Blockchain and Internet of Things in smart cities and drug supply management: Open issues, opportunities, and future directions

Blockchain-based drug supply management (DSM) requires powerful security and privacy procedures for high-level authentication, interoperability, and medical record sharing. Researchers have shown a surprising interest in Internet of Things (IoT)-based smart cities in recent years. By providing a variety of intelligent applications, such as intelligent transportation, industry 4.0, and smart financing, smart cities (SC) can improve the quality of life for their residents. Blockchain technology (BCT) can allow SC to offer a higher standard of security by keeping track of transactions in an immutable, secure, decentralized, and transparent distributed ledger. The goal of this study is to systematically explore the current state of research surrounding cutting-edge technologies, particularly the deployment of BCT and the IoT in DSM and SC. In this study, the defined keywords “blockchain”, “IoT”, drug supply management”, “healthcare”, and “smart cities” as well as their variations were used to conduct a systematic search of all relevant research articles that were collected from several databases such as Science Direct, JStor, Taylor & Francis, Sage, Emerald insight, IEEE, INFORMS, MDPI, ACM, Web of Science, and Google Scholar. The final collection of papers on the use of BCT and IoT in DSM and SC is organized into three categories. The first category contains articles about the development and design of DSM and SC applications that incorporate BCT and IoT, such as new architecture, system designs, frameworks, models, and algorithms. Studies that investigated the use of BCT and IoT in the DSM and SC make up the second category of research. The third category is comprised of review articles regarding the incorporation of BCT and IoT into DSM and SC-based applications. Furthermore, this paper identifies various motives for using BCT and IoT in DSM and SC, as well as open problems and makes recommendations. The current study contributes to the existing body of knowledge by offering a complete review of potential alternatives and finding areas where further research is needed. As a consequence of this, researchers are presented with intriguing potential to further create decentralized DSM and SC apps as a result of a comprehensive discussion of the relevance of BCT and its implementation.© 2023 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).fi=vertaisarvioitu|en=peerReviewed

Prompt Identification of Sepsis on Hospital Floors: Are Healthcare Professionals Ready for the Implementation of the Hour-1 Bundle?

Early intervention in sepsis management with recognized therapeutic targets may be effective in lowering sepsis-related morbidity and mortality, although this necessitates timely identification of sepsis by healthcare professionals. The present study aimed to assess knowledge levels, attitudes, and agreement among physicians regarding the Surviving Sepsis Campaign (SSC) guidelines (more specifically, the Hour-1 bundle). A quantitative, descriptive, cross-sectional study was conducted among physicians working in different clinical settings in Karachi, Pakistan, using a self-administered questionnaire. The mean cumulative knowledge score of the respondents towards SSC was 6.8 ± 2.1 (out of 10), where a total of n = 127 respondents (51.62%) had a strong understanding of the SSC guidelines, compared to n = 78 (31.7%) and n = 41 (16.7%) respondents with fair and inadequate knowledge, respectively. The majorly known bundle elements by the respondents were to administer broad-spectrum antibiotics (89.8%, n = 221), the need for taking blood cultures before administering antibiotics (87.8%, n = 216), and measurement of blood lactate levels (75.6%, n = 186). Experienced physicians were more likely to use norepinephrine as the first-choice vasopressor (p < 0.001). Female respondents were more likely to consider the duration of antibiotic therapy to be determined according to the site of infection, the microbiological etiology, the patient’s response to treatment, and the likelihood of achieving adequate source control (p = 0.001). The current study concluded that respondents had an optimistic approach and frequently practice in accordance with the SSC guidelines, while some respondents were not up to date with the most recent guidelines. There is a need for further interventions and continuous medical education to encourage physicians towards appropriate use of the recommended guiding principles for improving treatment outcomes in sepsis patients