the utilization of telehealth within Saudi Arabia's healthcare system.

Purpose: This study seeks to systematically review the literature related to examining the factors influencing telehealth adoption and identifying the barriers and determinants of the use of telehealth in Saudi's healthcare system.

Methods: A systematic review methodology was utilized in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The methodology included an exploratory and narrative design, a dual-phase search strategy, eligibility criteria, and analysis. The Joanna Briggs Institute (JBI) tool was employed to assess the quality of the chosen papers.

Results: The search yielded 3197 articles to which eligibility criteria were applied. Thirteen articles were deemed eligible, screened, and utilized for comprehensive analysis in the present study. Numerous articles indicated that the utilization of telehealth has risen in Saudi Arabia, particularly during the COVID-19 pandemic. The investment strategies have aligned with the demand for telehealth systems. The primary challenges were resource limitations and the absence of cultural frameworks conducive to the utilization of telehealth in the country.

Conclusion: Telehealth represents a major technological breakthrough in the healthcare industry. However, there are some drawbacks to its adoption. The limited availability of Telehealth technologies poses a significant challenge. Secondly, relying solely on privatization might not adequately address the issue at hand. Third, there is a lack of knowledge and awareness regarding its associated benefits among healthcare staff. The establishment of telemedicine and telehealth infrastructure necessitates significant financial investment, which serves as a major factor and obstacle to the widespread adoption of telehealth.

Objective: This study identify the prevalence of sharp object injuries (SOIs) among healthcare workers (HCWs) in Dammam and Jeddah, Saudi Arabia.

Methods: Quantitative methodology using a cross-sectional design was applied. Chi-square testing was employed for comparative analyses, and logistic regression encompassing univariate and multivariate models was implemented to ascertain the predictors of SOIs.

Results: Prevalence rate of SOIs among hospital HCWs in Dammam and Jeddah cities was 8.40%. Non-Saudi nationals had a rate of 11.9%, while participants who had more than 15 years of experience had a lower rate (9.9%). Gender was identified as a significant predictor of SOIs, with males being two times more likely to experience SOIs than females. The highest rates of injuries were observed among laboratory personnel (29.2%; odds ratios of 8.6 and 7.2 in univariate and multivariate models, respectively).

Conclusion: These findings show that HCWs in Dammam have a marginally higher risk of SOIs (prevalence rate 9%) than their counterparts in Jeddah (prevalence rate 7.8%). Further investigations are needed to tailor specific training programs to increase HCWs' awareness, safety knowledge, and practices to reduce SOIs.

Purpose: Global warming is one of the critical problems affecting health, society, and the economy. High temperatures are linked to an increase in heat-related illnesses, which have significantly impacted the public health system, particularly emergency medical services (EMS). Analyzing the pattern of heat-related illness cases in EMS can improve resource utilization and preparedness within the public health system.

Patients and methods: A retrospective study was conducted on EMS data from Srinagarind Hospital, Thailand, covering the summer months (February to May) from 2020 to 2024. Patients with heat-related illnesses were identified in the EMS database using the 10^th revision of the International Classification of Diseases (ICD-10) version 2019, specifically codes under "T67 Effects of Heat and Light", which include heat stroke, heat syncope, heat cramps, heat exhaustion, and heat fatigue.

Results: A total of 136 EMS operations from the hospital's database were analyzed. In the summer 2024 group, 95.7% (N=44) of the patients were male. The majority of EMS triage cases required resuscitation (P = 0.020). Outdoor activity was identified as a significant factor related to heat illness, with rates of 83.3%, 92.9%, 93.3%, 97.1%, and 93.5% over the five years of the study. The activation time was 1.30 minutes for the summer of 2024 and 1.24 minutes for the summer of 2023. Notably, the average scene time in the summer 2024 group was significantly longer at 25.2 minutes, compared to 12.0 minutes in the summer 2020 group (P<0.001).

Conclusion: Outdoor activity was the most significant risk factor associated with increased heat-related illnesses. Other contributing factors included male gender, age between 20-40 years, scene temperatures above 35°C, and prolonged scene times exceeding 15 minutes.

Purpose: A lack of confidence in vaccination is a threat to public health and undermines vaccine uptake at national and global levels. Unfortunately, COVID-19 vaccine confidence among Turkish young adults is poorly known. This study aims to understand COVID-19 vaccine confidence among Turkish young adults aged 18-29 and the barriers to and facilitators of vaccine uptake.

Methods: The present research is a cross-sectional study. Survey data were collected in May and June 2022 (n = 1066) during the COVID-19 vaccination campaign. Results were expressed in frequencies and percentages for dichotomous variables and mean with standard deviation for continuous variables. To assess COVID-19 vaccine confidence based on selected sociodemographic characteristics, a one-way ANOVA analysis and an independent-sample t-test were used.

Results: Almost half of the sample (43.9%) underestimated the risk of contracting COVID-19 disease. 65.9% of participants believed that getting vaccinated against COVID-19 was important, while 47.8% thought the vaccine was safe and not dangerous or harmful. Concerns about vaccine effectiveness (58.3%) were the primary reported reason for vaccination. The percentage of participants who reported barriers to vaccine access was generally low (8.7%). Importantly, 63.9% believed getting vaccinated is their responsibility to their community. 33.8% of participants reported encountering inaccurate, misleading, and unfavorable information about COVID-19 vaccines, while 22.9% said they were unsure.

Conclusion: Addressing concerns about COVID-19 vaccine safety and efficacy, emphasizing the role of vaccination in societal benefits, ensuring easy access to vaccines, and providing access to up-to-date and accurate information from reliable sources might help increase coverage among young adults. Perhaps the most crucial advice is to instill the correct comprehension of vaccination and make lifelong vaccination a reality before individuals develop false beliefs that are challenging to rectify.

Introduction: In Saudi Arabia, the HPV vaccine is administered to young females through school-based immunization programs; however, the program's efficacy depends on parental consent, with physicians acting as primary determinants in parental decision-making regarding HPV vaccination.

Methods: In this cross-sectional study, we recruited 128 physicians and assessed their knowledge and attitudes toward cervical cancer, HPV, and the HPV vaccine, and unraveled predictors of HPV vaccine acceptability and factors that would influence recommending the vaccine.

Results: Although the major factor that influenced recommending the vaccine negatively was the fear of vaccine side effects, a positive influence of the physician's personal reading (91%), recommendations from colleagues (88%), and government directives (87%) provided reassurance and increased confidence in recommending the vaccine. Longer clinical experience and institutional awareness were found to be a predictors of favorable recommendation of HPV vaccination. Physicians in vaccine-related medical specialty with more than 4 years of experience were 5 to 6 times more likely to have positive attitude and better knowledge regarding HPV and HPV vaccination. A notable finding was that participants who reported knowing a woman suffering from cervical cancer had more positive attitudes compared to those who did not.

Discussion: This study identified physicians' personal reading, peer recommendations, and government directives as factors affecting the physicians' decision to recommend HPV vaccine, and found that longer clinical experience and institutional awareness were predictors influencing physicians to recommend the vaccine. It also emphasizes on the influence of healthcare providers in promoting the HPV vaccination and the need for designing interventions targeting specific demographic and professional groups that would be more effective in improving better knowledge and promoting positive attitudes towards these critical public health issues.

Several studies show that the implementation of health promoting hospital (HPH) standard in Indonesian hospital has not reached optimal levels. Therefore, this study aimed to explore the implementation of health promoting hospital standard at a private hospital in Depok, Indonesia. This descriptive study was conducted at the end of 2023. A purposive sampling with a total of 20 health workers who are responsible for health promotion programs from various backgrounds, including nurses, physiotherapists, laboratory technicians, midwives, and pharmacists, was involved in this study. The instrument containing 35 questions was adopted from the Health Promoting Hospital Guidelines issued by the Indonesian Ministry of Health in 2018, which included four standards, namely: 1) policy and management, 2) assessment, 3) intervention, as well as 4) monitoring and evaluation. Meanwhile, descriptive analysis was performed using SPSS version 29.0. The results showed that assessment standards had the highest average score of 73.72, followed by the intervention of 72.71 out of a maximum of 100. The lowest score was reported in the monitoring and evaluation standard, with an average of 67.82. The components within each standard had an average score of less than 3 out of a maximum of 4. Organizational changes through short-term interventions, including leadership involvement and training the staff, were necessary to enhance the implementation effectiveness of health promoting hospital standards.