Search results for: medical model

Authors: Fatima Faraz

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BACKGROUND: While Artificial intelligence (AI) provides new opportunities across a wide variety of industries, healthcare is no exception. AI can lead to advancements in how the healthcare system functions and improves the quality of patient care. Developing countries like Pakistan are lagging in the implementation of AI-based solutions in healthcare. This demands increased knowledge and AI literacy among health care professionals. OBJECTIVES: To assess the level of awareness among medical students and faculty about AI in preparation for teaching AI basics and data science applications in clinical practice in an integrated medical curriculum. METHODS: An online 15-question semi-structured questionnaire, previously tested and validated, was delivered among participants through convenience sampling. The questionnaire composed of 3 parts: participant’s background knowledge, AI awareness, and attitudes toward AI applications in medicine. RESULTS: A total of 182 students and 39 faculty members from Rawalpindi Medical University, Pakistan, participated in the study. Only 26% of students and 46.2% of faculty members responded that they were aware of AI topics in clinical medicine. The major source of AI knowledge was social media (35.7%) for students and professional talks and colleagues (43.6%) for faculty members. 23.5% of participants answered that they personally had a basic understanding of AI. Students and faculty (60.1%) were interested in AI in patient care and teaching domain. These findings parallel similar published AI survey results. CONCLUSION: This survey concludes interest among students and faculty in AI developments and technology applications in healthcare. Further studies are required in order to correctly fit AI in the integrated modular curriculum of medical education.

Keywords: medical education, data science, artificial intelligence, curriculum

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Authors: Arvind Aggarwal

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We have developed a comprehensive global healthcare delivery System based on information technology. It has medical consultation system where a virtual consultant can give medical consultation to the patients and Doctors at the digital medical centre after reviewing the patient’s EMR file consisting of patient’s history, investigations in the voice, images and data format. The system has the surgical operation system too, where a remote robotic consultant can conduct surgery at the robotic surgical centre. The instant speech and text translation is incorporated in the software where the patient’s speech and text (language) can be translated into the consultant’s language and vice versa. A consultant of any specialty (surgeon or Physician) based in any country can provide instant health care consultation, to any patient in any country without loss of time. Robotic surgeons based in any country in a tertiary care hospital can perform remote robotic surgery, through patient friendly telemedicine and tele-surgical centres. The patient EMR, financial data and data of all the consultants and robotic surgeons shall be stored in cloud. It is a complete comprehensive business model with healthcare medical and surgical delivery system. The whole system is self-financing and can be implemented in any country. The entire system uses paperless, filmless techniques. This eliminates the use of all consumables thereby reduces substantial cost which is incurred by consumables. The consultants receive virtual patients, in the form of EMR, thus the consultant saves time and expense to travel to the hospital to see the patients. The consultant gets electronic file ready for reporting & diagnosis. Hence time spent on the physical examination of the patient is saved, the consultant can, therefore, spend quality time in studying the EMR/virtual patient and give his instant advice. The time consumed per patient is reduced and therefore can see more number of patients, the cost of the consultation per patients is therefore reduced. The additional productivity of the consultants can be channelized to serve rural patients devoid of doctors.

Keywords: e-health, telemedicine, telecare, IT-based healthcare

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Authors: Edlira Donefski, Lorenc Ekonomi, Tina Donefski

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Edgeworth approximation is one of the most important statistical methods that has a considered contribution in the reduction of the sum of standard deviation of the independent variables’ coefficients in a Quantile Regression Model. This model estimates the conditional median or other quantiles. In this paper, we have applied approximating statistical methods in an economical problem. We have created and generated a quantile regression model to see how the profit gained is connected with the realized sales of the cosmetic products in a real data, taken from a local business. The Linear Regression of the generated profit and the realized sales was not free of autocorrelation and heteroscedasticity, so this is the reason that we have used this model instead of Linear Regression. Our aim is to analyze in more details the relation between the variables taken into study: the profit and the finalized sales and how to minimize the standard errors of the independent variable involved in this study, the level of realized sales. The statistical methods that we have applied in our work are Edgeworth Approximation for Independent and Identical distributed (IID) cases, Bootstrap version of the Model and the Edgeworth approximation for Bootstrap Quantile Regression Model. The graphics and the results that we have presented here identify the best approximating model of our study.

Keywords: bootstrap, edgeworth approximation, IID, quantile

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Authors: Amir Mohammad Fathollahi Fard, Mostafa Hajiaghaei-Keshteli, Mohammad Mahdi Paydar

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With increasing life expectancy in developed countries, the role of home care services is highlighted by both academia and industrial contributors in Home Health Care Supply Chain (HHCSC) companies. The main decisions in such supply chain systems are the location of pharmacies, the allocation of patients to these pharmacies and also the routing and scheduling decisions of nurses to visit their patients. In this study, for the first time, an integrated model is proposed to consist of all preliminary and necessary decisions in these companies, namely, location-allocation-routing model. This model is a type of NP-hard one. Therefore, an Imperialist Competitive Algorithm (ICA) is utilized to solve the model, especially in large sizes. Results confirm the efficiency of the developed model for HHCSC companies as well as the performance of employed ICA.

Keywords: home health care supply chain, location-allocation-routing problem, imperialist competitive algorithm, optimization

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Authors: Hamdi Sana, Emna Bouazizi, Sami Faiz

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In recent years, there is a huge increase in the use of spatio-temporal applications where data and queries are continuously moving. As a result, the need to process real-time spatio-temporal data seems clear and real-time stream data management becomes a hot topic. Sliding window model and frequent itemset mining over dynamic data are the most important problems in the context of data mining. Thus, sliding window model for frequent itemset mining is a widely used model for data stream mining due to its emphasis on recent data and its bounded memory requirement. These methods use the traditional transaction-based sliding window model where the window size is based on a fixed number of transactions. Actually, this model supposes that all transactions have a constant rate which is not suited for real-time applications. And the use of this model in such applications endangers their performance. Based on these observations, this paper relaxes the notion of window size and proposes the use of a timestamp-based sliding window model. In our proposed frequent itemset mining algorithm, support conditions are used to differentiate frequents and infrequent patterns. Thereafter, a tree is developed to incrementally maintain the essential information. We evaluate our contribution. The preliminary results are quite promising.

Keywords: real-time spatial big data, frequent itemset, transaction-based sliding window model, timestamp-based sliding window model, weighted frequent patterns, tree, stream query

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Authors: Ling Qi, Matloob Khushi, Josiah Poon

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This paper introduces a pre-trained Masked Candlestick Model (MCM) for trading time-series data. The pre-trained model is based on three core designs. First, we convert trading price data at each data point as a set of normalized elements and produce embeddings of each element. Second, we generate a masked sequence of such embedded elements as inputs for self-supervised learning. Third, we use the encoder mechanism from the transformer to train the inputs. The masked model learns the contextual relations among the sequence of embedded elements, which can aid downstream classification tasks. To evaluate the performance of the pre-trained model, we fine-tune MCM for three different downstream classification tasks to predict future price trends. The fine-tuned models achieved better accuracy rates for all three tasks than the baseline models. To better analyze the effectiveness of MCM, we test the same architecture for three currency pairs, namely EUR/GBP, AUD/USD, and EUR/JPY. The experimentation results demonstrate MCM’s effectiveness on all three currency pairs and indicate the MCM’s capability for signal extraction from trading data.

Keywords: masked language model, transformer, time series prediction, trading prediction, embedding, transfer learning, self-supervised learning

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Authors: Jung–Min Yang

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Solvability of the model matching problem for input/output switched asynchronous sequential machines is discussed in this paper. The control objective is to determine the existence condition and design algorithm for a corrective controller that can match the stable-state behavior of the closed-loop system to that of a reference model. Switching operations and correction procedures are incorporated using output feedback so that the controlled switched machine can show the desired input/output behavior. A matrix expression is presented to address reachability of switched asynchronous sequential machines with output equivalence with respect to a model. The presented reachability condition for the controller design is validated in a simple example.

Keywords: asynchronous sequential machines, corrective control, model matching, input/output control

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Authors: Hycham Aboutaleb, Bruno Monsuez

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Current systems complexity has reached a degree that requires addressing conception and design issues while taking into account all the necessary aspects. Therefore, one of the main challenges is the way complex systems are specified and designed. The exponential growing effort, cost and time investment of complex systems in modeling phase emphasize the need for a paradigm, a framework and a environment to handle the system model complexity. For that, it is necessary to understand the expectations of the human user of the model and his limits. This paper presents a generic framework for designing complex systems, highlights the requirements a system model needs to fulfill to meet human user expectations, and defines the refined functional as well as non functional requirements modeling tools needs to meet to be useful in model-based system engineering.

Keywords: system modeling, modeling language, modeling requirements, framework

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Authors: Faramarz Khosravi, Gokhan Izbirak

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A weighted statistical stochastic based Analytical Hierarchy Process (AHP) model for modeling the potential barriers and enablers of sustainability for measuring and assessing the sustainability level is proposed. For context-dependent potential barriers and enablers, the proposed model takes the basis of the properties of the variables describing the sustainability functions and was developed into a realistic analytical model for the sustainable behavior of an organization. This thus serves as a means for measuring the sustainability of the organization. The main focus of this paper was the application of the AHP tool in a statistically-based model for measuring sustainability. Hence a strong weighted stochastic AHP based procedure was achieved. A case study scenario of a widely reported major Canadian electric utility was adopted to demonstrate the applicability of the developed model and comparatively examined its results with those of an equal-weighted model method. Variations in the sustainability of a company, as fluctuations, were figured out during the time. In the results obtained, sustainability index for successive years changed form 73.12%, 79.02%, 74.31%, 76.65%, 80.49%, 79.81%, 79.83% to more exact values 73.32%, 77.72%, 76.76%, 79.41%, 81.93%, 79.72%, and 80,45% according to priorities of factors that have found by expert views, respectively. By obtaining relatively necessary informative measurement indicators, the model can practically and effectively evaluate the sustainability extent of any organization and also to determine fluctuations in the organization over time.

Keywords: AHP, sustainability fluctuation, environmental indicators, performance measurement

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Authors: Nikolaos Reppas, Yilin Gui, Ben Wetenhall, Colin Davie

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Injection of CO2 inside wellbore can induce different kind of loadings that can lead to thermal, hydraulic, and mechanical changes on the surrounding rock. A dual-porosity theoretical constitutive model will be presented for the stability analysis of the wellbore during CO2 injection. An elastoplastic damage response will be considered. A bounding yield surface will be presented considering damage effects on sandstone. The main target of the research paper is to present a theoretical constitutive model that can help industries to safely store CO2 in geological rock formations and forecast any changes on the surrounding rock of the wellbore. The fully coupled elasto-plastic damage Thermo-Hydraulic-Mechanical theoretical model will be validated from existing experimental data for sandstone after simulating some scenarios by using FEM on MATLAB software.

Keywords: carbon capture and storage, rock mechanics, THM effects on rock, constitutive model

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Authors: Hussain Syed Asad, Richard Kwok Kit Yuen, Gongsheng Huang

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Real-time optimization has been considered an effective approach for improving energy efficient operation of heating, ventilation, and air-conditioning (HVAC) systems. In model-based real-time optimization, model mismatches cannot be avoided. When model mismatches are significant, the performance of the real-time optimization will be impaired and hence the expected energy saving will be reduced. In this paper, the model mismatches for chiller plant on real-time optimization are considered. In the real-time optimization of the chiller plant, simplified semi-physical or grey box model of chiller is always used, which should be identified using available operation data. To overcome the model mismatches associated with the chiller model, hybrid Genetic Algorithms (HGAs) method is used for online real-time training of the chiller model. HGAs combines Genetic Algorithms (GAs) method (for global search) and traditional optimization method (i.e. faster and more efficient for local search) to avoid conventional hit and trial process of GAs. The identification of model parameters is synthesized as an optimization problem; and the objective function is the Least Square Error between the output from the model and the actual output from the chiller plant. A case study is used to illustrate the implementation of the proposed method. It has been shown that the proposed approach is able to provide reliability in decision making, enhance the robustness of the real-time optimization strategy and improve on energy performance.

Keywords: energy performance, hybrid adaptive modeling, hybrid genetic algorithms, real-time optimization, heating, ventilation, and air-conditioning

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Authors: Mohammad Reza Oftadeh

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The purpose of the article is to describe project objective structure (POS) concept that was developed on research activities and experiences about project management, Balanced Scorecard (BSC) and European Foundation Quality Management Excellence Model (EFQM Excellence Model). Furthermore, this paper tries to define a balanced, systematic, and integrated measurement approach to meet project objectives and project strategic goals based on a process-oriented model. In this paper, POS is suggested in order to measure project performance in the project life cycle. After using the POS model, the project manager can ensure in order to achieve the project objectives on the project charter. This concept can help project managers to implement integrated and balanced monitoring and control project work.

Keywords: project objectives, project performance management, PMBOK, key performance indicators, integration management

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Authors: Rupinder Pal Kaur, Vishal Goyal

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In this research, a systematic and quantitative engineering-based approach is followed by applying well-known international standards and guidelines to develop a web quality model (PH.WQT- Punjabi and Hindi Website Quality Tester) to measure external quality for websites of government domain that are developed in Punjabi and Hindi. Correspondingly, the model can be used for websites developed in other languages also. The research is valuable to researchers and practitioners interested in designing, implementing and managing websites of government domain Also, by implementing PH.WQT analysis and comparisons among web sites of government domain can be performed in a consistent way.

Keywords: external quality, PH.WQT, indian languages, punjabi and hindi, quality model, websites of government

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Authors: João Paulo Pascon

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A constitutive model accounting for large strains, thermoviscoplasticity, and ductile damage evolution is proposed in the present work. To this end, a fully Lagrangian framework is employed, considering plane stress conditions and multiplicative split of the deformation gradient. The full model includes Gurson’s void growth, nucleation and coalescence, plastic work heating, strain and strain-rate hardening, thermal softening, and heat conductivity. The contribution of the work is the combination of all the above-mentioned features within the finite-strain setting. The model is implemented in a computer code using triangular finite elements and nonlinear analysis. Two mechanical examples involving ductile damage and finite strain levels are analyzed: an inhomogeneous tension specimen and the necking problem. Results demonstrate the capabilities of the developed formulation regarding ductile fracture and large deformations.

Keywords: ductile damage model, finite element method, large strains, thermoviscoplasticity

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Authors: Chattrarat Hotrawaisaya

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This research aims to formulate the logistics collaborative model which is the management tool for orchid flower exporter. The researchers study logistics activities in orchid supply chain that stakeholders can collaborate and develop, including demand forecasting, inventory management, warehouse and storage, order-processing, and transportation management. The research also explores logistics collaboration implementation into orchid’s stakeholders. The researcher collected data before implementation and after model implementation. Consequently, the costs and efficiency were calculated and compared between pre and post period of implementation. The research found that the results of applying the logistics collaborative model to orchid exporter reduces inventory cost and transport cost. The model also improves forecasting accuracy, and synchronizes supply chain of exporter. This research paper contributes the uniqueness logistics collaborative model which value to orchid industry in Thailand. The orchid exporters may use this model as their management tool which aims in competitive advantage.

Keywords: logistics, orchid, supply chain, collaboration

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Authors: Jayanta Kumar Ghosh, Swastik Sunil Goriwale, Himangshu Sarkar

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Groundwater is one of the most valuable natural resources that society consumes for its domestic, industrial, and agricultural water supply. Its bulk and indiscriminate consumption affects the groundwater resource. Often, it has been found that the groundwater recharge rate is much lower than its demand. Thus, to maintain water and food security, it is necessary to monitor and management of groundwater storage. However, it is challenging to estimate groundwater storage (GWS) by making use of existing hydrological models. To overcome the difficulties, machine learning (ML) models are being introduced for the evaluation of groundwater level (GWL). Thus, the objective of this research work is to develop an ML-based model for the prediction of GWL. This objective has been realized through the development of an artificial neural network (ANN) model based on hydro-gravimetry. The model has been developed using training samples from field observations spread over 8 months. The developed model has been tested for the prediction of GWL in an observation well. The root means square error (RMSE) for the test samples has been found to be 0.390 meters. Thus, it can be concluded that the hydro-gravimetric-based ANN model can be used for the prediction of GWL. However, to improve the accuracy, more hydro-gravimetric parameter/s may be considered and tested in future.

Keywords: machine learning, hydro-gravimetry, ground water level, predictive model

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Authors: David F. Nettleton, Christian Wasiak, Jonas Dorissen, David Gillen, Alexandr Tretyak, Elodie Bugnicourt, Alejandro Rosales

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In this work, preliminary results are given for the modeling and calibration of two inline processes, pultrusion, and laser ablation, using machine learning techniques. The end product of the processes is the core of a medical guidewire, manufactured to comply with a user specification of diameter and flexibility. An ensemble approach is followed which requires training several models. Two state of the art machine learning algorithms are benchmarked: Kernel Recursive Least Squares (KRLS) and Support Vector Regression (SVR). The final objective is to build a precise digital model of the pultrusion and laser ablation process in order to calibrate the resulting diameter and flexibility of a medical guidewire, which is the end product while taking into account the friction on the forming die. The result is an ensemble of models, whose output is within a strict required tolerance and which covers the required range of diameter and flexibility of the guidewire end product. The modeling and automatic calibration of complex in-line industrial processes is a key aspect of the Industry 4.0 movement for cyber-physical systems.

Keywords: calibration, data modeling, industrial processes, machine learning

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Authors: Lisa Fox, Jill Aylott

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There is a global need to identify ways to engage doctors in non-clinical matters such as medical leadership, service improvement and health system transformation. Using the core principles of Realistic Evaluation (RE), this study examined what works, for doctors of different grades, specialities and experience in an acute NHS Hospital Trust in the UK. Realistic Evaluation is an alternative to more traditional cause and effect evaluation models and seeks to understand the interdependencies of Context, Mechanism and Outcome proposing that Context (C) + Mechanism (M) = Outcome (O). In this study, the context, mechanism and outcome were examined from within individual medical leaders to determine what enables levels of medical engagement in a specific improvement project to reduce hospital inpatient mortality. Five qualitative case studies were undertaken with consultants who had regularly completed mortality reviews over a six month period. The case studies involved semi-structured interviews to test the theory behind the drivers for medical engagement. The interviews were analysed using a theory-driven thematic analysis to identify CMO configurations to explain what works, for whom and in what circumstances. The findings showed that consultants with a longer length of service became more engaged if there were opportunities to be involved in the beginning of an improvement project, with more opportunities to affect the design. Those that are new to a consultant role were more engaged if they felt able to apply any learning directly into their own settings or if they could use it as an opportunity to understand more about the organisation they are working in. This study concludes that RE is a useful methodology for better understanding the complexities of motivation and consultant engagement in a trust wide service improvement project. The study showed that there should be differentiated and bespoke training programmes to maximise each individual doctor’s propensity for medical engagement. The RE identified that there are different ways to ensure that doctors have the right skills to feel confident in service improvement projects.

Keywords: realistic evaluation, medical leadership, medical engagement, patient safety, service improvement

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Authors: Jitendra Singh, Vivek Kumar

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In this paper, a susceptible infective susceptible mathematical model is proposed and analyzed where the migration of human population is given by migration function. It is assumed that the disease is transmitted by direct contact of susceptible and infective populations with constant contact rate. The equilibria and their stability are studied by using the stability theory of ordinary differential equations and computer simulation. The model analysis shows that the spread of infectious disease increases when human population immigration increases in the habitat but it decreases if emigration increases.

Keywords: SIS (Susceptible Infective Susceptible) model, migration function, susceptible, stability

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Authors: Tarek Sayed Taha Ali

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The dependence of the axial-vector coupling constant gA on the quark masses has been investigated in the frame work of the extended linear sigma model. The field equations have been solved in the mean-field approximation. Our study shows a better fitting to the experimental data compared with the existing models.

Keywords: extended linear sigma model, nucleon properties, axial coupling constant, physic

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Authors: Shende Suraj Balu, A. B. Deoghare, K. M. Pandey

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The human middle ear (ME) is a delicate and vital organ. It has a complex structure that performs various functions such as receiving sound pressure and producing vibrations of eardrum and propagating it to inner ear. It consists of Tympanic Membrane (TM), three auditory ossicles, various ligament structures and muscles. Incidents such as traumata, infections, ossification of ossicular structures and other pathologies may damage the ME organs. The conditions can be surgically treated by employing prosthesis. However, the suitability of the prosthesis needs to be examined in advance prior to the surgery. Few decades ago, this issue was addressed and analyzed by developing an equivalent representation either in the form of spring mass system, electrical system using R-L-C circuit or developing an approximated CAD model. But, nowadays a three-dimensional ME model can be constructed using micro X-Ray Computed Tomography (μCT) scan data. Moreover, the concern about patient specific integrity pertaining to the disease can be examined well in advance. The current research work emphasizes to develop the ME model from the stacks of μCT images which are used as input file to MIMICS Research 19.0 (Materialise Interactive Medical Image Control System) software. A stack of CT images is converted into geometrical surface model to build accurate morphology of ME. The work is further extended to understand the dynamic behaviour of Harmonic response of the stapes footplate and umbo for different sound pressure levels applied at lateral side of eardrum using finite element approach. The pathological condition Cholesteatoma of ME is investigated to obtain peak to peak displacement of stapes footplate and umbo. Apart from this condition, other pathologies, mainly, changes in the stiffness of stapedial ligament, TM thickness and ossicular chain separation and fixation are also explored. The developed model of ME for pathologies is validated by comparing the results available in the literatures and also with the results of a normal ME to calculate the percentage loss in hearing capability.

Keywords: computed tomography (μCT), human middle ear (ME), harmonic response, pathologies, tympanic membrane (TM)

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Authors: Autcha Araveeporn

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This paper presents a study about a nonparametric regression model consisting of a smoothing spline method and a penalized spline regression method. We also compare the techniques used for estimation and prediction of nonparametric regression model. We tried both methods with crude oil prices in dollars per barrel and the Stock Exchange of Thailand (SET) index. According to the results, it is concluded that smoothing spline method performs better than that of penalized spline regression method.

Keywords: nonparametric regression model, penalized spline regression method, smoothing spline method, Stock Exchange of Thailand (SET)

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Authors: Hanjong Kim, Changwan Han, Seonghun Park

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Heat exchanger manifolds in aircraft play an important role in evenly distributing the fluid entering through the inlet to the heat transfer unit. In order to achieve this requirement, the manifold should be designed to have a light weight by withstanding high internal pressure. Therefore, this study aims at minimizing the weight of the heat exchanger manifold through topology optimization. For topology optimization, the initial design space was created with the inner surface extracted from the currently used manifold model and with the outer surface having a dimension of 243.42 mm of X 74.09 mm X 65 mm. This design space solid model was transformed into a finite element model with a maximum tetrahedron mesh size of 2 mm using ANSYS Workbench. Then, topology optimization was performed under the boundary conditions of an internal pressure of 5.5 MPa and the fixed support for rectangular inlet boundaries by SIMULIA TOSCA. This topology optimization produced the minimized finial volume of the manifold (i.e., 7.3% of the initial volume) based on the given constraints (i.e., 6% of the initial volume) and the objective function (i.e., maximizing manifold stiffness). Weight of the optimized model was 6.7% lighter than the currently used manifold, but after smoothing the topology optimized model, this difference would be bigger. The current optimized model has uneven thickness and skeleton-shaped outer surface to reduce stress concentration. We are currently simplifying the optimized model shape with spline interpolations by reflecting the design characteristics in thickness and skeletal structures from the optimized model. This simplified model will be validated again by calculating both stress distributions and weight reduction and then the validated model will be manufactured using 3D printing processes.

Keywords: topology optimization, manifold, heat exchanger, 3D printing

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Authors: H. Hosseini, B. V. Berdyshev, I. Iskopintsev

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This paper presents a rheological model for producing shape-memory thermoplastic polymers. Shape-memory occurs as a result of internal rearrangement of the structural elements of a polymer. A non-linear viscoelastic model was developed that allows qualitative and quantitative prediction of the stress-strain behavior of shape-memory polymers during heating. This research was done to develop a technique to determine the maximum possible change in size of heat-shrinkable products during heating. The rheological model used in this work was particularly suitable for defining process parameters and constructive parameters of the processing equipment.

Keywords: elastic deformation, heating, shape-memory polymers, stress-strain behavior, viscoelastic model

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Authors: Zuodong Liang, Dong-Sheng Jeng

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Seabed instability around an offshore pipeline is one of key factors that need to be considered in the design of offshore infrastructures. Unlike previous investigations, a three-dimensional numerical model for the wave-induced soil response around an offshore pipeline is proposed in this paper. The numerical model was first validated with 2-D experimental data available in the literature. Then, a parametric study will be carried out to examine the effects of wave, seabed characteristics and confirmation of pipeline. Numerical examples demonstrate significant influence of wave obliquity on the wave-induced pore pressures and the resultant seabed liquefaction around the pipeline, which cannot be observed in 2-D numerical simulation.

Keywords: pore pressure, 3D wave model, seabed liquefaction, pipeline

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Authors: Zheng Junchao, Wang Zhu

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With the advancement of China's urbanization process, the Chinese government has put forward the strategy of rural revitalization which is aiming at realizing the comprehensive integration of urban and rural areas and the comprehensive revitalization of rural areas. The path of rural revitalization in Zhejiang province put forward a typical model from four dimensions: suburban area, plain, island and mountain area. Research methods include on-the-spot investigation, visiting a number of successful demonstration villages in Zhejiang and interviewing village officials. Based on the location conditions, resource endowments, industrial forms and development foundations of Zhejiang Province, this paper introduces in detail the model of rural revitalization in Zhejiang Province and the challenges it encounters, as well as the role of building construction. The rural development model of Zhejiang province makes the rural culture flourish. Taking the construction of rural scenic spots as the carrier, the rural culture, and natural landscape are constantly improved. It provides a model and template for the country's rural revitalization. The promotion of Zhejiang rural revitalization model will improve the current rural landscape, living standard and industrial structure, which will narrow the urban-rural gap greatly.

Keywords: comprehensive rural revitalization, Zhejiang model, reproducible, comprehensive integration

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Authors: Andrés I. Ávila, Patricia Aros, César San Martín, Elizabeth Kehr, Yovana Leal

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We consider a linear programming model to help farmers to decide if it is convinient to choose among three kinds of export fruits for their future investment. We consider area, investment, water, productivitiy minimal unit, and harvest restrictions and a monthly based model to compute the average income in five years. Also, conditions on the field as area, water availability and initia investment are required. Using the Chilean costs and dollar-peso exchange rate, we can simulate several scenarios to understand the possible risks associated to this market.

Keywords: mixed integer problem, fruit production, support decision model, fruit tree farms

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Authors: Min Bae

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Hygiene had traditionally meant ways of healthy and right living. However, the nineteenth century was the time when a gradual shift in medical and hygienic paradigms took place from holism to reductionism. Against this medical and social background, E. W. Lane (MD, Edinburgh, 1853) formulated his own medical philosophies in his book Hydropathy: Or Hygienic Medicine (1859). Until the 1880s when he published his last book on the hygienic medicine, he consistently intended to raise the importance of hygienic holism in medicine, while adopting hydropathy as his main therapeutic measure. Lane’s case reflects the mid-nineteenth century trend in which since the 1840s, the rational and holistic facets in medicine had significantly transferred to hydropathy, which was the most naturalistic healing system in the medical market. Hygiene for Lane was no longer the ancient form of ‘six non-naturals’. He emphasised physiology as the rational grounds for his project of the medicalisation of hygiene. His medical philosophy was profoundly naturalistic and holistic against the opposite trend of the contemporary hygiene and medicine. Conflicting aspects may often be best embodied in persons who stood on the boundaries between inside and outside. Lane’s theories on hygienic medicine did not develop into a new medical system which he believed would reconciliate orthodox medicine and hydropathy of his time had also adopted increasingly reductionist approaches since 1860s. Nevertheless, the naturalistic philosophies and approaches in Lane’s hygienic medicine demonstrates a continuous effort for a theoretical reformulation of hydropathy during its stagnant and declining period to constantly fit into the holistic paradigm of medicine and hygiene. Considering the fact that the nature cure concept in hydropathy and its individualistic approach were succeeded by naturopathy at the end of the century, analysis of Lane’s medical thoughts reveals part of a ‘thin red line’ of naturalism in the battleground between reductionism and holism during the nineteenth century in the history of medicine and hygiene.

Keywords: E. W. Lane, hygienic medicine, hydropathy, naturopath

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Authors: Cleto J. Sauer Jr

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Introduction: Brazil’s new national curriculum guidelines (NCG) for medical education were published in 2014, presenting active learning methodologies as a cornerstone. Simulation was initially applied for aviation pilots’ training and is currently applied in health sciences. The high-fidelity simulator replicates human body anatomy in detail, also reproducing physiological functions and its use is increasing in medical schools. Realistic Simulation (RS) has pedagogical aspects that are aligned with Brazil’s NCG teaching concepts. The main objective of this study is to carry on a narrative review on RS’s aspects that are aligned with Brazil’s new NCG teaching concepts. Methodology: A narrative review was conducted, with search in three databases (PubMed, Embase and BVS) of studies published between 2010 and 2020. Results: After systematized search, 49 studies were selected and divided into four thematic groups. RS is aligned with new Brazilian medical curriculum as it is an active learning methodology, providing greater patient safety, uniform teaching, and student's emotional skills enhancement. RS is based on reflective learning, a teaching concept developed for adult’s education. Conclusion: RS is a methodology aligned with NCG teaching concepts and has potential to assist in the implementation of new Brazilian medical school’s curriculum. It is an immersive and interactive methodology, which provides reflective learning in a safe environment for students and patients.

Keywords: curriculum, high-fidelity simulator, medical education, realistic simulation

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Authors: Rihab Gamaoun, Cynthia El Hage, Laura Ruiz, Erin Prosk, Antonio Vigano

Abstract:

Introduction: Santé Cannabis (SC), a Canadian medical cannabis-specialized group of clinics based in Montreal and in the province of Québec, has served more than 5000 patients seeking cannabis-based treatment prescription for medical indications over the past five years. Within a research frame, data on the use of medical cannabis products from all the above patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to gather information on the profiles of both patients and prescribed medical cannabis products at SC clinics and to assess the safety of medical cannabis among Canadian patients. Methods: Using a retrospective analysis of the database, records of 2585 patients who were prescribed medical cannabis products for therapeutic purposes between 01-November 2017 and 04-September 2019 were included. Patients’ demographics, primary diagnosis, route of administration, and chemovars recorded at the initial visits were investigated. Results: At baseline: 9% of SC patients were female, with a mean age of 57 (SD= 15.8, range= [18-96]); Cannabis products were prescribed mainly for patients with a diagnosis of chronic pain (65.9% of patients), cancer (9.4%), neurological disorders (6.5%), mood disorders (5.8 %) and inflammatory diseases (4.1%). Route of administration and chemovars of prescribed cannabis products were the following: 96% of patients received cannabis oil (51% CBD rich, 42.5% CBD:THC); 32.1% dried cannabis (21.3% CBD:THC, 7.4% THC rich, 3.4 CBD rich), and 2.1% oral spray cannabis (1.1% CBD:THC, 0.8% CBD rich, 0.2% THC rich). Most patients were prescribed simultaneously, a combination of products with different administration routes and chemovars. Safety analysis is undergoing. Conclusion: Our results provided initial information on the profile of medical cannabis products prescribed in a Canadian population and the experienced adverse events over the past three years. The Santé Cannabis database represents a unique opportunity for comparing clinical practices in prescribing and titrating cannabis-based medications across different centers. Ultimately real-world data, including information about safety and effectiveness, will help to create standardized and validated guidelines for choosing dose, route of administration, and chemovars types for the cannabis-based medication in different diseases and indications.

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

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