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Cureus May 2024The impact of artificial intelligence (AI) will be felt not only in the arena of patient care and deliverable therapies but will also be uniquely disruptive in medical... (Review)
Review
The impact of artificial intelligence (AI) will be felt not only in the arena of patient care and deliverable therapies but will also be uniquely disruptive in medical education and healthcare simulation (HCS), in particular. As HCS is intertwined with computer technology, it offers opportunities for rapid scalability with AI and, therefore, will be the most practical place to test new AI applications. This will ensure the acquisition of AI literacy for graduates from the country's various healthcare professional schools. Artificial intelligence has proven to be a useful adjunct in developing interprofessional education and team and leadership skills assessments. Outcome-driven medical simulation has been extensively used to train students in image-centric disciplines such as radiology, ultrasound, echocardiography, and pathology. Allowing students and trainees in healthcare to first apply diagnostic decision support systems (DDSS) under simulated conditions leads to improved diagnostic accuracy, enhanced communication with patients, safer triage decisions, and improved outcomes from rapid response teams. However, the issue of bias, hallucinations, and the uncertainty of emergent properties may undermine the faith of healthcare professionals as they see AI systems deployed in the clinical setting and participating in diagnostic judgments. Also, the demands of ensuring AI literacy in our healthcare professional curricula will place burdens on simulation assets and faculty to adapt to a rapidly changing technological landscape. Nevertheless, the introduction of AI will place increased emphasis on virtual reality platforms, thereby improving the availability of self-directed learning and making it available 24/7, along with uniquely personalized evaluations and customized coaching. Yet, caution must be exercised concerning AI, especially as society's earlier, delayed, and muted responses to the inherent dangers of social media raise serious questions about whether the American government and its citizenry can anticipate the security and privacy guardrails that need to be in place to protect our healthcare practitioners, medical students, and patients.
PubMed: 38840993
DOI: 10.7759/cureus.59747 -
Frontiers in Psychology 2024Although the effects of counterstereotypic individuating information (i.e., information specific to individual members of stereotyped groups that disconfirms the group...
Although the effects of counterstereotypic individuating information (i.e., information specific to individual members of stereotyped groups that disconfirms the group stereotype) on biases in explicit person perception are well-established, research shows mixed effects of such information on implicit person perception. The present research tested the overarching hypothesis that, when social group membership is perceived to be under an individual's control, diagnostic individuating information would have lesser effects on implicit person perception than it would when social group membership is perceived not to be under an individual's control. This hypothesis was tested in the domain of implicit attitudinal and stereotype-relevant judgments of individuals who belonged to existing social groups and individuals who belonged to novel social groups. We found that individuating information consistently shifted scores on implicit measures among targets belonging to existing social groups, but not in a theoretically predicted direction among targets belonging to novel social groups. Controllability of group membership did not moderate such effects. Results of implicit and explicit measures were mostly consistent when targets belonged to existing social groups, but mostly inconsistent when targets belonged to novel social groups.
PubMed: 38840743
DOI: 10.3389/fpsyg.2024.969382 -
Frontiers in Veterinary Science 2024Dehorning calves is necessary to minimize injury because intensive raising circumstances make horned cows more aggressive. However, acute pain is commonly perceived by...
INTRODUCTION
Dehorning calves is necessary to minimize injury because intensive raising circumstances make horned cows more aggressive. However, acute pain is commonly perceived by farm animals when undergoing painful practices such as dehorning, affecting their health status and quality of life. By quantifying the magnitude of pain and discomfort associated with dehorning, we aim to contribute to a more humane and sustainable cattle farming industry.
METHODS
The objective of this study was to evaluate the behavioral, physiological, and emotional effects of acute dehorning pain in calves using two methods: dehorning cream and dehorning hot-iron.30 Holstein calves aged 4 days were selected for the study. These calves were randomly assigned to two experimental groups based on the method of disbudding: dehorning cream ( = 15) and hot-iron dehorning ( = 15). Before and after dehorning, we evaluated their physiological indicators of infrared eye temperature, concentrations of substance P, IL-6, cortisol, haptoglobin, as well as emotional state, and pain-related behavioral reactions.
RESULTS
Post-dehorning, the duration of lying down decreased significantly in both groups (DI and DC: 0-4 h) after dehorning ( < 0.05). Both groups exhibited increased frequencies of pain-related behaviors such as head shaking (DI: 1-7 h, DC: 1-6 h), ear flicking (DI: 2-7 h, DC: 2-7 h), head scratching (DI: 2-3 h, DC: 1-7 h), and top scuffing (DI: 2 h, DC: 2-7 h) compared to pre-dehorning ( < 0.05). The DC group demonstrated a higher frequency of head-shaking, ear-flicking, head-scratching, and top-rubbing behaviors, along with a longer duration of lying down (0-4 h), compared to the DI group ( < 0.05). Post-dehorning, play behavior reduced significantly in both groups (6-8 h) ( < 0.05), whereas judgment bias and fear levels showed no significant change ( > 0.05). Physiological measures including eye temperature, and blood levels of substance P and IL-6, did not differ significantly between the groups before and after dehorning ( > 0.05). However, 48 h after dehorning, calves in the DC group had significantly higher haptoglobin levels compared to the DI group ( = 0.015). Additionally, salivary cortisol levels in the DC group increased significantly at 3.5 h and 7 h post-dehorning ( = 0.018, = 0.043).
DISCUSSION
Both hot-iron and cream dehorning induced pain in calves, as evidenced by increased pain-related behaviors, elevated salivary cortisol, and higher haptoglobin levels, alongside reduced positive behaviors. Notably, these effects were more pronounced in the DC group than in the DI group, suggesting that dehorning hot-iron may be a comparatively less stressful dehorning method for young calves. Moreover, the brief duration of pain response and weaker response to dehorning observed in 13-day-age calves in this study suggests that dehorning at younger ages may be more advisable and warrants further research.
PubMed: 38840635
DOI: 10.3389/fvets.2024.1406576 -
Surgical Neurology International 2024Gunshot wounds (GSWs) can result in various peripheral nerve injuries (PNIs), ranging from direct nerve transection to neuropraxia caused by the ballistic shockwave...
BACKGROUND
Gunshot wounds (GSWs) can result in various peripheral nerve injuries (PNIs), ranging from direct nerve transection to neuropraxia caused by the ballistic shockwave mechanism. PNIs from GSWs can be treated with either early or delayed intervention, with the literature supporting both approaches and sparking a debate between early and delayed intervention for PNIs from GSWs. Here, we present a case that underwent delayed exploration of the right common peroneal nerve after GSW and a literature review comparing early versus delayed intervention for PNIs from GSWs.
CASE DESCRIPTION
A 29-year-old male underwent right common peroneal nerve exploration 2 months after he sustained a GSW to the right lower extremity at the level of the fibular head tracking to the lateral malleolus. Initially, after the injury, he was offered supportive care. On evaluation, 1 month later, he reported a right-sided foot drop and paresthesias in the right lower extremity. A partial-thickness injury of the right peroneal nerve was seen on ultrasound, and a bullet fragment in the distal right lower extremity was revealed on computed tomography. The surgical intervention consisted of the right common peroneal nerve decompression proximally to distally and removal of the bullet fragment. Postoperatively, the patient did well with improvements in his right ankle dorsiflexion and plantar flexion seen at his 1.5-month follow-up visit.
CONCLUSION
Many factors must be considered when treating PNIs from GSWs. For each case, clinical judgment, injury mechanism, and risk-benefit analysis must be evaluated to determine each patient's optimal treatment strategy.
PubMed: 38840615
DOI: 10.25259/SNI_197_2024 -
Alternative Therapies in Health and... Jun 2024To compare the positioning effect of three-dimensional reconstruction technology and Hook-wire puncture operation on small pulmonary nodules during video-assisted...
OBJECTIVE
To compare the positioning effect of three-dimensional reconstruction technology and Hook-wire puncture operation on small pulmonary nodules during video-assisted thoracoscopic surgery (VATS), and evaluate its effectiveness, efficiency, and safety.
METHODS
The subjects of this study were 50 patients with small pulmonary nodules admitted to the Department of Cardiothoracic Surgery of Heilongjiang Provincial Hospital from January 2020 to December 2022, and all underwent thoracoscopic surgical resection. All study subjects met the inclusion criteria, grouping according to the intraoperative positioning method, the control group (n = 25) used Hook-wire puncture positioning, and the observation group (n = 25) used three-dimensional reconstruction technology. The positioning effect, pain level, and postoperative complications were compared between the two groups.
RESULTS
The incidence rate of complications after puncture was 16.00% in the control group and 4.00% in the observation group, the complication rate in the observation group was significantly lower; the positioning success rate of the observation group was 96.00%, which was higher than that of the control group (92.00%). The operation time (32.25±6.08) min was lower than (38.50±7.12) min in the control group. The two groups had no statistical significance in the wedge resection success rate, VAS score, and complication rate (P > .05).
CONCLUSION
Three-dimensional reconstruction technology mainly makes preliminary judgments on the location, shape, size, and relationship between nodules and surrounding tissues based on preoperative CT scan images. It can select suitable scanning locations, map puncture paths, and anchor them in and around small lung nodules. The operation is simple, and the positioning success rate is high. The existence of three-dimensional reconstruction technology to position the guide wire can quickly shorten the time to detect lesions, shorten the time of VATS, reduce the occurrence of pulmonary infection in patients, and improve the prognosis.
PubMed: 38836733
DOI: No ID Found -
Frontiers in Psychology 2024Moral judgments are often viewed as the outcome of affective and deliberative processes that could be impacted by social factors and individual characteristics. The...
Moral judgments are often viewed as the outcome of affective and deliberative processes that could be impacted by social factors and individual characteristics. The purpose of this study was to examine the interaction between gender and social context on moral judgment. Participants included 315 undergraduate students (67.3% female). The participants completed the Moral Decision-Making Task while seated at row tables facing the front of the room or round tables facing other participants. The results indicated that males responded in a more utilitarian manner (harm one to save five) than females for moral impersonal (MI) and moral personal (MP) dilemmas regardless of seating arrangements. When seated at round tables, all participants were more likely to respond deontologically (cause no harm) to the moral impersonal dilemmas. In addition, we calculated a moral reasoning difference score for each participant as the difference between the MI and MP scores to represent additional reactivity due to the idea of taking direct action. The moral reasoning difference score was consistent for females but indicated a more deontological response from males at round tables and a more utilitarian response from males at row tables. These results suggest that males are more utilitarian than females and are more likely to be influenced by social context when responding to moral dilemmas. More broadly, the current results indicate that moral judgments are affected by social context particularly in males in ways that have not been incorporated in many models of moral decision making.
PubMed: 38836238
DOI: 10.3389/fpsyg.2024.1397069 -
Frontiers in Psychology 2024Investigating the effects of monetary incentives on dishonest behavior provides valuable insights into human integrity and ethical decision-making processes. This study...
BACKGROUND
Investigating the effects of monetary incentives on dishonest behavior provides valuable insights into human integrity and ethical decision-making processes. This study is conducted through the lens of self-concept maintenance theory.
AIM
The aim of this study is to examine the influence of different types of rewards (score-based vs. monetary) and their magnitude on dishonest behavior within a gender judgment task.
METHOD
Using a quantitative experimental design, this study involved 116 participants who were randomly assigned to conditions that differed in reward type (score or money) and magnitude (10 yuan vs. 50 yuan). Dishonest behavior was assessed using a gender judgment task with mechanisms to simulate conditions conducive to planned cheating.
RESULTS
Results revealed significant differences in dishonesty rates between score and money conditions, with a higher proportion of dishonest participants observed in the score condition compared to the money condition. The timing of initial cheating was earlier in the score condition compared to the money condition. No significant differences were found in the proportion of dishonest participants, the cheating rate, or the timing of initial cheating across reward levels within either condition. The rate of cheating increased over time, suggesting a temporal dynamic in unethical decision making.
CONCLUSION
The study demonstrates that the nature of rewards significantly influences the likelihood of dishonest behavior, with intangible score-based rewards facilitating rationalizations for dishonesty more readily than tangible financial incentives. These findings enrich the understanding of moral psychology by highlighting the complex interplay between reward types, ethical rationalization, and the dynamics of dishonest behavior.
PubMed: 38836237
DOI: 10.3389/fpsyg.2024.1290793 -
F1000Research 2024Comprehensive oral care is a service centered around the patient, and individuals who need it the most often face limited access. Patient perception acts as a guide for...
INTRODUCTION
Comprehensive oral care is a service centered around the patient, and individuals who need it the most often face limited access. Patient perception acts as a guide for enhancing quality, ensuring patients' future intent to utilize the services and facilitating recommendations to others. The present study aimed to assess the patients' perception of comprehensive dental services availed at a Primary Health Center (PHC).
METHODS
This qualitative study was based on a phenomenological interpretive approach, and judgment sampling method was employed. A validated interview guide, developed from relevant literature was employed in the local language to conduct interviews among adults visiting the PHC, gathering their views regarding the services provided. The interviews were audio recorded on a digital voice recorder, and files were password protected. Content saturation guided the determination of the final number of participants interviewed. After translating and transcribing the interviews, thematic analysis and coding were performed using ATLAS. ti 23 for Windows.
RESULTS
A total of 12 participants were included in the study, following data saturation. Among them, there were 8(66.7%) female and 4(33.3%) male participants. Ten overarching main themes were discerned through the assigned codes, including positive views, neutral views, negative views, previous dental clinics visited, previous experience with dental treatment, treatments sought at the center, referrals, source of information about the dental center, subsequent visits and suggestions for improvement.
CONCLUSIONS
The findings of this study revealed a positive patient perception of the comprehensive dental services offered at the PHC. Through insightful interviews, various strengths, and areas for improvement regarding the center and care provision were identified. These insights provide valuable suggestions that can be applied to elevate the utilization of dental services, ensuring continuous improvement in patient care.
Topics: Humans; Female; Male; Qualitative Research; Adult; Primary Health Care; Middle Aged; Dental Care; Perception
PubMed: 38835936
DOI: 10.12688/f1000research.146781.2 -
Health Science Reports Jun 2024Critical appraisal or risk of bias assessment is a fundamental part of systematic reviews that clarifies the degree to which included research articles are qualified and...
BACKGROUND AND AIMS
Critical appraisal or risk of bias assessment is a fundamental part of systematic reviews that clarifies the degree to which included research articles are qualified and reliable. Version 2 of the Cochrane tool for assessing the risk of bias in randomized trials (RoB 2), the updated version of the first tool, was released in 2019. Here, we have compared these two versions of Cochrane risk of bias assessment tools and highlighted the pros and cons of RoB 2.
METHODS
Statistical analysis and methodology is not applicable to this article as no new data were created or analyzed in this study.
RESULTS
The overall approach in RoB 2 is that by answering some signaling questions after the specification of results, effects of interest, and sources of information, an overall judgment for the quality of each study is reached. Accordingly, in the original version of the Cochrane RoB tool, the judgment can be in three different conclusions, including low, unclear, and high risk of bias. The most prominent difference in bias domains is the removal of "other bias" domain being replaced by "overall bias" judgment. Also, the most common presentation types of Cochrane risk of bias assessments are the "summary" and "graph" which are generated by Review Manager, web-based applications, or packages in R software.
CONCLUSION
The RoB 2 tool, compared to the original RoB, has improved and is the recommended version by the Cochrane Collaboration for quality assessment of randomized controlled trials. It is recommended to consider funding source, duration of follow-up, declaration of data availability, the status of baseline characteristics between groups, and sample size calculation methods in further revisions of the Cochrane risk of bias assessment tools.
PubMed: 38835932
DOI: 10.1002/hsr2.2165 -
BMC Primary Care Jun 2024Many patients with diabetic kidney disease (DKD) do not receive evidence-based, guideline-recommended treatment shown to reduce DKD progression and complications....
BACKGROUND
Many patients with diabetic kidney disease (DKD) do not receive evidence-based, guideline-recommended treatment shown to reduce DKD progression and complications. Proactive electronic consultations (e-consults) are an emerging intervention strategy that could potentially allow nephrologists to provide timely and evidence-based guidance to primary care providers (PCPs) engaged in early DKD care.
METHODS
The objective of this study was to explore perspectives about potential barriers and facilitators associated with a proactive e-consult program to improve DKD care delivery. We conducted semi-structured qualitative interviews with PCPs across three different health systems. Interview transcripts were reviewed in a rapid qualitative analysis approach to iteratively identify, refine, and achieve consensus on a final list of themes and subthemes.
RESULTS
A total of 18 interviews were conducted. PCPs across all sites identified similar challenges to delivering guideline-recommended DKD care. PCPs were supportive of the proactive e-consult concept. Three major themes emerged surrounding (1) perceived potential benefits of proactive e-consults, including educational value and improved specialist access; (2) concerns about the proactive nature of e-consults, including the potential to increase PCP workload and the possibility that e-consults could be seen as documenting substandard care; and (3) leveraging of care teams to facilitate recommended DKD care, such as engaging clinic-based pharmacists to implement specialist recommendations from e-consults.
CONCLUSION
In this pre-implementation qualitative study, PCPs noted potential benefits and identified concerns and implementation barriers for proactive e-consults for DKD care. Strategies that emerged for promoting successful implementation included involving clinic support staff to enact e-consult recommendations and framing e-consults as a system improvement effort to avoid judgmental associations.
Topics: Humans; Qualitative Research; Diabetic Nephropathies; Physicians, Primary Care; Attitude of Health Personnel; Male; Female; Nephrology; Primary Health Care; Interviews as Topic; Remote Consultation
PubMed: 38834994
DOI: 10.1186/s12875-024-02454-w