Development of an explicit and implicit knowledge identification tool for the analysis of the decision-making process of traditional Asian medicine doctors

Background and objectives: While pattern identification (PI) is an essential process for diagnosis and treatment in traditional Asian medicine (TAM), it is difficult to objectify since it relies heavily on implicit knowledge. Here, we propose a machine learning-based analysis tool to objectify and evaluate the clinical decision-making process of PI in terms of explicit and implicit knowledge. Methods: Clinical data for the development of the analysis tool were collected using a questionnaire administered to allergic rhinitis (AR) patients and the diagnosis and prescription results of TAM doctors based on the completed AR questionnaires. Explicit knowledge and implicit knowledge were defined based on the explicit and implicit importance scores of the AR questionnaire, which were obtained through doctors′ explicit scoring and feature evaluations of machine learning models, respectively. The analysis tool consists of eight evaluation indicators used to compare, analyze and visualize the explicit and implicit knowledge of TAM doctors. Results: The analysis results for 8 doctors showed that our tool could successfully identify explicit and implicit knowledge in the PI process. We also conducted a postquestionnaire study with the doctors who participated to evaluate the applicability of our tool. Conclusions: This study proposed a tool to evaluate and compare decision-making processes of TAM doctors in terms of their explicit and implicit knowledge. We identified the differences between doctors′ own explicit and implicit knowledge and the differences among TAM doctors. The proposed tool would be helpful for the clinical standardization of TAM, doctors′ own clinical practice, and intern/resident training.

The Association between Facial Morphology and Cold Pattern

Objectives: Facial diagnosis is an important part of clinical diagnosis in traditional East Asian Medicine. In this paper, using a fully automated facial shape analysis system, we show that facial morphological features are associated with cold pattern.Methods: The facial morphological features calculated from 68 facial landmarks included the angles, areas, and distances between the landmark points of each part of the face. Cold pattern severity was determined using a questionnaire and the cold pattern scores (CPS) were used for analysis. The association between facial features and CPS was calculated using Pearson's correlation coefficient and partial correlation coefficients.Results: The upper chin width and the lower chin width were negatively associated with CPS. The distance from the center point to the middle jaw and the distance from the center point to the lower jaw were negatively associated with CPS. The angle of the face outline near the ear and the angle of the chin line were positively associated with CPS. The area of the upper part of the face and the area of the face except the sensory organs were negatively associated with CPS. The number of facial morphological features that exhibited a statistically significant correlation with CPS was 37 (unadjusted).Conclusions: In this study of a Korean population, subjects with a high CPS had a more pointed chin, longer face, more angular jaw, higher eyes, and more upward corners of the mouth, and their facial sensory organs were relatively widespread.

Understanding the experiences and perception of people living with HIV on integrative traditional East Asian medicine management in Korea: an interview protocol for qualitative research

IntroductionPatients with HIV/AIDS have been able to experience the average life expectancy of the general population due to medical advancements. However, they face physical, emotional and social difficulties that worsen their quality of life. The pharmacological approach is often the first choice to address these issues, but it involves some limitations. Integrative traditional East Asian medicine (ITEAM) can compensate for the limitations of drugs and can be applied to treat physiological and psychiatric problems. In Korea, ITEAM interventions are easily accessible under the government insurance. However, the experiences, perceptions and barriers to the use of ITEAM in patients with HIV/AIDS are less studied. Therefore, we will interview them to explore their experiences and examine the strengths, limitations, barriers and improvements in the use of ITEAM.Methods and analysisThis is a qualitative study using a phenomenological framework. We will conduct one-to-one interviews with 3–10 patients with HIV/AIDS who have been treated with ITEAM from March 2021 to January 2022. We will present semistructured open-ended questions and analyse them using experiential phenomenological research methods. The results will be reported in accordance with the Consolidated Criteria for Reporting Qualitative Studies.Ethics and disseminationThis research was approved by the Institutional Review Board of the National Medical Center (IRB number, NMC-2101-008). The results of this study will be disseminated through journal articles, newspapers and conference proceedings.Trial registration numberClinical Research Information Service: KCT0005855; Pre-results.

Products of Sericulture and Their Hypoglycemic Action Evaluated by Using the Silkworm, Bombyx mori (Lepidoptera: Bombycidae), as a Model

Sericulture generates different natural products with potential medical applications. Silk peptides, worms, or even pupae are commonly employed in traditional Asian medicine with a wide variety of purposes, and some scientific work has been focused on their antidiabetic properties. This work evaluates the postprandial antihyperglycemic activity of fibroin, sericin, and powder made from either larvae or pupae of silkworms, and Bombyx mori L. (Lepidoptera: Bombycidae), employing the silkworm itself as an animal model. The results indicate a reduction in the glucose levels in hemolymph after sucrose or glucose-induced hyperglycemia when these products are included in the diet of the worms.

Comparing scientific worldviews between allopathic medical degree and East Asian medicine degree students utilizing the thinking about science survey instrument (TSSI)

Background Integrative medicine has become a new healthcare model due to the growing evidence base for complementary and integrative therapies. However, some question whether complementary and integrative therapies can truly be integrated with biomedicine due to differences in underlying paradigms and theoretical bases. This study aimed to explore differences in scientific worldviews between students studying East Asian medicine and those completing an allopathic medical degree using the validated Thinking about Science Survey Instrument (TSSI). Methods 122 medical students from Albert Einstein College of Medicine (Einstein) and 48 East Asian medicine students from the Pacific College of Health and Science (Pacific College) participated in this study. Participants completed the TSSI, a 60-item Likert-scale instrument that quantitatively measures the sociocultural resistance to, and support for science. Item and category means were compared between each group using an independent sample t-test. Results Distinct differences were seen between the two groups of students with regard to age, gender distribution and prior education. Einstein students were generally supportive of science and Pacific College students were generally supportive of/positively neutral to science. Einstein students more strongly affirmed the relationship of science in relation to the categories of Epistemology, Public Health, Emotion and Aesthetics, the Economy, and Public Policy. Pacific College students more strongly affirmed the relationship between science and the category Race and Gender. There were no differences in the categories of Environment and Resource, Science for All, and Religion and Morality. Conclusion This study suggests that there are differences underlying the scientific worldviews of Einstein and Pacific College students, particularly with regard to Epistemology and Public Health. Such differences may be related to the different theoretical knowledge bases and ways of viewing health within the two disciplines. Despite demographic and educational differences between the two groups their overall scientific worldviews were similar with neither group expressing disparate views. This suggests that both groups may be receptive to the value of other paradigms. Providing courses that focus on different therapeutic approaches and paradigms during medical training may foster interprofessional understanding and collaborative practice between health professionals of different medical disciplines.

Fighting Medical Racism with Education and Action

Denise Tyson is the president of the Maryland Acupuncture Society (US), one of the state-level professional organizations that comprises the American Society of Acupuncturists. Following the police murder of George Floyd on May 25, 2020, she called on her colleagues in the acupuncture profession to take meaningful action against racism and to educate themselves about the long history of racist violence against African Americans. In July 2020 an editor of Asian Medicine interviewed Tyson to learn about her medical career and her perspectives on race and health care. The main themes of the interview include: her affinity for acupuncture and Chinese medicine, her experiences with racial bias in both biomedicine and integrative medicine, strategies for making acupuncture organizations more inclusive, and the crucial role that education plays in combating racism.

Black Lives and Asian Medicine

This essay examines the intersections between Asian medicines, racial healthcare inequities, and social justice movements, and explains how they are illuminated by the interviews and essays in this special issue. Important themes include: how the protests following the murder of George Floyd in May 2020 spurred US organizations of alternative, complementary, and integrative medicine to undertake antiracist initiatives; how acupuncturists have been working to properly acknowledge the contributions of African American practitioners in their historical narratives; and how acupuncture may be a useful tool for mitigating racial health disparities.

Acupuncture, the Black Panther Party, and People’s Medicine

Tolbert Small (b. 1943) is a physician and civil rights activist best known for his advocacy for research on sickle cell anemia. In the summer of 2020 two of Asian Medicine’s editors, Daniel Burton-Rose and Yi-Li Wu, interviewed Small about his clinical career of more than fifty years. The interview focuses on Small’s experience with acupuncture, the practice of Chinese medicine in the United States, and his commitment to social justice. Small was introduced to acupuncture in 1972 as a member of a delegation of the Black Panther Party to the People’s Republic of China, and he incorporated it into his clinical practice upon his return to Oakland, California. Small began practicing acupuncture at a time when instructional materials and therapeutic implements were difficult to obtain. He witnessed the gradual mainstreaming of Chinese medicine in the United States, accompanied by problems of differential access based on race and income.

Community Medicine as Racial Justice

Tenisha Dandridge is a cofounder and the current president of the Black Acupuncturist Association (US). She advocates using Chinese medicine and acupuncture to address the racial health disparities afflicting African Americans. In June 2020 an editor of Asian Medicine interviewed her about her career and medical activism. The main themes of the interview include: how racial bias results in disproportionately high rates of morbidity and mortality among African Americans; how the theories and therapies of Chinese medicine are well suited for addressing the psychophysiological harms caused by racial discrimination; why it is important to increase Black representation in the acupuncture profession; and how community-based modes of healing can expand African Americans’ interest in, access to, and utilization of acupuncture and ear seed acupressure.