Annals of medicine
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Over the past two decades, the use of Metaverse-enhanced simulations in medical education has witnessed significant advancement. These simulations offer immersive environments and technologies, such as augmented reality, virtual reality, and artificial intelligence that have the potential to revolutionize medical training by providing realistic, hands-on experiences in diagnosing and treating patients, practicing surgical procedures, and enhancing clinical decision-making skills. This scoping review aimed to examine the evolution of simulation technology and the emergence of metaverse applications in medical professionals' training, guided by Friedman's three dimensions in medical education: physical space, time, and content, along with an additional dimension of assessment. ⋯ Our study provides an updated perspective on the achievements and limitations of using simulation to transform medical education, offering insights that can inform development priorities and research directions for human-centered, ethical metaverse applications that enhance healthcare professional training.
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Hepatic portal venous gas(HPVG) represents a rare radiographic phenomenon frequently linked to intestinal necrosis, historically deemed to need immediate surgical intervention. The pivotal query arises about the imperative of urgent surgery when a patient manifests HPVG after gastrointestinal surgery. This inquiry seeks to elucidate whether emergent surgical measures remain a requisite in such cases. ⋯ After gastrointestinal surgery, in Computed Tomography (CT) imaging, the coexistence of HPVG and gastrointestinal dilatation, without signs of peritoneal irritation on abdominal examination, may suggest HPVG due to acute gastrointestinal injury, intestinal gas, and displacement of gas-producing bacteria. These patients can be managed conservatively under close supervision. In cases where HPVG coexists with gastrointestinal dilatation and Pneumatosis intestinalis (PI) without signs of peritoneal irritation, conservative treatment may be continued under close supervision. However, if progressive exacerbation occurs despite close monitoring and the aforementioned treatments, timely surgical exploration is deemed necessary. When HPVG is combined with signs of peritoneal irritation, prompt laparotomy and exploration are preferred.
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The small island nations, territories, and states dotting the Pacific are among the most disproportionately affected populations worldwide in the face of climate change. Sea level rise coupled with increased tropical storms contribute to seawater incursion, flooding, personal injury, trauma, and death. They face an existential threat due to the consequences of global warming, specifically ice melt resulting in sea level rise, repercussions for which they are not historically culpable. ⋯ Just as crucial to the narrative of the Marshallese people is a fundamental indigenous knowledge of their surroundings and an inseparable relationship to the environment, aquatic animals, and communities around them, denoting a holistic living system. Though the outlook is precarious, solutions centering on lifestyle interventions that are informed by Indigenous cultural strengths can provide a responsive framework and a ray of hope, offering potential solutions to these two. This short perspective highlights the RMI as a case study of the challenges the Pacific Island nations bear, from a legacy of annexation to the modern threat of climate change, compounded by health disparities.
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Review
Epidemiology, pathogenesis, clinical characteristics, and treatment of mucormycosis: a review.
This review aims to summarize the epidemiology, etiology, pathogenesis, clinical manifestations, and current diagnostic and therapeutic approaches for mucormycosis. The goal is to improve understanding of mucormycosis and promote early diagnosis and treatment to reduce mortality. ⋯ An enhanced understanding of the epidemiology, pathogenesis, and clinical presentation of mucormycosis, along with the adoption of improved diagnostic and therapeutic approaches, is essential for reducing mortality rates associated with this opportunistic fungal infection. Early diagnosis and prompt treatment are critical to improving patient outcomes.
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Opioids are the most prescribed drugs for the alleviation of pain. Both clinical and preclinical studies have reported strong evidence for sex-related divergence regarding opioid analgesia. ⋯ This review presents an overview of the importance of gonadal steroids in modulating opioid analgesic responsiveness and focuses on elaborating what is currently known regarding the underlyingmechanism. We sought to identify the link between gonadal hormones and the effect of oipiod antinociception.