Search results for: patient engagement

Authors: Joung Hyoun Lee

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Intransitive verbs consist of two subclasses called unergatives and unaccusatives. However, traditionally Italian intransitive verbs have been taught regardless their semantic distinctions and any mention of grammatical terms such as unaccusatives and unergatives even though there is a huge gap between them. This paper aims to explore the teaching of Italian intransitive verbs categorizing them into unaccusatives and unergatives, which is compared with researches on the teaching of English unaccusative and unergative verbs. For this purpose, first, the study analyses various aspects of English vs. Italian unergatives and unaccusatives, and their properties of the constructions. Next, this study highlights the research trend on Korean students' learning errors, which is leaning toward causal analyses of the over passivization of English unaccusative verbs. In order to investigate these issues, 53 students of the Busan University of Foreign Studies, who are studying Italian language as a second language, were surveyed through a grammaticality judgment test divided into 9 sections. As expected, the findings confirmed that the test results of Italian unaccusatives and unergatives showed similar and different aspects comparing to those of English. Moreover, there was a highly affirmative demand for a more careful way of teaching which should be considered both syntactically and semantically according to the grammatical items. The research provides a framework of a more effective and systematic teaching method of Italian intransitive verbs for further research.

Keywords: unaccusative verbs, unergative verbs, agent, patient, theme, overpassivization

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Authors: Mouli Banga, Chaya Ravindra

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Wound classification is a crucial step in wound diagnosis. An effective classifier can aid wound specialists in identifying wound types with reduced financial and time investments, facilitating the determination of optimal treatment procedures. This study presents a deep neural network-based classifier that leverages wound images and their corresponding locations to categorize wounds into various classes, such as diabetic, pressure, surgical, and venous ulcers. By incorporating a developed body map, the process of tagging wound locations is significantly enhanced, providing healthcare specialists with a more efficient tool for wound analysis. We conducted a comparative analysis between two prominent convolutional neural network models, ResNet50 and MobileNetV2, utilizing a dataset of 730 images. Our findings reveal that the RestNet50 outperforms MovileNetV2, achieving an accuracy of approximately 90%, compared to MobileNetV2’s 83%. This disparity highlights the superior capability of ResNet50 in the context of this dataset. The results underscore the potential of integrating deep learning with spatial data to improve the precision and efficiency of wound diagnosis, ultimately contributing to better patient outcomes and reducing healthcare costs.

Keywords: wound classification, MobileNetV2, ResNet50, multimodel

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Authors: D. Schafer, H. Booke, R. Nordmeier

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Patients suffering from chronic musculoskeletal pain ( > 12 months) are a challenging clientele for pain specialists. A multimodal approach, characterized by a two weeks inpatient treatment, often is the ultimate therapeutic attempt. The lasting effects of such a multimodal approach were analyzed, especially since two weeks of inpatient therapy, although very intense, often seem too short to make a difference in patients suffering from chronic pain for years. The study includes 32 consecutive patients suffering from chronic pain over years who underwent a two weeks multimodal inpatient treatment of pain. Twelve months after discharge, each patient was interviewed to objectify any lasting effects. Pain was measured on admission and 12 months after discharge using the numeric rating scale (NRS). For statistics, a paired students' t-test was used. Significance was defined as p < 0.05. The average intensity of pain on admission was 8,6 on the NRS. Twelve months after discharge, the intensity of pain was still reduced by an average of 48% (average NRS 4,4), p < 0.05. Despite this significant improvement in pain severity, two thirds (66%) of the patients still judge their treatment as not sufficient. In conclusion, inpatient treatment of chronic pain has a long-lasting effect on the intensity of pain in patients suffering from chronic musculoskeletal pain for more than 12 months.

Keywords: chronic pain, inpatient treatment, multimodal pain treatment, musculoskeletal pain

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Authors: Amin Nakhostin-Ansari, Samaneh Akbarour, Khosro Sadeghniiat Haghighi, Zahra Banafsheh Alemohammad, Farnaz Etesam, Arezu Najafi, Mahnaz Khalafehnilsaz

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Introduction: The outbreak of coronavirus disease has considerably burdened the healthcare system in Iran. This study aimed to evaluate the characteristics of insomnia experienced by the general Iranian population during the COVID-19 pandemic. Method: A scale(FCV-19) was used for Fear of COVID-19, Insomnia Severity Index (ISI), Patient Health Questionnaire-2 (PHQ-2), and Generalized Anxiety Disorder Scale-2 (GAD-2) for detailed characterization of insomnia and its patterns Results: In total, 675 people with insomnia with the mean age of 40.28 years (SD=11.15) participated in this study. Prevalence of difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening (EMA) were 91.4%, 86.7%, and 77%, respectively. DIS, DMS, and EMA were more common in people with depression and anxiety. FCV-19 score was higher in those with more severe types of DIS, DMS, and EMA (P<0.001). FCV-19 was a risk factor for all patterns of insomnia (OR=1.19, 1.12, 1.02 for DIS, DMS, and EMA, respectively). Conclusion: fear of COVID-19 is a major factor to insomnia patterns. Investigation of COVID-19 fear in people with insomnia and the addition of attributed relieving or management strategies to conventional management of insomnia are reasonable approaches to improve the sleep condition of people in the pandemic.

Keywords: insomnia, difficulty maintaining sleep, COVID-19, Coronavirus

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Authors: Francisco Alvarado, Luz Ramírez

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Corneal diseases are one of the main causes of visual impairment and affect almost 4 million, and this study assesses the effects of deep anterior lamellar keratoplasty (DALK) with porcine corneal stroma and postoperative topical treatment with tacrolimus in patients with infectious keratitis. No patient was observed with clinical graft rejection. Among the cases: 2 were positive to fungal culture, 2 with Aspergillus and the other 8 cases were confirmed by bacteriological culture. Corneal diseases are one of the main causes of visual impairment and affect almost 4 million. This study assesses the effects of deep anterior lamellar keratoplasty (DALK) with porcine corneal stroma and postoperative topical treatment with tacrolimus in patients with infectious keratitis. Receiver bed diameters ranged from 7.00 to 9.00 mm. No incidents of Descemet's membrane perforation were observed during surgery. During the follow-up period, no corneal graft splitting, IOP increase, or intolerance to tacrolimus were observed. Deep anterior lamellar keratoplasty seems to be the best option to avoid xenograft rejection, and it could help new surgical techniques in humans.

Keywords: ophthalmology, cornea, corneal transplant, xenografts, surgical innovations

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Authors: M. S. Mousavi-Daramoroudi, H. Yousefnia, S. Zolghadri, F. Abbasi-Davani

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Dosimetry is an indispensable and precious factor in patient treatment planning; to minimize the absorbed dose in vital tissues. In this study, In accordance with the proper characteristics of DOTATOC and ¹⁷⁷Lu, after preparing ¹⁷⁷Lu-DOTATOC at the optimal conditions for the first time in Iran, radionuclidic and radiochemical purity of the solution was investigated using an HPGe spectrometer and ITLC method, respectively. The biodistribution of the compound was assayed for treatment of adenocarcinoma breast cancer in bearing BALB/c mice. The results have demonstrated that ¹⁷⁷Lu-DOTATOC is a profitable selection for therapy of the tumors. Because of the vital role of internal dosimetry before and during therapy, the effort to improve the accuracy and rapidity of dosimetric calculations is necessary. For this reason, a new method was accomplished to calculate the absorbed dose through mixing between compartmental model, animal dosimetry and extrapolated data from animal to human and using MIRD method. Despite utilization of compartmental model based on the experimental data, it seems this approach may increase the accuracy of dosimetric data, confidently.

Keywords: ¹⁷⁷Lu-DOTATOC, biodistribution modeling, compartmental model, internal dosimetry

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Authors: Fatemeh Keshavarz

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Background: Rheumatoid arthritis (RA) is one of the most common autoimmune diseases, often leading to joint damage and physical disability. This study aimed to investigate the relationship of serum levels of interleukin 17 and anti-CCP factor with disease severity in RA patients. Materials and Methods: Fifty-four patients with RA confirmed by clinical and laboratory criteria were recruited. A 5 ml venous blood sample was taken from every patient, its serum was separated. Based on clinical data and severity of symptoms, patients were classified into three groups of those with mild, moderate, and severe symptoms. Serum levels of IL-17 and anti-CCP in all samples were measured using ELISA. Results: Analysis of IL-17 serum levels in different groups showed that its amount was higher in the group with mild clinical symptoms than in other groups. Comparison of IL-17 serum levels between mild and moderate disease severity groups showed a statistically significant relationship. There was also a positive linear relationship between anti-CCP and serum IL-17 levels in different groups of the disease, and serum IL-17 levels were inversely related to the duration of exposure to the disease. Conclusion: Higher IL-17 serum levels in patients with mild symptom severity confirm that this highly specific marker is involved in the pathogenesis of RA and may be effective in initiating patients’ clinical symptoms.

Keywords: IL-17, anti-CCP, rheumatoid arthritis, autoimmune

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Authors: Philip A. Szlosek, M. Susan Guyer, Mary G. Barnum, Elizabeth M. Mullin

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In the United States, athletic training is a healthcare profession that encompasses the prevention, examination, diagnosis, treatment, and rehabilitation of injuries and medical conditions. Athletic trainers work under the direction of or in collaboration with a physician and are recognized by the American Medical Association as allied healthcare professionals. Internationally, this profession is often known as athletic therapy. As healthcare professionals, athletic trainers must be prepared for autonomous practice immediately after graduation. However, new athletic trainers have been shown to have clinical areas of strength and weakness.To better assess professional readiness and improve the preparedness of new athletic trainers, the factors of athletic training professional readiness must be defined. Limited research exists defining the holistic aspects of professional readiness needed for athletic trainers. Confirming the factors of professional readiness in athletic training could enhance the professional preparation of athletic trainers and result in more highly prepared new professionals. The objective of this study was to further explore and confirm the factors of professional readiness in athletic training. Authors useda qualitative design based in grounded theory. Participants included athletic trainers with greater than 24 months of experience from a variety of work settings from each district of the National Athletic Trainer’s Association. Participants took the demographic questionnaire electronically using Qualtrics Survey Software (Provo UT). After completing the demographic questionnaire, 20 participants were selected to complete one-on-one interviews using GoToMeeting audiovisual web conferencing software. IBM Statistical Package for the Social Sciences (SPSS, v. 21.0) was used to calculate descriptive statistics for participant demographics. The first author transcribed all interviews verbatim and utilized a grounded theory approach during qualitative data analysis. Data were analyzed using a constant comparative analysis and open and axial coding. Trustworthiness was established using reflexivity, member checks, and peer reviews. Analysis revealed four overarching themes, including management, interpersonal relations, clinical decision-making, and confidence. Management was categorized as athletic training services not involving direct patient care and was divided into three subthemes, including administration skills, advocacy, and time management. Interpersonal Relations was categorized as the need and ability of the athletic trainer to properly interact with others. Interpersonal relations was divided into three subthemes, including personality traits, communication, and collaborative practice. Clinical decision-making was categorized as the skills and attributes required by the athletic trainer whenmaking clinical decisions related to patient care. Clinical decision-making was divided into three subthemes including clinical skills, continuing education, and reflective practice. The final theme was confidence. Participants discussed the importance of confidence regarding relationships building, clinical and administrative duties, and clinical decision-making. Overall, participants explained the value of a well-rounded athletic trainer and emphasized that athletic trainers need communication and organizational skills, the ability to collaborate, and must value self-reflection and continuing education in addition to having clinical expertise. Future research should finalize a comprehensive model of professional readiness for athletic training, develop a holistic assessment instrument for athletic training professional readiness, and explore the preparedness of new athletic trainers.

Keywords: autonomous practice, newly certified athletic trainer, preparedness for professional practice, transition to practice skills

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Authors: Ramon F. B. da Silva, Mateus Batistella, Emilio Moran

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Although the existence of two Forest Transition (FT) pathways, the economic development and the forest scarcity, there are many contexts that shape the model of FT observed in each particular region. This means that local conditions, such as relief, soil quality, historic land use/cover, public policies, the engagement of society in compliance with legal regulations, and the action of enforcement agencies, represent dimensions which combined, creates contexts that enable forest regeneration. From this perspective we can understand the regeneration process of native vegetation cover in the Paraíba Valley (Forest Atlantic biome), ongoing since the 1960s. This research analyzed public information, land use/cover maps, environmental public policies, and interviewed 17 stakeholders from the Federal and State agencies, municipal environmental and agricultural departments, civil society, farmers, aiming comprehend the contexts behind the forest regeneration in the Paraíba Valley, Sao Paulo State, Brazil. The first policy to protect forest vegetation was the Forest Code n0 4771 of 1965, but this legislation did not promote the increase of forest, just the control of deforestation, not enough to the Atlantic Forest biome that reached its highest pick of degradation in 1985 (8% of Atlantic Forest remnants). We concluded that the Brazilian environmental legislation acted in a strategic way to promote the increase of forest cover (102% of regeneration between 1985 and 2011) from 1993 when the Federal Decree n0 750 declared the initial and advanced stages of secondary succession protected against any kind of exploitation or degradation ensuring the forest regeneration process. The strategic policy formulation was also observed in the Sao Paulo State law n0 6171 of 1988 that prohibited the use of fire to manage agricultural landscape, triggering a process of forest regeneration in formerly pasture areas.

Keywords: forest transition, land abandonment, law enforcement, rural economic crisis

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Authors: Ayu Nabila Kusuma Pradana, Aprinaldi Jasa Mantau, Tomohiko Akahoshi

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The incidence of Disseminated intravascular coagulation (DIC) following gastrointestinal surgery has a poor prognosis. Therefore, it is important to determine the factors that can predict the prognosis of DIC. This study will investigate the factors that may influence the outcome of DIC in patients after gastrointestinal surgery. Eighty-one patients were admitted to the intensive care unit after gastrointestinal surgery in Kyushu University Hospital from 2003 to 2021. Acute DIC scores were estimated using the new Japanese Association for Acute Medicine (JAAM) score from before and after surgery from day 1, day 3, and day 7. Acute DIC scores will be compared with The Sequential Organ Failure Assessment (SOFA) score, platelet count, lactate level, and a variety of biochemical parameters. This study applied machine learning algorithms to predict the prognosis of DIC after gastrointestinal surgery. The results of this study are expected to be used as an indicator for evaluating patient prognosis so that it can increase life expectancy and reduce mortality from cases of DIC patients after gastrointestinal surgery.

Keywords: the survival rate, gastrointestinal surgery, JAAM score, neural network, machine learning, disseminated intravascular coagulation (DIC)

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Authors: Mingke Ma

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The recent discovery of the High-Income Trap phenomena and the established Middle-Income Trap literature have identified the similarity of the structural challenges that both Mainland China and Taiwan have been facing since the simultaneous growth slowdown from the 2000s. Mainland China and Taiwan’s ineffectiveness in productivity growth weakened their overall competitiveness in Global Value Chains. With the subsequent decline of industrial profitability, social compression from late development persists and jeopardises the social cohesion. From Ma Ying-jeou’s ‘633’ promise and Tsai Ing-wen’s ‘5+2’ industrial framework to Mainland China’s 11th to 14th Five-Year Plans, leaderships across the Strait have been striving to constitute new models for inclusive and sustainable development through policy responses. This study argues that social consensuses that have been constructed by the domestic political processes define the feasibility of the reform strategies, which further construct the conditions for Cross-Strait interactions. Based on the existing literature of New Institutional Economics, Middle/High Income Trap, and Compressed Development, this study adopts a Historical Institutionalist analytical framework to identify how the historical path-dependency contributes to the contemporary growth constraints in both economies and the political difficulty on navigating the institutional and Organisational change. It continues by tracing the political process of economic reform to examine the sustainability and resilience of the manifested social consensus that had empowered the proposed policy frameworks. Afterwards, it examines how the political outcomes in such a simultaneous process shared by both Mainland China and Taiwan construct the social, economic, institutional, and political foundations of contemporary Cross-Strait engagement.

Keywords: historical institutionalism, political economy, cross-strait relations, high/middle income trap

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Authors: Kevin R. Wilson, Roger Mantie

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Community arts-based learning and participatory education are pedagogical techniques that serve to be advantageous for students, curriculum development, and local communities. Using an interpretive approach to examine the significance of this arts-informed research in relation to the eight ‘design imperatives’ proposed as the new model for measuring quality in scholarship for Arizona State University as ‘A New American University’, the purpose of this study was to investigate personal, social, and cultural benefits resulting from student engagement in interdisciplinary community-based projects. Students from a graduate level music education class at the ASU Tempe campus (n=7) teamed with students from an undergraduate level community development class at the ASU Downtown Phoenix campus (n=14) to plan, facilitate, and evaluate seven community-based projects in several locations around the Phoenix-metro area. Data was collected using photo evidence, student reports, and evaluative measures designed by the students. The effectiveness of each project was measured in terms of their ability to meet the eight design imperatives to: 1) leverage place; 2) transform society; 3) value entrepreneurship; 4) conduct use-inspired research; 5) enable student success; 6) fuse intellectual disciplines; 7) be socially embedded; and 8) engage globally. Results indicated that this community arts-based project sufficiently captured the essence of each of these eight imperatives. Implications for how the nature of this interdisciplinary initiative allowed for the eight imperatives to manifest are provided, and project success is expounded upon in relation to utility of each imperative. Discussion is also given for how this type of service learning project formatted within the ‘New American University’ model for measuring quality in academia can be a beneficial pedagogical tool in higher education.

Keywords: community arts-based learning, participatory education, pedagogy, service learning

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Authors: S. Nandagopalan, N. Pradeep

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The aim of this paper is to propose a general framework for storing, analyzing, and extracting knowledge from two-dimensional echocardiographic images, color Doppler images, non-medical images, and general data sets. A number of high performance data mining algorithms have been used to carry out this task. Our framework encompasses four layers namely physical storage, object identification, knowledge discovery, user level. Techniques such as active contour model to identify the cardiac chambers, pixel classification to segment the color Doppler echo image, universal model for image retrieval, Bayesian method for classification, parallel algorithms for image segmentation, etc., were employed. Using the feature vector database that have been efficiently constructed, one can perform various data mining tasks like clustering, classification, etc. with efficient algorithms along with image mining given a query image. All these facilities are included in the framework that is supported by state-of-the-art user interface (UI). The algorithms were tested with actual patient data and Coral image database and the results show that their performance is better than the results reported already.

Keywords: active contour, bayesian, echocardiographic image, feature vector

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Authors: Annika Kjallman Alm, Ove Hellzen, Malin Rising-Holmstrom

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Worldwide, the number of people who are living with dementia is increasing because of an aging population, which leads to increased financial and social costs, including reduced quality of life for people with dementia and their care partners. Most people who have dementia reside in the community. Aging in place could be described as having the health and social supports and services you need to live safely and independently in your home or your society for as long as you wish and are able. People with dementia are not different than people without dementia where they want to remain at home, if possible, with a sense of familiarity and engagement in typical everyday activities. So how do persons with dementia or cognitive decline see their possibilities to be socially involved and experience support? The aim of this study was to explore persons with cognitive decline's sense of involvement and support living in the ordinary dwelling. The study was approved by the Ethical Review Authority in Sweden prior to the interviews. Interviews were conducted with 20 persons living at home, either alone or in a relationship. The persons had perceived cognitive decline; some were under investigation or already had a diagnose of early dementia. Thematic analysis was used to identify, analyze, and report patterns within the data. Researchers extracted three main themes through participants’ interviews: a) Importance of social involvement with family and friends. b) Hindrances for social involvement. c) Struggling mentally with a new life situation. Results found that going to activity centers, staying involved, and meeting friends and family enhanced the sense of involvement and support. There were also hindrances to a sense of involvement and support as they struggled with the diagnose and the changes in daily life, such as physical problems, mental problems, or economic issues. The mental struggle of accepting the cognitive decline and the changes in daily life it brought was also an issue for some of the participants. A multidimensional support should be provided by the community to enable persons with cognitive decline to stay involved in family and community in the comfort of their own homes.

Keywords: aging in place, cognitive decline, dementia, sense of involvement

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Authors: S. Ayeko, J. Milton, C. Hughes, K. Anderson, R. G. Middleton

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Background: Periprosthetic femoral fractures (PFF) in association with hip hemiarthroplasty or total hip arthroplasty is a common and serious complication. In the Vancouver Classification system algorithm, B1 fractures should be treated with Open Reduction and Internal Fixation (ORIF) and preferentially revised in combination with ORIF if B2 or B3. This study aims to assess patient outcomes after plate osteosynthesis alone for Vancouver B1 and B2 fractures. The main outcome is the 1-year re-revision rate, and secondary outcomes are 30-day and 1-year mortality. Method: This is a retrospective single-centre case-series review from January 2016 to June 2021. Vancouver B1 and B2, non-malignancy fractures in adults over 18 years of age treated with polyaxial Non-Contact Bridging plate osteosynthesis, have been included. Outcomes were gathered from electronic notes and radiographs. Results: There were 50 B1 and 64 B2 fractures. 26 B2 fractures were managed with ORIF and revision, 39 ORIF alone. Of the revision group, one died within 30 days (3.8%), one at one year (3.8%), and two were revised within one year (7.7). Of the B2 ORIF group, three died within 30-day mortality (7.96%), eight at one year (21.1%), and 0 were revised in 1 year. Conclusion: This study has demonstrated that satisfactory outcomes can be achieved with ORIF, excluding revision in the management of B2 fractures.

Keywords: arthroplasty, bridging plate, periprosthetic fracture, revision surgery

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Authors: Teja Koduru

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Untreated Lyme disease can lead to neurological, cardiac, and dermatological complications. Rapid diagnosis of the erythema migrans (EM) rash, a characteristic symptom of Lyme disease is therefore crucial to early diagnosis and treatment. In this study, we aim to utilize deep learning frameworks including Tensorflow and Keras to create deep convolutional neural networks (DCNN) to detect images of acute Lyme Disease from images of erythema migrans. This study uses a custom database of erythema migrans images of varying quality to train a DCNN capable of classifying images of EM rashes vs. non-EM rashes. Images from publicly available sources were mined to create an initial database. Machine-based removal of duplicate images was then performed, followed by a thorough examination of all images by a clinician. The resulting database was combined with images of confounding rashes and regular skin, resulting in a total of 683 images. This database was then used to create a DCNN with an accuracy of 93% when classifying images of rashes as EM vs. non EM. Finally, this model was converted into a web and mobile application to allow for rapid diagnosis of EM rashes by both patients and clinicians. This tool could be used for patient prescreening prior to treatment and lead to a lower mortality rate from Lyme disease.

Keywords: Lyme, untreated Lyme, erythema migrans rash, EM rash

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Authors: Ghazala Yasmeen, Zahid Yousaf

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Frequent social media use has significantly changed people's life and communication styles during the last two decades. Social media use has multiple dimensions, and there are nuanced relationships between it and how it affects different societal subgroups. With the increased popularity and rapid growth of social networking sites, people are experiencing potential social media addiction, which causes severe mental health problems. How social media is dramatically influencing the lives and mental health of its users, and particularly of the students, creating psychological issues, e.g., isolation, depression, and anxiety, will be the primary objective of this study. This research will address the problems confronted by many students who are regular social media users and can undergo mental distress. This study aims to explore how social media use can lead to isolation, depression, and anxiety. This research will also investigate the effects of cyber-bullying on social, emotional, and psychological wellbeing. For this purpose, the researcher will use the survey technique as a method of inquiry. Ryff's theory of Psychological wellbeing will be used as a theoretical framework to explore the association between social media addiction and psychological effects among users. For data collection, the researcher will use the quantitative research method through a survey questionnaire from three universities in Pakistan from the public and private sectors. This study will imply a two-stage random sampling technique. At first, the researcher will select 20% of students from universities. In the second stage, 20% of students using different social networking sites will be chosen, and draw a representative sample from these will be. The intended study will use questionnaires comprising two portions. The first section will consist of social media engagement by the students, following impacts on their mental health and reported attitude towards psychological wellbeing. This study will spotlight the considerations of parents, educationists, and policymakers to take measures against the devastating effects of cyber-crimes on young adults.

Keywords: anxiety, depression, isolation, social media, wellbeing

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Authors: David Armany, Matthew Allaway, Preet Gosal, Senarath Edirimanne

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A potentially devastating complication of routine laparoscopic cholecystectomy includes iatrogenic bile duct injuries, which represent a stable incidence rate of 0.3% over the past three decades. Whilst related to several relative risks such as surgeon experience and patient factors (older age, male sex), misinterpretation of biliary tree anatomy remains the most common cause, accounting for 80% of iatrogenic Common Bile Duct injuries. Whilst extremely rare, a duplicate common bile duct anomaly remains a potential variation to encounter during biliary surgery, with 30 recognised cases in the worldwide literature, of which type Vb accounts for 4. We report the case of a rare type Vb variation encountered during intra-operative laparoscopic cholecystectomy and confirmed on cholangiogram. To our knowledge, this is the first documented Type Vb case encountered in an Australian population. Given these anomalies are asymptomatic and can perpetuate iatrogenic common bile duct injuries, awareness of all subtypes is crucial. Irrevocably, preoperative Magnetic Resonance Cholangiopancreatography can help recognise these anomalies before the operating theatre; however, their widespread adoption is limited by expensive and availability.

Keywords: duplicated common bile duct, type Vb, cholecystitis, MRCP, cholangiogram, iatrogenic CBD

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Authors: Geetanjali Saggar

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Background: Partial hearing loss is the inability to hear effectively as a normal hearing individual whose hearing threshold is 20 dB or better in both ears. Individuals with partial hearing loss may benefit from non-invasive electrical stimulation as a method of therapy and possible intervention. Objective: The project aims to assess and relate the efficacy of electrical stimulation on individuals with partial hearing loss. The study's goal was to evaluate the different sorts of non-invasive electrical stimulation in tinnitus and hearing loss in order to build the framework for future research. Method: In this pilot study, a total of five patients of age group above 50 years were selected with partial hearing loss. The electrical modality of Repetitive Transcranial Magnetic Stimulation (RTMS) was used among the patients and was evaluated using gold questionnaires- HHIA and APHAB for hearing at intervals of 0-7-14 days. The statistical data was analyzed by SPSS software-16. Results: There were not much significant changes in the hearing of the patients when non-invasive electrical modality was applied as an intervention in the partial hearing loss condition. However, there was minimal change in the daily functioning of the patient with the application of intervention. Conclusion: This study concluded that non-invasive electrical stimulation had minimal to no effect on the partial hearing of the patients.

Keywords: non-invasive, hearing loss, transcranial magnetic stimulation, partial deafness, transcranial direct current stimulation, tinnitus

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Authors: Ayesha Agha Shah

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The purpose of a mosque or a place of worship is to build a spiritual relation with God. If the sense of spirituality is not achieved, then sacred architecture appears to be lacking depth. Form and space play a significant role to enhance the architectural quality to impart a divine feel to a place. To achieve this divine feeling, form and space, and unity of opposites, either abstract or symbolic can be employed. It is challenging to imbue the emptiness of a space with qualitative experience. Mosque architecture mostly entails traditional forms and design typology. This approach for Muslim worship produces distinct landmarks in the urban neighborhoods of Muslim societies, while creating a great sense of spirituality. The universal symbolic characters in the mosque architecture had prototype geometrical forms for a long time in history. However, modern mosques have deviated from this approach to employ different built elements and symbolism, which are often hard to be identified as related to mosques or even as Islamic. This research aims to explore the sense of spirituality in modern mosques and questions whether the modification of geometrical features produce spirituality in the same manner. The research also seeks to investigate the role of ‘geometry’ in the modern mosque architecture. The research employs the analytical study of some modern mosque examples in the Kingdom of Bahrain, reflecting on the geometry and symbolism adopted in the new mosque architecture design. It buttresses the analysis by the engagement of people’s perceptions derived using a survey of opinions. The research expects to see the significance of geometrical architectural elements in the mosque designs. It will find answers to the questions such as; what is the role of the form of the mosque, interior spaces and the effect of the modified symbolic features in the modern mosque design? How can the symbolic geometry, forms and spaces of a mosque invite a believer to leave the worldly environment behind and move towards spirituality?

Keywords: geometry, mosque architecture, spirituality, symbolism

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Authors: Zahra Ghasemi, Fatemeh Babaei

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Plasma-derived medicinal products are vital categories of biological therapies. These products are used to treat rare, chronic, severe, and life-threatening conditions, such as bleeding disorders (Hemophilia A and B), hemolytic disease of the fetus and newborn, severe infections, burns and liver diseases, and other diseases caused by the absence or malfunction of certain proteins. In addition, they improve the patient’s quality of life. The process of producing plasma-derived medicinal products begins with the collection of human plasma from healthy donors. This initial stage is complex and is monitored with high precision and sensitivity by global authorities to maintain the quality and safety of the final products as well as the health of the donors. The amount of manufactured plasma-derived medicinal products depends on the availability of its raw material, human plasma, so collecting enough plasma for fractionation is essential. Therefore, adopting a suitable national policy regarding plasma donation, establishing collection centers, and increasing public awareness of the importance of plasma donation will improve any country’s conditions regarding the timely and sufficient supply of these medicines. In this study, we tried to briefly examine the importance of sustainability of the plasma industry and its situation in our beloved country of Iran.

Keywords: plasma, source plasma, plasma-derived medicinal products, fractionation

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Authors: Cassandra Springate, Alexandra Furber, Jack E. Hines

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Objectives: To create an evidence map of the cost-utility studies available with non-small cell lung cancer patients, and identify the geographical settings and interventions used. Methods: Using the Disease, Study Type, and Model Type filters in heoro.com we identified all cost-utility studies published between 1960 and 2017 with patients with non-small cell lung cancer. These papers were then indexed according to pre-specified categories. Results: Heoro.com identified 89 independent publications, published between 1995 and 2017. Of the 89 papers, 74 were published since 2010, 28 were from the USA, and 35 were from Europe, 16 of which were from the UK. Other publications were from China and Japan (13), Canada (9), Australia and New Zealand (4), and other countries (8). Fifty-nine studies included a chemotherapy intervention, of which 23 included erlotinib or gefitinib, 21 included pemetrexed or docetaxel, others included nivolumab (3), pembrolizumab (2), crizotinib (2), denosumab (2), necitumumab (1), and bevacizumab (1). Also, 19 studies modeled screening, staging, or surveillance strategies. Conclusions: The cost-utility studies found for NSCLC most commonly looked at the effectiveness of different chemotherapy treatments, with some also evaluating the addition of screening strategies. Most were also conducted with patient data from the USA and Europe.

Keywords: cancer, cost-utility, economic model, non-small cell lung cancer

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Authors: J. Bernasovská, R. Lohajová Behulová, E. Petrejčiková, I. Boroňová, I. Bernasovský

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Y chromosome microdeletions are the most common genetic cause of male infertility and screening for these microdeletions in azoospermic or severely oligospermic men is now standard practice. Analysis of the Y chromosome in men with azoospermia or severe oligozoospermia has resulted in the identification of three regions in the euchromatic part of the long arm of the human Y chromosome (Yq11) that are frequently deleted in men with otherwise unexplained spermatogenic failure. PCR analysis of microdeletions in the AZFa, AZFb and AZFc regions of the human Y chromosome is an important screening tool. The aim of this study was to analyse the type of microdeletions in men with fertility disorders in Slovakia. We evaluated 227 patients with azoospermia and with normal karyotype. All patient samples were analyzed cytogenetically. For PCR amplification of sequence-tagged sites (STS) of the AZFa, AZFb and AZFc regions of the Y chromosome was used Devyser AZF set. Fluorescently labeled primers for all markers in one multiplex PCR reaction were used and for automated visualization and identification of the STS markers we used genetic analyzer ABi 3500xl (Life Technologies). We reported 13 cases of deletions in the AZF region 5,73%. Particular types of deletions were recorded in each region AZFa,b,c .The presence of microdeletions in the AZFc region was the most frequent. The study confirmed that percentage of microdeletions in the AZF region is low in Slovak azoospermic patients, but important from a prognostic view.

Keywords: AZF, male infertility, microdeletions, Y chromosome

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Authors: Swati Kishor Zode, Rahul Ambekar

Abstract:

Data mining is the extraction of fascinating examples on the other hand information from enormous measure of information and choice is made as indicated by the applicable information extracted. As of late, with the dangerous advancement in internet, stockpiling of information and handling procedures, privacy preservation has been one of the major (higher) concerns in data mining. Various techniques and methods have been produced for protection saving data mining. In the situation of Clinical Decision Support System, the choice is to be made on the premise of the data separated from the remote servers by means of Internet to diagnose the patient. In this paper, the fundamental thought is to build the precision of Decision Support System for multiple diseases for different maladies and in addition protect persistent information while correspondence between Clinician side (Client side) also, the Server side. A privacy preserving protocol for clinical decision support network is proposed so that patients information dependably stay scrambled amid diagnose prepare by looking after the accuracy. To enhance the precision of Decision Support System for various malady C5.0 classifiers and to save security, a Homomorphism encryption algorithm Paillier cryptosystem is being utilized.

Keywords: classification, homomorphic encryption, clinical decision support, privacy

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Authors: Kaoutar Chbihi, Aziza Menouni, Imane Berni, Tarik Abchouch, Samir El Jaafari

Abstract:

The unpredictability and ambiguity of a pandemic, combined with the economic impact, sedentary lifestyle, and increased living cost, have the potential to seriously raise the risk of mental health issues among the population. Therefore, this study had the aim to assess the magnitude of mental health outcomes and risk factors among the general population in Morocco in times of the Covid-19 pandemic. This study consisted of a cross-sectional design and was survey-based and region-stratified by collecting demographic data and mental health measurements from 523 participants. The degree of depression, anxiety, and insomnia symptoms were assessed by using the 9-item Patient Health Questionnaire and the 7-items Generalized Anxiety Disorder. The survey was completed by 523 individuals. Results showed that 67.9% were women, and 58.6% were aged 18-30 years. 49% of participants reported depression issues, while 39.8% experienced anxiety. Being a married woman with children was associated with severe symptoms of depression and anxiety. Finally, our findings reported a significant mental health burden among the general population of Morocco, which needs to be tackled by specific co-created interventions and adapted strategies in order to prevent impacts on public health.

Keywords: anxiety, COVID-19, depression, mental health, Morocco, pandemic

Procedia PDF Downloads 79

Authors: Huang Wei-Yi

Abstract:

Purpose: Oral cancer patients undergoing skin flap reconstruction may have wounds in the oral cavity, leading to accumulation of blood, clots, and secretions. Inadequate oral care by nursing staff can result in oral infections and pain. Methods: An investigation revealed that ICU nurses' knowledge and adherence to oral care standards were below acceptable levels. Key issues identified included lack of hands-on training opportunities, insufficient experience, absence of oral care standards and regular audits, no in-service education programs, and a lack of oral care educational materials. Interventions: The following measures were implemented: 1) in-service education programs, 2) development of care standards, 3) creation of a monitoring plan, 4) bedside demonstration teaching, and 5) revision of educational materials. Results: The intervention demonstrated that ICU nurses' knowledge and adherence to oral care standards improved, leading to better quality oral care and reduced pain for patients. Conclusion: Through in-service education, bedside demonstrations, establishment of oral care standards, and regular audits, the oral care skills of ICU nurses were significantly enhanced, resulting in improved oral care quality and decreased patient pain.

Keywords: oral care, ICU, improving, oral cancer

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Authors: Valerie Isaak

Abstract:

Background: This study explores the effectiveness of refresher training sessions of an intervention program at reducing the employees’ risk of injury due to patient violence in a forensic psychiatric hospital. Methods: The original safety intervention program that consisted of a 3 days’ workshop was conducted in the maximum-security ward of a psychiatric hospital in Israel. Ever since the original intervention, annual refreshers were conducted, highlighting one of the safety elements covered in the original intervention. The study examines the effect of the intervention program along with the refreshers over a period of 10 years in four wards. Results: Analysis of the data demonstrates that beyond the initial reduction following the original intervention, refreshers seem to have an additional positive long-term effect, reducing both the number of violent incidents and the number of actual employee injuries in a forensic psychiatric hospital. Conclusions: We conclude that such an intervention program followed by refresher training would promote employees’ wellbeing. A healthy work environment is part of management’s commitment to improving employee wellbeing at the workplace.

Keywords: wellbeing, violence at work, intervention program refreshers, public sector mental healthcare

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Authors: Djallel Bouamama, Yasser R. Haddadi

Abstract:

Accurate brain tumor segmentation is crucial for diagnosis and treatment planning, yet it remains a challenging task due to the variability in tumor shapes and intensities. This paper introduces a distinct approach to brain tumor image segmentation by leveraging an advanced architecture known as Mamba-Unet. Building on the well-established U-Net framework, Mamba-Unet incorporates distinct design enhancements to improve segmentation performance. Our proposed method integrates a multi-scale attention mechanism and a hybrid loss function to effectively capture fine-grained details and contextual information in brain MRI scans. We demonstrate that Mamba-Unet significantly enhances segmentation accuracy compared to conventional U-Net models by utilizing a comprehensive dataset of annotated brain MRI scans. Quantitative evaluations reveal that Mamba-Unet surpasses traditional U-Net architectures and other contemporary segmentation models regarding Dice coefficient, sensitivity, and specificity. The improvements are attributed to the method's ability to manage class imbalance better and resolve complex tumor boundaries. This work advances the state-of-the-art in brain tumor segmentation and holds promise for improving clinical workflows and patient outcomes through more precise and reliable tumor detection.

Keywords: brain tumor classification, image segmentation, CNN, U-NET

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Authors: Claire Williams

Abstract:

Randomised controlled Trials (RCTs) of efficacy are still perceived as the gold standard for the generation of evidence, and whilst advances in data collection methods are well developed, this progress has not been matched for the reporting of adverse events (AEs). Assessment and reporting of AEs in clinical trials are fraught with human error and inefficiency and are extremely time and resource intensive. Recent research conducted into the quality of reporting of AEs during clinical trials concluded it is substandard and reporting is inconsistent. Investigators commonly send reports to sponsors who are incorrectly categorised and lacking in critical information, which can complicate the detection of valid safety signals. In our presentation, we will describe an electronic data capture system, which has been designed to support clinical trial processes by reducing the resource burden on investigators, improving overall trial efficiencies, and making trials safer for patients. This proprietary technology was developed using expertise proven in the delivery of the world’s first prospective, phase 3b real-world trial, ‘The Salford Lung Study, ’ which enabled robust safety monitoring and reporting processes to be accomplished by the remote monitoring of patients’ EHRs. This technology enables safety alerts that are pre-defined by the protocol to be detected from the data extracted directly from the patients EHR. Based on study-specific criteria, which are created from the standard definition of a serious adverse event (SAE) and the safety profile of the medicinal product, the system alerts the investigator or study team to the safety alert. Each safety alert will require a clinical review by the investigator or delegate; examples of the types of alerts include hospital admission, death, hepatotoxicity, neutropenia, and acute renal failure. This is achieved in near real-time; safety alerts can be reviewed along with any additional information available to determine whether they meet the protocol-defined criteria for reporting or withdrawal. This active surveillance technology helps reduce the resource burden of the more traditional methods of AE detection for the investigators and study teams and can help eliminate reporting bias. Integration of multiple healthcare data sources enables much more complete and accurate safety data to be collected as part of a trial and can also provide an opportunity to evaluate a drug’s safety profile long-term, in post-trial follow-up. By utilising this robust and proven method for safety monitoring and reporting, a much higher risk of patient cohorts can be enrolled into trials, thus promoting inclusivity and diversity. Broadening eligibility criteria and adopting more inclusive recruitment practices in the later stages of drug development will increase the ability to understand the medicinal products risk-benefit profile across the patient population that is likely to use the product in clinical practice. Furthermore, this ground-breaking approach to AE detection not only provides sponsors with better-quality safety data for their products, but it reduces the resource burden on the investigator and study teams. With the data taken directly from the source, trial costs are reduced, with minimal data validation required and near real-time reporting enables safety concerns and signals to be detected more quickly than in a traditional RCT.

Keywords: more comprehensive and accurate safety data, near real-time safety alerts, reduced resource burden, safer trials

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Authors: Merve Aydin, Mağfiret Kara Kaşikçi

Abstract:

Aim: To determine the perceptions of inpatients about care at Farabi Hospital in KTU. Material and Method: This research was conducted by using the universe known examples of formulas and probability selected by sampling method with 277 chosen patients in the hospital at least 14 days in other internal and surgical clinics except for pediatric, psychiatry, and intensive care unit services between January-March 2014 in KTU Farabi Hospital. The data was collected through the forms of nursing care perception scale of patients and defining characteristics of patients. In the evaluation of data, percentage, mean, Mann Whitney U, Student t and Kurskall Wallis tests were applied. Results: The average point the patients got in nursing care perception scale is 62.64±10.08’dir. 48.7 % of patients regard nursing care well and 36.8 % of them regard it very well. 19 % of the patients regard nursing care badly. When the age, sex, occupation, marital status, educational background, residential place, income level, hospitalization period, hospitalization clinic and having a hospital attendant were compared with nursing care perception average point, the difference among point averages was not found meaningful statistically (p > 0.05). The average point of nursing care perception was found greater in those having chronic disease (p < 0.05). Conclusion: The perception point of patients about nursing care is above the average according to the average of the lowest and highest points. The great majority of patients regard nursing care well or very well.

Keywords: hospital, patient, perception of nursing care, nursing care

Procedia PDF Downloads 396