Intelligent medicine and beyond

With the developments of medical artificial intelligence (AI), meta-data analysis, intelligence-aided drug design and discovery, surgical robots and image-navigated precision treatments, intelligent medicine (IM) as a new era evolved from ancient medicine and biomedical medicine, has become an emerging topic and important criteria for clinical applications. It is fully characterized by fundamental research-driven, new-generation technique-directed as well as state-of-the-art paradigms for advanced disease diagnosis and therapy leading to an even broader future of modern medicine. As a fundamental subject and also a practice-oriented field, intelligent medicine is highly trans-disciplinary and cross-developed, which has emerged the knowledge of modern medicine, basic sciences and engineering. Basically, intelligent medicine has three domains of intelligent biomaterials, intelligent devices and intelligent techniques. Intelligent biomaterials derive from traditional biomedical materials, and currently are endowed with multiple functionalities for medical uses. For example, micro-/nanorobots, smart responsive biomaterials and digital drugs are representative intelligent biomaterials which have been already commercialized and applied to clinical uses. Intelligent devices, such as surgical robots, rehabilitation robots and medical powered exoskeleton, are an important majority in the family of intelligent medicine. Intelligent biomaterials and intelligent devices are more and more closely integrated with each other especially on the occasions of intelligence acquisition, remote transmission, AI-aided analysis and management. In comparison, intelligent techniques are internalized in the former two domains and are playing a critical role in the development of intelligent medicine. Representative intelligent techniques of telemedicine, image-navigated surgery, virtual/augmented reality and AI-assisted image analysis for early-stage disease assessments have been employed in nowadays clinical operations which to a large extent relieved medical labors. In the past decades, China has been in the leading groups compared to international colleagues in the arena of intelligent medicine, and a series of eminent research has been clinically translated for practical uses in China. For instance, the first 5G-aided remote surgery has been realized in Fujian Province in January 2019, which for the first time validated their applicability for human uses. The surgical robots have found China as the most vigorous market, and more than 10 famous Chinese companies are developing versatile surgical robots for both Chinese people and people all over the world. China also applied AI techniques to new drug developments especially in early 2020 when COVID-19 epidemic roared, and several active molecules and drug motifs have been discovered for early-stage COVID-19 screening and treatments. Based on the significance of intelligent medicine and its rapid developments in both basic research and industrials, this review summarized the comprehensive viewpoints of the Y6 Xiangshan Science Conferences titled with Fundamental Principles and Key Technologies of Intelligent Medicine, and gave an in-depth discussion on main perspectives of future developments of the integration of biomaterial and devices, the integration of bioinformatics and medical hardware, and the synergy of biotechnology and intelligence information. It is expected that this featuring article will further promote intelligent medicine to an even broader community not only for scientists but also for industrials, and in the long run embrace a perspective future for its blooming and rich contributions in China in the coming 5 years. © 2023 Chinese Academy of Sciences. All rights reserved.

A Transfer Learning Method for Covid-19 and Pneumonia Diagnosis Based on Chest Radiograph Classification

Pneumonia has been a tough and dangerous human illness for a history-long time, notably since the COVID-19 pandemic outbreak. Many pathogens, including bacteria or viruses like COVID-19, can cause pneumonia, leading to inflammation in patients' alveoli. A corresponding symptom is the appearance of lung opacities, which are vague white clouds in the lungs' darkness in chest radiographs. Modern medicine has indicated that pneumonia-associated opacities are distinguishable and can be seen as fine-grained labels, which make it possible to use deep learning to classify chest radiographs as a supplementary aid for disease diagnosis and performing pre-screening. However, deep learning-based medical imaging solutions, including convolutional neural networks, often encounter a performance bottleneck when encountering a new disease due to the dataset's limited size or class imbalance. This study proposes a deep learning-based approach using transfer learning and weighted loss to overcome this problem. The contributions of it are three-fold. First, we propose an image classification model based on pre-trained Densely Connected Convolutional Networks using Weighted Cross Entropy. Second, we test the effect of masking non-lung regions on the classification performance of chest radiographs. Finally, we summarize a generic practical paradigm for medical image classification based on transfer learning. Using our method, we demonstrate that pre-training on the COVID-19 dataset effectively improves the model's performance on the non-COVID Pneumonia dataset. Overall, the proposed model achieves excellent performance with 95.75% testing accuracy on a multiclass classification for the COVID-19 dataset and 98.29% on a binary classification for the Pneumonia dataset. © 2023 IEEE.

The History of Infectious Diseases and Medicine.

From ancient times to the present, mankind has experienced many infectious diseases, which have mutually affected the development of society and medicine. In this paper, we review various historical and current infectious diseases in a five-period scheme of medical history newly proposed in this paper: (1) Classical Western medicine pioneered by Hippocrates and Galen without the concept of infectious diseases (ancient times to 15th century); (2) traditional Western medicine expanded by the publication of printed medical books and organized medical education (16th to 18th century); (3) early modern medicine transformed by scientific research, including the discovery of pathogenic bacteria (19th century); (4) late modern medicine, suppressing bacterial infectious diseases by antibiotics and elucidating DNA structure as a basis of genetics and molecular biology (20th century, prior to the 1980s); and (5) exact medicine saving human life by in vivo visualization and scientifically verified measures (after the 1990s). The historical perspectives that these five periods provide help us to appreciate ongoing medical issues, such as the present COVID-19 pandemic in particular, and remind us of the tremendous development that medicine and medical treatment have undergone over the years.

WHAT IS AFTER COVID-19?: CHANGING ECONOMIES OF THE SHIPPING INDUSTRIES AND MARITIME EDUCATION INSTITUTIONS

Most of the people in the world are struggling to ensure their presence and livelihood activities during this pandemic period. Achieving the third Sustainable Development Goal: “Ensure Healthy Lives and promote Well-being for all at all ages” since the end of 2019 is a big question mark to most of the economies. The first Case of Covid-19 was found in China during the mid of November 2019, still now there is no proper medicine and vaccine were found to cure fully. The vaccination availed after one year also not resulting 100% and the modern medicine there is no satisfactory effective therapy available to cure the Covid-19 infection due to the less genetic information regarding the mutation of this virus. World Health Organization suggested to implement Lock downs to handle this pandemic. Upto the end of first month of this decade more than 100 million people were infected and more than 2 million people were lost their lives. This pandemic severely affected most economic sectors of the world without any partiality. This attempt was made to analyze the impact of Covid-19 pandemic on the Maritime Education sector and Shipping Industry. For the study purpose detailed survey was conducted among the Maritime students, educators, sailors and practitioners in the different parts of the world. Collection of qualitative data for this study is quite difficult due to pandemic. So present study adopts descriptive cum analytical research design was adopted for the study. Totally 1094 respondents of the 16 countries were approached for the study purpose and received the responses from 857 respondents were responded to the survey and results were documented here to understand the future of the Maritime industry. The results of the study are interesting and highlighted the present mentality and economic status of mariners and future of the students. Mariners reported that they have less sailing opportunities compared to the past. Many of the respondents were worried that this economic slowdown due to pandemic had a huge impact on the industry is terms of less Liner schedules and reduced employment opportunities and poor practical exposure. Maritime Students highlighted that they were unable to get the practical exposures to meet out the challenges and virtual education system gave less chances to learn the practical aspects. Maritime educators pointed that less interaction between the students resulted in terms of adverse results. Meanwhile few of them responded that this pandemic helps them in terms of increased business growth in absence of Air Cargos. This study suggests that both public and private sector should take initiatives to meet out the challenges of this changes in the Maritime sector. Maritime Education institutions have to revise their mandatory policies to meet out the changing trends in education sector. It concludes that both positive and negative aspects of this pandemic resulted the tremendous changes in the Maritime sector hugely in reduced possibilities in the economies of the maritime business ventures. Further, this study suggests future researchers to carry out the segment specific both qualitative and analytical studies to handle the pandemic situation to effectively meet out the needs of the sector for the sustainability. © 2021 21st Annual General Assembly, IAMU AGA 2021 - Proceedings of the International Association of Maritime Universities ,IAMU Conference. All rights reserved.

Knowledge, attitude, and utilization of drugs toward COVID-19 pandemic among Bale Zone residents, Southeast Ethiopia.

BACKGROUND: Coronavirus disease is a highly transmittable and pathogenic viral infection caused by severe acute respiratory syndrome coronavirus 2, which poses therapeutic dilemmas. Some suggestions for drug treatment seem problematic. Beliefs about the causes of health problems are determinants of treatment seeking decisions. Hence, one of the alternatives for the solution of health problems is employing traditional medicine to prevent coronavirus disease 19. OBJECTIVE: To assess the knowledge, attitude, and utilization of drugs toward the coronavirus disease 19 pandemic among Bale zone residents. METHODS: Community-based cross-sectional study was conducted among the Bale Zone population from May 30 to June 30, 2020. Eight hundred fifty-four participants were selected using a single population formula, and a multistage sampling technique was employed. Data were analyzed using SPSS version 25.0. Descriptive and binary logistic regression was used to analyze the outcomes. A p value ⩽ 0.05 was considered statistically significant. RESULTS: Out of the total 854 respondents, about 534 (62.5%) got information about coronavirus disease 19 from TV/radio. More than two-thirds (71.9%) of the respondents have known that severe acute respiratory syndrome coronavirus 2 has no curative drugs, and 65.4% had a more appropriate attitude toward overall drug use in coronavirus disease 19. Level of education and, attitude towards drug use were singnificantly associated with knowledge of drugs, source of information about coronavirus disease 19 and having good practice were significantly associated with atittude toward drug utilization. CONCLUSION: One out of two study participants have good knowledge regarding drugs to the coronavirus disease 19 pandemic. Illiterate people in the community were identified to have poor knowledge about drugs, hence community educuation program is important to improve the knowledge about drugs towards the coronavirus disease 19 pandemic.

Efficacy of the combination of modern medicine and traditional Chinese medicine in pulmonary fibrosis arising as a sequelae in convalescent COVID-19 patients: a randomized multicenter trial.

BACKGROUND: The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to a significant number of mortalities worldwide. COVID-19 poses a serious threat to human life. The clinical manifestations of COVID-19 are diverse and severe and 20% of infected patients are reported to be in a critical condition. A loss in lung function and pulmonary fibrosis are the main manifestations of patients with the severe form of the disease. The lung function is affected, even after recovery, thereby greatly affecting the psychology and well-being of patients, and significantly reducing their quality of life. METHODS: Participants must meet the following simultaneous inclusion criteria: over 18 years of age, should have recovered from severe or critical COVID-19 cases, should exhibit pulmonary fibrosis after recovery, and should exhibit Qi-Yin deficiency syndrome as indicated in the system of traditional Chinese medicine (TCM). The eligible candidates will be randomized into treatment or control groups. The treatment group will receive modern medicine (pirfenidone) plus TCM whereas the control group will be administered modern medicine plus TCM placebo. The lung function index will be continuously surveyed and recorded. By comparing the treatment effect between the two groups, the study intend to explore whether TCM can improve the effectiveness of modern medicine in patients with pulmonary fibrosis arising as a sequelae after SARS-CoV-2 infection. DISCUSSION: Pulmonary fibrosis is one of fatal sequelae for some severe or critical COVID-19 cases, some studies reveal that pirfenidone lead to a delay in the decline of forced expiratory vital capacity, thereby reducing the mortality partly. Additionally, although TCM has been proven to be efficacious in treating pulmonary fibrosis, its role in treating pulmonary fibrosis related COVID-19 has not been explored. Hence, a multicenter, parallel-group, randomized controlled, interventional, prospective clinical trial has been designed and will be conducted to determine if a new comprehensive treatment for pulmonary fibrosis related to COVID-19 is feasible and if it can improve the quality of life of patients. TRIAL REGISTRATION: This multicenter, parallel-group, randomized controlled, interventional, prospective trial was registered at the Chinese Clinical Trial Registry (ChiCTR2000033284) on 26th May 2020 (prospective registered).

Exploration on the feasibility of moxibustion in prevention and treatment of COVID-19 from the perspective of modern medical mechanism.

Novel coronavirus pneumonia (COVID-19) is rampant in many countries and regions and there is no time to delay the exploration of the scheme for its prevention and control. The pathogenic characteristics of novel coronavirus and the effect of moxibustion for warming up yang and strengthening the antipathogenic qi were analyzed in this paper. From the perspective of modern medical mechanism, during the prevention and treatment of novel coronaviral infection, moxibustion may be able to prevent and treat COVID-19 by improving the body's immunity so as to conquer virus, by anti-inflammation to alleviate the inflammatory response of COVID-19 and by improving lung function to inhibit pulmonary fibrosis.