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Student and Physician Views of How the Dobbs Decision Affects Training and Practice Location Preferences: Cross-Sectional Questionnaire Study. 学生和医生对多布斯决策如何影响训练和实习地点偏好的看法:横断面问卷研究。
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-07 DOI: 10.2196/55035
Morgan S Levy, Simone A Bernstein, Sarah M McNeilly, Abigail Liberty, Shira Fishbach, Shikha Jain, Jessica A Gold, Vineet M Arora
<p><strong>Background: </strong>By allowing for abortion bans and restrictions to take effect in the majority of US states, the 2022 Dobbs v Jackson Women's Health Organization decision portends to have lasting impacts on patient care and the physician workforce. Notably, it is already beginning to impact practice location preferences of US health care workers, evidenced by declining application rates to residency programs in abortion-restrictive states since 2022. Yet, there remains a gap in the literature regarding why this trend exists.</p><p><strong>Objective: </strong>This study aims to describe what factors are driving the practice location preferences of medical students and physicians after the Dobbs decision.</p><p><strong>Methods: </strong>This study analyzes qualitative data from a web-based, cross-sectional study. In August 2022, a nonprobabilistic sample of physicians and medical students were surveyed on social media about the impact of overturning Roe v Wade on practice location preferences, which included the free-text question "Please share your thoughts about the overturning of Roe v Wade and how it will affect your decision about your (residency/job or fellowship) programs." A total of 3 independent team members completed an inductive thematic analysis of 524 free responses, resolving differences by discussion.</p><p><strong>Results: </strong>Approximately 1 in 4 survey respondents also completed the free-response item (524/2063, 25.4%); a total of 219 were medical students, 129 were residents and fellows, and 176 were practicing physicians. Of them, approximately half (261/524, 50.5%) resided in states where abortion bans were in place or anticipated. Those who answered the free-response item were relatively more likely to hail from states with restrictive abortion bans (P<.001) compared to those who did not, with other demographic characteristics being largely similar between the groups. Inductive thematic analysis yielded 2 broad thematic categories: patient-related and workforce-related factors influencing practice decision preferences. The 3 most common themes overall were respondent concerns regarding their patient's access to care (249/524, 47.5%), their desire not to practice or train in a state with abortion restrictions regardless of current residence (249/524, 47.5%), and their personal belief that abortion bans are human rights and/or body autonomy violation (197/524, 37.6%). Some respondents stated that the Dobbs decision would not impact their choice of practice location (41/524, 7.8%), and some supported it (35/594, 6.7%).</p><p><strong>Conclusions: </strong>This study shows that abortion restrictions are having an impact on the practice location preferences of the physician workforce due to both patient care and personal factors. It is important that state policy makers and others who are considering abortion restrictions also consider how to address these concerns of physicians and medical students, to avoid wo
背景:通过允许堕胎禁令和限制在美国大多数州生效,2022年多布斯诉杰克逊妇女健康组织的决定预示着对患者护理和医生队伍产生持久的影响。值得注意的是,它已经开始影响美国卫生保健工作者的实践地点偏好,自2022年以来,堕胎限制州的住院医师项目申请率下降就是证明。然而,关于这种趋势存在的原因,文献中仍然存在空白。目的:本研究旨在探讨医学生和医生在多布斯决定后对实习地点偏好的影响因素。方法:本研究分析了基于网络的横断面研究的定性数据。2022年8月,在社交媒体上对医生和医学生进行了非概率抽样调查,了解推翻罗伊诉韦德案对实习地点偏好的影响,其中包括自由文本问题“请分享你对推翻罗伊诉韦德案的看法,以及它将如何影响你对(住院医师/工作或奖学金)项目的决定。”共有3名独立小组成员对524个自由回复进行归纳性专题分析,通过讨论解决分歧。结果:约1 / 4的受访者还完成了自由回答项目(524/2063,25.4%);其中医学生219人,住院医师和研究员129人,执业医师176人。其中,大约一半(261/524,50.5%)居住在堕胎禁令实施或预期的州。回答自由回答项目的人相对更有可能来自限制堕胎禁令的州(结论:本研究表明,由于患者护理和个人因素,堕胎限制对医生劳动力的实践地点偏好产生了影响。重要的是,正在考虑限制堕胎的国家决策者和其他人士也应考虑如何解决医生和医学生的这些关切,以避免医生的地理分布不均衡恶化,以及公民获得医生护理的机会恶化。
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引用次数: 0
Simplified Medication Adherence Questionnaire (SMAQ) for People Living With HIV in a National Hospital in Mexico: Instrument Validation Study. 墨西哥某国立医院HIV感染者简化服药依从性问卷(SMAQ):工具验证研究
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-07 DOI: 10.2196/59562
Luis Eduardo Del Moral Trinidad, Luz Alicia González Hernández, Jaime Federico Andrade Villanueva, Pedro Martínez-Ayala, Adriana Valle Rodríguez, Vida Veronica Ruíz Herrera, José Adán Vizcaíno Résendiz, Melva Guadalupe Herrera Godina, Sergio Dominguez-Lara

Background: Adherence to antiretroviral therapy is a critical component in achieving viral suppression in people living with HIV in addition to increasing overall quality of life. Several indirect methods have been used to measure adherence including the Simplified Medication Adherence Questionnaire (SMAQ).

Objective: The objective of this study is to evaluate the reliability and validity of the SMAQ in men living with HIV/AIDS attending a Mexican national hospital.

Methods: A cross-sectional analytical design study was carried out in a Mexican National Hospital in Jalisco, including men aged >18 years with at least 3 months of antiretroviral treatment, excluding those with cognitive difficulties in answering the survey. A minimum sample size was calculated to detect the contribution of the variables within the model. The analysis included descriptive tests, confirmatory factor analysis, reliability and validity assessment, correlation between adherence and viral load, and association between viral load and adherence.

Results: The final analysis included a total of 260 patients with a mean age of 43 (SD 12) years and an average of 8.97 (SD 6.33) years on antiretroviral treatment. The SMAQ showed sufficient structural validity (comparative fit index=1, root-mean-square error of approximation=0, 90% CI 0-0.085) with satisfactory factor loadings on most questions except item 2 (Do you always take your medication at the prescribed time?). The reliability of the scale is acceptable (Cronbach α=0.702, ω=0.718). Adherence correlated with viral load significantly but not with recent TCD4 lymphocyte levels. Patients classified as adherent were three times more likely to be undetectable than nonadherent patients (odds ratio 3.31, 95% CI 1.13-9.64, P=.04).

Conclusions: The SMAQ represents an adequate tool to assess adherence in men living with HIV in the Mexican context, this will contribute to this study and compression of adherence to establish future intervention programs.

背景:除了提高总体生活质量外,坚持抗逆转录病毒治疗是实现艾滋病毒感染者病毒抑制的关键组成部分。一些间接的方法被用来测量依从性,包括简化药物依从性问卷(SMAQ)。目的:本研究的目的是评估在墨西哥国立医院就诊的艾滋病毒/艾滋病男性患者的SMAQ的信度和效度。方法:在哈利斯科州的墨西哥国立医院进行了一项横断面分析设计研究,包括年龄在bb0 - 18岁,接受抗逆转录病毒治疗至少3个月的男性,不包括回答调查有认知困难的男性。计算最小样本量以检测模型内变量的贡献。分析包括描述性检验、验证性因子分析、信度和效度评估、依从性与病毒载量的相关性、病毒载量与依从性的相关性。结果:最终分析共纳入260例患者,平均年龄为43岁(SD 12),抗逆转录病毒治疗的平均年龄为8.97岁(SD 6.33)。SMAQ显示足够的结构效度(比较拟合指数=1,近似均方根误差=0,90% CI 0-0.085),除第2项(您是否总是按规定时间服药?)外,大多数问题的因子负荷令人满意。量表的信度可接受(Cronbach α=0.702, ω=0.718)。粘附性与病毒载量显著相关,但与近期TCD4淋巴细胞水平无关。被归类为黏附的患者被检测不到的可能性是非黏附患者的三倍(优势比3.31,95% CI 1.13-9.64, P= 0.04)。结论:SMAQ是评估墨西哥男性HIV感染者依从性的适当工具,这将有助于本研究和依从性的压缩,以建立未来的干预方案。
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引用次数: 0
Citizen Worry and Adherence in Response to Government Restrictions in Switzerland During the COVID-19 Pandemic: Repeated Cross-Sectional Online Surveys. 在2019冠状病毒病大流行期间,瑞士公民对政府限制的担忧和遵守:重复的横断面在线调查。
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-07 DOI: 10.2196/55636
Vanessa Kraege, Céline Dumans-Louis, Céline Maglieri, Séverine Bochatay, Marie-Anne Durand, Antoine Garnier, Kevin Selby, Christian von Plessen
<p><strong>Background: </strong>Good communication between health authorities and citizens is crucial for adherence to preventive measures during a pandemic. Crisis communication often appeals to worries about negative consequences for oneself or others. While worry can motivate protective behavior, it can also be overwhelming and lead to irrational choices or become a mental health problem. Also, the levels and consequences of worry can differ between different groups of citizens. Little is known about the evolution of worries during the pandemic and adherence to measures in distinct groups.</p><p><strong>Objective: </strong>This study aimed to evaluate worries in the Swiss population as well as associations between worry levels and citizens' adherence to government restrictions during different phases of the COVID-19 pandemic.</p><p><strong>Methods: </strong>We carried out an observational study with 4 cross-sectional online surveys of adults in the Canton of Vaud, Switzerland. Questionnaires were distributed through social media and websites during 4 periods: survey 1: April 17 to May 14, 2020; survey 2: May 15 to June 22, 2020; survey 3: October 30 to December 12, 2020; and survey 4: June 18 to December 30, 2021. On visual analog scales from 0 to 100, participants reported worry, self-adherence to pandemic restrictions, and their perceived adherence to others. We used multivariable linear regression, adjusting for age, gender, health literacy, and education to assess associations between self-reported worry, adherence, and study periods.</p><p><strong>Results: </strong>We collected 7106 responses. After excluding 2377 questionnaires (incomplete, age <18 years, residence outside Vaud), 4729 (66.55%) were analyzed (mean age 47, SD 15.6 years, 63.96% women). Mean worry across the 4 periods was 42/100, significantly higher in women (44.25/100, vs 37.98/100; P<.001) and young people (43.77/100 in those aged 18-39 years, vs 41.69/100; P=.005; in those aged 40-64 years and 39.16/100; P=.002; in those aged >64 years). Worries were higher during survey 1 and survey 3 (52.41/100 and 56.32/100 vs 38.93/100, P<.001; and 35.71/100, P<.001) than during survey 2 and survey 4, respectively. This corresponds to pandemic peaks during which federal restrictions were better followed with self-reported adherence of 84.80/100 and 89.59/100 in survey 1 and survey 3 versus 78.69/100 (P<.001) and 78.64/100 (P<.001) in survey 2 and survey 4. A 2.9-point increase in worry score, adjusted for the pandemic period, gender, age, education, and health literacy, was associated with a 10-point increase in personal adherence score (95% CI 2.5-3.2; P<.001).</p><p><strong>Conclusions: </strong>Worries were higher in women, young people, and during the peak of the COVID-19 pandemic. Higher worry levels were associated with increased self-reported adherence to federal restrictions. Authorities should consider population worry levels and population subgroups in the planning and des
背景:在大流行期间,卫生当局与公民之间的良好沟通对于遵守预防措施至关重要。危机沟通通常会引起对自己或他人的负面后果的担忧。虽然担心可以激发保护行为,但它也可能是压倒性的,导致不合理的选择或成为心理健康问题。此外,不同人群的担忧程度和后果也不尽相同。人们对大流行期间担忧的演变以及不同群体对措施的遵守情况知之甚少。目的:本研究旨在评估瑞士人口的担忧情绪,以及担忧程度与公民在COVID-19大流行不同阶段遵守政府限制措施之间的关系。方法:我们开展了一项观察性研究,对瑞士沃州的成年人进行了4次横断面在线调查。通过社交媒体和网站分4期发放问卷:调查一:2020年4月17日至5月14日;调查二:2020年5月15日至6月22日;调查三:2020年10月30日至12月12日;调查四:2021年6月18日至12月30日。在从0到100的视觉模拟量表上,参与者报告了他们的担忧、对流行病限制的自我遵守以及他们对他人的依从性。我们使用多变量线性回归,调整年龄、性别、健康素养和教育来评估自我报告的担忧、依从性和研究时间之间的关系。结果:共收集问卷7106份。剔除2377份问卷(不完整,年龄64岁)。调查1和调查3期间担忧情绪较高(分别为52.41/100和56.32/100 vs 38.93/100)。结论:女性、年轻人和COVID-19大流行高峰期的担忧情绪较高。焦虑程度越高,自我报告的遵守联邦限制的程度越高。当局应在大流行传播的规划和设计中考虑人口担忧程度和人口分组。
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引用次数: 0
Personality Types of Medical Students in Terms of Their Choice of Medical Specialty: Cross-Sectional Study. 医学生在医学专业选择上的人格类型:横断面研究
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-12-31 DOI: 10.2196/60223
Małgorzata Tobiaszewska, Tytus Koweszko, Jonasz Jurek, Karolina Mikołap, Jacek Gierus, Jantoni Mikulski, Napoleon Waszkiewicz

Background: Research on personality types among doctors reveals its impact on medical specialty choices, suggesting that considering personality in career planning may enhance work satisfaction and reduce burnout risks.

Objective: This study, encompassing 2104 medical students, explores how personality types, traits, and gender relate to specialty preferences.

Methods: Participants of this study were medical students from various universities in Poland. The study surveyed 2104 participants. Each participant completed a general questionnaire and a NERIS Type Explorer personality test, based on the Myers-Briggs Type Indicator inventory and the "Big Five" personality traits concept. The questionnaire was distributed on social media groups for medical students from all Polish universities. An exploratory statistical analysis was performed to find relationships. For each tested relationship a Fisher exact test was conducted and the significance level was P<.05. Each test resulted in a P value and odds ratio (OR) with a CI. To ensure we included undecided students and obtained meaningful data, we allowed participants to select up to three medical specialties from the 77 available in Poland at the time of the study.

Results: The findings unveil significant relationships between gender, personality types, traits, and specialty preferences. Women tended to favor Neonatology (OR 9.15, 95% CI 3.02-45.46), while men leaned toward Orthopedics and traumatology of the locomotor system (OR 7.53, 95% CI 4.87-11.94). Extroverted, Intuitive, Feeling, Prospecting, and Turbulent students showed a heightened interest in Psychiatry (OR 2.23, 95% CI 1.64-3.01), whereas Introverted, Observant, Feeling, Judging, and Turbulent types favored Family Medicine (OR 2.98, 95% CI 2.08-4.24) and Pediatrics (OR 2.13, 95% CI 1.51-2.99).

Conclusions: In conclusion, this research establishes a link between personality and medical specialty selection. Taking into account the significant role of personality traits, it should be considered to integrate them into the process of selecting a medical career or designing a medical curriculum. This approach may allow for the customization of programs to match students' traits, thereby cultivating improved clinical communication skills, fostering interprofessional collaboration and ultimately enhancing treatment outcomes and professional fulfillment among physicians. The main limitation of this study is that it was conducted on medical students, who lack the full knowledge of the work as a specific specialist. A study surveying medical doctors with longer internships across different wards could be conducted to check for any variabilities. Moreover, there are other significant factors that influence one's medical specialty choice. Certainly, this area could be further explored.

背景:对医生人格类型的研究揭示了人格类型对医学专业选择的影响,表明在职业生涯规划中考虑人格因素可以提高工作满意度,降低职业倦怠风险。目的:本研究包括2104名医科学生,探讨人格类型、特征和性别与专业偏好的关系。方法:本研究以波兰各大学医学生为研究对象。这项研究调查了2104名参与者。每位参与者都完成了一份普通问卷和NERIS类型探索者人格测试,该测试基于迈尔斯-布里格斯类型指标清单和“大五”人格特征概念。问卷在波兰所有大学的医学生的社交媒体群中分发。进行探索性统计分析以发现相关关系。对于每一种被测试的关系,都进行了Fisher精确检验,显著性水平为:结果:研究结果揭示了性别、人格类型、性格特征和专业偏好之间的显著关系。女性倾向于选择新生儿科(OR 9.15, 95% CI 3.02-45.46),而男性倾向于选择运动系统骨科和创伤学(OR 7.53, 95% CI 4.87-11.94)。外向型、直觉型、感觉型、探察型和狂暴型学生对精神病学表现出更高的兴趣(OR 2.23, 95% CI 1.64-3.01),而内向型、观察型、感觉型、判断型和狂暴型学生对家庭医学(OR 2.98, 95% CI 2.08-4.24)和儿科(OR 2.13, 95% CI 1.51-2.99)更感兴趣。结论:本研究建立了人格与医学专业选择之间的联系。考虑到人格特质的重要作用,应该考虑将其纳入选择医学职业或设计医学课程的过程中。这种方法可以根据学生的特点定制课程,从而培养更好的临床沟通技巧,促进跨专业合作,最终提高医生的治疗效果和专业成就感。本研究的主要局限性是它是对医学院学生进行的,他们缺乏作为特定专家的工作的充分知识。一项调查在不同病房实习时间较长的医生的研究可以用来检查任何变量。此外,还有其他显著因素影响一个人的医学专业选择。当然,这一领域还有待进一步探索。
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引用次数: 0
Patient-Centric Approach to Personalized Electronic Medical Records via QR Code in Japan. 日本以患者为中心的QR码个性化电子病历。
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-12-23 DOI: 10.2196/57332
Yoshihiko Izumida, Takashi Omura, Masahiro Fujiwara, Shoko Nukaya, Akio Yoneyama, Sow Boubacar, Shinichiro Yabe, Rika Noguchi, Shima Nakayama, Wataru Muraoka, Yuki Okuno, Sho Miyashita, Yurika Ishihara, Yuto Moriwaki, Ryoji Otani, Junichiro Adachi, Kenichiro Tanabe, Yoshihisa Yamano, Yasushi Takai, Masaru Honjo

Government policies in the United States and the European Union promote standardization and value creation in the use of FAIR (findability, accessibility, interoperability, and reusability) data, which can enhance trust in digital health systems and is crucial for their success. Trust is built through elements such as FAIR data access, interoperability, and improved communication, which are essential for fostering innovation in digital health technologies. This Viewpoint aims to report on exploratory research demonstrating the feasibility of testing a patient-centric data flow model facilitating semantic interoperability on precision medical information. In this global trend, the interoperable interface called Sync for Science-J (S4S-J) for linking electronic medical records (EMRs) and personal health records was launched as part of the Basic Policy for Economic and Fiscal Management and Reform in Japan. S4S-J controls data distribution consisting of EMR and patient-generated health data and converts this information into QR codes that can be scanned by mobile apps. This system facilitates data sharing based on personal information beliefs and unlocks siloed Internet of Things systems with a privacy preference manager. In line with Japanese information handling practices, the development of a mobile cloud network will lower barriers to entry and enable accelerated data sharing. To ensure cross-compatibility and compliance with future international data standardization, S4S-J conforms to the Health Level 7 Fast Health Care Interoperability Resources standard and uses the international standardized logical observation identifiers names and codes (LOINC) to redefine medical terms used in different terminology standards in different medical fields. It is developed as an applied standard in medical information intended for industry, health care services, and research through secondary use of data. A multicenter collaborative study was initiated to investigate the effectiveness of this system; this was a registered, multicenter, randomized controlled clinical trial, the EMBRACE study of the mobile health app M♡Link for hyperglycemic disorders in pregnancy, which implements an EMR-personal health record interoperable interface via S4S-J. Nevertheless, the aforementioned new challenges, the pivotal Health Level 7 Fast Health Care Interoperability Resources system, and LOINC data mapping were successfully implemented. Moreover, the preliminary input of EMR-integrated patient-generated health data was successfully shared between authorized medical facilities and health care providers in accordance with the patients' preferences. The patient-centric data flow of the S4S-J in Japan is expected to guarantee the right to data portability, which promotes the maximum benefit of use by patients themselves, which in turn contributes to the promotion of open science.

美国和欧盟的政府政策促进了使用FAIR(可查找性、可访问性、互操作性和可重用性)数据的标准化和价值创造,这可以增强对数字卫生系统的信任,对其成功至关重要。信任是通过公平获取数据、互操作性和改进通信等要素建立起来的,这些要素对于促进数字卫生技术的创新至关重要。本观点旨在报告探索性研究,证明测试以患者为中心的数据流模型的可行性,从而促进精确医疗信息的语义互操作性。在这一全球趋势中,作为日本经济和财政管理与改革基本政策的一部分,推出了名为“科学- j同步”(S4S-J)的可互操作接口,用于连接电子医疗记录和个人健康记录。S4S-J控制由电子病历和患者生成的健康数据组成的数据分发,并将这些信息转换为可通过移动应用程序扫描的二维码。该系统促进了基于个人信息信念的数据共享,并通过隐私偏好管理器解锁了孤立的物联网系统。根据日本的信息处理实践,移动云网络的发展将降低进入壁垒,加速数据共享。为了确保交叉兼容和符合未来的国际数据标准化,S4S-J遵循Health Level 7 Fast Health Care Interoperability Resources标准,使用国际标准化的逻辑观察标识符名称和代码(LOINC)对不同医学领域的不同术语标准中使用的医学术语进行重新定义。它是作为医疗信息的应用标准开发的,旨在通过数据的二次使用为工业、卫生保健服务和研究提供医疗信息。一项多中心合作研究已启动,以调查该系统的有效性;这是一项注册的、多中心的、随机对照的临床试验,对移动健康应用M♡Link进行妊娠高血糖疾病的EMBRACE研究,该应用通过S4S-J实现了emr -个人健康记录的互操作接口。尽管如此,上述新挑战、关键的卫生7级快速卫生保健互操作性资源系统和LOINC数据映射成功实现。此外,根据患者的偏好,授权医疗机构和卫生保健提供者之间成功地共享了emr集成患者生成的健康数据的初步输入。日本S4S-J以患者为中心的数据流有望保障数据可移植性的权利,从而促进患者自身使用的最大利益,从而促进开放科学的发展。
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引用次数: 0
Unveiling the Influence of AI on Advancements in Respiratory Care: Narrative Review. 揭示人工智能对呼吸护理进步的影响:叙述性评论。
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-12-20 DOI: 10.2196/57271
Mohammed M Alqahtani, Abdullah M M Alanazi, Saleh S Algarni, Hassan Aljohani, Faraj K Alenezi, Tareq F Alotaibi, Mansour Alotaibi, Mobarak K Alqahtani, Mushabbab Alahmari, Khalid S Alwadeai, Saeed M Alghamdi, Mohammed A Almeshari, Turki Faleh Alshammari, Noora Mumenah, Ebtihal Al Harbi, Ziyad F Al Nufaiei, Eyas Alhuthail, Esam Alzahrani, Husam Alahmadi, Abdulaziz Alarifi, Amal Zaidan, Taha T Ismaeil

Background: Artificial intelligence is experiencing rapid growth, with continual innovation and advancements in the health care field.

Objective: This study aims to evaluate the application of artificial intelligence technologies across various domains of respiratory care.

Methods: We conducted a narrative review to examine the latest advancements in the use of artificial intelligence in the field of respiratory care. The search was independently conducted by respiratory care experts, each focusing on their respective scope of practice and area of interest.

Results: This review illuminates the diverse applications of artificial intelligence, highlighting its use in areas associated with respiratory care. Artificial intelligence is harnessed across various areas in this field, including pulmonary diagnostics, respiratory care research, critical care or mechanical ventilation, pulmonary rehabilitation, telehealth, public health or health promotion, sleep clinics, home care, smoking or vaping behavior, and neonates and pediatrics. With its multifaceted utility, artificial intelligence can enhance the field of respiratory care, potentially leading to superior health outcomes for individuals under this extensive umbrella.

Conclusions: As artificial intelligence advances, elevating academic standards in the respiratory care profession becomes imperative, allowing practitioners to contribute to research and understand artificial intelligence's impact on respiratory care. The permanent integration of artificial intelligence into respiratory care creates the need for respiratory therapists to positively influence its progression. By participating in artificial intelligence development, respiratory therapists can augment their clinical capabilities, knowledge, and patient outcomes.

背景:人工智能正在快速发展,在医疗保健领域不断创新和进步。目的:本研究旨在评估人工智能技术在呼吸护理各个领域的应用。方法:对人工智能在呼吸护理领域应用的最新进展进行综述。搜索是由呼吸护理专家独立进行的,每个人都专注于他们各自的实践范围和感兴趣的领域。结果:本文综述了人工智能的各种应用,重点介绍了其在呼吸保健相关领域的应用。人工智能在该领域的各个领域都得到了应用,包括肺部诊断、呼吸护理研究、重症监护或机械通气、肺部康复、远程医疗、公共卫生或健康促进、睡眠诊所、家庭护理、吸烟或电子烟行为、新生儿和儿科。凭借其多方面的实用性,人工智能可以增强呼吸护理领域,有可能在这一广泛的保护伞下为个人带来更好的健康结果。结论:随着人工智能的发展,提高呼吸护理专业的学术标准势在必行,使从业者能够为研究和理解人工智能对呼吸护理的影响做出贡献。人工智能在呼吸护理中的永久整合创造了呼吸治疗师积极影响其进展的需求。通过参与人工智能的开发,呼吸治疗师可以增强他们的临床能力、知识和患者的治疗效果。
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引用次数: 0
Skeletal Muscle Mass Loss and Physical Function in Young to Middle-Aged Adult Patients With Diabetes: Cross-Sectional Observational Study. 青壮年糖尿病患者骨骼肌质量损失和身体功能:横断面观察研究。
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-12-18 DOI: 10.2196/58038
Aki Naruse, Yuka Yamada, Takeshi Miyamoto
<p><strong>Background: </strong>Recently, it has been reported that older adults with type 2 diabetes mellitus (T2DM) have lower skeletal muscle mass than healthy individuals. Although skeletal muscle mass in older adults with diabetes is occasionally reported, similar reports on young to middle-aged adults are limited.</p><p><strong>Objective: </strong>This study aims to assess the prevalence of skeletal muscle loss in young to middle-aged adults with diabetes, examine the relationship between skeletal muscle loss and physical function in these patients, and examine whether there are differences in these characteristics between men and women.</p><p><strong>Methods: </strong>This cross-sectional, observational study included patients younger than 65 years with T2DM who were admitted to our hospital between 2014 and 2022 for educational admission for glycemic control and requested rehabilitation by the Department of Metabolic Medicine. The control group consisted of patients who received rehabilitation during their hospitalization at our hospital and did not have diabetes. The main parameters included skeletal muscle mass, muscle strength, physical function, and activities of daily living.</p><p><strong>Results: </strong>The prevalence of skeletal muscle mass loss in this study was 18.2% (10/55) in men and 7.7% (4/52) in women. The skeletal muscle mass index (SMI) was 7.7 (SD 0.8) and 8.4 (SD 0.5) for men in the T2DM and control groups, respectively, and 7.0 (SD 0.9) and 6.8 (SD 0.7) for women in the T2DM and control groups, respectively. Therefore, compared with the nondiabetes group, a significant difference was observed in men but not in women (men: P<.001, women: P=.35). Nonetheless, the diabetes group exhibited significantly lower physical functions, such as a walking speed of 1.3 (SD 0.2) m/s and 1.2 (SD 0.43) m/s for men and women in the T2DM group and 1.6 (SD 0.2) m/s and 1.5 (SD 0.1) m/s for men and women in the control group, respectively (men: P<.001, women: P<.001). One-leg standing time was measured as 30.7 (SD 26.9) seconds and 29.4 (SD 25.5) seconds for men and women in the T2DM group, compared with 100.5 (SD 30.6) seconds and 82.5 (SD 39.8) seconds for men and women in the control group, respectively, with the T2DM group's times being significantly lower (men: P<.001, women: P<.001). Univariate logistic regression analysis showed that SMI was significantly associated with age, BMI, and peripheral neuropathy (all P≤.002). Multiple logistic regression analysis showed that BMI exhibited the strongest association (odds ratio 1.15, 95% CI 1.07-1.23; P<.001), and peripheral neuropathy was also significantly associated with SMI (P=.009).</p><p><strong>Conclusions: </strong>Patients with diabetes, even those who are not older adults, face an elevated rate of skeletal muscle mass loss, muscle weakness, and a decline in physical function; moreover, they are susceptible to dynapenia and presarcopenia. Therefore, early intervention focusing on
背景:最近,有报道称老年2型糖尿病(T2DM)患者骨骼肌质量低于健康人。虽然老年糖尿病患者的骨骼肌质量偶尔有报道,但类似的关于青年到中年人的报道是有限的。目的:本研究旨在评估青壮年糖尿病患者骨骼肌损失的患病率,研究这些患者骨骼肌损失与身体功能的关系,并研究这些特征在男性和女性之间是否存在差异。方法:这项横断面观察性研究纳入了2014年至2022年期间在我院接受血糖控制教育住院并要求代谢医学科康复的65岁以下T2DM患者。对照组为住院期间接受康复治疗且无糖尿病的患者。主要参数包括骨骼肌质量、肌肉力量、身体机能和日常生活活动。结果:在这项研究中,骨骼肌质量损失的患病率在男性中为18.2%(10/55),在女性中为7.7%(4/52)。T2DM组男性和对照组的骨骼肌质量指数(SMI)分别为7.7 (SD 0.8)和8.4 (SD 0.5),女性T2DM组和对照组的骨骼肌质量指数分别为7.0 (SD 0.9)和6.8 (SD 0.7)。因此,与非糖尿病组相比,在男性中观察到显著差异,但在女性中没有观察到显著差异(男性:p)。结论:糖尿病患者,即使是那些不是老年人的患者,也面临骨骼肌质量损失、肌肉无力和身体功能下降的发生率升高;此外,他们易患运动障碍和肌肉减少症。因此,关注肌肉评估和锻炼的早期干预是至关重要的。
{"title":"Skeletal Muscle Mass Loss and Physical Function in Young to Middle-Aged Adult Patients With Diabetes: Cross-Sectional Observational Study.","authors":"Aki Naruse, Yuka Yamada, Takeshi Miyamoto","doi":"10.2196/58038","DOIUrl":"10.2196/58038","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Recently, it has been reported that older adults with type 2 diabetes mellitus (T2DM) have lower skeletal muscle mass than healthy individuals. Although skeletal muscle mass in older adults with diabetes is occasionally reported, similar reports on young to middle-aged adults are limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to assess the prevalence of skeletal muscle loss in young to middle-aged adults with diabetes, examine the relationship between skeletal muscle loss and physical function in these patients, and examine whether there are differences in these characteristics between men and women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional, observational study included patients younger than 65 years with T2DM who were admitted to our hospital between 2014 and 2022 for educational admission for glycemic control and requested rehabilitation by the Department of Metabolic Medicine. The control group consisted of patients who received rehabilitation during their hospitalization at our hospital and did not have diabetes. The main parameters included skeletal muscle mass, muscle strength, physical function, and activities of daily living.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The prevalence of skeletal muscle mass loss in this study was 18.2% (10/55) in men and 7.7% (4/52) in women. The skeletal muscle mass index (SMI) was 7.7 (SD 0.8) and 8.4 (SD 0.5) for men in the T2DM and control groups, respectively, and 7.0 (SD 0.9) and 6.8 (SD 0.7) for women in the T2DM and control groups, respectively. Therefore, compared with the nondiabetes group, a significant difference was observed in men but not in women (men: P&lt;.001, women: P=.35). Nonetheless, the diabetes group exhibited significantly lower physical functions, such as a walking speed of 1.3 (SD 0.2) m/s and 1.2 (SD 0.43) m/s for men and women in the T2DM group and 1.6 (SD 0.2) m/s and 1.5 (SD 0.1) m/s for men and women in the control group, respectively (men: P&lt;.001, women: P&lt;.001). One-leg standing time was measured as 30.7 (SD 26.9) seconds and 29.4 (SD 25.5) seconds for men and women in the T2DM group, compared with 100.5 (SD 30.6) seconds and 82.5 (SD 39.8) seconds for men and women in the control group, respectively, with the T2DM group's times being significantly lower (men: P&lt;.001, women: P&lt;.001). Univariate logistic regression analysis showed that SMI was significantly associated with age, BMI, and peripheral neuropathy (all P≤.002). Multiple logistic regression analysis showed that BMI exhibited the strongest association (odds ratio 1.15, 95% CI 1.07-1.23; P&lt;.001), and peripheral neuropathy was also significantly associated with SMI (P=.009).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Patients with diabetes, even those who are not older adults, face an elevated rate of skeletal muscle mass loss, muscle weakness, and a decline in physical function; moreover, they are susceptible to dynapenia and presarcopenia. Therefore, early intervention focusing on","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"13 ","pages":"e58038"},"PeriodicalIF":1.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Decomposition Analysis of the Prevalence of Denture Use Between Rural and Urban Older Individuals With Edentulism in China: Cross-Sectional Study. 中国农村和城市老年义齿患者义齿使用率的分解分析:横断面研究。
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-12-13 DOI: 10.2196/48778
Lei Yuan, Yuan Yuan, Haotian Ren, Feng Zhang, Zhe Zhao, Qinqin Jiang, Zhenbang Wei, Jin-Hai Sun
<p><strong>Background: </strong>Edentulism impacts the physical health and quality of life of older individuals. The prevalence, influencing factors, and differences in terms of edentulism in urban and rural areas of China are unclear.</p><p><strong>Objective: </strong>This study investigated the denture-wearing conditions and causes affecting older patients with edentulism in urban and rural areas of China and analyzed the differences.</p><p><strong>Methods: </strong>This cross-sectional study included the data of 5139 older individuals (age>65 years) with edentulism obtained from 23 Chinese provinces in 2018. Participants were divided into urban and rural groups based on their household registration. Factors influencing denture use in both groups were explored using binary logistic regression, while factors influencing differences in denture wearing in both groups were explored using the Fairlie decomposition model.</p><p><strong>Results: </strong>Of the 5139 participants, 67.05% (808/1205) from urban areas and 51.12% (2011/3934) from rural areas wore dentures. In the urban group, participants with a higher level of education (1-6 years: odds ratio [OR] 2.093, 95% CI 1.488-2.945; ≥7 years: OR 2.187, 95% CI 1.565-3.055) or who exercised (OR 2.840, 95% CI 2.016-3.999) preferred wearing dentures, but individuals with BMI<18.5 kg/m2 (OR 0.558, 95% CI 0.408-0.762) or widowed (OR 0.618, 95% CI 0.414-0.921) did not. In the rural group, a higher level of education (1-6 years: OR 1.742, 95% CI 1.429-2.123; ≥7 years: OR 1.498, 95% CI 1.246-1.802), living alone (OR 1.372, 95% CI 1.313-1.663), exercise (OR 1.612, 95% CI 1.340-1.940), high economic status (OR 1.234, 95% CI 1.035-1.472), residence in the eastern area (OR 2.045, 95% CI 1.723-2.427), presence of chronic diseases (1 disease: OR 1.534, 95% CI 1.313-1.793; ≥2 diseases: OR 1.500, 95% CI 1.195-1.882) were positively associated and age≥80 years (OR 0.318, 95% CI 0.247-0.408), BMI<18.5 kg/m2 (OR 0.692, 95% CI 0.590-0.813), and widowed (OR 0.566, 95% CI 0.464-0.690) or other marital status (OR 0.600, 95% CI 0.392-0.918) were negatively associated with denture use. The Fairlie decomposition model revealed that the number of chronic diseases (16.34%), education level (11.94%), region of residence (11.00%), annual income (10.55%), exercise (6.81%), and age (-0.92%) were the main factors responsible for differences between urban and rural edentulism and could explain the difference in the denture-wearing rate (58.48%) between both groups.</p><p><strong>Conclusions: </strong>Older individuals with edentulism with a higher education level and who exercise are more willing to wear dentures, while those with BMI<18.5 kg/m2 show a decreased willingness to wear dentures in both urban and rural areas in China. Controlling the number of chronic diseases, improving the education level and annual income, cultivating good exercise habits, and bridging the gap between the economic status of the east and west can narr
背景:蛀牙症影响老年人的身体健康和生活质量。中国城市和农村缺牙症的患病率、影响因素和差异尚不清楚。目的:研究影响中国城乡老年义齿患者义齿佩戴情况及原因,并分析差异。方法:本横断面研究纳入了2018年来自中国23个省份的5139名老年(年龄在50 ~ 65岁)全牙颌患者的数据。参与者根据户籍情况分为城市组和农村组。采用二元logistic回归分析影响两组义齿使用的因素,采用Fairlie分解模型分析影响两组义齿佩戴差异的因素。结果:5139名参与者中,67.05%(808/1205)来自城市地区,51.12%(2011/3934)来自农村地区。在城市组中,受教育程度较高的参与者(1-6年):优势比[OR] 2.093, 95% CI 1.488-2.945;≥7岁:OR 2.187, 95% CI 1.565-3.055)或运动者(OR 2.840, 95% CI 2.016-3.999)更倾向于佩戴义齿,但BMI患者更倾向于佩戴义齿。结论:年龄较大、受教育程度较高且运动的义齿患者比BMI患者更愿意佩戴义齿
{"title":"Decomposition Analysis of the Prevalence of Denture Use Between Rural and Urban Older Individuals With Edentulism in China: Cross-Sectional Study.","authors":"Lei Yuan, Yuan Yuan, Haotian Ren, Feng Zhang, Zhe Zhao, Qinqin Jiang, Zhenbang Wei, Jin-Hai Sun","doi":"10.2196/48778","DOIUrl":"10.2196/48778","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Edentulism impacts the physical health and quality of life of older individuals. The prevalence, influencing factors, and differences in terms of edentulism in urban and rural areas of China are unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study investigated the denture-wearing conditions and causes affecting older patients with edentulism in urban and rural areas of China and analyzed the differences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional study included the data of 5139 older individuals (age&gt;65 years) with edentulism obtained from 23 Chinese provinces in 2018. Participants were divided into urban and rural groups based on their household registration. Factors influencing denture use in both groups were explored using binary logistic regression, while factors influencing differences in denture wearing in both groups were explored using the Fairlie decomposition model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 5139 participants, 67.05% (808/1205) from urban areas and 51.12% (2011/3934) from rural areas wore dentures. In the urban group, participants with a higher level of education (1-6 years: odds ratio [OR] 2.093, 95% CI 1.488-2.945; ≥7 years: OR 2.187, 95% CI 1.565-3.055) or who exercised (OR 2.840, 95% CI 2.016-3.999) preferred wearing dentures, but individuals with BMI&lt;18.5 kg/m2 (OR 0.558, 95% CI 0.408-0.762) or widowed (OR 0.618, 95% CI 0.414-0.921) did not. In the rural group, a higher level of education (1-6 years: OR 1.742, 95% CI 1.429-2.123; ≥7 years: OR 1.498, 95% CI 1.246-1.802), living alone (OR 1.372, 95% CI 1.313-1.663), exercise (OR 1.612, 95% CI 1.340-1.940), high economic status (OR 1.234, 95% CI 1.035-1.472), residence in the eastern area (OR 2.045, 95% CI 1.723-2.427), presence of chronic diseases (1 disease: OR 1.534, 95% CI 1.313-1.793; ≥2 diseases: OR 1.500, 95% CI 1.195-1.882) were positively associated and age≥80 years (OR 0.318, 95% CI 0.247-0.408), BMI&lt;18.5 kg/m2 (OR 0.692, 95% CI 0.590-0.813), and widowed (OR 0.566, 95% CI 0.464-0.690) or other marital status (OR 0.600, 95% CI 0.392-0.918) were negatively associated with denture use. The Fairlie decomposition model revealed that the number of chronic diseases (16.34%), education level (11.94%), region of residence (11.00%), annual income (10.55%), exercise (6.81%), and age (-0.92%) were the main factors responsible for differences between urban and rural edentulism and could explain the difference in the denture-wearing rate (58.48%) between both groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Older individuals with edentulism with a higher education level and who exercise are more willing to wear dentures, while those with BMI&lt;18.5 kg/m2 show a decreased willingness to wear dentures in both urban and rural areas in China. Controlling the number of chronic diseases, improving the education level and annual income, cultivating good exercise habits, and bridging the gap between the economic status of the east and west can narr","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"13 ","pages":"e48778"},"PeriodicalIF":1.9,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Close-Up on Ambulance Service Estimation in Indonesia: Monte Carlo Simulation Study. 印度尼西亚救护车服务估算特写:蒙特卡罗模拟研究
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-12-13 DOI: 10.2196/54240
Syaribah N Brice, Justin J Boutilier, Geraint Palmer, Paul R Harper, Vincent Knight, Mark Tuson, Daniel Gartner

Background: Emergency medical services have a pivotal role in giving timely and appropriate responses to emergency events caused by medical, natural, or human-caused disasters. To provide adequate resources for the emergency services, such as ambulances, it is necessary to understand the demand for such services. In Indonesia, estimates of demand for emergency services cannot be obtained easily due to a lack of published literature or official reports concerning the matter.

Objective: This study aimed to ascertain an estimate of the annual volume of hospital emergency visits and the corresponding demand for ambulance services in the city of Jakarta.

Methods: In this study, we addressed the problem of emergency services demand estimation when aggregated detailed data are not available or are not part of the routine data collection. We used survey data together with the local Office of National Statistics reports and sample data from hospital emergency departments to establish parameter estimation. This involved estimating 4 parameters: the population of each area per period (day and night), the annual per capita hospital emergency visits, the probability of an emergency taking place in each period, and the rate of ambulance need per area. Monte Carlo simulation and naïve methods were used to generate an estimation for the mean ambulance needs per area in Jakarta.

Results: The results estimated that the total annual ambulance need in Jakarta is between 83,000 and 241,000. Assuming the rate of ambulance usage in Jakarta at 9.3%, we estimated the total annual hospital emergency visits in Jakarta at around 0.9-2.6 million. The study also found that the estimation from using the simulation method was smaller than the average (naïve) methods (P<.001).

Conclusions: The results provide an estimation of the annual emergency services needed for the city of Jakarta. In the absence of aggregated routinely collected data on emergency medical service usage in Jakarta, our results provide insights into whether the current emergency services, such as ambulances, have been adequately provided.

背景:紧急医疗服务在及时、适当地应对医疗、自然或人为灾害造成的紧急事件方面发挥着举足轻重的作用。要为救护车等急救服务提供充足的资源,就必须了解对此类服务的需求。在印度尼西亚,由于缺乏相关的出版文献或官方报告,因此无法轻易获得对急救服务需求的估计:本研究旨在确定雅加达市每年医院急诊量的估计值以及相应的救护车服务需求:在这项研究中,我们探讨了在没有详细的综合数据或数据收集工作不常规的情况下如何估算急救服务需求的问题。我们利用调查数据、当地国家统计局的报告和医院急诊科的抽样数据来进行参数估计。这涉及到 4 个参数的估算:每个地区每个时段(白天和夜晚)的人口数量、年人均医院急诊量、每个时段发生急诊的概率以及每个地区的救护车需求率。采用蒙特卡洛模拟法和天真法对雅加达每个地区的平均救护车需求量进行了估算:结果:据估计,雅加达每年的救护车总需求在 83,000 到 241,000 之间。假设雅加达的救护车使用率为 9.3%,我们估计雅加达每年的医院急诊总人次约为 90 万至 260 万。研究还发现,使用模拟法估算的结果小于平均(天真)法(PConclusions:研究结果对雅加达市每年所需的急救服务进行了估算。在雅加达缺乏常规收集的急救医疗服务使用情况综合数据的情况下,我们的结果提供了对当前急救服务(如救护车)是否已得到充分提供的深入了解。
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引用次数: 0
Public Awareness and Use of Price Transparency: Report From a National Survey. 公众对价格透明度的认识和使用:全国调查报告。
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-12-12 DOI: 10.2196/64439
Yuvraj Pathak, David Muhlestein
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引用次数: 0
期刊
Interactive Journal of Medical Research
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