Background Digital health technologies (ie, the integration of digital technology and health information) aim to increase the efficiency of health care delivery; they are rapidly adapting to health care contexts to provide improved medical services for citizens. However, contrary to expectations, their rapid adoption appears to have led to health inequities, with differences in health conditions or inequality in the distribution of health care resources among different populations. Objective This scoping review aims to identify and describe the inequities of health care services brought about by the adoption of digital health technologies. The factors influencing such inequities, as well as the corresponding countermeasures to ensure health equity among different groups of citizens, were also studied. Methods Primary studies and literature, including articles and reviews, published in English between 1990 and 2020 were retrieved using appropriate search strategies across the following three electronic databases: Clarivate Analytics’ Web of Science, PubMed, and Scopus. Data management was performed by two authors (RY and WZ) using Thomson Endnote (Clarivate Analytics, Inc), by systematically screening and identifying eligible articles for this study. Any conflicts of opinion were resolved through discussions with the corresponding author. A qualitative descriptive synthesis was performed to determine the outcomes of this scoping review. Results A total of 2325 studies were collected during the search process, of which 41 (1.76%) papers were identified for further analysis. The quantity of literature increased until 2016, with a peak in 2020. The United States, the United Kingdom, and Norway ranked among the top 3 countries for publication output. Health inequities caused by the adoption of digital health technologies in health care services can be reflected in the following two dimensions: the inability of citizens to obtain and adopt technology and the different disease outcomes found among citizens under technical intervention measures. The factors that influenced inequities included age, race, region, economy, and education level, together with health conditions and eHealth literacy. Finally, action can be taken to alleviate inequities in the future by government agencies and medical institutions (eg, establishing national health insurance), digital health technology providers (eg, designing high-quality tools), and health care service recipients (eg, developing skills to access digital technologies). Conclusions The application of digital health technologies in health care services has caused inequities to some extent. However, existing research has certain limitations. The findings provide a comprehensive starting point for future research, allowing for further investigation into how digital health technologies may influence the unequal distribution of health care services. The interaction between individual subjective factors as well as social support and influencing factors should be included in future studies. Specifically, access to and availability of digital health technologies for socially disadvantaged groups should be of paramount importance.
A biochemistry course is a fundamental but important subject in medical education in China. In recent years, the number of international medical students has increased. Curriculum reform in biochemistry teaching is needed because of the knowledge limitations of students, a close linkage of biochemical content with clinics, the shortcomings of lecture-centered teaching, and the requirements for early clinical practice training and competence. In this study, we analyzed a novel curriculum reform, "Hybrid-PBL," which combined problem-based learning (PBL) with biochemistry lectures and was implemented for biochemical teaching at Dalian Medical University (DMU) in China. The change in curriculum affected 189 international medical students. This study selected two PBL cases concerning the basic biochemical issues of carbohydrate metabolism and liver biochemistry for the analysis, and ten examples of learning issues for each case were reported by the international students. A questionnaire was utilized to evaluate students' perceptions of the Hybrid-PBL, and examination scores were analyzed to assess the curriculum reform in biochemistry teaching. A statistical analysis revealed that the Hybrid-PBL curriculum was well accepted by the international students as an effective supplement to lecture-centered teaching programs. The students obtained more abilities, higher examination scores, and an improved understanding of biomedical information from the Hybrid-PBL program than from conventional teaching methods. Our study was an innovative trial that applied a PBL curriculum to the specific discipline of biochemistry and may provide a potential and promising new teaching method that can be widely utilized. © 2017 by The International Union of Biochemistry and Molecular Biology, 45(4):336-342, 2017.
Sensitivity to DNase I digestion is an indicator of the accessibility and configuration of chromatin in eukaryotic genomes. Open chromatin exhibits high sensitivity to DNase I cleavage. DNase I hypersensitive sites (DHSs) in eukaryotic genomes can be identified through DNase I treatment followed by sequencing (DNase-seq). DHSs are most frequently associated with various cis-regulatory DNA elements, including promoters, enhancers, and silencers in both animal and plant genomes. Genome-wide identification of DHSs provides an efficient method to interpret previously un-annotated regulatory DNA sequences. In this review, we provide an overview of the historical perspective of DHS research in eukaryotes. We summarize the main achievements of DHS research in model animal species and review the recent progress of DHS research in plants. We finally discuss possible future directions of using DHS as a tool in plant genomics research.
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