Search results for: medical interpreting

Authors: O. Kahraman, M. S. Alatas, O. B. Citil

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In determination of values of feeds which, are used in ruminant nutrition, different methods are used like in vivo, in vitro, in situ or in sacco. Generally, the most reliable results are taken from the in vivo studies. But because of the disadvantages like being hard, laborious and expensive, time consuming, being hard to keep the experiment conditions under control and too much samples are needed, the in vitro techniques are more preferred. The most widely used in vitro techniques are two-staged digestion technique and gas production technique. In vitro gas production technique is based on the measurement of the CO2 which is released as a result of microbial fermentation of the feeds. In this review, the factors affecting the results obtained from in vitro gas production technique (Hohenheim Feed Test) were discussed. Some factors must be taken into consideration when interpreting the findings obtained in these studies and also comparing the findings reported by different researchers for the same feeds. These factors were discussed in 3 groups: factors related to animal, factors related to feeds and factors related with differences in the application of method. These factors and their effects on the results were explained. Also it can be concluded that the use of in vitro gas production technique in feed evaluation routinely can be contributed to the comprehensive feed evaluation, but standardization is needed in this technique to attain more reliable results.

Keywords: In vitro, gas production technique, Hohenheim feed test, standardization

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Authors: Hanna Teklu Gebregziabher

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Background: A variety of techniques for medical termination of second-trimester pregnancy can be used, but there is no consensus about which is the best. Even though most evidence suggests the combined use of intracervical Foley catheter and vaginal misoprostol is safe, effective, and acceptable method for termination of second-trimester pregnancy, which is comparable to mifepristone-misoprostol combination regimen with lower cost and no additional maternal risks. The use of mifepristone and misoprostol alone with no other procedure is still the most common procedure in different institutions for 2nd-trimester pregnancy. Methods: A cross-sectional comparative prospective study design is employed on women who were admitted for 2nd-trimester medical abortion and medical abortion failed or if there was no change in cervical status after 24 hours of 1st dose of misoprostol. The study was conducted at St. Paulose Hospital Millennium Medical College. A sample of 44 participants in each arm was necessary to give a two-tailed test, a type 1 error of 5%, 80% statistical power, and a 1:1 ratio among groups. Thus, a total of 94 cases, 47 from each arm, were recruited. Data was entered and cleaned by using Epi-info and analyzed using SPSS version 29.0 statistical software and was presented in descriptive and tabular forms. Different variables were cross-tabulated and compared for significant differences and statistical analysis using the chi-square test and independent t-test, to conclude. Result: There was a significant difference between the two groups on induction to expulsion time and number of doses used. The mean ± SD of induction to expulsion time for those used misoprostol alone was 48.09 ± 11.86 and those who used trans-cervical catheter sequentially with misoprostol were 36.7 ±6.772. Conclusion: The use of a trans-cervical Foley catheter in conjunction with misoprostol in a sequential manner is a more effective, safe, and easily accessible procedure. In addition, the cost of utilizing the catheter is less compared to the cost of misoprostol and is readily available. As a good substitute, we advised using Trans-cervical Catether even for medical abortions performed in the second trimester.

Keywords: second trimester, medical abortion, catheter, misoprostol

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Authors: Zarini Ismail, Nurul Azmawati Mohamed, Shalinawati Ramli, Nurul Hayati Chamhuri, Nur Syahrina Rahim, Khairani Omar

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Choosing a career is one of the most important decisions that people have to make in life. While choosing a suitable career, a person cannot ignore their intrinsic traits such as the type of personality, interests, values, and aptitude. The objective of this study is to ascertain the personality of the pre-clinical medical students and their reasons or intentions for choosing medicine as a career. This study is a cross-sectional study involving Year 3 pre-clinical medical students at Universiti Sains Islam Malaysia. Participants were given a set of validated questionnaires on demographic data and open-ended questions for reasons of choosing medicine. Thematic analysis were used to analyse the open-ended question. The Participants were also required to answer a Career Interest Questionnaire (based on Holland’s Theory). A total of 81 Year 3 medical students were involved in this study. About two third (69%) of them were female and their age ranged from 20 to 21 years old. The majority of them were from middle-income families. From the thematic analysis, there were several reasons given for choosing medicine by the students. The majority of the students stated that it was their passion and interest in the medical field (45.7%). Approximately 24.7% decided to take the medical course because of parents/family influenced and 19.8% mentioned that they wanted to help the society. Other themes emerged were jobs opportunity in future (1.2%) and influenced by friends (3.7%). Based on Holland’s theory, ideally to become a good medical doctor one should score high in investigative and social personality trait. However, 26.3% of the students had low scores in these personality traits. We then looked into the reasons given by these students for choosing medicine. Approximately 28% were due to parents/family decision while 52% admitted that it was due to their interest. When compared with the group of students with high personality scores (investigative and social), there was not much difference in the reasons given for choosing medicine. The main reasons given by the students for choosing medicine were own interest, family’s influence and to help others. However, a proportion of them had low scores in the personality traits which are relevant for medicine. Although some of these students admitted that they choose medicine based on their interest, their strength might not be suitable for their chosen carrier.

Keywords: career, medical students, medicine, personality

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Authors: Gorkem Algan, Ilkay Ulusoy, Saban Gonul, Banu Turgut, Berker Bakbak

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Computer vision systems recently made a big leap thanks to deep neural networks. However, these systems require correctly labeled large datasets in order to be trained properly, which is very difficult to obtain for medical applications. Two main reasons for label noise in medical applications are the high complexity of the data and conflicting opinions of experts. Moreover, medical imaging datasets are commonly tiny, which makes each data very important in learning. As a result, if not handled properly, label noise significantly degrades the performance. Therefore, a label-noise-robust learning algorithm that makes use of the meta-learning paradigm is proposed in this article. The proposed solution is tested on retinopathy of prematurity (ROP) dataset with a very high label noise of 68%. Results show that the proposed algorithm significantly improves the classification algorithm's performance in the presence of noisy labels.

Keywords: deep learning, label noise, robust learning, meta-learning, retinopathy of prematurity

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Authors: Yujie Zhang

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There are debates around the legitimacy of capital punishment, i.e., whether death could serve as a proper execution in our legal system or not. Different arguments have been raised. However, none of them seem able to provide a determined answer to the issue; this results in a lack of instruction in the legal practice. This article, therefore, devotes itself to the effort to find such an answer. It takes the perspective of rights, through interpreting the concept of right to life, which capital punishment appears to be in confliction with in the two traditional approaches, to reveal a possibly best account of the right and its conclusion on capital punishment. However, this effort is not a normative one which focuses on what ought to be. It means the article does not try to work out which argument we should choose and solve the hot debate on whether capital punishment should be allowed or not. It, again, does not propose which perspective we should take to approach this issue or generally which account of right must be better; rather, it is more a thought experiment. It attempts to raise a new perspective to approach the issue of the legitimacy of capital punishment. Both its perspective and conclusion therefore are tentative: what if we view this issue in a way we have never tried before, for example the different accounts of right to life? In this sense, the perspective could be defied, while the conclusion could be rejected. Other perspectives and conclusions are also possible. Notwithstanding, this tentative perspective and account of the right still could not be denied from serving as a potential approach, since it does have the ability to provide us with a determined attitude toward capital punishment that is hard to achieve through existing arguments.

Keywords: capital punishment, right to life, theories of rights, the choice theory

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Authors: Vichayada Laohapiboolkul

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Introduction: As the legal use of cannabis is being widely accepted throughout the world, medical cannabis has been explored in order to become an alternative cure for patients. Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are natural cannabinoids found in the Cannabis plant which is proved to have positive treatment for various diseases and symptoms such as chronic pain, neuropathic pain, spasticity resulting from multiple sclerosis, reduce cancer-associated pain, autism spectrum disorders (ASD), dementia, cannabis and opioid dependence, psychoses/schizophrenia, general social anxiety, posttraumatic stress disorder, anorexia nervosa, attention-deficit hyperactivity disorder, and Tourette's disorder. Regardless of all the medical benefits, THC, if not metabolized, can lead to mild up to severe adverse drug reactions (ADR). The enzyme CYP2C19 was found to be one of the metabolizers of THC. However, the suballele CYP2C19*2 manifests as a poor metabolizer which could lead to higher levels of THC than usual, possibly leading to various ADRs. Objective: The aim of this study was to investigate the distribution of CYP2C19, specifically CYP2C19*2, genes in Thai patients treated with medical cannabis along with adverse drug reactions. Materials and Methods: Clinical data and EDTA whole blood for DNA extraction and genotyping were collected from patients for this study. CYP2C19*2 (681G>A, rs4244285) genotyping was conducted using the Real-time PCR (ABI, Foster City, CA, USA). Results: There were 42 medical cannabis-induced ADRs cases and 18 medical cannabis tolerance controls who were included in this study. A total of 60 patients were observed where 38 (63.3%) patients were female and 22 (36.7%) were male, with a range of age approximately 19 - 87 years. The most apparent ADRs for medical cannabis treatment were dry mouth/dry throat (76.7%), followed by tachycardia (70%), nausea (30%) and a few arrhythmias (10%). In the total of 27 cases, we found a frequency of 18 CYP2C19*1/*1 alleles (normal metabolizers, 66.7%), 8 CYP2C19*1/*2 alleles (intermediate metabolizers, 29.6%) and 1 CYP2C19*2/*2 alleles (poor metabolizers, 3.7%). Meanwhile, 63.6% of CYP2C19*1/*1, 36.3% and 0% of CYP2C19*1/*2 and *2/*2 in the tolerance controls group, respectively. Conclusions: This is the first study to confirm the distribution of CYP2C19*2 allele and the prevalence of poor metabolizer genes in Thai patients who received medical cannabis for treatment. Thus, CYP2C19 allele might serve as a pharmacogenetics marker for screening before initiating treatment.

Keywords: medical cannabis, adverse drug reactions, CYP2C19, tetrahydrocannabinol, poor metabolizer

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Authors: Waleed Mandour

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This study presents multidimensional scrutiny of Benson et al.’s seven-category taxonomy of lexical collocations used by Egyptian medical authors and their peers of native-English speakers. It investigates 212 medical papers, all published during a span of 6 years (from 2013 to 2018). The comparison is held to the medical research articles submitted by native speakers of English (25,238 articles in total with over 103 million words) as derived from the Directory of Open Access Journals (a 2.7 billion-word corpus). The non-native speakers compiled corpus was properly annotated and marked-up manually by the researcher according to the standards of Weisser. In terms of statistical comparisons, though, deployed were the conventional frequency-based analysis besides the relevant criteria, such as association measures (AMs) in which LogDice is deployed as per the recommendation of Kilgariff et al. when comparing large corpora. Despite the terminological convergence in the subject corpora, comparison results confirm the previous literature of which the non-native speakers’ compositions reveal limited ranges of lexical collocations in terms of their distribution. However, there is a ubiquitous tendency of overusing the NS-high-frequency multi-words in all lexical categories investigated. Furthermore, Egyptian authors, conversely to their English-speaking peers, tend to embrace more collocations denoting quantitative rather than qualitative analyses in their produced papers. This empirical work, per se, contributes to the English for Academic Purposes (EAP) and English as a Lingua Franca in Academic settings (ELFA). In addition, there are pedagogical implications that would promote a better quality of medical research papers published in Egyptian universities.

Keywords: corpus linguistics, EAP, ELFA, lexical collocations, medical discourse

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Authors: Thuvanan Borvornvitchotikarn, Werasak Kurutach

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Mutual information (MI) is widely used in medical image registration. In the different medical images analysis, it is difficult to choose an optimal bins size number for calculating the probability distributions in MI. As the result, this paper presents a new adaptive bins number selection approach that named a hybrid EMPCA-Scott approach. This work combines an expectation maximization principal component analysis (EMPCA) and the modified Scott’s rule. The proposed approach solves the binning problem from the various intensity values in medical images. Experimental results of this work show the lower registration errors compared to other adaptive binning approaches.

Keywords: mutual information, EMPCA, Scott, probability distributions

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Authors: Rakan Alajmi, Rahaf Alnazzawi, Yara Aljefri, Abdullah Alafif, Ali Alraddadi, Awadh Alamri

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Background: The distribution of physicians in different specialties across Saudi Arabia is determined by the career choices of medical students. Dermatology residency program is one of the highly competitive programs here in Saudi Arabia. Assessing and understanding the factors perceived to be attractive in choosing dermatology will aid the directors of the specialty programs to plan for a more balanced workforce distribution to better suit the needs of the specialties. Aim: The aim of our study is to determine and assess the factors perceived to be significantly attractive when choosing dermatology as a future specialty. Methods: The study is a cross-sectional study conducted in King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia. A validated questionnaire was sent electronically to clinical year medical students. In addition to the questionnaire, gender, grade point average, preferred specialty, and other socio-demographic data were assessed. Results: A total of 121 clinical years medical students completed the questionnaire, 8 (6.6%) preferred dermatology as a specialty. 76 (62.8%) of the participants score a grade point average of more than 4.5 and 83 students (68.6%) chose their specialty during clinical years. The appeal of being a dermatologist (P= 0.047), the portrayal of different specialities in the media (P= 0.005), and the likelihood that dermatologists can influence patients’ lives (P=0.010) were shown to be significantly attractive factors. Conclusion: There are many factors that are affecting students’ choices when choosing a medical specialty. The appeal of being a dermatologist, the portrayal of different specialities in the media, and the likelihood that dermatologists can influence patients’ lives were shown to be significantly attractive factors when choosing dermatology as a future specialty. Recognizing medical students’ specialty perception will lead them to a proper specialty tailored to their needs.

Keywords: dermatology, career choice, medical specialties, student's perception

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Authors: Samaneh Abolli, Mahdi Ahmadi Nasab, Kamyar Yaghmaeian, Mahmood Alimohammadi

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The quality of drinking water, in addition to the presence of physicochemical parameters, depends on the type and geographical location of water sources. In this study, groundwater quality was investigated by sampling total dissolved solids (TDS), electrical conductivity (EC), total hardness (TH), Cl, Ca²⁺, and Mg²⁺ parameters in 13 sites, and 40 water samples were sent to the laboratory. Electrometric, titration, and spectrophotometer methods were used. In the next step, the water quality index (WQI) was used to investigate the impact and weight of each parameter in the groundwater. The results showed that only the mean of magnesium ion (40.88 mg/l) was lower than the guidelines of World Health Organization (WHO). Interpreting the WQI based on the WHO guidelines showed that the statuses of 21, 11, and 7 samples were very poor, poor, and average quality, respectively, and one sample had excellent quality. Among the studied parameters, the means of EC (2,087.49 mS/cm) and Cl (1,015.87 mg/l) exceeded the global and national limits. Classifying water quality of TH was very hard (87.5%), hard (7.5%), and moderate (5%), respectively. Based on the geographical distribution, the drinking water index in sites 4 and 11 did not have acceptable quality. Chloride ion was identified as the responsible pollutant and the most important ion for raising the index. The outputs of statistical tests and Spearman correlation had significant and direct correlation (p < 0.05, r > 0.7) between TDS, EC, and chloride, EC and chloride, as well as TH, Ca²⁺, and Mg²⁺.

Keywords: water quality index, groundwater, chloride, GIS, Garmsar

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Authors: Manal Rauf

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Trained medical practitioners are produced from medical colleges serving in public and private sectors. Prime responsibility of teaching faculty is to inculcate required work ethic among the students by serving as role models for them. It is an observed fact that classroom incivility behaviours are providing a friction in achieving these targets. Present study aimed at identification of classroom incivility behaviours observed by teachers and students of public and private medical colleges as per Glasser’s Choice Theory, making a comparison and investigating the strategies being adopted by teachers of both sectors to control undesired class room behaviours. Findings revealed that a significant difference occurs between teacher and student incivility behaviours. Public sector teacher focussed on survival as a strong factor behind in civil behaviours whereas private sector teachers considered power as the precedent for incivility. Teachers of both sectors are required to use verbal as well as non-verbal immediacy to reach a healthy leaning environment.

Keywords: classroom incivility behaviour, glasser choice theory, Mehrabian immediacy theory

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Authors: Yoko Yamada, Chizumi Yamada

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Narrative psychology is based on the dialogical relationship between self and other. The dialogue can consist of divided, competitive, or opposite communication between self and other. We constructed models of coexistent dialogue in which self and other were positioned side by side and communicated sympathetically. We propose new mediation models for narrative relationships. The mediation models are based on triadic relationships that incorporate a medium or a mediator along with self and other. We constructed three types of mediation model. In the first type, called the “Joint Attention Model”, self and other are positioned side by side and share attention with the medium. In the second type, the “Triangle Model”, an agent mediates between self and other. In the third type, the “Caring Model”, a caregiver stands beside the communication between self and other. We apply the three models to the illness narratives of medical professionals and patients. As these groups have different views and experiences of disease or illness, triadic mediation facilitates the ability to see things from the other person’s perspective and to bridge differences in people’s experiences and feelings. These models would be useful for medical education in various situations, such as in considering the relationships between senior and junior doctors and between old and young patients.

Keywords: illness narrative, mediation, psychology, model, medical education

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Authors: Christopher Muhawe, Masooda Bashir

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With increased Internet Communication Technology(ICT), the virtual world has become the new normal. At the same time, there is an unprecedented collection of massive amounts of data by both private and public entities. Unfortunately, this increase in data collection has been in tandem with an increase in data misuse and data breach. Regrettably, the majority of data breach and data misuse claims have been unsuccessful in the United States courts for the failure of proof of direct injury to physical or economic interests. The requirement to express data privacy harms from an economic or physical stance negates the fact that not all data harms are physical or economic in nature. The challenge is compounded by the fact that data breach harms and risks do not attach immediately. This research will use a descriptive and normative approach to show that not all data harms can be expressed in economic or physical terms. Expressing privacy harms purely from an economic or physical harm perspective negates the fact that data insecurity may result into harms which run counter the functions of privacy in our lives. The promotion of liberty, selfhood, autonomy, promotion of human social relations and the furtherance of the existence of a free society. There is no economic value that can be placed on these functions of privacy. The proposed approach addresses data harms from a psychological and social perspective.

Keywords: data breach and misuse, economic harms, privacy harms, psychological harms

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Authors: S. Bahadır Yüksel, Alptuğ Ünal

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The composite shear walls (CSW) with steel encased profiles can be used as lateral-load resisting systems for buildings that require considerable large lateral-load capacity. The aim of this work is to propose the experimental work conducted on CSW having L section folded plate (L shape steel made-up sections) as longitudinal reinforcement in boundary regions. The study in this paper present the experimental test conducted on CSW having L section folded plate as longitudinal reinforcement in boundary regions. The tested 1/3 geometric scaled CSW has aspect ratio of 3.2. L-shape structural steel materials with 2L-19x57x7mm dimensions were placed in shear wall boundary zones. The seismic behavior of CSW test specimen was investigated by evaluating and interpreting the hysteresis curves, envelope curves, rigidity and consumed energy graphs of this tested element. In addition to this, the experimental results, deformation and cracking patterns were evaluated, interpreted and suggestions of the design recommendations were proposed.

Keywords: shear wall, composite shear wall, boundary reinforcement, earthquake resistant structural design, L section

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Authors: Ali Akbar Zeinali

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Lack of appropriate equivalences for the terms or technical words is the result of ineffective translation guidelines adopted in the translation processes. The increasing number of foreign words and specific terms incorporated into the native language are due to the ongoing development of technology and science. Many problems appear in medical translation when the Persian translators try to employ non-Persian or imported words in medical texts, in which multiple equivalents may be created for one particular word based on the individual preferences of authors and translators in the target language due to lack of standardization. The study attempted to discuss the findings based on the compatibility of the international naming criteria, considering the translation procedures. About 67% of 339 equivalents under this study were grouped as incompatible words while about 33% of them were compatible terms. The similarities and differences were investigated and discussed according to the compatibility status of the equivalents with Sager’s criteria. Such equivalents have been classified into several groups through bi-dimensional descriptions that were different features of translation procedures related to the international naming criteria. In review of the frequency distribution of compatibilities, the equivalents were divided into two categories of compatibles and incompatibles, indicating the effectiveness of the applied translation procedures.

Keywords: linguistics, medical translation, naming, terminology

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Authors: En-Tzu Wang, Ting-Ann Wang, Yi-Hui Shen, Yu-Min Chou, Chi-Tai Fang, Chin-Hui Yang

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Background and purpose: A mass varicella immunization program was established to provide free 1-dose vaccination for all 1-year-old children throughout Taiwan since 2004. The epidemiological characteristics and disease burden of varicella from 2000 to 2012 was investigated and the results will be essential to refine the national immunization policy. Method: We included patients (n = 17,838–164,245) with ICD-9-CM codes 052 (chickenpox) from the 2000 to 2012 National Health Insurance Database. The age, period, and cohort-specific incidence of varicella were calculated. The hospital admission rate, medical costs and indirect costs from the societal perspective of varicella including travel costs to the medical facility, registration fee, productivity losses of the patients and caregivers were also estimated. Result: There were 979,252 patients for medical treatment due to varicella from 2000 to 2012 in Taiwan. The implementation of a routine childhood varicella vaccination program has resulted in 87% decline in morbidity (881.49 to 115.17 per 100,000). The average age of patients increased from 7.9 years to 16.3 years. The overall varicella-related hospital admission rate was 15.5 per 1000 patients, and peaked in the groups of infants younger than 1 year, adults aged from 20 to 39 years and elders over 70 years. Among patients admitted to hospital, 33.5% of them had one or more complications. Patients with underlying diseases had higher admission rate (241.6 per 1,000) and longer duration of hospital stay (6.61 days vs. 4.76 days). The annual varicella-related medical expense declined after 2002 and the proportion of medical costs for admission has increased to 42%. The annual indirect costs from the societal perspective of varicella were 5.29 to 9.63 times higher than varicella-related medical costs. Every one dollar invested in the varicella immunization program, 2.97 dollars of medical and social costs were saved on average. Conclusion: The dramatic decline in morbidity, hospitalization, medical and social costs of varicella can be directly attributed to the implementation of the mass immunization program. Two-dose vaccination is recommended for both children with underlying diseases and susceptible adults to prevent serious complications and hospitalizations.

Keywords: disease burden, epidemiology, medical and social costs, varicella, varicella vaccine

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Authors: Akshay A. Pandya, B. R. Parekh

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This paper presents how earth fault damage in the transformer can be detected by Sweep Frequency Response Analysis (SFRA). The test methods used by the authors for presenting the results are described. The power transformer of rating 10 KVA, 11000 V/440 V, 3-phase, 50 Hz, Dyn11 has been specially developed in-house for carrying out SFRA testing by practically simulated various transformer damages on it. Earth fault has been practically simulated on HV “U” phase winding and LV “W” phase winding separately. The result of these simulated faults are presented and discussed. The motivation of this presented work is to extend the guideline approach; there are ideas to organize database containing collected measurement results. Since the SFRA interpretation is based on experience, such databases are thought to be of great importance when interpreting SFRA response. The evaluation of the SFRA responses against guidelines and experience have to be performed and conclusions regarding usefulness of each simulation has been drawn and at last overall conclusion has also been drawn.

Keywords: earth fault damage, power transformer, practical simulation, SFRA traces, transformer damages

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Authors: Sarah P. Wuebbolt, Ashlee N. Sawyer-Mays

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Non-medical prescription and other drug (NMPOD) use has been a significant public health issue for the last few decades, with problematic use increasing among university students more recently. The current study focused on associations between NMPOD use and mental health, well-being, and world beliefs among young adults. Young adults (N=513) completed online questionnaires assessing stress, demographic characteristics, self-esteem, NMPOD use, coping mechanisms, and anxiety. A substantial portion of participants reported using cannabis (48.5%, n=249), while smaller portions of participants reported using stimulants (26.7%, n = 137), sedatives (17.2%, n=88), opioids (10.8%, n=55), and hallucinogens (14.4%, n=74). Five hierarchical logistic regressions were performed to determine the independent relationships between mental health, well-being, and world belief factors and NMPOD use for the five classes of substances. After controlling for demographic factors (age, gender, race/ethnicity, sexual orientation, and religious affiliation), depression was associated with increased non-medical stimulant, opioid, and cannabis use; coping self-efficacy was associated with increased hallucinogen use, and attendance of worship services was associated with decreased non-medical cannabis and hallucinogen use. Results suggest that depression was strongly associated with non-medical stimulant, opioid, and cannabis use, and attendance of worship services was protective against cannabis and hallucinogen use. To the best of our knowledge, this is one of the first studies to investigate the relationships between mental health, well-being, world beliefs, and NMPOD use among young adults. The present study illuminates future targets for intervention, such as increased access to mental health diagnosis and treatment and the exploration of the roles of religion and shared community in the prevention of drug use among young adults.

Keywords: cannabis, mental health, non-medical prescription and other drug use, world beliefs

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Authors: S. J. Yune, K. H. Park

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The purpose of this study was to understand the experiences of medical students in volunteer activities and to draw implications for medical education. For this purpose, the questionnaire and the reflection essay on the volunteer experience of 54 students in the first year and 57 students in the second year were analyzed and analyzed. As a result, the participation of the students in the volunteer activities was the highest in the first semester and once a month in the second grade. Activities were mostly through volunteer organizations. The essence of the volunteering activities experience revealed through reflection essays was 'I want to avoid with fear' and 'I feel far away' in the recognition before volunteering activities. In terms of knowledge after participating in volunteer activities, 'breaking eggs and getting to know the world' and 'intellectual growth through social experience' appeared. In terms of attitude, it revealed 'deep reflection on me and others', 'understanding of service life'. And in terms of behavior, 'Begin preparing for a life of service' appeared. The results of this study revealed that volunteering activities provide students with opportunities for growth and development. In order to obtain more meaningful results, consciousness education related to social service should be done in advance.

Keywords: volunteering activity, pre-medical school student, reflection essay, qualitative analysis

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Authors: Mohammad Amin Mozaheb, Mahnaz Saeidi, Saeideh Ahangari, Saeideh Ahangari

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The present genre-driven study aims at comparing moves and sub-moves deployed by Iranian and English medical writers while writing their research articles in English. To obtain the goals of the study, the researchers randomly selected a number of medical articles and compared them using Nwogu (1997)’s model. The results of relevant statistical tests, Chi-square tests for goodness of fit, used for comparing the two groups of the articles dubbed IrISI (Iranian ISI articles) and EISI (English ISI articles) have shown that no significant difference exists between the two groups of the articles in terms of the moves and sub-moves used in the method and results sections of them. The findings can be beneficial for people interested in English for Specific Purposes (ESP) and medical experts. The findings can also increase language awareness and genre awareness among researchers who are interested in publishing their research outcomes in ISI-indexed journals in the Islamic Republic of Iran and some other world countries.

Keywords: writing, ESP, research articles, medical sciences, language, scientific writing

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Authors: Flaviu Mihai Frigura-Lliasa, Andreea Anamaria Anghel, Attila Simo

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Due to the beauty, usefulness, science, constantly changing, constantly evolving features, and most of the time, mystery it involves, nature-based art is seen as a both modern and timeless direction that has been extensively used in design. The goal of the team's activities was to experiment with ways of fusing the two most common contemporary ways of referring to green installations, that is, either in a pure artistic or in an ecological manner, and creating a living, dynamic, interactive installation capable of both receiving and interpreting external factors, such as natural and human stimuli, that would not only determine some of the mechanism's presets. By consequent, a complex experiment made up of various research and project stages was elaborated in order to transform an idea into an actual interactive green installation within months thanks to the interaction, teamwork, and design processes undertaken throughout the academic years by both university lecturers and some of our students. The outcomes would lead to the development of a dynamic artwork called "Modgrew" as well as the introduction of experiment-based learning at the Timisoara Faculty of Architecture and Urban Planning, as well as at the Faculty of Electrical and Power Engineering, for the green wall automation issues.

Keywords: green design, living walls, modular structure, interactive proof of concept

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Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa

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An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavoured to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learner. Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.

Keywords: medical education, clinical education, andragogy, pedagogy

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Authors: Nir Nissim, Erez Shalom, Tomer Lancewiki, Yuval Elovici, Yuval Shahar

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Background: A Medical Device (MD) is an instrument, machine, implant, or similar device that includes a component intended for the purpose of the diagnosis, cure, treatment, or prevention of disease in humans or animals. Medical devices play increasingly important roles in health services eco-systems, including: (1) Patient Diagnostics and Monitoring; Medical Treatment and Surgery; and Patient Life Support Devices and Stabilizers. MDs are part of the medical device eco-system and are connected to the network, sending vital information to the internal medical information systems of medical centers that manage this data. Wireless components (e.g. Wi-Fi) are often embedded within medical devices, enabling doctors and technicians to control and configure them remotely. All these functionalities, roles, and uses of MDs make them attractive targets of cyber-attacks launched for many malicious goals; this trend is likely to significantly increase over the next several years, with increased awareness regarding MD vulnerabilities, the enhancement of potential attackers’ skills, and expanded use of medical devices. Significance: We propose to develop and implement Cyber-Med, a unique collaborative project of Ben-Gurion University of the Negev and the Clalit Health Services Health Maintenance Organization. Cyber-Med focuses on the development of a comprehensive detection framework that relies on a critical attack repository that we aim to create. Cyber-Med will allow researchers and companies to better understand the vulnerabilities and attacks associated with medical devices as well as providing a comprehensive platform for developing detection solutions. Methodology: The Cyber-Med detection framework will consist of two independent, but complementary detection approaches: one for known attacks, and the other for unknown attacks. These modules incorporate novel ideas and algorithms inspired by our team's domains of expertise, including cyber security, biomedical informatics, and advanced machine learning, and temporal data mining techniques. The establishment and maintenance of Cyber-Med’s up-to-date attack repository will strengthen the capabilities of Cyber-Med’s detection framework. Major Findings: Based on our initial survey, we have already found more than 15 types of vulnerabilities and possible attacks aimed at MDs and their eco-system. Many of these attacks target individual patients who use devices such pacemakers and insulin pumps. In addition, such attacks are also aimed at MDs that are widely used by medical centers such as MRIs, CTs, and dialysis engines; the information systems that store patient information; protocols such as DICOM; standards such as HL7; and medical information systems such as PACS. However, current detection tools, techniques, and solutions generally fail to detect both the known and unknown attacks launched against MDs. Very little research has been conducted in order to protect these devices from cyber-attacks, since most of the development and engineering efforts are aimed at the devices’ core medical functionality, the contribution to patients’ healthcare, and the business aspects associated with the medical device.

Keywords: medical device, cyber security, attack, detection, machine learning

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Authors: Mohit Kumar, Mayur Betharia

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Healthcare domain, with the emergence of Electronic Medical Record (EMR), collects a lot of data which have been attracting Data Mining expert’s interest. In the past, doctors have relied on their intuition while making critical clinical decisions. This paper presents the means to analyze the Medical workflows to get business insights out of huge dumped medical databases. Market Basket Analysis (MBA) which is a special data mining technique, has been widely used in marketing and e-commerce field to discover the association between products bought together by customers. It helps businesses in increasing their sales by analyzing the purchasing behavior of customers and pitching the right customer with the right product. This paper is an attempt to demonstrate Market Basket Analysis applications in healthcare. In particular, it discusses the Market Basket Analysis Algorithm ‘Apriori’ applications within healthcare in major areas such as analyzing the workflow of diagnostic procedures, Up-selling and Cross-selling of Healthcare Systems, designing healthcare systems more user-friendly. In the paper, we have demonstrated the MBA applications using Angiography Systems, but can be extrapolated to other modalities as well.

Keywords: data mining, market basket analysis, healthcare applications, knowledge discovery in healthcare databases, customer relationship management, healthcare systems

Procedia PDF Downloads 174

Authors: Usiobaifo Agharese Rosemary, Osaseri Roseline Oghogho

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Diabetes is a complex group of disease with a variety of causes; it is a disorder of the body metabolism in the digestion of carbohydrates food. The application of machine learning in the field of medical diagnosis has been the focus of many researchers and the use of recognition and classification model as a decision support tools has help the medical expert in diagnosis of diseases. Considering the large volume of medical data which require special techniques, experience, and high diagnostic skill in the diagnosis of diseases, the application of an artificial intelligent system to assist medical personnel in order to enhance their efficiency and accuracy in diagnosis will be an invaluable tool. In this study will propose a diabetes diagnosis model using rough set and K-nearest Neighbor classifier algorithm. The system consists of two modules: the feature extraction module and predictor module, rough data set is used to preprocess the attributes while K-nearest neighbor classifier is used to classify the given data. The dataset used for this model was taken for University of Benin Teaching Hospital (UBTH) database. Half of the data was used in the training while the other half was used in testing the system. The proposed model was able to achieve over 80% accuracy.

Keywords: classifier algorithm, diabetes, diagnostic model, machine learning

Procedia PDF Downloads 336

Authors: Sonika Raj, Amarjeet Singh, Vijay Lakshmi Sharma

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Introduction: In 21st century, due to revolution in Information and Communication Technologies (ICTs), there has been phenomenal development in quality and quantity of knowledge in the field of medical science. So, the access to relevant information to physicians is critical to the delivery of effective healthcare services to patients. The study was conducted to assess the information needs and attitudes of the medical professionals; to determine the sources and channels of information used by them; to ascertain the current usage of ICTs and the barriers faced by them in utilization of ICTs in health information access. Methodology: This descriptive cross-sectional study was carried in 2015 on hundred medical professionals working in public and private sectors of Chandigarh. The study used both quantitative and qualitative method for data collection. A semi structured questionnaire and interview schedule was used to collect data on information seeking needs, access to ICTs and barriers to healthcare information access. Five Data analysis was done using SPSS-16 and qualitative data was analyzed using thematic approach. Results: The most preferred sources to access healthcare information were internet (85%), trainings (61%) and communication with colleagues (57%). They wanted information on new drug therapy and latest developments in respective fields. All had access to computer with but almost half assessed their computer knowledge as average and only 3% had received training regarding usage. Educational status (p=0.004), place of work (p=0.004), number of years in job (p=0.004) and sector of job (p=0.04) of doctors were found to be significantly associated with their active search for information. The major themes that emerged from in-views were need; types and sources of healthcare information; exchange of information among different levels of healthcare providers; usage of ICTs to obtain and share information; barriers to access of healthcare information and quality of health information materials and involvement in their development process Conclusion and Recommendations: The medical professionals need information in their in their due course of work. However, information needs of medical professionals were not being adequately met. There should be training of professional regarding internet skills and the course on bioinformatics should be incorporated in the curricula of medical students. The policy framework must be formulated that will encourage and promote the use of ICTs as tools for health information access and dissemination.

Keywords: health information, ICTs, medical professionals, qualitative

Procedia PDF Downloads 350

Authors: Arash Sepehri bonab

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One of the regions of critical development in medical devices has been the part of the software - as an indispensable component of a therapeutic device, as a standalone device, and more as of late, as applications on portable gadgets. The chance related to a breakdown of the standalone computer program utilized inside healthcare is in itself not a model for its capability or not as a medical device. It is, subsequently, fundamental to clarify a few criteria for the capability of a stand-alone computer program as a medical device. The number of computer program items and therapeutic apps is persistently expanding and so as well is used in wellbeing education (e. g., in clinics and doctors' surgeries) for determination and treatment. Within the last decade, the use of information innovation in healthcare has taken a developing part. In reality, the appropriation of an expanding number of computer devices has driven several benefits related to the method of quiet care and permitted simpler get to social and health care assets. At the same time, this drift gave rise to modern challenges related to the usage of these modern innovations. The program utilized in healthcare can be classified as therapeutic gadgets depending on the way they are utilized and on their useful characteristics. In the event that they are classified as therapeutic gadgets, they must fulfill particular directions. The point of this work is to show a computer program improvement system that can permit the generation of secure and tall, quality restorative gadget computer programs and to highlight the correspondence between each program advancement stage and the fitting standard and/or regulation.

Keywords: medical devices, regulation, software, development, healthcare

Procedia PDF Downloads 108

Authors: Etaf Khlaed Haroun Alkhlaifat

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When doctors and patients do not share the same first language, language barriers may exist, which may have negative effects on the quality of communication and care provided. Doctors’ use of medical jargon and patients’ inability to fully express their illness, to a potential loss of relevant information can often create misunderstanding. This study sought to examine the extent to which a lack of “common” language represents one of the linguistic obstacles that may adversely influence the quality of healthcare services in Jordan. Communication Accommodation Theory (CAT) was used to interpret the phenomena under study. Doctors (n=9) and patients (n=18) were observed and interviewed in natural Jordanian medical settings. A thematic qualitative approach was employed to analyse the data. The preliminary findings of the study revealed that most doctors appeared to have a good sense of appropriate ways to break through communication barriers by changing medical terminologies or jargons into lay terms. However, for some, there were two main challenges: 1) the use of medical jargon in explaining medication and side effects and 2) the lack of patients’ knowledge in providing a full explanation about their illnesses. The study revealed that language barriers adversely affect health outcomes for patients with limited fluency in the English language. It argues that it is doctors’ responsibility to guarantee mutual understanding, educate patients on their condition and improve their health outcomes.

Keywords: communication accommodation theory, doctor-patient interaction, language barrier, medical jargon, misunderstanding

Procedia PDF Downloads 86

Authors: Lucile Rapin, Cynthia El Hage, Rihab Gamaoun, Maria-Fernanda Arboleda, Erin Prosk

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Introduction: Sante Cannabis (SC), a Canadian group of clinics dedicated to medical cannabis, based in Montreal and in the province of Quebec, has served more than 8000 patients seeking cannabis-based treatment over the past five years. As randomized clinical trials with natural medical cannabis are scarce, real-world evidence offers the opportunity to fill research gaps between scientific evidence and clinical practice. Data on the use of medical cannabis products from SC patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to report information on the profiles of both patients and prescribed medical cannabis products at SC clinics, and to assess the safety of medical cannabis among Canadian patients. Methods: This is an observational retrospective study of 1342 adult patients who were authorized with medical cannabis products between October 2017 and September 2019. Information regarding demographic characteristics, therapeutic indications for medical cannabis use, patterns in dosing and dosage form of medical cannabis and adverse effects over one-year follow-up (initial and 4 follow-up (FUP) visits) were collected. Results: 59% of SC patients were female, with a mean age of 56.7 (SD= 15.6, range= (19-97)). Cannabis products were authorized mainly for patients with a diagnosis of chronic pain (68.8% of patients), cancer (6.7%), neurological disorders (5.6%), and mood disorders (5.4 %). At initial visit, a large majority (70%) of patients were authorized exclusively medical cannabis products, 27% were authorized a combination of pharmaceutical cannabinoids and medical cannabis and 3% were prescribed only pharmaceutical cannabinoids. This pattern was recurrent over the one-year follow-up. Overall, oil was the preferred formulation (average over visits 72.5%) followed by a combination of oil and dry (average 19%), other routes of administration accounted for less than 4%. Patients were predominantly prescribed products with a balanced THC:CBD ratio (59%-75% across visits). 28% of patients reported at least one adverse effect (AE) at the 3-month follow-up visit and 12% at the six-month FUP visit. 84.8% of total AEs were mild and transient. No serious AE was reported. Overall, the most common side effects reported were dizziness (11.95% of total AEs), drowsiness (11.4%), dry mouth (5.5%), nausea (4.8%), headaches (4.6%), cough (4.4%), anxiety (4.1%) and euphoria (3.5%). Other adverse effects accounted for less than 3% of total AE. Conclusion: Our results confirm that the primary area of clinical use for medical cannabis is in pain management. Patients in this cohort are largely utilizing plant-based cannabis oil products with a balanced ratio of THC:CBD. Reported adverse effects were mild and included dizziness and drowsiness. This real-world data confirms the tolerable safety profile of medical cannabis and suggests medical indications not yet validated in controlled clinical trials. Such data offers an important opportunity for the investigation of the long-term effects of cannabinoid exposure in real-life conditions. Real-world evidence can be used to direct clinical trial research efforts on specific indications and dosing patterns for product development.

Keywords: medical cannabis, safety, real-world data, Canada

Procedia PDF Downloads 134

Authors: L. Major, J. M. Lackner, M. Dyner, B. Major

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Development of new generation bio- tribological, multilayer coatings, opens an avenue for fabrication of future high- tech functional surfaces. In the presented work, nano- composite, Cr/CrN+[Cr/ a-C:H implanted by metallic nanocrystals] multilayer coatings have been developed for surface protection of medical tools. Thin films were fabricated by a hybrid Pulsed Laser Deposition technique. Complex microstructure analysis of nano- multilayer coatings, subjected to mechanical and biological tests, were performed by means of transmission electron microscopy (TEM). Microstructure characterization revealed the layered arrangement of Cr23C6 nanoparticles in multilayer structure. Influence of deposition conditions on bio- tribological properties of the coatings were studied. The bio-tests were used as a screening tool for the analyzed nano- multilayer coatings before they could be deposited on medical tools. Bio- medical tests were done using fibroblasts. The mechanical properties of the coatings were investigated by means of a ball-on-disc mechanical test. The microhardness was done using Berkovich indenter. The scratch adhesion test was done using Rockwell indenter. From the bio- tribological point of view, the optimal properties had the C106_1 material.

Keywords: bio- tribological coatings, cell- material interaction, hybrid PLD, tribology

Procedia PDF Downloads 381