Search results for: healthcare disparities
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1807

Search results for: healthcare disparities

907 AI-Driven Strategies for Sustainable Electronics Repair: A Case Study in Energy Efficiency

Authors: Badiy Elmabrouk, Abdelhamid Boujarif, Zhiguo Zeng, Stephane Borrel, Robert Heidsieck

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In an era where sustainability is paramount, this paper introduces a machine learning-driven testing protocol to accurately predict diode failures, merging reliability engineering with failure physics to enhance repair operations efficiency. Our approach refines the burn-in process, significantly curtailing its duration, which not only conserves energy but also elevates productivity and mitigates component wear. A case study from GE HealthCare’s repair center vividly demonstrates the method’s effectiveness, recording a high prediction of diode failures and a substantial decrease in energy consumption that translates to an annual reduction of 6.5 Tons of CO2 emissions. This advancement sets a benchmark for environmentally conscious practices in the electronics repair sector.

Keywords: maintenance, burn-in, failure physics, reliability testing

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906 Gamma-Hydroxybutyrate (GHB): A Review for the Prehospital Clinician

Authors: Theo Welch

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Background: Gamma-hydroxybutyrate (GHB) is a depressant of the central nervous system with euphoric effects. It is being increasingly used recreationally in the United Kingdom (UK) despite associated morbidity and mortality. Due to the lack of evidence, healthcare professionals remain unsure as to the optimum management of GHB acute toxicity. Methods: A literature review was undertaken of its pharmacology and the emergency management of its acute toxicity.Findings: GHB is inexpensive and readily available over the Internet. Treatment of GHB acute toxicity is supportive. Clinicians should pay particular attention to the airway as emesis is common. Intubation is required in a minority of cases. Polydrug use is common and worsens prognosis. Conclusion: An inexpensive and readily available drug, GHB acute toxicity can be difficult to identify and treat. GHB acute toxicity is generally treated conservatively. Further research is needed to ascertain the indications, benefits, and risks of intubating patients with GHB acute toxicity. instructions give you guidelines for preparing papers for the conference.

Keywords: GHB, gamma-hydroxybutyrate, prehospital, emergency, toxicity, management

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905 Rule-Based Expert System for Headache Diagnosis and Medication Recommendation

Authors: Noura Al-Ajmi, Mohammed A. Almulla

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With the increased utilization of technology devices around the world, healthcare and medical diagnosis are critical issues that people worry about these days. Doctors are doing their best to avoid any medical errors while diagnosing diseases and prescribing the wrong medication. Subsequently, artificial intelligence applications that can be installed on mobile devices such as rule-based expert systems facilitate the task of assisting doctors in several ways. Due to their many advantages, the usage of expert systems has increased recently in health sciences. This work presents a backward rule-based expert system that can be used for a headache diagnosis and medication recommendation system. The structure of the system consists of three main modules, namely the input unit, the processing unit, and the output unit.

Keywords: headache diagnosis system, prescription recommender system, expert system, backward rule-based system

Procedia PDF Downloads 219
904 Do the Health Benefits of Oil-Led Economic Development Outweigh the Potential Health Harms from Environmental Pollution in Nigeria?

Authors: Marian Emmanuel Okon

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Introduction: The Niger Delta region of Nigeria has a vast reserve of oil and gas, which has globally positioned the nation as the sixth largest exporter of crude oil. Production rapidly rose following oil discovery. In most oil producing nations of the world, the wealth generated from oil production and export has propelled economic advancement, enabling the development of industries and other relevant infrastructures. Therefore, it can be assumed that majority of the oil resource such as Nigeria’s, has the potential to improve the health of the population via job creation and derived revenues. However, the health benefits of this economic development might be offset by the environmental consequences of oil exploitation and production. Objective: This research aims to evaluate the balance between the health benefits of oil-led economic development and harmful environmental consequences of crude oil exploitation in Nigeria. Study Design: A pathway has been designed to guide data search and this study. The model created will assess the relationship between oil-led economic development and population health development via job creation, improvement of education, development of infrastructure and other forms of development as well as through harmful environmental consequences from oil activities. Data/Emerging Findings: Diverse potentially suitable datasets which are at different geographical scales have been identified, obtained or applied for and the dataset from the World Bank has been the most thoroughly explored. This large dataset contains information that would enable the longitudinal assessment of both the health benefits and harms from oil exploitation in Nigeria as well as identify the disparities that exist between the communities, states and regions. However, these data do not extend far back enough in time to capture the start of crude oil production. Thus, it is possible that the maximum economic benefits and health harms could be missed. To deal with this shortcoming, the potential for a comparative study with countries like United Kingdom, Morocco and Cote D’ivoire has also been taken into consideration, so as to evaluate the differences between these countries as well as identify the areas of improvement in Nigeria’s environmental and health policies. Notwithstanding, these data have shown some differences in each country’s economic, environmental and health state over time as well as a corresponding summary statistics. Conclusion: In theory, the beneficial effects of oil exploitation to the health of the population may be substantial as large swaths of the ‘wider determinants’ of population heath are influenced by the wealth of a nation. However, if uncontrolled, the consequences from environmental pollution and degradation may outweigh these benefits. Thus, there is a need to address this, in order to improve environmental and population health in Nigeria.

Keywords: environmental pollution, health benefits, oil-led economic development, petroleum exploitation

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903 Integrating Natural Language Processing (NLP) and Machine Learning in Lung Cancer Diagnosis

Authors: Mehrnaz Mostafavi

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The assessment and categorization of incidental lung nodules present a considerable challenge in healthcare, often necessitating resource-intensive multiple computed tomography (CT) scans for growth confirmation. This research addresses this issue by introducing a distinct computational approach leveraging radiomics and deep-learning methods. However, understanding local services is essential before implementing these advancements. With diverse tracking methods in place, there is a need for efficient and accurate identification approaches, especially in the context of managing lung nodules alongside pre-existing cancer scenarios. This study explores the integration of text-based algorithms in medical data curation, indicating their efficacy in conjunction with machine learning and deep-learning models for identifying lung nodules. Combining medical images with text data has demonstrated superior data retrieval compared to using each modality independently. While deep learning and text analysis show potential in detecting previously missed nodules, challenges persist, such as increased false positives. The presented research introduces a Structured-Query-Language (SQL) algorithm designed for identifying pulmonary nodules in a tertiary cancer center, externally validated at another hospital. Leveraging natural language processing (NLP) and machine learning, the algorithm categorizes lung nodule reports based on sentence features, aiming to facilitate research and assess clinical pathways. The hypothesis posits that the algorithm can accurately identify lung nodule CT scans and predict concerning nodule features using machine-learning classifiers. Through a retrospective observational study spanning a decade, CT scan reports were collected, and an algorithm was developed to extract and classify data. Results underscore the complexity of lung nodule cohorts in cancer centers, emphasizing the importance of careful evaluation before assuming a metastatic origin. The SQL and NLP algorithms demonstrated high accuracy in identifying lung nodule sentences, indicating potential for local service evaluation and research dataset creation. Machine-learning models exhibited strong accuracy in predicting concerning changes in lung nodule scan reports. While limitations include variability in disease group attribution, the potential for correlation rather than causality in clinical findings, and the need for further external validation, the algorithm's accuracy and potential to support clinical decision-making and healthcare automation represent a significant stride in lung nodule management and research.

Keywords: lung cancer diagnosis, structured-query-language (SQL), natural language processing (NLP), machine learning, CT scans

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902 Investigating the Factors Affecting Generalization of Deep Learning Models for Plant Disease Detection

Authors: Praveen S. Muthukumarana, Achala C. Aponso

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A large percentage of global crop harvest is lost due to crop diseases. Timely identification and treatment of crop diseases is difficult in many developing nations due to insufficient trained professionals in the field of agriculture. Many crop diseases can be accurately diagnosed by visual symptoms. In the past decade, deep learning has been successfully utilized in domains such as healthcare but adoption in agriculture for plant disease detection is rare. The literature shows that models trained with popular datasets such as PlantVillage does not generalize well on real world images. This paper attempts to find out how to make plant disease identification models that generalize well with real world images.

Keywords: agriculture, convolutional neural network, deep learning, plant disease classification, plant disease detection, plant disease diagnosis

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901 An Exploration of the Emergency Staff’s Perceptions and Experiences of Teamwork and the Skills Required in the Emergency Department in Saudi Arabia

Authors: Sami Alanazi

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Teamwork practices have been recognized as a significant strategy to improve patient safety, quality of care, and staff and patient satisfaction in healthcare settings, particularly within the emergency department (ED). The EDs depend heavily on teams of interdisciplinary healthcare staff to carry out their operational goals and core business of providing care to the serious illness and injured. The ED is also recognized as a high-risk area in relation to service demand and the potential for human error. Few studies have considered the perceptions and experiences of the ED staff (physicians, nurses, allied health professionals, and administration staff) about the practice of teamwork, especially in Saudi Arabia (SA), and no studies have been conducted to explore the practices of teamwork in the EDs. Aim: To explore the practices of teamwork from the perspectives and experiences of staff (physicians, nurses, allied health professionals, and administration staff) when interacting with each other in the admission areas in the ED of a public hospital in the Northern Border region of SA. Method: A qualitative case study design was utilized, drawing on two methods for the data collection, comprising of semi-structured interviews (n=22) with physicians (6), nurses (10), allied health professionals (3), and administrative members (3) working in the ED of a hospital in the Northern Border region of SA. The second method is non-participant direct observation. All data were analyzed using thematic analysis. Findings: The main themes that emerged from the analysis were as follows: the meaningful of teamwork, reasons of teamwork, the ED environmental factors, the organizational factors, the value of communication, leadership, teamwork skills in the ED, team members' behaviors, multicultural teamwork, and patients and families behaviors theme. Discussion: Working in the ED environment played a major role in affecting work performance as well as team dynamics. However, Communication, time management, fast-paced performance, multitasking, motivation, leadership, and stress management were highlighted by the participants as fundamental skills that have a major impact on team members and patients in the ED. It was found that the behaviors of the team members impacted the team dynamics as well as ED health services. Behaviors such as disputes among team members, conflict, cooperation, uncooperative members, neglect, and emotions of the members. Besides that, the behaviors of the patients and their accompanies had a direct impact on the team and the quality of the services. In addition, the differences in the cultures have separated the team members and created undesirable gaps such the gender segregation, national origin discrimination, and similarity and different in interests. Conclusion: Effective teamwork, in the context of the emergency department, was recognized as an essential element to obtain the quality of care as well as improve staff satisfaction.

Keywords: teamwork, barrier, facilitator, emergencydepartment

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900 The Lived Experience of Pregnant Saudi Women Carrying a Fetus with Structural Abnormalities

Authors: Nasreen Abdulmannan

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Fetal abnormalities are categorized as a structural abnormality, non-structural abnormality, or a combination of both. Fetal structural abnormalities (FSA) include, but are not limited, to Down syndrome, congenital diaphragmatic hernia, and cleft lip and palate. These abnormalities can be detected in the first weeks of pregnancy, which is almost around 9 - 20 weeks gestational. Etiological factors for FSA are unknown; however, transmitted genetic risk can be one of these factors. Consanguineous marriage often referred to as inbreeding, represents a significant risk factor for FSA due to the increased likelihood of deleterious genetic traits shared by both biological parents. In a country such as the Kingdom of Saudi Arabia (KSA), consanguineous marriage is high, which creates a significant risk of children being born with congenital abnormalities. Historically, the practice of consanguinity occurred commonly among European royalty. For example, Great Britain’s Queen Victoria married her German first cousin, Prince Albert of Coburg. Although a distant blood relationship, the United Kingdom’s Queen Elizabeth II married her cousin, Prince Philip of Greece and Denmark—both of them direct descendants of Queen Victoria. In Middle Eastern countries, a high incidence of consanguineous unions still exists, including in the KSA. Previous studies indicated that a significant gap exists in understanding the lived experiences of Saudi women dealing with an FSA-complicated pregnancy. Eleven participants were interviewed using a semi-structured interview format for this qualitative phenomenological study investigating the lived experiences of pregnant Saudi women carrying a child with FSA. This study explored the gaps in current literature regarding the lived experiences of pregnant Saudi women whose pregnancies were complicated by FSA. In addition, the researcher acquired knowledge about the available support and resources as well as the Saudi cultural perspective on FSA. This research explored the lived experiences of pregnant Saudi women utilizing Giorgi’s (2009) approach to data collection and data management. Findings for this study cover five major themes: (1) initial maternal reaction to the FSA diagnosis per ultrasound screening; (2) strengthening of the maternal relationship with God; (3) maternal concern for their child’s future; (4) feeling supported by their loved ones; and (5) lack of healthcare provider support and guidance. Future research in the KSA is needed to explore the network support for these mothers. This study recommended further clinical nursing research, nursing education, clinical practice, and healthcare policy/procedures to provide opportunities for improvement in nursing care and increase awareness in KSA society.

Keywords: fetal structural abnormalities, psychological distress, health provider, health care

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899 Traumatic Brain Injury in Cameroon: A Prospective Observational Study in a Level 1 Trauma Centre

Authors: Franklin Chu Buh, Irene Ule Ngole Sumbele, Andrew I. R. Maas, Mathieu Motah, Jogi V. Pattisapu, Eric Youm, Basil Kum Meh, Firas H. Kobeissy, Kevin W. Wang, Peter J. A. Hutchinson, Germain Sotoing Taiwe

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Introduction: Studying TBI characteristics and their relation to outcomes can identify initiatives to improve TBI prevention and care. The objective of this study was to define the features and outcomes of TBI patients seen over a 1-year period in a level-I trauma center in Cameroon. Methods: Data on demographics, causes, injury mechanisms, clinical aspects, and discharge status were prospectively collected over a period of 12 months. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Questionnaire after Brain Injury (QoLIBRI) were used to evaluate outcomes 6-months after TBI. Categorical variables were described as frequencies and percentages. Comparisons between 2 categorical variables were done using Pearson's Chi-square test or Fisher's exact test. Results: A total of 160 TBI patients participated in the study. The age group 15-45 years (78%; 125) was most represented. Males were more affected (90%; 144). Low educational level was recorded in 122 (76%) cases. Road traffic incidents (RTI) were the main cause of TBI (85%), with professional bike riders being frequently involved (27%, 43/160). Assaults (7.5%) and falls (2.5%) represent the second and third most common causes of TBI in Cameroon, respectively. Only 15 patients were transported to the hospital by ambulance, and 14 of these were from a referring hospital. CT-imaging was performed in 78% (125/160) of cases intracranial traumatic abnormality was identified in 77/125 (64%) cases. Financial constraints were the main reason for not performing a CT scan on 35 patients. A total of 46 (33%) patients were discharged against medical advice (DAMA) due to financial constraints. Mortality was 14% (22/160) but disproportionately high in patients with severe TBI (46%). DAMA had poor outcomes with QoLIBRI. Only 4 patients received post-injury physiotherapy services. Conclusion: TBI in Cameroon mainly results from RTIs and commonly affects young adult males, and low educational or socioeconomic status and commercial bike riding appear to be predisposing factors. Lack of pre-hospital care, financial constraints limiting both CT-scanning and medical care, and lack of acute physiotherapy services likely influenced care and outcomes adversely.

Keywords: characteristics, traumatic brain injury, outcome, disparities in care, prospective study

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898 Remote Patient Monitoring for Covid-19

Authors: Launcelot McGrath

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The Coronavirus disease 2019 (COVID-19) has spread rapidly around the world, resulting in high mortality rates and very large numbers of people requiring medical treatment in ICU. Management of patient hospitalisation is a critical aspect to control this disease and reduce chaos in the healthcare systems. Remote monitoring provides a solution to protect vulnerable and elderly high-risk patients. Continuous remote monitoring of oxygen saturation, respiratory rate, heart rate, and temperature, etc., provides medical systems with up-to-the-minute information about their patients' statuses. Remote monitoring also limits the spread of infection by reducing hospital overcrowding. This paper examines the potential of remote monitoring for Covid-19 to assist in the rapid identification of patients at risk, facilitate the detection of patient deterioration, and enable early interventions.

Keywords: remote monitoring, patient care, oxygen saturation, Covid-19, hospital management

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897 Functionalized Nanoparticles for Biomedical Applications

Authors: Temesgen Geremew

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Functionalized nanoparticles have emerged as a revolutionary class of materials with immense potential in various biomedical applications. These engineered nanoparticles possess unique properties tailored to interact with biological systems, offering unprecedented opportunities in drug delivery, imaging, diagnostics, and therapy. This research delves into the design, synthesis, and characterization of functionalized nanoparticles for targeted biomedical applications. The primary focus lies on developing nanoparticles with precisely controlled size, surface chemistry, and biocompatibility for specific medical purposes. The research will also explore the crucial interaction of these nanoparticles with biological systems, encompassing cellular uptake, biodistribution, and potential toxicity evaluation. The successful development of functionalized nanoparticles holds the promise to revolutionize various aspects of healthcare. This research aspires to contribute significantly to this advancement by providing valuable insights into the design and application of these versatile materials within the ever-evolving field of biomedicine.

Keywords: nanoparticles, biomedicals, cancer, biocompatibility

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896 Cardiovascular Disease Prediction Using Machine Learning Approaches

Authors: P. Halder, A. Zaman

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It is estimated that heart disease accounts for one in ten deaths worldwide. United States deaths due to heart disease are among the leading causes of death according to the World Health Organization. Cardiovascular diseases (CVDs) account for one in four U.S. deaths, according to the Centers for Disease Control and Prevention (CDC). According to statistics, women are more likely than men to die from heart disease as a result of strokes. A 50% increase in men's mortality was reported by the World Health Organization in 2009. The consequences of cardiovascular disease are severe. The causes of heart disease include diabetes, high blood pressure, high cholesterol, abnormal pulse rates, etc. Machine learning (ML) can be used to make predictions and decisions in the healthcare industry. Thus, scientists have turned to modern technologies like Machine Learning and Data Mining to predict diseases. The disease prediction is based on four algorithms. Compared to other boosts, the Ada boost is much more accurate.

Keywords: heart disease, cardiovascular disease, coronary artery disease, feature selection, random forest, AdaBoost, SVM, decision tree

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895 Ion Beam Sputtering Deposition of Inorganic-Fluoropolymer Nano-Coatings for Real-Life Applications

Authors: M. Valentini, D. Melisi, M. A. Nitti, R A. Picca, M. C. Sportelli, E. Bonerba, G. Casamassima, N. Cioffi, L. Sabbatini, G. Tantillo, A. Valentini

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In recent years antimicrobial coatings are receiving increasing attention due to their high demand in medical applications as well as in healthcare and hygiene. Research and technology are constantly involved to develop advanced finishing which can provide bacteriostatic growth without compromising the other typical properties of a textile as durability and non-toxicity, just to cite a few. Here we report on the antimicrobial coatings obtained, at room temperature and without the use of solvents, by means of the ion beam co-sputtering technique of an Ag target and a polytetrafluoroethylene one. In particular, such method allows to conjugate the well-known antimicrobial action of silver with the anti-stain and water-repellent properties of the fluoropolymer. Moreover, different Ag nanoparticle loadings (φ) were prepared by tuning the material deposition conditions achieving a fine control on film thickness and their antimicrobial/anti-stain properties.

Keywords: antimicrobial, ion beam sputtering, nanocoatings, anti-stain

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894 Development of a Nurse Led Tranexamic Acid Administration Protocol for Trauma Patients in Rural South Africa

Authors: Christopher Wearmouth, Jacob Smith

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Administration of tranexamic acid (TXA) reduces all-cause mortality in trauma patients when given within 3 hours of injury. Due to geographical distance and lack of emergency medical services patients often present late, following trauma, to our emergency department. Additionally, we found patients that may have benefited from TXA did not receive it, often due to lack of staff awareness, staff shortages out of hours and lack of equipment for delivering infusions. Our objective was to develop a protocol for nurse-led administration of TXA in the emergency department. We developed a protocol using physiological observations along with criteria from the South African Triage Scale to allow nursing staff to identify patients with, or at risk of, significant haemorrhage. We will monitor the use of the protocol to ensure appropriate compliance and for any adverse events reported.

Keywords: emergency department, emergency nursing, rural healthcare, tranexamic acid, trauma, triage

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893 An Empirical Examination on the Relationships between Organizational Justice, Affective Commitment and Absenteeism

Authors: Emine Öğüt, Mehtap Öztürk, Adem Öğüt

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Affective commitment is defined as a strong belief in and acceptance of the organization’s goals and values. Organizational justice is an antecedent of the organizational commitment and it has the potential to create powerful benefits for organizations and employees alike. When perceived unfairness among employees increases, affective commitment decreases and absenteeism increases accordingly. In this research, relationships between organizational justice perception, affective commitment and absenteeism is analysed. In this regard, a field study has been conducted over the physicians working in the hospitals of the Health Ministry and University Hospitals in the province of Konya. The partial least squares (PLS) method is used to analyse the survey data. The findings of the research shows that there is a positive statistically significant relationship between organizational justice perception and affective commitment while there is a negative statistically significant relationship between organizational justice and absenteeism.

Keywords: organizational justice, affective commitment, absenteeism, healthcare management

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892 Evaluation of the Sterilization Practice in Liberal Dental Surgeons at Sidi Bel Abbes- Algeria

Authors: A. Chenafa, S. Boulenouar, M. Zitouni, M. Boukouria

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The sterilization of medical devices constitutes for all the medical professions, an inescapable obligation. It has for objective to prevent the infectious risk, both for the patient and for the medical team. The Dental surgeon as every healthcare professional has to master perfectly this subject and to train his staff to the various techniques of sterilization. It is the only way to assure the patients all the security for which they are entitled to wait when they undergo a dental care. It’s for it, that we undertook to lead an investigation aiming at estimating the sterilization practice at the dental surgeon of Sidi bel Abbes. The survey result showed a youth marked with the profession with a majority use of autoclave with cycle B and an almost total absence of the sterilization controls (test of Bowie and Dick). However, the majority of the dentists control and validate their sterilizers. Finally, our survey allowed us to describe some practices which must be improved regarding control, regarding qualification and regarding staff training. And suggestions were made in this sense.

Keywords: dental surgeon, medical devices, sterilization, survey

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891 Automatic Queuing Model Applications

Authors: Fahad Suleiman

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Queuing, in medical system is the process of moving patients in a specific sequence to a specific service according to the patients’ nature of illness. The term scheduling stands for the process of computing a schedule. This may be done by a queuing based scheduler. This paper focuses on the medical consultancy system, the different queuing algorithms that are used in healthcare system to serve the patients, and the average waiting time. The aim of this paper is to build automatic queuing system for organizing the medical queuing system that can analyses the queue status and take decision which patient to serve. The new queuing architecture model can switch between different scheduling algorithms according to the testing results and the factor of the average waiting time. The main innovation of this work concerns the modeling of the average waiting time is taken into processing, in addition with the process of switching to the scheduling algorithm that gives the best average waiting time.

Keywords: queuing systems, queuing system models, scheduling algorithms, patients

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890 Study to Understand the Social Implications of Sexually Transmitted Infections in Patients Belonging to Low Socio-Economic Status

Authors: Rudraksh Kesharwani, Ritika Agarkar

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Sexually transmitted diseases are a major public health concern affecting both the mortality and the morbidity of a population. It is among the most serious causes of the diseases affecting the quality of life of a individual leading to a significant decrease in their health. In India, STIs have been a significant public health concern due to various reasons, including a large population, limited access to healthcare in certain areas, stigma around discussing sexual health, and insufficient sex education. Some common STIs in India include HIV/AIDS, syphilis, gonorrhea, chlamydia, and herpes. This research report aims to determine the percentage of people infected with sexually transmitted infections (STI) worrying about it’s impact on their day to day activity, specifically focusing on it’s impact on the mentaland sexual health of the patient infected along with his/her partner.

Keywords: sexual health, mental health, sexually transmitted disease, sexual taboos

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889 Text Mining Past Medical History in Electrophysiological Studies

Authors: Roni Ramon-Gonen, Amir Dori, Shahar Shelly

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Background and objectives: Healthcare professionals produce abundant textual information in their daily clinical practice. The extraction of insights from all the gathered information, mainly unstructured and lacking in normalization, is one of the major challenges in computational medicine. In this respect, text mining assembles different techniques to derive valuable insights from unstructured textual data, so it has led to being especially relevant in Medicine. Neurological patient’s history allows the clinician to define the patient’s symptoms and along with the result of the nerve conduction study (NCS) and electromyography (EMG) test, assists in formulating a differential diagnosis. Past medical history (PMH) helps to direct the latter. In this study, we aimed to identify relevant PMH, understand which PMHs are common among patients in the referral cohort and documented by the medical staff, and examine the differences by sex and age in a large cohort based on textual format notes. Methods: We retrospectively identified all patients with abnormal NCS between May 2016 to February 2022. Age, gender, and all NCS attributes reports were recorded, including the summary text. All patients’ histories were extracted from the text report by a query. Basic text cleansing and data preparation were performed, as well as lemmatization. Very popular words (like ‘left’ and ‘right’) were deleted. Several words were replaced with their abbreviations. A bag of words approach was used to perform the analyses. Different visualizations which are common in text analysis, were created to easily grasp the results. Results: We identified 5282 unique patients. Three thousand and five (57%) patients had documented PMH. Of which 60.4% (n=1817) were males. The total median age was 62 years (range 0.12 – 97.2 years), and the majority of patients (83%) presented after the age of forty years. The top two documented medical histories were diabetes mellitus (DM) and surgery. DM was observed in 16.3% of the patients, and surgery at 15.4%. Other frequent patient histories (among the top 20) were fracture, cancer (ca), motor vehicle accident (MVA), leg, lumbar, discopathy, back and carpal tunnel release (CTR). When separating the data by sex, we can see that DM and MVA are more frequent among males, while cancer and CTR are less frequent. On the other hand, the top medical history in females was surgery and, after that, DM. Other frequent histories among females are breast cancer, fractures, and CTR. In the younger population (ages 18 to 26), the frequent PMH were surgery, fractures, trauma, and MVA. Discussion: By applying text mining approaches to unstructured data, we were able to better understand which medical histories are more relevant in these circumstances and, in addition, gain additional insights regarding sex and age differences. These insights might help to collect epidemiological demographical data as well as raise new hypotheses. One limitation of this work is that each clinician might use different words or abbreviations to describe the same condition, and therefore using a coding system can be beneficial.

Keywords: abnormal studies, healthcare analytics, medical history, nerve conduction studies, text mining, textual analysis

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888 Xiaflex (Collagenase) Impact on the Management of Dupuytren's Disease: Making the Case for Treatment in a Public Healthcare System

Authors: Anthony Barker, Roland Jiang

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Dupuytren’s contractures are a debilitating condition affecting the palmar fascia of the hand reducing its function. This case series looks at the minimally-invasive technique of Xiaflex injections and the outcome in a public health setting. 15 patients undertook collagenase injection (Xiaflex, C. histolyticum) injection over the period from September 2015 to May 2017 at Fairfield Hospital, NSW. Their reported outcome post injection and in follow-up was recorded as well as their satisfaction and likelihood to request the procedure in the future. Other treatment modalities include percutaneous needle aponeurotomy, limited palmar fasciotomy, and palmar fasciectomy. A literature review of cost-effectiveness was performed to compare Xiaflex suitability for waitlist reduction in a public setting given average waiting times in the public setting extend past 365 days.

Keywords: Dupuytrens Disease, xiaflex, collagenase, plastic surgery

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887 Seroprevalence of Cytomegalovirus among Pregnant Women in Islamabad, Pakistan

Authors: Hassan Waseem

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Cytomegalovirus (CMV) is ubiquitously distributed viral agent responsible for different clinical manifestations that may vary according to the immunologic status of the patient. CMV can cause morbidity and mortality among fetuses and patients with compromised immune system. A cross-sectional study was carried out in Islamabad to investigate the prevalence and risk factors associated with CMV infection among pregnant women. Blood samples of 172 pregnant women visiting Mother and Child Healthcare, Pakistan Institute of Medical Sciences (PIMS) Islamabad were taken. In present study, serum samples of the women were checked for CMV-specific IgG and IgM antibodies by enzyme linked immunosorbent assay (ELISA). Clinical, obstetrical and socio-demographical characteristics of the women were collected by using structured questionnaires. Out of 172 pregnant women included in the study, 171 (99.4%) were CMV specific IgG positive and 30 (17.4%) were found positive for CMV-IgM antibodies. The CMV has taken an endemic form in Pakistan so, routine screening of CMV among pregnant women is recommended.

Keywords: Cytomegalovirus, blood transfusion, ELISA, seroprevalence

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886 Course Perceiving Differences among College Science Students from Various Cultures: A Case Study in the US

Authors: Yuanyuan Song

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Background: As we all know, culture plays a pivotal role in the realm of education, influencing study perceptions and outcomes. Nevertheless, there remains a need to delve into how culture specifically impacts the perception of courses. Therefore, the impact of culture on students' perceptions and academic performance is explored in this study. Drawing from cultural constructionism and conflict theories, it is posited that when students hailing from diverse cultures and backgrounds converge in the same classroom, their perceptions of course content may diverge significantly. This study seeks to unravel the tangible disparities and ascertain how cultural nuances shape students' perceptions of classroom content when encountering diverse cultural contexts within the same learning environment. Methodology: Given the diverse cultural backgrounds of students within the US, this study draws upon data collected from a course offered by a US college. In pursuit of answers to these inquiries, a qualitative approach was employed, involving semi-structured interviews conducted in a college-level science class in the US during 2023. The interviews encompassed approximately nine questions, spanning demographic particulars, cultural backgrounds, science learning experiences, academic outcomes, and more. Participants were exclusively drawn from science-related majors, with each student originating from a distinct cultural context. All participants were undergraduates, and most of them were from eighteen to twenty-five years old, totaling six students who attended the class and willingly participated in the interviews. The duration of each interview was approximately twenty minutes. Results: The findings gleaned from the interview data underscore the notable impact of varying cultural contexts on students' perceptions. This study argues that female science students, for instance, are influenced by gender dynamics due to the predominant male presence in science majors, creating an environment where female students feel reticent about expressing themselves in public. Students of East Asian origin exhibit a stronger belief in the efficacy of personal efforts when contrasted with their North American counterparts. Minority students indicated that they grapple with integration into the predominantly white mainstream society, influencing their eagerness to engage in classroom activities that are conducted by white professors. All of them emphasized the importance of learning science.

Keywords: multiculture education, educational sociology, educational equality, STEM education

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885 How COVID 19 Changed Policy Makers Behavior toward Environmental Policy

Authors: Ammar Alrefaei

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The COVID-19 pandemic changed human life. The vast majority of the COVID effect was on the healthcare sector, but its impact on the global economy cannot be denied. In the field of environment, the pandemic may have a more significant impact on the environment than all environmental activity and policies of recent years. The pandemic consequences for the environment may be far more unpredictable than one might assume. In view of this, it is imperative for legislators from different states to be prepared to apply adequate measures to counteract such consequences. This article aimed to examine the obstacles to implementing effective environmental policies after the COVID-19 pandemic using different examples from different countries. Also, how adopting new initiatives, such as the Saudi Green Initiative and the Middle East Green Initiative, can help policymakers and legislators adopt new laws and policies. In addition, this paper reviewed the developing dangers to environmental protection after the pandemic and analyzed the major challenges to instrument active environmental policies during COVID-19 and in the world after COVID.

Keywords: environmental policy, environment law, green initiative, COVID 19

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884 Analysis of Road Risk in Four French Overseas Territories Compared with Metropolitan France

Authors: Mohamed Mouloud Haddak, Bouthayna Hayou

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Road accidents in French overseas territories have been understudied, with relevant data often collected late and incompletely. Although these territories account for only 3% to 4% of road traffic injuries in France, their unique characteristics merit closer attention. Despite lower mobility and, consequently, lower exposure to road risks, the actual road risk in Overseas France is as high or even higher than in Metropolitan France. Significant disparities exist not only between Metropolitan France and Overseas territories but also among the overseas territories themselves. The varying population densities in these regions do not fully explain these differences, as each territory has its own distinct vulnerabilities and road safety challenges. This analysis, based on BAAC data files from 2005 to 2018 for both Metropolitan France and the overseas departments and regions, examines key variables such as gender, age, type of road user, type of obstacle hit, type of trip, road category, traffic conditions, weather, and location of accidents. Logistic regression models were built for each region to investigate the risk factors associated with fatal road accidents, focusing on the probability of being killed versus injured. Due to insufficient data, Mayotte and the Overseas Communities (French Polynesia and New Caledonia) were not included in the models. The findings reveal that road safety is worse in the overseas territories compared to Metropolitan France, particularly for vulnerable road users such as pedestrians and motorized two-wheelers. These territories present an accident profile that sits between that of Metropolitan France and middle-income countries. A pressing need exists to standardize accident data collection between Metropolitan and Overseas France to allow for more detailed comparative analyses. Further epidemiological studies could help identify the specific road safety issues unique to each territory, particularly with regards to socio-economic factors such as social cohesion, which may influence road safety outcomes. Moreover, the lack of data on new modes of travel, such as electric scooters, and the absence of socio-economic details of accident victims complicate the evaluation of emerging risk factors. Additional research, including sociological and psychosocial studies, is essential for understanding road users' behavior and perceptions of road risk, which could also provide valuable insights into accident trends in peri-urban areas in France.

Keywords: multivariate logistic regression, french overseas regions, road safety, road traffic accidents, territorial inequalities

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883 Complicated Sinusitis with Sphenopalatine Artery Thrombosis in a Covid-19 Patient

Authors: Sara Mahmood, Omar Ahmed, Youssef Aladham, Moustafa Abdelnaby

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The varied complications of COVID-19 present an ongoing challenge to healthcare professionals. A rare presentation of complicated sinusitis with pre-septal cellulitis and hard palatal necrosis in a COVID-19 patient, was reported. A 52-year-old male was admitted to the hospital with typical COVID manifestations where he had two successive COVID-19 positive swabs. During his admission, he developed symptoms of right orbital complications of sinusitis along with both clinical and radiological evidence of ipsilateral hard palatal necrosis. Imaging confirmed a diagnosis of right pan-sinusitis complicated with right pre-septal infection and hard palatal bony defect on the same side. Intra-operatively, the sphenopalatine artery was found to be thrombosed. This case focuses on the possible association between these manifestations and the known thromboembolic complications of COVID-19. Ongoing management of such complicated rare cases should be through a multidisciplinary team.

Keywords: COVID-19, sinusitis, sphenopalatine artery, thrombosis

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882 A Path for Assistance for People With Stroke in Angola

Authors: Lourenço José, Elsa Melo, Sandra Viera, Ana Pinheiro

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Introduction: People with stroke in Angola face challenges in accessing appropriate healthcare and rehabilitation services. There is a lack of information on the quality of care provided and the development of early intervention plans Methods: Two different methods will be chosen. The exploratory, descriptive, and longitudinal study (E1) to characterize health care for people with stroke, housed in 2 hospitals in Luanda; the quality and transverse study (E2) concerning the development and evaluation of a strategic early intervention plan for a stroke patient. Ethical and deontological principles for an investigation will be proposed. Results: Contributor to the knowledge of the reality of providing care to the person after a stroke, in Angola; Propose and develop an early action plan. Contribute to integration to influence policy makers on the need for assistance with stroke, aiming at their functional, family and social rehabilitation, particularly in the labor market.

Keywords: stroke, functional recovery, quality of life, health

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881 A Numerical Computational Method of MRI Static Magnetic Field for an Ergonomic Facility Design Guidelines

Authors: Sherine Farrag

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Magnetic resonance imaging (MRI) presents safety hazards, with the general physical environment. The principal hazard of the MRI is the presence of static magnetic fields. Proper architectural design of MRI’s room ensure environment and health care staff safety. This research paper presents an easy approach for numerical computation of fringe static magnetic fields. Iso-gauss line of different MR intensities (0.3, 0.5, 1, 1.5 Tesla) was mapped and a polynomial function of the 7th degree was generated and tested. Matlab script was successfully applied for MRI SMF mapping. This method can be valid for any kind of commercial scanner because it requires only the knowledge of the MR scanner room map with iso-gauss lines. Results help to develop guidelines to guide healthcare architects to design of a safer Magnetic resonance imaging suite.

Keywords: designing MRI suite, MRI safety, radiology occupational exposure, static magnetic fields

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880 Migration, Accessing Health Services and Mental Health Outcomes: Evidence From Microdata Analysis

Authors: Suzan Odabasi

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Suicide attempts and mental health problems among immigrants have been increasing and have become important public health concerns during the last century. Immigrants may face more difficulties in society because of social conflict, language barriers, inadequate social support, socioeconomic problems, and delay in accessing help. The limited number of research has shown that: first-generation migrants may be at higher risk of mental disorders and a higher prevalence of suicide attempts. The main aim of the proposed work is to identify to what degree each of these pressures is causing higher suicides currently observed. In addition, a comparison will be conducted between females and males and also rural and urban areas for which recent data are available. Specifically, this study investigates how accessing mental health services, the uninsured population rate, socioeconomic factors, and being an immigrant affect Turkish immigrants’ mental health and suicide attempts.

Keywords: access to healthcare, immigration, health economics, mental health economics

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879 Public-Private Partnership for Community Empowerment and Sustainability: Exploring Save the Children’s 'School Me' Project in West Africa

Authors: Gae Hee Song

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This paper aims to address the evolution of public-private partnerships for mainstreaming an evaluation approach in the community-based education project. It examines the distinctive features of Save the Children’s School Me project in terms of empowerment evaluation principles introduced by David M. Fetterman, especially community ownership, capacity building, and organizational learning. School Me is a Save the Children Korea funded-project, having been implemented in Cote d’Ivoire and Sierra Leone since 2016. The objective of this project is to reduce gender-based disparities in school completion and learning outcomes by creating an empowering learning environment for girls and boys. Both quasi-experimental and experimental methods for impact evaluation have been used to explore changes in learning outcomes, gender attitudes, and learning environments. To locate School Me in the public-private partnership framework for community empowerment and sustainability, the data have been collected from School Me progress/final reports, baseline, and endline reports, fieldwork observations, inter-rater reliability of baseline and endline data collected from a total of 75 schools in Cote d’Ivoire and Sierra Leone. The findings of this study show that School Me project has a significant evaluation component, including qualitative exploratory research, participatory monitoring, and impact evaluation. It strongly encourages key actors, girls, boys, parents, teachers, community leaders, and local education authorities, to participate in the collection and interpretation of data. For example, 45 community volunteers collected baseline data in Cote d’Ivoire; on the other hand, three local government officers and fourteen enumerators participated in the follow-up data collection of Sierra Leone. Not only does this public-private partnership improve local government and community members’ knowledge and skills of monitoring and evaluation, but the evaluative findings also help them find their own problems and solutions with a strong sense of community ownership. Such community empowerment enables Save the Children country offices and member offices to gain invaluable experiences and lessons learned. As a result, empowerment evaluation leads to community-oriented governance and the sustainability of the School Me project.

Keywords: community empowerment, Cote d’Ivoire, empowerment evaluation, public-private partnership, save the children, school me, Sierra Leone, sustainability

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878 Economic Impact of Drought on Agricultural Society: Evidence Based on a Village Study in Maharashtra, India

Authors: Harshan Tee Pee

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Climate elements include surface temperatures, rainfall patterns, humidity, type and amount of cloudiness, air pressure and wind speed and direction. Change in one element can have an impact on the regional climate. The scientific predictions indicate that global climate change will increase the number of extreme events, leading to more frequent natural hazards. Global warming is likely to intensify the risk of drought in certain parts and also leading to increased rainfall in some other parts. Drought is a slow advancing disaster and creeping phenomenon– which accumulate slowly over a long period of time. Droughts are naturally linked with aridity. But droughts occur over most parts of the world (both wet and humid regions) and create severe impacts on agriculture, basic household welfare and ecosystems. Drought condition occurs at least every three years in India. India is one among the most vulnerable drought prone countries in the world. The economic impacts resulting from extreme environmental events and disasters are huge as a result of disruption in many economic activities. The focus of this paper is to develop a comprehensive understanding about the distributional impacts of disaster, especially impact of drought on agricultural production and income through a panel study (drought year and one year after the drought) in Raikhel village, Maharashtra, India. The major findings of the study indicate that cultivating area as well as the number of cultivating households reduced after the drought, indicating a shift in the livelihood- households moved from agriculture to non-agriculture. Decline in the gross cropped area and production of various crops depended on the negative income from these crops in the previous agriculture season. All the landholding categories of households except landlords had negative income in the drought year and also the income disparities between the households were higher in that year. In the drought year, the cost of cultivation was higher for all the landholding categories due to the increased cost for irrigation and input cost. In the drought year, agriculture products (50 per cent of the total products) were used for household consumption rather than selling in the market. It is evident from the study that livelihood which was based on natural resources became less attractive to the people to due to the risk involved in it and people were moving to less risk livelihood for their sustenance.

Keywords: climate change, drought, agriculture economics, disaster impact

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