A Review of Issues in Healthcare Information Management Systems and Blockchain Solutions

Healthcare is a data-driven domain where a large volumes of data are created, accessed, stored, and disseminated daily. In this paper, issues such as security, privacy, data transparency, interoperability, data accessibility, user interface issues in healthcare information management systems are presented. In addition, blockchain technology related studies in healthcare information systems are discussed with the aim to find what issues in healthcare system present research opportunities using blockchains

Vestibular deficits in neurodegenerative disorders: balance, dizziness, and spatial disorientation

The vestibular system consists of the peripheral vestibular organs in the inner ear and the associated extensive central nervous system projections—from the cerebellum and brainstem to the thalamic relays to cortical projections. This system is important for spatial orientation and balance, both of critical ecological importance, particularly for successful navigation in our environment. Balance disorders and spatial disorientation are common presenting features of neurodegenerative diseases; however, little is known regarding central vestibular processing in these diseases. A ubiquitous aspect of central vestibular processing is its promiscuity given that vestibular signals are commonly found in combination with other sensory signals. This review discusses how impaired central processing of vestibular signals—typically in combination with other sensory and motor systems—may account for the impaired balance and spatial disorientation in common neurodegenerative conditions. Such an understanding may provide for new diagnostic tests, potentially useful in detecting early disease while a mechanistic understanding of imbalance and spatial disorientation in these patients may enable a vestibular-targeted therapy for such problems in neurodegenerative diseases. Studies with state of the art central vestibular testing are now much needed to tackle this important topic

Does concurrent breastfeeding alongside the introduction of solid food prevent the development of food allergy?

The timing of introduction of solid food on the subsequent development of food allergy is under debate and the role of concurrent breastfeeding is unclear. The aim of the present study was to investigate the role of solid food introduction whilst concurrently breastfeeding on food allergy outcome, with a specific focus on cows’ milk allergy. Prospectively collected infant feeding data from a birth cohort were analysed. Participants with histories suggestive of food allergy underwent diagnostic food challenges. Children with food allergy were matched to control participants for age and sex. Mann–Whitney U tests, χ2, Fisher exact tests and logistic regression calculations were undertaken. A total of thirty-nine food-allergic children and seventy-eight matched controls were identified, including twenty-two cows’ milk-allergic children and forty-four matched controls. The control group introduced solid food earlier than the food-allergic group (P < 0·05). There was no effect of concurrent breastfeeding alongside cows’ milk introduction or other food allergens on the development of food allergy. Due to small numbers, it was not possible to explore differences for food allergy phenotype. We have therefore found no evidence that introducing solids, or food allergens, whilst breastfeeding has an allergy-preventative effect; however, the results should be interpreted with caution due to sample size. Recommendations regarding infant feeding and food allergy should be carefully considered. Although breastfeeding should be promoted for many health reasons, larger studies looking at the introduction of food allergens on the development of food allergy are needed to make a final conclusion

Fussy eating and feeding difficulties in infants and toddlers consuming a cows’ milk exclusion diet

Cows’ milk allergy (CMA) is the most common infant food allergy in the United Kingdom, requiring a strict exclusion diet. Feeding difficulties and fussy eating are also very common problems in young children and can negatively influence feeding and dietary intake in an infant with CMA. The aim of this study was to compare the levels of fussy eating and feeding difficulties in two groups of young children: a group consuming an exclusion diet for CMA and a control group of children consuming an unrestricted diet.MethodParticipants were recruited from allergy and health visitor clinics on the Isle of Wight. Parents completed a number of questionnaires about their child's feeding behaviour.ResultsOne hundred and twenty-six participants (mean age 13 months) were recruited. Participants consuming an exclusion diet for CMA had significantly higher scores for both fussy eating and feeding difficulties (p < 0.05), although overall both groups were within the normal range. A number of symptoms were found to be positively moderately correlated with higher feeding difficulty score (p < 0.05). A higher consumption of milk/milk substitute consumed per day was positively correlated to both feeding difficulties and fussy eating (p < 0.05).ConclusionParticipants consuming an exclusion diet for CMA have higher scores for feeding difficulties and fussy eating than those consuming an unrestricted diet; however, the majority of participants’ scores were within the normal range and did not affect the growth

Lubrication effects on the flow of wet granular materials

We investigate the dynamics of a partially saturated grain-liquid mixture with a rotating drum apparatus. The drum is partially filled with the mixture and then rotated about its horizontal axis. We focus on the continous avalanching regime and measure the impact of volume fraction and viscosity of the liquid on the dynamic surface angle. The inclination angle of the surface is observed to increase sharply to a peak and then decrease as a function of liquid volume fraction. The height of the peak is observed to increase with rotation rate. For higher liquid volume fractions, the inclination angle of the surface can decrease with viscosity before increasing. The viscosity where the minima occurs decreases with the rotation rate of the drum. Limited measurements of the flow depth were made, and these were observed to show only fractional changes with volume fraction and rotation speeds. We show that the qualitative features of our observations can be understood by analyzing the effect of lubrication forces on the timescale over which particles come in contact.Comment: 7 pages, 8 figure

A Comment on Curvature Effects In CFTs And The Cardy-Verlinde Formula

We examine the Cardy-Verlinde formula for finite temperature N=4 Super Yang-Mills theory on $R\times S^3$, and its AdS dual. We find that curvature effects introduce non-trivial corrections to thermodynamic quantities computed on both sides. We find a modified version of the Cardy-Verlinde formula for the SYM theory, incorporating these. On the gravity side, these corrections imply that the Cardy-Verlinde formula is exact.Comment: 8 Pages, To Appear in PL

The natural history of peanut sensitization and allergy in a birth cohort

Information on the natural history of peanut-induced allergic sensitization (PAS) and clinical peanut allergy (PA) remains limited. Most previous studies selected children who were given a diagnosis of PA, which does not provide the population perspective and probably ignores those with low levels of sensitization.1,2 There are no population-based studies on the natural history of PAS or PA. To provide a population perspective, we used the Isle of Wight birth cohort (n = 1456) and determined the natural history of PAS and PA, focusing on incidence, persistence, and remission

The contribution of the posterolateral capsule to elbow joint stability: a cadaveric biomechanical investigation.

BACKGROUND: Elbow posterolateral rotatory instability occurs after an injury to the lateral collateral ligament complex (LCLC) in isolation or in association with an osteochondral fracture of the posterolateral margin of the capitellum (Osborne-Cotterill lesion [OCL]). The contribution to elbow stability of the posterolateral capsule, attached to this lesion, is unknown. This study quantified the displacement of the radial head on simulated posterior draw with sectioning of the posterior capsule (a simulated OCL) or LCLC. METHODS: Biomechanical testing of the elbow was performed in 8 upper limb cadavers. With the elbow 0°, 30°, 60°, and 90° degrees of flexion, posterior displacement of the radius was measured at increments of a load of 5 N up to 50 N. A simulated OCL and LCLC injury was then performed. RESULTS: A simulated OCL results in significantly more displacement of the radial head compared with the intact elbow at 30° to 60° of elbow flexion. LCLC resection confers significantly more displacement. An OCL after LCLC resection does not create further displacement. CONCLUSIONS: The degree of radial head displacement is greater after a simulated OCL at 30° to 60° of flexion compared with the intact elbow with the same load but not as great as seen with sectioning of the LCLC. This study suggests that the posterior capsule attaching to the back of the capitellum is important to elbow stability and should be identified as the Osborne-Cotterill ligament. Clinical studies are required to determine the importance of these biomechanical findings

Comparison of Antibiotic Usage - Third Generation Cephalosporin Single Dosage Vs Multiple Dosage in case of Emergency Open Uncomplicated Appendicectomy

INTRODUCTION: Acute Appendicitis is the most common general surgical emergency and early surgical intervention improves outcome which makes Appendicectomy, the most commonly performed emergency operation in the world.Most patients with acute appendicitis are managed by prompt surgical removal of the appendix.If untreated or delay in treatment would result in fatal complications.If simple acute appendicitis is encountered,there is no benefit in extending antibiotic coverage beyond 24 hrs . For intraabdominal infections of GI tract origin that are of mild to moderate severity,the Surgical Infection society has recommended single-agent therapy with cefoxitin, cefotetan or ticarcillinclavulanic acid. But in daily practice multiple doses are used to prevent complications like wound infection and intra abdominal abscess.Antibiotics should be administered 30 minutes prior to incision to achieve adequate tissue levels. In non-perforated appendicitis single preoperative dose of antibiotic suffices. In cases of perforation, an extended course of atleast 5 days of antibiotics is advocated. AIMS & OBJECTIVES: • To know the outcome of single dose antibiotic (cefaperazone sulbactam) in cases of emergency open uncomplicated appendectomy. • To compare single dose (cefaperazone sulbactam) with multiple doses of antibiotics in case of emergency open uncomplicated appendectomy. Duration: Jan 2014 TO Sep 2014. Study Design: Prospective study. Sample Size: 300. Inclusion Criteria: Patients presenting with clinical features suggesting of acute appendicitis - anorexia,right iliac fossa pain,nausea,vomiting and fever are included in the study. Exclusion Criteria: • Patients with perforated appendicitis,appendicular abscess, appendicular mass formation METHODOLOGY: • Patients presenting with clinical features suggesting of acute appendicitisanoreixia, right iliac fossa pain,nausea,vomiting and fever admitted in emergency department of our hospital from January 2014 to November 2014 will be enrolled in our study. • These patients will be given single dose of cefaperazone sulbactam 1.5gm IV half an hour prior to incision. • The above group will be compared to those cases with admistration of multiple doses of antibioctics • The results are analyzed using Microsoft Excel for tabular transformation and graphical representation. For comparing the parameters and statistical analysis 2 sample z-test will be used. CONCLUSION; It is evident that prophylactic multiple doses of Cefaperazone sulbactam postoperatively confer no additional benefit over a single preoperative dose of Cefaperazone sulbactam. With additional benefits of the greater ease of administration and decreased cost, single dose Cefaperazone sulbactam is the prophylaxis of choice for appendicectomy in patients with nonperforated appendicitis in our study. It is essential for Surgeons and Surgical departments to update their routine practice of antibiotic prophylaxis to comply with updated guidelines and evidence base so as to avoid overuse of antibiotics and their multiple dosage schedule in order to prevent the emerging menace of drug resistance as well prevent the side effects in patient’s perspective