Search results for: wearable medical device
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5173

Search results for: wearable medical device

4303 Comparison of Medical Students Evaluation by Serious Games and Clinical Case-Multiple Choice Questions

Authors: Chamtouri I., Kechida M.

Abstract:

Background: Evaluation has a prominent role in medical education and graduation. This evaluation has usually done in face-to-face, by written or oral questions. Simulation is increasingly taking a part as a method of evaluation. Due to the Covid-19 pandemic, which disrupted face-to-face evaluation, simulation using serious games (SG) is emerging in the field of training and assessment of medical students. The aim of our study is to compare the results of the evaluation of medical students by virtual simulation by online serious games versus clinical case-multiple choice questions (MCQ) and to assess the degree of satisfaction from these two evaluation methods. Methods: Medical students from the same study level were voluntarily participated in this study. Groupe 1 had an evaluation by SG dealing with “diagnosis and management of ST-segment elevationmyocardialinfarction (STEMI)alreadyprepared on the website www.Mediactiv.com. Groupe 2 were evaluated by clinical case-MCQ having thes same topic as SG. Results of the two groups were compared. Satisfaction questionnaire was filled by the two groups. Satisfaction degree was compared between the two groups. Results. In this study, 64 medical students (G1:31 and G2: 33) were enrolled. Obtaining complete notes in the "questioning" and "clinical examination" parts is significantly more important in-group 1 compared to group 2. No significant difference detected between the two groups in terms of “ECG interpretation” and “diagnosis of STEMI” parts. A greater number of students of group 1 obtained the full note compared to group 2 in “the initial treatment part” (54.8% vs. 39.4%; p = 0.04). Thirty learners (96.8%) in-group 1 obtained a total score ≥ 50% versus 69.7% in-group 2 (p = 0.004). The full score of 100% was obtained in three learners in-group1, while no student scored 100% in-group2 (p = 0.027). Medical evaluation using SG was reported as more innovative, fun, and realistic compared to evaluation by clinical case-MCQ. No significant difference detected between the two methods in terms of stress. Conclusion: Simulation by SG can be considered as an innovative and effective method in evaluating medical students with a higher degree of satisfaction.

Keywords: evaluation, serious games, medical students, satisfaction

Procedia PDF Downloads 132
4302 The Need to Teach the Health Effects of Climate Change in Medical Schools

Authors: Ábrám Zoltán

Abstract:

Introduction: Climate change is now a major health risk, and its environmental and health effects have become frequently discussed topics. The consequences of climate change are clearly visible in natural disasters and excess deaths caused by extreme weather conditions. Global warming and the increasingly frequent extreme weather events have direct, immediate effects or long-term, indirect effects on health. For this reason, it is a need to teach the health effects of climate change in medical schools. Material and methods: We looked for various surveys, studies, and reports on the main pathways through which global warming affects health. Medical schools face the challenge of teaching the health implications of climate change and integrating knowledge about the health effects of climate change into medical training. For this purpose, there were organised World Café workshops for three target groups: medical students, academic staff, and practising medical doctors. Results: Among the goals of the research is the development of a detailed curriculum for medical students, which serves to expand their knowledge in basic education. At the same time, the project promotes the increase of teacher motivation and the development of methodological guidelines for university teachers; it also provides further training for practicing doctors. The planned teaching materials will be developed in a format suitable for traditional face-to-face teaching, as well as e-learning teaching materials. CLIMATEMED is a project based on the cooperation of six universities and institutions from four countries, the aim of which is to improve the curriculum and expand knowledge about the health effects of climate change at medical universities. Conclusions: In order to assess the needs, summarize the proposals, to develop the necessary strategy, World Café type, one-and-a-half to two-hour round table discussions will take place separately for medical students, academic staff, and practicing doctors. The CLIMATEMED project can facilitate the integration of knowledge about the health effects of climate change into curricula and can promote practical use. The avoidance of the unwanted effects of global warming and climate change is not only a public matter, but it is also a challenge to change our own lifestyle. It is the responsibility of all of us to protect the Earth's ecosystem and the physical and mental health of ourselves and future generations.

Keywords: climate change, health effects, medical schools, World Café, medical students

Procedia PDF Downloads 62
4301 Numerical Simulation of Production of Microspheres from Polymer Emulsion in Microfluidic Device toward Using in Drug Delivery Systems

Authors: Nizar Jawad Hadi, Sajad Abd Alabbas

Abstract:

Because of their ability to encapsulate and release drugs in a controlled manner, microspheres fabricated from polymer emulsions using microfluidic devices have shown promise for drug delivery applications. In this study, the effects of velocity, density, viscosity, and surface tension, as well as channel diameter, on microsphere generation were investigated using Fluent Ansys software. The software was programmed with the physical properties of the polymer emulsion such as density, viscosity and surface tension. Simulation will then be performed to predict fluid flow and microsphere production and improve the design of drug delivery applications based on changes in these parameters. The effects of capillary and Weber numbers are also studied. The results of the study showed that the size of the microspheres can be controlled by adjusting the speed and diameter of the channel. Narrower microspheres resulted from narrower channel widths and higher flow rates, which could improve drug delivery efficiency, while smaller microspheres resulted from lower interfacial surface tension. The viscosity and density of the polymer emulsion significantly affected the size of the microspheres, ith higher viscosities and densities producing smaller microspheres. The loading and drug release properties of the microspheres created with the microfluidic technique were also predicted. The results showed that the microspheres can efficiently encapsulate drugs and release them in a controlled manner over a period of time. This is due to the high surface area to volume ratio of the microspheres, which allows for efficient drug diffusion. The ability to tune the manufacturing process using factors such as speed, density, viscosity, channel diameter, and surface tension offers a potential opportunity to design drug delivery systems with greater efficiency and fewer side effects.

Keywords: polymer emulsion, microspheres, numerical simulation, microfluidic device

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4300 Calculation of the Supersonic Air Intake with the Optimization of the Shock Wave System

Authors: Elena Vinogradova, Aleksei Pleshakov, Aleksei Yakovlev

Abstract:

During the flight of a supersonic aircraft under various conditions (altitude, Mach, etc.), it becomes necessary to coordinate the operating modes of the air intake and engine. On the supersonic aircraft, it’s been done by changing various control factors (the angle of rotation of the wedge panels and etc.). This paper investigates the possibility of using modern optimization methods to determine the optimal position of the supersonic air intake wedge panels in order to maximize the total pressure recovery coefficient. Modern software allows us to conduct auto-optimization, which determines the optimal position of the control elements of the investigated product to achieve its maximum efficiency. In this work, the flow in the supersonic aircraft inlet has investigated and optimized the operation of the flaps of the supersonic inlet in an aircraft in a 2-D setting. This work has done using ANSYS CFX software. The supersonic aircraft inlet is a flat adjustable external compression inlet. The braking surface is made in the form of a three-stage wedge. The IOSO NM software package was chosen for optimization. Change in the position of the panels of the input device is carried out by changing the angle between the first and second steps of the three-stage wedge. The position of the rest of the panels is changed automatically. Within the framework of the presented work, the position of the moving air intake panel was optimized under fixed flight conditions of the aircraft under a certain engine operating mode. As a result of the numerical modeling, the distribution of total pressure losses was obtained for various cases of the engine operation, depending on the incoming flow velocity and the flight altitude of the aircraft. The results make it possible to obtain the maximum total pressure recovery coefficient under given conditions. Also, the initial geometry was set with a certain angle between the first and second wedge panels. Having performed all the calculations, as well as the subsequent optimization of the aircraft input device, it can be concluded that the initial angle was set sufficiently close to the optimal angle.

Keywords: optimal angle, optimization, supersonic air intake, total pressure recovery coefficient

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4299 Proof of Concept Design and Development of a Computer-Aided Medical Evaluation of Symptoms Web App: An Expert System for Medical Diagnosis in General Practice

Authors: Ananda Perera

Abstract:

Computer-Assisted Medical Evaluation of Symptoms (CAMEOS) is a medical expert system designed to help General Practices (GPs) make an accurate diagnosis. CAMEOS comprises a knowledge base, user input, inference engine, reasoning module, and output statement. The knowledge base was developed by the author. User input is an Html file. The physician user collects data in the consultation. Data is sent to the inference engine at servers. CAMEOS uses set theory to simulate diagnostic reasoning. The program output is a list of differential diagnoses, the most probable diagnosis, and the diagnostic reasoning.

Keywords: CDSS, computerized decision support systems, expert systems, general practice, diagnosis, diagnostic systems, primary care diagnostic system, artificial intelligence in medicine

Procedia PDF Downloads 137
4298 A Review of Optomechatronic Ecosystem

Authors: Sam Zhang

Abstract:

The landscape of Opto mechatronics is viewed along the line of light vs. matter, photonics vs. semiconductors, and optics vs. mechatronics. Optomechatronics is redefined as the integration of light and matter from the atom, device, and system to the application. The markets and megatrends in Opto mechatronics are further listed. The author then focuses on Opto mechatronic technology in the semiconductor industry as an example and reviews the practical systems, characteristics, and trends. Opto mechatronics, together with photonics and semiconductor, will continue producing the computational and smart infrastructure required for the 4th industrial revolution.

Keywords: photonics, semiconductor, optomechatronics, 4th industrial revolution

Procedia PDF Downloads 103
4297 A Learning Package on Medical Cannabis for Nurses

Authors: Kulveer Sandhu

Abstract:

Background: In 1999, the Government of Canada legalized the use of cannabis for the therapeutic purpose (CTP); however, its users remain highly vulnerable to stigma and are judged by care providers and nonusers of cannabis. Findings from a literature review suggest health care providers (HCPs), including nurses in palliative care settings, lack knowledge about medical cannabis. For this reason, it is important to enhance HCPs’awarenessand knowledge of medical cannabis. Significance of the Project: Nurses are the first point of contact and spend more time with patients than other care providers; it is, therefore, important for them to be informed about CTPto provide quality and equitable care for medical cannabis users. Although nurses and other HCPs want information on CTP, the topic is rarely included in their educational curriculum. The purpose of this project is to create an evidence informed Package designed to increase knowledge among palliative care nurses about CTP. The information package will empower palliative nurses to help palliative patients make informed decisions about their treatment plan. Method: The information package will include a basic overview of the endocannabinoid system, common cannabis plants and products, and methods of consumption, as well as information to help nurses better understand consumption and harm reduction. The package will also include a set of cannabis fact sheets for nurses. Each fact sheet will comprise a high-level overview with graphics followed by a description of medical cannabis with links and references. At the end of the learning package, there are five self-reflection questions that allow nurses to examine their personal values, attitudes, and practices regarding medical cannabis. These questions will help each nurse understand their personal approach towards CTP and its users.

Keywords: medical cannabis, improve knowledge, cannabis for therapeutic purpose (CTP), patient experience, palliative care

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4296 Research Related to the Academic Learning Stress, Reflected into PubMed Website Publications

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

Abstract:

Background: Academic environment led, in time, to the birth of some research subjects concluded with many publications. One of these issues is related to the learning stress. Thus far, the PubMed website displays an impressive number of papers related to the academic stress. Aims: Through this study, we aimed to evaluate the research concerning academic learning stress (ALS), by a retrospective analysis of PubMed publications. Methods: We evaluated the ALS, considering: a) different keywords as - ‘academic stress’ (AS), ‘academic stressors’ (ASs), ‘academic learning stress’ (ALS), ‘academic student stress’ (ASS), ‘academic stress college’ (ASC), ‘medical academic stress’ (MAS), ‘non-medical academic stress’ (NMAS), ‘student stress’ (SS), ‘nursing student stress’ (NS), ‘college student stress’ (CSS), ‘university student stress’ (USS), ‘medical student stress’ (MSS), ‘dental student stress’ (DSS), ‘non-medical student stress’ (NMSS), ‘learning students stress’ (LSS), ‘medical learning student stress’ (MLSS), ‘non-medical learning student stress’ (NMLSS); b) the year average for decades; c) some selection filters provided by PubMed website: Article types - Journal Article (JA), Clinical Trial (CT), Review (R); Species - Humans (H); Sex - Male (M) and Female (F); Ages - 13-18, 19-24, 19-44. Statistical evaluation was made on the basis of the Student test. Results: There were differences between keywords, referring to all filters. Nevertheless, for all keywords were noted the following: the majority of studies have indicated that subjects were humans; there were no important differences between the number of subjects M and F; the age of participants was mentioned only in some studies, predominating those with teenagers and subjects between 19-24 years. Conclusions: 1) PubMed publications document that concern for the research field of academic stress, lasts for 56 years and was materialized in more than 5.010 papers. 2) Number of publications in the field of academic stress varies depending on the selected keywords: those with a general framing (AS, ASs, ALS, ASS, SS, USS, LSS) are more numerous than those with a specific framing (ASC, MAS, NMAS, NS, CSS, MSS, DSS, NMSS, MLSS, NMLSS); those concerning the academic medical environment (MAS, NS, MSS, DSS, MLSS) prevailed compared to the non-medical environment (NMAS, NMSS, NMLSS). 3) Most of the publications are included at JA, of which a small percentage are CT and R. 4) Most of the academic stress studies were conducted with subjects both M and F, most aged under 19 years and between 19-24 years.

Keywords: academic stress, student stress, academic learning stress, medical student stress

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4295 Theoretical Investigation of Proton-Bore Fusion in Hot Spots

Authors: Morteza Habibi

Abstract:

As an alternative to D–T fuel, one can consider advanced fuels like D3-He and p-11B fuels, which have potential advantages concerning availability and/or environmental impact. Hot spots are micron-sized magnetically self-contained sources observed in pinched plasma devices. In hot spots, fusion power for 120 keV < Ti < 800 keV and 32 keV < Te < 129 keV exceeds bremsstrahlung loss and fraction of fusion power to bremsstrahlung loss reaches to 1.9. In this case, gain factor for a 150 kJ typical pulsed generator as a hot spot source will be 7.8 which is considerable for a commercial pinched plasma device.

Keywords: P-B fuel, hot spot, bremmsstrahlung loss, ion temperature

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4294 Study of Composite Materials for Aisha Containment Chamber

Authors: G. Costa, F. Noto, L. Celona, F. Chines, G. Ciavola, G. Cuttone, S. Gammino, O. Leonardi, S. Marletta, G. Torrisi

Abstract:

The ion sources for accelerators devoted to medical applications must provide intense ion beams, with high reproducibility, stability and brightness. AISHa (Advanced Ion Source for Hadron-therapy) is a compact ECRIS whose hybrid magnetic system consists of a permanent Halbach-type hexapole magnet and a set of independently energized superconducting coils. These coils will be enclosed in a compact cryostat with two cryocoolers for LHe-free operation. The AISHa ion source has been designed by taking into account the typical requirements of hospital-based facilities, where the minimization of the mean time between failures (MTBF) is a key point together with the maintenance operations which should be fast and easy. It is intended to be a multipurpose device, operating at 18 GHz, in order to achieve higher plasma densities. It should provide enough versatility for future needs of the hadron therapy, including the ability to run at larger microwave power to produce different species and highly charged ion beams. The source is potentially interesting for any hadrontherapy center using heavy ions. In the paper, we designed an innovative solution for the plasma containment chamber that allows us to solve our isolation and structural problems. We analyzed the materials chosen for our aim (glass fibers and carbon fibers) and we illustrated the all process (spinning, curing and machining) of the assembly of our chamber. The glass fibers and carbon fibers are used to reinforce polymer matrices and give rise to structural composites and composites by molding.

Keywords: hadron-therapy, carbon fiber, glass fiber, vacuum-bag, ECR, ion source

Procedia PDF Downloads 195
4293 A Literature Review on Emotion Recognition Using Wireless Body Area Network

Authors: Christodoulou Christos, Politis Anastasios

Abstract:

The utilization of Wireless Body Area Network (WBAN) is experiencing a notable surge in popularity as a result of its widespread implementation in the field of smart health. WBANs utilize small sensors implanted within the human body to monitor and record physiological indicators. These sensors transmit the collected data to hospitals and healthcare facilities through designated access points. Bio-sensors exhibit a diverse array of shapes and sizes, and their deployment can be tailored to the condition of the individual. Multiple sensors may be strategically placed within, on, or around the human body to effectively observe, record, and transmit essential physiological indicators. These measurements serve as a basis for subsequent analysis, evaluation, and therapeutic interventions. In conjunction with physical health concerns, numerous smartwatches are engineered to employ artificial intelligence techniques for the purpose of detecting mental health conditions such as depression and anxiety. The utilization of smartwatches serves as a secure and cost-effective solution for monitoring mental health. Physiological signals are widely regarded as a highly dependable method for the recognition of emotions due to the inherent inability of individuals to deliberately influence them over extended periods of time. The techniques that WBANs employ to recognize emotions are thoroughly examined in this article.

Keywords: emotion recognition, wireless body area network, WBAN, ERC, wearable devices, psychological signals, emotion, smart-watch, prediction

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4292 E-Commerce versus m-Commerce: The Dividing Line

Authors: Priscilla Omonedo, Paul Bocij

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Since the emergence of e-commerce, the world of business has witnessed a radical shift in the way business activities are conducted. However, the emergence of m-Commerce has further pushed the boundaries of virtual commerce revolution. As a result, there seems to be a growing blur in the distinction between e-Commerce and m-Commerce. In addition, existing definitions for both forms of commerce highlight characteristics (e.g. type of device and activity conducted) that may be applicable to both concepts. The aim of this paper is to identify the characteristics that help define and delineate between e- and m- Commerce. The paper concludes that characteristics of mobility, ubiquity, and immediacy provides a clearer and simpler template to distinguish between e-commerce and m-commerce.

Keywords: e-commerce, m-commerce, mobility, ubiquity

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4291 Observational Study -HIV/ AIDS and Medical Personnel in Mangalore, India

Authors: Anjana Sreedharan, Harish Rao

Abstract:

Background: India has the world’s third largest population of people living with HIV/AIDS, with a prevalence rate of 0.69 in the state of Karnataka. This study aims at assessing the HIV/AIDS related knowledge, attitude and behavior of the medical personnel in 3 hospitals in the city of Mangalore. Methods: Surgeons, Anesthetists, OT staff nurses, ward nursing staff, House surgeons working in the hospitals associated with Kasturba Medical college, Mangalore were given questionnaires and interviewed. Their knowledge about HIV, their attitude towards HIV positive patients and bias in management of the patients was assessed. Conclusion: So far, it has been found that amongst doctors, discrimination was mainly in the form of HIV testing without consent and a lack of confidentiality. However, the doctors rarely changed the treatment plan on knowing the HIV status of the patient. Amongst the nursing staff and interns, there is a serious lacuna of knowledge regarding HIV transmission, as compared to consultants. The patient seldom faced verbal abuse from the team. Use of universal precautions is less among the entire team due to insufficient availability of the same.

Keywords: discrimination, HIV/ AIDS, medical colleges, stigma

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4290 Radiation Protection Assessment of the Emission of a d-t Neutron Generator: Simulations with MCNP Code and Experimental Measurements in Different Operating Conditions

Authors: G. M. Contessa, L. Lepore, G. Gandolfo, C. Poggi, N. Cherubini, R. Remetti, S. Sandri

Abstract:

Practical guidelines are provided in this work for the safe use of a portable d-t Thermo Scientific MP-320 neutron generator producing pulsed 14.1 MeV neutron beams. The neutron generator’s emission was tested experimentally and reproduced by MCNPX Monte Carlo code. Simulations were particularly accurate, even generator’s internal components were reproduced on the basis of ad-hoc collected X-ray radiographic images. Measurement campaigns were conducted under different standard experimental conditions using an LB 6411 neutron detector properly calibrated at three different energies, and comparing simulated and experimental data. In order to estimate the dose to the operator vs. the operating conditions and the energy spectrum, the most appropriate value of the conversion factor between neutron fluence and ambient dose equivalent has been identified, taking into account both direct and scattered components. The results of the simulations show that, in real situations, when there is no information about the neutron spectrum at the point where the dose has to be evaluated, it is possible - and in any case conservative - to convert the measured value of the count rate by means of the conversion factor corresponding to 14 MeV energy. This outcome has a general value when using this type of generator, enabling a more accurate design of experimental activities in different setups. The increasingly widespread use of this type of device for industrial and medical applications makes the results of this work of interest in different situations, especially as a support for the definition of appropriate radiation protection procedures and, in general, for risk analysis.

Keywords: instrumentation and monitoring, management of radiological safety, measurement of individual dose, radiation protection of workers

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4289 Malpractice Makes Perfect: A Thematic Analysis on How Doctors Handle Medical Errors

Authors: Kathleen Joy Hingan, Jessiraye Luienne Catubigan, Carlo Mercado, Janisse RañEses

Abstract:

In this research, the researchers wanted to explore how specialists and resident doctors in the fields of surgery, and obstetrics and gynecology handle their medical errors. They are interested in understanding the factors that contributed to the disclosure of medical error, the feelings after the occurrence of an error, and the way they coped with it given the power relations in place. The researchers conducted semi-structured interviews, transcribed the recordings, and analyzed the transcripts using thematic analysis. They found that doctors disclosed to their superiors and co-residents to cope with and to learn from the errors. In terms of disclosure to patients, the participants told them about the adverse event, but not about the error because of fear for themselves, their colleagues, their institution, and their patient. Doctors also performed compensatory actions to make up for the error and the nondisclosure of its occurrence. These actions functioned as a form of damage control too. Resident doctors and specialists receive different sanctions because of the power structures in the system.

Keywords: coping, disclosure, doctors, interviews, medical errors, thematic analysis

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4288 Development of Medical Intelligent Process Model Using Ontology Based Technique

Authors: Emmanuel Chibuogu Asogwa, Tochukwu Sunday Belonwu

Abstract:

An urgent demand for creative solutions has been created by the rapid expansion of medical knowledge, the complexity of patient care, and the requirement for more precise decision-making. As a solution to this problem, the creation of a Medical Intelligent Process Model (MIPM) utilizing ontology-based appears as a promising way to overcome this obstacle and unleash the full potential of healthcare systems. The development of a Medical Intelligent Process Model (MIPM) using ontology-based techniques is motivated by a lack of quick access to relevant medical information and advanced tools for treatment planning and clinical decision-making, which ontology-based techniques can provide. The aim of this work is to develop a structured and knowledge-driven framework that leverages ontology, a formal representation of domain knowledge, to enhance various aspects of healthcare. Object-Oriented Analysis and Design Methodology (OOADM) were adopted in the design of the system as we desired to build a usable and evolvable application. For effective implementation of this work, we used the following materials/methods/tools: the medical dataset for the test of our model in this work was obtained from Kaggle. The ontology-based technique was used with Confusion Matrix, MySQL, Python, Hypertext Markup Language (HTML), Hypertext Preprocessor (PHP), Cascaded Style Sheet (CSS), JavaScript, Dreamweaver, and Fireworks. According to test results on the new system using Confusion Matrix, both the accuracy and overall effectiveness of the medical intelligent process significantly improved by 20% compared to the previous system. Therefore, using the model is recommended for healthcare professionals.

Keywords: ontology-based, model, database, OOADM, healthcare

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4287 Disentangling Palliative Care and Euthanasia/Assisted Suicide in Dementia Care

Authors: Michael Joseph Passmore

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Euthanasia, or assisted suicide (EAS), refers to the provision of medical assistance to individuals seeking to end their own lives. In Canada, the issue of EAS has been the subject of debate and legislative action for many years. In 2016, the Canadian government passed the Medical Assistance in Dying (MAID) Act. This legalized EAS in Canada is subject to certain eligibility criteria. In 2023, debate in Canada continues regarding the scope of MAID practice and associated legislation. Dementia is an illness that causes suffering at the end of life. Persons suffering due to dementia deserve timely and effective palliative care.

Keywords: palliative care, neurocognitive disorder, dementia, Alzheimer’s disease, euthanasia, assisted suicide, medical ethics, bioethics

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4286 Аnalysis of the Perception of Medical Professionalism by Specialists of Family Medicine in Kazakhstan

Authors: Nurgul A. Abenova, Gaukhar S. Dilmagambetova, Lazzat M. Zhamaliyeva

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Professionalism is a core competency that all medical students must achieve throughout their studies. Clinical knowledge, good communication skills and an understanding of ethics form the basis of professionalism. Patients, medical societies and accrediting organizations expect future specialists to be professionals in their field, which in turn leads to the best clinical results. Currently, there are no studies devoted to the study of medical professionalism in the Republic of Kazakhstan. As a result, medical education in the Kazakhstani system has a limited perception of the concept of professionalism compared to many Western medical schools. Thus, the primary purpose of this study is to analyze the perception of medical professionalism among residents and teachers of family medicine at the West Kazakhstan Marat Ospanov Medical University. А qualitative research method was used based on the content analysis methodology. A focus group discussion was held with 60 residents and 12 family medicine teachers to gather participants' views and experiences in the field of medical professionalism. The received information was processed using the MAXQDA-2020 software package. Respondents were selected for the study based on their age, gender, and educational level. The results of the conducted survey confirmed the respondents’ acknowledgment of the basic attributes of professionalism, such as medical knowledge and skills (more than 40% of the answers), personal and moral qualities of the doctor (more than 25% of the answers), respect for the interests of the patient (15% of the answers), the relationship between the doctor and the patient and among professionals themselves (15% of responses). Another important discovery of the survey was that residents are five times more likely to define the relationship between a doctor and a patient in a model “respect for the interests of the patient” in comparison with teachers of family medicine, who primarily reported responsibility and collegiality to be the basis for the development of professionalism and traditionally view doctor-patient relationship to be formed on the basis of paternalism defined by a high degree of control over patients. This significant difference demonstrates a rift among specialists in the field of family medicine, which causes a lot of problems. For example, nowadays, professional family doctors regularly face burnout problem due to many reasons and factors that force them to abandon their jobs. In addition to that, elements of professionalism such as reflective skills, time management and feedback collection were presented to the least extent (less than 1%) by both groups, which differs from the perception of the Western medical school and is a significant issue that needs to be solved. The qualitative nature of our study provides a detailed understanding of medical professionalism in the context of the Central Asian healthcare system, revealing many aspects that are inferior to the Western medical school counterparts and provides a solution, which is to teach the attributes and skills required for medical professionalism at all stages of medical education of family doctors.

Keywords: family medicine, family doctors, medical professionalism, medical education

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4285 Value Gaps Between Patients and Doctors

Authors: Yih-Jer Wu, Ling-Lang Huang

Abstract:

Shared decision-making (SDM) is a critical aspect of determining optimal medical strategies. However, current patient decision aids (PDAs) often prioritize evidence-based discussions over value-based considerations. Despite its significance, there is limited research addressing the 'value gap' between patients and healthcare providers. To address this gap, we developed the 'Patient-Doctor Relationship Questionnaire,' consisting of 12 questions. To explore potential variations in the patient-doctor value gap across different medical specialties, we conducted interviews with physicians, surgeons, and their respective patients, utilizing the questionnaire. Between 2020 and 2022, we interviewed a total of 144 patients and 19 doctors. Among the 12 questions, physicians demonstrated significant patient-doctor value gaps in 5 questions, while surgeons in 3 questions. Only one question turned out significant gaps in both physicians and surgeons. When asking both doctors and their patients to choose one from the following 6 answers (1. No issue significant; 2. Not knowing how to make a medical decision; 3. Not confident in the doctor’s clinical judgment; 4. Not knowing how to articulate one’s own condition; 5. Unable to afford medical expenses; 6. Not understanding what doctors explain) in response to the question “what the most significant issue is in the medical consultation”, over 50% of doctors chose “Not knowing how to make a medical decision” (physicians vs. patients, 50% vs. 11%, p=0.046; surgeon vs. patients, 83% vs. 29%, p=0.001), while significantly more patients chose “No issue significant” (10% vs. 52%, p=0.002; 0% vs. 33%, p<0.001, respectively). Our findings indicate that value gaps do exist between patients and doctors and that most patients in Taiwan "fully trust" their doctors' recommendations for medical decisions. However, when treatment outcomes are far from ideal, this overinflated "trust" may turn into frustration, which could become the catalyst for medical disputes. Doctors should spend more time having more effective communication with their patients, particularly regarding potentially dissatisfactory treatment outcomes. This study underscores the substantial variability in the patient-doctor value gap, often overlooked in SDM. Patients from different clinical backgrounds may hold values distinct from those of their healthcare providers. Bridging this value gap is imperative for achieving genuine and effective SDM.

Keywords: share-decision making, value gaps, communication, doctor-patient relationship

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4284 Awareness among Medical Students and Faculty about Integration of Artifical Intelligence Literacy in Medical Curriculum

Authors: Fatima Faraz

Abstract:

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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4283 Secure Texting Used in a Post-Acute Pediatric Skilled Nursing Inpatient Setting: A Multidisciplinary Care Team Driven Communication System with Alarm and Alert Notification Management

Authors: Bency Ann Massinello, Nancy Day, Janet Fellini

Abstract:

Background: The use of an appropriate mode of communication among the multidisciplinary care team members regarding coordination of care is an extremely complicated yet important patient safety initiative. Effective communication among the team members(nursing staff, medical staff, respiratory therapists, rehabilitation therapists, patient-family services team…) become essential to develop a culture of trust and collaboration to deliver the highest quality care to patients are their families. The inpatient post-acute pediatrics, where children and their caregivers come for continuity of care, is no exceptions to the increasing use of text messages as a means to communication among clinicians. One such platform is the Vocera Communications (Vocera Smart Mobile App called Vocera Edge) allows the teams to use the application and share sensitive patient information through an encrypted platform using IOS company provided shared and assigned mobile devices. Objective: This paper discusses the quality initiative of implementing the transition from Vocera Smartbage to Vocera Edge Mobile App, technology advantage, use case expansion, and lessons learned about a secure alternative modality that allows sending and receiving secure text messages in a pediatric post-acute setting using an IOS device. This implementation process included all direct care staff, ancillary teams, and administrative teams on the clinical units. Methods: Our institution launched this transition from voice prompted hands-free Vocera Smartbage to Vocera Edge mobile based app for secure care team texting using a big bang approach during the first PDSA cycle. The pre and post implementation data was gathered using a qualitative survey of about 500 multidisciplinary team members to determine the ease of use of the application and its efficiency in care coordination. The technology was further expanded in its use by implementing clinical alerts and alarms notification using middleware integration with patient monitoring (Masimo) and life safety (Nurse call) systems. Additional use of the smart mobile iPhone use include pushing out apps like Lexicomp and Up to Date to have it readily available for users for evident-based practice in medication and disease management. Results: Successful implementation of the communication system in a shared and assigned model with all of the multidisciplinary teams in our pediatric post-acute setting. In just a 3-monthperiod post implementation, we noticed a 14% increase from 7,993 messages in 6 days in December 2020 to 9,116messages in March 2021. This confirmed that all clinical and non-clinical teams were using this mode of communication for coordinating the care for their patients. System generated data analytics used in addition to the pre and post implementation staff survey for process evaluation. Conclusion: A secure texting option using a mobile device is a safe and efficient mode for care team communication and collaboration using technology in real time. This allows for the settings like post-acute pediatric care areas to be in line with the widespread use of mobile apps and technology in our mainstream healthcare.

Keywords: nursing informatics, mobile secure texting, multidisciplinary communication, pediatrics post acute care

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4282 Developing Medical Leaders: A Realistic Evaluation Study for Improving Patient Safety and Maximising Medical Engagement

Authors: Lisa Fox, Jill Aylott

Abstract:

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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4281 Mechanical Behavior of 16NC6 Steel Hardened by Burnishing

Authors: Litim Tarek, Taamallah Ouahiba

Abstract:

This work relates to the physico-geometrical aspect of the surface layers of 16NC6 steel having undergone the burnishing treatment by hard steel ball. The results show that the optimal effects of burnishing are closely linked to the shape and the material of the active part of the device as well as to the surface plastic deformation ability of the material to be treated. Thus the roughness is improved by more than 70%, and the consolidation rate is increased by 30%. In addition, modeling of the rational traction curves provides a work hardening coefficient of up to 0.3 in the presence of burnishing.

Keywords: 16NC6 steel, burnishing, hardening, roughness

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4280 Holistic and Naturalistic Traditions of British Hygiene and Medicine, Reflected in E. W. Lane's Hygienic Medicine, 1859

Authors: Min Bae

Abstract:

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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4279 Realistic Simulation Methodology in Brazil’s New Medical Education Curriculum: Potentialities

Authors: Cleto J. Sauer Jr

Abstract:

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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4278 Medical Authorizations for Cannabis-Based Products in Canada: Sante Cannabis Data on Patient’s Safety and Treatment Profiles

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

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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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4277 Improving Climate Awareness and the Knowledge Related to Climate Change's Health Impacts on Medical Schools

Authors: Abram Zoltan

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Over the past hundred years, human activities, particularly the burning of fossil fuels, have released enough carbon dioxide and other greenhouse gases to dissipate additional heat into the lower atmosphere and affect the global climate. Climate change affects many social and environmental determinants of health: clean air, safe drinking water, and adequate food. Our aim is to draw attention to the effects of climate change on the health and health care system. Improving climate awareness and the knowledge related to climate change's health impacts are essential among medical students and practicing medical doctors. Therefore, in their everyday practice, they also need some assistance and up-to-date knowledge of how climate change can endanger human health and deal with these novel health problems. Our activity, based on the cooperation of more universities, aims to develop new curriculum outlines and learning materials on climate change's health impacts for medical schools. Special attention is intended to pay to the possible preventative measures against these impacts. For all of this, the project plans to create new curriculum outlines and learning materials for medical students, elaborate methodological guidelines and create training materials for medical doctors' postgraduate learning programs. The target groups of the project are medical students, educational staff of medical schools and universities, practicing medical doctors with special attention to the general practitioners and family doctors. We had searched various surveys, domestic and international studies about the effects of climate change and statistical estimation of the possible consequences. The health effects of climate change can be measured only approximately by considering only a fraction of the potential health effects and assuming continued economic growth and health progress. We can estimate that climate change is expected to cause about 250,000 more deaths. We conclude that climate change is one of the most serious problems of the 21st century, affecting all populations. In the short- to medium-term, the health effects of climate change will be determined mainly by human vulnerability. In the longer term, the effects depend increasingly on the extent to which transformational action is taken now to reduce emissions. We can contribute to reducing environmental pollution by raising awareness and by educating the population.

Keywords: climate change, health impacts, medical students, education

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4276 Comparison of Fundamental Frequency Model and PWM Based Model for UPFC

Authors: S. A. Al-Qallaf, S. A. Al-Mawsawi, A. Haider

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Among all FACTS devices, the unified power flow controller (UPFC) is considered to be the most versatile device. This is due to its capability to control all the transmission system parameters (impedance, voltage magnitude, and phase angle). With the growing interest in UPFC, the attention to develop a mathematical model has increased. Several models were introduced for UPFC in literature for different type of studies in power systems. In this paper a novel comparison study between two dynamic models of UPFC with their proposed control strategies.

Keywords: FACTS, UPFC, dynamic modeling, PWM, fundamental frequency

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4275 Method for Identification of Through Defects of Polymer Films Applied onto Metal Parts

Authors: Yu A. Pluttsova , O. V. Vakhnina , K. B. Zhogova

Abstract:

Nowadays, many devices operate under conditions of enhanced humidity, temperature drops, fog, and vibration. To ensure long-term and uninterruptable equipment operation under adverse conditions, one applies moisture-proof films on products and electronics components, which helps to prevent corrosion, short circuit, allowing a significant increase in device lifecycle. The reliability of such moisture-proof films is mainly determined by their coating uniformity without gaps and cracks. Unprotected product edges, as well as pores in films, can cause device failure during operation. The work objective was to develop an effective, affordable, and profit-proved method for determining the presence of through defects of protective polymer films on the surface of parts made of iron and its alloys. As a diagnostic reagent, one proposed water solution of potassium ferricyanide (III) in hydrochloric acid, this changes the color from yellow to blue according to the reactions; Feº → Fe²⁺ and 4Fe²⁺ + 3[Fe³⁺(CN)₆]³⁻ → Fe ³⁺4[Fe²⁺(CN)₆]₃. There was developed the principle scheme of technological process for determining the presence of polymer films through defects on the surface of parts made of iron and its alloys. There were studied solutions with different diagnostic reagent compositions in water: from 0,1 to 25 mass fractions, %, of potassium ferricyanide (III), and from 5 to 25 mass fractions, %, of hydrochloride acid. The optimal component ratio was chosen. The developed method consists in submerging a part covered with a film into a vessel with a diagnostic reagent. In the polymer film through defect zone, the part material (ferrum) interacts with potassium ferricyanide (III), the color changes to blue. Pilot samples were tested by the developed method for the presence of through defects in the moisture-proof coating. It was revealed that all the studied parts had through defects of the polymer film coating. Thus, the claimed method efficiently reveals polymer film coating through defects on parts made of iron or its alloys, being affordable and profit-proved.

Keywords: diagnostic reagent, metal parts, polimer films, through defects

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4274 Decision Support System for Fetus Status Evaluation Using Cardiotocograms

Authors: Oyebade K. Oyedotun

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The cardiotocogram is a technical recording of the heartbeat rate and uterine contractions of a fetus during pregnancy. During pregnancy, several complications can occur to both the mother and the fetus; hence it is very crucial that medical experts are able to find technical means to check the healthiness of the mother and especially the fetus. It is very important that the fetus develops as expected in stages during the pregnancy period; however, the task of monitoring the health status of the fetus is not that which is easily achieved as the fetus is not wholly physically available to medical experts for inspection. Hence, doctors have to resort to some other tests that can give an indication of the status of the fetus. One of such diagnostic test is to obtain cardiotocograms of the fetus. From the analysis of the cardiotocograms, medical experts can determine the status of the fetus, and therefore necessary medical interventions. Generally, medical experts classify examined cardiotocograms into ‘normal’, ‘suspect’, or ‘pathological’. This work presents an artificial neural network based decision support system which can filter cardiotocograms data, producing the corresponding statuses of the fetuses. The capability of artificial neural network to explore the cardiotocogram data and learn features that distinguish one class from the others has been exploited in this research. In this research, feedforward and radial basis neural networks were trained on a publicly available database to classify the processed cardiotocogram data into one of the three classes: ‘normal’, ‘suspect’, or ‘pathological’. Classification accuracies of 87.8% and 89.2% were achieved during the test phase of the trained network for the feedforward and radial basis neural networks respectively. It is the hope that while the system described in this work may not be a complete replacement for a medical expert in fetus status evaluation, it can significantly reinforce the confidence in medical diagnosis reached by experts.

Keywords: decision support, cardiotocogram, classification, neural networks

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