Health alerts: Interaction protocols in remote health care monitoring

Remote health care monitoring is a promising technology to make health care more efficient and cost-effective. A crucial aspect of remote health care monitoring is interaction protocols that govern how alert and information messages are delivered to patients and health care professionals. Proper interaction protocols are essential in ensuring that not only the right messages are delivered to the right receiver in a timely manner but also that the intended actions are understood and carried out and any entailed exceptions are taken care of. In this paper, we discuss various issues in designing interaction protocols for remote health care monitoring. We also present a prototype implementation of an interaction protocol. A simple case study is shown to illustrate how the prototype works in a real-life scenario. © 2010 IADIS

Assistive care loop with electronic maternity records

Surprisingly women-held pregnancy health records (paper based) are still predominantly used in most hospitals in Australia. These records are not standardized as each hospital or state has a slightly different version. Early efforts have been made to standardize pregnancy records and make them available electronically. Electronic record systems do not allow dynamic interaction between users and they are not accessible when users are mobile. This paper describes an Assistive Maternity Care (AMC) system that addresses a number of important issues: 1) transforming a women-held paper-based record for pregnancy care into an Electronic Maternity Record (EMR); 2) investigating mechanisms to make the record active; 3) creating a system whereby details of the pregnant women and their carers can be recorded, updated over wired and wireless networks; and 4) creating a pregnancy care loop over which midwives and doctors and pregnant women under their care can communicate effectively anywhere, anytime for the duration of pregnancy. © 2008 IEEE

A Self Healing Microservices Architecture: A Case Study in Docker Swarm Cluster

One desired aspect of a self-adapting microservices architecture is the ability to continuously monitor the operational environment, detect and observe anomalous behaviour as well as implement a reasonable policy for self-scaling, self-healing, and self-tuning the computational resources in order to dynamically respond to a sudden change in its operational environment. Often the behaviour of a microservices architecture continuously changes over time and the identification of both normal and abnormal behaviours of running services becomes a challenging task. This paper proposes a self-healing Microservice architecture that continuously monitors the operational environment, detects and observes anomalous behaviours, and provides a reasonable adaptation policy using a multi-dimensional utility-based model. This model preserves the cluster state and prevents multiple actions to taking place at the same time. It also guarantees that the executed adaptation action fits the current execution context and achieves the adaptation goals. The results show the ability of this model to dynamically scale the architecture horizontally or vertically in response to the context changes

Protective effect of Arque-Ajeeb on acute experimental diarrhoea in rats

BACKGROUND: Diarrhoea is a major health problem for children worldwide, accounting for 5–8 million deaths each year. Arque-Ajeeb (AA) is a compound formulation of Unani medicine. It is reputed for its beneficial effects in the treatment of diarrhoea and cholera, but the claim of its efficacy is yet to be tested. Therefore the present study has been planned to investigate the real efficacy of this drug in rats. METHODS: The effect of Arque-Ajeeb was investigated for antidiarrhoeal activity against charcoal-induced gut transit, serotonin-induced diarrhoea and PGE(2)-induced small intestine enteropooling in rats. The control, standard and test groups of experimental animals were administered with normal saline (p.o.), diphenoxylate hydrochloride (5 mg/kg, p.o.) and Arque-Ajeeb (0.07 ml and 0.14 ml/kg, p.o.) respectively except the control group of PGE(2)-induced small intestine enteropooling which received only 5% ethanol in normal saline (i.p.). Charcoal (10 ml/kg, p.o.) and serotonin (600 μg/kg, i.p.) were administered after 30 min, while PGE(2 )(100 μg/kg, p.o.) was administered immediately afterwards. The distance traveled by charcoal in small intestine was measured after 15 and 30 min of charcoal administration, diarrhoea was observed every 30-min for six hour after serotonin administration and the volume of intestinal fluid was measured after 30 min of PGE(2 )administration. RESULTS: Arque-Ajeeb (0.07 ml and 0.14 ml/kg) significantly inhibited the frequency of defaecation and decreased the propulsion of charcoal meal through the gastrointestinal tract, reduced the wetness of faecal droppings in serotonin-induced diarrhoea and also reduced the PGE(2)-induced small intestine enteropooling. CONCLUSION: Arque-Ajeeb may have potential to reduce the diarrhoea in rats. Thus the drug may prove to be an alternate remedy in diarrhoea

In-Vitro Apatite Growth on Porous β-Tricalcium Phosphate Scaffolds Coated with PHBV

The bioactive properties of polyhydroxybutyrate-co-valerate (PHBV) coated beta-tricalcium phosphate (β-TCP) have been studied in- vitro. Porous β-TCP scaffolds have been prepared using a template method and sintered at 1450 °C. The bio ceramics were then coated with PHBV solution before being immersed for 6 weeks in a simulated body fluid (SBF) at 37°C. At the end of the immersion time, insignificant changes in the SBF pH value was observed, suggesting good stability against hydrolytic degradation. X-ray Diffraction (XRD) and Fourier Transform Infrared Spectroscopy (FTIR) analyses revealed the presence of apatite. Morphological analysis by SEM showed the formation of apatite crystals in the form of flakes and globular deposits on the scaffold surface. This bone- like apatite indicates good biological activity of the bio ceramics scaffold with PHVB coating suggesting that the composite has potential for bone tissue engineering applications

Self‐perceived preparedness of undergraduate dental students in dental public universities in Malaysia: A national study

Aims: To evaluate the self-perceived preparedness of final-year dental undergraduate students in dental public universities in Malaysia. Methods: Final-year dental undergraduate students from six dental public universities in Malaysia were invited to participate in an online study using a validated Dental Undergraduates Preparedness Assessment Scale DU-PAS. Results: In total, about 245 students responded to the online questionnaire yielding a response rate of 83.05%. The age range of the respondents was 23-29 years with a mean age of 24.36 (SD 0.797). The total score obtained by the respondents was ranged from 48 to 100 with a mean score of 79.56 (SD 13.495). Weaknesses were reported in several clinical skills, cognitive and behavioural attributes. Conclusions: The preparedness of undergraduate students at six dental institutions in Malaysia was comparable to students from developed countries. The dental undergraduate preparedness assessment scale is a useful tool, and dental institutions may be used for self-assessment as well as to obtain feedback from the supervisors

A novel point mutation in P450c17 (CYP17) causing combined 17 alpha-hydroxylase/17,20-lyase deficiency

Context: Combined 17 alpha-hydroxylase/17,20-lyase deficiency is a rare cause of congenital adrenal hyperplasia and hypogonadism. Novel single amino acid changes in P450c17 provide potentially important insights into key structural domains for enzyme function.Objective, Design, and Setting: We report a novel missense mutation in P450c17 in a 17-yr-old female presenting with a malignant mixed germ cell tumor with yolk sac elements who demonstrated clinical and biochemical features of combined 17 alpha-hydroxylase/17,20-lyase deficiency.Methods: Quantitative urinary steroid analysis was performed by high resolution gas chromatography. All eight coding exons of CYP17 were PCR amplified and sequenced. The position of arginine at codon 96 was modeled using the CYP17 structure 2c17 (www.rcsb.org). The CYP17 genes were subcloned into pcDNA3, expressed in HEK-293 cells, and chromatographed.Patient and Results: 17 beta-Hydroxylase deficiency was confirmed by marked reductions in urinary and serum cortisol, androgens, and estradiol. Mutational analysis revealed a novel homozygous R96Q missense mutation in P450c17, affecting an amino acid in a key substrate-binding region of the enzyme, leading to complete inactivity.Conclusion: The description of a second missense mutation at codon 96 (R96W and R96Q) in the substrate-binding region of P450c17 provides strong evidence for the key role of this amino acid in 17 alpha-hydroxylase/17,20-lyase function. An association between a malignant germ cell tumor and 17 alpha-hydroxylase deficiency has not been reported previously, although the presence of gonadoblastoma in the ovary of a patient with this condition has recently been described

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

Jet energy measurement with the ATLAS detector in proton-proton collisions at root s=7 TeV

The jet energy scale and its systematic uncertainty are determined for jets measured with the ATLAS detector at the LHC in proton-proton collision data at a centre-of-mass energy of √s = 7TeV corresponding to an integrated luminosity of 38 pb-1. Jets are reconstructed with the anti-kt algorithm with distance parameters R=0. 4 or R=0. 6. Jet energy and angle corrections are determined from Monte Carlo simulations to calibrate jets with transverse momenta pT≥20 GeV and pseudorapidities {pipe}η{pipe}<4. 5. The jet energy systematic uncertainty is estimated using the single isolated hadron response measured in situ and in test-beams, exploiting the transverse momentum balance between central and forward jets in events with dijet topologies and studying systematic variations in Monte Carlo simulations. The jet energy uncertainty is less than 2. 5 % in the central calorimeter region ({pipe}η{pipe}<0. 8) for jets with 60≤pT<800 GeV, and is maximally 14 % for pT<30 GeV in the most forward region 3. 2≤{pipe}η{pipe}<4. 5. The jet energy is validated for jet transverse momenta up to 1 TeV to the level of a few percent using several in situ techniques by comparing a well-known reference such as the recoiling photon pT, the sum of the transverse momenta of tracks associated to the jet, or a system of low-pT jets recoiling against a high-pT jet. More sophisticated jet calibration schemes are presented based on calorimeter cell energy density weighting or hadronic properties of jets, aiming for an improved jet energy resolution and a reduced flavour dependence of the jet response. The systematic uncertainty of the jet energy determined from a combination of in situ techniques is consistent with the one derived from single hadron response measurements over a wide kinematic range. The nominal corrections and uncertainties are derived for isolated jets in an inclusive sample of high-pT jets. Special cases such as event topologies with close-by jets, or selections of samples with an enhanced content of jets originating from light quarks, heavy quarks or gluons are also discussed and the corresponding uncertainties are determined. © 2013 CERN for the benefit of the ATLAS collaboration