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International Journal of Nursing Sciences 2024年第1期11卷 155-157页

作者： Abdulqadir J.Nashwan Director of Nursing for Education&Practice Development Hamad Medical CorporationDohaQatar Department of Public Health College of Health SciencesQU HealthQatar UniversityDohaQatar

The migration of healthcare professionals,including nurses,is a global *** is driven by various factors,including the pursuit of better opportunities,living conditions,and professional development,as well as political instability or conflict in their home *** World Health Organization(WHO)has noted that high-income countries often rely on foreign-trained nurses to fill gaps in their healthcare systems[1].For instance,as of 2021,over 40%(52 million)of all nurses in the United States(US)were expatriates[2].In the United Kingdom(UK),the percentage of expatriate nurses was even higher,reaching approximately 18%in 2021[3].Owing to globalization and migration,healthcare providers must possess cultural competence to deliver improved care[4,5].Culturally responsive teaching(CRT)is rooted in the idea that culture plays a vital role in shaping people’s behaviors,beliefs,values,and communication styles[6].Furthermore,these cultural factors influence patients’perspectives on health,illness,healing,and their preferences for care and communication[7].By recognizing and embracing these cultural differences,nurses can provide more effective and compassionate care to their diverse patient population[8].

关键词： teaching nurse forces

Ethical framework for artificial intelligence in healthcare research:A path to integrity

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World Journal of Methodology 2024年第3期14卷 1-6页

作者： Ahmad A Abujaber Abdulqadir J Nashwan Department of Nursing Hazm Mebaireek General Hospital(HMGH)Doha 3050Qatar Department of Nursing Hamad Medical CorporationDoha 3050Qatar

The integration of Artificial Intelligence(AI)into healthcare research promises unprecedented advancements in medical diagnostics,treatment personalization,and patient care ***,these innovations also bring forth significant ethical challenges that must be addressed to maintain public trust,ensure patient safety,and uphold data *** article sets out to introduce a detailed framework designed to steer governance and offer a systematic method for assuring that AI applications in healthcare research are developed and executed with integrity and adherence to medical research ethics.

关键词： Artificial intelligence Ethical framework healthcare research Ethical Principles Integrity Patient safety

Bridging the divide: Harmonizing polarized clinical laboratory medicine practices

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iLABMED 2024年第2期2卷 67-69页

作者： Yi-Wei Tang Joseph D.Yao Medical Affairs Danaher Corporation/CepheidNew YorkNew YorkUSA Division of Clinical Microbiology Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA

In today's healthcare,clinical laboratory medicine stands as a cornerstone of patient care,providing vital diagnostic insights that inform decisions in disease ***,within this crucial field,a dichotomy persists between two predominant models of laboratory testing to support clinical practice:point-of-care testing(PoCT)and central laboratory testing[1].This schism,while born of practical necessity and evolving technology,presents both opportunities and challenges that warrant closer examination.

关键词： central laboratory testing clinical microbiology point-of-care testing

Why Don’t We Adequately Identify and Manage Adverse Drug Reactions despite Having the Needed Information?

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Health 2024年第2期16卷 148-159页

作者： Mark J. Kupersmith Karl Kieburtz Department of Neurology Ophthalmology and Neurosurgery Icahn School of Medicine at Mount Sinai New York NY USA SafeTherapeutics LLC New York NY USA Clintrex Research corporation Sarasota FL USA

Importance/Objective: Adverse Drug Reactions (ADRs) are unavoidable, but recognizing and addressing ADRs early can improve wellness and prevent permanent injury. We suggest that available medical information and digital/electronic methods could be used to manage this major healthcare problem for individual patients in real time. Methods: We searched the available digital applications and three literature databases using the medical subject heading terms, adverse drug reaction reporting systems or management, filtered by clinical trial or systemic reviews, to detect publications with data about ADR identification and management approaches. We reviewed the reports that had abstract or summary data or proposed or implemented methods or systems with potential to identify or manage ADRs in clinical settings. Results: The vast majority of the 481 reports used retrospectively collected data for groups of patients or were limited to surveying one population group or class of medication. The reports showed potential and definite associations of ADRs for specific drugs and problems, mostly, but not exclusively, for patients in hospitals and nursing homes. No reports described complete methods to collect comprehensive data on ADRs for individual patients in a healthcare system. The digital applications have ADR information, but all are too cumbersome or incomplete for use in active clinical settings. Several studies suggested that providing information about potential ADRs to clinicians can reduce these problems. Conclusion and Relevance: Although investigators and government agencies agree with the need, there is no comprehensive ADR management program in current use. Informing the patient’s healthcare practitioners of potential ADRs at the point of service has the potential for reduction of these complications, which should improve healthcare and reduce unneeded costs.

关键词： Adverse Drug Reaction Medication Side Effect Identification Medication Complication Medication Safety

Clinical and biochemical predictors of intensive care unit admission among patients with diabetic ketoacidosis

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World Journal of Diabetes 2023年第3期14卷 271-278页

作者： Adeel Ahmad Khan Fateen Ata Phool Iqbal Mohammed Bashir Anand Kartha Department of Endocrinology Hamad Medical CorporationDoha 00000Qatar Department of Medicine Metropolitan Hospital CenterNew YorkNY 10595United States Department of Medicine Hamad Medical CorporationDoha 00000Qatar

BACKGROUND Diabetic ketoacidosis(DKA)contributes to 94%of diabetes-related hospital admissions,and its incidence is *** to the complexity of its management and the need for rigorous monitoring,many DKA patients are managed in the intensive care unit(ICU).However,studies comparing DKA patients managed in ICU to non-ICU settings show an increase in healthcare costs without significantly affecting patient *** is,therefore,essential to identify suitable candidates for ICU care in DKA *** To evaluate factors that predict the requirement for ICU care in DKA *** This retrospective study included consecutive patients with index DKA episodes who presented to the emergency department of four general hospitals of Hamad Medical corporation,Doha,Qatar,between January 2015 and March *** adult patients(>14 years)fulfilling the American Diabetes Association criteria for DKA diagnosis were *** We included 922 patients with DKA in the final analysis,of which 229(25%)were managed in the *** to non-ICU patients,patients admitted to ICU were older[mean(SD)age of 40.4±13.7 years vs 34.5±14.6 years;P<0.001],had a higher body mass index[median(IQR)of 24.6(21.5-28.4)kg/m2 vs 23.7(20.3-27.9)kg/m2;P<0.030],had T2DM(61.6%)and were predominantly males(69%vs 31%;P<0.020).ICU patients had a higher white blood cell count[median(IQR)of 15.1(10.2-21.2)×103/uL vs 11.2(7.9-15.7)×103/uL,P<0.001],urea[median(IQR)of 6.5(4.6-10.3)mmol/L vs 5.6(4.0-8.0)mmol/L;P<0.001],creatinine[median(IQR)of 99(75-144)mmol/L vs 82(63-144)mmol/L;P<0.001],C-reactive protein[median(IQR)of 27(9-83)mg/L vs 14(5-33)mg/L;P<0.001]and anion gap[median(IQR)of 24.0(19.2-29.0)mEq/L vs 22(17-27)mEq/L;P<0.001];while a lower venous pH[mean(SD)of 7.10±0.15 vs 7.20±0.13;P<0.001]and bicarbonate level[mean(SD)of 9.2±4.1 mmol/L vs 11.6±4.3 mmol/L;P<0.001]at admission than those not requiring ICU management of DKA(P<0.001).Patients in the ICU group had a longer LOS[median(IQR)of

关键词： Diabetic ketoacidosis Type 1 diabetes mellitus Type 2 diabetes mellitus Intensive care unit Critical care outcomes Length of stay

Requirements for implementation of artificial intelligence in the practice of gastrointestinal pathology

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World Journal of Gastroenterology 2021年第21期27卷 2818-2833页

作者： Hiroshi Yoshida Tomoharu Kiyuna Department of Diagnostic Pathology National Cancer Center HospitalTokyo 104-0045Japan Digital healthcare Business Development Office NEC CorporationTokyo 108-8556Japan

Tremendous advances in artificial intelligence(AI)in medical image analysis have been achieved in recent *** integration of AI is expected to cause a revolution in various areas of medicine,including gastrointestinal(GI)***,deep learning algorithms have shown promising benefits in areas of diagnostic histopathology,such as tumor identification,classification,prognosis prediction,and biomarker/genetic alteration *** AI cannot substitute pathologists,carefully constructed AI applications may increase workforce productivity and diagnostic accuracy in pathology *** of these promising advances,unlike the areas of radiology or cardiology imaging,no histopathology-based AI application has been approved by a regulatory authority or for public ***,implying that there are still some obstacles to be overcome before AI applications can be safely and effectively implemented in real-life pathology *** challenges have been identified at different stages of the development process,such as needs identification,data curation,model development,validation,regulation,modification of daily workflow,and cost-effectiveness *** aim of this review is to present challenges in the process of AI development,validation,and regulation that should be overcome for its implementation in real-life GI pathology practice.

关键词： Artificial intelligence Deep learning Digital image analysis Digital pathology Clinical implementation Gastrointestinal cancer

Mental health research in the Arab region in response to the COVID-19 pandemic:a scoping review

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General Psychiatry 2022年第2期35卷 85-91页

作者： Mohamed Hussein Mahmoud Osman Hassan Ibrahim Hamdy Ezzat Abdelhafez Sami Ouanes Eiman Al-Janahi Yuri Zoghbi Ovais Wadoo Mental Health Services Hamad Medical CorporationDohaAd DawhahQatar Department of Neurosurgery Hamad Medical CorporationDohaAd DawhahQatar College of Medicine Qatar UniversityDohaAd DawhahQatar Department of Psychiatry College of MedicineQatar UniversityDohaAd DawhahQatar

Background The ongoing pandemic has led to a global surge in coronavius disease 2019(COVID-19)-related mental health ***,most related publications come from Western countries or China,and their findings cannot alwrays be extrapolated to Arabl *** This study provides a quantitative and qualitative analysis of mental health research pertaining to Arab countries'response to the COVID-19 *** A scoping review of the World Health Organzation(WHO)C0VID-19 database for publications on mental health was conducted by authors afllated *** istutions,including artides from inception to 24 October *** indluded publications were evaluated for their national distribution,international cllaboration,publication type,and main research *** quality analysis of the incuded research studies was performed using the original and mdified versions of the Newcastle Ottawa *** In total,102 articles were included in this study,averaging 4.6 articles per Arab *** of the articles emerged from the Kingdom of Saudi Arabia,Jordan,and Egypt.A majority of publications demonstrated intermational *** of the publications were original research studies and cross sectional in *** predominant research theme was examining the pandemic s mental health effects on the general population and healthcare workers.0nly 28.0% of the studies were of high methodologial quality,where as 41.5% were moderate and 30.5% were low in *** Mental health research in response to the COVID-19 pandemic in the Arab region has quantitative and qualitative *** institutions need torespond to the pandemic prompty in order to address the delineated research gap and to generate higher-quality research output.

关键词： qualitative prompt publications

Robust Needle Localization and Enhancement Algorithm for Ultrasound by Deep Learning and Beam Steering Methods

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Journal of Computer Science & Technology 2021年第2期36卷 334-346页

作者： Jun Gao Paul Liu Guang-Di Liu Le Zhang College of Computer Science Sichuan UniversityChengdu 610065China Stork healthcare Chengdu 610000China College of Computer and Information Science Southwest UniversityChongqing 400715China West China Biomedical Big Data Center West China HospitalSichuan UniversityChengdu 610065China Pera corporation Ltd. Beijing 100025China

Ultrasound(US)imaging is clinically used to guide needle insertions because it is safe,real-time,and low *** localization of the needle in the ultrasound image,however,remains a challenging problem due to specular reflection off the smooth surface of the needle,speckle noise,and similar line-like anatomical *** study presents a novel robust needle localization and enhancement algorithm based on deep learning and beam steering methods with three key ***,we employ beam steering to maximize the reflection intensity of the needle,which can help us to detect and locate the needle ***,we modify the U-Net which is an end-to-end network commonly used in biomedical segmentation by using two branches instead of one in the last up-sampling layer and adding three layers after the last down-sample ***,the modified U-Net can real-time segment the needle shaft region,detect the needle tip landmark location and determine whether an image frame contains the needle by one ***,we develop a needle fusion framework that employs the outputs of the multi-task deep learning(MTL)framework to precisely locate the needle tip and enhance needle shaft ***,the proposed algorithm can not only greatly reduce the processing time,but also significantly increase the needle localization accuracy and enhance the needle visualization for real-time clinical intervention applications.

关键词： ultrasound deep learning segmentation classification optimization

Lipid dysregulation in hepatitis C virus, and impact of statin therapy upon clinical outcomes

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World Journal of Gastroenterology 2015年第27期21卷 8293-8303页

作者： Tracey G Simon Adeel A Butt Department of Medicine Brigham and Women’s Hospital Harvard Medical School Boston VA Pittsburgh healthcare System Pittsburgh University of Pittsburgh School of Medicine Hamad healthcare Quality Institute Hamad Medical corporation

The hepatitis C virus(HCV) is one of the most common causes of chronic liver disease and the leading indication for liver transplantation worldwide. Every aspect of the HCV life cycle is closely tied to human lipid metabolism. The virus circulates as a lipid-rich particle, utilizing lipoprotein cell receptors to gain entry into the hepatocyte. It has also been shown to upregulate lipid biosynthesis and impair lipid degradation, resulting in significant intracellular lipid accumulation and circulating hypocholesterolemia. Patients with chronic hepatitis C(CHC) are at increased risk of hepatic steatosis, fibrosis, and cardiovascular disease including accelerated atherosclerosis. HMG Co A Reductase inhibitors, or statins, have been shown to play an important role in the modulation of hepatic steatosis and fibrosis, and recent attention has focused upon their potential therapeutic role in CHC. This article reviews the hepatitis C viral life cycle as it impacts host lipoproteins and lipid metabolism. It then describes the pathogenesis of HCV-related hepatic steatosis, hypocholesterolemia and atherosclerosis, and finally describes the promising anti-viral and anti-fibrotic effects of statins, for the treatment of CHC.

关键词： Hepatitis C virus Lipid profiles Cholesterol Statin Fibrosis Cirrhosis

Telbivudine vs tenofovir in hepatitis B e antigen-negative chronic hepatitis B patients: OPTIMA roadmap study

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World Journal of Hepatology 2016年第32期8卷 1402-1413页

作者： Zahari Krastev Diana Petrova Iskren Kotzev Mustafa Kemal Celen Meryl Mendelson Richa Chandra Priti Pandey Kamal Hamed Clinic of Gastroenterology St.Ivan Rilsky University HospitalMedical University Department of Gastroenterology University Hospital Alexandrovska Clinic of Hepatogastroenterology University Hospital St Marina Infectious Disease Clinic Dicle University Novartis Pharmaceuticals corporation East Hanover Novartis healthcare Pvt. Ltd.

AIM To make efficacy and safety comparison of telbivudineraodmap and tenofovir-roadmap in hepatitis B e antigen(HBe Ag)-negative chronic hepatitis B(CHB) *** This was the first prospective, randomised, two-arm, open-label, non-inferiority study in HBe Ag-negative CHB patients that compared telbivudine and tenofovir administered as per roadmap concept. Patients were treated up to 24 wk and, depending on virologic response, continued the same therapy or received addon therapy up to 104 wk. Eligible patients received an additional 52 wk of treatment in the extension period(i.e., up to 156 wk). Patients who developed virologic breakthrough(VB) while on monotherapy also received add-on therapy. The primary efficacy endpoint was the rate of patients achieving hepatitis B virus(HBV) DNA < 300 copies/m L at week 52. Secondary efficacy endpoints included the rates of HBV DNA < 300 and < 169 copies/m L, HBV DNA change from baseline, alanine aminotransferase normalisation, hepatitis B surface antigen(HBs Ag) loss, HBs Ag seroconversion, VB, and emergence of resistance at various timepoints throughout the study. Safety and estimated glomerular filtration rate(e GFR) were also *** A total of 241 patients were randomised. Non-inferiority of telbivudine arm to tenofovir arm was demonstrated at week 52(± 7 d window), with over 91% of patients in each treatment arm achieving HBV DNA level < 300 copies/m L. Both arms were similar in terms of key secondary efficacy variables at weeks 104 and 156. The percentage of patients achieving HBV DNA < 300 copies/m L remained high and was similar in the telbivudine and tenofovir arms at both weeks 104 and 156. Over 82% of patients in both arms achieved alanine aminotransferase normalisation at week 52, and this percentage remained high at weeks 104 and 156. Telbivudine treatment progressively reduced serum HBs Ag levels from baseline while no change was reported in quantitative HBs Ag during therapy with tenofovir. Bot

关键词：长期的肝炎 B Glomerular 过滤率 Telbivudine Tenofovir 路线图概念