Search results for: medical interpreting

Authors: Salsabeel F. M. Alfalah, Jannat F. Falah, Nadia Muhaidat, Amjad Hudaib, Diana Koshebye, Sawsan AlHourani

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Educational technology is changing the way how students engage and interact with learning materials. This improved the learning process amongst various subjects. Virtual Reality (VR) applications are considered one of the evolving methods that have contributed to enhancing medical education. This paper utilizes VR to provide a solution to improve the delivery of the subject of Embryology to medical students, and facilitate the teaching process by providing a useful aid to lecturers, whilst proving the effectiveness of this new technology in this particular area. After evaluating the current teaching methods and identifying students ‘needs, a VR system was designed that demonstrates in an interactive fashion the development of the human embryo from fertilization to week ten of intrauterine development. This system aims to overcome some of the problems faced by the students’ in the current educational methods, and to increase the efficacy of the learning process.

Keywords: virtual reality, student assessment, medical education, 3D, embryology

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Authors: Chintan Chandrachud

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When primary legislation is challenged for breaching fundamental rights, many courts around the world adopt interpretive techniques to avoid finding such legislation incompatible or invalid. In the UK, these techniques find sanction in section 3 of the Human Rights Act 1998, which directs courts to interpret legislation in a manner which is compatible with European Convention rights, ‘so far as it is possible to do so’. In India, courts begin with the interpretive presumption that Parliament intended to comply with fundamental rights under the Constitution of 1949. In comparing rights-compliant interpretation of primary legislation under the Human Rights Act and the Indian Constitution, this paper makes two arguments. First, that in the absence of a section 3-type mandate, Indian courts have a smaller range of interpretive tools at their disposal in interpreting primary legislation in a way which complies with fundamental rights. For example, whereas British courts frequently read words into statutes, Indian courts consider this an inapposite interpretive technique. The second argument flows naturally from the first. Given that Indian courts have a smaller interpretive toolbox, one would imagine that ceteris paribus, Indian courts’ power to strike down legislation would be triggered earlier than the declaration of incompatibility is in the UK. However, this is not borne out in practice. Faced with primary legislation which appears to violate fundamental rights, Indian courts often reluctantly uphold the constitutionality of statutes (rather than striking them down), as opposed to British courts, which make declarations of incompatibility. The explanation for this seeming asymmetry hinges on the difference between the ‘strike down’ power and the declaration of incompatibility. Whereas the former results in the disapplication of a statute, the latter throws the ball back into Parliament’s court, if only formally.

Keywords: constitutional law, judicial review, constitution of India, UK Human Rights Act

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Authors: Prapaipan Phingchim

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The number of women approaching menopausal age in Thailand is increasing, making menopause an important health topic. In order to understand Thai women's different ways of interpreting menopausal experiences and the way they construct meaning relating to menopause, it is necessary to include the context in which meaning is constructed as well as the background of cultural attitudes to menopause existing in the Thai society. The aim of this study was to describe different discourses on menopause in Thailand that present themselves to menopausal women through the use of language and to analyze linguistic strategies used to represent such identity. This study adopts discourse theory and a close pragmatic analysis to examine the discursive construction of menopause for Thai women. Two hundreds and fifteen pieces of text under the heading or subject of `menopause' or `becoming a middle-aged woman', published from 2010 to 2019, were included. All material was addressed to Thai women, and consisted of booklets and informational material, articles from newspapers and magazines and popular science books. Five different discourses on menopause were identified: the biomedical discourse; the health-promotion discourse; the consumer discourse; the alternative discourse; and the feminist/ critical discourse. The biomedical discourse on menopause was found to be dominant, but was expanded or challenged by other discourses by offering different scopes of action and/or resting on different fundamental values. The discourses constructed and positioned individual women differently; thus, the women's position varied noticeably from one discourse to another. There are seven major linguistic strategies used to construct those identities. That is, lexical selection, presupposition manipulation, presupposition denial, the use of implication, the use of passive construction, using the cause and effect sentence structure, and rhetoric questions.

Keywords: discourse analysis, discursive construction, menopause, Thai women

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Authors: Nelson Igaba, C. Onaga, S. Hlongwane

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Background: Medical Male Circumcision (MMC) is part of a comprehensive HIV prevention strategy. The quality of MMC done at Right To Care (RtC) sites is maintained by Continuous Quality Improvement (CQI) based on findings of assessments by internal and independent external assessors who evaluate such parameters as the quality of the surgical procedure, infection control, etc. There are 12 RtC MMC teams in Mpumalanga, two of which are headed by Medical Officers and 10 by Clinical Associates (Clin A). Objectives: To compare the quality (i) of care rendered at doctor headed sites (DHS) versus Clin A headed sites (CHS); (ii) of CQI assessments (external versus internal). Methodology: A retrospective review of data from RightMax™ (a novel RtC data management system) and CQI reports (external and internal) was done. CQI assessment scores of October 2015 and October 2016 were taken as the baseline and latest respectively. Four sites with 745-810 circumcisions per annum were purposively selected; the two DHS (group A) and two CHS (group B). Statistical analyses were conducted using R (2017 version). Results: There were no significant difference in latest CQI scores between the two groups (DHS and CHS) (Anova, F = 1.97, df = 1, P = 0.165); between internal and external CQI assessment scores (Anova, F = 2.251, df = 1, P = 0.139) or among the individual sites (Anova, F = 1.095, df = 2, P = 0.341). Of the total of 16 adverse events reported by the four sites in the 12 months reviewed (all were infections), there was no statistical evidence that the documented severity of the infection was different for DHS and CHS (Fisher’s exact test, p-value = 0.269). Conclusion: At RtC VMMC sites in Mpumalanga, internal and external/independent CQI assessments are comparable, and quality of care of VMMC is standardized with the performance of well-supervised clinical associates comparing well with those of medical officers.

Keywords: adverse events, Right to Care, male medical circumcision, continuous quality improvement

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Authors: Hsiao-Chuan Huang, King-Lung Kuo, Mei-Hsin Lo, Hsiao-Yun Chou, Yusen Lin

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The most robust and economical method for laboratory diagnosis of TB is to identify mycobacterial bacilli (AFB) under acid-fast staining despite its disadvantages of low sensitivity and labor-intensive. Though digital pathology becomes popular in medicine, an automated microscopic system for microbiology is still not available. A new AI-assisted automated microscopic system, consisting of a microscopic scanner and recognition program powered by big data and deep learning, may significantly increase the sensitivity of TB smear microscopy. Thus, the objective is to evaluate such an automatic system for the identification of AFB. A total of 5,930 smears was enrolled for this study. An intelligent microscope system (TB-Scan, Wellgen Medical, Taiwan) was used for microscopic image scanning and AFB detection. 272 AFB smears were used for transfer learning to increase the accuracy. Referee medical technicians were used as Gold Standard for result discrepancy. Results showed that, under a total of 1726 AFB smears, the automated system's accuracy, sensitivity and specificity were 95.6% (1,650/1,726), 87.7% (57/65), and 95.9% (1,593/1,661), respectively. Compared to culture, the sensitivity for human technicians was only 33.8% (38/142); however, the automated system can achieve 74.6% (106/142), which is significantly higher than human technicians, and this is the first of such an automated microscope system for TB smear testing in a controlled trial. This automated system could achieve higher TB smear sensitivity and laboratory efficiency and may complement molecular methods (eg. GeneXpert) to reduce the total cost for TB control. Furthermore, such an automated system is capable of remote access by the internet and can be deployed in the area with limited medical resources.

Keywords: TB smears, automated microscope, artificial intelligence, medical imaging

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Authors: Abdullah I. Alkraiji, Thomas W. Jackson, Ian Murray

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The proliferation of health data standards today is somewhat overlapping and conflicting, resulting in market confusion and leading to increasing proprietary interests. The government role and support in standardization for health data are thought to be crucial in order to establish credible standards for the next decade, to maximize interoperability across the health sector, and to decrease the risks associated with the implementation of non-standard systems. The normative literature missed out the exploration of the different steps required to be undertaken by the government towards the development of national health data standards. Based on the lessons learned from a qualitative study investigating the different issues to the adoption of health data standards in the major tertiary hospitals in Saudi Arabia and the opinions and feedback from different experts in the areas of data exchange and standards and medical informatics in Saudi Arabia and UK, a list of steps required towards the development of national health data standards was constructed. Main steps are the existence of: a national formal reference for health data standards, an agreed national strategic direction for medical data exchange, a national medical information management plan and a national accreditation body, and more important is the change management at the national and organizational level. The outcome of this study can be used by academics and practitioners to develop the planning of health data standards, and in particular those in developing countries.

Keywords: interoperabilty, medical data exchange, health data standards, case study, Saudi Arabia

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Authors: M. A. Rahman, A. T. Ohta, H. V. Trinh, J. Hyvl

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Atmospheric pressure and oxygen (O2) concentration are critical life support parameters for human-occupied aerospace vehicles and habitats. Various medical conditions may require medical O2; for example, the American Medical Association has determined that commercial air travel exposes passengers to altitude-related hypoxia and gas expansion. It may cause some passengers to experience significant symptoms and medical complications during the flight, requiring supplemental medical-grade O2 to maintain adequate tissue oxygenation and prevent hypoxemic complications. Although supplemental medical grade O2 is a successful lifesaver for respiratory and cardiac failure, O2-enriched exhaled air can contain more than 95 % O2, increasing the likelihood of a fire. In an aerospace environment, a localized high concentration O2 bubble forms around a patient being treated for hypoxia, increasing the cabin O2 beyond the safe limit. To address this problem, this work describes a medical O2 delivery system that can reduce the O2 concentration from patient-exhaled O2-rich air to safe levels while maintaining the prescribed O2 administration to the patient. The O2 delivery system is designed to be a part of the medical O2 kit. The system uses cationic multimetallic cobalt complexes to reversibly, selectively, and stoichiometrically chemisorb O2 from the exhaled air. An air-release sub-system monitors the exhaled air, and as soon the O2 percentage falls below 21%, the air is released to the room air. The O2-enriched exhaled air is channeled through a layer of porous, thin-film heaters coated with the cobalt complex. The complex absorbs O2, and when saturated, the complex is heated to 100°C using the thin-film heater. Upon heating, the complex desorbs O2 and is once again ready to absorb or remove the excess O2 from exhaled air. The O2 absorption is a sub-second process, and desorption is a multi-second process. While heating at 0.685 °C/sec, the complex desorbs ~90% O2 in 110 sec. These fast reaction times mean that a simultaneous absorb/desorb process in the O2 delivery system will create a continuous absorption of O2. Moreover, the complex can concentrate O2 by a factor of 160 times that in air and desorb over 90% of the O2 at 100°C. Over 12 cycles of thermogravimetry measurement, less than 0.1% decrease in reversibility in O2 uptake was observed. The 1 kg complex can desorb over 20L of O2, so simultaneous O2 desorption by 0.5 kg of complex and absorption by 0.5 kg of complex can potentially continuously remove 9L/min O2 (~90% desorbed at 100°C) from exhaled air. The complex is synthesized and characterized for reversible O2 absorption and efficacy. The complex changes its color from dark brown to light gray after O2 desorption. In addition to thermogravimetric analysis, the O2 absorption/desorption cycle is characterized using optical imaging, showing stable color changes over ten cycles. The complex was also tested at room temperature in a low O2 environment in its O2 desorbed state, and observed to hold the deoxygenated state under these conditions. The results show the feasibility of using the complex for reversible O2 absorption in the proposed fire safe medical O2 delivery system.

Keywords: fire risk, medical oxygen, oxygen removal, reversible absorption

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Authors: Xinchen Zhu

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The rapid fame of the renowned female film star Tang Wei has made her a typical subject (or object) entangled with sensitive issues involving the official ideology, sexuality, and patriarchal values of contemporary China. In 2008, Tang Wei’s official ban has triggered the wave of debates concerning state power and censorship, actor’s rights, sexual ethics, and feminism in the public sphere. Her ban implies that Chinese film censorship acts as a key factor in reconstructing Chinese film stardom. Following the ban, as sensational media texts are re-interpreting the official discourses, the texts also functioned as a crucial vehicle in reconstructing Tang's female image. Therefore, the case study of Tang's film stardom allows us to further explore how female stardom has been entangled with the issues involving official ideology, female sexual ethics, and patriarchal values in contemporary China. This paper argues that Chinese female film stars shoulder the responsibility of film acting which would conform to the official male-dominated values. However, with the development of the Internet, the state no longer remains an absolute control over the new venues. The netizens’ discussion about her ban reshaped Tang’s image as a victim and scapegoat under the unfair oppression of the official authority. Additionally, this paper argues that similar to State’s discourse, netizens’ discourse did not reject patriarchal values, and in turn emphasized Tang Wei’s female chastity.

Keywords: film censorship, Chinese female film stardom, party-state’s power, national discourses, Tang Wei

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Authors: Chung-Yu Wu, Chia-Chi Chang, Wei-Ming Chen, Pu-Wei Wu, Shih-Fan Chen, Po-Chun Chen

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Electrostimulation medical devices for neural diseases require electroactive and biocompatible materials to transmit signals from electrodes to targeting tissues. Protection of surrounding tissues has become a great challenge for long-term implants. In this study, we designed back-end processes with compatible, efficient, and reliable advantages over the current state-of-the-art. We explored a hermetic packaging process with high quality of adhesion and uniformity as the biocompatible devices for long-term implantation. This approach is able to provide both excellent biocompatibility and protection to the biomedical electronic devices by performing conformal coating of biocompatible materials. We successfully developed a packaging process that is capable of exposing the stimulating electrode and cover all other faces of chip with high quality of protection to prevent leakage of devices and body fluid.

Keywords: biocompatible package, medical microelectronics, surface coating, long-term implantation

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Authors: Ramona-Niculina Jurcau, Ioana-Marieta Jurcau, Dong Hun Kwak, Nicolae-Alexandru Colceriu

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Background: Stress management (SM) is a topic of great academic interest and equally a task to accomplish. In addition, it is recognized the beneficial role of unconventional therapies (UCT) in stress modulation. Aims: The aim was to evaluate medical (MS) versus non-medical students’ (NMS) opinions about academic stress management (ASM) using UCT. Methods: MS (n=103, third year males and females) and NMS (n=112, males and females, from humanities faculties, different years of study), out of their academic program, voluntarily answered to a questionnaire concerning: a) Classification of the four most important academic stress factors; b) The extent to which their daily life influences academic stress; c) The most important SM methods they know; d) Which of these methods they are applying; e) the UCT they know or about which they have heard; f) Which of these they know to have stress modulation effects; g) Which of these UCT, participants are using or would like to use for modulating stress; and if participants use UTC for their own choose or following a specialist consultation in those therapies (SCT); h) If they heard about the following UCT and what opinion they have (using visual analogue scale) about their use (following CST) for the ASM: Phytotherapy (PT), apitherapy (AT), homeopathy (H), ayurvedic medicine (AM), traditional Chinese medicine (TCM), music therapy (MT), color therapy (CT), forest therapy (FT). Results: Among the four most important academic stress factors, for MS more than for NMS, are: busy schedule, large amount of information taught; high level of performance required, reduced time for relaxing. The most important methods for SM that MS and NMS know, hierarchically are: listen to music, meeting friends, playing sport, hiking, sleep, regularly breaks, seeing positive side, faith; of which, NMS more than MS, are partially applying to themselves. UCT about which MS and less NMS have heard, are phytotherapy, apitherapy, acupuncture, reiki. Of these UTC, participants know to have stress modulation effects: some plants, bee’s products and music; they use or would like to use for ASM (the majority without SCT) certain teas, honey and music. Most of MS and only some NMS heard about PT, AT, TCM, MT and much less about H, AM, CT, TT. NMS more than MS, would use these UCT, following CST. Conclusions: 1) Academic stress is similarly reflected in MS and NMS opinions. 2) MS and NMS apply similar but very few UCT for stress modulation. 3) Information that MS and NMS have about UCT and their ASM application is reduced. 4) It is remarkable that MS and especially NMS, are open to UCT use for ASM, following an SCT.

Keywords: academic stress, stress management, stress modulation, medical students, non-medical students, unconventional therapies

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Authors: Tripta Dixit, Smita Sahu, William Selvamurthy, Sadhana Srivastava

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India is battling with the issues of accessibility, affordability and availability of quality health to the masses. Indian medical heritage which dated back to 3000 BC unveils the rich knowledge pool which has undergone a perceptible change over years, such as eradication of many communicable diseases, increasing individual awareness of quality health and import driven medical device market etc. Despite a slew of initiatives the holistic slogan of ‘health for all’ remains elusive and a concern for the nation. The 21st-century projects a myriad of challenges like cultural diversity, large population, demographic dividend and geographical segmentation leading to varied needs of people as per their regional conditions of climate, disease prevalence, nutrition and sanitation. But these challenges are also opportunities for the development of indigenous, low cost and accessible technologies to tackle them. This requires reinforcing the potential of indigenous technologies in coordination with prevailing health issues in various regions of country. This paper emphasis on the strategy for exploring the indigenous technologies with entrusted up-scaling to meet the diverse needs of the people. This review proposes to adopt technology transfer as a strategy to establish a vibrant ecosystem for identifying and up-scaling the indigenous medical technologies with diligent hand-holding for public health.

Keywords: health, indigenous, medical technology, technology transfer

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Authors: Zainab Alghali Elsaid Muhammed

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Background : IBS is a gastrointestinal disorder characterized by a variety of symptoms that occur concurrently. It is very common and is associated with high levels of psychiatric comorbidities, all of which have a negative impact on the patient's quality of life. Abdominal pain, diarrhea, constipation, excess gas, and bloating are common symptoms of IBS. Objectives : The purpose of this study is to determine the prevalence of IBS among medical students and intern doctors in Sudan, as well as the risk factors associated with it. Study design: This cross-sectional study was carried out in Sudan from April to July 2022. All participants completed a six-part online questionnaire. The ROME IV criteria questionnaire was used to make an IBS diagnosis. Participants completed the hospital anxiety and depression questionnaire in order to be diagnosed with anxiety and depression. Results : 600 participants filled out the questionnaire. The overall prevalence of IBS was found to be 42%, with females being the most affected. Intern doctors had higher IBS rates (30.0%) than medical students, but this was not statistically significant. Single status (p =0.079), good GPAs (p =0.00), had significant associations with IBS occurrence. Other significantly associated habits were sleeping less than 8 hours (p =0.013), two cups or less of coffee per day (p = 0.109), No smoking (p =0.001), and No exercise (p =0.00, IBS participants were also found to have a significant relationship with abnormal anxiety (p =0.00) and borderline depression (p=0.0156). Conclusion : The high prevalence of IBS in this study suggests that medical students and interns are unable to recognize their symptoms. The main IBS predictors in this study were suffering from anxiety or depression, having an insufficient income, sleeping less than 8 hours per day, working/ studying more than 8 hours per day, and not performing any type of exercise.

Keywords: irritable bowel syndrome, sudan, HADS, rome IV, medical students

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Authors: Nasir Mustafa

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One of the prerequisites required for an efficient diagnosis in a medical practice is to have a strong command of both functional and clinical anatomy. In this study, we introduce a new collaborative approach to the effective teaching of the knee and hip joints. In the present teaching model, anatomists, orthopedists and physical therapists present the anatomy of the hip and knee joints in small groups. Courses for the hip and knee joints were scheduled during the early stages of the medical curriculum. Students of nursing and physical therapy were grouped together to sensitize to the importance of a collaborative effort. The study results clearly demonstrate that nursing students and physical therapy students appreciated this teaching approach. The collaborative approach further proved to be a suitable method to teach both functional and clinical anatomy of the hip and knee joints. Aside from this training, a collaborative approach between medical students and physical therapy students was also successful for a healthcare organization.

Keywords: hip and knee joint anatomy, collaborative, Anatomy teaching, Nursing students, Physiotherapy students

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Authors: Fangfei Li

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This research was conducted to explore how Chinese overseas students, who rarely received teacher feedback during their undergraduate studies in China, engaged in a different feedback provision context in the UK universities. In particular, this research provides some insights into Chinese students’ perspectives on how they made sense of the teacher feedback they obtained and how they took it on board in their assignments. Research questions in this study are 1) What are Chinese overseas students’ perceptions of teacher feedback on courses in UK higher education? 2) How do they respond to the teacher feedback they obtained? 3) What factors might influence their engagement with teacher feedback? Multiple case studies of five Chinese overseas students in a UK university have been carried out to address the research questions. The main data collection instruments are various types of semi-structured interviews, consisting of background interviews, scenario-based activities, stimulated recall sessions and retrospective interviews. Research findings indicate that student engagement with teacher feedback is a complex learning process incorporating several stages: from initial teacher input to ultimate transformational learning. Apart from students interpreting teachers’ comments/suggestions by themselves, students’ understandings of and responses to teacher feedback could also be influenced by pre-submission guidance, peer discussion, use of exemplars and post-submission discussion with teachers. These are key factors influencing students to make use of teacher feedback. Findings also reveal that the level of students’ reflections on tutor feedback influences the quality of their assignments and even their future learning. To sum up, this paper will discuss the current concepts of teacher feedback in existing studies and research findings of this study from which reconceptualization of teacher feedback has occurred.

Keywords: Chinese students, student engagement, teacher feedback, the UK higher education

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Authors: Nor Erlissa Abd Aziz, R. M. U. S. Udagedara, S. Sharifi

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Managing and sharing knowledge has been a broadly satisfactory strategy to most of the organisations. Harnessing the power of knowledge supported the organisations to gain a competitive advantage over their competitors. Along with the invention of social media, knowledge sharing process has been more efficient and comfortable. Numerous researches have been conducted to investigate the effect of social media platforms for public and academic use. Furthermore, knowledge sharing, in general, have been subject to considerable n research, but research on sharing knowledge in Higher Education Institutions (HEIs) is rare. Also, it is noted that still there is a gap related to the organisational elements that contribute to the successful knowledge sharing through social media platforms. Thus, this research aims to investigate organisational elements that influence the social media platform based knowledge sharing within the context of Malaysian Higher Education Institutions (HEIs). The research used qualitative research methods to get an in-depth understanding of the subject matter. The conclusions of this study are based on interpreting the results of semi-structured interviews with academic staff from various Malaysian HEIs from the public and private sectors. Documents review will supplement the data from the interviews, and this ensures triangulation of the responses and thus increase the validity of the research. This research contributes to the literature by investigating an in-depth understanding the role of organisational elements about the social media platform based knowledge sharing in nourishing knowledge and spreading it to become better HEIs in utilising their knowledge. The proposed framework which identifies the organisational elements influences of social media platform based knowledge sharing will present as the main contribution of this research.

Keywords: knowledge sharing, social media, knowledge and knowledge management

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Authors: Elzbieta Sikorska-Simmons

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Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.

Keywords: advanced dementia, family caregiver, medical decision-making, symptom management

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Authors: Guanghua Yu

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This article has examined the rise of the UK, US, and China at different historical times to explain the argument that it is open access in the economic sphere, as well as institutional building related to the protection of property rights, contract enforcement, financial market, the rule of law, and human resource accumulation that determine economic and human development. Both the UK, after the Glorious Revolution in the seventeenth century, and China, after its adoption of the open door policy at the end of the 1970s, follow such a path of development. The difference between the UK and China in moving toward that path is the different coordination of elites. While the coordination of elites in the UK through parliament played important roles in forcing the government to consider the wider encompassing interest in society after the Glorious Revolution, the coordination of elites in China has mainly been achieved by the Communist Party of China such that the Chinese Government has started to pay greater deal of attention to the wider encompassing interest in the country from 1978. The article has also examined the rise of the US following colonial settlement to independence and institutional building thereafter. The US case is similarly consistent with the argument that open access in the economic sphere and institutional building matter the most to economic development. More decentralized methods of the coordination of elites in the US among colonies (states), the federal governments, and other political groups similarly shaped the path towards open access in the economic sphere and institutional building. As such, open access in the political sphere plays an indirect role in development at best. If that is correct, there are possibilities that different political systems are able to achieve coordination of elites so that governments will turn their attention to development.

Keywords: open access, interconnected institutions, democracy, development

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Authors: Zahra Abdi, Roghayeh Alipour, Babak Farahi Ghasraboonasr

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Introduction: Diabetes is a serious medical condition that requires constant care. People with type 2 diabetes may also be likely to experience dry, itchy skin and poor wound healing. Some people with diabetes will have a skin problems at some time in their lives and for those not yet diagnosed with diabetes, a skin problem can be an indication of the disease. our purpose was to assess the capability and knowledge of students of Shiraz University of Medical Sciences about prevent from skin complications in diabetes type 2. Methods: In this descriptive cross-sectional study, knowledge of 360 students of Shiraz University of Medical Sciences was evaluated about different ways to avoid skin complications in diabetes type 2. Data were analyzed by spss19.(P<0.05) was considered significant. Results: 360 students of Shiraz University of Medical Sciences participated in this study. 45% of students agree with the effect of Moisturize skin daily, If Diabetics have sensitive skin, choose a fragrance-free, dye-free moisturizer that won’t irritate skin. 52% believe that Protect skin from sun can be so useful, Sun exposure is drying and aging. Use sunscreen with SPF 30 or higher whenever you’re outside. Wear gloves when doing yardwork to protect the skin on your hands. 62% of students strongly agree with Carefully clean any cuts and scrapes, If diabetics notice any sign of infection skin that’s red, swollen, or warm to the touch, or has a foul-smelling drainage or pus should consulting with a doctor immediately. Diabetics should be careful about any injury that takes longer than normal to heal and they should consulting with doctor about them too. 72% of students believe that diabetics should be diligent about daily foot care. Clean and moisturize feet each day and check each foot closely, top and bottom, for wounds even a tiny cut, blisters, or cracked skin. Conclusions: The risk of getting these diabetes complications can be lessened by controlling blood sugar. Skin complications can cause serious consequences. Taking care of skin is so important and using these tips are remarkable effective and help diabetics to look after their skin easier.

Keywords: skin complications, diabetes type 2, Shiraz University of Medical Sciences, diabetics

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Authors: Ali Elhatmi, Mustafa Elshbo, Hussin Alosta

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In this study the coper tube witch used in medical applications was brazed by Copper, Zink and Silver alloys, using BCuP2, RBCuZnAl and BAg2 filler metals. The sample of the medical tubes was chemically analyzed and the result matches the British standard. Tensile and hardness tests were carried out for brazed joints, and the tensile test results show that the BCuP2 has the hardest and the filler metal RBCuZnAl has the highest tensile strength.

Keywords: welding, Brazing, Copper tubes, Joints

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Authors: Dongping Fang, Lian Duan, Xiaojing Yuan, Mike Xu, Allyn Klunder, Kevin Tan, Suiting Cao, Yeqing Ji

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Accurate prediction of a medical condition with straight clinical evidence is a long-sought topic in the medical management and health insurance field. Although great progress has been made with machine learning algorithms, the medical community is still, to a certain degree, suspicious about the model's accuracy and interpretability. This paper presents an innovative hierarchical attention deep learning model to achieve good prediction and clear interpretability that can be easily understood by medical professionals. This deep learning model uses a hierarchical attention structure that matches naturally with the medical history data structure and reflects the member’s encounter (date of service) sequence. The model attention structure consists of 3 levels: (1) attention on the medical code types (diagnosis codes, procedure codes, lab test results, and prescription drugs), (2) attention on the sequential medical encounters within a type, (3) attention on the medical codes within an encounter and type. This model is applied to predict the occurrence of stage 3 chronic kidney disease (CKD3), using three years’ medical history of Medicare Advantage (MA) members from a top health insurance company. The model takes members’ medical events, both claims and electronic medical record (EMR) data, as input, makes a prediction of CKD3 and calculates the contribution from individual events to the predicted outcome. The model outcome can be easily explained with the clinical evidence identified by the model algorithm. Here are examples: Member A had 36 medical encounters in the past three years: multiple office visits, lab tests and medications. The model predicts member A has a high risk of CKD3 with the following well-contributed clinical events - multiple high ‘Creatinine in Serum or Plasma’ tests and multiple low kidneys functioning ‘Glomerular filtration rate’ tests. Among the abnormal lab tests, more recent results contributed more to the prediction. The model also indicates regular office visits, no abnormal findings of medical examinations, and taking proper medications decreased the CKD3 risk. Member B had 104 medical encounters in the past 3 years and was predicted to have a low risk of CKD3, because the model didn’t identify diagnoses, procedures, or medications related to kidney disease, and many lab test results, including ‘Glomerular filtration rate’ were within the normal range. The model accurately predicts members A and B and provides interpretable clinical evidence that is validated by clinicians. Without extra effort, the interpretation is generated directly from the model and presented together with the occurrence date. Our model uses the medical data in its most raw format without any further data aggregation, transformation, or mapping. This greatly simplifies the data preparation process, mitigates the chance for error and eliminates post-modeling work needed for traditional model explanation. To our knowledge, this is the first paper on an interpretable deep-learning model using a 3-level attention structure, sourcing both EMR and claim data, including all 4 types of medical data, on the entire Medicare population of a big insurance company, and more importantly, directly generating model interpretation to support user decision. In the future, we plan to enrich the model input by adding patients’ demographics and information from free-texted physician notes.

Keywords: deep learning, interpretability, attention, big data, medical conditions

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Authors: Filip Buruiana, Alexander Hall, Reimar Hofmann, Thomas Hofmann, Silviu Ganceanu, Alexandru Tudorica

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In-memory column-stores make interactive analysis feasible for many big data scenarios. PowerDrill is a system used internally at Google for exploration in logs data. Even though it is a highly parallelized column-store and uses in memory caching, interactive response times cannot be achieved for all datasets (note that it is common to analyze data with 50 billion records in PowerDrill). In this paper, we investigate two orthogonal approaches to optimize performance at the expense of an acceptable loss of accuracy. Both approaches can be implemented as outer wrappers around existing database engines and so they should be easily applicable to other systems. For the first optimization we show that memory is the limiting factor in executing queries at speed and therefore explore possibilities to improve memory efficiency. We adapt some of the theory behind data sketches to reduce the size of particularly expensive fields in our largest tables by a factor of 4.5 when compared to a standard compression algorithm. This saves 37% of the overall memory in PowerDrill and introduces a 0.4% relative error in the 90th percentile for results of queries with the expensive fields. We additionally evaluate the effects of using sampling on accuracy and propose a simple heuristic for annotating individual result-values as accurate (or not). Based on measurements of user behavior in our real production system, we show that these estimates are essential for interpreting intermediate results before final results are available. For a large set of queries this effectively brings down the 95th latency percentile from 30 to 4 seconds.

Keywords: big data, in-memory column-store, high-performance SQL queries, approximate SQL queries

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Authors: Mahsa Houshdar, Seyed Mehdi Samimi Ardestani , ُSeyed Saeed Sadr

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Introduction: Online Medicare is a method in which parts of a medical process - whether its diagnostics, monitoring or the treatment itself will be done by using online services. This system has been operated in one boy’s high school, one girl’s high school and one high school in deprived aria. Method: At the first step the students registered for using the system. It was not mandatory and not free. They participated in estimating depression scale, anxiety scale and clinical interview by online medical care system. During this estimation, we could find the existence and severity of depression and anxiety in each one of the participants, also we could find the consequent needs of each one, such as supportive therapy in mild depression or anxiety, need to visited by psychologist in moderate cases, need to visited by psychiatrist in moderate-severe cases, need to visited by psychiatrist and psychologist in severe cases and need to perform medical lab examination tests. The lab examination tests were performed on persons specified by the system. The lab examinations were included: serum level of vitamin D, serum level of vitamin B12, serum level of calcium, fasting blood sugar, HbA1c, thyroid function tests and CBC. All of the students were solely treated by vitamins or minerals therapy and/ or treatment of medical problem (such as hypothyroidism). After a few months, we came back to high schools and estimated the existence and severity of depression and anxiety in treated students. With comparing these results, the affectability of the system could be prof. Results: Totally, we operate this project in 1077 participants in 243 of participant, the lab examination test were performed. In girls high schools: the existence and severity of depression significantly deceased (P value= 0.018<0.05 & P value 0.004< 0.05), but results about anxiety was not significant. In boys high schools: the existence and severity of depression significantly decreased (P value= 0.023<0.05 & P value = 0.004< 0.05 & P value= 0.049< 0.05). In boys high schools: the existence and severity of anxiety significantly decreased (P value= 0.041<0.05 & P value = 0.046< 0.05 &) but in one high school results about anxiety was not significant. In high school in deprived area the students did not have any problem paying for participating in the project, but they could not pay for medical lab examination tests. Thus, operation of the system was not possible in deprived area without a sponsor. Conclusion: This online medical system was successful in creating medical and psychiatric profile without attending physician. It was successful in decreasing depression without using antidepressants, but it was partially successful in decreasing anxiety.

Keywords: depression, diabetes, online medicare, vitamin D deficiency

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Authors: Jang-hyun Oh, Kyoung-ho Choi, Jea-sun Lee

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The outbreak of the COVID-19 pandemic brought reconsiderations and doubts about urban density as compact cities became epidemic hot spots. Density, though, provides an upside in that medical services required to protect citizens against the spread of disease are concentrated within compact cities, which helps reduce the mortality rate. Sociodemographic characteristics are also a crucial factor in determining the vulnerability of the population, and the purpose of this study is to empirically discover how these three urban factors affect the severity of the epidemic impacts. The study aimed to investigate the influential relationships between urban factors and epidemic impacts and provide answers to whether superb medical service in compact cities can scale down the impacts of COVID-19. SEM (Structural Equation Modeling) was applied as a suitable research method for verifying interrelationships between factors based on theoretical grounds. The study accounted for 144 municipalities in South Korea during periods from the first emergence of COVID-19 to December 31st, 2022. The study collected data related to infection and mortality cases from each municipality, and it holds significance as primary research that enlightens the aspects of epidemic impact concerning urban settings and investigates for the first time the mediated effects of medical service. The result of the evaluation shows that compact cities are most likely to have lower sociodemographic vulnerability and better quality of medical service, while cities with low density contain a higher portion of vulnerable populations and poorer medical services. However, the quality of medical service had no significant influence in reducing neither the infection rate nor the mortality rate. Instead, density acted as the major influencing factor in the infection rate, while sociodemographic vulnerability was the major determinant of the mortality rate. Thus, the findings strongly paraphrase that compact cities, although with high infection rates, tend to have lower mortality rates due to less vulnerability in sociodemographics, Whereas death was more frequent in less dense cities due to higher portions of vulnerable populations such as the elderly and low-income classes. Findings suggest an important lesson for post-pandemic urban planning-intrinsic characteristics of urban settings, such as density and population, must be taken into account to effectively counteract future epidemics and minimize the severity of their impacts. Moreover, the study is expected to contribute as a primary reference material for follow-up studies that further investigate related subjects, including urban medical services during the pandemic.

Keywords: urban planning, sociodemographic vulnerability, medical service, COVID-19, pandemic

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Authors: Marzieh Imani

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Antoni Gaudi and Santiago Calatrava have reputation for designing bio-inspired creative and technical buildings. Even though they have followed different independent approaches towards design, the source of bio-inspiration seems to be common. Taking a closer look at their projects reveals that Calatrava has been influenced by Gaudi in terms of interpreting nature and applying natural principles into the design process. This research firstly discusses the dialogue between Biomimicry and architecture. This review also explores human/nature discourse during the history by focusing on how nature revealed itself to the fine arts. This is explained by introducing naturalism and romantic style in architecture as the outcome of designers’ inclination towards nature. Reviewing the literature, theoretical background and practical illustration of nature have been included. The most dominant practical aspects of imitating nature are form and function. Nature has been reflected in architectural science resulted in shaping different architectural styles such as organic, green, sustainable, bionic, and biomorphic. By defining a set of common aspects of Gaudi and Calatrava‘s design approach and by considering biomimetic design categories (organism, ecosystem, and behaviour as the main division and form, function, process, material, and construction as subdivisions), Gaudi’s and Calatrava’s project have been analysed. This analysis explores if their design approaches are equivalent or different. Based on this analysis, Gaudi’s architecture can be recognised as biomorphic while Calatrava’s projects are literally biomimetic. Referring to these architects, this review suggests a new set of principles by which a bio-inspired project can be determined either biomorphic or biomimetic.

Keywords: biomimicry, Calatrava, Gaudi, nature

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Authors: Lea Stein, Sabine Rösner, Alessandra Lo Giudice, Beate Ditzen, Tewes Wischmann

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For many couples bearing children is a consistent life goal; however, it cannot always be fulfilled. Undergoing infertility treatment does not guarantee pregnancies and live births. Couples have to deal with miscarriages and sometimes even discontinue infertility treatment. Significant medical predictors for the outcome of infertility treatment have yet to be fully identified. To further our understanding, a cross-sectional five-year follow-up survey was undertaken, in which 95 women and 82 men that have been treated at the Women’s Hospital of Heidelberg University participated. Binary logistic regressions, parametric and non-parametric methods were used for our sample to determine the relevance of biological (infertility diagnoses, maternal and paternal age) and lifestyle factors (smoking, drinking, over- and underweight) on the outcome of infertility treatment (clinical pregnancy, live birth, miscarriage, dropout rate). During infertility treatment, 72.6% of couples became pregnant and 69.5% were able to give birth. Suffering from miscarriages 27.5% of couples and 20.5% decided to discontinue an unsuccessful fertility treatment. The binary logistic regression models for clinical pregnancies, live births and dropouts were statistically significant for the maternal age, whereas the paternal age in addition to maternal and paternal BMI, smoking, infertility diagnoses and infections, showed no significant predicting effect on any of the outcome variables. The results confirm an effect of maternal age on infertility treatment, whereas the relevance of other medical predictors remains unclear. Further investigations should be considered to increase our knowledge of medical predictors.

Keywords: advanced maternal age, assisted reproductive technology, female factor, male factor, medical predictors, infertility treatment, reproductive medicine

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Authors: Hajar Al Rajaibi, Kawla Al Toubi, Saeed Al Jaadi, Deepali Jaju, Sanjay Jaju

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Background: The available evidence in Oman on lack of physical activity call for immediate intervention. Physical activity counseling by doctors to their patients is influenced by their attitudes and personal physical fitness. To our best knowledge, the physical activity status of Omani medical students has not been addressed before. These future doctors will have a critical role in improving physical activity in patients and thus their overall health. Objective: The aim of the study is to assess the physical activity level, physical fitness level, and attitudes towards physical activity among Sultan Qaboos University senior medical students. Methods: In this cross-sectional study (N=110; males 55), physical activity level was assessed using International Physical Activity Questionnaire (IPAQ ) short form and attitudes towards physical activity using a fifty-four-items Kenyon questionnaire. The physical fitness level was assessed by estimating maximal oxygen uptake (VO₂max) using Chester step test. Results: Female students reported more sitting time more than 7hr/day (85.5%) compared to male students (40%; p < 0.05). The IPAQ revealed moderate level of physical activity in 58% of students. Students showed a high positive attitude towards physical activity for health and fitness and low attitude for physical activity as tension and risk. Both female and male students had a similar level and attitude towards physical activity. Physical fitness level was excellent (VO₂max > 55ml O₂/kg/min) in 11% of students, good (VO₂max>44-54ml O₂/kg/min) in 49% and average to below-average in 40%. Objectively measured physical fitness level, subjectively reported physical activity level or attitudes towards physical activity were not correlated. Conclusion: Omani medical students have a positive attitude towards physical activity but moderate physical activity level. Longer sitting time in females need further evaluation. Efforts are required to understand reasons for present physical activity level and to promote good physical activity among medical students by creating more awareness and facilities.

Keywords: Chester step test, Kenyon scale, medical students, physical activity, physical fitness

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Authors: Shujon Mohammed Alazzam, Sarah Saad Alamer, Omar Hassan Kasule, Lama Suliman Aleid, Mohammad Abdulaziz Alakeel, Boshra Mosleh Alanazi, Abdullah Abdulelah Altowairqi, Yahya Ali Al-Asiri

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Background: Interventional radiology (IR) is a specialized field within radiology that diagnose and treat several conditions through a minimally invasive surgical procedure that involves the use of various radiological techniques. In the last few years, the role of IR has expanded to include a variety of organ systems which have been led to an increase in demand for these Specialties. The level of knowledge regarding IR is relatively low in general. In this study, we aimed to investigate the perceptions of interventional radiology (IR) as a specialty among medical students and medical interns in Riyadh, Saudi Arabia. Methodology: This study was a cross section. The target population is medical students in January 2023 in Riyadh city, KSA. We used the questionnaire for face-to-face interviews with voluntary participants to assess their knowledge of Interventional radiology. Permission was taken from participants to use their information. Assuring them that the data in this study was used only for scientific purposes. Results: According to the inclusion criteria, a total of 314 students participated in the study. (49%) of the participants were in the preclinical years, and (51%) were in the clinical years. The findings indicate more than half of the students think that they had good information about IR (58%), while (42%) reported that they had poor information and knowledge about IR. Only (28%) of students were planning to take an elective and radiology rotation, (and 27%) said they would consider a career in IR. (73%) of the participants who would not consider a career in IR, the highest reasons in order were due to "I do not find it interesting" (45%), then "Radiation exposure" (14%). Around half (48%) thought that an IRs must complete a residency training program in both radiology and surgery, and just (36%) of the students believe that an IRs must finish training in radiology. Our data show the procedures performed by IRs that (66%) lower limb angioplasty and stenting (58%) Cardiac angioplasty or stenting. (68%) of the students were familiar with angioplasty. When asked about the source of exposure to angioplasty, the majority (46%) were from a cardiologist, (and 16%) were from the interventional radiologist. Regarding IR career prospects, (78%) of the students believe that IRs have good career prospects. In conclusion, our findings reveal that the perception and exposure to IR among medical students and interns are generally poor. This has a direct influence on the student's decision regarding IR as a career path. Recommendations to attract medical students and promote IR as a career should be increased knowledge among medical students and future physicians through early exposure to IR, and this will promote the specialty's growth; also, involvement of the Saudi Interventional Radiology Society and Radiological Society of Saudi Arabia is essential.

Keywords: knowledge, medical students, perceptions, radiology, interventional radiology, Saudi Arabia

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Authors: Kim Lytle, Tim Talty, Alan Michaels, Jeff Reed

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Implantable medical devices (IMDs) are medically necessary devices embedded in the human body that monitor chronic disorders or automatically deliver therapies. Most IMDs have wireless capabilities that allow them to share data with an offboard programming device to help medical providers monitor the patient’s health while giving the patient more insight into their condition. However, serious security concerns have arisen as researchers demonstrated these devices could be hacked to obtain sensitive information or harm the patient. Cooperative jamming can be used to prevent privileged information leaks by maintaining an adequate signal-to-noise ratio at the intended receiver while minimizing signal power elsewhere. This paper uses ray tracing to demonstrate how a low number of friendly nodes abiding by Bluetooth Low Energy (BLE) transmission regulations can enhance IMD communication security in an office environment, which in turn may inform how companies and individuals can protect their proprietary and personal information.

Keywords: implantable biomedical devices, communication system security, array signal processing, ray tracing

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Authors: Chan Kwong Tung

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Since Baddeley and Hitch’s seminal research in 1974 on working memory (WM), this topic has been of great interest to language educators. Although there are some variations in the definitions of WM, recent findings in WM have contributed vastly to our understanding of language learning, especially its effects on second language acquisition (SLA). For example, the phonological component of WM (PWM) and the executive component of WM (EWM) have been found to be positively correlated with language learning. This paper discusses two general, yet highly relevant WM findings that could directly affect the effectiveness of Chinese Language (CL) vocabulary teaching and learning, as well as the quality of its assessment. First, PWM is found to be critical for the long-term learning of phonological forms of new words. Second, EWM is heavily involved in interpreting the semantic characteristics of new words, which consequently affects the quality of learners’ reading comprehension. These two ideas are hardly discussed in the Chinese literature, both conceptual and empirical. While past vocabulary acquisition studies have mainly focused on the cognitive-processing approach, active processing, ‘elaborate processing’ (or lexical elaboration) and other effective learning tasks and strategies, it is high time to balance the spotlight to the WM (particularly PWM and EWM) to ensure an optimum control on the teaching and learning effectiveness of such approaches, as well as the validity of this language assessment. Given the unique phonological, orthographical and morphological properties of the CL, this discussion will shed some light on the vocabulary acquisition of this Sino-Tibetan language family member. Together, these two WM concepts could have crucial implications for the design, development, and planning of vocabularies and ultimately reading comprehension teaching and assessment in language education. Hopefully, this will raise an awareness and trigger a dialogue about the meaning of these findings for future language teaching, learning, and assessment.

Keywords: Chinese Language, working memory, vocabulary assessment, vocabulary teaching

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Authors: Nur Gorkemli, Basak Solmaz

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With globalization, competition between cities increased and therefore cities started to give more importance to be a more differentiated one among thousands of their competitors. In order to become a more livable place and appeal more tourists, more investors, more students and more people cities give importance to marketing and branding activities. City image is very important concept for building a city brand. Cinemas, books, news or information about cities create 'city image' in peoples’ minds. Every city has their own peculiarities and changing their neutral or negative image to a positive way will bring advantages to them in national and even in international arena. Konya, which is a city in central Anatolia, has been an important city since very early times in human kind. It has the ruins of one of the first settlements existed approximately 9.000 years ago. Moreover, it was the capital of Selcuk Empire before Ottoman period and also a very important city during Ottoman Empire. With this historical richness, the city has important structures and works of art from those periods. Moreover, the city is also very well-known in the world with one of the greatest philosopher, poet, theologian, and Sufi mystic Mevlana Jelaleddin Rumi, who lived most of his life in Konya. Every year nearly two million people from various cities and countries visit Mevlana Museum. With all these potentials, Turkish Ministry of Culture and Tourism chose Konya to be a branded city in its 2023 action plan. For branding activities, understanding city image has a crucial role. Moreover, news about cities has a great potential on building a 'city image' in minds. This study is aimed at interpreting Konya’s image by categorizing Konya’s news existed in three national newspapers, which has the highest circulation in Turkey. Content analysis method will be used in this study.

Keywords: city branding, city image, newspaper analysis, Konya

Procedia PDF Downloads 318