Medical informatics in an undergraduate curriculum: a qualitative study

BACKGROUND: There is strong support for educating physicians in medical informatics, and the benefits of such education have been clearly identified. Despite this, North American medical schools do not routinely provide education in medical informatics. METHODS: We conducted a qualitative study to identify issues facing the introduction of medical informatics into an undergraduate medical curriculum. Nine key informants at the University of Toronto medical school were interviewed, and their responses were transcribed and analyzed to identify consistent themes. RESULTS: The field of medical informatics was not clearly understood by participants. There was, however, strong support for medical informatics education, and the benefits of such education were consistently identified. In the curriculum we examined, medical informatics education was delivered informally and inconsistently through mainly optional activities. Issues facing the introduction of medical informatics education included: an unclear understanding of the discipline; faculty and administrative detractors and, the dense nature of the existing undergraduate medical curriculum. CONCLUSIONS: The identified issues may present serious obstacles to the introduction of medical informatics education into an undergraduate medicine curriculum, and we present some possible strategies for addressing these issues

In Vivo Bioavailability and Therapeutic Assessment of Host-Guest Inclusion Phenomena for the Hydrophobic Molecule Etodolac: Pharmacodynamic and Pharmacokinetic Evaluation

The aim of present investigation was 1) to evaluate the in vivo bioavailability of an Etodolac (ETD)-β-cyclodextrin (β-CD) inclusion complex system prepared by kneading and spray drying techniques in rats, 2) to study the pharmacodynamic parameters in various animal models for analyzing the therapeutic response and, 3) to evaluate the pharmacokinetic profile of the drug administered. Inclusion complexation with β-CD enhanced the solubility of the drug, improved bioavailability and reduced ulcerogenicity of ETD in rats. Pharmacodynamic studies were carried out in normal LACA mice and pharmacokinetic evaluation was done in male Wistar rats. Pharmacokinetic parameters evaluated for the inclusion complexes revealed good correlation. The minimum dose necessary to produce analgesic or anti-arthritic activity was also decreased, indicating that the host-guest strategy that uses β-CD and ETD was very effective and could be successfully employed in the preparation of pharmaceutical formulations of anti-arthritics and analgesics

A Neuro-Expert Approach for Decision -Making in Welding Environment.

Decision making in welding is very important for achieving a good quality welded joint for the least possible cost. Of particular interest is decision making involving the selection of process, parameters, weld procedure specification, defect analysis and trouble shooting. This research has provided a means of capturing the planning knowledge in a Neuro-Expert System in a form that is capable of learning new information, correcting old information and automating the decision-making process in a welding environment. A strategy is formulated for the representation of knowledge in the form of a neural links and the translation of rules into neural link weights. After training those weights were converted back into rules to find out the inconsistent rules and capture new rules using a new approach. The various job variables affecting the process of welding are identified in detail and a Neuro-Expert system for the selection of process, parameters and weld procedure specification is developed. The neural networks are integrated with an expert system for decision making in welding environment. Apart from providing the initial parameters of welding, the expert system is used to validate the output of the neural network and served as a user-friendly interface for the neural network. Defect Analysis is performed in welding domain by mapping the welding parameters and defect patterns in a neural network. A neural network based approach for representing the knowledge in expert system is utilized for this purpose as the modification and updating of the knowledge was easier

A unique modular implant system enhances load sharing in anterior cervical interbody fusion: a finite element study

BACKGROUND: The efficacy of dynamic anterior cervical plates is somewhat controversial. Screws in static-plate designs have a smaller diameter and can cut through bone under load. While not ideal, this unintended loosening can help mitigate stress shielding. Stand-alone interbody devices with integral fixation have large endplate contact areas that may inhibit or prevent loosening of the fixation. This study investigates the load sharing ability of a novel dynamic plate design in preventing the stress shielding of the graft material compared to the non-dynamic devices. METHODS: An experimentally validated intact C5-C6 finite element model was modified to simulate discectomy and accommodate implant-graft assembly. Four implant iterations were modeled; InterPlate titanium device with dynamic surface features (springs), InterPlate titanium non-dynamic device, InterPlate titanium design having a fully enclosed graft chamber, and the InterPlate design in unfilled PEEK having a fully enclosed graft chamber. All the models were fixed at the inferior-most surface of C6 and the axial displacement required to completely embed the dynamic surface features was applied to the model. RESULTS: InterPlate device with dynamic surface features induced higher graft stresses compared to the other design iterations resulting in uniform load sharing. The distribution of these graft stresses were more uniform for the InterPlate dynamic design. CONCLUSIONS: These results indicate that the dynamic design decreases the stress shielding by increasing and more uniformly distributing the graft stress. Fully enclosed graft chambers increase stress shielding. Lower implant material modulus of elasticity does not reduce stress shielding significantly

Ameliorative effect of Albizzia procera leaves extract against experimentally induced gastric ulcer models in Wistar albino rats

Albizzia procera belongs to family Fabaceae and has several phytoconstituents like flavonoids, terpenes, alkaloids, saponins etc. The plant is commonly used in traditional medicines. The objective of the present study was to assess the ameliorative effect of A. procera leaves extract against an experimentally induced gastric ulcer in albino rats. The antiulcer, antisecretory and cytoprotective properties of an ethanolic extract prepared from the leaves was evaluated. When given in a 200 mg/kg oral (per. os) dose, the extract produced 74% and 85% protection index in ethanol-induced ulcer model and pylorus ligation model, respectively.  Additionally, the extract also prohibited the formation of haemorrhage and edema, significantly lessened catalase activity (p<0.0001) and the lipid peroxidation level (p<0.0001) in the glandular tissue of Wistar albino rats. Furthermore, the extract also significantly diminished the total acidity(p<0.0001) of the gastric fluid by increasing its pH (p<0.0001). The occupancy of different phytoconstituents in the extract, such as flavonoids and tannins were identified that may be responsible for its gastro-protective activity. All these results provide a basis explaining the antiulcer ability of A. procera being useful in the management of gastric ulcers

Mechanism of action of lenalidomide in hematological malignancies

Immunomodulatory drugs lenalidomide and pomalidomide are synthetic compounds derived by modifying the chemical structure of thalidomide to improve its potency and reduce its side effects. Lenalidomide is a 4-amino-glutamyl analogue of thalidomide that lacks the neurologic side effects of sedation and neuropathy and has emerged as a drug with activity against various hematological and solid malignancies. It is approved by FDA for clinical use in myelodysplastic syndromes with deletion of chromosome 5q and multiple myeloma. Lenalidomide has been shown to be an immunomodulator, affecting both cellular and humoral limbs of the immune system. It has also been shown to have anti-angiogenic properties. Newer studies demonstrate its effects on signal transduction that can partly explain its selective efficacy in subsets of MDS. Even though the exact molecular targets of lenalidomide are not well known, its activity across a spectrum of neoplastic conditions highlights the possibility of multiple target sites of action

Linkages between oral commensal bacteria and atherosclerotic plaques in coronary artery disease patients

Coronary artery disease is an inflammatory disorder characterized by narrowing of coronary arteries due to atherosclerotic plaque formation. To date, the accumulated epidemiological evidence supports an association between oral bacterial diseases and coronary artery disease, but has failed to prove a causal link between the two. Due to the recent surge in microbial identification and analyses techniques, a number of bacteria have been independently found in atherosclerotic plaque samples from coronary artery disease patients. In this study, we present meta-analysis from published studies that have independently investigated the presence of bacteria within atherosclerotic plaque samples in coronary artery disease patients. Data were collated from 63 studies covering 1791 patients spread over a decade. Our analysis confirms the presence of 23 oral commensal bacteria, either individually or in co-existence, within atherosclerotic plaques in patients undergoing carotid endarterectomy, catheter-based atherectomy, or similar procedures. Of these 23 bacteria, 5 (Campylobacter rectus, Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella intermedia, Prevotella nigrescens) are unique to coronary plaques, while the other 18 are additionally present in non-cardiac organs, and associate with over 30 non-cardiac disorders. We have cataloged the wide spectrum of proteins secreted by above atherosclerotic plaque-associated bacteria, and discuss their possible roles during microbial migration via the bloodstream. We also highlight the prevalence of specific poly-microbial communities within atherosclerotic plaques. This work provides a resource whose immediate implication is the necessity to systematically catalog landscapes of atherosclerotic plaque-associated oral commensal bacteria in human patient populations

“AI’s gonna have an impact on everything in society, so it has to have an impact on public health”: a fundamental qualitative descriptive study of the implications of artificial intelligence for public health

Background: Our objective was to determine the impacts of artificial intelligence (AI) on public health practice. Methods: We used a fundamental qualitative descriptive study design, enrolling 15 experts in public health and AI from June 2018 until July 2019 who worked in North America and Asia. We conducted in-depth semi-structured interviews, iteratively coded the resulting transcripts, and analyzed the results thematically. Results: We developed 137 codes, from which nine themes emerged. The themes included opportunities such as leveraging big data and improving interventions; barriers to adoption such as confusion regarding AI’s applicability, limited capacity, and poor data quality; and risks such as propagation of bias, exacerbation of inequity, hype, and poor regulation. Conclusions: Experts are cautiously optimistic about AI’s impacts on public health practice, particularly for improving disease surveillance. However, they perceived substantial barriers, such as a lack of available expertise, and risks, including inadequate regulation. Therefore, investment and research into AI for public health practice would likely be beneficial. However, increased access to high-quality data, research and education regarding the limitations of AI, and development of rigorous regulation are necessary to realize these benefits

Summative Approach for Slum Adolescents

Background: Urban slums in India are neglected communities as far as public health facilities are concerned. There is no health infrastructure since these slums are largely illegal and unauthorized. This community has poor awareness of health schemes and other social security benefits provided by the government. No initiatives have been taken to provide vocational training to empower this economically weaker and neglected section of the society.Objectives: To generate health awareness among the slum adolescents on various issues related to health, especially menstrual hygiene, personal hygiene, household methods of water purification as well as safe disposal of waste and also make them economically independent.Methodology: A summer workshop was conducted for a period of one week by MBBS students in the urban slums of Bhangel, during the summer vacations time of school going children. Two groups of slum adolescents were recognized. One group had younger adolescents and the other had older adolescents who acted as guides for the younger group. Health awareness sessions were conducted for these children everyday on community relevant health topics like personal hygiene, menstrual hygiene, water purification techniques, etc., along with teaching them some vocational skills like first aid box making, mehendi application, lipstick making, making of dust bins, etc. They were also taught marketing and selling skills. Both these groups were asked to identify another group of young adolescents and teach them what they learnt in the workshop, under observation of the medical students.Results: On comparing the pre and post workshop assessment, the results were very encouraging.Conclusion: Marked improvement was observed in the knowledge levels related to health issues and vocational independence could be promoted. However, there is a need to explore the possibility of replicating the same at a larger scale