Application of mHealth to improve service delivery and health outcomes: Opportunities and challenges

The use of mobile technologies for health related activities (mHealth) is a new but rapidly progressing activity with global penetration. However, few programs have been implemented at scale. The objective of this paper is to review the background and evidence on mHealth, particularly with respect to the benefits and challenges of scale-up. A comprehensive review of literature on mHealth, aspects of eHealth and the related regulatory environment was undertaken in August 2014. mHealth innovations vary broadly in purpose, delivery channel and target population. As a result of its broad applicability and geographic reach, the benefits of successfully, safely and widely implemented mHealth are numerous and promising. However, these benefits can only be realized if the associated risks are minimized and the barriers are purposefully overcome. Government stewardship and leadership is crucial in overcoming these barriers and scaling up mHealth

Influence of customer focused mission statement on customer satisfaction

The purpose of this study is to examine the influence of customer-focused mission statements on customer satisfaction in selected cell phone manufacturing companies in the United States. The study employed content analysis for the mission statement and data from America customer satisfaction index (ACSI). In analysing our data, Pearson correlation, and multiple regression techniques were used. The result showed that product and service, technology, philosophy, self-concept, and public image mission statement components are strongly positively correlated with customer satisfaction. Customer, survival, growth and profitability and market mission statement components are insignificantly negatively correlated with customer satisfaction. The study, therefore, recommends that companies that want to remain competitive by enhancing customer satisfaction should formulate mission statements from a customer perspective so that they include product and service, technology, philosophy, self-concept, and public image components. The main limitation of the study represents the sample size and structure. This study empirically investigated the correlation and association of nine mission statement components with customer satisfaction.O

Cloud Mask Intercomparison eXercise (CMIX): An evaluation of cloud masking algorithms for Landsat 8 and Sentinel-2

Cloud cover is a major limiting factor in exploiting time-series data acquired by optical spaceborne remote sensing sensors. Multiple methods have been developed to address the problem of cloud detection in satellite imagery and a number of cloud masking algorithms have been developed for optical sensors but very few studies have carried out quantitative intercomparison of state-of-the-art methods in this domain. This paper summarizes results of the first Cloud Masking Intercomparison eXercise (CMIX) conducted within the Committee Earth Observation Satellites (CEOS) Working Group on Calibration & Validation (WGCV). CEOS is the forum for space agency coordination and cooperation on Earth observations, with activities organized under working groups. CMIX, as one such activity, is an international collaborative effort aimed at intercomparing cloud detection algorithms for moderate-spatial resolution (10–30 m) spaceborne optical sensors. The focus of CMIX is on open and free imagery acquired by the Landsat 8 (NASA/USGS) and Sentinel-2 (ESA) missions. Ten algorithms developed by nine teams from fourteen different organizations representing universities, research centers and industry, as well as space agencies (CNES, ESA, DLR, and NASA), are evaluated within the CMIX. Those algorithms vary in their approach and concepts utilized which were based on various spectral properties, spatial and temporal features, as well as machine learning methods. Algorithm outputs are evaluated against existing reference cloud mask datasets. Those datasets vary in sampling methods, geographical distribution, sample unit (points, polygons, full image labels), and generation approaches (experts, machine learning, sky images). Overall, the performance of algorithms varied depending on the reference dataset, which can be attributed to differences in how the reference datasets were produced. The algorithms were in good agreement for thick cloud detection, which were opaque and had lower uncertainties in their identification, in contrast to thin/semi-transparent clouds detection. Not only did CMIX allow identification of strengths and weaknesses of existing algorithms and potential areas of improvements, but also the problems associated with the existing reference datasets. The paper concludes with recommendations on generating new reference datasets, metrics, and an analysis framework to be further exploited and additional input datasets to be considered by future CMIX activities

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

Sinteza mikrokompozitnih kroglic z magnetnimi nanodelci v porozni matriki CaCO[spodaj]3

A method for synthesis of soft magnetic microbeads is presented. The microbeads are made from magnetic nanoparticles dispersed in CaCO3 (calcium carbonate) matrix. The composite beads are almost perfectly spherical with a diameter of few micrometers. The majority of the composite beads consists of a porous CaCO3 matrix. Magnetic nanoparticles with a size of about 10-15 nm are made of Fe2O3. They are captured inside the pores of CaCO3 matrix during its formation. CaCO3 matrix is formed by crystallization from saturated solution of sodium carbonate and calcium chloride. The composite beads are coated with a layer of functionalized polymer. The magnetic microbeads were characterized by SEM and XPS. Different functional groups were detected by XPS measurements including SO3–,NH3+,NH2,CO32– and OH groups. The results indicate that the iron oxide particles are absent on the surface and that the polymer coating serves as a good biocompatible film.V tem prispevku predstavljamo metodo za sintezo delcev, ki so sestavljeni iz kompozita magnetnih nanodelcev v matrici iz kalcijevega karbonata (CaCO3). Velikost kompozitnih delcev, ki so popolnoma sferične oblike, je nekaj mikrometrov. Ključni del ogrodja kompozitnega delca sestavlja zelo porozna matrica CaCO3. Magnetni nanodelci velikosti približno 10-15 nm so narejeni iz Fe2O3. Ti nanodelci se med tvorjenjem matrice CaCO3 ujamejo v notranjost por. CaCO3 matrica se tvori pri kristalizaciji nasičene raztopine natrijevega karbonata in kalcijevega klorida. Tako nastali kompozit je nato oplaščen še s plastjo funkcionaliziranega polimera. Sintetizirane magnetne kompozitne delce smo analizirali z metodama SEM in XPS. Kot je razvidno iz XPS meritev, je prišlo na površini do nastanka različnih funkcionalnih skupin kot so SO3–,NH3+,NH2,CO32– in OH skupine. Rezultati dokazujejo, da na površini mikrodelcev ne najdemo nanodelcev, ki so skriti znotraj por, ter da lahko polimerna prevleka, ki prekriva mikrodelce, služi kot dobra biokompatibilna podlaga za nadaljnjo vezavo bioloških substanc

Simulations of blood as a suspension predicts a depth dependent hematocrit in the circulation throughout the cerebral cortex.

Recent advances in modeling oxygen supply to cortical brain tissue have begun to elucidate the functional mechanisms of neurovascular coupling. While the principal mechanisms of blood flow regulation after neuronal firing are generally known, mechanistic hemodynamic simulations cannot yet pinpoint the exact spatial and temporal coordination between the network of arteries, arterioles, capillaries and veins for the entire brain. Because of the potential significance of blood flow and oxygen supply simulations for illuminating spatiotemporal regulation inside the cortical microanatomy, there is a need to create mathematical models of the entire cerebral circulation with realistic anatomical detail. Our hypothesis is that an anatomically accurate reconstruction of the cerebrocirculatory architecture will inform about possible regulatory mechanisms of the neurovascular interface. In this article, we introduce large-scale networks of the murine cerebral circulation spanning the Circle of Willis, main cerebral arteries connected to the pial network down to the microcirculation in the capillary bed. Several multiscale models were generated from state-of-the-art neuroimaging data. Using a vascular network construction algorithm, the entire circulation of the middle cerebral artery was synthesized. Blood flow simulations indicate a consistent trend of higher hematocrit in deeper cortical layers, while surface layers with shorter vascular path lengths seem to carry comparatively lower red blood cell (RBC) concentrations. Moreover, the variability of RBC flux decreases with cortical depth. These results support the notion that plasma skimming serves a self-regulating function for maintaining uniform oxygen perfusion to neurons irrespective of their location in the blood supply hierarchy. Our computations also demonstrate the practicality of simulating blood flow for large portions of the mouse brain with existing computer resources. The efficient simulation of blood flow throughout the entire middle cerebral artery (MCA) territory is a promising milestone towards the final aim of predicting blood flow patterns for the entire brain

Assessing the impact of grief on quality of life, work productivity, and health outcomes for parents bereaved from SMA: A study protocol

Abstract Background U.S. cost-effectiveness recommendations suggest that analyses should include all costs and effects relevant to the decision problem [1]. However, in many diseases, including spinal muscular atrophy (SMA), few studies have evaluated bereaved family outcomes after a child has died, neglecting potential impacts on their health-related quality of life (HRQoL), work productivity, and mental health. Additionally, grief-related outcomes are rarely included in economic evaluations. This manuscript outlines the protocol of a study that will estimate the HRQoL, work functioning, and mental health of bereaved parents of children with SMA type 1 to determine how outcomes vary based on parent’s sex and the time since a child’s death. Methods This study will involve two phases. In Phase 1, we will conduct a literature review to identify prior research that has measured how parental grief impacts HRQoL, work productivity, and mental health. We will also interview four bereaved parents of children with SMA type 1, stratified by parent sex and time since their child’s death, and analyze findings using a thematic analysis. In Phase 2, we will develop a survey draft based on Phase 1 findings. Parents bereaved from SMA type 1 will review our survey draft and we will revise the survey based on their feedback. We will send a cross-sectional survey to approximately 880 parents bereaved from SMA type 1. We will analyze findings from the survey to investigate whether the severity of grief symptoms is correlated with HRQoL, productivity, depression and anxiety symptom severity. We will also evaluate whether the mean scores of grief and each of the outcomes vary significantly when stratified by parent sex and the time since the child’s death. Discussion Our results will provide preliminary information on how parental grief can impact HRQoL, productivity, and mental health outcomes over time. Increasing the availability of family outcomes data will potentially assist organizations performing health economic evaluations, such as the Institute of Clinical and Economic Review (ICER) in the U.S. This research will also help to inform the development of future economic guidelines on this topic