Search results for: healthcare coordination

Authors: Adriana Haulica

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Powered by Machine Learning, Precise medicine is tailored by now to use genetic and molecular profiling, with the aim of optimizing the therapeutic benefits for cohorts of patients. As the majority of Machine Language algorithms come from heuristics, the outputs have contextual validity. This is not very restrictive in the sense that medicine itself is not an exact science. Meanwhile, the progress made in Molecular Biology, Bioinformatics, Computational Biology, and Precise Medicine, correlated with the huge amount of human biology data and the increase in computational power, opens new healthcare challenges. A more accurate diagnosis is needed along with real-time treatments by processing as much as possible from the available information. The purpose of this paper is to present a deeper vision for the future of Artificial Intelligence in Precise medicine. In fact, actual Machine Learning algorithms use standard mathematical knowledge, mostly Euclidian metrics and standard computation rules. The loss of information arising from the classical methods prevents obtaining 100% evidence on the diagnosis process. To overcome these problems, we introduce MEDICOMPILLS, a new architectural concept tool of information processing in Precise medicine that delivers diagnosis and therapy advice. This tool processes poly-field digital resources: global knowledge related to biomedicine in a direct or indirect manner but also technical databases, Natural Language Processing algorithms, and strong class optimization functions. As the name suggests, the heart of this tool is a compiler. The approach is completely new, tailored for omics and clinical data. Firstly, the intrinsic biological intuition is different from the well-known “a needle in a haystack” approach usually used when Machine Learning algorithms have to process differential genomic or molecular data to find biomarkers. Also, even if the input is seized from various types of data, the working engine inside the MEDICOMPILLS does not search for patterns as an integrative tool. This approach deciphers the biological meaning of input data up to the metabolic and physiologic mechanisms, based on a compiler with grammars issued from bio-algebra-inspired mathematics. It translates input data into bio-semantic units with the help of contextual information iteratively until Bio-Logical operations can be performed on the base of the “common denominator “rule. The rigorousness of MEDICOMPILLS comes from the structure of the contextual information on functions, built to be analogous to mathematical “proofs”. The major impact of this architecture is expressed by the high accuracy of the diagnosis. Detected as a multiple conditions diagnostic, constituted by some main diseases along with unhealthy biological states, this format is highly suitable for therapy proposal and disease prevention. The use of MEDICOMPILLS architecture is highly beneficial for the healthcare industry. The expectation is to generate a strategic trend in Precise medicine, making medicine more like an exact science and reducing the considerable risk of errors in diagnostics and therapies. The tool can be used by pharmaceutical laboratories for the discovery of new cures. It will also contribute to better design of clinical trials and speed them up.

Keywords: bio-semantic units, multiple conditions diagnosis, NLP, omics

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Authors: Amie Smith, Jodi-Lyn Benjamin

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In 2020, there are currently four generations in the nursing workforce: The Veterans, Boomers, Generation X and Generation Y (Gen Y). Understanding each generation and their growing needs will equip the workforce for when the Boomers prepare for retirement, with majority of nursing leadership positions to be potentially replaced with Gen Y nurses. In SA Medical Imaging(SAMI), at Flinders Medical Centre (FMC), it has been proven that despite challenges in succession planning, Gen Y nurse leaders are able to overcome these obstacles and provide the leadership necessary to meet the changing needs in healthcare and across organisations. Changing the culture in radiology nursing has been seen as an obstacle due to the historical nursing practices and resistance to adapt to current/future practice. As radiology advances so does the role of the nurse in imaging, this has required resilience and strong support through leadership as we change and develop the culture to keep up with the evolution of technology and standard of patient care. As a result of supporting Gen Y nurses in leadership roles, SAMI, FMC has seen a positive change in culture by creating a healthy work environment which has allowed Gen Y nurses to make long lasting contributions to the nursing profession.

Keywords: changing culture, Generation Y, radiology, nursing, leadership

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Authors: Misra Ayse Adsiz, Selim Selvi

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In today's world, technology is competing with time. In order to catch up with the world's companies and adapt quickly to the changes, it is necessary to speed up the processes and keep pace with the rate of change of the technology. The missile system design processes, which are handled with classical methods, keep behind in this race. Because customer requirements are not clear, and demands are changing again and again in the design process. Therefore, in the system design process, a methodology suitable for the missile system design dynamics has been investigated and the processes used for catching up the era are examined. When commonly used design processes are analyzed, it is seen that any one of them is dynamic enough for today’s conditions. So a hybrid design process is established. After a detailed review of the existing processes, it is decided to focus on the Scrum Framework and Agile Philosophy. Scrum is a process framework. It is focused on to develop software and handling change management with rapid methods. In addition, agile philosophy is intended to respond quickly to changes. In this study, it is aimed to integrate Scrum framework and agile philosophy, which are the most appropriate ways for rapid production and change adaptation, into the missile system design process. With this approach, it is aimed that the design team, involved in the system design processes, is in communication with the customer and provide an iterative approach in change management. These methods, which are currently being used in the software industry, have been integrated with the product design process. A team is created for system design process. The roles of Scrum Team are realized with including the customer. A scrum team consists of the product owner, development team and scrum master. Scrum events, which are short, purposeful and time-limited, are organized to serve for coordination rather than long meetings. Instead of the classic system design methods used in product development studies, a missile design is made with this blended method. With the help of this design approach, it is become easier to anticipate changing customer demands, produce quick solutions to demands and combat uncertainties in the product development process. With the feedback of the customer who included in the process, it is worked towards marketing optimization, design and financial optimization.

Keywords: agile, design, missile, scrum

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Authors: Şebnem Aslan, Demet Akarçay

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The objective of this study is to investigate the feelings of health employees occurred by bullying and the relationships between these feelings at work place. In this context, the relationships between bullying and the feelings of self-esteem, employee silence, anger, self- blame and shame. This study was conducted among 512 health employees in three hospitals in Konya by using survey method and simple random sampling. The scales of bullying, self-esteem, employee silence, anger, self-blame, and shame were performed within the study. The obtained data were analyzed with descriptive analysis, correlation, confirmative factor analysis, structural equation modeling and path analysis. The results of the study showed that while bullying had a positive effect on self-esteem (.61), employee silence (.41), anger (.18), a negative effect on self-blame and shame (-.26) was observed. Employee silence affected self-blame and shame (.83) as positively. Besides, self-esteem impacted on self- blame and shame (.18), employee silence (.62) positively and self-blame and shame was observed as negatively affecting on anger (-.20). Similarly, self-esteem was found as negatively affected on anger (-.13).

Keywords: bullying, self-esteem, employee silence, anger, shame and guilt, healthcare employee

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Authors: Lucie Litvack, Malaz Elsaddig, Kevin Jones

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There is strong evidence to support the efficacy of the World Health Organization (WHO) Surgical Safety Checklist in improving patient safety; however, its use can be associated with difficulties. This study uses qualitative data collected in Kitovu Healthcare Complex, a rural Ugandan hospital, to identify factors that may influence the use of the checklist in a low-income setting. Potential barriers to and motivators for the hospital’s use of this checklist are identified and explored through observations of current patient safety practices; semi-structured interviews with theatre staff; a focus group with doctors; and trial implementation of the checklist. Barriers identified include the institutional context; knowledge and understanding; patient safety culture; resources and checklist contents. Motivators for correct use include prior knowledge; team attitudes; and a hospital advocate. Challenges are complex and unique to this socioeconomic context. Stepwise change to improve patient safety practices, local champions, whole team training, and checklist modification may assist the implementation and sustainable use of the checklist in an effective way.

Keywords: anaesthesia, patient safety, Uganda, WHO surgical safety checklist

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

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

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

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Authors: Antonio Espingardeiro

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It is likely that robots will cross the boundaries of industry into households over the next decades. With demographic challenges worldwide, the future ageing populations will require the introduction of assistive technologies capable of providing, care, human dignity and quality of life through the aging process. Robotics technology has a high potential for being used in the areas of social and healthcare by promoting a wide range of activities such as entertainment, companionship, supervision or cognitive and physical assistance. However, such close Human Robotics Interactions (HRIs) encompass a rich set of ethical scenarios that need to be addressed before Socially Assistive Robots (SARs) reach the global markets. Such interactions with robots may seem a worthy goal for many technical/financial reasons but inevitably require close attention to the ethical dimensions of such interactions. This article investigates the current HRI benchmark of social success. It revises it according to the ethical principles of beneficence, non-maleficence and justice aligned with social care ethos. An extension of such benchmark is proposed based on an empirical study of HRIs with elderly groups.

Keywords: HRI, SARs, social success, benchmark, elderly care

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Authors: Qianying Sun, Abdelhadi Kassiba, Guorong Li

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ZnO with wurtzite structure is a well-known semiconducting oxide (SCO), being applied in thermoelectric devices, varistors, gas sensors, transparent electrodes, solar cells, liquid crystal displays, piezoelectric and electro-optical devices. Intrinsically, ZnO is weakly n-type SCO due to native defects (Znⱼ, Vₒ). However, the substitutional doping by metallic elements as (Al, Ti) gives rise to a high n-type conductivity ensured by donor centers. Under CO+N₂ sintering atmosphere, Schottky barriers of ZnO ceramics will be suppressed by lowering the concentration of acceptors at grain boundaries and then inducing a large increase in the Hall mobility, thereby increasing the conductivity. The presented work concerns ZnO based ceramics, which are fabricated with doping by TiO₂ (0.50mol%), Al₂O₃ (0.25mol%) and MgO (1.00mol%) and sintering in different atmospheres (Air (A), N₂ (N), CO+N₂(C)). We obtained uniform, dense ceramics with ZnO as the main phase and Zn₂TiO₄ spinel as a secondary and minor phase. An important increase of the conductivity was shown for the samples A, N, and C which were sintered under different atmospheres. The highest conductivity (σ = 1.52×10⁵ S·m⁻¹) was obtained under the reducing atmosphere (CO). The role of doping was investigated with the aim to identify the local environment and valence states of the doping elements. Thus, Electron paramagnetic spectroscopy (EPR) determines the concentration of defects and the effects of charge carriers in ZnO ceramics as a function of the sintering atmospheres. The relation between conductivity and defects concentration shows the opposite behavior between these parameters suggesting that defects act as traps for charge carriers. For Al ions, nuclear magnetic resonance (NMR) technique was used to identify the involved local coordination of these ions. Beyond the six and forth coordinated Al, an additional NMR signature of ZnO based TCO requires analysis taking into account the grain boundaries and the conductivity through the Knight shift effects. From the thermal evolution of the conductivity as a function of the sintering atmosphere, we succeed in defining the conditions to realize ZnO based TCO ceramics with an important thermal coefficient of resistance (TCR) which is promising for electrical safety of devices.

Keywords: ceramics, conductivity, defects, TCO, ZnO

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Authors: Varsha Reddy Jayar

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Background: Our elderly family members deserve our best care. It's our responsibility to ensure they're healthy and safe. The population of India is increasing rapidly. People are literally being born in the streets, and there is a high growth on taxes and healthcare costs. Indian families are challenged with taking care of everyone. When you have elderly parents and a demanding job, it can be difficult to take care of them. You might not have enough time to care for them when you're already working or dealing with emotional difficulties. Living alone in old age can cause older individuals to face many health risks. Many seniors find living and caring for themselves challenging when they live by themselves. This study explored the factors that affect whether or not elderly people choose to live in old age homes. Methods: This study was carried out on 123 elderly people living in different old age homes in Karnataka, India. The reason for their residence at the home was explored using an interview. Results: It was found that the most common reason for living in an old age home is due to abuse from children and grandchildren; the majority reported were Daughter in law issues in the family specific to the adjustment and understanding amongst them. Conclusion: More and more elderly people in India are choosing to stay in old age homes as they get older. The government and voluntary agencies must have some sort of arrangements for institutional support.

Keywords: old age home, elderly, Aging, challenges of aging

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Authors: B. Alajmi, L. Marouf, A. S. Chaudhry

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In recent years, increasing emphasis has been placed upon issues concerning the evaluation of health care. In this regard, knowledge management has also been considered an important component of the evaluation process. KM facilitates the transfer of existing knowledge or the development of new knowledge among healthcare staff and patients. This research aimed to examine how hospitals in Kuwait employ knowledge management practices, including capturing, sharing, and generating, and the perceived impact of KM practices on performance of hospitals in Kuwait. Through adopting a quantitative survey method with 277 sample of doctors, the study found that in terms of the three major knowledge management practices – knowledge capturing, sharing, and generating – the adoption of KM practices were rated very low in the sampled hospitals in Kuwait. Hospitals paid little attention to the main activities that support the transfer of expertise among doctors in hospitals. However, as predicted by previous studies, knowledge management practices were perceived to have an impact on hospitals’ performance. Through knowledge capturing, sharing, and generating, hospitals could improve the services they provide through documenting best practices, transforming their hospitals into learning organizations in which lessons learned are captured, stored, and made available for others to learn from.

Keywords: knowledge management, hospitals, knowledge management practices, knowledge management tools, performance

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Authors: Ahasanul Haque, Noor Hazilah Abd Manaf, Zohurul Anis, Tarekol Islam

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Sustainable community health (SCH) is an example of a new healthcare concept formed from applying the Maqasid al-Shariah principle to hospital management and delivery services. Because the idea is novel, it needs comprehensive and ongoing investigation to be improved. However, there is a lack of research on the necessity of developing sustainable community health (SCH), particularly its organizational structure. Furthermore, there is a misconception about the order of components in Maqasid al-Shariah, particularly in a hospital setting. Furthermore, the use of medicines and treatment by conventional recommendations to carry out the treatment by the Maqasid al Shariah. As such, this study focuses on the essential prerequisite for establishing a sustainable community health system based on Maqasid al-Shariah. This study discusses the use of Maqasid al-Shariah in administration and treatment. In this qualitative research approach, a literature search and interviews with specialists are conducted. The gathered data is examined using content analysis, emphasizing inductive and deductive reasoning. The research reveals that the Shariah Advisory Council and Shariah Critical Point are necessary for sustainable community health. In conclusion, by discussing the causes for each instance, this research adds to the creation of methods for determining the level of Maasid al-Shariah in-hospital care.

Keywords: empowering, sustainability, community health, maqasid al shariah, hospital and malaysia

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Authors: Niaz Gharavi, Hexin Zhang

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In the structural timber design, the shear modulus of the timber beam is an important factor that needs to be determined accurately. According to BS EN 408, shear modulus can be determined using torsion test or shear field test method. Although torsion test creates pure shear status in the beam, it does not represent the real-life situation when the beam is in the service. On the other hand, shear field test method creates similar loading situation as in reality. The latter method is based on shear distortion measurement of the beam at the zone with the constant transverse load in the standardized four-point bending test as indicated in BS EN 408. Current testing practice code advised using two metallic arms act as an instrument to measure the diagonal displacement of the constructing square. Timber is not a homogenous material, but a heterogeneous and this characteristic makes timber to undergo a non-uniform deformation. Therefore, the dimensions and the location of the constructing square in the area with the constant transverse force might alter the shear modulus determination. This study aimed to investigate the impact of the shape, size, and location of the square in the shear field test method. A binocular stereo vision system was developed to capture the 3D displacement of a grid of target points. This approach is an accurate and non-contact method to extract the 3D coordination of targeted object using two cameras. Two group of three glue laminated beams were produced and tested by the mean of four-point bending test according to BS EN 408. Group one constructed using two materials, laminated bamboo lumber and structurally graded C24 timber and group two consisted only structurally graded C24 timber. Analysis of Variance (ANOVA) was performed on the acquired data to evaluate the significance of size and location of the square in the determination of shear modulus of the beam. The results have shown that the size of the square is an affecting factor in shear modulus determination. However, the location of the square in the area with the constant shear force does not affect the shear modulus.

Keywords: shear field test method, BS EN 408, timber shear modulus, photogrammetry approach

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Authors: Muhadam Labolo, Mughny Ibtisyam Mukhlis, Zulkarnaen, Safira Maulida Rahman Soulisa

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This research is motivated by one of the functions of government is a regulatory function. Aceh Province, especially in Banda Aceh City has special autonomy, one of them is in the application of Islamic law, but when the law implemented to the citizen, there are many problems happens. One of the problems faced by the Government and people of Banda Aceh was Seclusion. Seclusion/nasty silent act between two people mukallafor more of the opposite sex who is not mahram or without marriage. This study aims to determine and analyze how the effectiveness of the policy as well as enabling and inhibiting factors of Qanun Number 14 of 2003 On Khalwat (nasty) in sharia Islam Islamic law in the city of Banda Aceh. This type of research is qualitative research method is a descriptive and inductive approach. The source of data used is People, Problem, Phenomenon, and programs, while the data collection through field studies and literature such as interviews, observation, and documentation. The results of this study were analyzed by using data reduction, display data, conclusions, and verification. The results showed that the Qanun Number 14 of 2003 on Khalwat (nasty) in the establishment of Islamic law in Banda Aceh is still not effective. It is seen from the high number of violations seclusion committed by Banda Aceh citizen, especially among teenagers, lack of socialization, as well as a lack of budgetary support for the implementation of Islamic Law in Banda Aceh. The supporting factors are 1) Coordination and communication among agencies had been walking steadily. 2) Facilities and infrastructure Syar'iah Court of Banda Aceh and the Office of Sharia Islam Banda Aceh that very good. 3) The Cultural majority of the people of Banda Aceh that support. Inhibiting factors: 1) There are no written duties of each institution for the prosecution case Seclusion. 2) The lack of socialization programs. 3) Lack of facilities and infrastructure Municipal Police Unit and the WH less. 4) Lack of control by the family. 5) The absence of training for officials Municipal Police Units and the Wilayatul Hisbah Banda Aceh.

Keywords: effectiveness, Islamic Sharia, Khalwat, Qanun

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Authors: Richa Shri, Varinder Singh, Kundan Singh Bora, Abhishek Bhanot, Rahul Kumar, Amit Kumar, Ravinder Kaur

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The term ‘neuroprotection’ means preserving/salvaging function and structure of neurons. Neuroprotection is an adjunctive treatment option for neurodegenerative disorders. Oxidative stress is considered a major culprit in neurodegenerative disorders; hence, management strategies include use of antioxidants. Our search for a neuroprotective agent began with Allium cepa L. or onions, (family Amaryllidaceae) - a potent antioxidant. We have investigated the neuroprotective potential of onions in experimental models of ischemic stroke, diabetic neuropathy, neuropathic pain, and dementia. In pre and post-ischemic stroke model, the methanol extract of outer scales of onion bulbs (MEOS) prevented memory loss and motor in-coordination; reduced oxidative stress and cerebral infarct size. This also prevented and ameliorated diabetic neuropathy in mice. The MEOS was fractionated to yield a flavonoid rich fraction (FRF) that successfully reversed ischemia-reperfusion induced neuronal damage, thereby demonstrating that the flavonoids are responsible for the activity. The FRF effectively ameliorated chronic constriction induced neuropathic pain in rats. The FRF was subjected to bioactivity-guided fractionated. It was seen that FRF is more effective as compared to the isolated components probably due to synergism among the constituents (i.e., quercetin and quercetin glucosides) in the FRF. The outer scales of onion bulbs have great potential for prevention as well as for treatment of neuronal disorders. Red onions, with higher amounts of flavonoids as compared to the white onions, produced more significant neuroprotection. Thus, the standardized FRF from the waste material of a commonly used vegetable, especially the red variety, may be developed as a valuable neuroprotective agent.

Keywords: Allium cepa, antioxidant activity, flavonoid rich fraction, neuroprotection

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Authors: Melina Kopke, Jelle Van Dijk

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Persons with cognitive disabilities, such as Autism Spectrum Disorder (ASD) are often dependent on some form of professional support. Recent transformations in Dutch healthcare have spurred institutions to apply new, empowering methods and tools to enable their clients to cope (more) independently in daily life. Assistive Technologies (ATs) seem promising as empowering tools. While ATs can, functionally speaking, help people to perform certain activities without human assistance, we hold that, from a design-theoretical perspective, such technologies often fail to empower in a deeper sense. Most technologies serve either to prescribe or to monitor users’ actions, which in some sense objectifies them, rather than strengthening their agency. This paper proposes that theories of embodied interaction could help formulating a design vision in which interactive assistive devices augment, rather than replace, human agency and thereby add to a persons’ empowerment in daily life settings. It aims to close the gap between empowerment theory and the opportunities provided by assistive technologies, by showing how embodiment and empowerment theory can be applied in practice in the design of new, interactive assistive devices. Taking a Research-through-Design approach, we conducted a case study of designing to support independently living people with ASD with structuring daily activities. In three iterations we interlaced design action, active involvement and prototype evaluations with future end-users and healthcare professionals, and theoretical reflection. Our co-design sessions revealed the issue of handling daily activities being multidimensional. Not having the ability to self-manage one’s daily life has immense consequences on one’s self-image, and also has major effects on the relationship with professional caregivers. Over the course of the project relevant theoretical principles of both embodiment and empowerment theory together with user-insights, informed our design decisions. This resulted in a system of wireless light units that users can program as a reminder for tasks, but also to record and reflect on their actions. The iterative process helped to gradually refine and reframe our growing understanding of what it concretely means for a technology to empower a person in daily life. Drawing on the case study insights we propose a set of concrete design principles that together form what we call the embodied empowerment design framework. The framework includes four main principles: Enabling ‘reflection-in-action’; making information ‘publicly available’ in order to enable co-reflection and social coupling; enabling the implementation of shared reflections into an ‘endurable-external feedback loop’ embedded in the persons familiar ’lifeworld’; and nudging situated actions with self-created action-affordances. In essence, the framework aims for the self-development of a suitable routine, or ‘situated practice’, by building on a growing shared insight of what works for the person. The framework, we propose, may serve as a starting point for AT designers to create truly empowering interactive products. In a set of follow-up projects involving the participation of persons with ASD, Intellectual Disabilities, Dementia and Acquired Brain Injury, the framework will be applied, evaluated and further refined.

Keywords: assistive technology, design, embodiment, empowerment

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Authors: António J. R. Neves, Rui Garcia, Paulo Dias, Alina Trifan

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With the aging of the world population and the continuous growth in technology, service robots are more and more explored nowadays as alternatives to healthcare givers or personal assistants for the elderly or disabled people. Any service robot should be capable of interacting with the human companion, receive commands, navigate through the environment, either known or unknown, and recognize objects. This paper proposes an approach for object recognition based on the use of depth information and color images for a service robot. We present a study on two of the most used methods for object detection, where 3D data is used to detect the position of objects to classify that are found on horizontal surfaces. Since most of the objects of interest accessible for service robots are on these surfaces, the proposed 3D segmentation reduces the processing time and simplifies the scene for object recognition. The first approach for object recognition is based on color histograms, while the second is based on the use of the SIFT and SURF feature descriptors. We present comparative experimental results obtained with a real service robot.

Keywords: object detection, feature, descriptors, SIFT, SURF, depth images, service robots

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Authors: Merita Dauti, Edita Alili-Idrizi, Sihana Ahmeti –Lika, Ledjan Malaj

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The extermination and proper disposal of pharmaceutical wastes from expired and unused medications remains a disputable issue due to their specific nature and characteristics. Even though the hazards from these wastes are already well known in terms of environment and human health, people still treat them as usual wastes. At a national level, in many countries the management of pharmaceutical and medical wastes has been one of the main objectives in order to protect people’s health and the environment. Even though many legal regulations exist in this respect, there has not been a single law that would clearly explain the procedures of returning medicines, ways of selection, treatment and extermination of pharmaceutical wastes. This paper aims at analyzing the practices of pharmaceutical waste management and treatment in some European countries as well as a review of the legislation and official guidelines in managing these kinds of wastes and protecting the environment and human health. A suitable treatment and management of expired medications and other similar wastes would be in the interest of public health in the first place, as well as in the interest of healthcare institutions and other bodies engaged in environment protection.

Keywords: pharmaceutical waste, legal regulation, proper disposal, environment pollution

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Authors: Salma A. El-Marasy, Rehab F. Abdel-Rahman, Reham M. Abd-Elsalam

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The burden of stroke is intensely increasing worldwide. Brain injury following transient or permanent focal cerebral ischemia develops ischemic stroke as a consequence of a complex series of pathophysiological events. The aim of this study is to evaluate the possible neuroprotective effect of a dipeptidyl peptidase-4 inhibitor, vildagliptin, independent on its insulinotropic properties in non-diabetic rats subjected to cerebral ischemia. Anaesthetized Wistar rats were subjected to either left middle cerebral artery occlusion (MCAO) or sham operation followed by reperfusion after 30 min of MCAO. The other three groups were orally administered vildagliptin at 3 dose levels (2.5, 5, 10 mg/kg) for 3 successive weeks before subjected to left focal cerebral ischemia/reperfusion and till the end of the study. Neurological deficit scores and motor activity were assessed 24h following reperfusion. 48h following reperfusion, rats were euthanized and their left brain hemispheres were harvested and used in the biochemical, histopathological, and immunohistochemical investigations. Vildagliptin pretreatment improved neurological score deficit, locomotor activity and motor coordination in MCAO rats. Moreover, vildagliptin reduced malondialdehyde (MDA), elevated reduced glutathione (GSH), phosphotylinosital 3 kinase (PI3K), phosphorylated of protein kinase B (p-AKT), and mechanistic target of rapamycin (mTOR) brain contents in addition to reducing protein expression of caspase-3. Also, vildagliptin showed a dose-dependent attenuation in neuronal cell loss and histopathological alterations in MCAO rats. This study proves that vildagliptin exerted the neuroprotective effect in a dose-dependent manner as shown in amelioration of neuronal cell loss and histopathological damage in MCAO rats, which may be mediated by attenuating neuronal and motor deficits, it’s anti-oxidant property, activation of PI3K/AKT/mTOR pathway and its anti-apoptotic effect.

Keywords: caspase-3, cerebral ischemia, dipeptidyl peptidase-4 inhibitor, oxidative stress, PI3K/AKT/mTOR pathway, rats, vildagliptin

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Authors: Aicha Akrout, Amira Echtioui, Mohamed Ghorbel

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Pneumonia remains a significant global health concern, posing a substantial threat to human lives due to its contagious nature and potentially fatal respiratory complications caused by bacteria, fungi, or viruses. The reliance on chest X-rays for diagnosis, although common, often necessitates expert interpretation, leading to delays and potential inaccuracies in treatment. This study addresses these challenges by employing transfer learning techniques to automate the detection of lung diseases, with a focus on pneumonia. Leveraging three pre-trained models, VGG-16, ResNet50V2, and MobileNetV2, we conducted comprehensive experiments to evaluate their performance. Our findings reveal that the proposed model based on VGG-16 demonstrates superior accuracy, precision, recall, and F1 score, achieving impressive results with an accuracy of 93.75%, precision of 94.50%, recall of 94.00%, and an F1 score of 93.50%. This research underscores the potential of transfer learning in enhancing pneumonia diagnosis and treatment outcomes, offering a promising avenue for improving healthcare delivery and reducing mortality rates associated with this debilitating respiratory condition.

Keywords: chest x-ray, lung diseases, transfer learning, pneumonia detection

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Authors: Kausar Harun, Ahmad Azmin Mohamad

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Zinc oxide (ZnO) has been extensively used in optoelectronic devices, with recent interest as photoanode material in dye-sensitize solar cell. Numerous methods employed to experimentally synthesized ZnO, while some are theoretically-modeled. Both approaches provide information on ZnO properties, but theoretical calculation proved to be more accurate and timely effective. Thus, integration between these two methods is essential to intimately resemble the properties of synthesized ZnO. In this study, experimentally-grown ZnO nanoparticles were prepared by sol-gel storage method with zinc acetate dihydrate and methanol as precursor and solvent. A 1 M sodium hydroxide (NaOH) solution was used as stabilizer. The optimum time to produce ZnO nanoparticles were recorded as 12 hours. Phase and structural analysis showed that single phase ZnO produced with wurtzite hexagonal structure. Further work on quantitative analysis was done via Rietveld-refinement method to obtain structural and crystallite parameter such as lattice dimensions, space group, and atomic coordination. The lattice dimensions were a=b=3.2498Å and c=5.2068Å which were later used as main input in first-principles calculations. By applying density-functional theory (DFT) embedded in CASTEP computer code, the structure of synthesized ZnO was built and optimized using several exchange-correlation functionals. The generalized-gradient approximation functional with Perdew-Burke-Ernzerhof and Hubbard U corrections (GGA-PBE+U) showed the structure with lowest energy and lattice deviations. In this study, emphasize also given to the modification of valence electron energy level to overcome the underestimation in DFT calculation. Both Zn and O valance energy were fixed at Ud=8.3 eV and Up=7.3 eV, respectively. Hence, the following electronic and optical properties of synthesized ZnO were calculated based on GGA-PBE+U functional within ultrasoft-pseudopotential method. In conclusion, the incorporation of Rietveld analysis into first-principles calculation was valid as the resulting properties were comparable with those reported in literature. The time taken to evaluate certain properties via physical testing was then eliminated as the simulation could be done through computational method.

Keywords: density functional theory, first-principles, Rietveld-refinement, ZnO nanoparticles

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Authors: Danielle Page

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Foregoing studies, statistics, and medical evaluations have established a relationship between Posttraumatic stress disorder (PTSD) and criminal justice involvement in Vietnam veterans. War is highly trauma inducing and can leave combat veterans with mental disorders ranging from psychopathic thoughts to suicidal ideation. The majority of those suffering are unaware that they have PTSD, and as a coping mechanism, they often turn to self isolation. Beyond isolation, many veterans with symptomatic PTSD turn to aggression and substance abuse to cope with their internal agony. The most common crimes committed by veterans with PTSD fall into the assault and drug/alcohol abuse categories. Thus, a relationship is established between veteran populations and the criminal justice system. This dissertation aims to define the relationship between PTSD and criminal justice involvement in veterans, explore the mediating factors in this relationship, and analyze numerous court cases in this subject area. Further, it will examine the ways in which crime rates can be reduced for veterans with symptoms of PTSD. This ranges from the improvement of healthcare systems to the implementation of special courts to handle veteran cases.

Keywords: psychotraumatology, forensic psychology, PTSD, vietnam veterans

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Authors: Ian Walmsley

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The aim of this paper is to explore the influence of time and temporality on the experience of coming off heroin in prison. The presentation draws on qualitative data collected during a small-scale pilot study of the role of self-care in the process of coming off drugs in prison. Time and temporality emerged as a key theme in the interview transcripts. Drug dependent prisoners experience of time in prison has not been recognized in the research literature. Instead, the literature on prison time typically views prisoners as a homogenous group or tends to focus on the influence of aging and gender on prison time. Furthermore, there is a tendency in the literature on prison drug treatment and recovery to conceptualize drug dependent prisoners as passive recipients of prison healthcare, rather than active agents. In building on these gaps, this paper argues that drug dependent prisoners experience multiple temporalities which involve an interaction between the body-times of the drug dependent prisoner and the economy of time in prison. One consequence of this interaction is the feeling that they are doing, at this point in their prison sentence, double prison time. The second part of the argument is that time and temporality were a means through which they governed their withdrawing bodies. In addition, this paper will comment on the challenges of prison research in England.

Keywords: heroin withdrawal, time and temporality, prison, body

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Authors: Shaoyi Lu

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Background: Traditional Chinese medicine has been used to treat stroke, which is a major cause of morbidity and mortality. There is, however, no clear agreement about the optimal timing, population, efficacy, and predictive prognosis factors of traditional Chinese medicine supplemental therapy. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend. Key words: traditional Chinese medicine, acupuncture, Stroke, NIH stroke scale, Barthel index, predictive factor. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend.

Keywords: traditional Chinese medicine, complementary and alternative medicine, stroke, acupuncture

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Authors: James Pietris

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Glaucoma is a collection of irreversible optic neuropathies which, if left untreated, lead to severe visual field loss. These diseases are a leading cause of blindness across the globe and are estimated to affect approximately 80 million people, particularly women and people of Asian descent.1This represents a major burden on healthcare systems worldwide. Recently, there has been increasing interest in the potential of nicotinamide (vitamin B3) as a novel option in the management of glaucoma. This review aims to analyse the currently available literature to determine whether there is evidence of an association between nicotinamide adenine dinucleotide (NAD+) and glaucomatous optic neuropathy and whether nicotinamide has the potential to prevent or reverse these effects. The literature showed a strong connection between reduced NAD+ levels and retinal ganglion cell dysfunction through multiple different studies. There is also evidence of the positive effect of nicotinamide supplementation on retinal ganglion cell function in models of mouse glaucoma and in a study involving humans. Based on the literature findings, a recommendation has been made that more research into the efficacy, appropriate dosing, and potential side effects of nicotinamide supplementation is needed before it can be definitively determined whether it is appropriate for widespread prophylactic and therapeutic use against glaucoma in humans.

Keywords: glaucoma, nicotinamide, vitamin B3, optic neuropathy

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Authors: Elzbieta Sikorska-Simmons

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Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.

Keywords: advanced dementia, family caregiver, medical decision-making, symptom management

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Authors: Jessie Fazel, Kristen Smith

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Human trafficking is a multi-billion-dollar criminal industry that affects 24.9 million people around the world. There are several different types of trafficking, the most common being sex trafficking, labor trafficking, and domestic servitude. Survival sex is common in the pediatric population, as they engage in sex for food, a place to sleep, or other basic needs. Statistics show that health care workers are at a unique advantage to help identify victims and get them the help they need, as 88% of trafficked victims encounter a health care worker while being trafficked. Unfortunately, victims don’t usually self-identify that they are being trafficked and the situations they face can vary dramatically. It is imperative to remember that traditional red flags are not always present in the pediatric population. Risk factors and red flags with their history and physical exam are one of the best indicators that health care providers need to be vigilant in looking at. There are numerous barriers for disclosure in the healthcare setting. Periods of time before and after disclosure are often emotionally difficult and could be dangerous for the victim. It is extremely important to have a plan in place for intervention if the victim does disclose trafficking. A trauma informed approach to medical and mental health interventions, that focus on safety, are vital in this population. This is happening where you live and you can make a difference in their lives.

Keywords: human trafficking, public health, emergency medicine, sexual health

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Authors: Mehrnaz Mostafavi, Mahtab Shabani, Alireza Azani, Fatemeh Ghafari

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Artificial intelligence (AI) can transform breast cancer diagnosis and therapy by providing sophisticated solutions for screening, imaging interpretation, histopathological analysis, and treatment planning. This literature review digs into the many uses of AI in breast cancer treatment, highlighting the need for collaboration between AI scientists and healthcare practitioners. It emphasizes advances in AI-driven breast imaging interpretation, such as computer-aided detection and diagnosis (CADe/CADx) systems and deep learning algorithms. These have shown significant potential for improving diagnostic accuracy and lowering radiologists' workloads. Furthermore, AI approaches such as deep learning have been used in histopathological research to accurately predict hormone receptor status and categorize tumor-associated stroma from regular H&E stains. These AI-powered approaches simplify diagnostic procedures while providing insights into tumor biology and prognosis. As AI becomes more embedded in breast cancer care, it is crucial to ensure its ethical, efficient, and patient-focused implementation to improve outcomes for breast cancer patients ultimately.

Keywords: breast cancer, artificial intelligence, cancer diagnosis, clinical practice

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Authors: Danika Tynes

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Innovations in technology have implications for sustainable development in health and wellness. Remote monitoring is one innovation for which the evidence-base has grown to support its viability as a quality healthcare delivery adjunct. This research reviews global data on telehealth adoption, in particular, remote monitoring, and the conditions under which its success becomes more likely. System-level indicators were selected to represent four constructs of DoI theory (relative advantage, compatibility, complexity, and observability) and assessed against 5 types of Telehealth (Teleradiology, Teledermatology, Telepathology, Telepsychology, and Remote Monitoring) using ordinal logistic regression. Analyses include data from 84 countries, as extracted from the World Health Organization, World Bank, ICT (Information Communications Technology) Index, and HDI (Human Development Index) datasets. Analyses supported relative advantage and compatibility as the strongest influencers of remote monitoring adoption. Findings from this research may help focus on the allocation of resources, as a sustainability concern, through consideration of systems-level factors that may influence the success of remote monitoring adoption.

Keywords: remote monitoring, diffusion of innovation, telehealth, digital health

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Authors: Caroline Smith, Professor Debi Bhattacharya, Sion Scott

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Introduction: Oropharyngeal Dysphagia (OD) effects around 15% of older people, however it is often unrecognised and under diagnosed until they are hospitalised. There is a need for primary care healthcare practitioners (HCPs) to assume a proactive role in identifying and managing OD to prevent adverse outcomes such as aspiration pneumonia. Understanding the determinants of primary care HCPs undertaking this new behaviour provides the intervention targets for addressing. This realist review, underpinned by the Theoretical Domains Framework (TDF), aims to synthesise relevant literature and develop programme theories to understand what interventions work, how they work and under what circumstances to facilitate HCPs to prevent harm from OD. Combining realist methodology with behavioural science will permit conceptualisation of intervention components as theoretical behavioural constructs, thus informing the design of a future behaviour change intervention. Furthermore, through the TDF’s linkage to a taxonomy of behaviour change techniques, we will identify corresponding behaviour change techniques to include in this intervention. Methods & analysis: We are following the five steps for undertaking a realist review: 1) clarify the scope 2) Literature search 3) appraise and extract data 4) evidence synthesis 5) evaluation. We have searched Medline, Google scholar, PubMed, EMBASE, CINAHL, AMED, Scopus and PsycINFO databases. We are obtaining additional evidence through grey literature, snowball sampling, lateral searching and consulting the stakeholder group. Literature is being screened, evaluated and synthesised in Excel and Nvivo. We will appraise evidence in relation to its relevance and rigour. Data will be extracted and synthesised according to its relation to Initial programme theories (IPTs). IPTs were constructed after the preliminary literature search, informed by the TDF and with input from a stakeholder group of patient and public involvement advisors, general practitioners, speech and language therapists, geriatricians and pharmacists. We will follow the Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) quality and publication standards to report study results. Results: In this ongoing review our search has identified 1417 manuscripts with approximately 20% progressing to full text screening. We inductively generated 10 IPTs that hypothesise practitioners require: the knowledge to spot the signs and symptoms of OD; the skills to provide initial advice and support; and access to resources in their working environment to support them conducting these new behaviours. We mapped the 10 IPTs to 8 TDF domains and then generated a further 12 IPTs deductively using domain definitions to fulfil the remaining 6 TDF domains. Deductively generated IPTs broadened our thinking to consider domains such as ‘Emotion,’ ‘Optimism’ and ‘Social Influence’, e.g. If practitioners perceive that patients, carers and relatives expect initial advice and support, then they will be more likely to provide this, because they will feel obligated to do so. After prioritisation with stakeholders using a modified nominal group technique approach, a maximum of 10 IPTs will progress to test against the literature.

Keywords: behaviour change, deglutition disorders, primary healthcare, realist review

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Authors: Chau-Kuang Chen, Juanita Buford, Colette Davis, Raisha Allen, John Hughes, James Tyus, Dexter Samuels

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During the post-Civil War era, the city of Nashville, Tennessee, had the highest mortality rate in the country. The elevated death and disease among ex-slaves were attributable to the unavailability of healthcare. To address the paucity of healthcare services, the College, an institution with the mission of educating minority professionals and serving the under served population, was established in 1876. This study was designed to assess if the College has accomplished its mission of serving under served communities and contributed to the elimination of health disparities in the United States. The study objective was to quantify the impact of socioeconomic status and adverse health outcomes on primary care professionals serving disadvantaged communities, which, in turn, was significantly associated with a health professional shortage score partly designated by the U.S. Department of Health and Human Services. Various statistical methods were used to analyze the alumni data in years 1975 – 2013. K-means cluster analysis was utilized to identify individual medical and dental graduates into the cluster groups of the practice communities (Disadvantaged or Non-disadvantaged Communities). Discriminant analysis was implemented to verify the classification accuracy of cluster analysis. The independent t test was performed to detect the significant mean differences for clustering and criterion variables between Disadvantaged and Non-disadvantaged Communities, which confirms the “content” validity of cluster analysis model. Chi-square test was used to assess if the proportion of cluster groups (Disadvantaged vs Non-disadvantaged Communities) were consistent with that of practicing specialties (primary care vs. non-primary care). Finally, the partial least squares (PLS) path model was constructed to explore the “construct” validity of analytics model by providing the magnitude effects of socioeconomic status and adverse health outcome on primary care professionals serving disadvantaged community. The social ecological theory along with statistical models mentioned was used to establish the relationship between medical and dental graduates (primary care professionals serving disadvantaged communities) and their social environments (socioeconomic status, adverse health outcome, health professional shortage score). Based on social ecological framework, it was hypothesized that the impact of socioeconomic status and adverse health outcomes on primary care professionals serving disadvantaged communities could be quantified. Also, primary care professionals serving disadvantaged communities related to a health professional shortage score can be measured. Adverse health outcome (adult obesity rate, age-adjusted premature mortality rate, and percent of people diagnosed with diabetes) could be affected by the latent variable, namely socioeconomic status (unemployment rate, poverty rate, percent of children who were in free lunch programs, and percent of uninsured adults). The study results indicated that approximately 83% (3,192/3,864) of the College’s medical and dental graduates from 1975 to 2013 were practicing in disadvantaged communities. In addition, the PLS path modeling demonstrated that primary care professionals serving disadvantaged community was significantly associated with socioeconomic status and adverse health outcome (p < .001). In summary, the majority of medical and dental graduates from the College provide primary care services to disadvantaged communities with low socioeconomic status and high adverse health outcomes, which demonstrate that the College has fulfilled its mission.

Keywords: disadvantaged community, K-means cluster analysis, PLS path modeling, primary care

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