Congruent Feature Selection Method to Improve the Efficacy of Machine Learning-Based Classification in Medical Image Processing

Machine learning(ML)is increasingly applied for medical image processing with appropriate learning paradigms.These applications include analyzing images of various organs,such as the brain,lung,eye,etc.,to identify specific flaws/diseases for diagnosis.The primary concern of ML applications is the precise selection of flexible image features for pattern detection and region classification.Most of the extracted image features are irrelevant and lead to an increase in computation time.Therefore,this article uses an analytical learning paradigm to design a Congruent Feature Selection Method to select the most relevant image features.This process trains the learning paradigm using similarity and correlation-based features over different textural intensities and pixel distributions.The similarity between the pixels over the various distribution patterns with high indexes is recommended for disease diagnosis.Later,the correlation based on intensity and distribution is analyzed to improve the feature selection congruency.Therefore,the more congruent pixels are sorted in the descending order of the selection,which identifies better regions than the distribution.Now,the learning paradigm is trained using intensity and region-based similarity to maximize the chances of selection.Therefore,the probability of feature selection,regardless of the textures and medical image patterns,is improved.This process enhances the performance of ML applications for different medical image processing.The proposed method improves the accuracy,precision,and training rate by 13.19%,10.69%,and 11.06%,respectively,compared to other models for the selected dataset.The mean error and selection time is also reduced by 12.56%and 13.56%,respectively,compared to the same models and dataset.

Medical Diagnosis Based on Multi-Attribute Group Decision-Making Using Extension Fuzzy Sets,Aggregation Operators and Basic Uncertainty Information Granule

Accurate medical diagnosis,which involves identifying diseases based on patient symptoms,is often hindered by uncertainties in data interpretation and retrieval.Advanced fuzzy set theories have emerged as effective tools to address these challenges.In this paper,new mathematical approaches for handling uncertainty in medical diagnosis are introduced using q-rung orthopair fuzzy sets(q-ROFS)and interval-valued q-rung orthopair fuzzy sets(IVq-ROFS).Three aggregation operators are proposed in our methodologies:the q-ROF weighted averaging(q-ROFWA),the q-ROF weighted geometric(q-ROFWG),and the q-ROF weighted neutrality averaging(qROFWNA),which enhance decision-making under uncertainty.These operators are paired with ranking methods such as the similarity measure,score function,and inverse score function to improve the accuracy of disease identification.Additionally,the impact of varying q-rung values is explored through a sensitivity analysis,extending the analysis beyond the typical maximum value of 3.The Basic Uncertain Information(BUI)method is employed to simulate expert opinions,and aggregation operators are used to combine these opinions in a group decisionmaking context.Our results provide a comprehensive comparison of methodologies,highlighting their strengths and limitations in diagnosing diseases based on uncertain patient data.

Relationship between the use of smart medical services and mental health status

In this editorial,I comment on the article by Zhang et al.To emphasize the importance of the topic,I discuss the relationship between the use of smart medical devices and mental health.Smart medical services have the potential to positively influence mental health by providing monitoring,insights,and inter-ventions.However,they also come with challenges that need to be addressed.Understanding the primary purpose for which individuals use these smart tech-nologies is essential to tailoring them to specific mental health needs and prefe-rences.

Getting physical with medical education:Exercise based virtual anatomy review classes for medical students

The benefits of regular physical activity are well known.Yet,few studies have examined the effectiveness of integrating physical activity(PA)into curricula within a post-secondary setting.To investigate the incorporation of PA into medical curriculum,we developed a series of optional exercise-based review sessions designed to reinforce musculoskeletal(MSK)anatomy course material.These synchronous sessions were co-taught by a group fitness instructor and an anatomy instructor.The fitness instructor would lead students through both strength and yoga style exercises,while the anatomy instructor asked questions about relevant anatomical structures related to course material previously covered.After the sessions,participants were asked to evaluate the classes on their self-reported exam preparedness in improving MSK anatomy knowledge,PA levels,and mental wellbeing.Thirty participants completed surveys;a majority agreed that the classes increased understanding of MSK concepts(90.0%)and activity levels(97.7%).Many(70.0%)felt that the classes helped reduce stress.The majority of respondents(90.0%)agreed that the classes contributed to increased feelings of social connectedness.Overall,medical students saw benefit in PA based interventions to supplement MSK course concepts.Along with increasing activity levels and promoting health behaviours,integrating PA into medical curriculum may improve comprehension of learning material,alleviate stress and foster social connectivity among medical students.

Regulatory gaps in India’s medical device framework:The case of Johnson and Johnson’s faulty hip implants

The Johnson and Johnson faulty hip implant case represents one of the most significant crises in medical device history,impacting nearly 93000 patients worldwide.In response to alarming failure rates and a global recall in August 2010,countries such as Australia,the United States,and the United Kingdom quickly implemented revision surgeries and reimbursement programs to protect patient safety.In stark contrast,India's response was alarmingly delayed;defective implants continued to be sold even after the global recall.By the time the import license was revoked,and the Central Drugs Standard Control Organization issued a recall notice,these implants had already been involved in 4700 surgeries across India.This paper explores the systemic weaknesses in India’s medical device regulatory framework that contributed to this delayed action,resulting in many patients suffering from serious health complications.It highlights deficiencies in monitoring and reporting mechanisms,inadequate regulatory oversight,and insufficient approval processes.Furthermore,the inability to trace affected patients and provide necessary compensation underscores significant gaps in regulation.Although subsequent legislative reforms were introduced,this paper argues that substantial loopholes remain,posing risks for future incidents.Thus,urgent,comprehensive,and enforceable regulatory measures are needed to increase patient safety.

Medication patterns of ancient Chinese medicinal prescriptions fordiabetic retinopathy

Objective:To mine the medication patterns of ancient prescriptions for diabetic retinopathy(DR)from databases of traditional Chinese medicine(TCM)ancient books,and provide evidence for clinical practice and scientific research of TCM treatment for DR.Methods:The traditional library retrieval and modern data retrieval technology were combined to collect the ancient prescriptions in these databases,including the library ofHunan University ofChinese Medicine,Chinese Medical Dictionary,Duxiu,and Chaoxing Digital Library.And the TCM inheritance auxiliary platform(V3.0)was used for data mining,mainly including drug frequency analysis,medicinal property and meridian tropism analysis,efficacy analysis,correlation analysis,complex network analysis,and cluster analysis.Results:A total of 271 ancient prescriptions for the treatment of DR were collected,involving 296 drugs.The total medication frequency was 2,727.Most of them were cold and sweet drugs.The meridians primarily targeted were the liver,kidney,and spleen.The main effects of drugs were supplementing deficiency,clearing heat,releasing the exterior,inducing urination to drain dampness,pacifying liver and extinguishing wind,and circulating blood and transforming stasis.Saposhnikovia divaricata was the most frequently Chinese herbal medicine for DR in TCM ancient books.Saposhnikovia divaricata and ligusticum wallichi,saposhnikovia divaricata and notopterygium root,angelica sinensis and ligusticum wallichii were common herbal pairs.Saposhnikovia divaricata,ginseng,plantain seed,angelica sinensis,prepared rehmannia root and cassia seed constituted the core formula with the highest frequency.Conclusion:The core prescriptions for treating DR are mainly crafted from Dihuang pill,Ruiren powder,Siwu decoction,and Zhujing pill.Saposhnikovia divaricata is an important meridian-guiding medicine to open Xuanfu for DR.In clinical practice,the prescriptions should be modified according to the evolution of pathogenesis.

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”.

Blockchain-Assisted Electronic Medical Data-Sharing:Developments,Approaches and Perspectives

Medical blockchain data-sharing is a technique that employs blockchain technology to facilitate the sharing of electronic medical data.The blockchain is a decentralized digital ledger that ensures data-sharing security,transparency,and traceability through cryptographic technology and consensus algorithms.Consequently,medical blockchain data-sharing methods have garnered significant attention and research efforts.Nevertheless,current methods have different storage and transmission measures for original data in the medical blockchain,resulting in large differences in performance and privacy.Therefore,we divide the medical blockchain data-sharing method into on-chain sharing and off-chain sharing according to the original data storage location.Among them,off-chain sharing can be subdivided into on-cloud sharing and local sharing according to whether the data is moved.Subsequently,we provide a detailed analysis of basic processes and research content for each method.Finally,we summarize the challenges posed by the current methods and discuss future research directions.

A cross-sectional study to assess medication safety,knowledge,attitude,and practices regarding nutrition and medication among pregnant women

Objective:To assess pregnant women's knowledge,attitude,and practice regarding nutrition and medication usage,analyse the prescribing pattern,and categorize them based on the Food and Drug Administration(FDA)guidelines.Methods:A cross-sectional study was conducted with 264 pregnant women in the obstetrics and gynaecology department of a tertiary care hospital from October 2022 to August 2023.A knowledge,attitude,and practice(KAP)questionnaire was prepared in English language by the researchers and validated by an expert panel consisting of 12 members.The validated questionnaire was then translated into regional languages,Kannada and Malayalam.The reliability of the questionnaire was assessed with test-retest method with a representative sample population of 30 subjects(10 subjects for each language).The subjects'knowledge,attitude,and practice were evaluated using the validated KAP questionnaire.The safety of the medication was assessed using the FDA drug safety classification for pregnancy.Results:The mean scores for nutritional and medication usage knowledge,attitude,and practice were 4.14±1.15,4.50±1.09,and 3.00±1.47,respectively.Among 30 prescribed medications,3 belong to category A(no risk in human studies),8 belong to category B(no risk in animal studies),18 belong to category C(risk cannot be ruled out)and 1 drug is not classified.A significant association was observed between medication knowledge and practice(r=0.159,P=0.010).Conclusions:Most of the study population knows the need to maintain good dietary and medication practices during pregnancy.Counselling pregnant women regarding diet and medication usage is crucial in maternal care.

Mediating role of inner strength in the relationship between medication literacy and medication adherence among kidney transplant patients

Objective:Compared with long-term renal replacement therapy,kidney transplantation is the ideal treatment for end-stage renal disease(ESRD),significantly extending patient life and improving quality of life.Kidney transplant patients need to adhere to lifelong immunosuppressive medication regimens,but their medication adherence is generally poor compared with other organ transplant recipients.Medication adherence is closely related to medication literacy and psychological status,yet related studies are limited.This study aims to investigate the current status of medication adherence,inner strength,and medication literacy in kidney transplant patients,analyze the relationships among these 3 factors,and explore the mediating role of inner strength in the relationship between medication literacy and medication adherence.Methods:A cross-sectional survey was conducted from March to October 2023 involving 421 patients aged≥18 years who visited kidney transplantation outpatient clinics at 4 tertiary hospitals in Hunan Province.The inner strength,medication literacy,and medication adherence of kidney transplant patients were investigated using the Inner Strength Scale(ISS),the Chinese version of the Medication Literacy Assessment in Spanish and English(MedLitRxSE),and the Chinese version of the Morisky Medication Adherence Scale-8(C-MMAS-8),respectively.Univariate analysis was performed to examine the effects of demographic and clinical data on medication adherence.Correlation analysis was conducted to explore the relationships among medication literacy,medication adherence,and inner strength.Significant variables from univariate and correlation analyses were further analyzed using multiple linear regression,and the mediating effect of inner strength was explored.Results:Among the 421 questionnaires collected,408 were valid,with an effective rate of 96.91%.The scores of C-MMAS-8,MedLitRxSE,and ISS were 6.64±1.16,100.63±14.67,and 8.47±4.03,respectively.Among the 408 patients,only 86(21.08%)patients had a high level of medication adherence,whereas 230(56.37%)patients had a medium level of medication adherence,and 92(22.55%)patients had poor medication adherence.Univariate analysis indicated that the kidney transplant patients’age,marital status,education levels,years since their kidney transplant operation,number of hospitalizations after the kidney transplant,and adverse drug reactions showed significant differences in medication adherence(all P<0.05).Correlation analysis showed that inner strength positively correlated with both medication literacy(r=0.183,P<0.001)and medication adherence(r=0.201,P<0.001).Additionally,there was a positive correlation between medication adherence and medication literacy(r=0.236,P<0.001).Inner strength accounted for 13.22%of the total effect in the mediating role between medication literacy and medication adherence.Conclusion:The level of medication adherence among kidney transplant patients needs improvement,and targeted intervention measures are essential.Inner strength mediates the relationship between medication literacy and medication adherence in these patients.Healthcare professionals should focus on enhancing medication literacy and supporting patients’inner strength to improve medication adherence.

Analysis and improving countermeasures of medical disputes from the perspective of legal changes

Under the background of medical disputes growing in number,scale and intensity,tracing back legal changes in medical field as a breakthrough point,this paper took a legal perspective to illustrate changes in medical dispute settlements from legislative orientation to legal system improvement.In view of the fact that early legislation in medical field was biased towards identification and punishment of doctors’responsibility,and later intensive legislation in balancing increasing"medical trouble"phenomenon with limited effects and difficulties to abide by the law,this paper proposed to improve doctor-patient dispute settlements system in China referencing from foreign law experience,to reduce investigation of doctors at the judicial level,and to establish a settlement mechanism on doctors’apology at the legislative level,so as to promote a healthy development of doctor-patient relationship.

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.

A Review of Knowledge Graph in Traditional Chinese Medicine:Analysis,Construction,Application and Prospects

As an advanced data science technology,the knowledge graph systematically integrates and displays the knowledge framework within the field of traditional Chinese medicine(TCM).This not only contributes to a deeper comprehension of traditional Chinese medical theories but also provides robust support for the intelligent decision systems and medical applications of TCM.Against this backdrop,this paper aims to systematically review the current status and development trends of TCM knowledge graphs,offering theoretical and technical foundations to facilitate the inheritance,innovation,and integrated development of TCM.Firstly,we introduce the relevant concepts and research status of TCM knowledge graphs.Secondly,we conduct an in-depth analysis of the challenges and trends faced by key technologies in TCM knowledge graph construction,such as knowledge representation,extraction,fusion,and reasoning,and classifies typical knowledge graphs in various subfields of TCM.Next,we comprehensively outline the current medical applications of TCM knowledge graphs in areas such as information retrieval,diagnosis,question answering,recommendation,and knowledge mining.Finally,the current research status and future directions of TCM knowledge graphs are concluded and discussed.We believe this paper contributes to a deeper understanding of the research dynamics in TCM knowledge graphs and provides essential references for scholars in related fields.

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.

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.

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.

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”.

Holistic Integrative Medicine Declaration-Secondary publication

Holistic integrative medicine,abbreviated as HIM,has been officially proposed since 2012.Its theoretical system has been continuously improved,and its practical methods have become increasingly diverse,becoming an inevitable choice and path for the medical development in the new era.This article demonstrates ten major propositions for HIM,elaborating on the connotation and extension of HIM fromthe perspectives of epistemology and methodology,in order to achieve the transformation and adaptive evolution of modern medicine.

Study on the Medication Rules of Traditional Chinese Medicine Prescriptions for the Treatment of New Crown Pneumonia Based on Data Mining Technology

[Objectives]This study was conducted to analyze the medication rules of clinical prescriptions of traditional Chinese medicine decoction pieces for the treatment of novel coronavirus pneumonia(COVID-19)during the epidemic in multiple regions based on data mining technology,so as to provide a reference for the treatment of COVID-19 with traditional Chinese medicine.[Methods]The traditional Chinese medicine prescriptions used since the outbreak of COVID-19 in Hubei Province during the fight against the epidemic from February 25,2020 to February 14,2022,the traditional Chinese medicine prescriptions used by Guizhou traditional Chinese medicine expert team aiding Hubei Province,the traditional Chinese medicine prescriptions for rehabilitation and conditioning of patients in Ezhou of Hubei Province after discharge,the traditional Chinese medicine prescriptions for the prevention and treatment of COVID-19 in Guizhou Province,and the traditional Chinese medicine prescriptions for the treatment of COVID-19 collected from the end of 2019 to the present from the Chinese database of CNKI were collected as the data of this study.Excel was used to establish a database and enter it into the TCM inheritance calculation platform V3.5,and the association rules and k-means clustering algorithm were used to analyze the frequency of herbal medicines in prescriptions during the treatment of COVID-19,the frequency of four natures,five flavors,meridian distribution,and drug combinations.[Results]A total of 1859 COVID-19 patients treated with traditional Chinese medicine were included,and the proportion of males was higher than that of females,and middle-aged and elderly people were the most common group.A total of 2170 prescriptions of traditional Chinese medicine were included,involving a total of 383 traditional Chinese medicines.High-frequency medicines included poria,Radix Bupleuri,Radix Scutellariae,Herba Pogostemonis,Fructus Forsythiae,Flos Loniceraeetc.The four natures were mainly concentrated in cold,warm and neutral,and the five flavors were mainly concentrated in bitter,pungent and sweet.The herbal medicines were mainly attributed to the lungs and stomach meridians,and were mainly of heat-clearing,exterior syndrome-relieving and diuresis-promoting and damp-clearing types.A total of 24 high-frequency herbal combinations and 35 association rule were excavated,and 3 types of formulas were obtained by cluster analysis.[Conclusions]The analysis results and medicine combinations obtained in the formulas are consistent with the traditional Chinese medicine treatment theory of COVID-19 caused by wind-heat filth accompanied with damp and toxin.

Exploring the limited use of transdermal medications in psychiatry:Challenges and potential solutions

Transdermal medications are an useful yet underutilized tool in the field of psychiatry.Despite numerous advantages of using this route of medication delivery,transdermal medications remain less popular compared to other routes of medication administration such as oral and intramuscular routes in the management of various psychiatric conditions.In this editorial,we examine the advantages of transdermal medications with a brief overview of transdermal being used in psychiatry and other medical specialties.We discuss the factors that play a role in their limited usage in psychiatry.We highlight certain patient categories who can specifically benefit from them and discuss potential solutions that can broaden the perspective of treating clinicians making this an intriguing avenue in the field of psychiatry.