An embedded method which can provide privacy-safeguard and data-security layer for the Personal Health Records (PHR) is proposed. In our method, the fingerprint image of a patient or doctor is obtained with fingerprin...An embedded method which can provide privacy-safeguard and data-security layer for the Personal Health Records (PHR) is proposed. In our method, the fingerprint image of a patient or doctor is obtained with fingerprint scanner and the values of fingerprint features points are calculated and saved in an IC card. As a result, saving the fingerprint image is not required in our method. Based on the user's password, a transformation is applied on the fingerprint topology structural values. After that, we take these points' coordinates on the transformed topology structure as a cryptographic key, which is used with Advanced Encryption Standard (AES) algorithm to encrypt the users' privacy information, such as prescription, laboratory sheet, medical certificate, etc. The experimental results demonstrate that our method could bring patients the self-control and self-management on their own medical privacy information.展开更多
Abnormal high blood pressure or hypertension is still the leading risk factor for death and disability worldwide.This paper presents a new intelligent networked control of medical drug infusion system to regulate the ...Abnormal high blood pressure or hypertension is still the leading risk factor for death and disability worldwide.This paper presents a new intelligent networked control of medical drug infusion system to regulate the mean arterial blood pressure for hypertensive patients with different health status conditions.The infusion of vasoactive drugs to patients endures various issues,such as variation of sensitivity and noise,which require effective and powerful systems to ensure robustness and good performance.The developed intelligent networked system is composed of a hybrid control scheme of interval type-2 fuzzy(IT2F)logic and teaching-learning-based optimization(TLBO)algorithm.This networked IT2F control is capable of managing the uncertain sensitivity of the patient to anti-hypertensive drugs successfully.To avoid the manual selection of control parameter values,the TLBO algorithm is mainly used to automatically find the best parameter values of the networked IT2F controller.The simulation results showed that the optimized networked IT2F achieved a good performance under external disturbances.A comparative study has also been conducted to emphasize the outperformance of the developed controller against traditional PID and type-1 fuzzy controllers.Moreover,the comparative evaluation demonstrated that the performance of the developed networked IT2F controller is superior to other control strategies in previous studies to handle unknown patients’sensitivity to infused vasoactive drugs in a noisy environment.展开更多
The Buyi are a socio-linguistic group in Yunnan Province of southwest China that have a long history of using medicinal plants as part of their indigenous medical system.Given the limited written documentation of the ...The Buyi are a socio-linguistic group in Yunnan Province of southwest China that have a long history of using medicinal plants as part of their indigenous medical system.Given the limited written documentation of the Buyi indigenous medical system,the objective of this paper is to document the medicinal plants of the Buyi and associated traditional knowledge and transmission.Field research was conducted in four villages in Lubuge Township of Luoping County in Yunnan Province using ethnobotanical methodologies including participatory observation,semi-structured interviews,key informant interviews,and focus group discussions to elicit information on medicinal plants.In total,120 informants(including 15 key informants who are healers)were interviewed.This study found that a total of 121 medicinal plant species belonging to 64 families are used by the Buyi including by local healers to treat different diseases.Among the medicinal plants recorded in this study,56 species(46%)have not previously been documented in the scientific literature as having medicinal value,highlighting the pressing need for ethnobotanical documentation in indigenous communities.The most frequently used medicinal part was the leaf(24.9%of documented plants),and the most common preparation method was decoction(62.8%of medicinal).Medicinal plants were mainly used to treat rheumatism(12.4%of plants),trauma and injuries(9.6%).The documented plants are also used for other non-medicinal purposes including food,fodder,fencing,and ornamental.In addition,35 of the medicinal plants are considered poisonous and are used by local Buyi healers for medicine.The traditional Buyi beliefs and practices associated with the documented medicinal plants likely contributes to their conservation in the environments and around Buyi communities.This study further highlights that ethnomedicinal knowledge of the Buyi is at risk of disappearing due to increased introduction and use of modern medicine in Buyi communities,livelihood changes,rapid modernization,and urbanization.Research,policy,and community programs are urgently needed to conserve the biocultural diversity associated with the Buyi medical system including ethnobotanical knowledge towards supporting both environmental and human wellbeing.展开更多
The identification of the origin and molecular characteristics of prostate cancer(PCa)has crucial implications for personalized treatment.The development of effective treatments for PCa has been limited;however,the re...The identification of the origin and molecular characteristics of prostate cancer(PCa)has crucial implications for personalized treatment.The development of effective treatments for PCa has been limited;however,the recent establishment of several transgenicmouse lines and/or xenografting models is better reflecting the disease in vivo.With appropriate models,valuable tools for elucidating the functions of specific genes have gone deep into prostate development and carcinogenesis.In the present review,we summarize a number of important PCa research models established in our laboratories(PSA-Cre-ERT2/PTEN transgenic mouse models,AP-OX model,tissue recombination-xenografting models and PDX models),which represent advances of translational models from transgenic mouse lines to human tumor xenografting.Better understanding of the developments of these models will offer new insights into tumor progression and may help explain the functional significance of genetic variations in PCa.Additionally,this understanding could lead to new modes for curing PCa based on their particular biological phenotypes.展开更多
The widespread use of smartwatches has increased their specific and complementary activities in the health sector for patient’s prognosis.In this study,we propose a framework referred to as smart forecasting CardioWa...The widespread use of smartwatches has increased their specific and complementary activities in the health sector for patient’s prognosis.In this study,we propose a framework referred to as smart forecasting CardioWatch(SCW)to measure the heart-rate variation(HRV)for patients with myocardial infarction(MI)who live alone or are outside their homes.In this study,HRV is used as a vital alarming sign for patients with MI.The performance of the proposed framework is measured using machine learning and deep learning techniques,namely,support vector machine,logistic regression,and decision-tree classification techniques.The results indicated that the analysis of heart rate can help health services that are located remotely from the patient to render timely emergency health care.Further,taking more cardiac parameters into account can lead to more accurate results.On the basis of our findings,we recommend the development of health-related software to aid researchers to develop frameworks,such as SCW,for effective provision of emergency health.展开更多
目的:分析在诊断股骨头坏死的过程中GE MEDICAL SYSTEMS Revolution GSI CT与飞利浦ingenia CX核磁共振所获得的诊断价值。方法:本研究将2019年5月~2022年5月在本院接受股骨头坏死治疗的患者46例根据随机数字表法分为研究组(n=23,诊断方...目的:分析在诊断股骨头坏死的过程中GE MEDICAL SYSTEMS Revolution GSI CT与飞利浦ingenia CX核磁共振所获得的诊断价值。方法:本研究将2019年5月~2022年5月在本院接受股骨头坏死治疗的患者46例根据随机数字表法分为研究组(n=23,诊断方法:核磁共振)与参照组(n=23,诊断方法:CT)。结果:研究组患者股骨头坏死诊断阳性率明显高于参照组患者,P<0.05。研究组患者1期、2期股骨头坏死情况检出率与参照组患者相比明显较高,两组患者存在显著统计学差异,P<0.05;在3期、4期股骨头坏死情况检出率的比较上两组患者并无显著统计学差异,P>0.05。结论:在股骨头坏死患者诊断的过程中飞利浦ingenia CX核磁共振获得了较为理想的效果,其应用价值与GE MEDICAL SYSTEMS Revolution GSI CT相比明显较高,可以将其作为股骨头坏死的一种首选诊断方法。展开更多
The polarizabilities of DNA in transverse direction and CdSe semiconductor quantum dots (QDs) deposited on mica surface are compared by means of electrostatic force microscopy (EFM). We observe clear EFM-phase shi...The polarizabilities of DNA in transverse direction and CdSe semiconductor quantum dots (QDs) deposited on mica surface are compared by means of electrostatic force microscopy (EFM). We observe clear EFM-phase shift over CdSe QDs, while no obvious signal on DNA is detected, suggesting that DNA molecules is an electrical insulator.展开更多
We study the dynamics of tumor cell growth with time-delayed feedback driven by multiplicative noise in an asymmetrical bistable potential well. For a small delay time, the analytical solutions of the probability dist...We study the dynamics of tumor cell growth with time-delayed feedback driven by multiplicative noise in an asymmetrical bistable potential well. For a small delay time, the analytical solutions of the probability distribution and the first passage time show that, with the increasing delay time, the peak of the probability distribution in a lower population state would increase, but in a higher population state it decreases. It is shown that the multiplicative noise and the time delay play opposite roles in the tumor cell growth.展开更多
UreteroPelvic Junction Obstruction(UPJO)is a common hydronephrosis disease in children that can result in an even progressive loss of renal function.Ultrasonography is an economical,radiationless,noninvasive,and high ...UreteroPelvic Junction Obstruction(UPJO)is a common hydronephrosis disease in children that can result in an even progressive loss of renal function.Ultrasonography is an economical,radiationless,noninvasive,and high noise preliminary diagnostic step for UPJO.Artificial intelligence has been widely applied to medical fields and can greatly assist doctors'diagnostic abilities.The demand for a highly secure network environment in transferring electronic medical data online,therefore,has led to the development of blockchain technology.In this study,we built and tested a framework that integrates a deep learning diagnosis model with blockchain technology.Our diagnosis model is a combination of an attention-based pyramid semantic segmentation network and a discrete wavelet transformation-processed residual classification network.We also compared the performance between benchmark models and our models.Our diagnosis model outperformed benchmarks on the segmentation task and classification task with MloU=87.93,MPA=93.52,and accuracy=91.77%.For the blockchain system,we applied the InterPlanetary File System protocol to build a secure and private sharing environment.This framework can automatically grade the severity of UPJO using ultrasound images,guarantee secure medical data sharing,assist in doctors'diagnostic ability,relieve patients'burden,and provide technical support for future federated learning and linkage of the Internet of Medical Things(loMT).展开更多
Recently, 2007, the U.S. Food and Drug Administration (FDA) issued a draft guidance for the industry, titled "Complementary and Alternative Medicine Products and Their Regulation by the Food and Drug Administration...Recently, 2007, the U.S. Food and Drug Administration (FDA) issued a draft guidance for the industry, titled "Complementary and Alternative Medicine Products and Their Regulation by the Food and Drug Administration". This is another document closely related to Chinese Medical Sciences following the issuance of the Guidance for Industry: Botanical Drug Products in June 2004. This document conforms to the dramatically increased practice of Complementary and Alternative Medicine (CAM) in the United States in recent years.展开更多
Gases have long been used for medical applications across the world. Medical oxygen, one of the most important medical gases, has been widely applied both in hospitals and at home. It is defined as a drug and its pipe...Gases have long been used for medical applications across the world. Medical oxygen, one of the most important medical gases, has been widely applied both in hospitals and at home. It is defined as a drug and its pipeline distribution systems are medical devices whose quality and management should conform to specific standards. In China, several deficiencies relating to the distribution and use of medical oxygen, which may lead to a number of fatal accidents like gas pipeline explosion and cause illicit product use, have been revealed in health facilities. They are the result of a lack of the relevant standards, management and practical experiences. To overcome these failures, it might be interesting to refer to the experience and regulations of other countries, for example, those of France.展开更多
Research into the diagnostic methods and patterns of traditional East Asian medical (TEAM) systems of practice such as acupuncture and herbal medicine face certain challenges due to the nature of thinking in TEAM an...Research into the diagnostic methods and patterns of traditional East Asian medical (TEAM) systems of practice such as acupuncture and herbal medicine face certain challenges due to the nature of thinking in TEAM and the subjective basis of judgments made in practice. The TEAM-based diagnosis can take into account various findings and signs such as the appearance of the tongue, palpable qualities of the radial pulses, palpable qualities and findings on the abdomen, the complexion of the patient and so on. Both diagnostic findings and the patterns of diagnosis cannot be assumed to have objective bases or to be causally related to the complaints of the patient. However, the diagnoses of TEAM based acupuncture and herbal medicine have tended to look at pictures of the whole patient and rather than focus on a particular symptom, they have looked across a myriad of signs and symptoms to decide or identify the 'pattern' of diagnosis according to the theory in question. Although open for selective and subjective biases each diagnosis pattern always comes with a prescribed treatment tailored to the pattern. Further, the same research requirements needed for the validation of the diagnoses are needed also for these clinical observations and judgments. Hence, it is necessary, albeit challenging for research on TEAM diagnoses to first address these issues before proceeding to more complex investigations such as the development of instruments for making diagnostic observations, instruments for forming diagnostic conclusions or studies investigating the physiological bases of the diagnostic patterns. Preliminary work has started and instruments have been made, but we suggest that any instrumentation must necessarily be first validated by matching of the calibrated or scaled observations or judgments to observations made and agreed upon by relevant experts. Reliability of all observations and judgments are needed before any other tool, technology or more advanced approach can proceed and also whenever the natural system of diagnosis-treatment is applied in clinical trials. In this paper the authors highlight the core problems and describe a step wise process for addressing them.展开更多
As well for optimized emergency management in individual cases as for optimized mass medicine in disaster management, the principle of the medical doctors approaching the patient directly and timely, even close to the...As well for optimized emergency management in individual cases as for optimized mass medicine in disaster management, the principle of the medical doctors approaching the patient directly and timely, even close to the site of the incident, is a long-standing marker for quality of care and patient survival in Germany. Professional rescue and emergency forces, including medical services, are the "Golden Stan- dard" of emergency management systems. Regulative laws, proper organization of resources, equipment, training and adequate delivery of medical measures are key factors in systematic approaches to manage emergencies and disasters alike and thus save lives. During disasters command, communication, coor- dination and cooperation are essential to cope with extreme situations, even more so in a globalized world. In this article, we describe the major historical milestones, the current state of the German system in emergency and disaster management and its integration into the broader European approach.展开更多
文摘An embedded method which can provide privacy-safeguard and data-security layer for the Personal Health Records (PHR) is proposed. In our method, the fingerprint image of a patient or doctor is obtained with fingerprint scanner and the values of fingerprint features points are calculated and saved in an IC card. As a result, saving the fingerprint image is not required in our method. Based on the user's password, a transformation is applied on the fingerprint topology structural values. After that, we take these points' coordinates on the transformed topology structure as a cryptographic key, which is used with Advanced Encryption Standard (AES) algorithm to encrypt the users' privacy information, such as prescription, laboratory sheet, medical certificate, etc. The experimental results demonstrate that our method could bring patients the self-control and self-management on their own medical privacy information.
文摘Abnormal high blood pressure or hypertension is still the leading risk factor for death and disability worldwide.This paper presents a new intelligent networked control of medical drug infusion system to regulate the mean arterial blood pressure for hypertensive patients with different health status conditions.The infusion of vasoactive drugs to patients endures various issues,such as variation of sensitivity and noise,which require effective and powerful systems to ensure robustness and good performance.The developed intelligent networked system is composed of a hybrid control scheme of interval type-2 fuzzy(IT2F)logic and teaching-learning-based optimization(TLBO)algorithm.This networked IT2F control is capable of managing the uncertain sensitivity of the patient to anti-hypertensive drugs successfully.To avoid the manual selection of control parameter values,the TLBO algorithm is mainly used to automatically find the best parameter values of the networked IT2F controller.The simulation results showed that the optimized networked IT2F achieved a good performance under external disturbances.A comparative study has also been conducted to emphasize the outperformance of the developed controller against traditional PID and type-1 fuzzy controllers.Moreover,the comparative evaluation demonstrated that the performance of the developed networked IT2F controller is superior to other control strategies in previous studies to handle unknown patients’sensitivity to infused vasoactive drugs in a noisy environment.
基金This work was supported by the National Natural Science Foundation of China(31870316,31761143001)Key Laboratory of Ethnomedicine(Minzu University of China)of Ministry of Education of China(KLEMZZ201906,KLEM-ZZ201904)+3 种基金Jiansheng Fresh Herb Medicine R&D Foundation(JSYY-20190101-043)Biodiversity Survey and Assessment Project of the Ministry of Ecology and Environment of China(2019HJ2096001006)Minzu University of China(Collaborative Innovation Center for Ethnic Minority Development and YLDXXK201819)Ministry of Education of China and State Administration of Foreign Experts Affairs of China(B08044).
文摘The Buyi are a socio-linguistic group in Yunnan Province of southwest China that have a long history of using medicinal plants as part of their indigenous medical system.Given the limited written documentation of the Buyi indigenous medical system,the objective of this paper is to document the medicinal plants of the Buyi and associated traditional knowledge and transmission.Field research was conducted in four villages in Lubuge Township of Luoping County in Yunnan Province using ethnobotanical methodologies including participatory observation,semi-structured interviews,key informant interviews,and focus group discussions to elicit information on medicinal plants.In total,120 informants(including 15 key informants who are healers)were interviewed.This study found that a total of 121 medicinal plant species belonging to 64 families are used by the Buyi including by local healers to treat different diseases.Among the medicinal plants recorded in this study,56 species(46%)have not previously been documented in the scientific literature as having medicinal value,highlighting the pressing need for ethnobotanical documentation in indigenous communities.The most frequently used medicinal part was the leaf(24.9%of documented plants),and the most common preparation method was decoction(62.8%of medicinal).Medicinal plants were mainly used to treat rheumatism(12.4%of plants),trauma and injuries(9.6%).The documented plants are also used for other non-medicinal purposes including food,fodder,fencing,and ornamental.In addition,35 of the medicinal plants are considered poisonous and are used by local Buyi healers for medicine.The traditional Buyi beliefs and practices associated with the documented medicinal plants likely contributes to their conservation in the environments and around Buyi communities.This study further highlights that ethnomedicinal knowledge of the Buyi is at risk of disappearing due to increased introduction and use of modern medicine in Buyi communities,livelihood changes,rapid modernization,and urbanization.Research,policy,and community programs are urgently needed to conserve the biocultural diversity associated with the Buyi medical system including ethnobotanical knowledge towards supporting both environmental and human wellbeing.
基金The study was supported by funding from the NIDDK(DK098277)to Douglas W.Strandfrom the National Nature Scientific Foundation of China(NSFC No.81372772)to Dr.Ming Jiang,the Scientific Research Foundation for Jiangsu Specially-Appointed Professor(Sujiaoshi[2012]No.34),to Dr.Ming Jiang,Department of Education in Jiangsu Province,China and the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD),China.
文摘The identification of the origin and molecular characteristics of prostate cancer(PCa)has crucial implications for personalized treatment.The development of effective treatments for PCa has been limited;however,the recent establishment of several transgenicmouse lines and/or xenografting models is better reflecting the disease in vivo.With appropriate models,valuable tools for elucidating the functions of specific genes have gone deep into prostate development and carcinogenesis.In the present review,we summarize a number of important PCa research models established in our laboratories(PSA-Cre-ERT2/PTEN transgenic mouse models,AP-OX model,tissue recombination-xenografting models and PDX models),which represent advances of translational models from transgenic mouse lines to human tumor xenografting.Better understanding of the developments of these models will offer new insights into tumor progression and may help explain the functional significance of genetic variations in PCa.Additionally,this understanding could lead to new modes for curing PCa based on their particular biological phenotypes.
基金the Deanship of Scientific Research at Prince Sattam Bin Abdulaziz University under the research project#2019/01/9539.
文摘The widespread use of smartwatches has increased their specific and complementary activities in the health sector for patient’s prognosis.In this study,we propose a framework referred to as smart forecasting CardioWatch(SCW)to measure the heart-rate variation(HRV)for patients with myocardial infarction(MI)who live alone or are outside their homes.In this study,HRV is used as a vital alarming sign for patients with MI.The performance of the proposed framework is measured using machine learning and deep learning techniques,namely,support vector machine,logistic regression,and decision-tree classification techniques.The results indicated that the analysis of heart rate can help health services that are located remotely from the patient to render timely emergency health care.Further,taking more cardiac parameters into account can lead to more accurate results.On the basis of our findings,we recommend the development of health-related software to aid researchers to develop frameworks,such as SCW,for effective provision of emergency health.
文摘目的:分析在诊断股骨头坏死的过程中GE MEDICAL SYSTEMS Revolution GSI CT与飞利浦ingenia CX核磁共振所获得的诊断价值。方法:本研究将2019年5月~2022年5月在本院接受股骨头坏死治疗的患者46例根据随机数字表法分为研究组(n=23,诊断方法:核磁共振)与参照组(n=23,诊断方法:CT)。结果:研究组患者股骨头坏死诊断阳性率明显高于参照组患者,P<0.05。研究组患者1期、2期股骨头坏死情况检出率与参照组患者相比明显较高,两组患者存在显著统计学差异,P<0.05;在3期、4期股骨头坏死情况检出率的比较上两组患者并无显著统计学差异,P>0.05。结论:在股骨头坏死患者诊断的过程中飞利浦ingenia CX核磁共振获得了较为理想的效果,其应用价值与GE MEDICAL SYSTEMS Revolution GSI CT相比明显较高,可以将其作为股骨头坏死的一种首选诊断方法。
基金Supported by the National Natural Science Foundation under Grant No 10604034, the Natural Science Foundation of Zhejiang Province (Y606309), Ningbo Natural Science Foundation (2006A610046), and K. C. Wong Magna Fund in Ningbo University.
文摘The polarizabilities of DNA in transverse direction and CdSe semiconductor quantum dots (QDs) deposited on mica surface are compared by means of electrostatic force microscopy (EFM). We observe clear EFM-phase shift over CdSe QDs, while no obvious signal on DNA is detected, suggesting that DNA molecules is an electrical insulator.
基金Supported by the National Natural Science Foundation of China under Grant No 10975063, and the Fundamental Research Pund for Physics and Mathematics of Lanzhou University.
文摘We study the dynamics of tumor cell growth with time-delayed feedback driven by multiplicative noise in an asymmetrical bistable potential well. For a small delay time, the analytical solutions of the probability distribution and the first passage time show that, with the increasing delay time, the peak of the probability distribution in a lower population state would increase, but in a higher population state it decreases. It is shown that the multiplicative noise and the time delay play opposite roles in the tumor cell growth.
基金This study was supported by the National Key R&D Program of China(No.2020YFB2104402).
文摘UreteroPelvic Junction Obstruction(UPJO)is a common hydronephrosis disease in children that can result in an even progressive loss of renal function.Ultrasonography is an economical,radiationless,noninvasive,and high noise preliminary diagnostic step for UPJO.Artificial intelligence has been widely applied to medical fields and can greatly assist doctors'diagnostic abilities.The demand for a highly secure network environment in transferring electronic medical data online,therefore,has led to the development of blockchain technology.In this study,we built and tested a framework that integrates a deep learning diagnosis model with blockchain technology.Our diagnosis model is a combination of an attention-based pyramid semantic segmentation network and a discrete wavelet transformation-processed residual classification network.We also compared the performance between benchmark models and our models.Our diagnosis model outperformed benchmarks on the segmentation task and classification task with MloU=87.93,MPA=93.52,and accuracy=91.77%.For the blockchain system,we applied the InterPlanetary File System protocol to build a secure and private sharing environment.This framework can automatically grade the severity of UPJO using ultrasound images,guarantee secure medical data sharing,assist in doctors'diagnostic ability,relieve patients'burden,and provide technical support for future federated learning and linkage of the Internet of Medical Things(loMT).
文摘Recently, 2007, the U.S. Food and Drug Administration (FDA) issued a draft guidance for the industry, titled "Complementary and Alternative Medicine Products and Their Regulation by the Food and Drug Administration". This is another document closely related to Chinese Medical Sciences following the issuance of the Guidance for Industry: Botanical Drug Products in June 2004. This document conforms to the dramatically increased practice of Complementary and Alternative Medicine (CAM) in the United States in recent years.
文摘Gases have long been used for medical applications across the world. Medical oxygen, one of the most important medical gases, has been widely applied both in hospitals and at home. It is defined as a drug and its pipeline distribution systems are medical devices whose quality and management should conform to specific standards. In China, several deficiencies relating to the distribution and use of medical oxygen, which may lead to a number of fatal accidents like gas pipeline explosion and cause illicit product use, have been revealed in health facilities. They are the result of a lack of the relevant standards, management and practical experiences. To overcome these failures, it might be interesting to refer to the experience and regulations of other countries, for example, those of France.
文摘Research into the diagnostic methods and patterns of traditional East Asian medical (TEAM) systems of practice such as acupuncture and herbal medicine face certain challenges due to the nature of thinking in TEAM and the subjective basis of judgments made in practice. The TEAM-based diagnosis can take into account various findings and signs such as the appearance of the tongue, palpable qualities of the radial pulses, palpable qualities and findings on the abdomen, the complexion of the patient and so on. Both diagnostic findings and the patterns of diagnosis cannot be assumed to have objective bases or to be causally related to the complaints of the patient. However, the diagnoses of TEAM based acupuncture and herbal medicine have tended to look at pictures of the whole patient and rather than focus on a particular symptom, they have looked across a myriad of signs and symptoms to decide or identify the 'pattern' of diagnosis according to the theory in question. Although open for selective and subjective biases each diagnosis pattern always comes with a prescribed treatment tailored to the pattern. Further, the same research requirements needed for the validation of the diagnoses are needed also for these clinical observations and judgments. Hence, it is necessary, albeit challenging for research on TEAM diagnoses to first address these issues before proceeding to more complex investigations such as the development of instruments for making diagnostic observations, instruments for forming diagnostic conclusions or studies investigating the physiological bases of the diagnostic patterns. Preliminary work has started and instruments have been made, but we suggest that any instrumentation must necessarily be first validated by matching of the calibrated or scaled observations or judgments to observations made and agreed upon by relevant experts. Reliability of all observations and judgments are needed before any other tool, technology or more advanced approach can proceed and also whenever the natural system of diagnosis-treatment is applied in clinical trials. In this paper the authors highlight the core problems and describe a step wise process for addressing them.
文摘As well for optimized emergency management in individual cases as for optimized mass medicine in disaster management, the principle of the medical doctors approaching the patient directly and timely, even close to the site of the incident, is a long-standing marker for quality of care and patient survival in Germany. Professional rescue and emergency forces, including medical services, are the "Golden Stan- dard" of emergency management systems. Regulative laws, proper organization of resources, equipment, training and adequate delivery of medical measures are key factors in systematic approaches to manage emergencies and disasters alike and thus save lives. During disasters command, communication, coor- dination and cooperation are essential to cope with extreme situations, even more so in a globalized world. In this article, we describe the major historical milestones, the current state of the German system in emergency and disaster management and its integration into the broader European approach.