The disease COVID-19 is brought on by the acute respiratory syndrome coronavirus 2 (SARS-CoV-2) First appeared in China in December 2019 and quickly spread around the world after being declared a worldwide pandemic by the World Health Organization in March 2020. COVID-19, Medical Laboratory Professionals, SARS-COV-2, Diagnostic, Importance and difficulties for testing were the selected terms to search the databases of PubMed and Google Scholar for previously published material. Many diagnostic tests are applied in corona virus detection like Droplet Digital PCR (ddPCR), Multiplex PCR, Loop-mediated Isothermal Amplification (LAMP) and more. There is a lack of availability of molecular and serologic tests that have been clinically validated or authorized by national or international regulatory bodies. Clinical laboratory experts are tackling threats to our global defense and wellness, including infectious diseases. The opportunity to express gratitude to the unsung medical laboratory heroes and COVID0-19 pandemic allies is now greater than ever. Each year, Medical Laboratory Professionals Week should honors those who contribute key diagnostic data that help save lives. This review article explore overall summary on testing methods including Important and Difficult Tasks for Medical Laboratories which will provide good message for better public health matter.

No-show appointments in healthcare is a problem faced by medical centers around the world, and understand the factors associated with the no-show behavior is essential. In the last decades, artificial intelligence took place in the medical field and machine learning algorithms can work as a efficient tool to understand the patients behavior and to achieve better medical appointment allocation in scheduling systems. In this work, we provide a systematic literature review (SLR) of machine learning techniques applied to no-show appointments aiming at establishing the current state-of-the-art. Based on a SLR following the Kitchenham methodology, 24 articles were found and analyzed, in which the characteristics of the database, algorithms and performance metrics of each studies were synthesized. Results regarding which factors have a higher impact on missed appointment rates were analyzed too. The results indicate that the most appropriate algorithms for building the models are decision tree algorithms. Furthermore, the most significant determinants of no-show were related to the patients age, whether the patient missed a previous appointment, and the distance between the appointment and the patients scheduling.

This study assesses the efficacy of a microwave colonoscopy algorithm to detect colorectal cancer precursors or polyps in an ex-vivo human colon model. The algorithm works with a device composed of a cylindrical ring-shaped switchable antenna array, which can be attached to the tip of a conventional colonoscope as an accessory. The accessory is connected to an external processing unit that generates an acoustic signal when a polyp is detected. Nowadays, 22% of polyps go undetected with conventional colonoscopy and the risk of cancer after a negative colonoscopy can be up to 7.9%. Fifteen ex-vivo freshly excised human colons with cancer (n=12) or polyps (n=3) were examined with the microwave-assisted colonoscopy system simulating a real colonoscopy exploration. Successive measurements of the colon were taken with the microwave-based colonoscopy device and processed with a microwave imaging algorithm. After the experiment, the dielectric properties of the specimens were measured with a coaxial probe and finally the samples underwent a pathology analysis. The results show that all the neoplasms were detected with a sensitivity of 100% and specificity of 87.4%.

Raman Spectroscopy has long been anticipated to augment clinical decision making, such as classifying oncological samples. Unfortunately, the complexity of Raman data has thus far inhibited its routine use in clinical settings. Traditional machine learning models have been used to help exploit this information, but recent advances in deep learning have the potential to improve the field. However, there are a number of potential pitfalls with both traditional and deep learning models. We conduct a literature review to ascertain the recent machine learning methods used to classify cancers using Raman spectral data. We find that while deep learning models are popular, and ostensibly outperform traditional learning models, there are many methodological considerations which may be leading to an over-estimation of performance: primarily, small sample sizes which compound upon sub-optimal choices regarding sampling and validation strategies. Amongst several recommendations is a call to collate large benchmark Raman datasets, similar to those that have helped transform digital pathology, which researchers can use to develop and refine deep learning models.

We evaluated the usefulness of the novel cholesterol-triglyceride subgroup (CTS) indices that potentially reflect the metabolic status regarding risk of coronary heart disease (CHD) using a retrospective longitudinal study of the Japanese general population. We recruited 12,373 individuals from the annual users of our healthcare center. Among them, the first onset of CHD was recorded in 131 individuals between April, 2014 and March, 2020. The multivariate Cox proportional hazards regression analyses for all normalized lipid indices revealed that the CTSqnt index showed a comparable hazard ratio for the CHD outcome to non-high-density lipoprotein cholesterol (nonHDL-c) and triglycerides. The HR of the CTSqlt index was significantly lower than for CTSqnt, but still comparable to that for low-density lipoprotein cholesterol (LDL-c). In comparison with the other indices, CTSqlt is more sensitive to risk increment while the index value increases. Linear regression analyses for the CTS indices and previously known lipid indices suggest that the CTSqnt and CTSqlt indices reflect the quantity of atherogenic lipoproteins and size of smaller and denser LDLs, respectively. Furthermore, the CTSqnt/HDL-c index can be used as a comprehensive risk indicator that may represent the status of lipid metabolism determined by the CTSqlt and CTSqnt indices and thus may be useful for screening. The CTS indices can be used to evaluate the metabolic status of individuals, which may increase the risk of future CHD.

IntroductionThe use of protective masks, especially medical masks, increased dramatically during the COVID-19 crisis. Medical masks are made of synthetic materials, mainly polypropylene, and a majority of them are produced in China and imported to the European market. The urgency of the need has so far prevailed over environmental considerations.ObjectiveAssess the environmental impact of different strategies for the use of facemaskMethod Different strategies for the use of medical and community masks are being investigated for their environmental impact in this study. 8 scenarios, differentiating the typologies of masks and the modes of reuse are compared using several environmental impact indicators, mainly the Global Warming Potential (GWP100), and the plastic leakage (PL). This study attempts to provide clear recommendations that consider both the environmental impact and the protective effectiveness of face masks used in the community.Results The environmental impact of single-use masks is the most unfavorable, with a GWP of 0.4 -1.3 kgCO₂ eq., depending on the transport scenario, and a PL of 1.8 g, for a one month protection against COVID-19. The use of home-made cotton masks and prolonged use of medical masks through wait-and-reuse are the scenarios with the lowest impact.ConclusionThe use of medical masks with a wait and reuse strategy seems to be the most appropriate when considering both environmental impact and effectiveness. Our results also highlight the need to develop procedures and the legal/operational framework to extend the use of protective equipment during a pandemic.

Introduction Color vision deficiency (CVD) constitutes one of the frequently observed eye disorders in all human populations. Color is a prominent sign utilized in the medical profession to study and identify histopathological specimens, lab instruments, and patient examination. Color deficiency affects the medical skills of students resulting in poor clinical examination and color appreciation. There is no effective screening of CVD at any level of the medical profession. Hence, this study was aimed to determine the prevalence of CVD among medical students. Materials and methods This was a cross-sectional study conducted from September 2019 to February 2020 over a period of six months in Karachi, Pakistan. All medical students aged 18-21 years of either gender enrolled in the first and second years of medical college were included in this study. The examination was performed during daylight. Ishihara plates were placed at a distance of 75 cm from the subject and tilted so that the plane of the paper lies perpendicular to the line of vision. Students were given five seconds to read the plate and one examiner was instructed to mark the checklist. A score of less than 12 out of 14 red/green test plates (not including the demonstration plate) was considered as a CVD. All statistical analysis was performed using Statistical Package for Social Sciences version 20.0 (Armonk, NY: IBM Corp). Results The mean age of the medical students was 19.61± 1.22 years. There were (n=123) 53.0% females and (n=111) 47.0% males. Most of the medical students (n=131, 56.0%) belonged to the upper-middle-class socioeconomic group. CVD was observed in (n=13) 6.0%of medical students. Age (p=0.001) and socioeconomic status (p=0.001) were the only demographic factors significantly associated with color deficiency. Conclusions Color deficiency, although an unnoticed concern, is fairly common among medical students. Medical students must be screened for CVD as this will enable them to be aware of their limitations in their future observational skills as a doctor and devise ways of overcoming them in clinical practice.

Students’ anxiety due to the COVID-19 pandemic was expressed by some medical students in the form of anger and mistrust. This study aims to explore the reasons for mistrust between students and faculty among medical schools in Egypt that have flared during the COVID-19 pandemic. This is a three-phase exploratory qualitative study depending on thematic emergence from appreciative interviews (AI) sessions. Students are revealed to be very well-educated regarding contemporary medical education concepts. The most important factors from the student perspective were the presence of a well-designed assessment system aligned with the learning outcomes and teaching methodologies and the presence of extracurricular activities and soft skills, respectively. A balanced student life respecting their mental health was found important to increase trust. A roadmap to breaking the mistrust must be planned on several pivots: curriculum structure, extracurricular life, communication strategies, and identifying student roles in their learning and in decision making.

Coronavirus (COVID19) appears to be an inflection point that is forcing a disruption in medical education. However, it is not clear what the responses of the institutions are to this pandemic and how the adaptation of new methods may impact medical education in the post COVID-19 era. Objective: The study aims to explore how medical schools in Egypt responded to COVID-19 pandemic regarding the teaching and learning/assessment for undergraduate students. Design: A mixed method exploratory two-phase study was conducted. A survey was prepared and disseminated to a convenient non-probability sample of the medical school faculty through various social platforms. Then, a focus group guide was conducted to explore in more depth the findings. Results: The staff level of preparedness for that unexpected shift was evaluated by 55.1% of the survey participants as optimum to high and a good leadership support was reported by 70 % of them. They reported conflicting views about the proper role of medical education units but reinforced the idea of Egyptian Knowledge Bank’s crucial role in this transition. Additionally, there is a communication problem with the students that leads to their detachment. Subsequently, 84.6 % of the participants reported that their schools used alternative teaching methods for small groups, large groups, pre-clinical and clinical clerkships. However, 64.1 % of the participants identified a clinical skills teaching challenge. Although, 68.4% reported that alternative methods were used for formative assessment but absence of alternative methods for summative assessment was declared by 76.3%. Conclusions: Individuals moved faster than bodies and relied on support existing outside the universities when catastrophe happened. However, institutes which have experience in adapting modern engaging learning methods should organize a better response for crisis. Online learning should be integrated in the curriculum with a fair percentage especially in the early years of medical study.

Big Data in medicine includes possibly fast processing of large data sets, both current and historical in purpose supporting the diagnosis and therapy of patients' diseases. Support systems for these activities may include pre-programmed rules based on data obtained from the interview medical and automatic analysis of test results diagnostic results will lead to classification of observations to a specific disease entity. The current revolution using Big Data significantly expands the role of computer science in achieving these goals, which is why we propose a Big Data computer data processing system using artificial intelligence to analyze and process medical images.

COPD is currently the fourth leading cause of death in the world. Globally, due to continued exposure to COPD risk factors and an aging population, the burden of COPD is expected to increase in the coming decades. The BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index is a practical and multidimensional predictor for prognosis of COPD, and better than FEV1.We used the database of Kaohsiung Chang Gung Memorial Hospital medical center, Taiwan to analyze the correlation between BODE index, healthcare resource utilization, and Charlson comorbidity index (CCI). This retrospective study to collect COPD patients with complete BODE index data who had undergone a 6-minute walk examination in our hospital from January 2015 to December 2016. The medical cost and comorbidities database were analyzed from January 1, 2015, to August 31, 2017. Of 396 patients, 382 (96.5%) were male, with an average age of 71.3 ± 8.4 years. There was a significant association between the BODE index and the CCI of COPD patients (p < 0.001). Healthcare resource utilization was positively correlated with the BODE index during the 32 months of retrospective clinical outcomes: positively correlated with the number of hospitalizations (p<0.001), hospitalization days (p<0.001), hospitalization expenses (p=0.005), and total medical expenses (p=0.024), respectively. Our findings provide the crucial information for clinician to predict medical burden and comorbidities in patients with COPD by using BODE index.

Placing the needle inside the epidural space for locoregional anesthesia is a challenging procedure, which even today is left to the expertise of the operator. Recently, we have demonstrated that the use of optically sensorized needles significantly improve the effectiveness of such procedure. Here we propose an optimized configuration, where the optical fiber strain sensor is directly integrated inside the epidural catheter. The new design allows to solve the biocompatibility issues and increases the versatility of the former configuration. Through an in vivo study carried out on a porcine model we confirm the reliability of our approach, which also opens the way to catheter monitoring during its insertion inside biological spaces.

With recent focus on deep neural network architectures for development of algorithms for computer-aided diagnosis (CAD), we provide a review of studies within the last 3 years (2015-2017) reported in selected top journals and conferences. 29 studies that met our inclusion criteria were reviewed to identify trends in this field and to inform future development. Studies have focused mostly on cancer-related diseases within internal medicine while diseases within gender-/age-focused fields like gynaecology/pediatrics have not received much focus. All reviewed studies employed image datasets, mostly sourced from publicly available databases (55.2%) and few based on data from human subjects (31%) and non-medical datasets (13.8%), while CNN architecture was employed in most (70%) of the studies. Confirmation of the effect of data manipulation on quality of output and adoption of multi-class rather than binary classification also require more focus. Future studies should leverage collaborations with medical experts to aid future with actual clinical testing with reporting based on some generally applicable index to enable comparison. Our next steps on plans for CAD development for osteoarthritis (OA), with plans to consider multi-class classification and comparison across deep learning approaches and unsupervised architectures were also highlighted.

At present, medical institutes generally use EMR to record patient's condition, including diagnostic information, procedures performed and treatment results. EMR has been recognized as a valuable resource for large scale analysis. However, EMR has the characteristics of diversity, incompleteness, redundancy and privacy, which make it difficult to carry out data mining and analysis directly. Therefore, it is necessary to preprocess the source data in order to improve data quality and improve the data mining results. Different types of data require different processing technologies. Most structured data commonly needs classic preprocessing technologies, including data cleansing, data integration, data transformation and data reduction. For semi-structured or unstructured data, such as medical text, containing more health information, it requires more complex and challenging processing methods. The task of information extraction for medical texts mainly includes NER (Named Entity Recognition) and RE (Relation Extraction). In this paper, we introduce the process of EMR processing, including data collection, data preprocessing, data mining, evaluation and knowledge application, analyze the current status of the key technologies, such as data preprocessing and data mining, and provide an overview of the application domains and prospects of EMR mining technologies. Finally, we summarize the existing problems in the research of EMR mining, and review the development trends.

We used light, electron microscope and teased fiber autoradiography to show that myelinating Schwann cells synthesize phospholipids and proteins in perinuclear cytoplasm and superficial cytoplasmic channels or Cajal bands (SCC/CB). Neither phospholipid nor protein syntheses occur in paranodal loops, Schmidt-Lanterman incisures or adaxonal cytoplasm. Autoradiographic studies also show that in support of local protein synthesis, RNAs move from the nucleus into perinuclear cytoplasm and out along SCC/CB. Unlike other phospholipids, phosphatidylinositol synthesis occurs extensively in axons. This finding indicates differences in the distributions of phospholipid synthesizing enzymes in smooth endoplasmic reticulum of Schwann cell processes and axoplasm.Autoradiographs of nerves at longer survival times show that tritiated phosphatidylcholine and fucose-labeled glycoproteins move from synthetic sites to outermost myelin lamellae. From there, phosphatidylcholine spreads inward reaching innermost lamellae of thicker sheaths in days. Coupled with retention of fucose glycoproteins in outer myelin lamellae is the presence of fucose glycoprotein synthesized during early myelination in inner lamellae of thicker sheaths, a result consistent with growth of myelin sheaths from inner lamellae out. In this review, we revisit these studies because they provide temporal and spatial perspectives needed in understanding dynamic aspects of myelinogenesis and how myelinating cells respond to injury and from altered gene expression.

This paper explores if plants are capable of responding to human movement by changes in their electrical signals. Towards that goal we conducted a series of experiments, where humans over a period of 6 months were performing different types of eurythmic gestures in proximity of garden plants, namely salad, basil, and tomatoes. To measure plant perception, we used the plant spikerbox, a device that measures changes in voltage differentials of plants between roots and leaves. Using machine learning, we find that the voltage differentials over time of the plant predict if (a) eurythmy has been performed, and (b) which kind of eurythmy gestures has been performed. We also find that the signals are different based on the species of the plant. In other words, the perception of a salad, tomato, or basil might differ just as perception of different species of animals differ. This opens new ways of studying plant ecosystems, while also paving the way to use plants as biosensors for analyzing human movement.

ABSTRACT Heavy metals have been classified as dangerous environmental pollutants. Interest in feasible ways to reduce heavy metals pollution is a noble goal. Adsorption is an effective method based on its effectiveness and low- cost. Nowadays, low-cost bio-sorbents have been utilized to replace costly expensive adsorbents. Rich cellulose materials are effective heavy metal adsorbents, and their performance can be enhanced via chemical modification. The present work reviews the steady progress in the utilization of agriculture by-product wastes as heavy metal bio-sorbent. The unique advantages of these by-products such as renewability, abundance, simple processing, and low cost, justifier this work. The results confirm that the chemically treated agro-wastes exhibit high- removal efficiency (reaches 95% in most cases). The adsorption isotherm studies indicate that the concentration of the metal ions has a significant effect on the adsorption process. The Freundlich model provides a physical adsorption model of the metal ions on the bio-sorbent surface. Langmuir isotherm offers an estimate of the effect of different factors on the efficiency of the process. The adsorption kinetics studies offer an idea of reaction pathways including the adsorption mechanism and the efficiency of the metal ion removal. Applying the pseudo-first-order and pseudo-second-order models describes the adsorption kinetics. This information can be utilized in developing effective strategies to remove heavy metal ions using chemically treated agro-waste. The data confirmed that chemical modification is a significant parameter in the efficiency of metal ion removal. The feasibility and effectiveness of using these cellulosic by-products as bio-sorbent should be given attention and encouraged.

Based on the Flashing Ratchet Potential (FRP) and Electro-Spectroscopy detection techniques, a new detection method was experimentally examined. This method allows the detection of sub-micro particles in the human exhaled air such as viral particles and other biological agents. The detection signal created by this method is carried out by electron current buildup forming an Electric Current-Spectrum (ECS) distinguishing the contents of the exhaled air samples. The detection method was developed based on FRP and a beam of free charges passing through the electrodes of the FRP. The ECS is characterized by low-energy free charges interacting with the medium through which they pass, where numerous free charges are scattered (delayed) as a result of these interactions. The resulting ECS is characterized by FRP's capacity to drift back the delayed free charges to their original starting positions. By comparing the ECS of two exhale air samples, this new technology can be utilized to identify the presence of viral and microorganisms’ particles. The time-escalating ECS difference quickly indicates the presence of such particles. Moreover, the FRP's optimal operating settings was experimentally defined, in addition to the experimental evaluation of its functionality to confirm the FRP's promising sensing capabilities, which were statistically examined several times to ensure the reproducibility of the results.

The windowpane oyster Placuna placenta, lives in brackish coastal waters and has long been economically important to the Philippines because of its durable and translucent shell, which is used as a glass substitute and material for making windowpanes and handicrafts. There has been considerable degradation of the windowpane oyster fishery in past decades. Moreover, there are waste and under-exploited by-products such as the meat, which though nutritious and edible, currently has a very low value; its use being confined to dishes consumed by families in the fishing community. Historically there are instances of excellent practice in terms of regulating the windowpane oyster fishery, while in recent times there have been local initiatives to restore this and to develop high value food products from the meat. These initiatives have, however, never been followed through at a provincial or national level. Research on other molluscs and marine organisms highlights that these also contain high value pharmaceutical products. This review compiles evidence to establish the groundwork for an essential and comprehensive multidisciplinary research program centred around the windowpane oyster, which would ensure a high value for all parts of the oyster, including those currently discarded. By fostering a sustainable and circular economy within this fishery sector and its associated industry, its economic value would be amplified. This is particularly important for oyster harvesters in the Philippines, who often find themselves at the economic ladder's lower rungs. By integrating the principles of a circular economy, this initiative would not only aim to uplift the economic prospects of these harvesters but in doing so would drive the restoration of the windowpane oyster to its former range.

Reactive transport (RT) couples bio-geo-chemical reactions and transport. RT is important to understand numerous scientific questions and solve some engineering problems. RT is highly multidisciplinary, which hinders the development of a body of knowledge shared by RT modelers and developers. The goal of this paper is to review the basic conceptual issues shared by all RT problems, so as to facilitate advance along the current frontier: biochemical reactions. To this end, we review the basic equations to point that chemical systems are controlled by the set of equilibrium reactions, which are easy to model, but whose rate is controlled by mixing. Since mixing is not properly represented by the standard advection-dispersion equation (ADE), we conclude that this equation is poor for RT. This leads us to review alternative transport formulations, and the methods to solve RT problems using both the ADE and alternative equations. Since equilibrium is easy, difficulties arise for kinetic reactions, which is especially true for biochemistry, where numerous frontiers are open (how to represent microbial communities, impact of genomics, effect of biofilms on flow and transport, etc.). We conclude with the basic 10 issues that we consider fundamental for any conceptually sound RT effort.

In this study, effluent water was produced through Submerged Membrane Bio-Reactor (SMBR) process, which is a simple system and decomposes organic matter contained in wastewater with biological treatment process and performs solid-liquid separation, Especially, ozone oxidation treatment process is applied to effluent water containing fluorescent whitening agent, which is a trace pollutant which is not removed by biological treatment, and influences the quality of reused water. The concentration of COD in the SMBR was 449.3 mg/ℓ-COD, and the concentration of permeate water was 100.3 mg/ℓ-COD. The removal efficiency was about 70.1%. The amount of ozone re- quired for the removal of the fluorescent whitening agent in the permeated water in SMBR was 6.67 g-O3/min, and the amount of ozone required to remove COD relative to the permeate water was calculated to remove 0.997 mg-COD for 1 mg of O3.

This paper reports 2 × 4 hybrid Mach-zehnder interferometer (MZI) - multi-mode interferometers (MMI) based compact thermo-optical switch consisting of slab waveguides on silicon-on-insulator, SOI, platform. The device consists of two identical MMIs, each of 6 μm wide and 140 μm long connected with two phase shifters MMIs each with 2 μm wide and 8 μm long and linear tappers each 4 μm long, connected at both ends of the MMIs to minimize the power coupling loss. The loss for linear taper is found to be below 0.02dB. The footprint of the whole device is six 6 μm × 324 μm. This structure is based on unique multimode region shape, which leads optical switch to have less coupling loss and reduced cross-talk. The average thermo-optical switching power consumption is 1.4 mW, the excess losses are 0.8 dB, and the imbalances are 0.1 dB. Aluminum is used as a heating pad, and a trench is created around this pad to prevent from spreading of heat and reduce power loss almost by a factor of 2 to the adjacent phase shifter. Our new heating method has advantages of compact size and ease of fabrication with the current CMOS technology.

Carbon nanotubes have been attracting considerable interest among material scientists, physicists, chemists and engineers for almost 30 years. Owing to their high aspect ratio, coupled with remarkable mechanical, electronic and thermal properties, carbon nanotubes have found application in diverse fields. In this review, we will cover the work on carbon nanotubes used for sensing applications. In particular, we will see examples where carbon nanotubes act as main players in devices sensing biomolecules, gas, light or pressure changes. Furthermore, we will discuss how to improve the performance of carbon nanotube-based sensors after proper modification.

Activated carbons can be produced from biomass in a thermal process either in a direct carbonization-activation process or by first carbonizing the biomass and later on activating the biochars into activated carbons. The properties of the ACs are dependent on the type of process used for production. In this study, the properties of activated carbons produced in a one-stage and a two-stage process are considered. Activated carbons were produced by physical activation of two types of starting materials, bio chars produced from spruce and birch chips in a commercial carbonization plant and from the corresponding raw chips. The activated carbons produced were characterized regarding specific surfaces, pore volumes and pore size distributions. The un-activated bio chars had some degree of surface area 190 and 140 m²g^-1 for spruce and birch and pore volumes of 0.067 and 0.092 cm³g^-1. According to the results obtained, two slightly different types of activated carbons are produced depending if a one-stage or a two-stage carbonization and activation process is used. The ACs produced in the one-stage process had higher specific surface areas compared to the ones produced in a two-stage process (761-940 m²g^-1 vs. 540-650 m²g^-1) . In addition, total pore volumes were higher in one-stage process but development of micropores is greater compared to two-stage process. There was no significant difference in total carbon content between one-stage and two-stage process.

Disrupted nutrient recycling is a significant problem for Europe, while phosphorus and nitrogen are wasted instead of being used for plant nutrition. Mineral phosphate is critical raw material, which contains environmentally hazardous elements such as cadmium and uranium. Therefore, phosphorus recovery from agricultural by-product streams is critically important key priority. Phosphorus recovery from food grade animal bone by-products have been applied researched since 2002 with objective driven evolution progress towards specialized pyrolysis processing technology and animal bone char product (ABC) developments in economical industrial scale. Different animal bone by-products tested under different conditions at 400 kg/h throughput capacity in the continuously operated 3R zero emission autothermal carbonization system. The different material core treatment temperatures (between >300°C and <850°C) were combined with different residence times under industrial productive processing conditions. It has been industrial demonstrated that material core treatment temperature <850°C with 20 minutes residence time is necessary to achieve high quality ABC with useful agronomic value. The output ABC product having concentrated >30% phosphorus pentoxide (P2O5) and specific quality innovative fertilizer for agronomical efficient organic and low input farming applications as functional organic fertilizer, soil improver, growing medium and/or fertilizing product blend with high mineral phosphate fertiliser replacement value.

Diabetic retinopathy (DR) is the primary factor leading to vision impairment and blindness in diabetic people. Uncontrolled diabetes can damage the retinal blood vessels. Initial detection and prompt medical intervention are vital in preventing progressive vision impairment. Today's growing medical field poses more significant workload and diagnostic demands on medical professionals. In the proposed study, a convolutional neural network (CNN) is employed to detect the stages of DR. This research is crucial for studying DR because of its innovative methodology incorporating two different public datasets. This strategy enhances the model's capacity to generalize unseen DR images, as each dataset encompasses unique demographics and clinical circumstances. The network can learn and capture complicated hierarchical image features with asymmetric weights. Each image undergoes preprocessing using contrast-limited adaptive histogram equalization (CLAHE) and the discrete wavelet transform (DWT). The model is trained and validated using the combined datasets of Dataset for Diabetic Retinopathy (DDR) and the Asia Pacific Tele-Ophthalmology Society (APTOS). The CNN model is tuned with different learning rates and optimizers. The CNN model with Adam optimizer achieved 70% accuracy and an area under curve (AUC) score of 0.82. The recommended study results may reduce diabetes-related vision impairment by early DR severity identification.

Background: Citicoline, a medical food, lacks proven efficacy for ischemic stroke and has uncertainties around its harms. The continued prescription should be reevaluated given the more robust, high-quality Evidence against that medical food. This essay is based on a recent Cochrane review and uses only one all-cause mortality as the primary outcome. Therefore, the essay should be considered as something other than an updated Cochrane review but like a reflection based on Evidence-based Medicine and Philosophy of Science analysis. Question Research: Why citicoline (a medical food) should not be prescribed to treat people with acute ischemic stroke: The certainty of the Evidence.? Objective: Demonstrate from evidence-based medicine and philosophy of science perspective that citicoline should not be prescribed for acute ischemic stroke due to lack of efficacy and harm uncertainties. Search publications: We searched in PubMed and Cochrane Library from 2020 until 30 October 2023. We, furthermore, used engineering machines Bing and Google Scholar to detect additional papers. Additionally, we also reviewed reference lists of the retrieved publications and review articles and searched the websites of the U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA). Selection criteria: We included systematic reviews, meta-analyses, randomized clinical trials, clinical guidelines focused on acute ischemic stroke and comparing citicoline versus placebo or no intervention. We excluded narrative reviews, observational studies and ongoing trials. Data collection and analysis: We identified only new randomized clinical trials and assessed the risk of bias in seven domains. The other eight trials were already included in the mentioned Cochrane review. The systematic reviews with or without meta-analyses were assessed using McMaster University guidelines. We estimated risk ratios (RRs) for that outcome. We measured statistical heterogeneity using the I² statistic. We conducted our analyses using the fixed effect model. We did not use the GRADE approach due to what is shown in a Cochrane review published in 2020 by Martí-Carvajal et al. We used the RevMan 5.4 software from Cochrane Collaboration to conduct the forest plot. We used a Trial Sequential Analysis with Copenhagen Trial Unit Software. We estimated a Bayes factor from the relative risk and 95% confidence interval. Results: We identified only one new RCT (N = 99) reported mortality data and three clinical guidelines. We conducted a new meta-analysis with nine trials (N = 4461) having a high risk of bias and showing little to no difference in mortality between citicoline and placebo (17.1% vs 18.4%; RR 0.94, 95% CI 0.82 to 1.06; I2 = 0%). The Bayes factor was 0.7, indicating weak Evidence for the null over the alternative hypothesis. Trial sequential analysis suggested sufficiency of Evidence for mortality. No guidelines recommend citicoline. Conclusions: This essay reassessed citicoline for acute ischemic stroke after the 2020 Cochrane review. Adding a new RCT further supported the lack of mortality benefit with citicoline. The overall evidence quality could be better. Analyses using evidence-based medicine and philosophy of science approaches do not support prescribing citicoline due to a lack of efficacy substantiation and potential harms.

There are four categories of medical waste that cannot be mixed as this will cause serious problems such as environmental pollution or infection. In the past, the classification of medical waste often involved a lot of human and material resources to process, with workers at risk of exposure to infectious substances. Therefore, an augmented reality (AR) and artificial intelligence (AI) medical waste classification system and method were developed. This innovative medical waste classification system and method combines AR and AI identification technology to reduce the risk of manual judgment errors by clinical staff when handling medical waste.

Wildfires are a rising environmental threat which health impact remains poorly documented, in particular beyond the fire period. This ecological study investigates changes in health conditions before, during, and after two consecutive wildfires that occurred in France´s Gironde district in the summer 2022. Electronic records from the district´s emergency medical communication centre were used to identify calls with respiratory and cardiovascular diseases, and two specific subgroups of those, asthma (all ages and 0-5 years) and cardiac arrest, respectively. Compared to before the fires, respiratory disease cases were fewer during each fire (OR = 0.85, 95% CI: 0.79, 0.90 and OR = 0.62, 95% CI: 0.58, 0.67, respectively), cardiovascular disease cases, more common during the second fire, and asthma cases, higher following the fires (ORall ages= 1.85, 95% CI: 1.56, 2.21 and ORchildren= 3.52, 95% CI: 2.62, 4.80). Asthma cases also rose during the same calendar time in 2021, but to a lesser extent. In sum, except for asthma, emergency calls data in Gironde reveal few significant potentially smoke-related symptoms around fire periods, apart from post-fire asthma. Whether the effects are smoke- or season-related remains to be determined, preferably using additional data sources.

Unexpected preoperative surgery cancellations are one of the important problems in daily anesthesia practice. It's an even bigger problem if these cancellations happen in the operating room. Our aim was to draw attention to this issue and reveal the reasons. This prospective, cross-sectional study aimed to assess the prevalence and causes of elective surgery cancellations once patients are in the operating room. The study sample consisted of 7482 adult patients scheduled for elective surgeries and taken to the operating room. Sixty-seven patients whose surgeries were canceled were grouped into Group 1, while the remaining 7415 whose surgeries were completed were in Group 2. Patients were divided into two groups based on whether their surgeries were completed or canceled. Factors such as age, American Society of Anesthesiologists physical status, and surgical department were analyzed. Metrics involved comparisons between the two groups regarding age, American Society of Anesthesiologists physical status classification, surgical department, and timing of the surgery. The prevalence of elective surgery cancellations after patients were in the operating room was 0.9%. Group 1 was significantly older than Group 2 (p&lt;0.001). The proportion of patients classified as American Society of Anesthesiologists physical status III was higher in Group 1 (p&lt;0.001). The department with the highest cancellation rate was ophthalmology(2.5%), followed by general surgery(2.1%), urology(1.5%), and ear, nose, and throat(1.4%). Approximately 59.7% of cancellations were deemed potentially avoidable. The study suggests that many of these cancellations are potentially avoidable, underscoring the need for optimized surgical scheduling and patient assessment protocols.

In recent years, semiconductor survey meters have been developed and are in increasing demand worldwide. This study aimed to investigate whether it is possible to calculate the time constant of the semiconductor survey meter using the X-ray equipment installed in each medical facility and whether it is possible to calibrate the semiconductor survey meter. Attach an additional filter to the medical X-ray system to satisfy the standards of N-60 to N-120, add more copper plates from there, and calculate the first and second half-value layers to compare with N-60 to N-120 values. Next, we will measure the leakage dose using a medical X-ray system and calculate the time constant of the survey meter. The survey meter is then calibrated and compared with the calibration factors in industrial X-ray system. Per experimental results, it is possible to reproduce the N-60 to N-120 radiation quality using a medical X-ray system and to calculate the time constant from the measured results assuming actual leakage dosimetry using that radiation quality. We also found that the calibration factor was equivalent to that of an industrial X-ray device. It was revealed that semiconductor survey meters can be calibrated using a medical X-ray system.

Nurses in disaster response require comprehensive understanding, training, and col-laboration among educators, researchers, and practitioners to overcome challenges and improve their capabilities. This study evaluates the impact of simulation-based training on improving nursing students' knowledge and performance in crisis management and triage during mass casualty incidents in Saudi Arabia, aiming to enhance existing pro-tocols in disaster management. This quantitative interventional pre-post study aimed to assess the impact of a training intervention on the disaster nursing skills of nursing students at Taif University in Saudi Arabia. The study involved a random sample of 101 nursing students and utilized a realistic train accident simulation with a response team comprising healthcare professionals and emergency specialists. A detailed questionnaire was used to measure emergency management skills and knowledge, and pre-test and post-test evaluations were conducted. Data analysis was performed using SPSS, and the study was conducted on a voluntary basis with necessary approvals obtained. The findings have the potential to enhance disaster management protocols and improve the preparedness of nursing professionals in Saudi Arabia. The posttest analysis revealed that a significant portion of participants achieved excellent, very good, and good levels of performance, indicating the effectiveness of the training program. In contrast, the pretest grades showed a higher percentage of participants receiving fail level grades, high-lighting the need for improvement prior to the training intervention. This study high-lights the importance of comprehensive training and education in disaster nursing for improving emergency response and patient outcomes

Aims: Medical Nutritional Treatment (MNT) can be complex and associated to potential meta-bolic complications, which has been recently described as Nutritrauma. There is no data on the effect of applying this strategy in clinical practice. The aim of our work is to describe if applica-tion of Nutritrauma concept in real live is useful to detect metabolic complications associated to the prescription of MNT in critically ill patients. Methods: In this descriptive prospective study at a single center, we enrolled 30 consecutive crit-ical ill patients of a 14 beds medical – surgical Intensive Care Unit. The Nutritrauma strategy implementation was based in four M steps: Metabolic screening, MNT prescription, Biochemical Monitoring and Nutritional Management. The primary endpoint was to describe the metabolic complications of the MNT detected with Nutritrauma strategy. Secondary endpoint was to de-scribe the most frequent causes of inappropriate prescription. Results: We analysed 28 patients (mean age 69,7 ± 11,3 years; APACHE II 18,1 ± 8,1, SOFA 7,5 ± 3,7; Nutric Score modified 4,3 ± 2,01 and mean BMI 27,2 ± 3,8). The most frequent disease on admission was sepsis (46,4%). Length of ICU stay was 20,6 ± 15,1 days and 39,3% died during the ICU stay. Enteral nutrition (82,1%) was more frequent than parenteral nutrition (17,9%). During nutritional monitoring 54 specific analytical determinations were made. Hyperglycemia was the most frequent metabolic alteration (83,3% of the determinations). Electrolyte disturbance were hypocalcemia (50%), hypophosphatemia (29,6%) and hypokalemia (27,8%). The most frequent lipid profile abnormality were hypocholesterolemia (64,8%) and hypertriglyceridemia (27,8%). Furthermore, nutritional prescription was modified in the 53,6% of patients: increase protein dosage (25%), increase caloric dosage (21,4%) and change to an organ-specific diet (17,8%). Conclusions: The application of Nutritrauma strategy facilitate the detection of metabolic com-plications and the evaluation of the appropiate prescription of the MNT.

Ceruminous gland tumours are rare injuries of the external auditory canal (EAC). This tumor, even if considered a slow-growing carcinoma, has high rate of perineural invasion and metastasis. For this reason, it must be promptly diagnosed, then it must be treated with aggressive surgery combined with postoperative radiation. The present case report is about a case of an adenoid cystic carcinoma arising the external auditory canal of 46 years old female patient, who complained hypoacusis and pain. The profile of medical liability is substantiated on the delayed diagnosis when the lately observed tumor progression by the invasion of both surrounding bone and vascular structures.

The health equipment are used to keep track of significant health indicators, automate health interventions, and analyze health indicators. People have begun using mobile applications to track health characteristics and medical demands because all devices are linked to high-speed internet and phones. Such a combination of smart devices, the internet, and mobile applications expands the usage of remote health monitoring through the Internet of Medical Things (IoMT). The accessibility and unpredictable aspects of IoMT create massive security and confidentiality threats in IoMT systems. In this proposed paper - Octopus, Physically Unclonable Functions (PUFs) have been used to provide privacy to the healthcare device by masking the data, and machine learning (ML) technique is used to retrieve the health data back and for reducing security breaches on networks. This technique has exhibited 99.45% accuracy, which proves that this technique could be used to secure health data with masking.

Background: The effect of the COVID-19 pandemic has transformed medical education and is likely to have long-lasting effects on student learning, mental well-being, and eating behaviour. This study aimed to examine the learning behaviors of medical students at the American University of Integrative Sciences (AUIS), Barbados, during the COVID-19 pandemic. Methods: A cross-sectional web-based online survey was administered to medical students at AUIS from July until November 2021. The data collecting instrument recorded students’ demographic and learning behaviour information (Meo et al. 2020), and eating disorders (SCOFF questionnaire). Results: The overall response rate was 55% (n=120). In relation to learning behaviour, students agreed with the following statements: ‘deterioration in work performance and studying’ (48.4%), ‘remember subject’s contents appropriately’ (40.4%), ‘concentration on the studies’ (40.3%), ‘difficulty in performing two tasks simultaneously’ (38.7%), ‘difficulty in performing mental calculations’ (33.9%), ‘difficulty in recalling recent information’ (32.3%), and ‘difficulty in recalling old information’ (38.7%). Among the 8 dimensions of learning behaviors, deterioration in work performance or studying, and difficulties in recalling recent information were found to be significantly associated with the gender of the students. For SCOFF questionnaire, approximately 24.2% screened positive for eating disorders. Screening with the SCOFF test demonstrated that female, older (>25 years), overweight + obese, Clinical Sciences + PreMed, and non-USA-based students were at more risk of eating disorders. Conclusions: The results indicate that during the COVID-19 pandemic AUIS students have developed learning difficulties, and are likely to have eating disorders. University policymakers should take appropriate measures to support a healthy learning environment and improve students' mental well-being and eating behaviours.

Diffuse optical tomography (DOT) is an optical medical imaging method that can assess the structural properties of tissues and their functional characteristics, such as hemoglobin concentration, water content, as well as lipid concentration, via three-dimensional image reconstruction. This paper presents the theoretical basis and working principle of diffuse optical tomography. The paper explains how the optical properties of tissue can be imaged by photon migration techniques based on diffusion theory. The author presents the reasoning for near-infrared (NIR) imaging as the most effective technique in terms of quantitative recovery of spectroscopic optical parameters. This work also listed various advantages, applications, and challenges of DOT. The paper also briefly discusses current progress in near-infrared medical imaging and its future direction.

The Coronavirus disease 2019 (COVID-19) rapidly spread to over 180 countries and abruptly disrupted the production rates and supply chains worldwide. Since then, 3D printing also recognized as additive manufacturing (AM) and known to be a novel technique that uses layer-by-layer deposition of material to produce the intricate 3D geometry, has been engaged in reducing the distress caused by the outbreak. During the early stages of this pandemic, shortages of Personal Protection Equipment (PPE), including facemasks, shields, respirators, and other medical gears, were significantly answered by remotely 3D printing them. Amidst the growing testing requirements, the 3D printing emerged as a potential and fast solution manufacturing process to meet the production needs due to its flexibility, reliability, and rapid response capabilities. In the recent past, some of the other medical applications that have gained prominence in the scientific community include 3D printed ventilator splitters, device components, and patient-specific products. Regarding the non-medical applications, researchers have successfully developed contact-free devices to address the sanitary crisis in public places. This work aims to systematically review the applications of 3D printing or AM techniques that have been involved in producing various critical products essential to limit this deadly pandemic's progression.

Over recent years, the importance of patent literature has become more recognized in the academic setting. In the context of artificial intelligence, deep learning, and data sciences, patents are relevant to not only industry but also academe and other communities. In this article, we focus on deep tomographic imaging and perform a preliminary landscape analysis of the related patent literature. Our search tool is PatSeer . Our patent bibliometric data is summarized in various figures and tables. In particular, we qualitatively analyze key deep tomographic patent literature.

Background: Serious games are conceptualized as a broad topic and overlap segments of more modern forms of education: e-learning, edutainment, game-based learning, and digital game-based learning. Serious Games aligns with digitalization and the modern era and creates novel opportunities for learning and assessment in medical education. Escape rooms, a type of serious games, merge mental and physical aspects to reinforce critical skills useful in daily life. It challenges logic and reasoning and demands careful analysis of situations to correlate and solve different stages of the escape room under pressurized, timed conditions. Furthermore, it serves as an adequate environment to build problem-solving skills, communication skills, and leadership skills through the collaboration of people to achieve a common goal. The aim of this study was to investigate the applications of escape rooms in Medical Education. Method: This study investigated the applications of escape rooms in medical education. Serious games are expanding in education and have attained great relevance due to their intriguing and intrinsically motivating attributes. Within serious games, we focused on escape rooms in which participants are locked in a room, faced with puzzles that must be solved to ‘escape the room’. Compiling the data from the first 100 hits of medical application of escape rooms, we found 72 cases and categorized them by year, specialty, participants structure, simulation experience, and design. Results: We reported on escape rooms in medical education by the year in which they were reported, the medical specialty, the participant structure, grouped or individual, the experience design; real, hybrid, or digital, and the modality of the delivery. 72% of the escape rooms focused on four main areas: nursing education (25.0%), emergency medicine (22.2%), pharmacy (12.5%), and interprofessional education (12.5%). Most of the escape rooms had a group-based physical design and little attention was given to provide a detailed description of the design considerations, such as the pathway type (linear, semi-linear, open). Conclusion: Escape rooms are applied in a wide range of medical education areas. In Medical Education, group-based on-site escape rooms with a focus on nursing, emergency medicine, pharmacy and interprofessional education dominates the implementation landscape. To further advance the field, stronger emphasis on making explicit the design considerations will advance the research and inform implementations.

This study evaluated the impact of didactic videos and service user testimonial videos on mental illness stigma among medical students. Two randomized controlled trials were conducted in Nepal. Study 1 examined stigma reduction for depression. Study 2 examined depression and psychosis. Participants were Nepali medical students (Study 1:n=94, Study 2:¬n=213) randomized to three conditions: a didactic video based on the mental health Gap Action Programme (mhGAP), a service user video about living with mental illness, or a control condition with no videos. In Study 1, videos only addressed depression. In Study 2, videos addressed depression and psychosis. In Study 1, both didactic and service user videos reduced stigma compared to the control (F2,91=6.37, p=0.003). In Study 2 (depression and psychosis), there were no differences among the three arms (F2,210=2.07, p=0.13). When comparing Study 1 and 2, there was greater stigma reduction in the service user video arm with only depression versus service user videos with depression and psychosis (t(31)=-3.04, p=0.005). In summary, didactic and service user videos were associated with decreased stigma when content addressed only depression. However, no stigma reduction was seen when including depression and psychosis. This calls for different strategies based on types of mental illnesses. ClinicalTrials.gov identifier: NCT03231761

The COVID-19 pandemic has wreaked havoc on the whole world, taking over half a million lives and capsizing the world economy in unprecedented magnitudes. With the world scampering for a vaccine, early detection and containment is the only redress. Existing diagnostic technologies with high accuracy like RT-PCRs are expensive and sophisticated, requiring skilled individuals for specimen collection and screening, resulting in lower outreach. So, methods excluding direct human intervention are much sought after, and artificial intelligence-driven automated diagnosis, especially with radiography images, captured the researchers' interest. This survey marks a detailed inspection of the deep-learning-based automated detection of COVID-19 works done to date, a comparison of the available datasets, methodical challenges like imbalanced datasets, and others, along with probable solutions with different pre-processing methods, and scopes of future exploration in this arena. We also benchmarked the performance of 315 deep models in diagnosing COVID-19, Normal, and Pneumonia from x-ray images of a custom dataset created from four others. The dataset is publicly available at https://github.com/rgbnihal2/COVID-19-X-ray-Dataset. Our results show that DenseNet201 model with Quadratic SVM classifier performs the best (accuracy: 98.16%, sensitivity: 98.93%, specificity: 98.77%) and maintains high accuracies in other similar architectures as well. This proves that even though radiography images might not be conclusive for radiologists, but it is so for deep learning algorithms for detecting COVID-19. We hope this extensive review will provide a comprehensive guideline for researchers in this field.

This paper aims to implement histogram pyramids with marching cubes method for 3D medical volumetric rendering. The histogram pyramids are used for feature extraction by segmenting the image into the hierarchical order like the pyramid shape. The histogram pyramids can decrease the number of sparse matrixes that will occur during voxel manipulation. The important feature of the histogram pyramids is the direction of segments in the image. This feature will be then used for connecting pixels (2D) to form up voxel (3D) during marching cubes implementation. The proposed method is fast and easy to implement and it also produces a smooth result (compared to the traditional marching cubes technique). The experimental results show that time consuming for generating 3D model can be reduced by 15.59% in average. The paper also shows the comparison between the surface rendering using the traditional marching cubes and the marching cubes with histogram pyramids. Therefore, for the volumetric rendering such as 3D medical models and terrains where a large number of lookups in 3D grids are performed, this method is a particularly good choice for generating the smooth surface of 3D object.

The advance of the medical field in the 21st century has influenced the development of many innovations, including in medical education. PBL (problem-based learning) is one of the pedagogical approaches that has been studying and implementing worldwide to attract medical students’ attention with their learning style and learning environment. China is the most significant “receiver” country of foreign students in Asia, and clinical medicine is one of the most chosen majors for undergraduate. In China, PBL has been implementing in some schools, but mostly with the local students and only a few implementations to the international students. International medical students in China faced a variety of challenges during their studies. In this review paper, we give the solution to adapt to the challenges by focusing on the implementation the integrated organ/system curriculum/syllabus with the PBL method to the school system with the support of the school stakeholders and students’ role.

This work addresses the problem of the application of artificial intelligence to the creation and maintenance of medical documentation and the use of big data in medicine to support efficient patient diagnosis and treatment. This study covers the latest advances in AI and big data, based on literature reviews and interviews with leading experts in these fields. The following conclusions were obtained: (1) Based on the needs of patients and providers of medical services, and given the latest technological advances, all medical documentation should be digital and the processes of its creation, access, sharing, and consistency checking should by supported by suitably designed AI systems. (2) The knowledge contained in medical documentation constitutes a resource of strategic importance for humanity, with almost unlimited potential. (3) All medical documentation should be anonymised and should be made widely available, just like data and research results in the field of experimental physics. (4) This will accelerate development of new treatments, best practice and help to identify new medical emergencies, such as Covid-19. In practice today, unfortunately, the design of medical record systems is fragmented between institutions and countries, often focusing discussions on narrow technical details, and forcing clinicians to waste time on filling up multiple pages of illness history. This leads to many inefficiencies and lost opportunities and necessitates a fundamentally new approach.

The universal health insurance system in Taiwan was formed with good intentions to help vulnerable groups. However, the possibility of bankrupting the system due to wasted medical resources. In this study, using the medical expenditures of the Taiwanese Government and gross domestic product (GDP) as variables, the wavelet analysis method was used to empirically study the correlations and leading-lagging relationships in quarterly data in the period from 1996 to 2016. In addition, the dependent population of the insured was used as the control variable. This population had no income and had high medical demands. Results: After the dependent population was included as a control variable, there was a period of low-frequency (one to four years short-term) linkage correlation, as well as a period of high-frequency (four to eight years long-term) linkage correlation. In addition, for more than eight years, there was also a high degree of linkage correlation, indicating that the linkage between medical expenditures and GDP occurred over the long term. Moreover, since medical expenditures positively affected GDP, one-way causality was observed. However, after 2008, regardless of whether a long or short term was examined, there was almost no linkage correlation. Before 2008, the medical expenditures of the government were positively correlated with economic growth; i.e., they enhanced economic growth. But, after 2008, this effect had already disappeared. The universal health insurance system has long been denounced as a waste of medical resources, and the waste must be immediately stopped. The government urgently needs to find a new solution.

Background: The progression of periodontal diseases at national Portuguese level and its public awareness are of great interest, mainly due to the high burden of periodontitis. Objectives: To evaluate the prevalence progression of periodontal diseases in Portugal and correspondent public awareness, between 2004 and 2017, by using data from the Global Burden of Disease (GBD), Directorate-General of Health (DGH) and Google® Trends (GT). Methods: For the period 2004-2017, Portuguese national data of periodontal diseases prevalence were searched in the Institute for Health Metrics and Evaluation of GBD and DGH and for public awareness, GT comparison tool between Portuguese words for “Periodontitis”, “Gingivitis”, “Gums” and “Periodontal disease” trends was used. Results: For the period 2004-2017, the overall prevalence of periodontitis slightly increased from 11.3% to 11.7%. During that period the GT search term “Gums” (“Gengivas”) was the most relevant. It increased steadily over time while the search term “Periodontal disease” (“Doença periodontal”) decreased, being these search trends significantly correlated (

The possibility of using additive manufacturing (AM) in the medicine area has created a new opportunities in health care. This has contributed to a sharp increase in demand for 3D printers, their systems and materials that are adapted to strict medical requirements. We described herein a medical-grade thermoplastic polyurethane (S-TPU), which was developed and then formed into a filament for Fused Deposition Modeling (FDM) 3D printers during a melt-extrusion process. S-TPU consisting of aliphatic hexamethylene 1,6-diisocyanate (HDI), amorphous α,ω-dihydroxy(ethylene-butylene adipate) (PEBA) and 1,4 butandiol (BDO) as a chain extender, was synthesized without the use of a catalyst. The filament properties were characterized by rheological, mechanical, physico-chemical and in vitro biological properties. The tests showed biocompatibility of the obtained filament as well as revealed no significant effect of the filament formation process on its properties. This study may contribute to expanding the range of medical-grade flexible filaments for standard low-budget FDM printers.

The operations of digitization, transmission and storage of medical data, particularly images require increasingly effective encoding methods not only in terms of compression ratio and flow of information but also in terms of visual quality. At first, there was DCT (discrete cosine transform) then DWT (discrete wavelet transform) and their associated standards in terms of coding and image compression. After that, the 2nd generation wavelets seeks to be positioned and confronted to the image and video coding methods currently used. It is in this context that we suggested a method combining bandelets and SPIHT (set partitioning in hierarchical trees) algorithm. There are two main reasons for our approach: the first lies in the nature of the bandelet transform to take advantage by capturing the geometrical complexity of the image structure. The second reason stems in the suitability of encoding the bandelet coefficients by the SPIHT encoder. Quality measurements shows that in some cases (for low bit rates) the performances of the proposed coding compete with the well-established ones and opens up new application prospects in the field of medical imaging.

This paper investigates the effects of Inter-generational co-residence on health care market, and labor market outcomes, to see whether or not living under the same roof with at least one parent matters in health care market, and labor market behaviors in post-Affordable-Care Act (ACA) USA. The adopted analytical strategy involves not only looking at the gender differences in co-residence, and its effects on outcomes in the two markets, but also accounting for co-residence endogeneity following the recent literature. Unlike the recent literature that relies on instrumental variables methods, this study adopts a switching regression approach, defining inter-generational co-residence as an endogenous selection process using a binary probit equation, and modeled jointly with the extensive margins and intensive margins in the two markets. This novel approach results in a recursive trivariate probit model for each market, and estimated using penalized maximum likelihood methods. The results suggest that ACA by reorganizing the US health care market, seems to have reduced significantly disparities in health care access among males and females based on race, region of residence, place of birth, and citizenship. However not only do we observe significant differences in inter-generational co-residence status between males and females, we also find significant inequalities in the effects of co-residence on health care market, and labor market outcomes. In fact, co-residence is found to increase health care expenditure by 56.7% among females, while this figure increases to 74.2% among males. In addition co-residing individuals, while spending 69.7% more on health care annually are 1.22 times more likely to access health care, but 31% less likely to use health care intensively during the year. In the labor market, co-residence is found to reduce significantly hours of weekly labor supplied by 41% for females, and 55.6% for males. Furthermore co-residing individuals, while not significantly different in their likelihood of labor force participation, are 1.52 times less likely to work full time once they decide to participate, and also spend about 55.4% less time working in the labor market in post-ACA USA.

This paper presents a new optical, multi-functional, high-resolution 3-axis sensor which serves to navigate and can, for example, replace standard joysticks in medical devices such as electric wheelchairs, surgical robots or medical diagnosis devices. A light source, e.g. a laser diode is affixed to a movable axis and projects a random geometric shape on an image sensor (CMOS or CCD). The software in the downstream microcontroller identifies the geometric shape’s center, distortion and size, then calculates X, Y, and Z coordinates. These coordinates can then be processed in attached devices. The 3-axis sensor is characterized by its very high resolution, precise reproducibility and plausibility of the coordinates produced. In addition, optical processing of the signal provides a high level of safety against electromagnetic and radio frequency interference. The sensor presented here is adaptive and can be adjusted to fit a user’s range of motion (stroke and force). This recommendation aims to optimize sensor systems such as joysticks in medical devices in terms of safety, ease of use, and adaptability.

Centrifuges are commonly required devices in medical diagnostics facilities as well as scientific laboratories. Although there are commercial and open source centrifuges, costs of the former and required electricity to operate the latter, limit accessibility in resource-constrained settings. There is a need for low-cost, human-powered, verified and reliable lab-scale centrifuge. This study provides the designs for a low-cost 100% 3-D printed centrifuge, which can be fabricated on any low-cost RepRap-class fused filament fabrication (FFF) or fused particle fabrication (FPF)-based 3-D printer. In addition, validation procedures are provided using a web camera and free and open source software. This paper provides the complete open source plans including instructions for fabrication and operation for a hand-powered centrifuge. This study successfully tested and validated the instrument, which can be operated anywhere in the world with no electricity inputs obtaining a radial velocity of over 1750rpm and over 50N of relative centrifugal force. Using commercial filament the instrument costs about US$25, which is less than half of all commercially available systems; however, the costs can be dropped further using recycled plastics on open source systems for over 99% savings. The results are discussed in the contexts of resource-constrained medical and scientific facilities.

Reducing the carbon footprint of energy production is one of the most pressing challenges facing humanity today. Lignocellulosic biomass residues from fruit production industries show promise as a viable energy source. This paper presents a study of the Italian context concerning the utilization of orchard lignocellulosic residues for energy production as electricity or bioethanol. The potential of various orchard residues was assessed through chemical and physical analysis, and an equivalent electrical energy of about 6441.62 GWh or an amount of 0.48 Mt/y of bioethanol was obtained based on the average annual dry residue mass availability of about 3.04 Mt/y. These data represent the 9.30% of the national electrical energy production from renewable sources, as well as the 6.21% of the Italian demand for gasoline in 2022. Electricity generation from these residues shown its potential as a reliable and sustainable baseload power source, as well as source of renewable transportation fuel. The studied process could be a valuable reference to expand these concepts on global scale to achieve a greener and more sustainable energy future.

The objective of this paper was to verify the applicability of statistical learning (SL) compared to human reasoning with respect to the Universal Thermal Climate Index (UTCI), a complex tool for the assessment of outdoor thermal stress. UTCI is an equivalent temperature index based on the 48-dimensional output of an advanced model of human thermoregulation formed by 12 variables at four consecutive 30-minute intervals, which were calculated for 105642 thermal conditions from extreme cold to extreme heat. Comparing the performance of SL algorithms to the results accomplished by an international endeavor involving more than 40 experts from 23 countries, we found that random forests and k-nearest neighbors closely predicted UTCI values, but that clustering applied after dimension reduction algorithms (principal component analysis and t-distributed stochastic neighbor embedding) were inadequate for risk assessment in relation to the UTCI stress categories. This indicates a potential supportive role for SL, as it will not (yet) fully replace the bio-meteorological expert knowledge.

Recent development for synthesis of bio-based long chain aliphatic polyesters by acyclic diene metathesis (ADMET) polymerization of α,ω-dienes, derived from plant oils and bio-based chemicals, like bis(10-undecenoate) with isosorbide, using ruthenium-carbene catalysts have been reviewed. Development of subsequent (one-pot) tandem hydrogenation afforded saturated polyesters under mild conditions. The polymerizations under bulk (without solvent, 80-90 ºC) or in ionic liquids (50 ºC) under vacuum conditions enabled synthesis of high molar mass polymers (Mn &gt;30,000 g/mol). The polymerization by molybdenum-alkylidene catalyst afforded the highest molecular weight polyesters (44000‒49400 g/mol, in toluene at 25 ºC) exhibiting promising tensile properties (strength and elongation at break) beyond polyethylene, polypropylene. Depolymerizations of these polyesters including closed loop chemical recycling were also demonstrated. Catalyst developments (more active, under mild conditions) play a key role for the efficient synthesis.

The design of binders plays a pivotal role in achieving enduring high power in lithium-ion batteries (LIBs) and extending their overall lifespan. This review underscores the indispensable characteristics that a binder must possess when utilized in LIBs, considering factors such as electrochemical, thermal, and dispersion stability, compatibility with electrolytes, solubility in solvents, mechanical properties, and conductivity. In the case of anode materials, binders with robust mechanical properties and elasticity are imperative to uphold electrode integrity, par-ticularly in materials experiencing substantial volume changes. For cathode materials, the se-lection of a binder hinges on the crystal structure of the cathode material. Other vital consid-erations in binder design encompass cost-effectiveness, adhesion, processability, and envi-ronmental friendliness. Incorporating low-cost, eco-friendly, and biodegradable polymers can contribute significantly to sustainable battery development. This review serves as an invaluable resource for comprehending the prerequisites of binder design in high-performance LIBs and offers insights into binder selection for diverse electrode materials. The findings and principles articulated in this review can be extrapolated to other advanced battery systems, charting a course for the development of next-generation batteries characterized by enhanced perfor-mance and sustainability.

Introduction: The distribution of typical bacterial redox enzymes such as pyruvate-ferredoxin oxidoreductase (PFOR) in protozoa remains interestingly puzzling. Previous studies have demonstrated diverse cellular localizations of PFOR in amitochondriate anaerobic protozoa such as Trichomonas vaginalis. PFOR is of particular pharmacological importance because it catalyzes the reductive bio-activation of nitro-based prodrugs to cytotoxic radical metabolites. Metronidazole was developed primarily as an antiprotozoal agent against infections caused by T. vaginalis. However, its antimicrobial spectrum was subsequently expanded to cover anaerobic bacterial infections. It has been shown that mutations in the genes encoding PFOR result in inherent resistance of T. vaginalis and anaerobic bacteria to metronidazole. Aims: To analyze the phylogenetic distribution of PFOR in selected protozoa and bacteria using proteins encoded by housekeeping genes as controls. Using comparative bioinformatics to test the hypothesis that PFOR was most likely acquired through horizontal gene transfer from bacteria, proteome-wide analysis and gene expression analysis to identify other genes that were putatively acquired through horizontal gene transfer from bacteria to protozoa. Methods: Sequence similarity queries were performed using the proteins of interest against the NCBI non-redundant protein sequence database with BLASTP version 2.12.0+ from the NCBI website. Multiple sequence alignments were performed with MEGA version X software using the Muscle algorithm. These were then exported in Mega format to construct phylogenetic trees using the neighbor-joining algorithm and the Poisson substitution model. Complete proteomes of representative protozoan and bacterial species were downloaded in fasta format from the ensemblgenomes database. HMM profile libraries were used to screen the proteomes with hmmscan of the HMMer package. Whole proteome BLAST searches were performed between protozoan species of interest against closely related protozoa. The results were compared to the proteome BLAST against the intestinal bacteria Desulfovibrio vulgaris. Gene enrichment analysis was performed between the exclusively present proteins in the protozoa and D. vulgaris. Only results with p-values <0.05 were considered for analysis. Results and conclusions: A plausible explanation for the restricted occurrence of PFOR in protozoa is based on the hypothesis that bacteria serve as potential sources of genes that enhance optimal adaptation of protozoa in hostile environments. The expanded cladograms of Entamoeba and Cryptosporidium with their closely related genera substantiated this hypothesis. The exclusively expressed proteins obtained from E. histolytica and the putative bacterial gene donor, D. vulgaris, showed an over-representation of eleven genes involved in small molecule metabolism, generation of precursor metabolites, and carbohydrate metabolism. If these results can be reproduced in other PFOR-possessing protozoa, it would provide a more validated evidence to support the horizontal transfer of pfor from bacteria. Subsequent syntenic analyses of the significantly enriched genes would be required to provide further information regarding the positional relatedness of these genes at the chromosomal level. Since metronidazole is an established and well tolerated drug for treating infections caused by PFOR-possessing pathogens, it can be considered as a potential drug candidate for the treatment of infections caused by Cryptosporidium, Spironucleus and Blastocystis.

This study focused on the optimization of the flexural strength of bio-composite samples of palm kernel, whelks, clams, periwinkles shells and bamboo fiber, reinforced with resin for engineering applications. The aim of the study was to: formulate different samples of bio-composite reinforce with resin for engineering applications and to evaluate the flexural strength, of the fabricated composite. The hand lay-up technique was used for the composites produced by incorporating different percentage compositions of the shells/fiber (10%, 15%, 20%, 25% and 30%) into varied proportions of epoxy resin and catalyst. The cured samples after 24hours were subjected to tensile, impact, flexural and water absorption test. The experiments were conducted using Taguchi optimization method L25 (5x5) with five design parameters and five level combinations in Minitab 18 statistical software. The results showed that the average values of flexural was 114.87MPa when compared to the unreinforced of 72.33MPa bio-composite. The study recommended that agricultural waste like palm kernel shells, whelk shells, clams, periwinkle shells and bamboo fiber, should be converted into important engineering applications.

Reducing the costs of repairing concrete structures damaged due to the appearance of cracks and reducing the number of people involved in the process of their repair is the subject of a multitude of experimental studies. Special emphasis should be placed on research involving industrial by-products, the disposal of which has a negative environmental impact, as is the case in the research presented in this paper. The basic idea was to prepare a mortar with added granulated blast furnace slag from Smederevo Steel Mill and then treat artificialy produced cracks with a Sporosarcina pasteurii DSM 33 suspension under the conditions of sterile demineralized and water from Danube river in order to simulate natural conditions. The results show a bio-stimulated healing efficiency of 32.02% in sterile demineralized water and 42.74% in Danube water already after 14 days. The SEM images clearly show calcium carbonate crystals as the main compound that has started to fill the crack, and the crystals are much more developed under the Danube water conditions. As a special type of research, microscopic images of cracks were classified into those with and without the presence of bacterial culture. By applying convolutional neural networks (ResNet 50), the classification success rate was 91.55%.

We report the isolation of two novel degrading bacterial strains active against the potential environmental pollutant acetamino-phen/paracetamol. Streptomyces Chrestomyceticus (RS2) and Streptomyces Flavofuscus (M33) collected from El-Natrun Valley, Egypt, water, sediment, and sand samples were taxonomically characterized via conidiophores morphologic characterization under Trans-mission Electron Microscope (TEM). Genotypic identification, done based on their 16S rRNA gene sequence analysis followed by BLAST alignment and deposited on the NCBI as 2 novel strains. The phylogenetic tree was constructed using an appropriate software. Acetaminophen degradation-products chemical structure was identified by GC/LC MS. The biological antimicrobial activity of some selected acetaminophen degradation-products extracts and derived compounds was examined against panel of test micro-organisms and found to be have high anti-microbial effect. In addition, in silico cheminformatics Swiss ADMET evaluation of these selected deg-radation extract for gastric absorption, distribution, hepatic metabolism, renal excretion as well as distribution to CNS and finally not mutagenic/teratogenic or genotoxic virtually. In vitro cytotoxic activity of these selected bio-degradation products was performed against HepG2 and MCF7 cancer cell lines, revealing that M33 and RS2 extract effect on acetaminophen/paracetamol bio-degradation products are potentially safe with higher IC50 on HepG2 and MCF7, in comparison to acetaminophen/paracetamol with IC50 of 108.5 μg/ml. Moreover, the in vivo acute oral single dose toxicity experiment was conducted, being compared with acetamino-phen/paracetamol to confirm that the bio-degradation products have lower toxicity than acetaminophen in vivo and in silico.

CO₂ emissions have been identified as the main driver for climate change, with devastating consequences for the global natural environment. The steel industry is responsible for ca. 8%-11% of global CO₂ emissions, due to high fossil-fuel and energy consumption. The onus is therefore on industry to remedy the environmental damage caused and to decarbonise production. This desk research report follows a two-tiered route: 1) exploring the Bio Steel Cycle; 2) proposing a seven-step strategy to overcome the challenges within the iron and steel industry. The true levels of CO₂ emissions in the steelmaking process, during the blast-furnace/basic-oxygen-furnace operation, will be detailed first, at 4.61t of CO₂ emissions/t of steel produced. The manuscript proposes a solution for reduced carbon emissions steelmaking with the Bio Steel Cycle components and detail on how to reach net-zero carbon emissions steel production. The 7-step-implementation-strategy as a potential solution to achieve net and true zero carbon emissions steel production in the short to medium-term. The findings of this are pointing towards the conclusion that CO₂ emissions seem to have been under-reported and under-estimated in the past, but the emission can be addressed if the correct scenarios for net-zero steel manufacturing are implemented by 2050.

The nutraceutical value of pomegranate in the treatment of many neoplastic, cardiovascular, viral, inflammatory, metabolic, microbial, intestinal, reproductive and skin diseases is well-documented and is linked to its richness in phenolic compounds. This study aims to evaluate nutraceutical and genetic diversity of novel pomegranate genotypes (G1-G5) in comparison to leading commercial pomegranate varieties i.e. ‘Wonderful’, ‘Primosole’, ‘Dente di Cavallo’ and ‘Valenciana’. Morphometric measurements were carried out on fruits, accompanied by chemical characterization and the development of four new polymorphic SSR markers involved in the flavonoid pathway. The cultivars displayed a marked variability in the weight and shape of fruits, as well as in the weight of arils and juice yield. The highest level of total phenolic content and antioxidant activity was found in ‘Wonderful’ and G4, while the lowest was in ‘Dente di Cavallo’. Furthermore, the results showed that the pomegranate juice, is an excellent source of minerals, especially potassium, which plays a key role in organ functioning. The new flavonoid-related markers effectively differentiated the cultivars with the same diversity pattern as morpho-chemical characterization, so the SSRs developed in the present study can be used as a rapid tool for the identification of pomegranate cultivars with relevant nutraceutical traits.

The utilisation of the industrial residual products to create new value-added materials and to reduce footprint is a modern challenge of science and industry. Development of the new multifunctional and bio-based composites is an excellent opportunity for complex utilisation of industrial residual products. The study describes the preparation and characterisation of the three-phases bio-based composites. The main components are bio-based binder made of peat, devulcanised crumb rubber (DCR) from used tires and part of the fly ash the cenosphere (CS). Three-phase composite prepared in the form of a block for investigation of the mechanical properties and density and a form of granules for determination of the water and oil products sorption was investigated. This work investigated the dependence of the properties on the main component DCR and CS fraction. Is found, that maximum compression strength (in block form) observed for composition without CS and DCR addition - 79.3 MPa, the second highest value of compression strength is 11.2 MPa for composition with 27.3 wt% of CS. For compositions with bio binder content from 17.4 to 55.8 wt% and with DCR contents in range from 11.0 to 62.0 wt% compression strength is in range 1.1 to 2.0 MPa. Liquid sorption analysis (water and diesel) showed that the maximum saturation of liquids in both cases is set after 35 minutes and ranges from 1.05 to 1.4 g·g -1 for water and 0.77 to 1.25 g·g-1 for diesel. It was noted that 90% of the maximum saturation with diesel fuel comes after 10 minutes and for water after 35 minutes.

Delipidation is a method of defatting that is generally associated with the removal of residual lipids or lipid groups from matrices in which they are present in minute quantities. The bio-delipidation of protein-rich poultry slaughterhouse wastewater (PSW) pre-treated with a dissolved air flotation (DAF) system was developed using microbial lipases from bacterial strains isolated from the PSW. The efficacy of the bio-delipidation system was quantitatively characterised by comparing the quality parameters i.e., fats, oil and grease (FOGs), turbidity, total suspended solutes (TSS), total chemical oxygen demand (tCOD) and protein concentration of the DAF pre-treated PSW and bio-lipidized samples. As hypothesised, the bio-delipidation system was able to effectively reduce the levels of these quality parameters when crude lipases of Bacillus cereus AB1 (BF3) and Bacillus cereus CC-1 (B30) strains were used. Strain-dependent quality characteristics were also observed in bio-delipidized samples. The study successfully managed to complement physical reduction techniques (DAF) with biological strategies (bio-delipidation) for improved PSW quality, with potential industrial applications.

Smart electronic devices and telemedicine are widely used in humans' daily lives. This provides remote treatment of patients using information and communications technology. New telemedicine technologies, such as the Internet of Medical Things (IoMT), make it easier for medical and computing devices to communicate regularly and effectively. Critical motivations for adapting the IoMT are reduced cost, increased quality of life, and timely medical intervention. IoMT is significant because it enables continuous, real-time patient monitoring during routine everyday activities using a variety of wearables and sensors. With big data, the IoMT technology makes excellent use of Artificial Intelligence (AI) to support disease detection and health condition prediction, alerting patients and healthcare providers. Many research studies have been conducted to explore various aspects of IoMT and its applications in the real world. However, it is challenging to comprehend all the techniques and solutions proposed by the research community. Therefore, this survey sheds light on some crucial aspects of IoMT technologies and explores the potential research gaps and directions the research community could tackle. The survey examines and discusses the characteristics of IoMT standards, protocols, and types. It then delves into the layers of IoMT and distinguishes them into Fog and edge. The studies published under each type were explored, and the limitations of these works were highlighted. The research gaps and directions on IoMT approaches and technologies were also highlighted. With such findings and research directions, further research endeavors could be carried out to address the issues and existing limitations in the IoMT.

The institutionalization of people with intellectual disabilities has been a common international response across cultures and generations that persists to this day. This chapter recounts its inheritance and manifestation in modern service provision. An institutional mind-set persists among clinicians and managers despite policies that emphasise the rights of persons with intellectual disability and anti-discriminatory practice. Alternative provision is rooted in person-centred practice; with a growing body of evidence for the improved quality of life that results from it. A reflective activity encourages readers to examine a recent case when they were associated with an institutional placement and what alternatives might have been sought. Yet alliances with other professionals, self-advocates and family carers will be needed to effect real and lasting changes in our service cultures and even then, the long shadows of institutional care may still persist.

Background: Obesity is a global health crisis with a rapidly increasing prevalence among university students. Medical students are a unique population that may be at a higher risk of obesity due to the demanding nature of their studies and the associated stress. Objective: This study aimed to determine the prevalence of overweight, obesity, and the associated risk factors among medical students at Jazan University in Saudi Arabia. Methods: A cross-sectional study was conducted among 228 medical students from their 2nd to 6th academic years at the Faculty of Medicine, Jazan University. A self-administered questionnaire was used to collect data regarding sociodemographic characteristics, physical activity, dietary habits, comorbidities, medication use, family history, and lifestyle factors. Anthropometric measurements including height, weight, and waist circumference were recorded. Chi-square test and binary logistic regression were used to identify the risk factors associated with obesity. Results: The prevalence of overweight and obesity among the participants was 13.3% and 15% respectively. Hence, the combined prevalence of overweight and obesity is 28.3%. The mean weight was 63.39 ± 18.93 kilograms, and the mean height was 163.48 ± 9.78 centimeters. On the other hand, 17.3% of participants had underweight whereas 54.4% had normal BMI. Most of the participants (61%) did not engage in regular exercise. A high proportion consumed fruits (82.9%) and vegetables (58.8%) 3 or fewer days per week, and 84.2% consumed 3 or fewer meals per day. Fast food consumption more than 3 days per week was reported by 42.1% of participants. Obesity was not significantly associated with sociodemographic factors, physical activity, dietary habits, comorbidities, medication use, or family histories. However, those with a monthly family income of 15,000-24,999 riyals had significantly lower odds of obesity than those in the lowest income group (OR 0.230, p = 0.045). Conclusion: The prevalence of overweight and obesity among medical students at Jazan University is high. Although no significant associations were found between obesity and most risk factors, this study highlights the need for interventions that promote healthy lifestyles among medical students. Further research is needed to identify effective strategies for preventing and managing obesity in this population.

Dermal injections of hyaluronic acid gel for aesthetic skin rejuvenation are increasingly popular nowadays. Although these products are classified as medical devices, the regulations on their administration by licensed practitioners are still weak, whereas their manufacturers increasingly highlight and advertise the cellular effects that underpin the efficacy of these injections. In this re-view, we discuss all current knowledge on the mode of action of dermally injected hyaluronic acid and the potential toxicological implications especially from crosslinked gels in conjunction with the current global regulations. We conclude that dermal injections of hyaluronic acid have several therapeutic implications that warrant further research, and that strict regulations must be applied on their manufacture/quality control and the required qualifications of licensed aesthetic injectors.

Cross-institutional secondary use of medical data benefits from structured semantic annotation, which, ideally, enables matching and merging semantically related data items from different sources and sites. While numerous medical terminologies and ontologies, as well as some tooling, exist to support such annotation, cross-institutional data usage based on independently annotated datasets is challenging for multiple reasons: the annotation process is resource intensive and requires a combination of medical and technical expertise since it often requires judgment calls to resolve ambiguities resulting from non-uniqueness of potential mappings to various levels of ontological hierarchies and relational and representational systems. Divergent resolution of such ambiguities can inhibit joint cross-institutional data usage based on semantic annotation since data items with related content from different sites will not be identifiable based on their respective annotations if different choices were made without further steps such as ontological inference, which is still an active area of research. We hypothesize that a collaborative approach to semantic annotation of medical data can contribute to more resource efficient and high-quality annotation by utilizing prior annotational choices of others to inform the annotation process, thus both speeding up the annotation itself and fostering a consensus approach to resolving annotational ambiguities by enabling annotators to discover and follow pre-existing annotational choices. Therefore, we have implemented a prototypical Collaborative Annotation Tool (CoAT), evaluated its usability, and present first inter-institutional experiences with this novel approach to promoting practically relevant interoperability driven by use of standardized ontologies.

Introduction: In an era of increasing public awareness regarding the pivotal role of nutrition in the onset and progression of chronic degenerative diseases, there is a growing demand for information and assistance pertaining to the intricate relationship between diet and disease. Nutritional practices, therefore, emerge as a fundamental element in the prevention and management of these maladies, necessitating a proactive response from healthcare professionals (HCP). This study sought to evaluate the impact of participation in a Culinary Medicine (CM) program on Mediterranean diet adherence, food management skills, culinary proficiency, and counseling confidence among HCP. Methods: A mixed-methods pilot implementation program (PIP) was meticulously designed and executed, engaging a cohort of 20 HCP recruited from Hospital Clinic Barcelona. The program unfolded at the Alícia Foundation kitchen-lab and encompassed a series of interactive, hands-on sessions that delved into the realms of gastronomy, food management, culinary skills, and culinary diet therapy, with a specific focus on prevalent diseases and their prevention, treatment, and care. Tailored questionnaires were administered to all participants both before and after the PIP. Results: Of the 20 participants, 14 successfully completed the study, comprising 86% women, 86% aged above 40, 71% nurses, and 7% medical doctors. Interestingly, 86% of the participants had previously received nutrition training, whereas only 14% had received culinary training. Following the completion of the program, there was a remarkable improvement in adherence to the Mediterranean diet (p < 0.01). However, no statistically significant improvements were observed in food management and culinary skills or counseling confidence (p > 0.5). Despite the absence of statistical significance, there was a noteworthy trend towards greater advocacy for dietary changes before resorting to medication, along with enhanced confidence in providing nutritional and culinary guidance to patients. Conclusion: The findings from this study underscore the potential of hands-on CM training as a vital component of nutrition education for HCP. While statistically significant improvements in certain domains were not observed, the program did demonstrate its ability to influence attitudes, knowledge, and behaviors related to healthy cooking and eating for both HCP themselves and their patients. Given these promising trends, future studies with a larger sample size must be performed to further elucidate the impact of CM training on HCP and its potential benefits for public health.

In recent years, antibacterial coatings have become a significant approach in the global fight against bacterial pathogens. Developments in materials science, chemistry and biochemistry have led to a plethora of materials and chemical compounds that have potential for creating antibacterial coatings. Nonetheless, there has been insufficient consideration given to the analysis of the techniques and technologies used to apply these coatings. Among the various inorganic coating techniques, Atomic Layer Deposition (ALD) is noteworthy. It enables the successful synthesis of high-purity inorganic nanocoatings on surfaces of complex shape and topography, while also providing precise control over their thickness and composition. ALD has various industrial applications, but its practical application in medicine is still limited. In recent years, a substantial number of papers have been published on the suggested implementation of thin films and coatings produced through ALD in medicine, notably those with antibacterial properties. The aim of this paper is to carefully evaluate and analyse the relevant literature on this subject. Simple oxide coatings, including TiO2, ZnO, Fe2O3, MgO, and ZrO2, were examined, as well as coatings containing metal nanoparticles such as Ag, Cu, Pt, and Au, and mixed systems such as TiO2-ZnO, TiO2-ZrO2, ZnO-Al2O3, TiO2-Ag, and ZnO-Ag. Through comparative analysis, we have been able to draw conclusions on the effectiveness of various antibacterial coatings of different compositions, including key characteristics such as thickness, morphology, and crystal structure. ALD has been analysed in its use for developing antibacterial coatings for various applications. Furthermore, assumptions regarding the most promising development areas have been presented.

The automatic diagnosis of cardiovascular diseases has received much attention in the deep learning field. In this context, the segmentation of the left ventricle endocardium constitutes a major task in diagnosing heart conditions such as health failure and hypertrophic cardiomyopathy. The objective of this paper is to propose a "deep convolution network" for segmenting the internal cavity of the left ventricle (endocardium) using MRI images. In particular, we design an improved UNET model which handles additional inception modules for efficiently segmenting the internal cavity of the left ventricle. Our approach has been validated on the Sunnybrook Cardiac Data (SCD) dataset and has showed promising results in terms of precision. More specifically, the improved UNET largely outperforms the baseline UNET model and many existing state-of-the-art methods.

Since the emergence of convolutional neural networks (CNNs), and later vision transformers (ViTs), the standard paradigm for model development has been using a set of identical block types with varying parameters/hyper-parameters. To leverage the benefits of different architectural designs (e.g., CNNs and ViTs), we propose alternating structurally different types of blocks to generate a new architecture, mimicking how Lego blocks can be assembled. Using two CNN-based and one SwinViT-based blocks, we investigate three variations to the so-called LegoNet that apply the new block alternation concept for the segmentation task in medical imaging. We also study a new clinical problem that has not been investigated before – the right internal mammary artery (RIMA) and perivascular space segmentation from computed tomography angiography (CTA). It was proven to demonstrate a prognostic value to primary cardiovascular outcomes. We compare the model performance against popular CNN and ViT architectures using two large datasets (achieving 0.749 dice similarity coefficient (DSC) on the larger dataset). We also evaluate the model’s performance on three external testing cohorts, where an expert clinician corrected model-segmented results (DSC>0.90 for the three cohorts). To assess our proposed model for suitability in clinical use, we perform intra- and inter-observer variability analysis. Finally, we investigate a joint self-supervised learning approach to determine its impact on model performance.

Multimodal medical image fusion is a fundamental but challenging problem in the fields of brain science research and brain disease diagnosis, and it is challenging for sparse representation (SR)-based fusion to characterize activity level with single measurement and no loss of effective information. In this paper, the Kronecker-criterion-based SR framework is applied for medical image fusion with a patch-based activity level integrating salient features of multiple domains. Inspired by the formation process of vision system, the spatial saliency is characterized by textural contrast (TC), which is composed of luminance and orientation contrasts to promote more highlighted texture information to participate in the fusion process. As substitution of the conventional l1-norm-based sparse saliency, a metric of sum of sparse salient features (SSSF) is used for promoting more significant coefficients to participate in the composition of activity level measure. The designed activity level measure is verified to be more conducive to maintain the integrity and sharpness of detailed information. Various experiments on multiple groups of clinical medical images verify the effectiveness of the proposed fusion method on both visual quality and objective assessment. Furthermore, the research work of this paper is helpful for further detection and segmentation of medical images.

Freeze-drying is a well-established process in biomedical engineering for the fabrication of three-dimensional open-porous medical devices, especially those based on biopolymers. One of the most used biopolymers in this field is collagen, the most abundant protein in the human body and the main component of the extracellular-matrix, as well as its derivatives. Freeze-dried collagen-based sponges with a wide variety of attributes can be produced by design and have led to a wide range of successful commercial medical devices, foremost for dental, orthopedic, hemostatic and neuronal applications. However, this is still considered a high-cost and time-consuming process that is often used in a non-optimized manner. By combining advances in other technological fields, the opportunity arises to further evolve this process in a sustainable manner, and optimize the resulting products as well as create new opportunities in this field.

This study aimed to investigate Romanian physicians' awareness, recommendation practices, and opinions regarding using Foods for Special Medical Purposes (FSMPs) products. A total of ten physicians were interviewed using a structured questionnaire, and their responses were analysed using thematic content analysis. The study found that physicians were aware of FSMPs and recommended them to their patients based on nutritional deficits, weight loss, or deglutition impairments. In addition, disease stage, treatment scheme, taste, affordability, and availability were identified as factors influencing the recommendation and use of FSMPs. While physicians generally did not consult clinical trials, clinical experience was deemed essential for recommending FSMPs to patients. Patients' feedback regarding the usage and sourcing of FSMPs was generally positive, with some expressing concerns about the availability of different flavours and the costs of purchasing the products. The study concludes that physicians play a vital role in recommending FSMPs to patients and ensuring they have the necessary nutritional support during treatment. However, more patient education materials and collaboration with nutritionists may be required to improve patient outcomes and reduce patient financial burden.

Chronic non-communicable diseases (NCDs) are major public health problems and a significant financial burden on public health systems. By 2030, mortality due to NCDs, such as cardiovascular diseases, cancer, respiratory diseases, and diabetes, is predicted to increase in Brazil. A peculiar aspect of NCDs involves their long-term and integrated care management. This paper proposes a chronic disease management platform based on artificial intelligence to deliver digital health services everywhere. The proposed platform is anchored and built with healthcare 4.0 technologies, such as wearable devices, the internet of medical things, and artificial intelligence cloud-based solutions that allow the deployment of a smart healthcare system. In addition, the paper presents the feasibility of the platform in a diabetes prediction study case. For the study case, an initial dataset was established with bio-impedance, oxygen concentration, pulse rate, skin impedance, and skin temperature attributes. A baseline was implemented with ten regression models to assess the prediction performance of the mean squared error, root mean squared error, and r-squared score to compare predictive findings with capillary blood glucose measurements. Results evidence that the decision tree regressor and three ensemble methods (bagging decision tree regressor, random forest regressor, and AdaBoost regressor) yielded improvement over the other models. Moreover, a comparison among those models revealed that the decision tree regressor outperforms them and presents promissory outcomes.

Care coordination (CC) for children with special healthcare needs and medical complexity (CSHCN-CMC) is challenging, and medication management is especially difficult for providers, parents/caregivers, and patients alike. While numerous strategies for CC have been suggested and implemented, barriers to medication optimization remain. The report describes the creation of a pediatric clinical pharmacotherapy practice, related standard operating procedures to assure consistent application of screening tools and care provision through comprehensive medication management (CMM), and establishment of a collaborative practice agreement (CPA) to guide drug therapy delegation, monitoring, and modification. The methodology of a prospective case series is also presented to highlight drug therapy problems and their resolution in CSHCN-CMC. Future opportunities to expand the practice for engagement in population health management as well as prior authorization activities on behalf of physicians will be discussed.

Background: Media coverage of Lyme disease (LD) has led to an increase in consultations for presumed LD in Europe. However, LD is confirmed in only 10-20% of patients, with a significant number remaining in a diagnostic dead-end. Objectives: To reach a deeper understanding of how patients themselves contribute to the diagnostic process. To describe the genesis of the LD hypothesis in care pathways. Methods: In 2019, 30 patients from a prospective cohort consulting in the infectious diseases department at University Hospital in Marseille for presumed LD were recruited for semi-structured interviews. The inclusion criteria were : suffering from subjective symptoms for 6 months, no clinical or paraclinical argument suggesting current LD. The patients’ medical trajectories were collected using a biographical approach. Results: The diagnosis of Lyme disease was primarily triggered by identification with personal testimonies found on the internet. Most of patients were leading their own diagnostic investigation. The majority of participants were convinced they had LD despite the lack of medical evidence and the scepticism of their referring GP. Conclusion: GPs should first systematically explore patients’ etiologic representations in order to improve adherence to the diagnosis especially in the management of medically unexplained symptoms. Long COVID-19 syndrome challenge offers an opportunity to promote active patient involvement in diagnosis.

Data sets for medical images are generally imbalanced and limited in sample size because of high data collection costs, time-consuming annotations, and patient privacy concerns. The training of deep neural network classification models on these data sets to improve the generalization ability does not produce the desired results for classifying the medical condition accurately and often overfit the data on the majority of class samples. To address the issue, we propose a framework for improving the classification performance metrics of deep neural network classification models using transfer learning: pre-trained models, such as Xception, InceptionResNet, DenseNet along with the Generative Adversarial Network (GAN) – based data augmentation. Then, we trained the network by combining traditional data augmentation techniques, such as randomly flipping the image left to right and GAN-based data augmentation, and then fine-tuned the hyper-parameters of the transfer learning models, such as the learning rate, batch size, and the number of epochs. With these configurations, the Xception model outperformed all other pre-trained models achieving a test accuracy of 98.7%, the precision of 99%, recall of 99.3%, f1-score of 99.1%, receiver operating characteristic (ROC) - area under the curve (AUC) of 98.2%.

The presented research faces the problem of early detection of sepsis for patients in the Intensive Care Unit. The PhysioNet/Computing in Cardiology Challenge 2019 facilitated the development of automated, open-source algorithms for the early detection of sepsis from clinical data. A labeled clinical records dataset for training and verification of the algorithms was provided by the challenge organizers. However, a relatively small number of records with sepsis, supported by Sepsis-3 clinical criteria, led to highly unbalanced dataset (only 2% records with sepsis label). A high number of unbalanced data records is a great challenge for machine learning model training and is not suitable for training classical classifiers. To address these issues, a number of various models were investigated. A solution including feature selection and data balancing techniques was proposed in this paper. In addition, several performance metrics were investigated. Results show, that for successful prediction, a particular model having few or more predictors based on the length of stay in the Intensive Care Unit should be applied.

The 2019 Coronavirus pandemic which was initially referred to as 2019-nCoV, was first identified in Wuhan, China. Early response from the Chinese government included quarantine of infected persons, isolation and total lockdown of Wuhan province to prevent further spread. With the spread of the disease across national borders and declaration of the disease as a global pandemic, there has been a robust response by the international community to contain this deadly virus and prevent its further spread worldwide. Africa is not left out of this rampaging pandemic with documented cases in over 40 countries and still rising. Although extensive studies have been carried out on the novel SARS-CoV-2 on its pathogenesis, mode of infection and virulence but much is still unknown. However, potentially infectious samples are received routinely in the medical laboratory for analysis. This technical note reviews good laboratory practice (GLP) and processes across the different specialities of Medical Laboratory practice that should minimize the risk of infection to laboratory staff especially in resource-limited settings.

Objective: This study investigated the effect of the hierarchical medical system under the national health insurance program on resident’s healthcare-seeking behavior in Taiwan. Background: Healthcare authorities in Taiwan initiated the allowance reduction of outpatient visits at regional hospitals and higher hierarchical hospitals from 2018. The ultimate goal is to implement a hierarchical medical system and provide the residents accessible as well as consistent medical services. Methods: This research was conducted through the questionnaire survey method and data were collected between August and December 2018 from the records of subjects who had recently sought medical attention. A total of 1,340 valid questionnaires were returned. Results: Regarding the effect on healthcare-seeking behavior, the following factors were significant: being aged between 40 to 49 (p＜.1), subjects with an educational background of junior high school (p＜.05), those who were not aware of the policy (p＜.001), and an awareness about both the hierarchical medical system and the policy to reduce outpatient visits to large hospitals (p＜.001). Conclusion: The public should be made aware about the hierarchical medical system to improve healthcare.

This article presents a new input device for spastic patients and others with similar symptoms. The sensor consists of a disc used to determine positions and can replace standard joysticks in medical devices such as electric-powered wheelchairs. Using a standard joystick while operating a powered wheelchair can result in dangerous situations when spastic movements occur and extremities cramp making them uncontrollable. To avoid this, a disc was developed that can be controlled with any body part. By shifting weight (x- and y-axis) the disc can tilt in any direction creating a proportional output signal and can also be pushed down in the center (z-axis) to open a menu on a screen for example. When spasms occur it is impossible for users to get stuck on the input device because the disc is flat and can be mounted within a control panel. Body parts coming into contact with the disc would merely slide across the disc without triggering unintentional actions. The sensor presented here is also adaptive and can be adjusted to fit a user’s strength and range of motion. This proposal aims to develop an input device that enables spastic patients to operate sensitive systems safely.

Several series of new polymers were synthesized: binary copolyesters of vanillic (VA) and hydroxybiphenylcarboxylic (HBCA) acids, as well as ternary copolyesters additionally containing hydroxybenzoic acid (HBA) and obtained via three different ways (in solution, in melt and in solid state). The high values of logarithmic intrinsic viscosities and insolubility of several samples proved its high molecular weights. It has been shown that the use of vanillic acid leads to the production of copolyesters with a relatively high glass transition temperature (about 130°C). Thermogravimetric analysis revealed onset of weight loss temperatures of ternary copolyesters occurred at 330-350 °C, the temperature of 5% mass loss is in the range of 390-410 °C. Two-stage thermal destruction is observed for all aromatic copolyester of vanillic acid: decomposition begins with VA units at 420-480 °C, and then decomposition of more heat-resistant units demonstrated above 520 °C. The copolyesters are thermotropic and exhibit a typical nematic type of liquid crystalline order. Mechanical characteristics of copolyesters are close to those for semi-aromatic copolyesters, but are much lower than typical values for fully aromatic thermotropic polymers. Thus, vanillic acid is a mesogenic monomer suitable for the synthesis of thermotropic fully aromatic and semi-aromatic copolyester, but resulting processing temperature must not exceed 280°C.

Due to the high impact of the building sector on the environment, a growing interest focuses on insulating materials able to ensure good thermo-acoustic performance for the building envelope, in a sustainable and circular economy perspective. In this context, Moroccan natural gypsum was mixed with natural waste local materials. Thermal and acoustic properties of the samples were measured; they were compared to those of synthetic- and mineral-based gypsum plasters, manufactured with the same technique. A Small Hot Box apparatus was used for thermal characterization, whereas acoustic performance was investigated by means of a Kundt’s Tube. Natural and synthetic additives involved a reduction in density and an improvement in thermal performance. Conductivity values in the 0.181 – 0.238 W/mK range were obtained, depending on the type of natural additive, with respect to 0.275 – 0.323 W/mK of mineral-based gypsum plasters. The acoustic measurements showed that all the composites have similar performance in terms of acoustic absorption, whereas high Transmission Loss values were obtained for the natural additives (TL = 35 – 59 dB). Petiol of Palm and Stipa Tenacissima were found as the materials able to improve both thermal and acoustic properties.

The search for fundamental determinants of bio-molecular chirality is a hot topic in biology, clarifying the meaning of evolution and the enigma of life's origin. Non-biological and biological entities obey the universal laws of nature grounded on space-time symmetry (STS) transformations. The fabric of STS is the immense subject of our review. The symmetry, encompassing behavior of elementary particles and galaxy structure, imposes its fundamental laws on all hierarchical levels of the biological world. Objects across spatial scales may be classified as chiral or achiral concerning a specific space-related symmetry transformation - mirror reflection. Chirality as a symmetry element reflecting the property of asymmetry (or dissymmetry) is the critical structural feature of natural systems, including sub-atomic particles and living matter. The inheritance of molecular symmetry from the symmetry of elementary particles points to the bi-directional causal pathway of prevalent bio-chirality. We assume that both extremities of spatial dimension naturally influence this transitional state of biological matter. The current review promotes an integrative holistic approach to the new experimental results in fast-developing and divergent branches of STS and biological chirality. The generalized view on biological chirality is a necessary and promising avenue for adequately understanding the link between protein folding, cell morphology, neuronal signaling, and laterality of cognitive functions.

The shape of the knee is a chain-like structure of an ellipsoid. This suggests that, in the latest study, in addition to rolling, there is slippage in the motion of the knee. This paper selects a mechanical braking model for cattle based on two mechanical structures in different directions at the joints. The experimental results show that the modified dynamical system has strong chaotic properties. This can be one of the basis for judging various health states.

Burning woody biomass for energy is gaining attention due to environmental issues associated with fossil fuels and carbon emission. The carbon released from burning wood is absorbed by plants and is carbon neutral. The purpose of this study was to investigate the combustion characteristics (heat calorific values and ash contents) of three timbers: Araucaria cunninghamii, Instia bijuga and Pometia pinnata and recommend for fuelwood. The test samples were sawdust particles (treatment) and solid woods (control) extracted from the heartwoods. The sawdust particles were oven-dried, sieved and pelletized into pellets using a hand-held pelletizing device, thus, forming cylindrical dimension (volume 1178.57 mm3, oven dry density 0.0008 g/mm3). While the solid woods were cubed and oven-dried (volume 1000.00 mm3, oven dry density 0.001 g/mm3). Prior to combustion in a semi-automatic bomb calorimeter, 90 test specimens (15 replicates per treatment and control per species) were conditioned to 14 % moisture content (at temperature 105 ºC) and weighed to a constant (unit) mass (1.0 g). The heat energy outputs and ash residues (of treatments) were analyzed statistically. The results indicated variability in heat energy outputs and ash residues between test specimens of the three species. Comparatively, the treatment specimens of A. cunninghamii produced higher calorific value (18.546 kJ/g) than the control (18.376 kJ/g) whilst the treatment specimens of I. bijuga and P. pinnata generated lower heat calorific values (17.124 kJ/g and 18.822 kJ/g) than the control (18.415 kJ/g and 20.659 kJ/g), respectively. According to ash content analysis, A. cunninghamii generated higher residues (6.3%) followed by P. pinnata (4.5%) and I. bijuga (2.8%). The treatment specimens of the three species could not meet the standard heat energy requirement (20.0 kJ/g) and thus, were unsuitable for fuelwood. However, the control specimens of P. pinnata generated equivalent heat energy (20.659 kJ/g) and could be a potential fuelwood.

It is widely accepted that plastic waste is one of our most urgent environmental concerns the world is currently facing. Plastic has contributed greatly to innovation in all fields, but the raw material for its production (fossil fuels), as well as the linear economy in which it is currently produced and used, makes the material problematic from a sustainability and human health perspectives. The emergence of bio-based plastics provides an opportunity to reduce dependency on fossil fuels and transition to a more circular plastics economy. For polyethylene terephthalate (PET), one of the most prevalent plastics in packaging and textiles, there exist two bio-based alternatives that are similar or superior in material property and recyclability. These are polyethylene furanoate (PEF) and polytrimethylene terephthalate (PTT). The overarching aim of this study was to examine the transition from fossil-based to renewable plastics, through the lens of PET upcycling into PEF and PTT. The process for the production of PEF and PTT from three feed streams (post-consumer PET waste, lignocellulosic biomass-derived cellulose and biodiesel-derived crude glycerol) was developed in the software SuperPro Designer and the economic viability assessed via a discounted cumulative cash flow (DCCF) analysis. This study represents a conceptual case study of the valorisation of existing plastic waste into new, recyclable bio-based plastics, for a more sustainable plastics production. A techno-economic analysis of the designed process revealed that the minimum selling price (MSP) of second generation-derived PEF and PTT is 3.13 USD/kg, and that utilities and the feedstock used for the production of 2,5-furandicarboxylic acid (FDCA) needed in PEF synthesis contributed the most to the process operating costs. The effect of recycling PEF and PTT through the process at three recycling rates (42%, 50% and 55%) was investigated and revealed that increased recycling could reduce the MSP of the 2G bio-plastics (by 48.5%) to 1.61 USD/kg. This demonstrates that increasing recycling rates would have a beneficial effect on the economic viability of the plastic biorefinery.

The utilisation of the industrial residual products to develop new value-added materials and to reduce footprint is one of the critical challenges of science and industry. Development of the new multifunctional and bio-based composites materials is an excellent opportunity for the effective utilisation of industrial residual products. Keeping the different issues in mind, in this work, we describe the manufacturing and characterisation of the three-phases bio-based composites. The key components are bio-based binder made of peat, devulcanised crumb rubber (DCR) from used tires and part of the fly ash, i.e. the cenosphere (CS). The three-phase composite prepared in the form of a block were investigated for their mechanical properties and density. The three-phase composite was prepared in the form a) of a block were investigated for their mechanical properties, and density and b) a form of granules for determination of the water and oil products sorption were investigated. We have also investigated the dependence of the properties on the DCR and CS fraction. It has been found, that maximum compression strength (in block form) observed for composition without CS and DCR addition was- 79.3 MPa, while the second-highest value of compression strength is 11.2 MPa for composition with 27.3 wt% of CS. For compositions with bio binder content from 17.4 to 55.8 wt% and with DCR contents in range from 11.0 to 62.0 wt%, the compression strength is in the range from 1.1 to 2.0 MPa. Liquid sorption analysis (water and diesel) showed that the maximum saturation of liquids in both cases is set after 35 minutes and ranges from 1.05 to 1.4 g·g -1 for water and 0.77 to 1.25 g·g-1 for diesel. It was noted that 90% of the maximum saturation with diesel fuel comes after 10 minutes and for water after 35 minutes.

Medical image segmentation is a critical step in various healthcare applications, aiding in diagnosis, treatment planning, and disease monitoring. In this study, we investigate the efficacy of a segmentation approach based on the 2D wavelet transform. Leveraging a dataset comprising 10 diverse medical images, we evaluate the performance of our segmentation method using three key metrics: accuracy, precision, and recall. Our findings demonstrate that the proposed approach enhances segmentation accuracy, offering promising results compared to existing methods. By harnessing the multi-resolution feature extraction capabilities of the 2D wavelet transform, our method achieves improved delineation of medical image structures, paving the way for more accurate and efficient healthcare interventions.

The knowledge of the precise anatomy and dimensions of the pulp chamber in the different teeth allows the odontologist to perform correct diagnosis, as well as treatment planning and moni-toring. The clinical practice has introduced cone-beam computed tomography (CB-CT) as a method to evaluate the morphology and dimensions of the pulp chamber. Nevertheless, micro-computed tomography (micro-CT) is regarded as the gold standard in approaching those topics. Here we have designed an algorithm that takes as input DICOM images from in vivo CB-CT of permanent molars to determine the accuracy CB-CT for evaluation of pulp chamber volume. The values were compared with those from in vivo CB-CT (rough and expert manipulated) and ex vivo micro-CT. The relative errors obtained with the volume calculated by the algorithm vs. the volume measured by micro-CT do not exceed 5.7%; also, no significant differences were found between algorithm volumes vs. manipulated CB-CT volumes while all volumes were different from those obtained with automatic CB-CT software. These data demonstrate that volume algorithm CB-CT based may be a reliable technique for evaluation of the pulp chamber volume in permanent molars and can be useful in the diagnosis of pulp diseases, as well as in the planning and monitoring of their treatments.

Wearable antennas are increasingly vital in modern healthcare, facilitating continuous monitoring and communication for medical purposes. These antennas are integrated into wearable devices, allowing for the transmission and reception of vital health data, such as heart rate, body temperature, and blood pressure, to medical professionals or monitoring systems in real time. This instantaneous data transmission enables timely interventions, thus improving the quality of healthcare services. This review aims to comprehensively synthesize recent research from reputable databases, focusing on the functionality and effectiveness of wearable antennas in medical applications. The primary objectives of each study were categorized, including antenna design and integration, the performance of medical wearable antenna technology, safety considerations in wearable antenna biomedicine, and the use of antennas in clinical applications and their impact. This synthesis provides valuable insights for researchers and practitioners aiming to develop and deploy wearable antennas in medical settings, ultimately enhancing healthcare delivery and patient outcomes.

Exoskeletons designed to assist patients with activities of daily living are becoming increasingly popular, but still are subject to research. In order to gather requirements for the design of such systems, long-term gait observation of the patients over the course of multiple days in an environment of daily living are required. In this paper a wearable all-in-one data acquisition system for collecting and storing biomechanical data in everyday life is proposed. The system is designed to be cost efficient and easy to use, using off-the-shelf components and a cloud server system for centralized data storage. The measurement accuracy of the system was verified, by measuring the angle of the human knee joint at walking speeds between 3 and 12 km/h in reference to an optical motion analysis system. The acquired data was uploaded to a cloud database via a smartphone application. Verification results showed that the proposed toolchain works as desired. The system reached an RMSE from 2.9° to 8°, which is below most of the comparable system. The system provides a powerful, scalable platform for collecting and processing biomechanical data, which can help to automize the generation of an extensive database for human kinematics.

Fractional flow reserve (FFR) is well recognized as a gold standard measure for the estimation of functional coronary stenosis. Technological progressions in image processing have empowered the reconstruction of three-dimensional models of the coronary arteries via both non-invasive imaging modalities, such as Coronary Computed Tomography Angiography (CCTA), and invasive coronary angiography or intravascular imaging. The application of computational fluid dynamics (CFD) techniques to coronary 3D anatomical models allows the virtual evaluation of the hemodynamic significance of a coronary lesion with high diagnostic accuracy in comparison to the invasive FFR using pressure wires. These opportunities providing hemodynamic information based on anatomy have given rise to a new era of functional angiography and coronary imaging. However, further validations are needed to overcome several scientific and computational challenges before these methods are applied in everyday clinical practice. This review aims to present all the data on the studies and methodologies that have been presented for the virtual estimation of FFR, and the diagnostic execution of the virtual tools for the hemodynamic assessment of coronary lesions compared to the invasive FFR.

The emergence of Internet of Things (IoT) devices is revolutionizing healthcare. This dynamic healthcare environment relies on Internet of Healthcare Things (IoHT) and Internet of Medical Things (IoMT) technologies. Economic, social, and technological opportunities from the IoHT are transforming healthcare systems. This article covers the history, present condition, and future prospects of IoHT, as well as its topologies, platforms, services, applications, market trends, and solution types. It examines security issues, requirements, and a threat taxonomy, studying smart healthcare privacy and security. It explores future research and the challenges IoHT-based solutions face. International health rules and regulations based on the IoT and their social and economic effects on long-term development are also examined. Integrating IoMT into healthcare infrastructures enhances scalability, efficiency, reliability, and accuracy. Through communication networks and data-processing algorithms, IoMT creates smart hardware and software platforms that enhance decision-making. IoMT devices' low resources raise privacy and security concerns. Security and privacy issues are organised by healthcare IoMT adoption in this study. We give an extensive attack taxonomy against the IoMT infrastructure, encompassing devices, security mechanisms, and their pros and cons. Furthermore, it describes the privacy and security requirements for any unique security solutions against IoMT's multiple attack vectors. This article explains the complicated difficulties, security concerns, and future research pathways needed to safeguard and ensure the long-term expansion of these game-changing technologies in the healthcare ecosystem.

Many bio-applicable materials, medical devices, and prosthetics combine both polymer and metal components to benefit from their complementary properties. This goal is normally achieved by their mechanical bonding or casting only. Here, we report an alternative easy method for the chemical grafting of a polymer on the surfaces of a metal or metal alloys using alkoxy amine salt as a coupling agent. The surface morphology of the created composites was studied by various microscopy methods, and their surface area and porosity were determined by adsorption/desorption nitrogen isotherms. The surface chemical composition was also examined by various spectroscopy techniques and electrokinetic analysis. Elements distribution on the surface was determined and successful bonding of the metal/alloys on one side with the polymer on the other one was confirmed by alkoxy amine. The composites show significantly increased wettability, reliable chemical stability of the bonding, excellent bacterial anti-adhesive properties and functionality, i.e. the characteristics promising for their application in biomedical field.

Cancer is the second major cause of disease-related dead worldwide, and its accurate early diagnosis and therapeutic intervention are fundamental for saving the patient’s life. Cancer, as a complex and heterogeneous disorder, results from disruption and alteration of a wide variety of biological entities, including genes, proteins, mRNAs, miRNAs, and metabolites that eventually emerge as clinical symptoms. Traditionally, diagnosis is based on clinical examination, blood tests for biomarkers, histopathology of biopsy, and imaging (MRI, CT, PET, US). Additionally, omics biotechnologies help to further characterize the genome, metabolome, microbiome traits of the patient that could have an impact on the prognosis and patient’s response to the therapy. The integration of all these data relies on gathering of several experts and may require considerable time, and, unfortunately, it is not without the risk of error in the interpretation and therefore in the decision. Systems biology algorithms exploit Artificial Intelligence (AI) combined with omics technologies to perform a rapid and accurate analysis and integration of patient’s big data and support the physician in making diagnosis and tailoring the most appropriate therapeutic intervention. However, AI is not free from possible diagnostic and prognostic errors in the interpretation of images or biochemical-clinical data. Here, we first describe the methods used by systems biology for combining AI with omics and then discuss the potential, challenges, limitations, and critical issues in using AI in cancer research.

Background The workload of nurses in the intensive care unit (ICU) can affect the quality of nursing services. Aim This study aimed to determine the relationship between the nursing activity score and missed care in patients hospitalized in the ICU in Zanjan, Iran. Methods This observational and prospective study was conducted from April 3 to September 18 in 2021. In this study, the tools used included a patient and nurses' profile questionnaire, Nursing Activity Score (NAS). Missed care was observed in the 301 patients for whom the NAS was calculated. Analysis of variance (ANOVA) was used to investigate the differences in mean levels of missed care. Logistic regression models were used to assess the association between factors and missed nursing care. Results Results show that the Medical ICU's mean NAS was 76.31 (95% CI: -13.06 -14.89). In 9 dimensions of care, the extent of missed care was 40.7%. In the care dimensions of assessment, hand hygiene, and infection control, the mean NAS had a statistically significant increase at higher levels of missed care (P<.5). Furthermore, work experience was identified as a protective factor for missed care (OR =.59, 95% CI: .37–.94, χ2= =4.97, p =.026). Conclusion The study revealed a high incidence of missed care. The study revealed that the mean workload was high in certain dimensions of care such as assessment, hand hygiene, and infection control. The increase in workload for nurses results in lost care. Nonetheless, the utilization of experienced nurses can help mitigate this problem. However, utilizing experienced nurses can help reduce this problem.