Search results for: electronic medical records

Authors: Leila Khosravi

Abstract:

A major part of the drinking water in North West of Iran is supplied from Mahabad reservoir 80 km northwest of Mahabad. This reservoir collects water from 750 km-catchment which is undergoing accelerated changes due to deforestation and urbanization. The main objective of this study is to develop a catchment modeling platform which translates ongoing land-use changes, soil data, precipitation and evaporation into surface runoff of the river discharging into the reservoir: Soil and Water Assessment Tool, SWAT, model along with hydro -meteorological records of 1997–2011. A variety of statistical indices were used to evaluate the simulation results for both calibration and validation periods; among them, the robust Nash–Sutcliffe coefficients were found to be 0.52 and 0.62 in the calibration and validation periods, respectively. This project has developed a reliable modeling platform with the benchmark land physical conditions of the Mahabad dam basin.

Keywords: simulation, surface runoff, Mahabad dam, SWAT model

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Authors: M. Aljumaan, F. Alkhadra, A. Aldajani, M. Alarfaj, A. Alawami, Y. Aljamaan

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Introduction: The internet has been widely available with 18 million users in Saudi Arabia alone. It was shown that 58% of Saudis are using the internet as a source of health-related information which may contribute to overcrowding of the Emergency Room (ER). Not many studies have been conducted to show the effect of online searching for health related information (HRI) and its role in influencing internet users to visit various health care facilities. So the main objective is to determine a correlation between HRI website use and health care facility visits in Saudi Arabia. Methodology: By conducting a cross sectional study and distributing a questionnaire, a total number of 1095 people were included in the study. Demographic data was collected as well as questions including the use of HRI websites, type of websites used, the reason behind the internet search, which health care facility it lead them to visit and whether seeking health information on the internet influenced their attitude towards visiting health care facilities. The survey was distributed using an internet survey applications. The data was then put on an excel sheet and analyzed with the help of a biostatician for making a correlation. Results: We found 91.4% of our population have used the internet for medical information using mainly General medical websites (77.8%), Forums (34.2%), Social Media (21.6%), and government websites (21.6%). We also found that 66.9% have used the internet for medical information to diagnose and treat their medical conditions on their own while 34.7% did so due to the inability to have a close referral and 29.5% due to their lack of time. Searching for health related information online caused 62.5% of people to visit health care facilities. Outpatient clinics were most visited at 77.9% followed by the ER (27.9%). The remaining 37.5% do not visit because using HRI websites reassure them of their condition. Conclusion: In conclusion, there may be a correlation between health information website use and health care facility visits. However, to avoid potentially inaccurate medical information, we believe doctors have an important role in educating their patients and the public on where to obtain the correct information & advertise the sites that are regulated by health care officials.

Keywords: ER visits, health related information, internet, medical websites

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Authors: Carl Ashworth, Matthys Campher

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Spinal anaesthesia has been identified as the “gold standard” for primary elective total hip and knee arthroplasty, which is most commonly performed using longer-acting local anaesthetics, such as hyperbaric bupivacaine, to prolong the duration of anaesthesia and analgesia suitable for these procedures. Ketamine is known to have local anaesthetic effects with potent analgesic properties and has been evaluated as a sole anaesthetic agent via intrathecal administration; however, the use of intrathecal ketamine as an adjunct to intrathecal hyperbaric bupivacaine, morphine, and fentanyl has not been extensively studied. The objective of this study was to identify the potential analgesic effects of the addition of intrathecal ketamine to spinal anaesthesia and to compare the efficacy and safety of adding intrathecal ketamine to spinal anaesthesia for hip- or knee arthroplasty with spinal anaesthesia for hip- or knee arthroplasty without intrathecal ketamine. The medical records of patients who underwent elective hip- or knee arthroplasty under spinal anaesthesia performed by an individual anaesthetist with either intrathecal hyperbaric bupivacaine, morphine and fentanyl or intrathecal hyperbaric bupivacaine, morphine, fentanyl and ketamine between June 4, 2020, and June 4, 2022, were retrospectively reviewed. These encounters were reviewed and analyzed from a perioperative pain perspective, with the primary outcome measure as the oral morphine equivalent (OME) usage in the 48 hours post-spinal anaesthesia, and secondary outcome measures including time to breakthrough analgesia, self-reported pain scores at rest and during movement at 24 and 48 hours after surgery, adverse effects of analgesia, complications, and length of stay. There were 26 patients identified who underwent TKR between June 4, 2020, and June 4, 2022, and 25 patients who underwent THR with the same conditions. It was identified that patients who underwent traditional spinal anaesthesia with the addition of ketamine for elective hip- or knee arthroplasty had a lower mean total OME in the 48 hours immediately post-spinal anaesthesia yet had a shorter time to breakthrough analgesia administration. The proposed mechanism of action for intrathecal ketamine as an additive to traditional spinal anaesthesia for elective hip- or knee arthroplasty is that it may prolong and attenuate the analgesic effect of traditional spinal anaesthesia. There were no significant differences identified in comparing the efficacy and safety of adding intrathecal ketamine to spinal anaesthesia for hip- or knee arthroplasty with spinal anaesthesia for hip- or knee arthroplasty without intrathecal ketamine.

Keywords: anaesthesia, spinal, intra-thecal, ketamine, spinal-morphine, bupivacaine

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Authors: S. Redjala, N. Ait Hocine, M. Gratton, N. Poirot, R. Ferhoum, S. Azem

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Polycarbonate (PC) is a promising polymer with high transparency in the range of the visible spectrum and is used in various fields, for example medical, electronic, automotive. Its low weight, chemical inertia, high impact resistance and relatively low cost are of major importance. In recent decades, some materials such as metals and ceramics have been replaced by polymers because of their superior advantages. However, some characteristics of the polymers are highly modified under the effect of ultraviolet (UV) radiation and temperature. The changes induced in the material by such aging depend on the exposure time, the wavelength of the UV radiation and the temperature level. The UV energy is sufficient to break the chemical bonds leading to a cleavage of the molecular chains. This causes changes in the mechanical, thermal, optical and morphological properties of the material. The present work is focused on the study of the effects of aging under ultraviolet (UV) radiation and under different temperature values on the physical-chemical and mechanical properties of a PC. Thus, various investigations, such as FTIR and XRD analyses, SEM and optical microscopy observations, micro-hardness measurements and monotonic and cyclic tensile tests, were carried out on the PC in the initial state and after aging. Results have shown the impact of aging on the properties of the PC studied. In fact, the MEB highlighted changes in the superficial morphology of the material by the presence of cracks and material de-bonding in the form of debris. The FTIR spectra reveal an attenuation of the peaks like the hydroxyl (OH) groups located at 3520 cm-1. The XRD lines shift towards a larger angle, reaching a maximum of 3°. In addition, Vickers micro-hardness measurements show that aging affects the surface and the core of the material, which results in different mechanical behaviours under monotonic and cyclic tensile tests. This study pointed out effects of aging on the macroscopic properties of the PC studied, in relationship with its microstructural changes.

Keywords: mechanical properties, physical-chemical properties, polycarbonate, UV aging, temperature aging

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Authors: S. Behnia, S. Fathizadeh, A. Akhshani

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In the recent decades, DNA has increasingly interested in the potential technological applications that not directly related to the coding for functional proteins that is the expressed in form of genetic information. One of the most interesting applications of DNA is related to the construction of nanostructures of high complexity, design of functional nanostructures in nanoelectronical devices, nanosensors and nanocercuits. In this field, DNA is of fundamental interest to the development of DNA-based molecular technologies, as it possesses ideal structural and molecular recognition properties for use in self-assembling nanodevices with a definite molecular architecture. Also, the robust, one-dimensional flexible structure of DNA can be used to design electronic devices, serving as a wire, transistor switch, or rectifier depending on its electronic properties. In order to understand the mechanism of the charge transport along DNA sequences, numerous studies have been carried out. In this regard, conductivity properties of DNA molecule could be investigated in a simple, but chemically specific approach that is intimately related to the Su-Schrieffer-Heeger (SSH) model. In SSH model, the non-diagonal matrix element dependence on intersite displacements is considered. In this approach, the coupling between the charge and lattice deformation is along the helix. This model is a tight-binding linear nanoscale chain established to describe conductivity phenomena in doped polyethylene. It is based on the assumption of a classical harmonic interaction between sites, which is linearly coupled to a tight-binding Hamiltonian. In this work, the Hamiltonian and corresponding motion equations are nonlinear and have high sensitivity to initial conditions. Then, we have tried to move toward the nonlinear dynamics and phase space analysis. Nonlinear dynamics and chaos theory, regardless of any approximation, could open new horizons to understand the conductivity mechanism in DNA. For a detailed study, we have tried to study the current flowing in DNA and investigated the characteristic I-V diagram. As a result, It is shown that there are the (quasi-) ohmic areas in I-V diagram. On the other hand, the regions with a negative differential resistance (NDR) are detectable in diagram.

Keywords: DNA conductivity, Landauer resistance, negative dierential resistance, Chaos theory, mean Lyapunov exponent

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Authors: Mary Butler

Abstract:

Background: Screening programmes for older drivers in Europe (though not the UK), and in many states in the US and in Australia are based on medical assessment of fitness to drive. These programmes require physicians (including general practitioners) to carry out an assessment of fitness to drive in their offices. In 2006, New Zealand changed from doing on-road driving tests with all older drivers from the age of 80, to a screening programme that uses medical assessment of fitness to drive only. Aim: This study set out to understand the experience of New Zealand GPs as they manage the process of medical assessment of fitness to drive assessments for older people. In particular, it aimed to establish how GPs understand the role of specialist driving assessment and rehabilitation carried out by occupational therapists. Design and setting: The study used an interpretive descriptive approach to analyze data from ten interviews with GPs in New Zealand. Results: The results indicated that GPs lack understanding about how occupational therapists can assist their patients, and tend to refer only when there is a disagreement with the patient. Conclusion: There are problems with the medical assessment of fitness to drive carried out by GPs, and there is a need for a more comprehensive community approach to driving cessation. Patients, families and the multidisciplinary team all have a role in deciding when driving cessation should occur. Occupational therapists have a particular responsibility for strategic leadership in this area of practice.

Keywords: assessment, driving, older people, occupational therapy

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Authors: Nasser A. Al-Azri

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The effectiveness of passive cooling techniques is assessed based on bioclimatic charts that require the typical meteorological year (TMY) for a specified location for their development. However, TMYs are not always available; mainly due to the scarcity of records of solar radiation which is an essential component used in developing common TMYs intended for general uses. Since solar radiation is not required in the development of the bioclimatic chart, this work suggests developing TMYs based solely on the relevant parameters. This approach improves the accuracy of the developed TMY since only the relevant parameters are considered and it also makes the development of the TMY more accessible since solar radiation data are not used. The presented paper will also discuss the development of the TMY from the raw data available at the NOAA-NCDC archive of world weather data and the construction of the bioclimatic charts for some randomly selected locations around the world.

Keywords: bioclimatic charts, passive cooling, TMY, weather data

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Authors: Umamaheswari Shanmugam, Silvia Ronchi

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that can use the large amount and variety of data generated during healthcare services every day; one of the significant advantages of these new technologies is the ability to get experience and knowledge from real-world use and to improve their performance continuously. Healthcare systems and institutions can significantly benefit because the use of advanced technologies improves the efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and protect patients' safety. The evolution and the continuous improvement of software used in healthcare must consider the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device's approval. Still, they are necessary to ensure performance, quality, and safety. At the same time, they can be a business opportunity if the manufacturer can define the appropriate regulatory strategy in advance. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems

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Authors: Darshani Premaratne, Afshin Kandampath Puthiyadath

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The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly, the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned. The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned.

Keywords: clinical information system, electronic health record, state regulations, integrated referral network of clinics

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Authors: Sabah Mohammed, Jinan Fiaidhi, Darien Sawyer

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Data integration of health through connected services can save lives in the event of a medical emergency or provide efficient and effective interventions for the benefit of the patients through the integration of bedside and bench side clinical research. Such integration will support all wind of change in healthcare by being predictive, pre-emptive, personalized, problem-oriented and participatory. Prototyping a healthcare system that enables data integration has been a big challenge for healthcare for a long time. However, an innovative solution started to emerge by focusing on problem lists where everything can connect the problem list forming a growing graph. This notion was introduced by Dr. Lawrence Weed in early 70’s, but the enabling technologies weren’t mature enough to provide a successful implementation prototype. In this article, we are describing our efforts in prototyping Dr. Lawrence Weed's problem-oriented medical record (POMR) and his patient case schema (SOAP) to shape a prototype for connected health. For this, we are using the TypeGraphQL API and our enterprise-based QL4POMR to describe a Web-Based gateway for healthcare services connectivity. Our prototype has reported success in connecting to the HL7 FHIR medical record and the OpenTarget biomedical repositories.

Keywords: connected health, problem-oriented healthcare record, SOAP, QL4POMR, typegraphQL

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Authors: Hamza Rekab Djabri, Salah Daoud

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The present paper deals with the computational of structural and electronic properties of ThC and ThN compounds using density functional theory within generalized-gradient (GGA) apraximation and local density approximation (LDA). We employ the full potential linear muffin-tin orbitals (FP-LMTO) as implemented in the Lmtart code. We have used to examine structure parameter in eight different structures such as in NaCl (B1), CsCl (B2), ZB (B3), NiAs (B8), PbO (B10), Wurtzite (B4) , HCP (A3) βSn (A5) structures . The equilibrium lattice parameter, bulk modulus, and its pressure derivative were presented for all calculated phases. The calculated ground state properties are in good agreement with available experimental and theoretical results.

Keywords: DFT, GGA, LDA, properties structurales, ThC, ThN

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Authors: Mingming Guo, Xiaozan Wang

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Introduction: The purpose of this study is to examine the correlation between the physical fitness of Chinese college students and their daily running habits (RH). Methods: A total of 718 college students from East China Normal University participated in this study (385 boys and 333 girls). Each participant participated in the Chinese Students’ Physical Fitness Test during the 2018-2019 school year. In addition, each student is also required to use the app to record all their running results during each run during the 2018-2019 school year. Researchers can query and export all running records through the app's management platform. Results: (1) The total number of kilometers run by the students showed a significant negative correlation with their vital capacity (VC), sitting body flexion (SBF), and long jump (LJ) (rᵥ

Keywords: college students, physical fitness, running habits, data mining

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Authors: Eleni Maistrou, D. Kosmopoulos, Carolina Moretti, Amalia Konidi, Katerina Boulougoura

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InterArch is an ongoing research project that has been running since September 2020. It aims to propose the design of a site-based digital application for archaeological sites and outdoor guided tours, supporting virtual and augmented reality technology. The research project is co‐financed by the European Union and Greek national funds, through the Operational Program Competitiveness, Entrepreneurship, and Innovation, under the call RESEARCH - CREATE – INNOVATE (project code: Τ2ΕΔΚ-01659). It involves mutual collaboration between academic and cultural institutions and the contribution of an IT applications development company. The research will be completed by July 2023 and will run as a pilot project for the city of Ancient Messene, a place of outstanding natural beauty in the west of Peloponnese, which is considered one of the most important archaeological sites in Greece. The applied research project integrates an interactive approach to the natural environment, aiming at a manifold sensory experience. It combines the physical space of the archaeological site with the digital space of archaeological and cultural data while at the same time, it embraces storytelling processes by engaging an interdisciplinary approach that familiarizes the user with multiple semantic interpretations. The mingling of the real-world environment with its digital and cultural components by using augmented reality techniques could potentially transform the visit on-site into an immersive multimodal sensory experience. To this purpose, an extensive spatial analysis along with a detailed evaluation of the existing digital and non-digital archives is proposed in our project, intending to correlate natural landscape morphology (including archaeological material remains and environmental characteristics) with the extensive historical records and cultural digital data. On-site research was carried out, during which visitors’ itineraries were monitored and tracked throughout the archaeological visit using GPS locators. The results provide our project with useful insight concerning the way visitors engage and interact with their surroundings, depending on the sequence of their itineraries and the duration of stay at each location. InterArch aims to propose the design of a site-based digital application for archaeological sites and outdoor guided tours, supporting virtual and augmented reality technology. Extensive spatial analysis, along with a detailed evaluation of the existing digital and non-digital archives, is used in our project, intending to correlate natural landscape morphology with the extensive historical records and cultural digital data. The results of the on-site research provide our project with useful insight concerning the way visitors engage and interact with their surroundings, depending on the sequence of their itineraries and the duration of stay at each location.

Keywords: archaeological site, digital space, semantic interpretations, cultural heritage

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Authors: Umamaheswari Shanmugam, Silvia Ronchi, Radu Vornicu

Abstract:

Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that are able to use the large amount and variety of data generated during healthcare services every day. As we read the news, over 500 machine learning or other artificial intelligence medical devices have now received FDA clearance or approval, the first ones even preceding the year 2000. One of the big advantages of these new technologies is the ability to get experience and knowledge from real-world use and to continuously improve their performance. Healthcare systems and institutions can have a great benefit because the use of advanced technologies improves the same time efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and also to protect patients’ safety. The evolution and the continuous improvement of software used in healthcare must take into consideration the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device approval, but they are necessary to ensure performance, quality, and safety, and at the same time, they can be a business opportunity if the manufacturer is able to define in advance the appropriate regulatory strategy. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems.

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Authors: M. J. Gibbons, A. J. Robinson

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Increasing expectations on small form factor electronics to be more compact while increasing performance has driven conventional cooling technologies to a thermal management threshold. An emerging solution to this problem is electrospray (ES) cooling. ES cooling enables two phase cooling by utilising Coulomb forces for energy efficient fluid atomization. Generated charged droplets are accelerated to the grounded target surface by the applied electric field and surrounding gravitational force. While in transit the like charged droplets enable plume dispersion and inhibit droplet coalescence. If the electric field is increased in the cone-jet regime, a subsequent increase in the plume spray angle has been shown. Droplet segregation in the spray plume has been observed, with primary droplets in the plume core and satellite droplets positioned on the periphery of the plume. This segregation is facilitated by inertial and electrostatic effects. This result has been corroborated by numerous authors. These satellite droplets are usually more densely charged and move at a lower relative velocity to that of the spray core due to the radial decay of the electric field. Previous experimental research by Gomez and Tang has shown that the number of droplets deposited on the periphery can be up to twice that of the spray core. This result has been substantiated by a numerical models derived by Wilhelm et al., Oh et al. and Yang et al. Yang et al. showed from their numerical model, that by varying the extractor potential the dispersion radius of the plume also varies proportionally. This research aims to investigate this dispersion density and the role it plays in the local heat transfer coefficient profile (h) of ES cooling. This will be carried out for different extractor – target separation heights (H2), working fluid flow rates (Q), and extractor applied potential (V2). The plume dispersion will be recorded by spraying a 25 µm thick, joule heated steel foil and by recording the thermal footprint of the ES plume using a Flir A-40 thermal imaging camera. The recorded results will then be analysed by in-house developed MATLAB code.

Keywords: electronic cooling, electrospray, electrospray plume dispersion, spray cooling

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Authors: Majed Ahmed Alfayad

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Technology is now present in almost all areas and practices globally, and this has led governments around the world to adopt technology in the public sector. Therefore, electronic government has been introduced as a means of the automation of government services. New technologies and trends appear every single day, and governments need to meet the citizen’s requirements and expectations in order to succeed in the E-Government program. This research investigates the potential of mobile government as an enhancement force for the E-Government project in the Kingdom of Saudi Arabia, where the usage of mobile technology is coming to be favoured by citizens. Qualitative methodology has been adopted in this study for the data collection and analysis, and in particular the grounded theory approach.

Keywords: e-government, e-participation, m-government, mobile technology

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Authors: Tiago Sigal Linhares, Ana Amélia Nascimento da Silva Bones, Juliana Miola, McArthur Alexander Barrow, Airton Tetelbom Stein

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Introduction: As a result of increased globalization and changing migration trends, it is expected that a significant portion of People Living with HIV/AIDS (PLWHA) will change their place of residence over time. In order to provide better health care, monitor the HIV epidemic and plan urban public health care and policies, there is a growing need to formulate a strategy for monitoring PLWHA care, location and migration patterns. The Porto Alegre District is characterized by a high prevalence of PLWHA and is considered one of the epicenters of HIV epidemic in Latin America. Objectives: The aim of this study is to create a digital and easily editable map in order to create a visual representation of the location of PLWHA and to monitor their migration within the city and the country in an effort to promote longitudinal care. Methods: This Experience Report used Google Maps Map Creator to generate an active digital map showing the location and changes in residence of 165 PLWHA who received care at two Primary Health Care (PHC) clinics, which attended an estimated population of five thousand patients, in downtown Porto Alegre over the last four years. Their current addresses were discovered in the unified Brazilian health care system digital records (e-SUS) and updated on the map. Results: A digital map with PLWHA current residence location was created. It was possible to demonstrate visually areas with a large concentration of PLWHA and the migration of the population within the city as wells as other cities, regions and states. Conclusions: An easily reproducible and free map could aid in PLWHA monitoring, urban public health planning, target interventions and situational diagnosis. Moreover, a visual representation of PLWHA location and migration could help bring more attention and investments to areas with geographic inequities or higher prevalence of PLWHA. It also enables notification of local PHC units of monitored patients inside their area, which are in clinical risk or with treatment abandonment through active case findings, improving the care of PLWHA.

Keywords: health care, medical public health, theoretical and conceptual innovations, urban public health

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

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

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

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Authors: Olivera Lupescu, Taina Elena Avramescu, Mihail Nagea, Alexandru Dimitriu

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Acetabular fractures represent a real challenge due to their impact upon the long term function of the hip joint, and due to the risk of intra- and peri-operative complications especially that they affect young, active people. That is why treating these fractures require certain skills which must be exercised, regarding the pre-operative planning, as well as the execution of surgery.The authors retrospectively analyse 38 cases with acetabular fractures operated using the posterior approach in our hospital between 01.01.2013- 01.01.2015 for which complete medical records ensure a follow-up of 24 months, in order to establish the main causes of potential errors and to underline the methods for preventing them. This target is included in the Erasmus + project ‘Collaborative learning for enhancing practical skills for patient-focused interventions in gait rehabilitation after orthopedic surgery COR-skills’. This paper analyses the pitfalls revealed by these cases, as well as the measures necessary to enhance the practical skills of the surgeons who perform acetabular surgery. Pre-op planning matched the intra and post-operative outcome in 88% of the analyzed points, from 72% at the beginning to 94% in the last case, meaning that experience is very important in treating this injury. The main problems detected for the posterior approach were: nervous complications - 3 cases, 1 of them a complete paralysis of the sciatic nerve, which recovered 6 months after surgery, and in other 2 cases intra-articular position of the screws was demonstrated by post-operative CT scans, so secondary screw removal was necessary in these cases. We analysed this incident, too, due to lack of information about the relationship between the screws and the joint secondary to this approach. Septic complications appeared in 3 cases, 2 superficial and 1 profound (requiring implant removal). The most important problems were the reduction of the fractures and the positioning of the screws so as not to interfere with the the articular space. In posterior acetabular fractures, pre-op complex planning is important in order to achieve maximum treatment efficacy with minimum of risk; an optimal training of the surgeons insisting on the main points of potential mistakes ensure the success of the procedure, as well as a favorable outcome for the patient.

Keywords: acetabular fractures, articular congruency, surgical skills, vocational training

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Authors: Meenal Badki

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We address the issue of active feature determination, where the objective is to determine the set of examples on which additional data (such as lab tests) needs to be gathered, given a large number of examples with some features (such as demographics) and some examples with all the features (such as the complete Electronic Health Record). We note that certain features may be more costly, unique, or laborious to gather. Our proposal is a general active learning approach that is independent of classifiers and similarity metrics. It allows us to identify examples that differ from the full data set and obtain all the features for the examples that match. Our comprehensive evaluation shows the efficacy of this approach, which is driven by four authentic clinical tasks.

Keywords: feature determination, classification, active learning, sample-efficiency

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Authors: Asad Naeem, Jinkoo Kim

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This research proposes a self-centering passive damping system consisting of a spring viscous damper linked with a preloaded tendon. The seismic performance of the spring viscous damper is evaluated by pseudo-dynamic tests, and the results are used for the formulation of an analytical model of the damper in the structural analysis program. The shaking table tests of a two-story steel frame installed with the proposed damping system are carried out using five different earthquake records. The results from the shaking table tests are verified by numerical simulation of the retrofitted structure. The results obtained from experiments and numerical simulations demonstrate that the proposed damping system with self-centering capability is effective in reducing earthquake-induced displacement and member forces.

Keywords: seismic retrofit, spring viscous damper, shaking table test, earthquake resistant structures

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Authors: Chrysi K. Nikoloutsou, Gianna Th. Siapati

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The pandemic limitations have altered architectural education as the discourse shifted towards virtual studios and blended learning. In addition, lockdown conditions and remote working have affected habitation. Adaptability is now a key factor. The architectural studio needs to adjust to these new terms both in education and in inhabitation. This paper will investigate the operation of an architectural studio in relation to how one experiences their house due to the pandemic, based on a literature review and qualitative research methods (interviews & workshops with students). Zenetos’ prophetic ideas of ‘Electronic Urbanism’ and ‘tele-activities’ are now more present than ever.

Keywords: architectural education, pandemic, residential design, studio pedagogy

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Authors: Yi-Jiun Chou, Ying-Hsuan Li, Yi-Jung Liu, Hsin-Yu Chiang, Hsuan-Ching Wang

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Background: Patients received therapeutic hypothermia (TH) after resuscitation from cardiac arrest are more dependent on continue and intensive nursing care. It involves many difficult steps, especially achieving target body temperature. To our best knowledge, there is no consensus or recommended standards on nursing practice of TH. Aim: The aim of this study is to increase the completion rate of nursing care at therapeutic hypothermia. Methods: We took five measures: (1) Amendment of nursing standards of therapeutic hypothermia; (2) Amendment of TH checklist items to nursing records; (3) Establishment of monitor procedure; (4) Design each period of TH care reminder cards; (5) Providing in-service training sections of TH for ICU nursing staff. Outcomes: The completion rate of nursing care at therapeutic hypothermia increased from 78.1% to 89.3%. Conclusion: The project team not only increased the completion rate but also improved patient safety and quality of care.

Keywords: therapeutic hypothermia, nursing, critical care, quality of care

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Authors: Daniela V. Bavaresco, Tamy Colonetti, Antonio Jose Grande, Francesc Colom, Joao Quevedo, Samira S. Valvassori, Maria Ines da Rosa

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Objective: Performed a systematic review and meta-analysis to evaluated the potential effect of the cyclo-oxygenases (Cox)-2 inhibitor Celecoxib adjunct treatment in Bipolar Disorder (BD), through of randomized controlled trials. Method: A search of the electronic databases was proceeded, on MEDLINE, EMBASE, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), Biomed Central, Web of Science, IBECS, LILACS, PsycINFO (American Psychological Association), Congress Abstracts, and Grey literature (Google Scholar and the British Library) for studies published from January 1990 to February 2018. A search strategy was developed using the terms: 'Bipolar disorder' or 'Bipolar mania' or 'Bipolar depression' or 'Bipolar mixed' or 'Bipolar euthymic' and 'Celecoxib' or 'Cyclooxygenase-2 inhibitors' or 'Cox-2 inhibitors' as text words and Medical Subject Headings (i.e., MeSH and EMTREE) and searched. The therapeutic effects of adjunctive treatment with Celecoxib were analyzed, it was possible to carry out a meta-analysis of three studies included in the systematic review. The meta-analysis was performed including the final results of the Young Mania Rating Scale (YMRS) at the end of randomized controlled trials (RCT). Results: Three primary studies were included in the systematic review, with a total of 121 patients. The meta-analysis had significant effect in the YMRS scores from patients with BD who used Celecoxib adjuvant treatment in comparison to placebo. The weighted mean difference was 5.54 (95%CI=3.26-7.82); p < 0.001; I2 =0%). Conclusion: The systematic review suggests that adjuvant treatment with Celecoxib improves the response of major treatments in patients with BD when compared with adjuvant placebo treatment.

Keywords: bipolar disorder, Cox-2 inhibitors, Celecoxib, systematic review, meta-analysis

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Authors: Heichia Wang, Yalan Chao

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Social inequality is a persistent problem. One of the ways to solve this problem is through education. At present, vulnerable groups are often less geographically accessible to educational resources. However, compared with educational resources, communication equipment is easier for vulnerable groups. Now that information and communication technology (ICT) has entered the field of education, today we can accept the convenience that ICT provides in education, and the mobility that it brings makes learning independent of time and place. With mobile learning, teachers and students can start discussions in an online chat room without the limitations of time or place. However, because liquidity learning is quite convenient, people tend to solve problems in short online texts with lack of detailed information in a lack of convenient online environment to express ideas. Therefore, the ICT education environment may cause misunderstanding between teachers and students. Therefore, in order to better understand each other's views between teachers and students, this study aims to clarify the essays of the analysts and classify the students into several types of learning questions to clarify the views of teachers and students. In addition, this study attempts to extend the description of possible omissions in short texts by using external resources prior to classification. In short, by applying a short text classification, this study can point out each student's learning problems and inform the instructor where the main focus of the future course is, thus improving the ICT education environment. In order to achieve the goals, this research uses convolutional neural network (CNN) method to analyze short discussion content between teachers and students in an ICT education environment. Divide students into several main types of learning problem groups to facilitate answering student problems. In addition, this study will further cluster sub-categories of each major learning type to indicate specific problems for each student. Unlike most neural network programs, this study attempts to extend short texts with external resources before classifying them to improve classification performance. In short, by applying the classification of short texts, we can point out the learning problems of each student and inform the instructors where the main focus of future courses will improve the ICT education environment. The data of the empirical process will be used to pre-process the chat records between teachers and students and the course materials. An action system will be set up to compare the most similar parts of the teaching material with each student's chat history to improve future classification performance. Later, the function of short text classification uses CNN to classify rich chat records into several major learning problems based on theory-driven titles. By applying these modules, this research hopes to clarify the main learning problems of students and inform teachers that they should focus on future teaching.

Keywords: ICT education improvement, social equality, short text analysis, convolutional neural network

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Authors: Cátia Regina Branco da Fonseca, Maria Wany Louzada Strufaldi, Lídia Raquel de Carvalho, Rosana Fiorini Puccini

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Background: Birth weight reflects gestational conditions and development during the fetal period. Low birth weight (LBW) may be associated with antenatal care (ANC) adequacy and quality. The purpose of this study was to analyze ANC adequacy and its relationship with LBW in the Unified Health System in Brazil. Methods: A case-control study was conducted in Botucatu, São Paulo, Brazil, 2004 to 2008. Data were collected from secondary sources (the Live Birth Certificate), and primary sources (the official medical records of pregnant women). The study population consisted of two groups, each with 860 newborns. The case group comprised newborns weighing less than 2,500 grams, while the control group comprised live newborns weighing greater than or equal to 2,500 grams. Adequacy of ANC was evaluated according to three measurements: 1. Adequacy of the number of ANC visits adjusted to gestational age; 2. Modified Kessner Index; and 3. Adequacy of ANC laboratory studies and exams summary measure according to parameters defined by the Ministry of Health in the Program for Prenatal and Birth Care Humanization. Results: Analyses revealed that LBW was associated with the number of ANC visits adjusted to gestational age (OR = 1.78, 95% CI 1.32-2.34) and the ANC laboratory studies and exams summary measure (OR = 4.13, 95% CI 1.36-12.51). According to the modified Kessner Index, 64.4% of antenatal visits in the LBW group were adequate, with no differences between groups. Conclusions: Our data corroborate the association between inadequate number of ANC visits, laboratory studies and exams, and increased risk of LBW newborns. No association was found between the modified Kessner Index as a measure of adequacy of ANC and LBW. This finding reveals the low indices of coverage for basic actions already well regulated in the Health System in Brazil. Despite the association found in the study, we cannot conclude that LBW would be prevented only by an adequate ANC, as LBW is associated with factors of complex and multifactorial etiology. The results could be used to plan monitoring measures and evaluate programs of health care assistance during pregnancy, at delivery and to newborns, focusing on reduced LBW rates.

Keywords: low birth weight, antenatal care, prenatal care, adequacy of health care, health evaluation, public health system

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Authors: J. Garfield, B. O'Hare, V. Bell

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The use of social media is continuing to grow and is now widely used for product and service advertising. This research investigated the social media usage across all age ranges in the United Kingdom to determine the impact on purchasing habits. A questionnaire was distributed to people of different ages and with different experiences of social media usage. The results showed that Facebook continues to be the most popular social media network. Respondents in the younger age group were more likely to be influenced by brand marketing and advertising, but the study concluded that celebrity endorsements had little or no influence.

Keywords: social media advertising, social networking sites, electronic word of mouth, celebrity endorsements

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Authors: Amar Partap Singh Pharwaha, Shweta Rani

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This paper is aimed at proposing a rhombus shaped wearable fractal antenna for wireless communication systems. The geometrical descriptors of the antenna have been obtained using bacterial foraging optimization (BFO) for wide band operation. The method of moment based IE3D software has been used to simulate the antenna and observed that miniaturization of 13.08% has been achieved without degrading the resonating properties of the proposed antenna. An analysis with different substrates has also been done in order to evaluate the effectiveness of electrical permittivity on the presented structure. The proposed antenna has low profile, light weight and has successfully demonstrated wideband and multiband characteristics for wearable electronic applications.

Keywords: BFO, bandwidth, electrical permittivity, fractals, wearable antenna

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

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

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

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Authors: Etaf Alkhlaifat

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This study drew conceptually on Communication Accommodation Theory to describe and analyze conversations between doctors and patients to examine the extent to which patients’ level of literacy represents one of the linguistic obstacles that may adversely influence the quality of healthcare services in Jordan. A thematic qualitative approach was employed to interpret the phenomena under study, which required direct observation and interviews with doctors (n=6) and patients (n=15) in natural Jordanian medical settings. This generated a comprehensive corpus of audio and videotaped data, which revealed that most doctors expressed dissatisfaction with patients’ ability to express themselves and comprehend them as a result of a lack of medical awareness and limited health education. The significance of this study rests on its detailed investigation of the impact of health literacy on patients’ health outcomes and while providing unique insights into how low health literacy could contribute to misunderstanding and potential ill-health.

Keywords: doctor-patient communication, health literacy, medical knowledge, communication accommodation theory, qualitative research

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