Добірка наукової літератури з теми "Lifesaving app"

Sometimes infectious diseases can seem to be the least interesting subspecialty of internal medicine. We don’t offer lifesaving or pain-relieving procedures. We offer the same advice over and over again hoping someday it might stick: wash your hands; stop prescribing antibiotics when there is no evidence of infection; and take your flu shot—it really won’t give you the flu. We give advice that some consider expendable. Shouldn’t all physicians be able to prescribe antibiotics with a little help from an online textbook or computer app? On top of all that, we apparently aren’t very stylish. One of my female colleagues recently told me she can pick out all of the male infectious disease physicians at scientific meetings by the standard uniform of ill-fitting khakis and button-down shirts.But a new crisis is always lurking to remind us that infectious diseases can be one of the most interesting and challenging areas of medicine. Emerging infections—often exotic and frightening—grab the attention of everyone from frontline personnel to the news media: Legionnaires’ disease; HIV; West Nile virus; SARS; MERS; chikungunya; Ebola virus; Zika virus; and Mycobacterium chimaera to name just a few. Without warning, common pathogens create havoc when they acquire new resistance mechanisms or virulence factors: multidrug-resistant gram-negative bacilli; Staphylococcus aureus; and Clostridium difficile. Standard procedures such as transrectal biopsy of the prostate and endoscopic retrograde cholangiopancreatography suddenly become risky due to increasing antimicrobial resistance or inadequate methods for device reprocessing.

Background A lifesaving treatment for myocardial infarction is the placement of a stent in a closed or obstructed coronary artery. The largest modifiable risk factor after receiving a stent is medication adherence to Dual AntiPlatelet Therapy, a combination of P2Y12 inhibitors and aspirin. Objective This study aimed to determine the acceptability of a protocol and an intervention using the My Interventional Drug-Eluting Stent Educational App (MyIDEA) and to evaluate medication adherence using the proportion of days covered (PDC) and platelet activation tests in a multisite randomized controlled trial. Methods Potential participants who received a post percutaneous coronary intervention (PCI) procedure with a drug-eluting stent were approached. All patients older than 50 years and who spoke English were recruited. Participants were recruited, baseline demographics were collected, and the Hospital Anxiety and Depression Scale (HADS), Rapid Estimate of Adult Literacy in Medicine-Short Form, Burden-Benefit questionnaire, 36-Item Short Form Health Survey, and PCI knowledge questionnaire were administered. Block randomization was used to randomize participants to either usual care or MyIDEA supplementation. MyIDEA is a personalized educational intervention based on the Kolb experiential learning theory using patient narratives for education. During the visits, participants’ blood was collected to measure platelet suppression from medication. During the second and third encounters, the Morisky medication adherence score and cardiology outcomes were measured. The study was conducted at the University of Illinois Hospital and John H Stroger Jr Cook County Hospital with appropriate ethical approvals. Platelet suppression was measured through aspirin reactive units and P2Y12 reactive units. Medication adherence was measured using the PDC. The analysis team was blinded to the participants’ group membership. The primary outcome was a feasibility analysis of recruitment and retention. Results The mean age of participants was 60.4 years (SD 7.1); the majority of patients were black and non-Hispanic. The majority of patients’ reading levels were seventh grade or above, and they were not very familiar with other electronic devices for information and communication. The number of control subjects was 21, and the number of participants in the interventional arm was 24. The interventional group was able to use MyIDEA in both the hospital and outpatient setting. However, there was no significant difference in platelet suppression or medication adherence between groups. There were also differences between the groups in terms of depression and anxiety, initially, as measured by HADS. No documented adverse event associated with the intervention was found. Conclusions Elderly patients are willing to use tablet devices to be educated about health conditions. Additional studies are required to measure the effectiveness and determine the most suitable timing and location for patient education. Trial Registration ClinicalTrials.gov NCT04439864; https://clinicaltrials.gov/ct2/show/NCT04439864

Background: Skin cancer classificationusing convolutional neural networks (CNNs) proved better results in classifying skin lesions compared with dermatologists which is lifesaving in terms of diagnosing. This will help people diagnosetheir cancer on their own by just installing app on mobile devices. It is estimated that 6.3 billion people will use the subscriptions by the end of year 2021[28] for diagnosing their skin cancer. Objective: This study represents review of many research articles on classifying skin lesions using CNNs. With the recent enhancement in machine learning algorithms, misclassification rate of skin lesions has reduced compared to a dermatologist classifying them.In this article we discuss how using CNNs has evolved in successfully classifying skin cancer type, and methods implemented, and the success rate. Even though Deep learning using CNN has advantages compared to a dermatologist, it also has some vulnerabilities, in terms of misclassifying images under some Criteria, and situations. We also discuss about those Vulnerabilities in this review study. Methods: We searched theScienceDirect, PubMed,Elsevier, Web of Science databases and Google Scholar for original research articles that are published. We selected papers that have sufficient data and information regarding their research, and we created a review on their approaches and methods they have used. From the articles we searched online So far no review paper has discussed both opportunities and vulnerabilities that existed in skin cancer classification using deep learning. Conclusions: The improvements in machine learning, Deep learning techniques, can avoid human mistakes that could be possible in misclassifying and diagnosing the disease. We will discuss, how Deep learning using CNN helped us and its vulnerabilities.

Background Adherence to lifesaving antiretroviral therapy (ART) for HIV infection remains a challenge for many patients. Routine screening for barriers to ART adherence could help make HIV care more patient-centered and prevent virologic rebound or failure. Our team is currently developing a new HIV-specific patient-reported outcome measure (PROM) of these barriers for use in Canada and France along with a digital app for its electronic administration. In our previous work, we developed the PROM’s multidimensional conceptual framework and generated 100 English items, which have been translated to French. Objective This study aims to use a Web-based Delphi to help validate and select the content of this new HIV-specific PROM, based on the perspective of anglophone and francophone patients and providers in Canada and France. Here, we present the proposal for this Delphi. Methods This modified Delphi will involve a diverse panel of patients (n=32) and providers (n=52) recruited especially from the 9 sites of the PROM development study (site locations in Canada: Montreal, Toronto, Vancouver; in France: Paris, Nantes, Clermont-Ferrand, Saint-Martin, Cayenne). Overall, 2 rounds of Web-based questionnaires will be conducted. The threshold for consensus is set at 60% and will determine which items are carried forward to the second round. Per item, 3 aspects will be rated: importance as a barrier to ART adherence, relevance for HIV care, and clarity. In both rounds, space will be available for free text comments. Overall comprehensiveness will be assessed in the second round. Results This study has undergone a methodological review by experts in patient-oriented research. It has received approval from a research ethics board of the McGill University Health Centre. It is financially supported, in part, by the Canadian Institutes of Health Research’s Strategy for Patient-Oriented Research-Quebec Support Unit (M006). As of May 21, 2019, 15 people living with HIV and 25 providers completed the first round of the Delphi (24 from Canada and 16 from France). Conclusions To our knowledge, this is the first Delphi to seek consensus on the most relevant and clinically actionable barriers to ART adherence, collecting opinions on an extensive list of barriers. Drawing on a relatively large and diverse panel of HIV patients and providers, it essentially engages key stakeholders in decision making about the PROM’s final content, helping to ensure its utility and adoption. International Registered Report Identifier (IRRID) PRR1-10.2196/12836

Context Research suggests that knowledge gaps regarding the appropriate use of airway adjuncts exist among various health care practitioners, and that knowledge is especially limited within athletic training. Objective To determine the relationship between perceived knowledge (PK) and actual knowledge (AK) of airway adjunct use and the difference in PK after AK assessment. Design Knowledge assessment. Patients or Other Participants Two thousand athletic trainers received the survey via e-mail; 152 (7.6%) responded. Intervention(s) The AK assessment included 7 items based on the use and implementation of airway adjuncts based on the National Athletic Trainers' Association educational competencies. Perceived knowledge was measured using a well-established PK questionnaire, which also included 1 item to rate likelihood to pursue continuing education (CE). Main Outcome Measure(s) Perceived knowledge was compared pre- and posttest. Our demographic variables assessed how often lifesaving skills were used. We used total scores of the AK assessment to measure AK. We employed dependent t tests to determine the pre- and posttest differences in PK and likelihood to pursue CE. We used a correlation analysis to determine the relationship between PK and AK. We calculated separate analyses of variance to determine differences in AK between the frequencies of lifesaving skill use. Results We identified no significant change (t150 = −0.91, P = .37, 95% confidence interval = −0.17 to 0.06) in likelihood to pursue CE. Greater PK was weakly associated with greater AK (r = 0.36, P < .001). We found a significant difference (F1,145 = 4.63, P = .03, effect size = 0.031, 1 − β = 0.57) between the frequency of use of lifesaving skills and AK. Conclusion We identified a knowledge gap among athletic trainers in the use of airway adjuncts. Although the likelihood to pursue CE score was high, the score did not significantly increase after completing the assessment. Participants who use lifesaving skills more frequently scored higher on the AK assessment, suggesting that the more frequently athletic trainers utilize a skill, the more knowledgeable they are.

Cette thèse adopte une perspective de recherche en sciences sociales pour examiner les usages de l'application SMSlivräddare (eng. SMSlifesaving), devenue Heartrunner, ayant pour objectif de solliciter des bénévoles à proximité de personnes presumées victimes d'un arrêt cardiaque extra-hospitalier. Cette étude de cas sur les usages de cette application médicale et de santé juxtapose les « portraits » publics de l'application, de ses utilisateurs potentiels, de leurs rôles actifs et de leurs pratiques d'usage et les témoignages des utilisateurs bénévoles. Cette analyse explore les dimensions des rôles actifs de l'application et de ses utilisateurs tels qu’ils sont délégués par les « portraits » de la technologie et tels qu’ils sont perçus par ses utilisateurs. Cette analyse rend visibles les aspects des rôles actifs et des pratiques des utilisateurs bénévoles au moment de la mise en œuvre de cette technologie dans deux premières régions, avant son adoption ultérieure dans d'autres régions de Suède ainsi qu’au Danemark. La perspective de la recherche médicale a jusqu'à présent dominé les études sur les applications de secourisme. Ces études ont évalué les résultats de l'usage de l'application par les bénévoles et se sont concentrées sur l'examen de l'efficacité de ces applications, par des indicateurs tels que le nombre d'utilisateurs arrivés sur place et le nombre de ceux qui ont participé à la réanimation des personnes victimes. Dans le même temps, ces travaux ont contribué à la construction de discours prometteurs et à des approches instrumentales appliquées pour comprendre les significations et les usages des applications médicales et de santé. En revanche, en s'appuyant sur l'analyse discursive et thématique du matériel de recherche qualitative, cette thèse cherche à mettre en évidence les perspectives des utilisateurs dans leur co-construction de la technologie de secourisme à travers leurs pratiques d'usage de l'application. Par une approche théorique socio-matérielle, elle explore de manière critique les rôles actifs des utilisateurs tels qu'ils sont délégués par les discours des développeurs du projet, des gestionnaires et des évaluateurs de cette technologie médicale et tels qu'ils sont négociés par les utilisateurs dans leurs pratiques quotidiennes. Cette thèse examine tout d'abord les « portraits » de l'application publiés en ligne, de ses utilisateurs et de leurs rôles actifs, mais aussi dans les pratiques de recrutement des utilisateurs et enfin dans une publication de recherche médicale évaluant cette technologie de secourisme. Ensuite, la thèse examine comment les bénévoles décrivent les motifs de leur décision de devenir usagers de l’application, le contexte social de leurs décisions et les significations qu'ils attribuent à leurs pratiques. Troisièmement, la thèse examine comment les récits des bénévoles, en juxtaposition avec les « portraits » en ligne de la technologie SMSlifesaving, représentent les pratiques d'usage de l'application par les bénévoles aux differentes étapes: avant la réception des notifications les informant des cas d'arrêts cardiaques, au moment de la réception de ces notifications, et après leur acceptation.Contribuant au champ de la recherche sociale critique sur les applications médicales et de santé, la thèse met en relief que les utilisateurs de l'application SMSlifesaving et les technologies qu'ils co-construisent ont des rôles actifs. Elle illustre les rôles actifs délégués et négociés par les utilisateurs ; ces derniers lorsqu'ils surmontent les dépendances quotidiennes de l'application et mesurent l'importance de leur travail bénévole, par l’intermédiaire de leur usage de l’application, par rapport à leur travail rémunéré et à leurs engagements de vie privée, développent un engagement consciencieux envers l'application et redéfinissent les promesses médicales de l'application pour les personnes victimes et leurs familles
This thesis embraces a social science research perspective to examine uses of the app SMSlivräddare (eng. SMSlifesaving), now Heartrunner, dedicated to alert volunteers nearby to assist people suspected to suffer from a cardiac arrest outside hospital. This case study of the uses of the health and medical app juxtaposes the public portrayals of the app, its prospective users, their agencies and use practices with the volunteer users’ own accounts. The analysis explores dimensions of the app’s and its users’ agencies as delegated by the technology’s portrayals and perceived by its users. It renders visible also possibly obscured aspects of the volunteer users’ agencies and practices at the time of the technology’s implementation in the two first regions, before its subsequent adoption in other Swedish regions and in Denmark. A medical research perspective has so far dominated the studies of lifesaving apps. Such research evaluates the patients’ health outcomes resulting from the app use by the volunteers and concentrates on the examination of the efficiency aspects of the app, such as how many users arrived and how many engaged in resuscitating the patients. At the same time, it contributes to the promissory discourses and instrumental approaches applied to understand the meanings and uses of health and medical apps. In contrast, building on the discourse and thematic analysis of the qualitative research material, this thesis seeks to highlight the users’ perspectives in their co-constructing of the SMSlifesaving technology through their app use practices; it embraces a socio-material theoretical approach and critically explores the users’ agencies as delegated by the discourses of the project developers, managers and evaluators of the medical technology and as negotiated by the users in their daily practices. This thesis, first, investigates the public portrayals of the app, its users and their agencies published online, in the user-recruiting practices, and in a medical research publication evaluating the SMSlifesaving technology. Next, it examines how the volunteers’ accounts describe the rationales of their entry into their SMSlifesaving app use practices, the social context embedding their entry and the meanings which they ascribe to their practices. Third, the study investigates how the volunteers’ accounts in juxtaposition to the online portrayals of the SMSlifesaving technology represent the volunteers’ app use before their receptions of the app’s notifications which inform them about cardiac-arrest cases nearby, at the time of reception of such notifications, and following acceptance of such notifications.Contributing to the field of critical social research on health and medical apps, the thesis identifies that both the SMSlifesaving app users and the technologies they co-construct have agencies. It illustrates the users’ agencies delegated and negotiated; the latter when they overcome the app everyday dependencies and judge the app-mediated volunteer work importance versus their paid work and private life commitments, develop dutiful engagement with the app and re-define the app’s medical promises for the patients and their families

The response to HIV and AIDS has to be funded, whether the emphasis is on prevention, treatment, or both. AIDS is unique in part because of its complex financing. It requires long-term commitments for those increasing numbers on relatively expensive lifesaving treatment. ‘Funding the epidemic’ looks at the history of funding from the mobilization of international money into low- to middle-income countries to the increased domestic funding from government budgets fed from general tax revenues. Looking forward, AIDS resource needs are projected to increase at least until 2020. The problem is that treatment for people living with HIV is long-term and these costs remain unacknowledged by governments and donors.

Pharmaceutical firms have a noteworthy contribution in SDGs (Sustainable development goals). Their unceasing innovation of low-cost medicines and discovery of lifesaving drugs can assist in achieving the SDG 3 (good health and well-being). Having gone through the M&A scenario in the global pharmaceutical industry and the amount disbursed on R&D, the authors tried to find answers to a few important questions to understand whether these activities are in line to achieve global goals i.e. first, does Merger and Acquisition M&A in pharmaceutical sector increase innovations? Second, how can companies fully utilize M&A activities to increase innovation in the pharmaceutical sector? Third, is there any association between R&D expenditures and innovation outcome? We theoretically analyze and consolidate academic research on how M&A activities support innovation in the pharmaceutical industry. The present chapter also tried to unveil the association between R&D expenditures and the firm innovation as measured by the number of patent applications by selected Indian pharmaceutical firms.

Pharmaceutical firms have a noteworthy contribution in SDGs (Sustainable development goals). Their unceasing innovation of low-cost medicines and discovery of lifesaving drugs can assist in achieving the SDG 3 (good health and well-being). Having gone through the M&A scenario in the global pharmaceutical industry and the amount disbursed on R&D, the authors tried to find answers to a few important questions to understand whether these activities are in line to achieve global goals i.e. first, does Merger and Acquisition M&A in pharmaceutical sector increase innovations? Second, how can companies fully utilize M&A activities to increase innovation in the pharmaceutical sector? Third, is there any association between R&D expenditures and innovation outcome? We theoretically analyze and consolidate academic research on how M&A activities support innovation in the pharmaceutical industry. The present chapter also tried to unveil the association between R&D expenditures and the firm innovation as measured by the number of patent applications by selected Indian pharmaceutical firms.

This chapter explores the relationship between international humanitarian law and human rights law in safeguarding health and protecting rights in conflict and emergencies, examining the evolving role of aid workers as protectors of health-related rights. Complex Humanitarian Emergencies (CHEs)—from mass displacements, to disease outbreaks, to violent conflicts—create an environment for human rights violations and a challenge for human rights promotion. Humanitarian aid, operating within an interconnecting framework across two bodies of law, has the distinctive ability to mitigate violations, prevent harm, and realize rights. Yet the breakdown in social norms and government systems in conflicts and emergencies creates chaos that requires humanitarian responders to engage in lifesaving service provision and community resiliency support. This role, carrying both power and privilege, requires systems of accountability to ensure health and human rights.

This chapter explores the relationship between international humanitarian law and human rights law in safeguarding health and protecting rights in conflict and emergencies, examining the evolving role of aid workers as protectors of health-related rights. Complex Humanitarian Emergencies (CHEs)—from mass displacements, to disease outbreaks, to violent conflicts—create an environment for human rights violations and a challenge for human rights promotion. Humanitarian aid, operating within an interconnecting framework across two bodies of law, has the distinctive ability to mitigate violations, prevent harm, and realize rights. Yet the breakdown in social norms and government systems in conflicts and emergencies creates chaos that requires humanitarian responders to engage in lifesaving service provision and community resiliency support. This role, carrying both power and privilege, requires systems of accountability to ensure health and human rights.

Gestational Trophoblastic Neoplasia presenting after a normal delivery is very rare & seen in 1 in 1,60,000 pregnancies and is associated with a poor outcome due to delay in diagnosis. Only three cases have been reported in the literature till date. A 27 year old lady, P2L1 delivered a stillborn baby in some peripheral hospital. Intrapartumand post-partum period were uneventful. After a period of 2 months, in view of persistent bleeding pervaginumshe underwent dilatation & evacuation in the same hospital. Ultrasonography showed circumscribed lesion 4.1 x 3.6 cm in lower uterine segment indenting the endometrium. MRI showed a heterogeneous space (4.2 x 3.2 x 3.3 cm) occupying lesion extending to involve the anterior myometrium. She was discharged on single dose of methotrexate 50 mg intramuscular injection. After one month, she again had an episode of heavy bleeding pervaginum leading to shock, for which she was referred to Safdarjung Hospital for further management. At Safdarjung Hospital an emergency hysterectomy was performed as a lifesaving measure. Preoperative serum Bhcg was >1 lac mIU/ml. later it was reported as gestational choriocarcinoma by histopathology. Metastatic workup showed cannonball lesions in lungs. On the 10th post-op day, she had severe episode of headache followed by right sided hemiplegia. NCCT head showed multiple haemorrhagiclesion in bilateral parietal and right frontal region suggestive of brain metastasis. She was started on the EMA/CO regimen. Conclusion: The main modality of treatment of choriocarcinoma is multiagent chemotherapy. Hysterectomy is generally reserved for those gestational trophoblasticneoplasia where it is chemotherapy resistant. Although in exceptional circumstances of heavy uncontrolled bleeding per vaginum hysterectomy is a lifesaving procedure, it is not curative to the other metastatic manifestations.