Search results for: medical imagine

Authors: Siyuan Cai

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This paper takes community segregation during major infectious diseases as the background, based on the physiological needs and safety needs of citizens during home segregation, and based on the selection of convenient facilities and medical facilities as the main research objects. Based on the POI data of public facilities in Chongqing, the spatial distribution characteristics of the convenience and medical facilities in the 15-minute living circle centered on three neighborhoods in Shapingba, namely Shengwei Community, Anju Commmunity and Fengtian Garden Community, were explored by means of GIS spatial analysis. The results show that the spatial distribution of convenience and medical facilities in this area has significant clustering characteristics, with a point-like distribution pattern of "dense in the west and sparse in the east", and a grouped and multi-polar spatial structure. The spatial structure is multi-polar and has an obvious tendency to the intersections and residential areas with dense pedestrian flow. This study provides a preliminary exploration of the distribution of medical and convenience facilities within the 15-minute living circle of a segregated community, which makes up for the lack of spatial research in this area.

Keywords: ArcGIS, community segregation, convenient facilities; distribution pattern, medical facilities, POI, 15-minute community life circle

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Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa

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Introduction: An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavored to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learners. Aim: Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Methods: Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Results: Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. Discussion: After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Conclusion: Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.

Keywords: ethics, medical student, doubt, medical education, faith

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Authors: Keiko Yamauchi, Motoyuki Nakao, Yoko Ishihara

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The increase in the number of women with breast cancer in Japan has required hospitals to provide a higher quality of medicine so that patients are satisfied with the treatment they receive. However, patients’ satisfaction following breast cancer treatment has not been sufficiently studied. Hence, we investigated the factors influencing patient satisfaction following breast cancer treatment among Japanese women. These women underwent either breast-conserving surgery (BCS) (n = 380) or total mastectomy (TM) (n = 247). In March 2016, we conducted a cross-sectional internet survey of Japanese women with breast cancer in Japan. We assessed the following factors: socioeconomic status, cancer-related information, the role of medical decision-making, the degree of satisfaction regarding the treatments received, and the regret arising from the medical decision-making processes. We performed logistic regression analyses with the following dependent variables: extreme satisfaction with the treatments received, and regret regarding the medical decision-making process. For both types of surgery, the odds ratio (OR) of being extremely satisfied with the cancer treatment was significantly higher among patients who did not have any regrets compared to patients who had. Also, the OR tended to be higher among patients who chose to play a wanted role in the medical decision-making process, compared with patients who did not. In the BCS group, the OR of being extremely satisfied with the treatment was higher if, at diagnosis, the patient’s youngest child was older than 19 years, compared with patients with no children. The OR was also higher if patient considered the stage and characteristics of their cancer significant. The OR of being extremely satisfied with the treatments was lower among patients who were not employed on full-time basis, and among patients who considered the second medical opinions and medical expenses to be significant. These associations were not observed in the TM group. The OR of having regrets regarding the medical decision-making process was higher among patients who chose to play a role in the decision-making process as they preferred, and was also higher in patients who were employed on either a part-time or contractual basis. For both types of surgery, the OR was higher among patients who considered a second medical opinion to be significant. Regardless of surgical type, regret regarding the medical decision-making process decreases treatment satisfaction. Patients who received breast-conserving surgery were more likely to have regrets concerning the medical decision-making process if they could not play a role in the process as they preferred. In addition, factors associated with the satisfaction with treatment in BCS group but not TM group included the second medical opinion, medical expenses, employment status, and age of the youngest child at diagnosis.

Keywords: medical decision making, breast-conserving surgery, total mastectomy, Japanese

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Authors: Laura Brennan, Ram Balakumar

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ChatGPT has been developed by Open AI (Nov 2022) as a powerful artificial intelligence (AI) language model which has been designed to produce human-like text from user written prompts. To gain the most from the system, user written prompts must give context specific information. This article aims to give guidance on how to optimise the ChatGPT system in the context of education for otolaryngology. Otolaryngology is a specialist field which sees little time dedicated to providing education to both medical students and doctors. Additionally, otolaryngology trainees have seen a reduction in learning opportunities since the COVID-19 pandemic. In this article we look at these various barriers to medical education in Otolaryngology training and suggest ways that ChatGPT can overcome them and assist in simulation-based training. Examples provide how this can be achieved using the Authors’ experience to further highlight the practicalities. What this article has found is that while ChatGPT cannot replace traditional mentorship and practical surgical experience, it can serve as an invaluable supplementary resource to simulation based medical education in Otolaryngology.

Keywords: artificial intelligence, otolaryngology, surgical training, medical education

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Authors: Volkan Kaya, Ersin Elbasi

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Watermarking and stenography are getting importance recently because of copyright protection and authentication. In watermarking we embed stamp, logo, noise or image to multimedia elements such as image, video, audio, animation and text. There are several works have been done in watermarking for different purposes. In this research work, we used watermarking techniques to embed patient information into the medical magnetic resonance (MR) images. There are two methods have been used; frequency domain (Digital Wavelet Transform-DWT, Digital Cosine Transform-DCT, and Digital Fourier Transform-DFT) and spatial domain (Least Significant Bits-LSB) domain. Experimental results show that embedding in frequency domains resist against one type of attacks, and embedding in spatial domain is resist against another group of attacks. Peak Signal Noise Ratio (PSNR) and Similarity Ratio (SR) values are two measurement values for testing. These two values give very promising result for information hiding in medical MR images.

Keywords: watermarking, medical image, frequency domain, least significant bits, security

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Authors: Benny Sand, Yotam Lurie, Shlomo Mark

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Medical Internet of Things (MIoT), AI, and data privacy are linked forever in a gordian knot. This paper explores the conflicts of interests between the stakeholders regarding data privacy in the MIoT arena. While patients are at home during healthcare hospitalization, MIoT can play a significant role in improving the health of large parts of the population by providing medical teams with tools for collecting data, monitoring patients’ health parameters, and even enabling remote treatment. While the amount of data handled by MIoT devices grows exponentially, different stakeholders have conflicting understandings and concerns regarding this data. The findings of the research indicate that medical teams are not concerned by the violation of data privacy rights of the patients' in-home healthcare, while patients are more troubled and, in many cases, are unaware that their data is being used without their consent. MIoT technology is in its early phases, and hence a mixed qualitative and quantitative research approach will be used, which will include case studies and questionnaires in order to explore this issue and provide alternative solutions.

Keywords: MIoT, data privacy, stakeholders, home healthcare, information privacy, AI

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Authors: Lelika Lazarus, Reshma Sookrajh, Kapil S. Satyapal

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Reflecting on teaching is commonly cited as a fundamental practice for personal and professional development. Educational research into the scholarship of teaching and learning anatomy includes engaging in discipline specific literature on teaching, reflecting on individual teaching methods and communicating these findings to peers. The aim of this paper is to formally assess the opinions of senior anatomy instructors regarding the state of anatomical knowledge at their respective institutions. The context of the paper derives from ongoing debates about the perceived decline in standards of anatomical knowledge of medical students and postgraduate learners. An open ended questionnaire was devised consisting of eight direct questions seeking opinions on anatomy teaching, knowledge, and potential educational developments and general thoughts on the teaching of anatomy to medical students. These were distributed to senior anatomy Faculty (identified by the author by their affiliation with the Anatomical Society of Southern Africa) based at the eight national medical schools within the country. A number of key themes emerged. Most senior faculty felt that the standard of medical education at their respective institutions was ‘good.’. However, emphasis was also placed on the ‘quality of teaching’ incorporating clinical scenarios. There were also indications that staff are split into those that are keen to do research and those that are happy to provide teaching to medical students as their primary function. Several challenges were also highlighted such as time constraints within the medical curriculum, the lack of cadavers to reinforce knowledge and gain depth perception and lack of appropriately qualified staff. Recommendations included fostering partnerships with both clinicians and medical scientists into the anatomy curriculum thus improving teaching and research.

Keywords: anatomy, education, reflection, teaching

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Authors: H. Al-Khalaifa, A. Al-Nasser

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The viewpoint towards the use of drugs or vaccines against avian parasitic diseases is one of the most striking challenges in avian medical parasitology. This includes many difficulties associated with drug resistance and in developing prophylactic vaccines. In many instances, the potential success of a vaccination in controlling parasitic diseases in poultry is well-documented. However, some medical, technical and financial limitations are still paramount. On the other hand, chemotherapy is not very well-recommended due to a number of medical limitations. But in the absence of an effective vaccine, drugs are used against parasitic diseases. This paper sheds light on some the advantages and disadvantages of using vaccination and drugs in controlling parasitic diseases in poultry species. The usage of chemotherapeutic drugs is discussed with some examples. Then, more light will be shed on using vaccines as a potentially effective and promising control tool.

Keywords: drugs, parasitology, poultry, vaccines

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Authors: Hannah Yael Ephraim

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During reproductive age (between 15 and 44), women are particularly susceptible to psychiatric illness. Depression and anxiety disorders are especially common for women during reproductive age. Women of reproductive age are also at greater risk for multiple physical conditions during this time. Existing literature focuses on the impact of mental health on physical health, showing that people with anxiety and depression repeatedly show greater physical health risk among those with developing chronic medical illness. However, there is limited research on the impact physical health has on mental health in women of reproductive age, a large and vulnerable population. For this reason, the current study seeks to ask the following questions: are women of reproductive age with a diagnosis of a chronic physical condition more likely to experience symptoms of mental illness than women without a diagnosis of a chronic physical condition? Does the type of physical illness relate to signs and symptoms of depression and anxiety? A quasi-experimental research design was implemented to compare the mental health outcomes of women with the diagnosis of chronic medical conditions and women without the diagnosis of a chronic medical condition. Quantitative data was collected through an anonymous ten-minute Qualtrics survey. The survey was sent out through multiple online platforms. The sample includes two groups of women: one group with the diagnosis of a chronic medical illness, and one group without a diagnosis and/or symptoms (N = 541). Participants identify as a woman and are between the ages of 15 and 44. A comparison of women with a diagnosis of a chronic physical condition and those without a diagnosis will be conducted to explore differences in depression and anxiety symptoms between women with and without a chronic medical diagnosis. The impact race, SES, and occupation will also be addressed in relation to anxiety and/or depression in women of reproductive age. This study will further the understanding of the relationship between mental illness in women of reproductive age with chronic medical conditions. The results of this study will have implications for the integration of mental health care in women’s health centers and perhaps training of clinicians and physicians providing psychological and medical care to women of reproductive age.

Keywords: mental health, physical health, reproductive age, women

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Authors: N. Al Khashan, H. Al Shammari, W. Al Bahli

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Patients who are eligible to receive treatment at the National Guard Health Affairs (NGHA), Saudi Arabia will typically have four medical record numbers (MRN), one in each of the geographical areas. More hospitals and primary healthcare facilities in other geographical areas will launch soon which means more MRNs. When patients own four MRNs, this will cause major drawbacks in patients’ quality of care such as creating new medical files in different regions for relocated patients and using referral system among regions. Consequently, the access to a patient’s medical record from other regions and the interoperability of health information between the four hospitals’ information system would be challenging. Thus, there is a need to unify medical records among these five facilities. As part of the effort to increase the quality of care, a new Hospital Information Systems (HIS) was implemented in all NGHA facilities by the end of 2016. NGHA’s plan is put to be aligned with the Saudi Arabian national transformation program 2020; whereby 70% citizens and residents of Saudi Arabia would have a unified medical record number that enables transactions between multiple Electronic Medical Records (EMRs) vendors. The aim of the study is to explore the plan, the challenges and barriers of unifying the 4 MRNs into one Enterprise Patient Identifier (EPI) in NGHA hospitals by December 2018. A descriptive study methodology was used. A journey map and a project plan are created to be followed by the project team to ensure a smooth implementation of the EPI. It includes the following: 1) Approved project charter, 2) Project management plan, 3) Change management plan, 4) Project milestone dates. Currently, the HIS is using the regional MRN. Therefore, the HIS and all integrated health care systems in all regions will need modification to move from MRN to EPI without interfering with patient care. For now, the NGHA have successfully implemented an EPI connected with the 4 MRNs that work in the back end in the systems’ database.

Keywords: consumer health, health informatics, hospital information system, universal medical record number

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Authors: Nangialai Yousufzai, Eysosiyas Etana, Ikuo Sugiyama

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Kabul population has been growing continually since 2001 and reaching six million in 2025 due to the rapid inflow from the neighboring countries. As a result of the population growth, lack of living facilities supported by infrastructure services is becoming serious in social and economic aspects. However, about 70% of the city is still occupied illegally and the government has little information on the infrastructure demands. To improve this situation, land readjustment is one of the powerful development tools, because land readjustment does not need a high governmental budget of itself. Instead, the method needs cooperation between stakeholders such as landowners, developers and a local government. So it is becoming crucial for both government and citizens to implement land readjustment for providing tidy urban areas with enough public services to realize more livable city as a whole. On the contrary, the traditional land readjustment tends to spend a long time until now to get consensus on the new plan between stakeholders. One of the reasons is that individual land area (land parcel) is decreased due to the contribution to public such as roads/parks/squares for improving the urban environment. The second reason is that the new plan is difficult for dwellers to imagine new life after the readjustment. Because the paper-based plan is made by an authority not for dwellers but for specialists to precede the project. This paper aims to shorten the time to realize quick consensus between stakeholders. The first improvement is utilizing questionnaire(s) to assess the demand and preference of the landowners. The second one is utilizing 3D model for dwellers to visualize the new environment easily after the readjustment. In additions, the 3D model is reflecting the demand and preference of the resident so that they could select a land parcel according to their sense value of life. The above-mentioned two improvements are carried out after evaluating total land prices of the new plans to select for maximizing the project value. The land price forecasting formula is derived from the current market ones in Kabul. Finally, it is stressed that the rapid consensus-building of land readjustment utilizing ICT and open data analysis is essential to redevelop slums and illegal occupied areas in Kabul.

Keywords: land readjustment, consensus building, land price formula, 3D simulation

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Authors: Vijaya Yuvaram Singh V M, Kameshwar Rao J V

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The challenge with development of neural network based methods for medical is the availability of data. Anatomical landmark detection in the medical domain is a process to find points on the x-ray scan report of the patient. Most of the time this task is done manually by trained professionals as it requires precision and domain knowledge. Traditionally object detection based methods are used for landmark detection. Here, we utilize reinforcement learning and query based method to train a single agent capable of detecting multiple landmarks. A deep Q network agent is trained to detect single and multiple landmarks present on hip and shoulder from x-ray scan of a patient. Here a single agent is trained to find multiple landmark making it superior to having individual agents per landmark. For the initial study, five images of different patients are used as the environment and tested the agents performance on two unseen images.

Keywords: reinforcement learning, medical landmark detection, multi target detection, deep neural network

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Authors: Nurul Azmawati Mohamed, Zarini Ismail, Shalinawati Ramli, Nurul Hayati Chamhuri, Nur Syahrina Rahim, K. Omar

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Choosing a career is one of the most important decisions in our life. A right career leads a person to grow with that career and achieve success through the decision. Thus, career suitability assessment is important to help individuals to understand how a variety of personal attributes can impact their potential success and satisfaction with different career options and work environments. Some career needs specific personality trait that relates to attributes of job requirements and commitments. For medicine, being caring, approachable, inquisitive, able to listen and understand patients’ pain, anxiety and sorrow are important. The aim of this study was to evaluate the career suitability of pre-clinical students. This was a cross sectional study conducted among pre-clinical medical students in Universiti Sains Islam Malaysia. 'Sidek Career Interest Inventory’ was used to assess the students’ suitability for the course. This instrument had been validated locally to suit the local social and cultural context. It assessed the students’ personality trait based on Holland’s theory and their interests. For students to pursue in the medical course, two main personality trait are believed to be essential namely investigative and social trait personalities. Some of the characteristics of investigative trait are analytical, rational, intellectual and curious, while the characteristics of social trait personality include empathy, friendly, understanding and accommodating. The score for each personality trait were categorized as low (0-3.99), moderate (4-6.99) and high (7-10). A total of 81 pre-clinical medical students were included in this study. About two third (93.8%) of them were female and all of them are from 20 to 21 of age. Approximately, half of the students (47.5%) scored high and another 46.3% scored moderate for investigative trait. For social trait, only 13.8% scored high while 31.3% scored moderate. Only 12.5% (10) students had high scores for both investigative and social traits. Most of the pre-clinical medical students scored high in the investigative sections, however their social values were inadequate (low scores). For them to become good medical doctors, they should be good in both investigative and social skills to enhance their suitability for this career. Therefore, there is a need to nurture these medical students with appropriate social values and soft skills.

Keywords: career suitability, career interest, medical students, personality trait

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Authors: Katarzyna Pasternak

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Experiencing the meaning of life is widely recognised as a vital element of well-being and central human motivation. Studies have shown that a higher meaning of life is associated, among other things, with a higher quality of life, higher levels of happiness and better declared health. The subject of the study is the meaning in life measured with The Meaning in Life Questionnaire and the presence of such emotions as nostalgia, awe and hope, and the content of imaginations measured after temporal mental simulations in Americans and Poles. The respondents had to imagine themselves in future, in 40 years and describe two events that would take place at that time. Next, participants assessed the importance of the events described by them, recognised whether during their journey through time they felt awe, hope and nostalgia, and answered the questionnaire examining the meaning in life. 204 (102 from Poland 102 from the USA ) people aged 21 to 60 participated in the study. The study checked whether there were differences in the content of the imaginations of the respondents from Poland and USA, and whether there were statistically significant difference between the declared sense of meaning in life among participants from both countries. The result of the study hane shown that there were no differences in the overall result obtained by the participants in The Meaning in Life Questionnaire , while there were statistically significant differences among the subscales of the questionnaire. It turned out that Americans have a higher presence of meaning in life than Poles, but they obtained lower results in searching of meaning in life. Studies have also shown that there was a statistically significant difference between Poles and Americans in feeling awe after a mental simulation. Poles felt higher level of awe. Images about the future differed between Poles and Americans. Poles judged that the events they described were very important to them. Interestingly, the content of American participants’ imaginations was dominated by topics related to the future of the world, ecology and world peace. There were also ideas about nice moments spent with friends and family. Among Poles, ideas related to professional career and development as well as family events dominated. Research shows that despite the lack of differences in the general meaning in life, Poles are more focused on searching for meaning in life than Americans. The study shows interesting differences between the two cultures.

Keywords: meaning in life, mental simulations, imaginations, temporal mental simulations, future, cultural differences

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Authors: S. Kurian, S. Satpathy, S. K. Gupta, S. Arya, D. K. Sharma

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Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: adverse events, health care technology, medical devices, public sector hospital, reporting systems

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Authors: Hao-Jun Hong, Jung-Tang Huang

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The world is gradually becoming an aging society, and with the lack of laboring forces, this phenomenon is affecting the nation’s economy growth. Although nursing centers are booming in recent years, the lack of medical resources are yet to be resolved, thus creating an innovative wearable medical device could be a vital solution. This research is focused on the design and development of a wearable device which obtains a more precise heart failure measurement than products on the market. The method used by the device is based on the sensor fusion and big data algorithm. From the test result, the modified structure of wearable device can significantly decrease the MA (Motion Artifact) and provide users a more cozy and accurate physical monitor experience.

Keywords: big data, heart failure, motion artifact, sensor fusion, wearable medical device

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Authors: Carmen Nechita

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This research explores the world of Syrian refugee women living in Dresden and their efforts to reconstruct their lives in the state of Saxony in Germany. The focus is on the initial period of adjustment and understanding how refugee women use culture, family ties, and tradition to contest and rebuild new relationships with the host country. Faced with a new status as “the refugee”, women have to re-imagine their ethno-cultural identity in order to cope with life in Diaspora. In order to understand the coping mechanism and the displacement effects on Syrian women, interviews with twelve refugee women were conducted. Traumatic experiences of loss and oppression are at the core of their confessions. While gender violence, abuse and patriarchal framework shape their narratives, this research argues that there is a need to look at this from a cultural perspective and try to distance ourselves from the western paradigm. The way Syrian women refute and rebuild their national and ethno-cultural identity in order to negotiate for themselves new space within German borders is explored. Two discourses are bridged: one of multiculturalism and one of tradition in order to explain how Syrian women experience western notions of family, womanhood and spousal dynamics. The process is painful, traumatic and marked by feelings of low self-worth, but in the end, new codes emerge and these women come out more empowered. The paper includes the migration experience and explores the ways in which Syrian refugee women tend to tell their complex stories, and how they reconstruct their identity in a new territory while faced with a different culture that discriminates against them. During the research, four distinct phases in the acculturation period were identified: “the survival”, “the honeymoon period”, “the isolation period” and “the anger period”. Each phase is analyzed in order to understand what triggers them, how women migrate from one phase to another and what can be done to make the process easier. This paper contributes to the field of refugee studies by offering a thorough understanding of the initial phases of the acculturation process in the case of Syrian refugee women. The study examines the fleeing and settlement experience in order to understand the complex ways that refugee women cope with the traumatic experience of settlement in another country and in a different culture. *Almanya: The Arabic word for Germany.

Keywords: displacement, migration, refugee women, Syria

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Authors: Maryam Nzari

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Today, with the advancement of Internet technology, one of the tools used by humans is a tool that allows them to do what they need easily. Online platforms in different forms and by providing different services make it possible for users to communicate with each other and users with platforms. Audience communication with mass media is not the same as in the past. Today the conditions are different; With online platforms that provide the latest news minute by minute, he has access to all the content and can choose more quickly and easily. According to professionals Galloway, Apple, Amazon, Facebook and Google companies create a wide range. They are among the products and services that are connected with the daily life of billions of people all over the planet. Over time, platforms gain high economic value and in this way gain power that will influence the social, cultural, economic and political aspects of people’s lives. As a result of the effects of the process of platformization on all areas of individual and collective life, we now live in a platform society, which communicates It is close to “platform politics”. Nowadays, with social media platforms, users can interact with many people and people can share their data on various topics with others in this space. In this research, what will be investigated is the role of these online platforms in economic growth and the introduction of local culture areas in tourist areas. Tourism in a region is linked with various factors; One of the important factors that attract tourists to a region is its culture, and on the other hand, this culture can also affect economic growth. Without a proper understanding of the culture of these tourist areas, it is not possible to plan properly for the growth of the tourism industry and the subsequent increase in economic growth. The interaction of local people and tourists will have social and cultural effects on each other and will give them the opportunity to get to know each other. Therefore, the purpose of this research is to examine issues such as the role that online platforms play in cultural interaction in tourist areas and to understand that online platforms are only seeking to show the good aspects of a region and then generate enough extra income or that platforms can They play a role beyond what we imagine and introduce the culture of a region in a proper way so that we don’t see disagreements in the tourism planning of that region. in this article It has been tried by using library and field methods Answer the questions.

Keywords: online platforms, economic growth, culture Indigenous, tourism

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Authors: Madhav Pant, Khem N. Poudel

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Wireless power transfer is continuously becoming more powerful and compact in medical implantable devices and the wide range of applications. A rectenna is designed for wireless power transfer technique that can be applied to medical implant devices. The experiment is performed using ANSYS HFSS, a full wave electromagnetic simulation. The dipole antenna combinations operating at 2.4 GHz are used for wireless power transfer and the maximum DC voltage reception by the implant considering International Commission on Non-Ionizing Radiation Protection (ICNIRP) regulation. The power receiving dipole antenna is placed inside the cylindrical geometry having the similar properties of the human body at the frequency of 2.4 GHz. Our design can provide the power at the depth of 5 mm skin and 5mm of bone for the implant. The voltage doubler/quadrupler rectifier in ANSYS Simplorer is used to calculate the exact DC current utilized by implant inside the human body. The qualitative design and analysis of this wireless power transfer method could also be used for other biomedical implants systems such as cardiac pacemaker, insulin pump, and retinal implants.

Keywords: dipole antenna, medical implants, wireless power transfer, rectifier

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Authors: Manushi Srivastava

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Introduction: Doctor’s role, and relation with respect to patient care is at the core of medical ethics. The rapid pace of medical advances along with increasing consumer awareness about their rights and hike in cost of effective health care demand a robust, transparent and patient-friendly medical care system. However, doctors’ role performance is still in the frame of activity-passivity model of Doctor-Patient Relationship (DPR) where doctors act as parent and use to instruct their patients, without their consensus that is not going to help in the 21st century. Thus the current situation is a new challenge for traditional doctor-patient relationship after the introduction of Consumer Protection Act (CPA) in medical profession and the same is evidenced by increasing cases of medical litigation. To strengthen this system of medical services, the doctor plays a vital role, and the same should be reviewed in the present context. Objective: To understand the opinion of consultants regarding medical negligence and effect of Consumer Protection Act in terms of current practices of patient care. Method: This is a cross-sectional study in which both quantitative and qualitative methods are applied. Total 69 consultants were selected from multi-specialty hospitals of densely populated Varanasi city catering a population of about 1.8 million. Two-stage sampling was used for selection of respondents. At the first stage, selection of major wards (Medicine, Surgery, Ophthalmology, Gynaecology, Orthopaedics, and Paediatrics) was carried out, which are more susceptible to medical negligence. At the second stage, selection of consultants from the respective wards was carried out. In-depth Interviews were conducted with the help of semi-structured schedule. Two case studies of medical negligence were also carried out as part of the qualitative study. Analysis: Data were analyzed with the help of SPSS software (21.0 trial version). Semi-structured research tool was used to know consultant’s opinion about the pattern of medical negligence cases, litigations and claims made by patient community and inclusion of government medical services in CPA. Statistical analysis was done to describe data, and non-parametric test was used to observe the association between the variables. Analysis of Verbatim was used in case-study. Findings and Conclusion: Majority (92.8%) of consultants felt changes in the behaviour of community (patient) after implementation of CPA, as it had increased awareness about their rights. Less than half of the consultants opined that Medical Negligence is an Unintentional act of doctors and generally occurs due to communication gap and behavioural problem between doctor and patients. Experienced consultants ( > 10 years) pointed out that unethical practice by doctors and mal-intention of patient to harass doctors were additional reasons of Medical Negligence. In-depth interview revealed that now patients’ community expects more transparency and hence they demand cafeteria approach in diagnosis and management of cases. Thus as study results, we propose ‘Agreement Model’ of DPR to re-ensure ethical practice in medical profession.

Keywords: doctors, communication, consumer protection act (CPA), medical error

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Authors: Hamed Bagheri, Seyd Javid Shariati

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The effects of type and amount of solvent on lubricant which is used in disposable medical devices are investigated in this article. Two kinds of common solvent, n-Hexane and n-Heptane, are used. The mechanical behavior of syringe has shown that n-Heptane has better mixing ratio and also more effective spray process in the barrel of syringe than n-Hexane because of similar solubility parameter to silicon oil. The results revealed that movement of plunger in the barrel increases when pure silicone is used because non-uniform film is created on the surface of barrel, and also, it seems that the form of silicon is converted from oil to gel due to sterilization process. The results showed that the convenient mixing ratio of solvent/lubricant oil is 80/20.

Keywords: disposal medical devices, lubricant oil, solvent effect, solubility parameter

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Authors: Hassan Wajid, Syed T. Ahmed, Syed G. Haider Jr., Razia Latif, Ahsan Ali, Maira Anam

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The phenomenon of Metamorphosis can be associated with any object, organism, or structure gradually and progressively going through the change of systemic or morphological form. This phenomenon can be integrated while teaching drawing to architecture students. In architectural drawings, metamorphosis’s main focus and purpose are not to completely imitate any object. In the process of drawing, the changes in systemic or morphological form happen until the complete process, and the visuals of the complete process change the drawing, opening up possibilities for the imagination of the perceivers. Metamorphosis in architectural drawings begins with an initial form and, through various noticeable stages, ends up final form or manifestation. How much of the initial form is manifested in the final form and progressively among various intermediate stages becomes an indication of the nature of metamorphosis as a phenomenon. It is important at this stage to clarify that the term metamorphosis is presently being coopted from its original domain, usually in life sciences. In this current exercise, the architectural drawings are to act as an operative analog process transforming one image of art and/or architecture in its broadest sense. That composition is claimed to have come from one source (individual work, a cultural artifact, civilizational remain). It dialectically meets, opposes, or confronts some carefully chosen alien opposites from a different domain. As an example, the layers of a detailed drawing of a Turkish prayer rug of 5 x 7 ratio over a detailed architectural plan of a religious, historical complex can be observed such that the two drawings, though at markedly different scales could dialectically converse with one another and through their mutual congruencies. In the final stage, the idea concludes contradictions across the scales to initiate the analogous roles of metamorphosed third reality, which suggests the previous un-acknowledged architectural or artistic identity. The proposed paper explores the trajectory of reproduction by analyzing drawings through detailed drawing stages and analyzes challenges as well as opportunities in the discovered realm of imagination. This description further aims at identifying factors influencing creativity and innovation in producing architectural drawings through the process of observing drawings from inception to the concluding stage.

Keywords: architectural drawings, metamorphosis, perceptions, discovery

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Authors: Divyani Redhu, Manisha Rathaur

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India has emerged as a very lucrative market for the smartphones in a very short span of time. The number of smartphone users here is growing massively with each passing day. Also, the expansion of internet services to far corners of the nation has also given a push to the smartphone revolution in India. Millennial, also known as Generation Y or the Net Generation is the generation born between the early 1980s and mid-1990s (some definitions extending further to early 2000s). Spanning roughly over 15 years, different social classes, cultures, and continents; it is irrational to imagine that millennial have a unified identity. But still, it cannot be denied that the growing millennial population is not only young but is highly tech-savvy too. It is not just the appearance of the device that today; we call it ‘smart’. Rather, it is the numerous tasks and functions that it can perform which has led its name to evolve as that of a ‘smartphone’. From usual tasks that were earlier performed by a simple mobile phone like making calls, sending messages, clicking photographs, recording videos etc.; today, the time has come where most of our day – to – day tasks are being taken care of by our all-time companion, i.e. smartphones. From being our alarm clock to being our note-maker, from our watch to our radio, our book-reader to our reminder, smartphones are present everywhere. Smartphone has now become an essential device for particularly the millennial to communicate not only with their friends but also with their family, colleagues, and teachers. The study by the researchers would be quantitative in nature. For the same, a survey would be conducted in particularly the capital of India, i.e. Delhi and the National Capital Region (NCR), which is the metropolitan area covering the entire National Capital Territory of Delhi and urban areas covering states of Haryana, Uttarakhand, Uttar Pradesh and Rajasthan. The tool of the survey would be a questionnaire and the number of respondents would be 200. The results derived from the study would primarily focus on the increasing reach of smartphones in India, smartphones as technological innovation and convergent tools, smartphone usage pattern of millennial in India, most used applications by the millennial, the average time spent by them, the impact of smartphones on the personal interactions of millennial etc. Thus, talking about the smartphone technology and the millennial in India, it would not be wrong to say that the growth, as well as the potential of the smartphones in India, is still immense. Also, very few technologies have made it possible to give a global exposure to the users and smartphone, if not the only one is certainly an immensely effective one that comes to the mind in this case.

Keywords: Delhi – NCR, India, millennial, smartphone

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Authors: R. Sumalatha, M. V. Subramanyam

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In medical image processing the quality of the image is degraded in the presence of noise. Especially in ultra sound imaging and Magnetic resonance imaging the data was corrupted by signal dependent noise known as salt and pepper noise. Removal of noise from the medical images is a critical issue for researchers. In this paper, a new type of technique Adaptive Spatial Mask Filter (ASMF) has been proposed. The proposed filter is used to increase the quality of MRI and ultra sound images. Experimental results show that the proposed filter outperforms the implementation of mean, median, adaptive median filters in terms of MSE and PSNR.

Keywords: salt and pepper noise, ASMF, PSNR, MSE

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Authors: Ikuko Tomomatsu, Beverley Anne Yamamoto

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Background: There has been an increase in the number of Children with Complex Medical Care Needs (CCMCN) living outside hospital settings in Japan. Most CCMCNs require someone to provide or support them in the provision of care and to respond in the case of an emergency in their everyday lives, including in school settings. One or two yoga teachers qualified within the teacher-training system to work in the health rooms in schools, are assigned to schools in Japan based on enrollment numbers, and are responsible for all students' health. CCMCN requires individualized support, which the Yogo teachers cannot adequately provide. Clinically trained nurses have increasingly been allocated to mainstream schools to provide medical care support for the CCMCN as a new kind of school nurse, but the supply has fallen far short of demand. In 2021, the Act on Support for Children with Complex Medical Care Needs and their Families was passed, requiring local governments to assign school nurses to schools to support CCMCN. The study aimed to understand these nurses' experiences (job description, rewards, challenges) allocated to schools to provide medical care for CCMCN. The study also aimed to explore what professional development looks like for nurses working in schools. Methods: Using a semi-structured interview technique, we interviewed sixteen nurses currently providing care to CCMCN in mainstream schools. Using an interview guide, they were asked about their work, satisfaction, challenges and concerns, thoughts on professionalism, and the educational and training environment. The interviews were audio-recorded and transcribed. We conducted a thematic analysis of the data. Results: The main concerns and problems were not directly related to medical care delivery but to communication with the children, the teachers' understanding of educational policy, and the principal's philosophy. Unlike medical institutions, where treatment is the priority, most children do not need treatment in schools. Even those needing medical care do not need interventions for most of the day. In this environment, the nurses interviewed reported that it is important to understand the school situation and the teachers' philosophies when providing medical care. One of the main challenges is knowing what to do when not providing care, especially if requests from school staff have nothing to do with their professional skills. Conclusion: Through the analysis of concerns and challenges faced by the nurses, the process of providing medical care in a school setting as a health care provider was discussed as follows. Each nurse contemplates the methods and implications of safely implementing medical care in schools. This was considered a process of situating the implementation of medical care by the nurses in the context of education. This requires that the nurses develop new skills and knowledge, which some nurses find stimulating while others find challenging.

Keywords: school nurse, children with complex medical care needs, professionalization, mainstream school

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Authors: Vasudeva Murthy Challakere Ramaswamy

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Background: Conventionally forensic pathology is learnt through autopsy demonstrations which carry various limitations such as unavailability of cases in the mortuary, medico-legal implication and infection. Over the years forensic pathology and science has undergone significant evolution in this digital world. Forensic imaging is a technology which can be effectively utilized for overcoming the current limitations in the undergraduate learning of forensic curriculum. Materials and methods: demonstration of forensic imaging was done using a novel technology of autopsy which has been recently introduced across the globe. Three sessions were conducted in international medical university for a total of 196 medical students. The innovative educational tool was evacuated by using quantitative questionnaire with the scoring scales between 1 to 10. Results: The mean score for acceptance of new tool was 82% and about 74% of the students recommended incorporation of the forensic imaging in the regular curriculum. 82% of students were keen on collaborative research and taking further training courses in forensic imaging. Conclusion: forensic imaging can be an effective tool and also a suitable alternative for teaching undergraduate students. This feedback also supports the fact that students favour the use of contemporary technologies in learning medicine.

Keywords: forensic imaging, forensic pathology, medical students, learning tool

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Authors: Naoko Ono, Junko Kato

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According to the Ministry of Justice, 9,044,000 foreigners visited Japan in 2010. The number of foreign residents in Japan was over 2,134,000 at the end of 2010. Further, medical tourism has emerged as a new area of business. Against this background, language barriers put the health of foreigners in Japan at risk, because they have difficulty in accessing health care and communicating with medical professionals. Medical interpreting training is urgently needed in response to language problems resulting from the rapid increase in the number of foreign workers in Japan over recent decades. Especially, there is a growing need in medical settings in Japan to speak international languages for communication, with Tokyo selected as the host city of the 2020 Summer Olympics. Due to the limited number of practical activities on medical interpreting, it is difficult for learners to acquire the interpreting skills. In order to eliminate the shortcoming, a web-based English-Japanese medical interpreting training system was developed. We conducted a literature review to identify learning contents, core competencies for medical interpreters by using Pubmed, PsycINFO, Cochrane Library, and Google Scholar. Selected papers were investigated to find core competencies in medical interpreting. Eleven papers were selected through literature review indicating core competencies for medical interpreters. Core competencies in medical interpreting abstracted from the literature review, showed consistency in previous research whilst the content of the programs varied in domestic and international training programs for medical interpreters. Results of the systematic review indicated five core competencies: (a) maintaining accuracy and completeness; (b) medical terminology and understanding the human body; (c) behaving ethically and making ethical decisions; (d) nonverbal communication skills; and (e) cross-cultural communication skills. We developed an e-leaning program for training medical interpreters. A Web-based Medical Interpreter Training Program which cover these competencies was developed. The program included the following : online word list (Quizlet), allowing student to study online and on their smartphones; self-study tool (Quizlet) for help with dictation and spelling; word quiz (Quizlet); test-generating system (Quizlet); Interactive body game (BBC);Online resource for understanding code of ethics in medical interpreting; Webinar about non-verbal communication; and Webinar about incompetent vs. competent cultural care. The design of a virtual environment allows the execution of complementary experimental exercises for learners of medical interpreting and introduction to theoretical background of medical interpreting. Since this system adopts a self-learning style, it might improve the time and lack of teaching material restrictions of the classroom method. In addition, as a teaching aid, virtual medical interpreting is a powerful resource for the understanding how actual medical interpreting can be carried out. The developed e-learning system allows remote access, enabling students to perform experiments at their own place, without being physically in the actual laboratory. The web-based virtual environment empowers students by granting them access to laboratories during their free time. A practical example will be presented in order to show capabilities of the system. The developed web-based training program for medical interpreters could bridge the gap between medical professionals and patients with limited English proficiency.

Keywords: e-learning, language education, moodle, medical interpreting

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Authors: Aliya Moreira, Blake Duffy, Sam Kosinski, Kate Heckman, Erika Steensma

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Introduction: The One Health initiative promotes recognition of the interrelatedness between people, animals, plants, and their shared environment. The field of comparative medicine studies the similarities and differences between humans and animals for the purpose of advancing medical sciences. Currently, medical school education is narrowly focused on human anatomy and physiology, but as the COVID-19 pandemic has demonstrated, a holistic understanding of health requires comprehension of the interconnection between health and the lived environment. To prepare future physicians for unique challenges from emerging zoonoses to climate change, medical students can benefit from exposure to and experience with One Health and Comparative Medicine content. Methods: In January 2020, an elective course for medical students on One Health and Comparative Medicine was created to provide medical students with the background knowledge necessary to understand the applicability of animal and environmental health in medical research and practice. The 2-week course was continued in January 2021, with didactic and experiential activities taking place virtually due to the COVID-19 pandemic. In response to student feedback, lectures were added to expand instructional content on zoonotic and wildlife diseases for the second iteration of the course. Other didactic sessions included interprofessional lectures from 20 physicians, veterinarians, public health professionals, and basic science researchers. The first two cohorts of students were surveyed regarding One Health and Comparative Medicine concepts at the beginning and conclusion of the course. Results: 16 medical students have completed the comparative medicine course thus far, with 87.5% (n=14) completing pre-and post-course evaluations. 100% of student respondents indicated little to no exposure to comparative medicine or One Health concepts during medical school. Following the course, 100% of students felt familiar or very familiar with comparative medicine and One Health concepts. To assess course efficacy, questions were evaluated on a five-point Likert scale. 100% agreed or strongly agreed that learning Comparative Medicine and One Health topics augmented their medical education. 100% agreed or strongly agreed that a course covering this content should be regularly offered to medical students. Conclusions: Data from the student evaluation surveys demonstrate that the Comparative Medicine course was successful in increasing medical student knowledge of Comparative Medicine and One Health. Results also suggest that interprofessional training in One Health and Comparative Medicine is applicable and useful for medical trainees. Future iterations of this course could capitalize on the inherently interdisciplinary nature of these topics by enrolling students from veterinary and public health schools into a longitudinal course. Such recruitment may increase the course’s value by offering multidisciplinary student teams the opportunity to conduct research projects, thereby strengthening both the individual learning experience as well as sparking future interprofessional research ventures. Overall, these efforts to educate medical students in One Health topics should be reproducible at other institutions, preparing more future physicians for the diverse challenges they will encounter in practice.

Keywords: medical education, interprofessional instruction, one health, comparative medicine

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Authors: Mejía M. Paula, Ramírez L. Leonardo, Puerta A. Gabriel

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In telemedicine, the image repository service is important to increase the accuracy of diagnostic support of medical personnel. This study makes comparison between two routing algorithms regarding the quality of service (QoS), to be able to analyze the optimal performance at the time of loading and/or downloading of medical images. This study focused on comparing the performance of Tabu Search with other heuristic and metaheuristic algorithms that improve QoS in telemedicine services in Colombia. For this, Tabu Search and Simulated Annealing heuristic algorithms are chosen for their high usability in this type of applications; the QoS is measured taking into account the following metrics: Delay, Throughput, Jitter and Latency. In addition, routing tests were carried out on ten images in digital image and communication in medicine (DICOM) format of 40 MB. These tests were carried out for ten minutes with different traffic conditions, reaching a total of 25 tests, from a server of Universidad Militar Nueva Granada (UMNG) in Bogotá-Colombia to a remote user in Universidad de Santiago de Chile (USACH) - Chile. The results show that Tabu search presents a better QoS performance compared to Simulated Annealing, managing to optimize the routing of medical images, a basic requirement to offer diagnostic images services in telemedicine.

Keywords: medical image, QoS, simulated annealing, Tabu search, telemedicine

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Authors: R. L. David, E. C. P. Tan, M. A. Ferenczi

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This study aimed to investigate the effect of a 'one-time' optional Information Literacy (IL) workshop to enhance Year 1 medical students' literature search, writing, and citation management skills as directed by a customized five-year IL framework developed for LKC Medicine students. At the end of the IL workshop, the overall rated 'somewhat difficult' when finding, citing, and using information from sources. The study method is experimental using a standardized IL test to study the cohort effect of a 'one-time' optional IL workshop on Year 1 students; experimental group in comparison to Year 2 students; control group. Test scores from both groups were compared and analyzed using mean scores and one-way analysis of variance (ANOVA). Unexpectedly, there were no statistically significant differences between group means as determined by One-Way ANOVA (F₁,₁₉₃ = 3.37, p = 0.068, ηp² = 0.017). Challenges and shortfalls posed by 'one-time' interventions raised a rich discussion to adopt an 'embedded librarianship' approach, which shifts the medial librarians' role into the curriculum and uses Team Based Learning to teach IL skills to medical students. The customized five-year IL framework developed for LKC Medicine students becomes a useful librarian-faculty model for embedding and bringing IL into the classroom.

Keywords: information literacy, 'one-time' interventions, medical students, standardized tests, embedded librarianship, curriculum, medical librarians

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