Revolutionizing Healthcare Image Analysis in Pandemic-Based Fog-Cloud Computing Architectures

The emergence of pandemics has significantly emphasized the need for effective solutions in healthcare data analysis. One particular challenge in this domain is the manual examination of medical images, such as X-rays and CT scans. This process is time-consuming and involves the logistical complexities of transferring these images to centralized cloud computing servers. Additionally, the speed and accuracy of image analysis are vital for efficient healthcare image management. This research paper introduces an innovative healthcare architecture that tackles the challenges of analysis efficiency and accuracy by harnessing the capabilities of Artificial Intelligence (AI). Specifically, the proposed architecture utilizes fog computing and presents a modified Convolutional Neural Network (CNN) designed specifically for image analysis. Different architectures of CNN layers are thoroughly explored and evaluated to optimize overall performance. To demonstrate the effectiveness of the proposed approach, a dataset of X-ray images is utilized for analysis and evaluation. Comparative assessments are conducted against recent models such as VGG16, VGG19, MobileNet, and related research papers. Notably, the proposed approach achieves an exceptional accuracy rate of 99.88% in classifying normal cases, accompanied by a validation rate of 96.5%, precision and recall rates of 100%, and an F1 score of 100%. These results highlight the immense potential of fog computing and modified CNNs in revolutionizing healthcare image analysis and diagnosis, not only during pandemics but also in the future. By leveraging these technologies, healthcare professionals can enhance the efficiency and accuracy of medical image analysis, leading to improved patient care and outcomes

Potential Effect of Biochar on Soil Properties, Microbial Activity and <i>Vicia faba</i> Properties Affected by Microplastics Contamination

Microplastics (MPs) contamination is an emerging issue globally; however, adverse impacts of MPs on soil, plants and microbial activity have not been intensively studied. In this study, the potential effect of different levels of MPs (1.5, 7.5, 15%) has been investigated on soil properties, plant properties (Vicia Faba) and microbial activities through a pot experiment. The effect of biochar (BC: 2%) to mitigate the adverse effects of MP has also been examined. Soil properties (pH, EC, OM, CaCO3 and some elements) have significantly differed due to contamination of soil by MPs as well as by adding BC to the soil. The pH and CaCO3 were significantly increased more than in the control, while EC, TDS, available P, Mn and Fe were significantly decreased lower than the control, which implies adsorption on microplastic. Plant properties, such as enzymes, chlorophyll and fresh and dry weight in roots, were adversely affected by MPs contamination; however, BC mitigated this effect, especially with low contamination levels of MPs. The fresh and dry weight of the shoot was not significantly affected by MPs. The cytogenetic analysis showed that the mitotic index was significantly reduced compared to the control (9.39%), while BC increased the mitotic index at 1.5% MPs (7.11%) although it was less than the control. The percentage of abnormalities of V. faba root tip cells under different levels of MPs was significantly increased more than the control; however, BC mitigated this effect, especially at 7.5% MPs. The total count of bacteria and fungi even in soil or in the rhizosphere area did not follow a clear trend; however, the effect of BC was clear in increasing their activities. Microbial biomass carbon and nitrogen were also significantly affected by MPs and BC. In this study, the BC level was low, however, it mitigated some adverse effects of MPs, especially at 1.5 and 7.5% of MPs. Thus, the BC could be promising in mitigating the negative impacts of MPs when applied with suitable levels that need more future studies

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research