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The use of digital technology is increasing rapidly across surgical specialities, yet there is no consensus for the term ‘digital surgery’. This is critical as digital health technologies present technical, governance, and legal challenges which are unique to the surgeon and surgical patient. We aim to define the term digital surgery and the ethica...
Article
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Ethics is an unconventional field of research for a surgeon, as ethics in surgery owns several specificities and surgery is considered an aggressive specialty. Therefore, the interest of research in medical ethics is sometimes unclear. In this short essay, we discussed the interest of research in medical ethics using a comparison to thermodynamics...
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The Sharīʿah affords considerable concern for human emotions, with its rulings seeking to remove the deliberate and accidental types of harm that may be inflicted on individuals or society. The principle of medical confidentiality protects patients’ dignity and avoids potential harm if otherwise practised. Texts from the Quran and Sunnah substantia...
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Surrogacy is an important alternative method of reproduction where traditional methods are not possible. However, several legal, ethical, medical and economic arguments have been made against this practice. Recent developments in the legal framework governing surrogacy aimed to answer these questions. Through the introduction of the surrogacy (regu...
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In economics, contract theory studies how economic agents can and do construct contractual agreements. The 2016 Nobel Prize in Economics was awarded to Oliver Hart and Bengt Holmström for their work on contract theory. Contracts develop a framework for understanding agreements such as insurance contracts, employer relationships, and property rights...
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Frequent media reports of disputes between medical teachers, resident doctors, and patients have been disturbing thus indicating an increasing gap and decline in the values of the profession. The foundation of medical professionalism and ethics is trust, truth, human values, and strong societal commitment. Our professional responsibilities as medic...
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In his Disrupted Dialogue: Medical Ethics and the Collapse of Physician-Humanist Communication (1770-1980) Robert Veatch presents a scholarly tour de force of eighteenth- and nineteenth-century Anglophone medical ethics to demonstrate how the easy communication between physicians and humanists in the Scottish Enlightenment progressively dissipated...
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Maqāṣidus-Sharīʻah (the objectives of the Islamic law) and medicine share inherent intersections and sometimes work as integral subjects, the ultimate aim of which is “harm reduction”, “promotion of wellbeing” and “care for human being”. The maqāṣidus-Sharīʻah does this through wadding-off harm, providing values and principles of good conducts, whi...
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The current legal status and medical ethics of routine or religious penile circumcision of minors is a matter of ongoing controversy in many countries. We focus on the United Kingdom as an illustrative example, giving a detailed analysis of the most recent guidance on the subject, from 2019, from the British Medical Association (BMA). We argue that...
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Purpose of Review The purpose of this paper is to open a discussion of the ethics of medical sexual health education (SHE) and its provision in medical education. The paper utilizes a qualitative analysis of currently available literature on medical SHE and a medical ethics framework of the four prima facie principles of (1) respect for autonomy, (...
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Nas últimas décadas, a Medicina convive com o aumento de denúncias éticas e processos judiciais. Este artigo avaliou as sindicâncias apreciadas pelo Conselho Regional de Medicina do Piauí, de 2001 a 2016. Foram incluídas 1011 sindicâncias, totalizando 1073 médicos implicados. Houve significativo crescimento da quantidade de médicos denunciados em f...
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Zusammenfassung Die Abwehr von Gefahren für Dritte als Aufgabe der Psychiatrie wird kontrovers diskutiert und immer wieder grundsätzlich infrage gestellt. Ethisch sind Zwangsmaßnahmen oder Zwangsbehandlungen im Kontext von Fremdgefährdung in jedem Fall begründungsbedürftig. In diesem Beitrag wird zunächst dargestellt, wie sich Maßnahmen gegen den W...
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Purpose: Professionalism and Communication were formally introduced in India's Competency based Curriculum (CBC) as part of the five roles of an Indian Medical Graduate and ten core competencies in the Bachelor of Science Nursing program. It may be challenging to teach the complexity of clinical medical ethics to undergraduate students at a young...
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Phenomenology gives rise to certain ontological considerations that have far-reaching implications for standard conceptions of patient autonomy in medical ethics, and, as a result, the obligations of and to patients in clinical decision-making contexts. One such consideration is the phenomenological reduction in classical phenomenology, a core feat...
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RESUMEN: El saber y el actuar medico son inherentes a la ética, la educación basada en valores hace parte del proceso de formación integral del profesional. Estos valores son milenarios y tienen su origen en el Juramento Hipocrático, el cual ha tenido múltiples modificaciones de acuerdo a las necesidades históricas; actualmente la pandemia por el C...
Book
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El libro aborda el origen y desarrollo de varias enfermedades de origen infeccioso y los procedimientos técnicos más importantes para su diagnóstico adecuado. A lo largo de sus 15 temas incluye también aspectos indispensables relacionados con los principios de la ética médica. Se incorporan además las normas de bioseguridad, y se profundiza no solo...
Article
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Introduction: Patient safety captures the essence of the primary principle of medical ethics, primum non nocere, first do no harm; this is an important concern in the health care system. Nurses are indispensable members of this system and are the largest group of health care providers involved in the direct delivery of patient care. As an integral...
Article
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Background Medical assistance in dying (MAiD) traverses challenging and emotionally overwhelming territories: healthcare providers (HCPs) across jurisdictions experience myriad of affective responses secondary to possible tensions between normative and interwoven values, such as sanctity of life, dignity in death and dying and duty to care. Object...
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Introduction A substantial proportion of individuals infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), report persisting symptoms weeks and months following acute infection. Estimates on prevalence vary due to differences in study designs, populations, heterogeneity of symptoms and the way symptoms are measured. Common sym...
Article
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Objective. When medical resources are scarce, clinicians must make difficult triage decisions. When these decisions affect public trust and morale, as was the case during the COVID-19 pandemic, experts will benefit from knowing which triage metrics have citizen support. Design. We conducted an online survey in 20 countries, comparing support for 5...
Article
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Moral enhancement proposals struggle to be both plausible and ethically defensible while nevertheless interestingly distinct from both cognitive enhancement as well as (mere) moral education. Brian Earp ( Royal Institute of Philosophy Supplement 83:415–439, 12) suggests that a promising middle ground lies in focusing on the (suitably qualified) use...
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The Covid-19 pandemic caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) has faced the transplant community with unprecedented clinical challenges in a highly vulnerable patient category. These were associated with many uncertainties for patients and healthcare professionals and prompted many ethical debates regarding safe del...
Article
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Limiting or withdrawing nonbeneficial medical care is considered ethically responsible throughout most of critical care and medical ethics literature. Practically, however, setting limits to treatment is often challenging. We review the literature to identify best practices for using the definition of futility as an anchoring concept to aid the eth...
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Introduction: This study aims to identify the full spectrum of ethical challenges of all forms of palliative sedation for adults as presented in current clinical practice guidelines (CPGs) and to determine whether CPGs specify ethical challenges of this therapy for patients with cancer and non-cancer and, if so, how exactly they do this. To the be...
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Objectives To describe the prevalence and sources of experienced moral stress and anxiety by Swedish frontline healthcare staff in the early phase of COVID-19. Design Cross-sectional survey, quantitative and qualitative. Participants and setting 1074 healthcare professionals (75% nurses) in intensive, ward-based, primary and municipal care in one...
Article
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Objectives To measure medical students’ exposure to pharmaceutical product promotion and incentives nationwide, and to evaluate students’ attitudes towards the pharmaceutical industry, access to education on promotional strategies and knowledge of institutional policies about drug company-student relationships. Design Cross-sectional survey based...
Article
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Informed consent is one of the most essential pillars of medical research ethics (1). It encompasses the medical ethical principle of autonomy which enables the participants to decide on whether or not to partake in a study without any coercion (2). It also enables patients to make informed decisions after critically analyzing the implications of t...
Article
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Background Improving maternal lifestyle before conception may prevent the adverse effects of maternal obesity on their children’s future cardiovascular disease (CVD) risk. In the current study, we examined whether a preconception lifestyle intervention in women with obesity could alter echocardiographic indices of cardiovascular health in their chi...
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Background Moyamoya disease (MMD) is a chronic progressive cerebrovascular disease mainly existing in the Asian population, which can be divided into unilateral and bilateral types. Contralateral progression has been reported in pediatric patients with unilateral MMD, while large series about contralateral progression in Chinese adult patients were...
Article
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Introduction Supplemental oxygen is the most important treatment for preterm born infants with established bronchopulmonary dysplasia (BPD). However, it is unknown what oxygen saturation levels are optimal to improve outcomes in infants with established BPD from 36 weeks postmenstrual age (PMA) onwards. The aim of this study is to compare the use o...
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Introduction Conflict is unfortunately well-documented in the adult intensive care unit (AICU). In the context of end-of-life (EOL) decision-making (ie, the withdrawal or withholding of life-sustaining treatment), conflict commonly occurs when a consensus cannot be reached between the healthcare team and the patient’s family on the ‘best interests’...
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Michael E Schatman,1,2 Kelly Kooharian,3 Patricia Guerrero4 1Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Grossman School of Medicine, New York, NY, USA; 2Department of Population Health – Division of Medical Ethics, NYU Grossman School of Medicine, New York, NY, USA; 3Hospice Department, VNA of Cape Cod, Hyannis, MA, US...
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p> Background and Objective: The essential goal of any medical school is to train medical graduates to work as independent clinicians. Inadequately prepared doctors put the well-being of patients at a great risk. The objective of the study was to evaluate the preparedness for independent clinical practice of house officers who graduated from medica...
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In this paper, we start by comparing the two agents, Ann and Bob, who are involved in two car crashes. Whereas Ann crashes her car through no fault of her own, Bob crashes as a result of reckless driving. Unlike Ann, Bob is held criminally responsible, and the insurance company refuses to cover the car’s damages. Nonetheless, Ann and Bob both recei...
Preprint
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Unethical practices and Professional Misconduct by doctors are on the rise with the result trust between doctors and patient declined and dissatisfaction is on the rise among consumers of health care in India. To have disciplinary control over registered medical practitioner in India, Medical Council of India has enacted the Indian Medical Council...
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Background Consent to treatment is a cornerstone of medical ethics and law. Nevertheless, very little empirical evidence is available to inform clinicians and policy makers regarding the capacities of forensic patients with Schizophrenia Spectrum Disorders (SSD) to make decisions about their treatment, with the risks of both clinical and legal iner...
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Objectives Incentives have been effectively used in several healthcare contexts. This systematic review aimed to ascertain whether incentives can improve antipsychotic adherence, what ethical and practical issues arise and whether existing evidence resolves these issues. Design Systematic review of MEDLINE, EMBASE and PsycINFO. Searches on 13 Janu...
Article
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Discharge against medical advice (DAMA) has medical, ethical and legal implications. While the medical team should always act in the best interest of a child, parents realize they have autonomy to decide when a child should be discharged especially when they are responsible for paying the medical bills. The reasons for DAMAin a neonatal unit can va...
Presentation
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(2022) https://www.youtube.com/watch?v=kOokDY8t9vs A pesar de la complejidad del lenguaje filosófico, la noción de carne propuesta por Merleau-Ponty podría ayudarnos a concebir que la experiencia personal de la enfermedad corporal y el cuerpo fisiopatológicamente enfermo no sólo conforman una unidad indisoluble, sino que además su facticidad ocurre...
Article
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With the continuous deepening of artificial intelligence (AI) in the medical field, the social risks brought by the development and application of medical AI products have become increasingly prominent, bringing hidden worries to the protection of civil rights, social stability, and healthy development. There are many new problems that need to be s...
Article
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“Wicked” problems are characterized by intractable complexity, uncertainty, and conflict between individuals or institutions, and they inhabit almost every corner of medical ethics. Despite wide acceptance of the same ethical principles, we nevertheless disagree about how to formulate such problems, how to solve them, what would count as solving th...
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Purpose Prior to radiotherapy combined with chemotherapy (CRT) or biotherapy (BRT) for oropharyngeal squamous cell carcinoma (OPSCC), teeth with poor prognosis that pose a risk for post-RT osteoradionecrosis (ORN) are removed. The effect of tooth loss on body weight loss and tube feeding (TF) dependency during CRT/BRT is unknown. This study aimed t...
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This article provides a critical comparative analysis of the substantive and procedural values and ethical concepts articulated in guidelines for allocating scarce resources in the COVID-19 pandemic. We identified 21 local and national guidelines written in English, Spanish, German and French; applicable to specific and identifiable jurisdictions;...
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Resumen La esclerosis lateral amiotrófica es una enfermedad neurodegenerativa progresiva, sin tratamiento curativo, cuya expectativa de vida varía entre 2 a 5 años posterior al diagnóstico y es una de las causas de solicitud de eutanasia debido a su rápida progresión y mal pronóstico. A continuación se presenta el caso de una paciente femenina de 5...
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Objectives To investigate German physicians’ attitudes towards and experiences with voluntary disclosure of payments by pharmaceutical companies in a public database and their impact on future decisions for or against disclosure. Design A national cross-sectional survey conducted in 2018 among physicians who voluntarily disclosed at least one paym...
Article
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Objectives The Plutocratic Proposal is a novel method of funding early phase clinical trials where a single donor funds the entire trial and in so doing secures a place on it. The aim of this study was to identify and explore concerns that may be raised by UK research ethics committees (RECs) when reviewing clinical trials funded in this way. Desi...
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In tracheal tissue engineering, the construction of tracheal scaffolds with adequate biodegradable mechanical capacity and biological functions that mimic the structure of a natural trachea is challenging. To explore the feasibility of preparing biomimetic degradable scaffolds with C‐type cartilage rings and an inner tracheal wall of polycaprolacto...
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Industrial advances have caused significant loss of diversity in our gut microbiome, potentially increasing our susceptibility to many diseases. Recently, rewilding the human gut microbiome – that is, bringing it back to an ancestral or preindustrial state (e.g., by transplanting stool material from donors in nonindustrial societies) – has been hot...
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The COVID-19 pandemic has accelerated a long-term trend of smart hospital development. However, there is no consistent conceptualization of what a smart hospital entails. Few hospitals have genuinely reached being “smart,” primarily failing to bring systems together and consider implications from all perspectives. Hospital Intelligent Twins, a new...
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Background Stigma about mental illness—both public and self—is one of the most important factors hindering help-seeking. Stigma can occur during an acute episode of mental illness or be anticipatory. One group affected by stigma, but often neglected, is mental health professionals. This study examined the anticipated form of mental-illness and help...
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This study examined whether baseline (3–14 days pre-surgery) levels of (i) depressive or (ii) anxiety symptoms and (iii) illness beliefs moderate the effects of additional preoperative interventions before coronary artery bypass graft surgery on (i) depressive or (ii) anxiety symptoms and (iii) illness beliefs 1 day before surgery, 1 week and 6 mon...
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In this paper, I discuss stigma, understood as a category which includes acknowledged, enacted degradation, discreditation and discrimination. My discussion begins with an analysis of HIV stigma, as discussed in a social media post on Twitter. I then analyse a fictionalized clinical stigma scenario. These two analyses are undertaken to highlight as...
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This collaborative essay experimentally applies the insights of Mary Shelley's 1818 gothic fantasy Frankenstein to clinical interactions between present-day physicians and the patients they, akin to Shelley's human protagonist, so often seem to bring (back) to life. Because that process is frequently fraught with unspoken elements of ambivalence, d...
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Modern healthcare research has only in recent years investigated the impact of health care workers’ religious and other values on medical practice, interaction with patients, and ethically complex decision making. So far, only limited international data exist on the way such values vary across different countries. We therefore established the NERSH...
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Background Over two million adults experience domestic violence and abuse (DVA) in England and Wales each year. Domestic homicide reviews often show that health services have frequent contact with victims and perpetrators, but healthcare professionals (HCPs) do not share information related to DVA across healthcare settings and with other agencies...
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Background Standards generally reported in the literature about informing children and respecting their consent or refusal before elective heart surgery may differ from actual practice. This research aims to summarize the main themes in the literature about paediatric anaesthesia and compare these with research findings on how health professionals...
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Background In China, informal payments in the medical profession, which workers in the public health care system receive from patients in the course of performing profession-related activities, are usually referred to as “red packets” ( Hongbao 红包). The phenomenon of red packets is widespread and has become one of the most negative factors affectin...
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Error in medicine and medical liability has a long history dating back to Antiquity. During the 19th Century, most lawsuits related to errors in treating surgical problems were settled. However, in the first half of the 20th Century, lawsuits claimed that mistakes were related to the doctor's action: the doctor made something wrong (errors of commi...
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La subjectivité (…)-obligée à l´égard du prochain-est le point de rupture de l´essence excédée par l´Infini>> 1 .-Nuestro propósito: hacia algunos límites insuperables para el proyecto o sueño transhumanista. El transhumanismo actual, en cuanto movimiento concreto de pensamiento contemporáneo, se presenta de acuerdo a múltiples modulaciones y forma...
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Thought experiments that concoct bizarre possible world modalities are standard fare in debates on personal identity. Appealing to intuitions raised by such evocations is often taken to settle differences between conflicting theoretical views that, albeit, have practical implications for ethical controversies of personal identity in health care. Em...
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Over the past decade, there has been an increase in the number of clinical trials for psychedelic therapies as treatments for a wide range of psychiatric conditions. We are concerned that research organizations overseeing these trials have neglected the inclusion of individuals with physical and sensory disabilities. We suggest that psychedelic res...
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The article deals with a contemporary debate on Hippocratic ethics. Both the opponents and proponents of Hippocratic medical ethics seem to ignore the complexity of the said ethical system. The ethics of the Corpus Hippocraticum can be properly understood only in relation to physiological, psychological, and other factors. Therefore, the ongoing de...
Article
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Background Due to respiratory motion, accurate radiotherapy delivery to thoracic and abdominal tumors is challenging. We aimed to quantify the ability of mechanical ventilation to reduce respiratory motion, by measuring diaphragm motion magnitudes in the same volunteers during free breathing (FB) , mechanically regularized breathing (RB) at 22 brea...
Article
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The practice of medicine reflects a symbiotic existence between that discipline and other disciplines including philosophy, culture, sciences, politics and most importantly, law. It therefore cannot be bereft of usual relationship conflicts. Indeed, various situations occur that create conflicts between morality and medicine as in such instances of...
Book
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Hippokrates ist sicher der berühmteste Arzt des Altertums, wenn nicht der berühmteste Arzt überhaupt. Statt auf magische Praktiken setzte der „Vater der Medizin“ auf vernunftbasierte Beobachtung und Erfahrung und begründete so die Medizin als Wissenschaft. Der Hippokratische Eid gilt noch heute als beispielgebend für die medizinische Ethik. Unter...
Article
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Background Most of the medical schools in Saudi Arabia are currently evolving their curricula in accordance with the most recognized medical education trends worldwide. Undergraduate medical school’s curriculum should be compatible with community health needs. Therefore, the study aims to explore the current contents of Saudi undergraduate medical...
Preprint
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In a case before Delhi High Court after death of a patient undergone hair transplant, suffered serious complications. Various medicolegal and ethical issues emerged and need felt for National Protocol for hair transplant in India, as procedure is unregulated by statute, even in Capital of India, Delhi exposing issue of patient safety. Delhi High Co...
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Objectives The aim of this systematic review is to find evidence to determine which strategies are effective for improving hospitalised patients’ perception of respect and dignity. Methods A systematic review of the literature was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. The ME...
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Objective: Standard surgical treatment of advanced-stage ovarian carcinoma with electrosurgery cannot always result in complete cytoreductive surgery (CRS), especially when many small metastases are found on the mesentery and intestinal surface. We investigated whether adjuvant use of a neutral argon plasma device can help increase the complete cy...
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Objectives: To investigate whether there is an association between women's representation as peer reviewers and editors of medical journals. Methods: In this cross-sectional study, the gender of editors and peer reviewers of journals of the British Medical Journal Publishing Group (BMJ-PG) in 2020 was determined based on given names. Trends over...
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Background With the advancement of information technology, teachers have become able to overcome the limitations of time and room capacity by carrying out teaching activities online. This practice, however, also presents new challenges. The present study explores how to fully capitalize on the advantages of online and offline teaching and improve t...
Article
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Introduction: Sepsis, a life-threatening organ dysfunction syndrome occurring in the context of severe infections, remains a major burden on global health with high morbidity and high mortality rates. Despite recent advances in the understanding of its pathophysiology, the treatment of sepsis remains supportive of nature with few interventions spe...
Preprint
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Domain Generalization is a challenging topic in computer vision, especially in Gastrointestinal Endoscopy image analysis. Due to several device limitations and ethical reasons, current open-source datasets are typically collected on a limited number of patients using the same brand of sensors. Different brands of devices and individual differences...
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Background: Empathy is an important key driver of any therapeutic relationship. It is beneficial for both physicians and patients. Enhancing physician's empathy should be an important goal of medical education. As there was a literature gap regarding the topic of empathy among medical students in Greece, this study aimed to contribute to filling t...
Poster
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Philotimo Med Abroad organization was founded in, New Jersey, USA. We provide Medical Shadowing Fellowship Programs abroad for undergraduate students, gap year students, pre-med, medical students, medical residents, and practitioners, in Athens the capital of Greece as well as in Larisa in Thessaly. Larisa is the fourth largest city in Greece. Ph...
Article
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Background The internationalization of clinical studies requires a shared understanding of the fundamental ethical values guiding clinical studies. It is important that these values are not only embraced at the legal level but also adopted by clinicians themselves during clinical studies. Objective Our goal is to provide an insight on how clinicia...