Search results for: medical pragmatics

Authors: Jerzy Slowik, Elzbieta Grochowska-Niedworok

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The analysis of the market needs and trends in both treatment and prophylaxis shows the growing need to implement comprehensive solutions that would enable safe contact of the beneficiaries with the therapeutic and diagnostic support group. Based on the evaluation of the medical and sports industry services market, projects co-financed by the EFRR in the form of comprehensive care systems using IT tools for patients under treatment in the field of obesity and metabolism using the system were implemented under the Regional Operational Program of the Silesian Voivodeship for 2014-2020. SFAO 1.0 (Support for the Fight Against Obesity) number of the WND-RPSL project. 01.02.00-24-06EA / 16) as well as for competitors in qualified sports SK system (qualified sports) project number WND-RPSL. 01.02.00-24-0630 / 17-002. The service provided in accordance with SFAO 1.0 has shown a wide range of therapy possibilities - from monitoring the body's reactions during sports activities of healthy people to remote care for sick patients. As a result of the introduction of an innovative service, it was possible to increase the effectiveness of the therapy, which was manifested in the reduction of the starting doses of drugs by 10%, improvement of the efficiency of the respiratory and blood circulation system, and a 10% increase in bone density. Innovation in the provision of medical services in the field of qualified sports SK was a response to the needs of the athletes and their parents, coaches, physiotherapists, dieticians, and doctors who take care of people actively practicing qualified sports. The creation of the platform made it possible to constantly monitor the trainers necessary for both the proper training process and the control over the health of patients. Monitoring the patient's health by a specialized team in the field of various specialties allows for the proper targeting of the treatment and training process due to the increase in the availability of medical counseling. Specialists taking care of the patient can provide additional advice and modify the medical treatment of the patient on an ongoing basis, which is why we are dealing with a holistic approach.

Keywords: innovation of medical services, sport, obesity, innovation

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Authors: Omar Bobes, Abeer Al-Attar, Mohammad Hassan Kharita, Huda Al-Naemi

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The number of radiological examinations has increased steadily in recent years. As a result, the risk of possible radiation-induced consequential damage also increases through continuous, lifelong, and increasing exposure to ionizing radiation. Therefore, radiation dose monitoring in medicine became an essential element of medical practice. In this study, the occupational cumulative doses for radiation workers in Hamad medical corporation in Qatar have been assessed for a period of five years. The number of monitored workers selected for this study was 555 (out of a total of 1250 monitored workers) who have been working continuously -with no interruption- with ionizing radiation over the past five years from 2015 to 2019. The aim of this work is to examine the occupational groups and the activities where the higher radiation exposure occurred and in what order of magnitude. The most exposed group was the nuclear medicine technologist staff, with an average cumulative dose of 8.4 mSv. The highest individual cumulative dose was 9.8 mSv recorded for the PET-CT technologist category.

Keywords: cumulative dose, effective dose, monitoring, occupational exposure, dosimetry

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Authors: Ashlesha Khanapure, Harsh Kashyap, Abhinav Anand, Sanjana Habib, Anupama Bidargaddi

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Technologies that are developing quickly are being developed daily in a variety of disciplines, particularly the medical field. For the purpose of detecting bone fractures in X-ray pictures of different body segments, our work compares the ResNet-50 and MobileNetV3 architectures. It evaluates accuracy and computing efficiency with X-rays of the elbow, hand, and shoulder from the MURA dataset. Through training and validation, the models are evaluated on normal and fractured images. While ResNet-50 showcases superior accuracy in fracture identification, MobileNetV3 showcases superior speed and resource optimization. Despite ResNet-50’s accuracy, MobileNetV3’s swifter inference makes it a viable choice for real-time clinical applications, emphasizing the importance of balancing computational efficiency and accuracy in medical imaging. We created a graphical user interface (GUI) for MobileNet V3 model bone fracture detection. This research underscores MobileNetV3’s potential to streamline bone fracture diagnoses, potentially revolutionizing orthopedic medical procedures and enhancing patient care.

Keywords: CNN, MobileNet V3, ResNet-50, healthcare, MURA, X-ray, fracture detection

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Authors: Wu Liching

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Aim This case aims to discuss the pathogenesis, clinical manifestations and medical treatment of strokes caused by mitochondrial gene mutations. Methods Diagnosis of ischemic stroke caused by mitochondrial gene defect by means of "next-generation sequencing mitochondrial DNA gene variation detection", imaging examination, neurological examination, and medical history; this study took samples from the neurology ward of a medical center in northern Taiwan cases diagnosed with acute cerebral infarction as the research objects. Result This case is a 49-year-old married woman with a rare disease, mitochondrial gene mutation inducing ischemic stroke. She has severe hearing impairment and needs to use hearing aids, and has a history of diabetes. During the patient’s hospitalization, the blood test showed that serum Lactate: 7.72 mmol/L, Lactate (CSF) 5.9 mmol/L. Through the collection of relevant medical history, neurological evaluation showed changes in consciousness and cognition, slow response in language expression, and brain magnetic resonance imaging examination showed subacute bilateral temporal lobe infarction, which was an atypical type of stroke. The lineage DNA gene has m.3243A>G known pathogenic mutation point, and its heteroplasmic level is 24.6%. This pathogenic point is located in MITOMAP and recorded as Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes (MELAS) , Leigh Syndrome and other disease-related pathogenic loci, this mutation is located in ClinVar and recorded as Pathogenic (dbSNP: rs199474657), so it is diagnosed as a case of stroke caused by a rare disease mitochondrial gene mutation. After medical treatment, there was no more seizure during hospitalization. After interventional rehabilitation, the patient's limb weakness, poor language function, and cognitive impairment have all improved significantly. Conclusion Mitochondrial disorders can also be associated with abnormalities in psychological, neurological, cerebral cortical function, and autonomic functions, as well as problems with internal medical diseases. Therefore, the differential diagnoses cover a wide range and are not easy to be diagnosed. After neurological evaluation, medical history collection, imaging and rare disease serological examination, atypical ischemic stroke caused by rare mitochondrial gene mutation was diagnosed. We hope that through this case, the diagnosis of rare disease mitochondrial gene variation leading to cerebral infarction will be more familiar to clinical medical staff, and this case report may help to improve the clinical diagnosis and treatment for patients with similar clinical symptoms in the future.

Keywords: acute stroke, MELAS, lactic acidosis, mitochondrial disorders

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Authors: Hayat Omar

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Languages provide speakers with a wide range of linguistic units to organize and deliver information. There are several ways to verbally express the mental representations of events. According to the linguistic tools they have acquired, speakers select the one that brings out the most communicative effect to convey their message. Our study focuses on two markers, -mm and dämmo, in Amharic (Ethiopian Semitic language). Our aim is to examine, from a developmental perspective, how they are used by speakers. We seek to distinguish the communicative and pragmatic functions indicated by means of these markers. To do so, we created a corpus of sixty narrative productions of children from 5-6, 7-8 to 10-12 years old and adult Amharic speakers. The experimental material we used to collect our data is a series of pictures without text 'Frog, Where are you?'. Although -mm and dämmo are each used in specific contexts, they are sometimes analyzed as being interchangeable. The suffix -mm is complex and multifunctional. It marks the end of the negative verbal structure, it is found in the relative structure of the imperfect, it creates new words such as adverbials or pronouns, it also serves to coordinate words, sentences and to mark the link between macro-propositions within a larger textual unit. -mm was analyzed as marker of insistence, topic shift marker, element of concatenation, contrastive focus marker, 'bisyndetic' coordinator. On the other hand, dämmo has limited function and did not attract the attention of many authors. The only approach we could find analyzes it in terms of 'monosyndetic' coordinator. The paralleling of these two elements made it possible to understand their distinctive functions and refine their description. When it comes to marking a referent, the choice of -mm or dämmo is not neutral, depending on whether the tagged argument is newly introduced, maintained, promoted or reintroduced. The presence of these morphemes explains the inter-phrastic link. The information is seized by anaphora or presupposition: -mm goes upstream while dämmo arrows downstream, the latter requires new information. The speaker uses -mm or dämmo according to what he assumes to be known to his interlocutors. The results show that -mm and dämmo, although all the speakers use them both, do not always have the same scope according to the speaker and vary according to the age. dämmo is mainly used to mark a contrastive topic to signal the concomitance of events. It is more commonly used in young children’s narratives (F(3,56) = 3,82, p < .01). Some values of -mm (additive) are acquired very early while others are rather late and increase with age (F(3,56) = 3,2, p < .03). The difficulty is due not only because of its synthetic structure but primarily because it is multi-purpose and requires a memory work. It highlights the constituent on which it operates to clarify how the message should be interpreted.

Keywords: acquisition, cohesion, connection, contrastive topic, contrastive focus, discourse marker, pragmatics

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Authors: H. Jalahi, A. Yazdanpanah Nozari

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Background and Purpose: Assessment of learners’ performance is an important factors in teaching-learning process. When a factor is sensitive and has high influence on life, their assessment should be done precisely. Thinking dispositions are very important factors in medical education because of its specific condition. In this study a model is designed for fostering thinking dispositions of learners in which authentic assessment is an important element. Materials and Methods: Objective based research is developmental, and such a model was not designed for curricula. Data collection and comparing approaches about assessment and analyzing current assessments offered applied proposals. Results: Based on research findings, the current assessments are response-based, that is students instead of product of response, only offers the specific response which the teachers expects; but authentic assessment is a form of assessment in which students are asked to perform real-word tasks that demonstrate meaningful application of essential knowledge and skills. Conclusion: Because of the difficulties and unexpected problems in life and individuals needs to lifelong learning and conditions in medical course that require decision making in specific times, we must pay attention to reach thinking dispositions and it should be included in curriculum. Authentic assessment as an important aspect of curriculum can help fostering thinking dispositions of learners. Using this kind of assessments which focus on application of information and skills to solve real-word tasks have more important role in medical courses.

Keywords: assessment, authentic, medical courses, developmental

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Authors: Julia Wimmers-Klick

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In the contemporary study of anatomy, medical students utilize a diverse array of resources, including lab handouts, lectures, and, increasingly, digital media such as interactive anatomy apps and digital images. Notably, a significant shift has occurred, with fewer students possessing traditional anatomy atlases or books, reflecting a broader trend towards digital approaches like Virtual Reality, Augmented Reality, and web-based programs. This paper seeks to explore the evolution of anatomy education by contrasting current digital tools with historical resources, such as classical anatomical illustrations and atlases, to assess their relevance and potential benefits in modern medical education. Through a comprehensive literature review, the development of anatomical illustrations is traced from the textual descriptions of Galen to the detailed and artistic representations of Da Vinci, Vesalius, and later anatomists. The examination includes how the printing press facilitated the dissemination of anatomical knowledge, transforming covert dissections into public spectacles and formalized teaching practices. Historical illustrations, often influenced by societal, religious, and aesthetic contexts, not only served educational purposes but also reflected the prevailing medical knowledge and ethical standards of their times. Critical questions are raised about the place of historical illustrations in today's anatomy curriculum. Specifically, their potential to teach critical thinking, highlight the history of medicine, and offer unique insights into past societal conditions are explored. These resources are viewed in their context, including the lack of diversity and the presence of ethical concerns, such as the use of illustrations from unethical sources like Pernkopf’s atlas. In conclusion, while digital tools offer innovative ways to visualize and interact with anatomical structures, historical illustrations provide irreplaceable value in understanding the evolution of medical knowledge and practice. The study advocates for a balanced approach that integrates traditional and modern resources to enrich medical education, promote critical thinking, and provide a comprehensive understanding of anatomy. Future research should investigate the optimal combination of these resources to meet the evolving needs of medical learners and the implications of the digital shift in anatomy education.

Keywords: human anatomy, historical illustrations, historical context, medical education

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Authors: Siddhant Yadav, Ann Vincent, Sanjeev Nanda, Karen M. Fischer, Jessica A. Wright

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Statement of the Problem: Despite the growing popularity of cannabis in the general population, there are several unknowns regarding its use, specific reasons for use, patient’s choice of products, health benefits, and adverse effects. The aim of our study was to evaluate patient-reported information related to cannabis use that was recorded in the electronic medical records. Methodology & Theoretical Orientation: We manually reviewed the electronic medical records of cannabis users who were part of a large pharmacogenomic study. Data abstracted included demographics, level of education, concurrent alcohol and tobacco use, type of cannabis utilized, formulation, indication, symptomatic improvement, or adverse effects reported. Following this, we did a descriptive statistical analysis. Findings: Our sample of 164 cannabis users were predominantly female (73.2%); 66% of users reported using cannabis for medical indications. Of the 109 patients who recorded information pertaining to alcohol/tobacco use, two-thirds of cannabis users reported concurrent use of alcohol, and about half of them were former or current tobacco users. The mean age of cannabis use was 66 years. Regarding the type of cannabis, 34.1% reported using marijuana, 32.3% reported CBD use, 1.8% reported using THC, and 1.2% reported using Marinol. Oral formulations (capsules, oils, suspensions, brownies, cakes, and tea) were the most common route (44 %). Indications for use included chronic pain (n=76), anxiety (n=9), counteracting side effects of chemotherapy (n=4), and palliative reasons (n=2). Fifty-eight of the 76 users endorsed improvement in chronic pain (80%), 5 users reported improvement in anxiety, and 2 reported improvement in side effects of chemotherapy. Conclusion & Significance: The majority of our cannabis users were Caucasian females, and there was a high likelihood of coinciding use of alcohol/tobacco in patients using cannabis. Most of our patients used the oral formulation for chronic pain. Importantly, a considerable number of patients reported improvements in chronic pain, anxiety, and side effects of chemotherapy.

Keywords: cannabis use, adverse effects, medical practice, indications

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Authors: Elizaveta S. Prokofyeva, Svetlana V. Maltseva, Roman D. Zaitsev

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Rapidly evolving modern data analysis technologies in healthcare play a large role in understanding the operation of the system and its characteristics. Nowadays, one of the key tasks in urban healthcare is to optimize the resource allocation. Thus, the application of data analysis in medical institutions to solve optimization problems determines the significance of this study. The purpose of this research was to establish the dependence between the indicators of the effectiveness of the medical institution and its resources. Hospital discharges by diagnosis; hospital days of in-patients and in-patient average length of stay were selected as the performance indicators and the demand of the medical facility. The hospital beds by type of care, medical technology (magnetic resonance tomography, gamma cameras, angiographic complexes and lithotripters) and physicians characterized the resource provision of medical institutions for the developed models. The data source for the research was an open database of the statistical service Eurostat. The choice of the source is due to the fact that the databases contain complete and open information necessary for research tasks in the field of public health. In addition, the statistical database has a user-friendly interface that allows you to quickly build analytical reports. The study provides information on 28 European for the period from 2007 to 2016. For all countries included in the study, with the most accurate and complete data for the period under review, predictive models were developed based on historical panel data. An attempt to improve the quality and the interpretation of the models was made by cluster analysis of the investigated set of countries. The main idea was to assess the similarity of the joint behavior of the variables throughout the time period under consideration to identify groups of similar countries and to construct the separate regression models for them. Therefore, the original time series were used as the objects of clustering. The hierarchical agglomerate algorithm k-medoids was used. The sampled objects were used as the centers of the clusters obtained, since determining the centroid when working with time series involves additional difficulties. The number of clusters used the silhouette coefficient. After the cluster analysis it was possible to significantly improve the predictive power of the models: for example, in the one of the clusters, MAPE error was only 0,82%, which makes it possible to conclude that this forecast is highly reliable in the short term. The obtained predicted values of the developed models have a relatively low level of error and can be used to make decisions on the resource provision of the hospital by medical personnel. The research displays the strong dependencies between the demand for the medical services and the modern medical equipment variable, which highlights the importance of the technological component for the successful development of the medical facility. Currently, data analysis has a huge potential, which allows to significantly improving health services. Medical institutions that are the first to introduce these technologies will certainly have a competitive advantage.

Keywords: data analysis, demand modeling, healthcare, medical facilities

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Authors: Julia Wimmers-Klick

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At the Canadian University of British Columbia's Faculty of Medicine, anatomy has traditionally been taught through a combination of lectures and dissection labs in the first two years, with radiology taught separately through lectures and online modules. However, this separation may leave students underprepared for medical practice, as medical imaging is essential for diagnosing anatomical and pathological conditions. To address this, a pilot project was initiated aimed at integrating radiological imaging into anatomy dissection labs from day one of medical school. The incorporated radiological images correlated with the current dissection areas. Additional stations were added within the lab, tailored to the specific content being covered. These stations focused on bones, and quiz questions, along with light-box exercises using radiographs, CT scans, and MRIs provided by the radiology department. The images used were free of pathologies. Examples of these will be presented in the poster. Feedback from short interviews with students and instructors has been positive, particularly among second-year students who appreciated the integration compared to their first-year experience. This low-budget approach was easy to implement but faced challenges, as lab instructors were not radiologists and occasionally struggled to answer students' questions. Instructors expressed a desire for basic training or a refresher course in radiology image reading, particularly focused on identifying healthy landmarks. Overall, all participants agreed that integrating radiology with anatomy reinforces learning during dissection, enhancing students' understanding and preparation for clinical practice.

Keywords: quality improvement, radiology education, anatomy education, integration

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Authors: Mohammad Al-Mousawi

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This academic article explores the indispensable role of critical thinking in the process of diagnosing diseases. Employing a multidisciplinary approach, we delve into the cognitive skills and analytical mindset that clinicians, researchers, and healthcare professionals must employ to navigate the complexities of disease identification. By examining the integration of critical thinking within the realms of medical education, diagnostic decision-making, and technological advancements, this article aims to underscore the significance of cultivating and applying critical thinking skills in the ever-evolving landscape of healthcare.

Keywords: critical thinking, medical education, diagnostic decision-making, fostering critical thinking

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Authors: Jeroen S. de Bruin, Karin Schindler, Christian Schuh

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With increasingly more mobile health applications appearing due to the popularity of smartphones, the possibility arises that these data can be used to improve the medical diagnostic process, as well as the overall quality of healthcare, while at the same time lowering costs. However, as of yet there have been no reports of a successful combination of patient-generated data from smartphones with data from clinical routine. In this paper, we describe how these two types of data can be combined in a secure way without modification to hospital information systems, and how they can together be used in a medical expert system for automatic nutritional classification and triage.

Keywords: mobile health, data integration, expert systems, disease-related malnutrition

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Authors: Goitom Molalign Takele, Tsegalem Hailemariam Ballo, Kiros Belay Gebrekidan, Birhan Gebresilassie Gebregiorgis

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Background: Emergency medical services (EMS) are services that provide out-of-hospital emergency medical care to injured or ill peoples, and transporting to definitive care. EMS is an integral part of the emergency medical system and has been associated with decreased morbidity and mortality related to emergency cases. The aim of this study was to assess the utilization, barriers, and determinants of EMS in Mekelle, Ethiopia. Methods: A community-based cross-sectional study was conducted in selected sub-cities of Mekelle. A multistage sampling method was employed to recruit study participants, and data were collected by trained data collectors using an interviewer-administered questionnaire. Multivariate logistic regression analysis was used to examine the statistical association of the determinants of EMS utilization. Results: Half (50.5%) of the respondents had experienced or witnessed an emergency incident in the past year. The common means of transportations used were Bajaj’s (39.2%) and ambulances (22.7%). Majority (88.1%) of the respondents did not knew the EMS access phone number of an ambulance. As their preferred mode of transportation in case of emergency conditions, 42.2% of the participants reported an ambulance, followed by Bajaj 33.7%. Where participants who had gynecologic emergencies were 9.4 times (AOR=9.4, 95% CI: 1.04, 85, p=0.046), and those who knew any ambulance numbers were 3.6 times (AOR=3.6, 95% CI: 1.22, 10.8, p=0.02) more likely to use ambulance services in case of emergencies. Conclusion: The ambulance utilization level in Mekelle city was low and victims of emergency conditions were being transported mainly using public transports such as Bajaj’s and taxis. Even though the perception of the public towards EMS services is favorable, lack of awareness of EMS access, and lack of integrated EMS system in the city are the barriers that may have contributed to the low utilization. Actions to improve EMS access and integrating the system are warranted to promote the services utilization.

Keywords: emergency medical services, utilization, Mekelle, barriers

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Authors: B. Bricklin Zeff

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This research explores the development and application of a specialized chatbot tailored for a nursing English course, with a primary objective of augmenting student engagement through situational content and responsiveness to key expressions and vocabulary. Introducing the chatbot, elucidating its purpose, and outlining its functionality are crucial initial steps in the research study, as they provide a comprehensive foundation for understanding the design and objectives of the specialized chatbot developed for the nursing English course. These elements establish the context for subsequent evaluations and analyses, enabling a nuanced exploration of the chatbot's impact on student engagement and language learning within the nursing education domain. The subsequent exploration of the intricate language model development process underscores the fusion of scientific methodologies and artistic considerations in this application of artificial intelligence (AI). Tailored for educators and curriculum developers in nursing, practical principles extending beyond AI and education are considered. Some insights into leveraging technology for enhanced language learning in specialized fields are addressed, with potential applications of similar chatbots in other professional English courses. The overarching vision is to illuminate how AI can transform language learning, rendering it more interactive and contextually relevant. The presented chatbot is a tangible example, equipping educators with a practical tool to enhance their teaching practices. Methodologies employed in this research encompass surveys and discussions to gather feedback on the chatbot's usability, effectiveness, and potential improvements. The chatbot system was integrated into a nursing English course, facilitating the collection of valuable feedback from participants. Significant findings from the study underscore the chatbot's effectiveness in encouraging more verbal practice of target expressions and vocabulary necessary for performance in role-play assessment strategies. This outcome emphasizes the practical implications of integrating AI into language education in specialized fields. This research holds significance for educators and curriculum developers in the nursing field, offering insights into integrating technology for enhanced English language learning. The study's major findings contribute valuable perspectives on the practical impact of the chatbot on student interaction and verbal practice. Ultimately, the research sheds light on the transformative potential of AI in making language learning more interactive and contextually relevant, particularly within specialized domains like nursing.

Keywords: chatbot, nursing, pragmatics, role-play, AI

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Authors: Julius Steinkopf, Eric Rost, Aike Hessel, Sonia Lippke

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Objective: This study examined possible determinants of return to work (RTW) in individuals who participated in a medical rehabilitation program longitudinally over a time period of six months. Design/methodology/approach: N=1,044 rehabilitants were included in the baseline measurement in terms of completing a questionnaire during their medical rehabilitation. About 30% (n=350) have remained in the study in terms of participating in computer-assisted telephone interviewing (CATI) six months later. Frequency analyses and Regression analyses were run. Findings: About 70% of the rehabilitants returned to work six months after rehabilitation. Regression analyses revealed that the RTW rates were significantly predicted by gender (OR=0.12, men were more likely to return), perceived social support (OR=3.01) and current physical functioning (OR=1.25). Furthermore RTW motives, like expected monetary rewards (OR=25.2) and feelings of being needed (OR=0.18) same as motives for not returning to work (nRTW), like the wish to stop working in order to spend time with the spouse (OR=0.13) or a lack of enjoyment of work (OR=3.81), significantly predicted return to work rates. Life satisfaction, self-efficacy beliefs, mental health, current income, educational background or age did not significantly increase explained variance (all ps > .05). Practical implications: Taking theses predictors into account provides options to increase the effectiveness of interventions aiming at increasing RTW: Medical rehabilitations should not only aim at improving the physical functioning but also to enhance beneficial motives and social support as well as support women specifically in order to improve the effectiveness of medical rehabilitation and public health interventions. Originality/value: Illness-caused work absences are related to high financial costs and individual burden. Despite of the public health and societal implications, this is one of the very few studies investigating systematically fitness and health for the return to work.

Keywords: gender, fitness, health, physical functioning

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Authors: Munir Ashraf, Shagufta Riaz

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Personal protective equipment (PPE) and bioactive textiles are highly important for the health care of front line hospital workers, patients, and the general population to be safe from highly infectious diseases. This was even more critical in the wake of COVID-19 outbreak. Most of the medical textiles are inactive against various viruses and bacteria, hence there is a need to wash them frequently to avoid the spread of microorganisms. According to survey conducted by the world health organization, more than 500 million people get infected from hospitals, and more than 13 million died due to these hospitals’ acquired deadly diseases. The market available PPE are though effective against the penetration of pathogens and to kill bacteria but, they are not breathable and active against different viruses. Therefore, there was a great need to develop textiles that are not only effective against bacteria, fungi, and viruses but also are comfortable to the medical personnel and patients. In the present study, waterproof breathable, and biologically active textiles were developed using antiviral and antibacterial nanomaterials. These nanomaterials like TiO₂, ZnO, Cu, and Ag were immobilized at the surface of cotton fabric by using different silane coupling agents and electroless deposition that they retained their functionality even after 30 industrial laundering cycles. Afterwards, the treated fabrics were coated with a waterproof breathable film to prevent the permeation of liquid droplets, any particle or microorganisms greater than 80 nm. The developed cotton fabric was highly active against bacteria and viruses. The good durability of nanomaterials at the cotton surface after several industrial washing cycles makes this fabric an ideal candidate for bioactive textiles used in the medical field.

Keywords: antibacterial, antiviral, cotton, durable

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Authors: Supriyo Das, Elbir Jove, Ajay Singh, Sophie Corbet, Noel Carr, Martin Deetz

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Water is a critical commodity in the healthcare and medical field. The utility of medical-grade water spans from washing surgical equipment, drug preparation to the key element of life-saving therapy such as hydrotherapy and hemodialysis for patients. A properly treated medical water reduces the bioburden load and mitigates the risk of infection, ensuring patient safety. However, any compromised condition during the production of medical-grade water can create a favorable environment for microbial growth putting patient safety at high risk. Therefore, proper upstream treatment of the medical water is essential before its application in healthcare, pharma and medical space. Reverse Osmosis (RO) is one of the most preferred treatments within healthcare industries and is recommended by all International Pharmacopeias to achieve the quality level demanded by global regulatory bodies. The RO process can remove up to 99.5% of constituents from feed water sources, eliminating bacteria, proteins and particles sizes of 100 Dalton and above. The combination of RO with other downstream water treatment technologies such as Electrodeionization and Ultrafiltration meet the quality requirements of various pharmacopeia monographs to produce highly purified water or water for injection for medical use. In the reverse osmosis process, the water from a liquid with a high concentration of dissolved solids is forced to flow through an especially engineered semi-permeable membrane to the low concentration side, resulting in high-quality grade water. However, these specially engineered RO membranes need to be sanitized either chemically or at high temperatures at regular intervals to keep the bio-burden at the minimum required level. In this paper, we talk about Dupont´s FilmTec Heat Sanitizable Reverse Osmosis membrane (HSRO) for the production of medical-grade water. An HSRO element must be pre-conditioned prior to initial use by exposure to hot water (80°C-85°C) for its stable performance and to meet the manufacturer’s specifications. Without pre-conditioning, the membrane will show variations in feed pressure operations and salt rejection. The paper will discuss the critical variables of pre-conditioning steps that can affect the overall performance of the HSRO membrane and demonstrate the data to support the need for pre-conditioning of HSRO elements. Our preliminary data suggests that there can be up to 35 % reduction in flow due to initial heat treatment, which also positively affects the increase in salt rejection. The paper will go into detail about the fundamental understanding of the performance change of HSRO after the pre-conditioning step and its effect on the quality of medical water produced. The paper will also discuss another critical point, “regular hot water sanitization” of these HSRO membranes. Regular hot water sanitization (at 80°C-85°C) is necessary to keep the membrane bioburden free; however, it can negatively impact the performance of the membrane over time. We will demonstrate several data points on hot water sanitization using FilmTec HSRO elements and challenge its robustness to produce quality medical water. The last part of this paper will discuss the construction details of the FilmTec HSRO membrane and features that make it suitable to pre-condition and sanitize at high temperatures.

Keywords: heat sanitizable reverse osmosis, HSRO, medical water, hemodialysis water, water for Injection, pre-conditioning, heat sanitization

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Authors: Policarpio Jr. Joves

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Physicians in most teaching hospitals are commonly promoted into managerial roles, yet their training is mostly in clinical and scientific skills but not in leadership competencies. When they shift into roles of physician leadership, the majority hold on to their primary identity of physicians. These conflicting roles affect their identity and eventually their work. The physician leaders also face additional challenges related to academics which include incorporation of new knowledge into the existing curriculum, use of technology in the delivery of teaching, the need to train medical students outside of hospital wards, etc. The study aims to explore how physician leaders in teaching hospitals of private medical schools enact their leadership roles and how they face the challenges as physician leaders. The study setting shall be teaching hospitals of three private medical schools situated in the National Capital Region, Philippines. A multiple case study design shall be adopted in this research. Physicians shall be eligible to participate in the study if they are practicing clinicians limited to the five major clinical specialty: Internal Medicine, Pediatrics, Family Medicine, Surgery, Obstetrics and Gynecology. They must be teaching in the College of Medicine prior to their appointments as physician leaders in both medical school and teaching hospital. Semi-structured face-to-face interviews shall be utilized as a means of data collection, with open-ended questions, enabling physician leaders to present narratives about their identity, role enactment, conflicts, reaction of colleagues, and the challenges encountered in their day-to-day work as physician leaders. Interviews shall be combined with observations and review of records to gain more insights into how the physician leaders are 'doing' management. Within-case analysis shall be done initially followed by a thematic analysis across the cases, referred to as cross–case analysis or cross-case synthesis.

Keywords: academic leaders, academic managers, physician leaders, physician managers

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Authors: Amir Moslemi, Amir movafeghi, Shahab Moradi

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One of the most important challenging factors in medical images is nominated as noise.Image denoising refers to the improvement of a digital medical image that has been infected by Additive White Gaussian Noise (AWGN). The digital medical image or video can be affected by different types of noises. They are impulse noise, Poisson noise and AWGN. Computed tomography (CT) images are subjected to low quality due to the noise. The quality of CT images is dependent on the absorbed dose to patients directly in such a way that increase in absorbed radiation, consequently absorbed dose to patients (ADP), enhances the CT images quality. In this manner, noise reduction techniques on the purpose of images quality enhancement exposing no excess radiation to patients is one the challenging problems for CT images processing. In this work, noise reduction in CT images was performed using two different directional 2 dimensional (2D) transformations; i.e., Curvelet and Contourlet and Discrete wavelet transform(DWT) thresholding methods of BayesShrink and AdaptShrink, compared to each other and we proposed a new threshold in wavelet domain for not only noise reduction but also edge retaining, consequently the proposed method retains the modified coefficients significantly that result in good visual quality. Data evaluations were accomplished by using two criterions; namely, peak signal to noise ratio (PSNR) and Structure similarity (Ssim).

Keywords: computed tomography (CT), noise reduction, curve-let, contour-let, signal to noise peak-peak ratio (PSNR), structure similarity (Ssim), absorbed dose to patient (ADP)

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Authors: Ayman M. Mansour

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In this paper, we propose an intelligent system that is used for monitoring the health conditions of Patients. Monitoring the health condition of Patients is a complex problem that involves different medical units and requires continuous monitoring especially in rural areas because of inadequate number of available specialized physicians. The proposed system will Improve patient care and drive costs down comparing to the existing system in Jordan. The proposed system will be the start point to Faster and improve the communication between different units in the health system in Jordan. Connecting patients and their physicians beyond hospital doors regarding their geographical area is an important issue in developing the health system in Jordan. The propose system will provide an intelligent system that will generate initial diagnosing to the patient case. This will assist and advice clinicians at the point of care. The decision is based on demographic data and laboratory test results of patient data. Using such system with the ability of making medical decisions, the quality of medical care in Jordan and specifically in Tafial is expected to be improved. This will provide more accurate, effective, and reliable diagnoses and treatments especially if the physicians have insufficient knowledge.

Keywords: GSM, SMS, patient, monitoring system, fuzzy logic, multi-agent system

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Authors: Mohammad Reza Naghavi, Farzad Alaeimoghadam, Hossein Ghafoori

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Artemisia species, which are medically beneficial, are widespread in temperate regions of both Northern and Southern hemispheres among which Iran is located. About 35 species of Artemisia are indigenous in Iran among them some are widespread in all or most provinces, yet some are restricted to some specific regions. In this review paper, initially, GC-Mass results of some experiments done in different provinces of Iran are mentioned among them some compounds are common among species, some others are mostly restricted to other species; after that, medical advantages based on some researches on species of this genus are reviewed; different qualities such as anti-leishmania, anti-bacteria, antiviral as well as anti-proliferative could be mentioned.

Keywords: artemisia, GC-Mass analysis, medical advantage, antiviral

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

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Choosing a career which matches a student’s personality traits is one of the key factors for future work satisfaction. This is because career satisfaction is at the highest when it is in line with one’s personality strength, values and attitudes. Personality traits play a major role in determining the success of a student in the medical course. In the pre-clinical years, medical theories are being emphasized, thus, conscientious students would perform better than those with lower level of this trait. As the emphasis changes in the clinical years during which patient interaction is important, personality traits which involved interpersonal values become more essential for success. The aim of this study was to determine the personality traits of students who had chosen medicine as their career. It was a cross-sectional study conducted at the Islamic Science University of Malaysia. The respondents consisted of 81 students whose age ranged between 20-21 years old. A set of personality assessment inventory index which has been validated for the local context was used to determine the students’ personality traits. The instrument assessed 15 personality traits namely: aggressive, analytical, autonomy, creativity, extrovert, intellectual, motivation, diversity, resiliency, self-criticism, control, helpful, support, structured and achievement. The scores ranged between 1-100%, and they were categorized into low (1-30%), moderate (40-60%) and high scores (70-100%). The respondents were Year 3 pre-clinical medical students and there were more female students (69%) compared to male students (31%). Majority of them were from middle-income families. Approximately 70% of both parents of the respondents had tertiary education. Majority of the students had high scores in autonomy, creativity, diversity, helpful, structured and achievement. In other words, more than 50% of them scored high (70-100%) in these traits. Scoring high in these traits was beneficial for the medical course. For aggressive trait, 54% of them had moderate scores which is compatible for medicine as this indicated an inclination to being assertive. In the analytical and intellectual components, only 40% and 25% had high scores respectively. These results contradicted the usual expectation of medical students whereby they are expected to be highly analytical and intellectual. It would be an added value if the students had high scores in being extrovert as this reflects on good interpersonal values, however, the students had approximately similar scores in all categories of this trait. Being resilient in the medical school is important as the course is difficult and demanding. The students had good scores in this component in which 46% had high scores while 39% had moderate scores. In conclusion, by understanding their personality traits, strengths and weaknesses, the students will have an opportunity to improve themselves in the areas they lack. This will help them to become better doctors in future.

Keywords: career, medical students, medicine, personality traits

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Authors: Qasim Munye, Juned Islam, Haseeb Qureshi, Syed Jung

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Lung nodules are commonly identified in computed tomography (CT) scans by experienced radiologists at a relatively late stage. Early diagnosis can greatly increase survival. We propose using a pix2pix conditional generative adversarial network to generate realistic images simulating early-stage lung nodule growth. We have applied deep images prior to 2341 slices from 895 computed tomography (CT) scans from the Lung Image Database Consortium (LIDC) dataset to generate pseudo-healthy medical images. From these images, 819 were chosen to train a pix2pix network. We observed that for most of the images, the pix2pix network was able to generate images where the nodule increased in size and intensity across epochs. To evaluate the images, 400 generated images were chosen at random and shown to a medical student beside their corresponding original image. Of these 400 generated images, 384 were defined as satisfactory - meaning they resembled a nodule and were visually similar to the corresponding image. We believe that this generated dataset could be used as training data for neural networks to detect lung nodules at an early stage or to improve the accuracy of such networks. This is particularly significant as datasets containing the growth of early-stage nodules are scarce. This project shows that the combination of deep image prior and generative models could potentially open the door to creating larger datasets than currently possible and has the potential to increase the accuracy of medical classification tasks.

Keywords: medical technology, artificial intelligence, radiology, lung cancer

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Authors: Seyedfateh Moradi

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Medical issues mark the beginning of a new form of epistemology in nineteenth-century Iran. The emergence of epidemic diseases led to the formation of a medical discourse and conflict over the body which displayed itself in the concept of health progress and development. The discourse attributed to this development in the health system defines the general structure of the given period. This discourse manifested itself in the conflict between the traditional and new medicine. The regulation and classification of body and population reveal the nature of this period. The government attempted to adapt itself to the modern and progressive discourse. This paper seeks to reveal part of this rupture and adaptation around epidemics and modern medical discourse. Also, accepting part of the traditional discourse in the new era, or adapting and integrating parts of it indicate a delegation of part of the power of traditional authorities. The delegation of power arose in the context of the discursive hegemony of Western modernism from which there was no escape. This provided the ground for the acceptance of government and emergence of other discourses. Finally, during the reign of Reza Shah (1922-1942), body and population planning changed into the key issues of government, which created serious tensions in society.

Keywords: epidemic, population, body, cholera, plague

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Authors: Yanyan Wang

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This paper on second language teaching and learning uses conversation analysis (CA) approach and focuses on how second language learners of Chinese do repair when making clarification requests. In order to demonstrate their behavior in interaction, a comparison was made to study the differences between native speakers of Chinese with non-native speakers of Chinese. The significance of the research is to make second language teachers and learners aware of repair and how to seek clarification. Utilizing the methodology of CA, the research involved two sets of naturally occurring recordings, one of native speaker students and the other of non-native speaker students. Both sets of recording were telephone talks between students and teachers. There were 50 native speaker students and 50 non-native speaker students. From multiple listening to the recordings, the parts with repairs for clarification were selected for analysis which included the moments in the talk when students had problems in understanding or hearing the speaker and had to seek clarification. For example, ‘Sorry, I do not understand ‘and ‘Can you repeat the question? ‘were the parts as repair to make clarification requests. In the data, there were 43 such cases from native speaker students and 88 cases from non-native speaker students. The non-native speaker students were more likely to use repair to seek clarification. Analysis on how the students make clarification requests during their conversation was carried out by investigating how the students initiated problems and how the teachers repaired the problems. In CA term, it is called other-initiated self-repair (OISR), which refers to student-initiated teacher-repair in this research. The findings show that, in initiating repair, native speaker students pay more attention to mutual understanding (inter-subjectivity) while non-native speaker students, due to their lack of language proficiency, pay more attention to their status of knowledge (epistemic) switch. There are three major differences: 1, native Chinese students more often initiate closed-class OISR (seeking specific information in the request) such as repeating a word or phrases from the previous turn while non-native students more frequently initiate open-class OISR (not specifying clarification) such as ‘sorry, I don’t understand ‘. 2, native speakers’ clarification requests are treated by the teacher as understanding of the content while non-native learners’ clarification requests are treated by teacher as language proficiency problem. 3, native speakers don’t see repair as knowledge issue and there is no third position in the repair sequences to close repair while non-native learners take repair sequence as a time to adjust their knowledge. There is clear closing third position token such as ‘oh ‘ to close repair sequence so that the topic can go back. In conclusion, this paper uses conversation analysis approach to compare differences between native Chinese speakers and non-native Chinese learners in their ways of conducting repair when making clarification requests. The findings are useful in future Chinese language teaching and learning, especially in teaching pragmatics such as requests.

Keywords: conversation analysis (CA), clarification request, second language (L2), teaching implication

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Authors: Marica Pidor-Quingco, Francis Cabatingan

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Background: One of the essential roles of a physician is to assess a patient’s worth and support them in making decisions regarding their future preferences when it comes to medical care. Advance Directives is a patient-centered approach which is liked to a better-quality treatment at the end of life. General Objective: To assess and describe the knowledge, attitudes and practices of resident physicians regarding advance directive among the resident physicians in Vicente Sotto Memorial Medical Study. Methods: An analytical cross-sectional study was conducted at Vicente Sotto Memorial Medical Center. There was a total of 129 respondents who gave their consent and was given survey questionnaire containing the demographic profile, knowledge, attitude and practices. Categorical variables were presented as frequency and percentage. Chi Square Test was used to determine the association of demographic profile with knowledge and attitude. Man-Whitney U test was utilized for the association of age with knowledge and attitude. Results: Out of 129 respondents, 36.59% were in favor towards self-determination and autonomy. Majority of the revealed an adequate knowledge and positive attitude regarding advance directives. Based on the results, there were no significant correlations between sociodemographic of the residents towards to knowledge and attitude. Over 66.7% of the respondents had used Advance Directives to their patients but 25% were not comfortable about it. Though most of the respondents was able to discuss AD with their patients, 7.0% of them are not willing to open the topic to the family. Conclusion: VSMMC is a tertiary hospital which also caters Hospice, Palliative and Supportive care to the patients. One of the services offered is initiating Advance Directives which may be a factor for a positive knowledge, attitude and practices towards this topic.

Keywords: advance directives, philippines, physicians, palliative

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Authors: Ali Seddiki, Mohamed Djebbouri, Driss Guerchi

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Medical imaging produces human body pictures in digital form. Since these imaging techniques produce prohibitive amounts of data, compression is necessary for storage and communication purposes. In some areas in medicine, it may be sufficient to maintain high image quality only in region of interest (ROI). This paper discusses a contribution to quality purpose compression in the region of interest of scintigraphic images based on dual tree complex wavelet transform (DT-CWT) using Run-Length coding (RLE) and Huffman coding (HC).

Keywords: DT-CWT, region of interest, run length coding, Scintigraphic images

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Authors: Rahaf Mandura

Abstract:

Background: Idiopathic intracranial hypertension (IIH) is a disorder with elevated intracranial pressure (ICP) more than 250 mm H₂O, without evidence of meningeal inflammation, space-occupying lesion, or venous thrombosis. The aim of this research is to study the clinical profile, evaluation, management, and visual outcome in a hospital-based population of IIH cases in Jeddah. Methodology: This is a retrospective observational study that included the medical records of all patients referred to neuro-ophthalmology service for evaluation of papilledema. The medical records have been reviewed from October 2018 to February 2020 at Jeddah Eye Hospital (JEH), Saudi Arabia. A total of fifty-one patients presented with papilledema in the studied period. Forty-seven patients met our inclusion criteria and were included in the study. Results: Most of the patients were females (43, 91.5%) with a mean age of presentation of 30.83±11.40 years. The most common presenting symptom was headache (40 patients, 85.1%), followed by transient visual obscuration (20 patients, 42.6%), and reduced visual acuity (15 patients, 31.9%). All 47 patients were started on medical treatment with oral acetazolamide with four patients (8.5%) shifted to topiramate because of the lack of response or intolerance to acetazolamide while four patients (8.5%) underwent lumbar-peritoneal shunt because of inadequate control of the disease despite the treatment with medical therapy. For both eyes, the change in visual acuity across all assessment points was statistically significant. Nevertheless, there were no significant changes in the visual field findings among all of the compared assessment points. Conclusion: The present study has shown that IIH-related papilledema is common in young female patients with headaches, transient visual obscurations and reduced visual acuity. Those are the commonest symptoms in our IIH population. Medical treatment of IIH is significantly efficacious and should be considered in order to enhance the prognosis of IIH-related complications. Therefore, the visual status should be frequently monitored for these patients.

Keywords: idiopathic intracranial hypertension, intracranial hypertension, papilledema, headache

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Authors: Siti Salbiah Samsudin, Hamzah Arof, Ainuddin Wahid Abdul Wahab, Mohd Yamani Idna Idris

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Standard X-ray spine images produced by conventional screen-film technique have a limited field of view. This limitation may obstruct a complete inspection of the spine unless images of different parts of the spine are placed next to each other contiguously to form a complete structure. Another solution to producing a whole spine image is by assembling the digitized x-ray images of its parts automatically using image stitching. This paper presents a new Medical Image Stitching (MIS) method that utilizes Minimum Average Correlation Energy (MACE) filters to identify and merge pairs of x-ray medical images. The effectiveness of the proposed method is demonstrated in two sets of experiments involving two databases which contain a total of 40 pairs of overlapping and non-overlapping spine images. The experimental results are compared to those produced by the Normalized Cross Correlation (NCC) and Phase Only Correlation (POC) methods for comparison. It is found that the proposed method outperforms those of the NCC and POC methods in identifying both the overlapping and non-overlapping medical images. The efficacy of the proposed method is further vindicated by its average execution time which is about two to five times shorter than those of the POC and NCC methods.

Keywords: image stitching, MACE filter, panorama image, scoliosis

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Authors: Sheema Shuja Khattak, Gule Saman, Imran Khan, Abdus Salam

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Image segmentation plays an important role in medical imaging applications. Therefore, accurate methods are needed for the successful segmentation of medical images for diagnosis and detection of various diseases. In this paper, we have used maximum entropy to achieve image segmentation. Maximum entropy has been calculated using Shannon, Renyi, and Tsallis entropies. This work has novelty based on the detection of skin lesion caused by the bite of a parasite called Sand Fly causing the disease is called Cutaneous Leishmaniasis.

Keywords: shannon, maximum entropy, Renyi, Tsallis entropy

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