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Verhoef, Grietjie. "From Friendly Society to Compulsory Medical Aid Association". Social Science History 30, nr 4 (2006): 601–27. http://dx.doi.org/10.1017/s0145553200013602.
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The compulsory medical benefit scheme for white public servants in South Africa grew out of a friendly society founded in 1905. This development diverged from the experience of other members of the British Commonwealth, where universal health insurance schemes developed following the British example. The Civil Servants’ Medical Benefit Association (CSMBA) addressed the needs of white public servants, leaving the non-white communities without any form of government-sponsored medical support, apart from health care provided at government hospitals. The CSMBA was a well-managed medical benefit association, but when it was appointed the compulsory medical benefit association for white public servants, government intervention affected the financial viability of the organization, despite the payment of a state subsidy.
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A, Sonya, Jeevitha S i Vaishnavi M. "Secure Storage and Access Scheme for E-Medical Records Using Block Chain Environment". Journal of University of Shanghai for Science and Technology 23, nr 05 (29.05.2021): 776–86. http://dx.doi.org/10.51201/jusst/21/05211.
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Blockchain has been a fascinating exploration region for quite a while and the advantages it gives have been utilized by various different ventures. Additionally, the medical services area stands to profit tremendously from blockchain innovation because of safety, security, and decentralization. In any case, the Electronic Health Record (EHR) frameworks deal with issues in regards to information security, uprightness, and the executives. In the proposed work, to communicate approximately how the blockchain innovation can be applied to alternate the EHR frameworks and solution of those issues. To propose a system that can be applied for the execution of blockchain innovation in scientific offerings location for EHR. The factor of our proposed system is first and to execute blockchain innovation for EHR and moreover to provide the stable ability of digital information with the aid of using characterizing granular get right of entry to regulations for the customers. Besides, this system examines the flexibility problem seemed with the aid of using the blockchain innovation average through the usage of off-chain stockpiling of the information. This structure offers the benefits of getting an adaptable, stable, and vital blockchain-primarily based totally association with usage of PoW (Proof of Work) Algorithm.
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Modi, Bhavesh V., Bhautik Modi i Paresh V. Dave. "Financial incentive- Does this have impact on outcome of Tuberculosis?" Indian Journal of Community Health 32, nr 2 (30.06.2020): 418–22. http://dx.doi.org/10.47203/ijch.2020.v32i02.020.
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Background: Although most public services provide tests and TB drugs free of charge worldwide, opportunity costs pose barriers to accessing TB services and treatment. 'Kumar Raajratna Bhimrao Ambedkar Vaidakiya Sahay Yojana (KRBAVSY)' popularly known as Free Medical Aid Scheme is in operation in Gujarat since early 70s for SC and since 1991 for SEBC to provide monetary incentive. Primary objective: Evaluation of utilization and effectiveness of Financial incentives given under Free Medical Aids scheme on RNTCP in Gujarat. Methodology: A retrospective cohort study was undertaken in which all TB patients registered under RNTCP in Gandhinagar district were evaluated for their eligibility for KRBAVSY scheme, and whether eligible patients got benefit or not. Also, treatment outcome of patients were compared. Results: Out of total 1430 patients inquired, 896 (62.7%) patients were found eligible for the scheme, while only 87 (9.7%) patients confirmed that they had got the benefit of scheme. Eligible patients who got benefit under scheme had almost five times higher odds of successful outcome of TB treatment. Conclusion: The TB patients who got benefit of KRBAVSY scheme had significantly better successful treatment outcome in comparison to the TB patients who did not get benefit.
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Bredmose, P. P., R. A. Forbes, G. E. Davies, R. Freij i D. Lockey. "Medical response times to major incidents: potential benefits of a regional air ambulance mutual aid scheme". Emergency Medicine Journal 25, nr 12 (1.12.2008): 851–53. http://dx.doi.org/10.1136/emj.2008.059436.
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TSUMOTO, SHUSAKU, HIROSHI TANAKA, HIROMI AMANO, KIMIE OHYAMA i TAKAYUKI KURODA. "COBRA: INTEGRATION OF HETEROGENEOUS KNOWLEDGE-BASES IN MEDICAL DOMAIN". International Journal of Cooperative Information Systems 04, nr 04 (grudzień 1995): 387–403. http://dx.doi.org/10.1142/s0218843095000172.
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Medical data consist of many kinds of data from different resources, such as natural language data, sound data from physical examinations, numerical data from laboratory examinations, time-series data from monitoring systems, and medical images (e.g. X-ray, Computer Tomography, and Magnetic Resonance Image). Therefore it has been pointed out that medical databases should be implemented as multidatabases. However, there have been few systems which integrate these data into multidatabases. In this paper, we report a system called COBRA (Computer-Operated Birth-defect Recognition Aid), which supports diagnosis and information retrieval of congenital malformation diseases and which also integrates natural language data, sound data, numerical data, and medical images into multidatabases on syndrome of congenital malformation. The results show that object-oriented scheme makes it easy to implement and integrate these knowledge-databases in COBRA, which suggests that these clinical databases should be implemented as object-oriented databases.
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Wang, Chen, Jian Shen, Qi Liu, Yongjun Ren i Tong Li. "A Novel Security Scheme Based on Instant Encrypted Transmission for Internet of Things". Security and Communication Networks 2018 (2018): 1–7. http://dx.doi.org/10.1155/2018/3680851.
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Internet of Things (IoT) is a research field that has been continuously developed and innovated in recent years and is also an important driving force for the improvement of people’s life in the future. There are lots of scenarios in IoT where we need to collaborate through devices to complete tasks; that is, a device sends data to other devices, and other devices operate on the aid of the data. These transmitted data are often users’ privacy data, such as medical data and grid data. We propose an instant encrypted transmission based security scheme for such scenarios in IoT. The analysis in this paper indicates that our scheme can guarantee the security of users’ data while ensuring rapid transmission and acquisition of instant IoT data.
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Pantophlet, Ralph, Lore Brade i Helmut Brade. "Generation and Serological Characterization of Murine Monoclonal Antibodies against O Antigens from Acinetobacter Reference Strains". Clinical Diagnostic Laboratory Immunology 8, nr 4 (1.07.2001): 825–27. http://dx.doi.org/10.1128/cdli.8.4.825-827.2001.
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ABSTRACT O-antigen-specific monoclonal antibodies were generated againstAcinetobacter strains from international type culture collections and characterized by enzyme immunoassay and Western and colony blotting. The antibodies aid in the further completion of an O-serotyping scheme for Acinetobacter and, due to their high specificity, are especially useful to all working with these strains.
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Cheng, Wenhong, Fang Zhang, Yingqi Hua, Zhi Yang i Jun Liu. "Development of a psychological first-aid model in inpatients with COVID-19 in Wuhan, China". General Psychiatry 33, nr 3 (czerwiec 2020): e100292. http://dx.doi.org/10.1136/gpsych-2020-100292.
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BackgroundFacing the social panic and substantial shortage of medical resources during the coronavirus disease 2019 (COVID-19) outbreak, providing psychological first-aid to inpatients is essential for their rehabilitation and the orderly operating of medical systems. However, the closed-ward environment and extreme shortage of onsite mental health workers have limited the use of traditional face-to-face diagnosis and psychological interventions.AimTo develop a mental health intervention model for inpatients that can be applied during a widespread epidemic, such as COVID-19.MethodsIn a medical team stationed in Leishenshan Hospital, Wuhan, China, we integrated onsite and online psychological support resources to implement a graded psychological intervention system. The onsite psychiatrist established trust with the patients and classified them into categories according to their symptom severity. While face-to-face evaluation and intervention are critical for effective online support, the online team effectively extended the scope of the ‘first-aid’ to all patients.ConclusionThis integrated onsite and online approach was effective and efficient in providing psychological interventions for inpatients during the crisis. Our model provides a realistic scheme for healthcare systems in or after the COVID-19 epidemic and also could be adopted in areas of the world with insufficient mental healthcare resources.
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Da Costa, MarioPeter. "Using Outsourcing as a Competitive Edge: the Case of Medical Aid Schemes". INTERNATIONAL JOURNAL OF MANAGEMENT SCIENCE AND BUSINESS ADMINISTRATION 5, nr 1 (2018): 23–30. http://dx.doi.org/10.18775/ijmsba.1849-5664-5419.2014.51.1003.
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After analyzing environments Rosenborg Football Club operates in we introduce the regional-global model as a new organizational model in order to explain the success of the team using insights from managerial cognition and chaos theory. The success of the club in the years from 1988 until 2002 can be explained by the use of good routines linked to improvisation. We link improvisation to “total football” and “flow theory as a means to achieve success. We focus on qualitative methods when interviewing the former coach Mr, Niels Arne Eggen and former players were interviewed using thematic analysis in order to gain deep insights. We also used secondary sources in the data collection process building on work a being conducted on Rosenborg as a leading Norwegian football club.
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Angus, Derek C., Ernesto A. Pretto, Joel I. Abrams i Peter Safar. "Recommendations for Life-Supporting First-Aid Training of the Lay Public for Disaster Preparedness". Prehospital and Disaster Medicine 8, nr 2 (czerwiec 1993): 157–60. http://dx.doi.org/10.1017/s1049023x00040231.
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AbstractIn catastrophic disasters such as major earthquakes in densely populated regions, effective Life-Supporting First-Aid (LSFA) and basic rescue can be administered to the injured by previously trained, uninjured survivors (co victims). Administration of LSFA immediately after disaster strikes can add to the overall medical response and help to diminish the morbidity and mortality that result from these events. Widespread training of the lay public also may improve bystander responses in everyday emergencies. However, for this scheme to be effective, a significant percentage of the lay population must learn the eight basic steps of LSFA. These have been developed by the International Resuscitation Research Center in collaboration with the World Association for Emergency and Disaster Medicine, the City of Pittsburgh Department of Public Safety, and the American Red Cross (Pennsylvania chapter). They include: 1) scene survey; 2) airway control; 3) rescue breathing (mouth-to-mouth); 4) circulation (chest compressions; may be omitted for disasters, but should be retained for everyday bystander response); 5) abdominal thrusts for choking (may be omitted for disasters, but retained for everyday bystander response); 6) control of external bleeding; 7) positioning for shock; and 8) call for help.
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Marinho da Silva, Márcia Elizabeth, Eduardo R. Santos i Denis Borenstein. "Implementing Regulation Policy in Brazilian Health Care Regulation Centers". Medical Decision Making 30, nr 3 (29.12.2009): 366–79. http://dx.doi.org/10.1177/0272989x09344748.
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The regulation of specialist medical appointments represents one of the problematic areas of the Brazilian Public Health System. In this regulation process, 2 issues stand out: 1) which patients should have the highest attendance priority, and 2) which service suppliers can best resolve the specific health problem of a patient? Based on the consideration of the existing Brazilian context in the field of medical assistance, this study proposes a model designed to aid regulation centers deal with the decisions related to the process of allocating specialist medical appointments. The model integrates multicriteria decision analysis and linear programming for the specialist medical appointment allocation, in which the allocation of patients is defined as a function of the relative significance of a set of criteria related to the notion of effectiveness of the specialist medical care and the capability of the accredited specialist health care units. The integrated model was implemented in a computer-based system and validated using cardiology and vein surgery data from the regulation center in Porto Alegre, Brazil. The validated computational system was applied to mammography services in another regulation center. The system successfully implemented a prioritization scheme, decreasing significantly the examination waiting time of severe cases.
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Zheng, Guangyuan, Guanghui Han, Nouman Q. Soomro, Linjuan Ma, Fuquan Zhang, Yanfeng Zhao, Xinming Zhao i Chunwu Zhou. "A Novel Computer-Aided Diagnosis Scheme on Small Annotated Set: G2C-CAD". BioMed Research International 2019 (15.04.2019): 1–14. http://dx.doi.org/10.1155/2019/6425963.
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Purpose. Computer-aided diagnosis (CAD) can aid in improving diagnostic level; however, the main problem currently faced by CAD is that it cannot obtain sufficient labeled samples. To solve this problem, in this study, we adopt a generative adversarial network (GAN) approach and design a semisupervised learning algorithm, named G2C-CAD. Methods. From the National Cancer Institute (NCI) Lung Image Database Consortium (LIDC) dataset, we extracted four types of pulmonary nodule sign images closely related to lung cancer: noncentral calcification, lobulation, spiculation, and nonsolid/ground-glass opacity (GGO) texture, obtaining a total of 3,196 samples. In addition, we randomly selected 2,000 non-lesion image blocks as negative samples. We split the data 90% for training and 10% for testing. We designed a DCGAN generative adversarial framework and trained it on the small sample set. We also trained our designed CNN-based fuzzy Co-forest on the labeled small sample set and obtained a preliminary classifier. Then, coupled with the simulated unlabeled samples generated by the trained DCGAN, we conducted iterative semisupervised learning, which continually improved the classification performance of the fuzzy Co-forest until the termination condition was reached. Finally, we tested the fuzzy Co-forest and compared its performance with that of a C4.5 random decision forest and the G2C-CAD system without the fuzzy scheme, using ROC and confusion matrix for evaluation. Results. Four different types of lung cancer-related signs were used in the classification experiment: noncentral calcification, lobulation, spiculation, and nonsolid/ground-glass opacity (GGO) texture, along with negative image samples. For these five classes, the G2C-CAD system obtained AUCs of 0.946, 0.912, 0.908, 0.887, and 0.939, respectively. The average accuracy of G2C-CAD exceeded that of the C4.5 random decision tree by 14%. G2C-CAD also obtained promising test results on the LISS signs dataset; its AUCs for GGO, lobulation, spiculation, pleural indentation, and negative image samples were 0.972, 0.964, 0.941, 0.967, and 0.953, respectively. Conclusion. The experimental results show that G2C-CAD is an appropriate method for addressing the problem of insufficient labeled samples in the medical image analysis field. Moreover, our system can be used to establish a training sample library for CAD classification diagnosis, which is important for future medical image analysis.
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Li, Dan, Liang Zhu, Jian Zhang i Jinjuan Yang. "Decomposing Differences of Health Service Utilization among Chinese Rural Migrant Workers with New Cooperative Medical Scheme: A Comparative Study". International Journal of Environmental Research and Public Health 18, nr 17 (2.09.2021): 9291. http://dx.doi.org/10.3390/ijerph18179291.
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The New Rural Cooperative Medical Insurance (NCMS) in China has provided benefits for rural migrant workers’ health service utilization, but the financial coordination and mutual aid of NCMS is mainly based on the county or district as a unit, leading NCMS with the characteristics of regional segmentation. Our study aims to explore their health service utilization, as well as to decompose differences of the health service utilization into contributors. Data from the China Labor-Force Dynamic Survey in 2016 and Urban Statistical Yearbook in 2016 were used. We used coarsened exact matching to control the confounding factors in order to enhance the comparison of two groups. The Fairlie decomposition method was used to analyze the differences and the sources of health service utilization. Influencing factors of health service utilization for rural migrant workers with NCMS were diversified, especially contextual characteristic and individual characteristics. The proportion of ethnic minorities, the number of medical institutions for 10,000 people in the community, the number of beds for 10,000 people in the city, and the urban service quality index were the major contributors of the differences. The proportion of difference in the health service utilization of rural migrant workers with NCMS caused by health service need were −54.73% and 6.92%, respectively. The inequities of the probability of two weeks outpatient, and the probability of inpatients, were −0.006 and −0.007, respectively. There were substantial differences in the health service utilization between rural migrant workers with NCMS in the county/district and rural migrant workers with NCMS across the county/district. Our results illustrated the inequity from the differences on basis of characteristic effect and the discrimination effect. Our studies clarified that health service needs of should be fully considered, contributing to a more reliable understanding of the health service utilization of rural migrant workers.
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Michael, John A., i Joseph A. Barbera. "Mass Gathering Medical Care: A Twenty-Five Year Review". Prehospital and Disaster Medicine 12, nr 4 (grudzień 1997): 72–79. http://dx.doi.org/10.1017/s1049023x00037857.
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AbstractIntroduction:The purpose of this study was to critically review the provision of medical care at mass gatherings as described in 25 years of case reports. Specifically measured was the relationship between the size of a mass gathering and the frequency of patients seeking medical aid and the effects of certain event characteristics on this relationship.Methods:Data were obtained through a retrospective literature review. Medline and CINHAL computerized databases were searched for English language articles using several keywords: “mass gathering”, “concert”, “festival”, “Olympics”, “crowd”, “riot”, “stadium”, “sports”, “games”, “papal”, and “football”. Only articles containing complete information on the number of spectators, number of patients, type, location, and duration of the mass gathering were included in the primary analysis. As available, additional information was added including the described weather patterns, number of patients transported to a hospital, and number of patients suffering a cardiac arrest. Thirty-five of the approximately 100 articles reviewed, met these criteria.Results:A Spearman Rank Correlation Coefficient was calculated for number of spectators and patients and a significant relationship was identified (p = 0.0001). Mann-Whitney U-tests indicated that papal masses (p = 0.04), rock concerts (p = 0.005), hot climatic conditions (p = 0.03) and events held in the British Commonwealth (p = 0.03) had a significantly higher frequency of patient visits. Significantly more cardiac arrests occurred at papal masses (p = 0.04) and sporting events (p = 0.0002).Conclusion:Type of event, country, weather, and the size of the mass gathering had a significant effect on the numbers of spectators seeking medical care. A uniform classification scheme is necessary for future prospective studies of mass gatherings.
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Torkko, Pirjo, Marja-Leena Katila i Merja Kontro. "Gas-chromatographic lipid profiles in identification of currently known slowly growing environmental mycobacteria". Journal of Medical Microbiology 52, nr 4 (1.04.2003): 315–23. http://dx.doi.org/10.1099/jmm.0.05113-0.
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Cellular fatty acid analysis by GLC is widely used in the species identification of mycobacteria. Combining mycolic acid cleavage products with shorter cellular fatty acids increases the informative value of the analysis. A key has been created to aid in the identification of all currently known slowly growing environmental species. In this scheme, the species are classified into six categories, each characterized by a combination of fatty markers shared by those species. Within each category, individual species may be distinguished by the presence or absence of specific marker substances, such as methyl-branched fatty acids or secondary alcohols. This study also describes earlier unpublished GLC profiles of 14 rare, slowly growing, environmental mycobacteria, Mycobacterium asiaticum, Mycobacterium botniense, Mycobacterium branderi, Mycobacterium conspicuum, Mycobacterium cookii, Mycobacterium doricum, Mycobacterium heckeshornense, Mycobacterium heidelbergense, Mycobacterium hiberniae, Mycobacterium kubicae, Mycobacterium lentiflavum, Mycobacterium scrofulaceum, Mycobacterium triplex and Mycobacterium tusciae. Though no single identification technique alone, even sequencing of an entire single gene such as 16S rRNA, can identify all mycobacterial species accurately, GLC has proven to be both reliable and reproducible in the identification of slowly growing mycobacteria. In cases of earlier unknown species, it generates useful information that allows their further classification and may lead to the description of novel species.
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Horan, Emily, i David Tuthill. "P015 Yellow cards are still not on everyone’s to do list". Archives of Disease in Childhood 104, nr 7 (19.06.2019): e2.18-e2. http://dx.doi.org/10.1136/archdischild-2019-nppc.25.
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AimTo look at how the Yellow Card Scheme is used by health care professionals (HCPs) in child health.MethodsAn online SurveyMonkey questionnaire was devised to look at how healthcare professionals (HCPs) have used the Yellow Card Scheme in clinical practice. It comprised of 10 questions (9 multiple choice and 1 freestyle text). What type of healthcare professional are you? Are you aware of the Yellow Card reporting scheme? Have you ever used the Yellow Card Scheme to report an adverse drug reaction? If yes, how did you make the report? (If no, select N/A) If you haven’t ever reported a reaction, would you know how to? Have you ever completed an e learning module about the Yellow Card Scheme? Are you aware that parents can report adverse drug reactions using the Yellow Card Scheme? Have you ever been aware of an adverse drug reaction but decided not to report it? If yes, what was the reason you chose not to report it? (If no, select N/A) Can you think of any ways to make the Yellow Card Scheme more accessible to healthcare professionals? It was piloted on 5 HCPS and minor textural revisions made. The questionnaire was then undertaken via face-to-face interviews during June 2018.Results50 healthcare professionals completed the questionnaire: 16 doctors, 13 nurses, 8 pharmacists, 9 medical students, 2 nursing students and 2 pharmacy technicians. 43/50 were aware of the Yellow Card Scheme (10 undergraduates and 33 postgraduates). 18 participants had used the Yellow Card whilst 32 had not reported an adverse drug event. Out of the 32 respondents who had never reported a reaction, 13 (7 undergraduates and 6 postgraduates) said that they would not know how to report a reaction if required. Only 9 had completed an online e learning module about the Yellow Card scheme. 30 participants were aware that parents could report using the scheme. 10 participants had been aware of an adverse drug reaction but decided not to report it. The most common reason for this was being too busy. The most common suggestion on how to improve accessibility to the Yellow Card Scheme was the implementation of a mobile phone application.ConclusionMost participants were aware of the Yellow Card scheme although undergraduates less so. Many had reported, although some had chosen not to report because they were: too busy; not being concerned enough; not knowing how to; having forgotten. An app already exists, but awareness of this appears low, as it was the commonest suggestion to aid the low reporting.
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Aikins, Moses, Philip Teg-Nefaah Tabong, Paola Salari, Fabrizio Tediosi, Francis M. Asenso-Boadi i Patricia Akweongo. "Positioning the National Health Insurance for financial sustainability and Universal Health Coverage in Ghana: A qualitative study among key stakeholders". PLOS ONE 16, nr 6 (15.06.2021): e0253109. http://dx.doi.org/10.1371/journal.pone.0253109.
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Introduction The National Health Insurance Scheme (NHIS) was introduced in 2003 to reduce “out-of-pocket” payments for health care in Ghana. Over a decade of its implementation, issues about the financial sustainability of this pro-poor policy remains a crippling fact despite its critical role to go towards Universal Health Coverage. We therefore conducted this study to elicit stakeholders’ views on ways to improve the financial sustainability of the operations of NHIS. Methods Twenty (20) stakeholders were identified from Ministry of Health, Ghana Health Services, health workers groups, private medical practitioners, civil society organizations and developmental partners. They were interviewed using an interview guide developed from a NHIS policy review and analysis. All interviews were recorded and transcribed verbatim. The data were analysed thematically with the aid of NVivo 12 software. Results Stakeholders admitted that the NHIS is currently unable to meet its financial obligations. The stakeholders suggested first the adoption of capitation as a provider payment mechanism to minimize the risk of providers’ fraud and protection from political interference. Secondly, they indicated that rapid releases of specific statutory deductions and taxes for NHIS providers could reduce delays in claims’ reimbursement which is one of the main challenges faced by healthcare providers. Aligning the NHIS with the Community-based Health Planning and Services and including preventive and promotive health is necessary to position the Scheme for Universal Health Coverage. Conclusion The Scheme will potentially achieve UHC if protected from political interference to improve the governance and transparency that affects the finances of the scheme and the expansion of services to include preventive and promotive services and cancers.
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Zheng, Miao, Changlin Yin, Ying Cao, Yonghui Zhang, Kuoliang Zhang, Xiaoqin Zhang, Wei Bian i Lihua Wang. "Development and evaluation of a decision aid for family surrogate decision-makers for patients with acute kidney injury requiring renal replacement therapy (RRT) in ICUs: a study protocol". BMJ Open 11, nr 2 (luty 2021): e043385. http://dx.doi.org/10.1136/bmjopen-2020-043385.
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IntroductionShared decision making is endorsed by guidelines for both acute kidney injury and critical care medicine. However, there is still a huge need for effective interventions, especially those focusing on decisions about renal replacement therapy for intensive care unit (ICU) patients with acute kidney injury. The decision aids provide evidence-based support for shared decision making, to achieve better decisions through enhanced knowledge of treatment options and treatment aligns with patients’ preferences and values. Therefore, our objectives are to develop and evaluate a decision aid systematically and rigorously for family surrogate decision makers of ICU patients with acute kidney injury who need renal replacement therapy.Methods and analysisWe will use a systematic development process that focuses on user-centred design to develop and evaluate the decision aid in three phases: (1) development of a draft prototype for the decision aid based on extensive literature reviews, interviews with key stakeholders and evidence synthesis; (2) alpha testing (‘near live’ usability) the decision aid during simulated clinical encounters to test its comprehensibility, acceptability and usability and (3) beta testing (‘live’ usability) to examine the aid’s clinical feasibility. User testing will be conducted using mixed-methods approach to support iterative revision of the decision aid. The IPDASi (V.4.0) will be used for following qualitative assessment. All interviews will be analysed by Colaizzi’s seven-step approach to qualitative analysis. The coding scheme will use to analyse user interactions. Questionnaire surveys will be analysed using paired sample t-tests when related to the before-and-after survey, otherwise using one-sample t-test.Ethics and disseminationEthical approval for this research was obtained from the Ethics Committee of the First Affiliated Hospital of Army Medical University, PLA (Ref: KY2020104). All participants will sign a formal informed consent form. The findings will be published in peer-reviewed journals and reported in appropriate meetings.Trial registration numberChiCTR2000031613.
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Wake, Nicola. "Recognising Acute Intoxication as Diminished Responsibility? A Comparative Analysis". Journal of Criminal Law 76, nr 1 (luty 2012): 71–98. http://dx.doi.org/10.1350/jcla.2012.76.1.751.
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This article provides an analysis of the extent to which acute intoxication may or may not satisfy the ‘recognised medical condition’ requirement under s. 2 of the Homicide Act 1957, as amended by s. 52 of the Coroners and Justice Act 2009. It is argued that jurisprudential authorities clarifying the parameters of the ‘recognised medical condition’ requirement are urgently needed. In the interim period the importation of the novel terminology remains open to conjecture. The author argues that ‘acute intoxication’ potentially satisfies the revised plea and utilises the position adopted in Scotland, New South Wales and New Zealand to demonstrate this proposition. The latter jurisdiction has never had a formal diminished responsibility plea, although it has been identified that evidence of a defendant's mental abnormality was often used to reduce a murder conviction to one of voluntary manslaughter via the legal conduit of provocation. Following the demise of the provocation defence, however, issues pertaining to provocative conduct and/or a defendant's mental abnormality fall to be considered by the sentencing judge, but only in restricted circumstances. The recent implementation of a tripartite sentencing regime in New Zealand means that the alcohol-dependent and/or provoked defendant who kills will not have such mitigation considered if they have previously committed a qualifying offence under the scheme. The position in New Zealand is set against the Legal Aid, Sentencing and Punishment of Offenders Bill 2010–11 which proposes a ‘two-strike’ system for a variety of offences including voluntary manslaughter. It is submitted that this type of scheme has potentially significant consequences for the alcohol-dependent defendant who may not have had appropriate treatment for his mental abnormality following a first conviction.
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Jaiyeoba, Olumide Olasimbo, Totwana Tito Chimbise i Mornay Roberts-Lombard. "E-service usage and satisfaction in Botswana". African Journal of Economic and Management Studies 9, nr 1 (12.03.2018): 2–13. http://dx.doi.org/10.1108/ajems-03-2017-0061.
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Purpose The purpose of this paper is to establish the level of usage of e-services (websites and e-mail) by Botswana Public Officers Medical Aid Scheme (BPOMAS) and PULA Medical Aid (PULA) customers; the level of satisfaction; perceived value; and benefits derived from the website and e-mail services. Design/methodology/approach In total, 200 BPOMAS members and 100 PULA members were sampled. Systematic sampling technique was used to select the participants. A questionnaire mainly guided by the E-S-QUAL and E-RecS-QUAL scales was designed to gain an in-depth understanding of customers’ perceptions and experiences of e-service quality. Findings It was established that there is a positive and significant relationship between the usage of e-services and benefits derived from e-services and between the usage of e-services and satisfaction. In addition, a nexus of relationship was observed between perceived value of the e-services and satisfaction. Research limitations/implications The management of healthcare services in Botswana needs to understand customers’ value perceptions of e-services and e-service quality in order to establish where to make the most of their efforts. Practical implications The managers of healthcare insurance providers should consider stepping up e-service usage and satisfaction levels, supported by client-centred training programmes, to assist clinicians deliver care to the expectation of patients. Originality/value There is an acute lack of research in the Botswana context, particularly into the link between e-service usage and satisfaction in the health insurance industry. This paper contributes to the extant literature by elucidating the nexus of relationship between e-service usage and satisfaction in Botswana.
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Lahey, Lauren J., Michael W. Panas, Rong Mao, Michelle Delanoy, John J. Flanagan, Steven R. Binder, Alison W. Rebman i in. "Development of a Multiantigen Panel for Improved Detection of Borrelia burgdorferi Infection in Early Lyme Disease". Journal of Clinical Microbiology 53, nr 12 (7.10.2015): 3834–41. http://dx.doi.org/10.1128/jcm.02111-15.
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The current standard for laboratory diagnosis of Lyme disease in the United States is serologic detection of antibodies againstBorrelia burgdorferi. The Centers for Disease Control and Prevention recommends a two-tiered testing algorithm; however, this scheme has limited sensitivity for detecting early Lyme disease. Thus, there is a need to improve diagnostics for Lyme disease at the early stage, when antibiotic treatment is highly efficacious. We examined novel and established antigen markers to develop a multiplex panel that identifies early infection using the combined sensitivity of multiple markers while simultaneously maintaining high specificity by requiring positive results for two markers to designate a positive test. Ten markers were selected from our initial analysis of 62B. burgdorferisurface proteins and synthetic peptides by assessing binding of IgG and IgM to each in a training set of Lyme disease patient samples and controls. In a validation set, this 10-antigen panel identified a higher proportion of early-Lyme-disease patients as positive at the baseline or posttreatment visit than two-tiered testing (87.5% and 67.5%, respectively;P< 0.05). Equivalent specificities of 100% were observed in 26 healthy controls. Upon further analysis, positivity on the novel 10-antigen panel was associated with longer illness duration and multiple erythema migrans. The improved sensitivity and comparable specificity of our 10-antigen panel compared to two-tiered testing in detecting earlyB. burgdorferiinfection indicates that multiplex analysis, featuring the next generation of markers, could advance diagnostic technology to better aid clinicians in diagnosing and treating early Lyme disease.
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Lee, Jae-Ho, Yong-Jun Choi, Ji-Sook Choi i Sera Kim. "Patient assessment of primary care under the Designated Practice Scheme for Medical Aid beneficiaries, using the Korean Primary Care Assessment Tool (K-PCAT): a district of Seoul, South Korea". Journal of the Korean Medical Association 55, nr 2 (2012): 187. http://dx.doi.org/10.5124/jkma.2012.55.2.187.
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Pakulski, Cezary, i Maciej Denisiuk. "The ability to perform a post-traumatic examination as an indicator of the effects of teaching emergency medicine at the successive stages of the educational process: medical students, trainee physicians." Journal of Medical Science 87, nr 2 (2.07.2018): 86–91. http://dx.doi.org/10.20883/jms.2018.258.
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Introduction. Emergency management at the accident site is often of key importance for the later fate of patients who have sustained severe injuries. The scheme for post-traumatic examination has been developed to improve dealing with trauma patients.Aim. The aim of this study was to analyze the effects of teaching emergency medicine to students and graduates of the Faculty of Medicine in Szczecin, on the basis of their ability to carry out post-traumatic examination. The skills at recognizing a direct threat to life and performing basic life-saving procedures were appraised. Material and Methods. The study involved 81 individuals, who were evaluated three times at different stages of their educational process. Groups I and II comprised of fifth year students before and after an emergency medicine course, and group III consisted of trainee physicians. The Laerdal MegaCode Kelly manikin was employed in the project. Each of the simulated patients had the same external injury symptoms and parameters of vital functions.Results. Evaluation of vital functions was correctly done by 14.8% of group I, 59.3% of group II, and no one in group III. A quick post-traumatic examination was performed properly by 11.2% of group I, 55.5% of group II, and no one in group III.Conclusions. Group I lacked the ability to perform post-traumatic examination and first aid procedures. Participation in emergency medicine courses had positive effects on the participants’ skills (group II). The ability of trainee physicians (group III) to perform the majority of the tested elements of post-traumatic examination, including first aid procedures, noticeably declined and reached the initial level.
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Freeman, Phyllis, i Anthony Robbins. "THE U.S. HEALTH DATA PRIVACY DEBATE". International Journal of Technology Assessment in Health Care 15, nr 2 (maj 1999): 316–31. http://dx.doi.org/10.1017/s026646239901524x.
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After 25 years of debate about privacy of automated personal health data, the U.S. Congress has set a deadline of August 1999 for enacting health information privacy legislation. The urgency to establish national policy in the United States re-emerges with implementation of a 1996 law mandating a unique identifier for each participant in the U.S. medical care system and the use of a uniform electronic data set for all health information transmitted in financial and administrative transactions. The impact of electronic data storage and transmittal on privacy, health outcomes, and medical care is unclear. A three-step analytic scheme can clarify the issues in the policy debate and for future assessment. The first step is intended to elicit, for the first time, a precise, accurate, and reproducible description of personal health data transactions and chains of transactions, independent of the policy preferences of any interested party. The second step allows the reader to analyze these transactions according to who benefits first and foremost from each. This scrutiny clarifies the reasons why parties to the debate tend to disagree. The third step characterizes how Congress is likely to perceive the policy process and consider its options before enacting any particular set of compromises. Understanding the policy deliberations and potential effects of evolving information technologies and new national privacy rules should aid assessment of results.
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Jian Yan, Jian Yan, Qingxu Deng Jian Yan i Guangjie Han Yuhan Lin Qingxu Deng. "Novel Data Fusion Scheme of WBAN for Medical Monitoring". 網際網路技術學刊 22, nr 4 (lipiec 2021): 877–89. http://dx.doi.org/10.53106/160792642021072204015.
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Kunduru, Vindhya, i Shalini Prasad. "Electrokinetic Formation of “Microbridges” for Protein Biomarkers as Sensors". JALA: Journal of the Association for Laboratory Automation 12, nr 5 (październik 2007): 311–17. http://dx.doi.org/10.1016/j.jala.2007.06.001.
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We demonstrate a technique to detect protein biomarkers contained in vulnerable coronary plaque using a platform-based microelectrode array (MEA). The detection scheme is based on the property of high specificity binding between antibody and antigen similar to most immunoassay techniques. Rapid clinical diagnosis can be achieved by detecting the amount of protein in blood by analyzing the protein's electrical signature. Polystyrene beads which act as transportation agents for the immobile proteins (antigen) are electrically aligned by application of homogenous electric fields. The principle of electrophoresis is used to produce calculated electrokinetic movement among the anti-C-reactive protein (CRP), or in other words antibody funtionalized polystyrene beads. The electrophoretic movement of antibody-functionalized polystyrene beads results in the formation of “Microbridges” between the two electrodes of interest which aid in the amplification of the antigen—antibody binding event. Sensitive electrical equipment is used for capturing the amplified signal from the “Microbridge” which essentially behaves as a conducting path between the two electrodes. The technique circumvents the disadvantages of conventional protein detection methods by being rapid, noninvasive, label-free, repeatable, and inexpensive. The same principle of detection can be applied for any receptor—ligand-based system because the technique is based only on the volume of the analyte of interest. Detection of the inflammatory coronary disease biomarker CRP is achieved at concentration levels spanning over the lower microgram/milliliter to higher order nanogram/milliliter ranges.
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Duran-Lopez, Lourdes, Juan Pedro Dominguez-Morales, Jesús Corral-Jaime, Saturnino Vicente-Diaz i Alejandro Linares-Barranco. "COVID-XNet: A Custom Deep Learning System to Diagnose and Locate COVID-19 in Chest X-ray Images". Applied Sciences 10, nr 16 (16.08.2020): 5683. http://dx.doi.org/10.3390/app10165683.
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The COVID-19 pandemic caused by the new coronavirus SARS-CoV-2 has changed the world as we know it. An early diagnosis is crucial in order to prevent new outbreaks and control its rapid spread. Medical imaging techniques, such as X-ray or chest computed tomography, are commonly used for this purpose due to their reliability for COVID-19 diagnosis. Computer-aided diagnosis systems could play an essential role in aiding radiologists in the screening process. In this work, a novel Deep Learning-based system, called COVID-XNet, is presented for COVID-19 diagnosis in chest X-ray images. The proposed system performs a set of preprocessing algorithms to the input images for variability reduction and contrast enhancement, which are then fed to a custom Convolutional Neural Network in order to extract relevant features and perform the classification between COVID-19 and normal cases. The system is trained and validated using a 5-fold cross-validation scheme, achieving an average accuracy of 94.43% and an AUC of 0.988. The output of the system can be visualized using Class Activation Maps, highlighting the main findings for COVID-19 in X-ray images. These promising results indicate that COVID-XNet could be used as a tool to aid radiologists and contribute to the fight against COVID-19.
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van Noort, S. P., M. Muehlen, H. Rebelo de Andrade, C. Koppeschaar, J. M. Lima Lourenço i M. GM Gomes. "Gripenet: an internet-based system to monitor influenza-like illness uniformly across Europe". Eurosurveillance 12, nr 7 (1.07.2007): 5–6. http://dx.doi.org/10.2807/esm.12.07.00722-en.
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Gripenet has been monitoring the activity of influenza-like-illness (ILI) with the aid of volunteers via the internet in the Netherlands and Belgium since 2003 and in Portugal since 2005. In contrast with the traditional system of sentinel networks of mainly primary care physicians coordinated by the European Influenza Surveillance Scheme (EISS), Gripenet obtains its data directly from the population. Any resident of the three countries can participate in Gripenet by completing an application form on the appropriate websites (http://www.gripenet.pt), which contains various medical, geographic and behavioural questions. Participants report weekly on the website any symptoms they have experienced since their last visit. ILI incidence is determined on the basis of a uniform case definition.In the 2006/2007 season, 19,623 persons participated in Gripenet in the Netherlands, 7,025 in Belgium and 3,118 in Portugal. The rise, peak and decline of ILI activity occurred at similar times according to Gripenet and EISS. However, ILI attack rates in the Netherlands (6.6%), Belgium (6.1%) and Portugal (5.6%) were remarkably more similar in Gripenet than in EISS (0.8%, 3.9%, and 0.6% respectively).Monitoring ILI activity with the direct participation of volunteers provides similar incidence curves compared to the traditional system coordinated by EISS. Whereas EISS provides an established system whose data is validated by virology tests, Gripenet is a fast and flexible monitoring system whose uniformity allows for direct comparison of ILI rates between countries. A current objective of Gripenet is to engage more European countries.
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Marshall, Aniqa Islam, Kanang Kantamaturapoj, Kamonwan Kiewnin, Somtanuek Chotchoungchatchai, Walaiporn Patcharanarumol i Viroj Tangcharoensathien. "Participatory and responsive governance in universal health coverage: an analysis of legislative provisions in Thailand". BMJ Global Health 6, nr 2 (luty 2021): e004117. http://dx.doi.org/10.1136/bmjgh-2020-004117.
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Participatory and responsive governance in universal health coverage (UHC) systems synergistically ensure the needs of citizens are protected and met. In Thailand, UHC constitutes of three public insurance schemes: Civil Servant Medical Benefit Scheme, Social Health Insurance and Universal Coverage Scheme. Each scheme is governed through individual laws. This study aimed to identify, analyse and compare the legislative provisions related to participatory and responsive governance within the three public health insurance schemes and draw lessons that can be useful for other low-income and middle-income countries in their legislative process for UHC. The legislative provisions in each policy document were analysed using a conceptual framework derived from key literature. The results found that overall the UHC legislative provisions promote citizen representation and involvement in UHC governance, implementation and management, support citizens’ ability to voice concerns and improve UHC, protect citizens’ access to information as well as ensure access to and provision of quality care. Participatory governance is legislated in 33 sections, of which 23 are in the Universal Coverage Scheme, 4 in the Social Health Insurance and none in the Civil Servant Medical Benefit Scheme. Responsive governance is legislated in 24 sections, of which 18 are in the Universal Coverage Scheme, 2 in the Social Health Insurance and 4 in the Civil Servant Medical Benefit Scheme. Therefore, while several legislative provisions on both participatory and responsive governance exist in the Thai UHC, not all schemes equally bolster citizen participation and government responsiveness. In addition, as legislations are merely enabling factors, adequate implementation capacity and commitment to the legislative provisions are equally important.
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Bei, Bei, Donna Pinnington, Nina Quin, Lin Shen, Michelle Blumfield, Joshua Wiley, Sean Drummond, Louise Newman i Rachel Manber. "340 Improving maternal sleep via cognitive behavioral intervention: A randomised controlled trial from pregnancy to 2 years postpartum". Sleep 44, Supplement_2 (1.05.2021): A136. http://dx.doi.org/10.1093/sleep/zsab072.339.
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Abstract Introduction Maternal sleep disturbance is common during pregnancy and postpartum periods. This study evaluated the feasibility and efficacy of a scalable cognitive behavioural therapy (CBT) sleep intervention tailored for these periods. Methods This is a two-arm, parallel-group, single-blind, superiority randomised controlled trial. Nulliparous women without major medical/psychiatric conditions were randomised 1:1 to CBT or active control of equal frequency/duration. All participants received a 1-hr telephone session and automated multimedia emails from the 3rd trimester until 6 months postpartum. Outcomes were assessed with validated instruments at gestation weeks 30 (baseline) and 35 (pregnancy endpoint), and postpartum months 1.5, 3, 6 (postpartum endpoint), 12, and 24. Results 163 eligible participants (age M +/- SD = 33.35 +/- 3.42) were randomised. The CBT intervention was well accepted, with no reported adverse effect. Intention-to-treat analyses showed that compared to active control, receiving CBT was associated with lower insomnia severity and sleep disturbance (two primary outcomes), and lower sleep-related impairment at the pregnancy endpoint (p-values ≤ .001), as well as at 24 months postpartum (p ranges .012-.052). Group differences across the first postpartum year were nonsignificant. Women with elevated insomnia symptoms at baseline benefitted substantially more from CBT (vs control), including having significantly lower insomnia symptoms throughout the first postpartum year. Group differences in symptoms of depression or anxiety were nonsignificant. Conclusion A scalable CBT sleep intervention is efficacious in buffering against sleep disturbance during pregnancy, with long-term benefits to maternal sleep, especially for women with sleep complaints during pregnancy. The intervention holds promise for implementation into routine perinatal care. Support (if any) Data collection was supported by Rob Pierce Grant-in-Aid and Helen Bearpark Scholarship from Australasian Sleep Association, Strategic Grant Scheme from Monash University, and the Royal Women’s Hospital Foundation. Intervention materials were adapted from those developed via a National Institute of Health R01 grant (NR013662). Bei (APP1140299) and Wiley (APP1178487) are supported by National Health and Medical Research Council Fellowships, and Pinnington, Quin, Shen by Australian Postgraduate Awards by Department of Education and Training. The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.
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Shu, Hong, Ping Qi, Yongqing Huang, Fulong Chen, Dong Xie i Liping Sun. "An Efficient Certificateless Aggregate Signature Scheme for Blockchain-Based Medical Cyber Physical Systems". Sensors 20, nr 5 (10.03.2020): 1521. http://dx.doi.org/10.3390/s20051521.
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Different from the traditional healthcare field, Medical Cyber Physical Systems (MCPS) rely more on wireless wearable devices and medical applications to provide better medical services. The secure storage and sharing of medical data are facing great challenges. Blockchain technology with decentralization, security, credibility and tamper-proof is an effective way to solve this problem. However, capacity limitation is one of the main reasons affecting the improvement of blockchain performance. Certificateless aggregation signature schemes can greatly tackle the difficulty of blockchain expansion. In this paper, we describe a two-layer system model in which medical records are stored off-blockchain and shared on-blockchain. Furthermore, a multi-trapdoor hash function is proposed. Based on the proposed multi-trapdoor hash function, we present a certificateless aggregate signature scheme for blockchain-based MCPS. The purpose is to realize the authentication of related medical staffs, medical equipment, and medical apps, ensure the integrity of medical records, and support the secure storage and sharing of medical information. The proposed scheme is highly computationally efficient because it does not use bilinear maps and exponential operations. Many certificateless aggregate signature schemes without bilinear maps in Internet of things (IoT) have been proposed in recent years, but they are not applied to the medical field, and they do not consider the security requirements of medical data. The proposed scheme in this paper has high computing and storage efficiency, while meeting the security requirements in MCPS.
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Yang, Xiaofang, Dina Kandil, Ediz F. Cosar i Ashraf Khan. "Fibroepithelial Tumors of the Breast: Pathologic and Immunohistochemical Features and Molecular Mechanisms". Archives of Pathology & Laboratory Medicine 138, nr 1 (1.01.2014): 25–36. http://dx.doi.org/10.5858/arpa.2012-0443-ra.
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Context.—The 2 main prototypes of fibroepithelial tumors of the breast include fibroadenoma and phyllodes tumor (PT). Although both tumors share some overlapping histologic features, there are significant differences in their clinical behavior and management. Phyllodes tumors have been further divided into clinically relevant subtypes, and there is more than one classification scheme for PT currently in use, suggesting a lack of consistency within different practices. Accurate differentiation between fibroadenoma and PT, as well as the grading of PT, may sometimes be challenging on preoperative core needle biopsy. Some immunohistochemical markers have been suggested to aid in the pathologic classification of these lesions. Objective.—To discuss the salient histopathologic features of fibroepithelial tumors and review the molecular pathways proposed for the initiation, progression, and metastasis of PTs. Also, to provide an update on immunohistochemical markers that may be useful in their differential diagnosis and outline the practice and experience at our institution from a pathologic perspective. Data Sources.—Sources included published articles from peer-reviewed journals in PubMed (US National Library of Medicine). Conclusions.—Fibroepithelial tumor of the breast is a heterogenous group of lesions ranging from fibroadenoma at the benign end of the spectrum to malignant PT. There are overlapping histologic features among various subtypes, and transformation and progression to a more malignant phenotype may also occur. Given the significant clinical differences within various subtypes, accurate pathologic classification is important for appropriate management. Although some immunohistochemical markers may be useful in this differential diagnosis, histomorphology still remains the gold standard.
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Sawe, Hendry R., Juma A. Mfinanga, Samwel Kisakeni, Patrick Shao, Paulina Nkondora, Libby White, Christina Bollinger i in. "Development and Implementation of Short Courses to Support the Establishment of a Prehospital System in Sub-Saharan Africa: Lessons Learned from Tanzania". Emergency Medicine International 2019 (1.12.2019): 1–7. http://dx.doi.org/10.1155/2019/3160562.
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Background. Tanzania has no formal prehospital system. The Tanzania Ministry of Health launched a formal prehospital system to address this gap. The Muhimbili University of Health and Allied Sciences (MUHAS) was tasked by the Ministry of Health to develop and implement a multicadre/provider prehospital curriculum so as to produce necessary healthcare providers to support the prehospital system. We aim to describe the process of designing and implementing the multicadre/provider prehospital short courses. The lessons learned can help inform similar initiatives in low- and middle-income countries. Methods. MUHAS collaborated with local and international Emergency Medicine and Emergency Medical Services (EMS) specialists to form the Emergency Medical Systems Team (EMST) that developed and implemented four short courses on prehospital care. The EMST used a six-step approach to develop and implement the curriculum: problem identification, general needs assessment, targeted needs assessment, goals and objectives, educational strategies, and implementation. The EMST modified current best EMS practices, protocols, and curricula to be context and resource appropriate in Tanzania. Results. We developed four prehospital short courses: Basic Ambulance Provider (BAP), Basic Ambulance Attendant (BAAT), Community First Aid (CFA), and EMS Dispatcher courses. The curriculum was vetted and approved by MUHAS, and courses were launched in November 2018. By the end of July 2019, a total of 63 BAPs, 104 BAATs, 25 EMS Dispatchers, and 287 CFAs had graduated from the programs. The main lessons learned are the importance of a practical approach to EMS development and working with the existing government cadre/provider scheme to ensure sustainability of the project; clearly defining scope of practice of EMS providers before curriculum development; and concurrent development of a multicadre/provider curriculum to better address the logistical barriers of implementation. Conclusion. We have provided an overview of the process of designing and implementing four short courses to train multiple cadres/providers of prehospital system providers in Tanzania. We believe this model of curricula development and implementation can be replicated in other countries across Africa.
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Manikandan, Vazhora Malayil, Nelapati Lava Prasad i Masilamani Vedhanayagam. "Half Difference Expansion Based Reversible Data Hiding Scheme for Medical Image Forensics". Current Medical Imaging Formerly Current Medical Imaging Reviews 16, nr 4 (7.05.2020): 383–96. http://dx.doi.org/10.2174/1573405614666180903120018.
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Background: Medical image authentication is an important area which attempts to establish ownership authentication and data authentication of medical images. Aims: In this paper, we propose a new reversible watermarking scheme based on a novel half difference expansion technique for medical image forensics. Methods: Conventional difference expansion based reversible watermarking scheme generates watermarked images with less visual quality, and the embedding rate was considerably less due to the high probability of overflow or underflow. In the proposed scheme, the quality of the watermarked image has been improved by modifying the traditional difference expansion based watermarking scheme, half of the difference between two pixels will be expanded during watermarking. The modification of pixels during watermarking is limited by expanding half of the pixel difference, which helps to obtain watermarked images with better visual quality and improved embedding rate due to less chance of overflow or underflow during watermarking. We also propose a tamper detection localization process to detect the tampered regions from the watermarked image. Results: Experimental study of the proposed scheme on the standard medical images from Osrix medical image data set shows that the proposed watermarking scheme outperforms the existing schemes in terms of visual quality of the watermarked image and embedding rate. Conclusion: The overhead related to location map and parity information need to be addressed in future works to improve the proposed scheme.
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Chi, Tianyu, Baodong Qin i Dong Zheng. "An Efficient Searchable Public-Key Authenticated Encryption for Cloud-Assisted Medical Internet of Things". Wireless Communications and Mobile Computing 2020 (14.07.2020): 1–11. http://dx.doi.org/10.1155/2020/8816172.
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In recent years, it has become popular to upload patients’ medical data to a third-party cloud server (TCS) for storage through medical Internet of things. It can reduce the local maintenance burden of the medical data and importantly improve accuracy in the medical treatment. As remote TCS cannot be fully trusted, medical data should be encrypted before uploading, to protect patients’ privacy. However, encryption makes search capabilities difficult for patients and doctors. To address this issue, Huang et al. recently put forward the notion of Public-key Authenticated Encryption with Keyword Search (PAEKS) against inside keyword guessing attacks. However, the existing PAEKS schemes rely on time-consuming computation of parings. Moreover, some PAEKS schemes still have security issues in a multiuser setting. In this paper, we propose a new and efficient PAEKS scheme, which uses the idea of Diffie-Hellman key agreement to generate a shared secret key between each sender and receiver. The shared key will be used to encrypt keywords by the sender and to generate search trapdoors by the receiver. We prove that our scheme is semantically secure against inside keyword guessing attacks in a multiuser setting, under the oracle Diffie-Hellman assumption. Experimental results demonstrate that our PAEKS scheme is more efficient than that of previous ones, especially in terms of keyword searching time.
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Zhao, Zhuo, Chingfang Hsu, Lein Harn, Qing Yang i Lulu Ke. "Lightweight Privacy-Preserving Data Sharing Scheme for Internet of Medical Things". Wireless Communications and Mobile Computing 2021 (12.09.2021): 1–13. http://dx.doi.org/10.1155/2021/8402138.
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Internet of Medical Things (IoMT) is a kind of Internet of Things (IoT) that includes patients and medical sensors. Patients can share real-time medical data collected in IoMT with medical professionals. This enables medical professionals to provide patients with efficient medical services. Due to the high efficiency of cloud computing, patients prefer to share gathering medical information using cloud servers. However, sharing medical data on the cloud server will cause security issues, because these data involve the privacy of patients. Although recently many researchers have designed data sharing schemes in medical domain for security purpose, most of them cannot guarantee the anonymity of patients and provide access control for shared health data, and further, they are not lightweight enough for IoMT. Due to these security and efficiency issues, a novel lightweight privacy-preserving data sharing scheme is constructed in this paper for IoMT. This scheme can achieve the anonymity of patients and access control of shared medical data. At the same time, it satisfies all described security features. In addition, this scheme can achieve lightweight computations by using elliptic curve cryptography (ECC), XOR operations, and hash function. Furthermore, performance evaluation demonstrates that the proposed scheme takes less computation cost through comparison with similar solutions. Therefore, it is fairly an attractive solution for efficient and secure data sharing in IoMT.
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Dulepova, Angella A., O. V. Ruina, T. V. Pozdeeva, S. V. Kononova i D. V. Pisanenko. "THE CLINICAL ECONOMIC ANALYSIS OF SCHEMES OF GRADED ANTI-BACTERIAL THERAPY AS A LEVEL OF AMELIORATION OF QUALITY OF MEDICAL CARE SUPPORT OF PATIENTS WITH UROLOGICAL PATHOLOGY". Health Care of the Russian Federation 62, nr 1 (24.05.2019): 18–23. http://dx.doi.org/10.18821/0044-197x-2018-62-1-18-23.
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The necessity of implementing clinical economic studies was conditioned by a significant prevalence of infections of urinary tracts, wide variety and high cost of antibacterial pharmaceuticals for their treatment. The sampling included 539 cases of application of step schemes of antibiotics treatment in patients of urological departments in 2014-2015. Overall, six the most prevalent schemes (87.4% of all cases) were picked out. Every scheme was analyzed by application rate, clinical efficiency, treatment cost and average duration of patient stay in hospital. The most clinical efficiency was established for the scheme that included amoxicillin + сlavulanic acid in injection and peroral components without implementing peri-operational antibiotics prevention (97.7%). However, period of hospitalization was in average 2.9 days longer and transition of patient from injection component of therapy to a peroral one occurred 2.3 days later than in case of application of the same pharmaceutical in combination with peri-operational antibiotics prevention (efficiency index 96.0%). It is established that the scheme with amikacin being from economic point of view the most attractive one (cost of treatment is 2.5-6.1 times lower and period of hospitalization the shortest) and differing by high clinical efficiency (95.2%) is applied only in 4.4% of analyzed cases because amikacin has many side effects restricting its application in medical practice. The received information permits physician to rationally prescribe optimal schemes of treatment that decreases costs of therapy, risk of development of complications initiated by antibacterial therapy and also increases quality of life of patient.
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Lin, Chia-Chen, Chin-Chen Chang i Yao-Zhu Zheng. "A Ring Signature Based Anonymity Authentication Scheme for Group Medical Consultation". Symmetry 12, nr 12 (5.12.2020): 2009. http://dx.doi.org/10.3390/sym12122009.
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Due to the rapid development of physiological monitoring devices, internet of things (IoT) and communication technology, telecare medical information systems (TMIS) are getting more and more important in assisting doctors in completing medical work nowadays. Because of the open nature of wireless networks, a secure TMIS which offers authentication, anonymity and privacy features is required. There are many schemes protecting TMIS that have been proposed recently. Unfortunately, they cannot guarantee both patient’s and doctor’s privacy and security at the same time. This paper proposes a ring signature-based TMIS authentication scheme for a group consultation environment. In our proposed scheme, a patient can inquire about their symptoms without revealing their identity, and a doctor can also keep their own identity confidential when making a diagnosis. In view of the increasing number of serious patient–physician disputes, our proposed scheme can have a practical application. Compared to other related work, our scheme achieves improved security properties and higher efficiency.
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Bayissa, Badhaasaa Beyene, i Seifu Alemu. "Pattern of trauma admission and outcome among patients presented to Jimma University Specialized Hospital, south-western Ethiopia". Trauma Surgery & Acute Care Open 6, nr 1 (czerwiec 2021): e000609. http://dx.doi.org/10.1136/tsaco-2020-000609.
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BackgroundTrauma is an ever evolving world problem that needs close attention and devising means to prevent and treat. The aim of the study is to identify the main reason for trauma admissions and assess the patient outcome after intervention. Therefore, knowing its actual nature might aid in postulating possible intervention as well as prevention measures.MethodA cross-sectional study was conducted from August to December 2015 in Jimma University Specialized Hospital, which is located in south-western Ethiopia. Two hundred and eleven consecutive trauma admissions to surgery department were included in the study. Data were collected and analyzed using computer software SPSS V.23.ResultA total of 211 admitted trauma patients were studied with male to female ratio of 3.14. The leading cause of trauma admission was road traffic collision at 84 (39.8%) and the least being bullet injury which was 6 (2.8%). Hospital mortality was 31 (14.7%). Factors associated with outcome of patients before discharge from hospital were male sex, adjusted OR (AOR)=2.3, 95% CI 1.08 to 4.75; Glasgow Coma Scale score 15/15, AOR=0.04, 95% CI 0.00 to 0.46; and hemoglobin >10 g/L, AOR=0.225, 95% CI 0.074 to 0.464, p<0.05.ConclusionRoad traffic collision takes the top position from all causes of trauma and unlike other developed countries and low and middle-income countries, pedestrians and motorcyclists were the major victims of the collision in this study.Level of evidence VI (This level of effectiveness rating scheme is based on the following: Ackley, B. J., Swan, B. A., Ladwig, G., & Tucker, S. (2008). Evidence-based nursing care guidelines: Medical-surgical interventions. (p. 7). St. Louis, MO: Mosby Elsevier.
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ASWATHA KUMAR, M., B. N. CHATTERJI, JAYANTA MUKHERJEE i P. P. DAS. "REPRESENTATION OF 2D AND 3D BINARY IMAGES USING MEDIAL CIRCLES AND SPHERES". International Journal of Pattern Recognition and Artificial Intelligence 10, nr 04 (czerwiec 1996): 365–87. http://dx.doi.org/10.1142/s0218001496000256.
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Representation schemes play an important role in the fields of Computer Vision, Graphics, Image Processing, CAD/CAM etc. Various representation schemes have been discussed in the literature for both 2D and 3D. In this paper, we are presenting a scheme of representation using the concept of octagonal distances. They are called Medial Circle Representation (MCR) and Medial Sphere Representation (MSR) in 2D and 3D, respectively. Storage requirement, computational complexity, merits and demerits of the representation schemes are discussed.
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Kamili, Asra, Izat Fatima, Muzamil Hassan, Shabir A. Parah, V. Vijaya Kumar i L. S. Ambati. "Embedding information reversibly in medical images for e-health". Journal of Intelligent & Fuzzy Systems 39, nr 6 (4.12.2020): 8389–98. http://dx.doi.org/10.3233/jifs-189157.
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Embedding information in medical images is considered as one of the significant methods for safeguarding the integrity and authenticity of medical images besides providing security to electronic patient records (EPR). The conventional embedding methods deteriorate the perceptual quality of medical images making them unsuitable for proper diagnosis. To preserve the perceptual quality of medical images reversible embedding is used. The reversible embedding schemes, however, have less embedding capacity. In this work, a reversible scheme based on histogram bin shifting and RGB plane concatenation has been proposed which offers high embedding capacity as well. We have exploited the fact that medical images, unlike general images, consist of a large number of peaks and zero points that can be employed for reversibly embedding the data. Reversibility ensures that original image restoration takes place after the extraction of embedded data, which is of great importance in medical images for proper diagnosis and treatment. We have used various subjective and objective image quality metrics for analyzing the scheme. The proposed scheme has been shown to provide a Peak Signal to Noise Ratio (PSNR) value of above 56 dB for an embedding capacity of 0.58 bits per pixel (bpp). The results obtained show that the performance of scheme presented is far better in comparison to the state-of-the-art.
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Blodgett, Joanna M., Duncan Robertson, David Ratcliffe i Kenneth Rockwood. "An alternative model of pre-hospital care for 999 patients who require non-emergency medical assistance". International Journal of Emergency Services 6, nr 2 (7.08.2017): 99–103. http://dx.doi.org/10.1108/ijes-01-2017-0002.
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Purpose With the increasing demand on ambulance services, paramedics are tasked to arrange as much out of hospital care as possible, to develop integrated systems of care and work with hundreds of different providers – all in the 15 minutes allocated for assessment. A UK ambulance trust is navigating and leading much of this work as one of the first trusts to implement a general practitioner referral policy as an alternate to direct conveyance. The paper aims to discuss this issue. Design/methodology/approach Here the authors discuss the referral scheme, examine the limited evidence available and discuss what is needed to influence prospective success of implementing this scheme in other trusts. Findings Limited evidence for these schemes are described, however there is a clear gap in critical appraisal and methodologically rigorous evidence needed to implement these schemes in other ambulance schemes. Originality/value In order to facilitate collaboration of healthcare services and to minimize the burden of increasing numbers of patients, communication and discussion of alternate routes of care is crucial. This viewpoint piece is one of the first to emphasize the potential benefits of such schemes.
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Wu, Tsu-Yang, Tao Wang, Yu-Qi Lee, Weimin Zheng, Saru Kumari i Sachin Kumar. "Improved Authenticated Key Agreement Scheme for Fog-Driven IoT Healthcare System". Security and Communication Networks 2021 (30.01.2021): 1–16. http://dx.doi.org/10.1155/2021/6658041.
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The Internet of things (IoT) has been widely used for various applications including medical and transportation systems, among others. Smart medical systems have become the most effective and practical solutions to provide users with low-cost, noninvasive, and long-term continuous health monitoring. Recently, Jia et al. proposed an authentication and key agreement scheme for smart medical systems based on fog computing and indicated that it is safe and can withstand a variety of known attacks. Nevertheless, we found that it consists of several flaws, including known session-specific temporary information attacks and lack of per-verification. The opponent can readily recover the session key and user identity. In this paper, we propose a secure authentication and key agreement scheme, which compensates for the imperfections of the previously proposed. For a security evaluation of the proposed authentication scheme, informal security analysis and the Burrows–Abadi–Needham (BAN) logic analysis are implemented. In addition, the ProVerif tool is used to normalize the security verification of the scheme. Finally, the performance comparisons with the former schemes show that the proposed scheme is more applicable and secure.
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Kwon, DeokKyu, YoHan Park i YoungHo Park. "Provably Secure Three-Factor-Based Mutual Authentication Scheme with PUF for Wireless Medical Sensor Networks". Sensors 21, nr 18 (9.09.2021): 6039. http://dx.doi.org/10.3390/s21186039.
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Wireless medical sensor networks (WMSNs) are used in remote medical service environments to provide patients with convenient healthcare services. In a WMSN environment, patients wear a device that collects their health information and transmits the information via a gateway. Then, doctors make a diagnosis regarding the patient, utilizing the health information. However, this information can be vulnerable to various security attacks because the information is exchanged via an insecure channel. Therefore, a secure authentication scheme is necessary for WMSNs. In 2021, Masud et al. proposed a lightweight and anonymity-preserving user authentication scheme for healthcare environments. We discover that Masud et al.’s scheme is insecure against offline password guessing, user impersonation, and privileged insider attacks. Furthermore, we find that Masud et al.’s scheme cannot ensure user anonymity. To address the security vulnerabilities of Masud et al.’s scheme, we propose a three-factor-based mutual authentication scheme with a physical unclonable function (PUF). The proposed scheme is secure against various security attacks and provides anonymity, perfect forward secrecy, and mutual authentication utilizing biometrics and PUF. To prove the security features of our scheme, we analyze the scheme using informal analysis, Burrows–Abadi–Needham (BAN) logic, the Real-or-Random (RoR) model, and Automated Verification of Internet Security Protocols and Applications (AVISPA) simulation. Furthermore, we estimate our scheme’s security features, computation costs, communication costs, and energy consumption compared with the other related schemes. Consequently, we demonstrate that our scheme is suitable for WMSNs.
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Li, Tong, Yuhui Zheng i Ti Zhou. "Efficient Anonymous Authenticated Key Agreement Scheme for Wireless Body Area Networks". Security and Communication Networks 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/4167549.
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Wireless body area networks (WBANs) are widely used in telemedicine, which can be utilized for real-time patients monitoring and home health-care. The sensor nodes in WBANs collect the client’s physiological data and transmit it to the medical center. However, the clients’ personal information is sensitive and there are many security threats in the extra-body communication. Therefore, the security and privacy of client’s physiological data need to be ensured. Many authentication protocols for WBANs have been proposed in recent years. However, the existing protocols fail to consider the key update phase. In this paper, we propose an efficient authenticated key agreement scheme for WBANs and add the key update phase to enhance the security of the proposed scheme. In addition, session keys are generated during the registration phase and kept secretly, thus reducing computation cost in the authentication phase. The performance analysis demonstrates that our scheme is more efficient than the currently popular related schemes.
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Zhong, Xin, i Frank Y. Shih. "A High-Capacity Reversible Watermarking Scheme Based on Shape Decomposition for Medical Images". International Journal of Pattern Recognition and Artificial Intelligence 33, nr 01 (11.10.2018): 1950001. http://dx.doi.org/10.1142/s0218001419500010.
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We present a high-capacity reversible, fragile, and blind watermarking scheme for medical images in this paper. A bottom-up saliency detection algorithm is applied to automatically locate the multiple arbitrarily-shaped regions of interest (ROIs). The iterative square-production algorithm is developed to generate different sizes of squares for shape decomposition on the regions of noninterest (RONIs). This scheme of combining the frequency-domain watermarking and arbitrarily-shaped ROI methods can significantly increase the watermarking capacity, whereas the embedded image fidelity is preserved. Extensive experiments were carried out on the OASIS medical image dataset, which consists of a cross-sectional collection of 416 subjects, aged from 18 to 96 years old. The results show that the proposed scheme outperforms six existing state-of-the-art schemes in terms of watermarking capacity and embedded image fidelity.
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Wang, Chen, Wenying Zheng, Sai Ji, Qi Liu i Anxi Wang. "Identity-Based Fast Authentication Scheme for Smart Mobile Devices in Body Area Networks". Wireless Communications and Mobile Computing 2018 (5.08.2018): 1–7. http://dx.doi.org/10.1155/2018/4028196.
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Smart mobile devices are one of the core components of the wireless body area networks (WBANs). These devices shoulder the important task of collecting, integrating, and transmitting medical data. When a personal computer collects information from these devices, it needs to authenticate the identity of them. Some effective schemes have been put forward to the device authentication in WBANs. However, few researchers have studied the WBANs device authentication in emergency situations. In this paper, we present a novel system named emergency medical system without the assistance of doctors. Based on the system, we propose an identity-based fast authentication scheme for smart mobile devices in WBANs. The scheme can shorten the time of device authentication in an emergency to achieve fast authentication. The analysis of this paper proves the security and efficiency of the proposed scheme.
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Xu, Zhiyan, Min Luo, Neeraj Kumar, Pandi Vijayakumar i Li Li. "Privacy-Protection Scheme Based on Sanitizable Signature for Smart Mobile Medical Scenarios". Wireless Communications and Mobile Computing 2020 (22.11.2020): 1–10. http://dx.doi.org/10.1155/2020/8877405.
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With the popularization of wireless communication and smart devices in the medical field, mobile medicine has attracted more and more attention because it can break through the limitations of time, space, and objects and provide more efficient and quality medical services. However, the characteristics of a mobile smart medical network make it more susceptible to security threats such as data integrity damage and privacy leakage than those of traditional wired networks. In recent years, many digital signature schemes have been proposed to alleviate some of these challenges. Unfortunately, traditional digital signatures cannot meet the diversity and privacy requirements of medical data applications. In response to this problem, this paper uses the unique security attributes of sanitizable signatures to carry out research on the security and privacy protection of medical data and proposes a data security and privacy protection scheme suitable for smart mobile medical scenarios. Security analysis and performance evaluation show that our new scheme effectively guarantees data security and user privacy while greatly reducing computation and communication costs, making it especially suitable for mobile smart medical application scenarios.
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Chen, Yingwen, Linghang Meng, Huan Zhou i Guangtao Xue. "A Blockchain-Based Medical Data Sharing Mechanism with Attribute-Based Access Control and Privacy Protection". Wireless Communications and Mobile Computing 2021 (29.06.2021): 1–12. http://dx.doi.org/10.1155/2021/6685762.
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The rapid development of wearable sensors and the 5G network empowers traditional medical treatment with the ability to collect patients’ information remotely for monitoring and diagnosing purposes. Meanwhile, the health-related mobile apps and devices also generate a large amount of medical data, which is critical for promoting disease research and diagnosis. However, medical data is too sensitive to share, which is also a common issue for IoT (Internet of Things) data. The traditional centralized cloud-based medical data sharing schemes have to rely on a single trusted third party. Therefore, the schemes suffer from single-point failure and lack of privacy protection and access control for the data. Blockchain is an emerging technique to provide an approach for managing data in a decentralized manner. Especially, the blockchain-based smart contract technique enables the programmability for participants to access the data. All the interactions are authenticated and recorded by the other participants of the blockchain network, which is tamper resistant. In this paper, we leverage the K-anonymity and searchable encryption techniques and propose a blockchain-based privacy-preserving scheme for medical data sharing among medical institutions and data users. To be specific, the consortium blockchain, Hyperledger Fabric, is adopted to allow data users to search for encrypted medical data records. The smart contract, i.e., the chaincode, implements the attribute-based access control mechanisms to guarantee that the data can only be accessed by the user with proper attributes. The K-anonymity and searchable encryption ensure that the medical data is shared without privacy leaking, i.e., figuring out an individual patient from queries. We implement a prototype system using the chaincode of Hyperledger Fabric. From the functional perspective, security analysis shows that the proposed scheme satisfies security goals and precedes others. From the performance perspective, we conduct experiments by simulating different numbers of medical institutions. The experimental results demonstrate that the scalability and performance of our scheme are practical.
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Gadelshin, Vadim Maratovich, Reinhard Heinke, Tom Kieck, Tobias Kron, Pascal Naubereit, Frank Rösch, Thierry Stora, Dominik Studer i Klaus Wendt. "Measurement of the laser resonance ionization efficiency for lutetium". Radiochimica Acta 107, nr 7 (26.07.2019): 653–61. http://dx.doi.org/10.1515/ract-2019-3118.
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Abstract The development of a highly efficient resonance ionization scheme for lutetium is presented. A laser ion source, based on the all-solid-state Titanium:sapphire laser system, was used at the 30 keV RISIKO off-line mass separator to characterize different possible optical excitation schemes in respect to their ionization efficiency. The developed laser resonance ionization scheme can be directly applied to the use at radioactive ion beam facilities, e. g. at the CERN-MEDICIS facility, for large-scale production of medical radioisotopes.