Ethics of Human Resources Management in the Cameroonian Health System, Medical Nomadism and the Ineffectiveness of the Fight against High Blood Pressure

Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.

Incorporating Exercise Efficiency to Evaluate the Accessibility and Capacity of Medical Resources in Tibet, China

Accessibility and capacity of medical resources are key for the health care and emergency response, while the efficiency of the medical resources is very much limited by hypoxia in Tibet, China.Through introducing exercise efficiency, this study explores the accessibility of township residence to county-ship medical resources in Tibet using weighted mean travel time(WMT), and evaluates the medical capacity accordingly.The results show that: 1) the average travel time of township residence to county-level hospital is around2 h by motor vehicle in Tibet.More than half of the population can not reach the county-ship hospital within 1 h, 33.24% of the population can not reach within 2 h, and 3.75% of the population can not reach within 6 h.2) When considering the catchment of the medical resources and the population size, the WMT of the county-ship medical resources ranges from 0.25 h to 10.92 h.3) After adjusted by travel time and exercise efficiency, the county-ship medical capacity became more unequal, with 38 out of 74 counties could not meet the national guideline of 1.8 medical beds per 1000.4) In total, there are 17 counties with good WMT and sufficient medical resources,while 13 counties having very high WMT and low capacity of medical resources in Tibet.In the end, suggestions on medical resources relocation and to improve the capacity are provided.This study provides a method to incorporate exercise efficiency to access the accessibility and evaluate medical capacity that can be applied in high altitude ranges.

Structural properties of residual carbon in coal gasification fine slag and their influence on flotation separation and resource utilization:A review

Coal gasification fine slag(FS)is a typical solid waste generated in coal gasification.Its current disposal methods of stockpil-ing and landfilling have caused serious soil and ecological hazards.Separation recovery and the high-value utilization of residual carbon(RC)in FS are the keys to realizing the win-win situation of the coal chemical industry in terms of economic and environmental benefits.The structural properties,such as pore,surface functional group,and microcrystalline structures,of RC in FS(FS-RC)not only affect the flotation recovery efficiency of FS-RC but also form the basis for the high-value utilization of FS-RC.In this paper,the characteristics of FS-RC in terms of pore structure,surface functional groups,and microcrystalline structure are sorted out in accordance with gasification type and FS particle size.The reasons for the formation of the special structural properties of FS-RC are analyzed,and their influence on the flotation separation and high-value utilization of FS-RC is summarized.Separation methods based on the pore structural characterist-ics of FS-RC,such as ultrasonic pretreatment-pore-blocking flotation and pore breaking-flocculation flotation,are proposed to be the key development technologies for improving FS-RC recovery in the future.The design of low-cost,low-dose collectors containing polar bonds based on the surface and microcrystalline structures of FS-RC is proposed to be an important breakthrough point for strengthening the flotation efficiency of FS-RC in the future.The high-value utilization of FS should be based on the physicochemical structural proper-ties of FS-RC and should focus on the environmental impact of hazardous elements and the recyclability of chemical waste liquid to es-tablish an environmentally friendly utilization method.This review is of great theoretical importance for the comprehensive understand-ing of the unique structural properties of FS-RC,the breakthrough of the technological bottleneck in the efficient flotation separation of FS,and the expansion of the field of the high value-added utilization of FS-RC.

Advancements in medical treatment for pancreatic neuroendocrine tumors:A beacon of hope

This editorial highlights the remarkable advancements in medical treatment strategies for pancreatic neuroendocrine tumors(pan-NETs),emphasizing tailored approaches for specific subtypes.Cytoreductive surgery and somatostatin analogs(SSAs)play pivotal roles in managing tumors,while palliative options such as molecular targeted therapy,peptide receptor radionuclide therapy,and chemotherapy are reserved for SSA-refractory patients.Gastrinomas,insul-inomas,glucagonomas,carcinoid tumors and VIPomas necessitate distinct thera-peutic strategies.Understanding the genetic basis of pan-NETs and exploring immunotherapies could lead to promising avenues for future research.This review underscores the evolving landscape of pan-NET treatment,offering renewed hope and improved outcomes for patients facing this complex disease.

‘Partly'globalized networks and driving mechanism in resource-based state-owned enterprises:A case study of J Group

In the context of economic globalization,while multinational enterprises from developed countries occupy a high-end position in the global value chain,enterprises from developing countries are often marginalized in the world market.In China,resource-based state-owned enterprises(SOEs)are tasked with the mission of safeguarding resource security,and their internationalization development ideas and strategic deployment are significantly and fundamentally different from those of other non-state-owned enterprises and large multinational corporations.This study provides ideas for the globalization policies of enterprises in developing countries.We consider J Group in western China as a case and discuss its productive investment and global production network development from 2010 to 2019.We found that J Group was‘Partly'globalized,and there are multiple core nodes with the characteristics of centralized and decentralized coexistence in the production network;in addition,the overall layout centre shifted to Southeast Asia and China;however,its global production was restricted by the enterprise's investment security considerations,support and restrictions of the home country,political security risk of the host country,and sanctions from the West.These findings provide insights for future research:under the wave of anti-globalization and'internal circulation as the main body',resource SOEs should consider the potential risk of investment,especially keeping the middle and downstream industrial chain in China as much as possible.

AMAD:Adaptive Mapping Approach for Datacenter Networks,an Energy-Friend Resource Allocation Framework via Repeated Leader Follower Game

Cloud Datacenter Network(CDN)providers usually have the option to scale their network structures to allow for far more resource capacities,though such scaling options may come with exponential costs that contradict their utility objectives.Yet,besides the cost of the physical assets and network resources,such scaling may also imposemore loads on the electricity power grids to feed the added nodes with the required energy to run and cool,which comes with extra costs too.Thus,those CDNproviders who utilize their resources better can certainly afford their services at lower price-units when compared to others who simply choose the scaling solutions.Resource utilization is a quite challenging process;indeed,clients of CDNs usually tend to exaggerate their true resource requirements when they lease their resources.Service providers are committed to their clients with Service Level Agreements(SLAs).Therefore,any amendment to the resource allocations needs to be approved by the clients first.In this work,we propose deploying a Stackelberg leadership framework to formulate a negotiation game between the cloud service providers and their client tenants.Through this,the providers seek to retrieve those leased unused resources from their clients.Cooperation is not expected from the clients,and they may ask high price units to return their extra resources to the provider’s premises.Hence,to motivate cooperation in such a non-cooperative game,as an extension to theVickery auctions,we developed an incentive-compatible pricingmodel for the returned resources.Moreover,we also proposed building a behavior belief function that shapes the way of negotiation and compensation for each client.Compared to other benchmark models,the assessment results showthat our proposed models provide for timely negotiation schemes,allowing for better resource utilization rates,higher utilities,and grid-friend CDNs.

Starlet:Network defense resource allocation with multi-armed bandits for cloud-edge crowd sensing in IoT

The cloud platform has limited defense resources to fully protect the edge servers used to process crowd sensing data in Internet of Things.To guarantee the network's overall security,we present a network defense resource allocation with multi-armed bandits to maximize the network's overall benefit.Firstly,we propose the method for dynamic setting of node defense resource thresholds to obtain the defender(attacker)benefit function of edge servers(nodes)and distribution.Secondly,we design a defense resource sharing mechanism for neighboring nodes to obtain the defense capability of nodes.Subsequently,we use the decomposability and Lipschitz conti-nuity of the defender's total expected utility to reduce the difference between the utility's discrete and continuous arms and analyze the difference theoretically.Finally,experimental results show that the method maximizes the defender's total expected utility and reduces the difference between the discrete and continuous arms of the utility.

Mapping and resource evaluation of deep high-temperature geothermal resources in the Jiyang Depression,China

In China,geothermal resource utilization has mainly focused on resources at shallow and medium depths.Yet,the exploration of deep,high-temperature geothermal resources holds significant importance for achieving the“dual carbon”goals and the transition of energy structure.The Jiyang Depression in the Bohai Bay Basin has vast potential for deep,high-temperature geothermal resources.By analyzing data from 2187 wells with temperature logs and 270 locations for temperature measurement in deep strata,we mapped the geothermal field of shallow to medium-deep layers in the Jiyang Depression using ArcGIS and predicted the temperatures of deep layers with a burial depth of 4000 m.Through stochastic modeling and numerical simulation,a reservoir attribute parameter database for favorable deep,high-temperature geothermal areas was developed,systematically characterizing the spatial distribution of geothermal resources within a play fairway of 139.5 km2 and estimating the exploitable deep geothermal resource potential by using the heat storage method and Monte Carlo data analysis.The study reveals that the Fan 54 well block in the Boxing-Jijia region is of prime significance to develop deep,high-temperature geothermal resources in the Jiyang Depression.Strata from the Cenozoic to the Upper Paleozoic are identified as effective cap layers for these deep geothermal resources.The Lower Paleozoic capable of effectively storing thermal energy and possessing an exploitable resource volume up to 127 million tons of standard coal,is identified as a target system for the development of deep high-temperature geothermal resources,providing significant insights for the efficient development of geothermal resources in the Jiyang Depression.

Medical management of urolithiasis: Great efforts and limited progress

Objective:To provide a comprehensive review on the existing literature on medical management of urolithiasis.Methods:A thorough literature review was performed using Medline,PubMed/PMC,Embase,and the Cochrane Database of Systematic Reviews up to December 2022 to identify publications on the medical management of urolithiasis.Studies that assessed dietary and pharmacologic management of urolithiasis were reviewed;studies on medical expulsive therapy were not included in this review.Results:Medical management of urolithiasis ranges from the prophylactic management of kidney stone disease to dissolution therapies.While most treatment concepts have been long established,large randomized controlled trials are scarce.Dietary modification and increased fluid intake remain cornerstones in the conservative management of urolithiasis.A major limitation for medical management of urolithiasis is poor patient compliance.Conclusion:Medical management of urolithiasis is more important in patients with recurrent urolithiasis and patients with metabolic abnormalities putting them at higher risk of developing stones.Although medical management can be effective in limiting stone recurrence,medical interventions often fail due to poor compliance.

Importance-aware 3D volume visualization for medical content-based image retrieval-a preliminary study

Background A medical content-based image retrieval(CBIR)system is designed to retrieve images from large imaging repositories that are visually similar to a user′s query image.CBIR is widely used in evidence-based diagnosis,teaching,and research.Although the retrieval accuracy has largely improved,there has been limited development toward visualizing important image features that indicate the similarity of retrieved images.Despite the prevalence of 3D volumetric data in medical imaging such as computed tomography(CT),current CBIR systems still rely on 2D cross-sectional views for the visualization of retrieved images.Such 2D visualization requires users to browse through the image stacks to confirm the similarity of the retrieved images and often involves mental reconstruction of 3D information,including the size,shape,and spatial relations of multiple structures.This process is time-consuming and reliant on users'experience.Methods In this study,we proposed an importance-aware 3D volume visualization method.The rendering parameters were automatically optimized to maximize the visibility of important structures that were detected and prioritized in the retrieval process.We then integrated the proposed visualization into a CBIR system,thereby complementing the 2D cross-sectional views for relevance feedback and further analyses.Results Our preliminary results demonstrate that 3D visualization can provide additional information using multimodal positron emission tomography and computed tomography(PETCT)images of a non-small cell lung cancer dataset.

Reconstruction of Knowledge and Medical Images in the Convergence of Chinese and Western Medicine:Taking “Sweet Meat” as an Example

The pancreas is neither part of the five Zang organs(五脏) nor the six Fu organs(六腑).Thus,it has received little attention in Chinese medical literature.In the late 19th century,medical missionaries in China started translating and introducing anatomical and physiological knowledge about the pancreas.As for the word pancreas,an early and influential translation was “sweet meat”(甜肉),proposed by Benjamin Hobson(合信).The translation “sweet meat” is not faithful to the original meaning of “pancreas”,but is a term coined by Hobson based on his personal habits,and the word “sweet” appeared by chance.However,in the decades since the term “sweet meat” became popular,Chinese medicine practitioners,such as Tang Zonghai(唐宗海),reinterpreted it by drawing new medical illustrations for “sweet meat” and giving new connotations to the word “sweet”.This discussion and interpretation of “sweet meat” in modern China,particularly among Chinese medicine professionals,is not only a dissemination and interpretation of the knowledge of “pancreas”,but also a construction of knowledge around the term “sweet meat”.

Mindfulness training in medical education as a means to improve resilience,empathy,and mental health in the medical profession

The high rates of depression,burnout,and increased risk of suicide among medical students,residents,and physicians in comparison with other careers signal a mental health crisis within our profession.We contend that this crisis coupled with the inadequate acquisition of interpersonal skills during medical education results from the interaction between a challenging environment and the mental capital of individuals.Additionally,we posit that mindfulness-based practices are instrumental for the development of major components of mental capital,such as resilience,flexibility of mind,and learning skills,while also serving as a pathway to enhance empathy,compassion,self-awareness,conflict resolution,and relational abilities.Importantly,the evidence base supporting the effectiveness of mindfulness-based interventions has been increasing over the years,and a growing number of medical schools have already integrated mindfulness into their curricula.While we acknowledge that mindfulness is not a panacea for all educational and mental health problems in this field,we argue that there is currently an unprecedented opportunity to gather momentum,spread and study mindfulness-based programs in medical schools around the world as a way to address some longstanding shortcomings of the medical profession and the health and educational systems upon which it is rooted.

EDSUCh:A robust ensemble data summarization method for effective medical diagnosis

Identifying rare patterns for medical diagnosis is a challenging task due to heterogeneity and the volume of data.Data summarization can create a concise version of the original data that can be used for effective diagnosis.In this paper,we propose an ensemble summarization method that combines clustering and sampling to create a summary of the original data to ensure the inclusion of rare patterns.To the best of our knowledge,there has been no such technique available to augment the performance of anomaly detection techniques and simultaneously increase the efficiency of medical diagnosis.The performance of popular anomaly detection algorithms increases significantly in terms of accuracy and computational complexity when the summaries are used.Therefore,the medical diagnosis becomes more effective,and our experimental results reflect that the combination of the proposed summarization scheme and all underlying algorithms used in this paper outperforms the most popular anomaly detection techniques.

Flexner's legacy and the future of medical education:Embracing challenge and opportunity

This editorial comments on the article by Alzerwi.We focus on the development course,present challenges,and future perspectives of medical education.Modern medical education is gradually undergoing significant and profound changes worldwide.The emergence of new ideas,methodologies,and techniques has created opportunities for medical education developments and brought new concerns and challenges,ultimately promoting virtuous progress in medical education reform.The sustainable development of medical education needs joint efforts and support from governments,medical colleges,hospitals,researchers,administrators,and educators.

Optimization of resource allocation in FDD massive MIMO systems

The performance of massive MIMO systems relies heavily on the availability of Channel State Information at the Transmitter(CSIT).A large amount of work has been devoted to reducing the CSIT acquisition overhead at the pilot training and/or CsI feedback stage.In fact,the downlink communication generally includes three stages,i.e.,pilot training,CsI feedback,and data transmission.These three stages are mutually related and jointly determine the overall system performance.Unfortunately,there exist few studies on the reduction of csIT acquisition overhead from the global point of view.In this paper,we integrate the Minimum Mean Square Error(MMSE)channel estimation,Random Vector Quantization(RVQ)based limited feedback and Maximal Ratio Combining(MRC)precoding into a unified framework for investigating the resource allocation problem.In particular,we first approximate the covariance matrix of the quantization error with a simple expression and derive an analytical expression of the received Signal-to-Noise Ratio(SNR)based on the deterministic equivalence theory.Then the three performance metrics(the spectral efficiency,energy efficiency,and total energy consumption)oriented problems are formulated analytically.With practical system requirements,these three metrics can be collaboratively optimized.Finally,we propose an optimization solver to derive the optimal partition of channel coherence time.Experiment results verify the benefits of the proposed resource allocation schemes under three different scenarios and illustrate the tradeoff of resource allocation between three stages.

Special Issue: The Global Cross-cultural Integration of TCM in the Mainstream Healthcare, Medical Education and the Practice of Medicine

Ioannis Solos Ph.D.,M.D.(China),L.Ac.currently serves as President and CEO at the Saint George Clinic and Research Institute,Scottsdale,AZ.,and Associate Editor for Chinese Medicine and Culture.Professor Solos has earned his Master of Medicine in Traditional Diagnosis at the Beijing University of Chinese Medicine,and his Medical Ph.D.in Chinese and Western Integrative Medicine at the Jinan University in Guangzhou.He practices and teaches integrative clinical medicine,Jing Fang(经方TCM formulas),martial lineage acupuncture,and his personalized style of“tendon and fascia reconditioning manipulations for bone and joint disease”.

Advances in Biomedical Applications of Hydrogels from Seaweed-Derived Sulfated Polysaccharides:Carrageenan,Fucoidan,and Ulvan

Sulfated polysaccharides extracted from seaweeds,including Carrageenan,Fucoidan and Ulvan,are crucial bioactive compounds known for their diverse beneficial properties,such as anti-inflammatory,antitumor,immunomodulatory,antiviral,and anticoagulant effects.These polysaccharides form hydrogels hold immense promise in biomedicine,particularly in tissue engineering,drug delivery systems and wound healing.This review comprehensively explores the sources and structural characteristics of the three important sulfated polysaccharides extracted from different algae species.It elucidates the gelation mechanisms of these polysaccharides into hydrogels.Furthermore,the biomedical applications of these three sulfated polysaccharide hydrogels in wound healing,drug delivery,and tissue engineering are discussed,highlighting their potential in the biomedicine.

Investigation on the Knowledge, Attitude and Practice of Oral Health among Medical College and University Undergraduate

Objectives: This study aims to investigate the status of knowledge, attitude and practice (KAP) of oral health among medical undergraduate students, and provide reference for implementing oral health interventions. Methods: A total of 528 undergraduate students enrolled in Fuzhou Medical College from February 2023 to September 2023 were selected as the research subjects. Their oral health KAP were investigated, and the oral health behavior habits of different types of medical students were compared, and possible influencing factors were analyzed. Results: The total awareness rate of oral health knowledge among medical students is 77.0%, with an average score of 3.85 ± 1.16 points. The overall positive rate of oral health attitudes among medical students is 80.0%, with an average score of 3.19 ± 0.72 points. The total qualified rate of oral health behavior is 65.9%, with an average score of 4.61 ± 1.23 points. The scores of oral health knowledge, attitudes, and behaviors among medical students are related to gender, major, smoking status, and oral health status. The frequency of brushing teeth in the female group was higher than that in the male group, while the habit of brushing teeth before bedtime and the frequency of timely replacement of toothbrushes when deformed were lower, with statistical significance (p 0.05). The frequency of timely replacement of toothbrushes varies among medical students from different majors, and the difference is statistically significant (p 0.05). People who have a habit of eating hot and cold food have a higher frequency of brushing their teeth every day, and the difference is statistically significant (p 0.05). Non smokers have a better habit of brushing their teeth before bedtime and a higher frequency of timely replacement when their toothbrush deforms, with a statistically significant difference (p 0.05). The frequency of using fluoride toothpaste or medicated toothpaste, having a habit of unilateral chewing, and timely replacement of toothbrushes when deformed in patients with existing oral problems is higher than that of those without oral problems, and the difference is statistically significant (p 0.05). Conclusion: The knowledge, attitude, and behavior of oral health among medical students in this school are above average. Students with different genders, dietary and smoking habits, and oral health status have different oral health behavioral habits. It is recommended to include oral health education in mandatory courses for various medical majors.

Knowledge of Hospital Acquired Infections (HAIs) among Medical Students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria

Background: Hospital Acquired Infections (HAIs) remain a common cause of death, functional disability, emotional suffering and economic burden among hospitalized patients. Knowledge of HAIs is important in its prevention and control. This study seeks to assess the knowledge of Hospital Acquired Infections (HAIs) among medical students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria. Methods: This was a descriptive cross-sectional study done in October 2019 among clinical medical students using a Multistage sampling technique. Data was collected using a self-administered structured questionnaire and analyzed using the IBM SPSS 20 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics Committee, Jos, Plateau State. Results: A total of 219 students in the clinical arm of the College of Medicine and Health Sciences were selected. A higher proportion (97.7%) of respondents knew about Hospital Acquired Infections and 85.4% knew that Hospital Acquired infections occur in the hospital, and (86.3%) considered patients contagious with half (58.9%) considered patients as the most important source of HAIs, followed by care givers (13.2%), then doctors including medical students and interns (10.0%) and lastly nurses (8.7%). The majority of respondents (70.8%) considered Surgical Wound Infections to be the most commonly occurring HAI, followed by UTIs (69.9%), RTIs (61.2%), BSIs (37.0%) and others (0.9%). The clinical thermometer was the instrument that most commonly transmits HAIs (82.6%), then followed by stethoscope (62.1%), white coats (53.9%), and blood pressure cuff (51.1%). Most respondents knew the infectious substances, like blood (96.3%), nasal discharge (82.6%), saliva (85.3%), and faeces (79.4%) transmitted HAIs, 72.6% of the respondents said that they were aware of the recommended hand washing techniques by WHO. Conclusion: The majority of students 91.3% had good knowledge while 8.7% had poor knowledge of HAIs. Lower classes had more respondents with poor knowledge. This finding was statistically significant (p = 0.002, Chi-square 12.819). Students are encouraged to keep up the level of knowledge they have about HAIs. These students can help improve the knowledge of those whose knowledge level is low. Government and NGOs should support sponsorship for capacity-building events targeted at HAIs for healthcare workers and medical students.

Process,Material,and Regulatory Considerations for 3D Printed Medical Devices and Tissue Constructs

Three-dimensional(3D)printing is a highly automated platform that facilitates material deposition in a layer-by-layer approach to fabricate pre-defined 3D complex structures on demand.It is a highly promising technique for the fabrication of personalized medical devices or even patient-specific tissue constructs.Each type of 3D printing technique has its unique advantages and limitations,and the selection of a suitable 3D printing technique is highly dependent on its intended application.In this review paper,we present and highlight some of the critical processes(printing parameters,build orientation,build location,and support structures),material(batch-to-batch consistency,recycling,protein adsorption,biocompatibility,and degradation properties),and regulatory considerations(sterility and mechanical properties)for 3D printing of personalized medical devices.The goal of this review paper is to provide the readers with a good understanding of the various key considerations(process,material,and regulatory)in 3D printing,which are critical for the fabrication of improved patient-specific 3D printed medical devices and tissue constructs.