Machine Learning-Enabled Communication Approach for the Internet of Medical Things

The Internet ofMedical Things(IoMT)is mainly concernedwith the efficient utilisation of wearable devices in the healthcare domain to manage various processes automatically,whereas machine learning approaches enable these smart systems to make informed decisions.Generally,broadcasting is used for the transmission of frames,whereas congestion,energy efficiency,and excessive load are among the common issues associated with existing approaches.In this paper,a machine learning-enabled shortest path identification scheme is presented to ensure reliable transmission of frames,especially with the minimum possible communication overheads in the IoMT network.For this purpose,the proposed scheme utilises a well-known technique,i.e.,Kruskal’s algorithm,to find an optimal path from source to destination wearable devices.Additionally,other evaluation metrics are used to find a reliable and shortest possible communication path between the two interested parties.Apart from that,every device is bound to hold a supplementary path,preferably a second optimised path,for situations where the current communication path is no longer available,either due to device failure or heavy traffic.Furthermore,the machine learning approach helps enable these devices to update their routing tables simultaneously,and an optimal path could be replaced if a better one is available.The proposed mechanism has been tested using a smart environment developed for the healthcare domain using IoMT networks.Simulation results show that the proposed machine learning-oriented approach performs better than existing approaches where the proposed scheme has achieved the minimum possible ratios,i.e.,17%and 23%,in terms of end to end delay and packet losses,respectively.Moreover,the proposed scheme has achieved an approximately 21%improvement in the average throughput compared to the existing schemes.

Wireless communication and wireless power transfer system for implantable medical device

Traditional magnetically coupled resonant wireless power transfer technology uses fixed distances between coils for research,to prevent fluctuations in the receiving voltage,and lead to reduce transmission efficiency.This paper proposes a closed-loop control wireless communication wireless power transfer system with a wearable four-coil structure to stabilize the receiving voltage fluctuation caused by changes in the displacement between the coils.Test results show that the system can provide stable receiving voltage,no matter how the distance between the transmitting coil and the receiving coil is changed.When the transmission distance is 20 mm,the power transfer efficiency of the system can reach 18.5%under the open-loop state,and the stimulus parameters such as the stimulation period and pulse width can be adjusted in real time through the personal computer terminal.

German critical incident reporting system database of prehospital emergency medicine: Analysis of reported communication and medication errors between 2005–2015

BACKGROUND: Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well. We analyzed the database of the critical incident reporting system for prehospital emergency medicine in Germany retrospectively regarding communication errors.METHODS: Experts of prehospital emergency medicine and risk management screened the database for verbal communication failure, non-verbal communication failure and missing communication at all.RESULTS: Between 2005 and 2015, 845 reports were analyzed, of which 247 reports were considered to be related to communication failure. An arbitrary classifi cation resulted in six different kinds: 1) no acknowledgement of a suggestion; 2) medication error; 3) miscommunication with dispatcher; 4) utterance heard/understood improperly; 5) missing information transfer between two persons; and 6) other communication failure.CONCLUSION: Communication defi cits can lead to critical incidents in prehospital emergency medicine and are a very important aspect in patient safety.

Self Evaluation in Department of Communicable Diseases, Faculty of Medicine, Tehran University of Medical Sciences

Introduction: Self evaluation is a process that defines and collects required data to judge about decision making issues at educational system on whether the educational department is fit to educate students? The objective of this study was determining the quality of the structural elements of the department of Communicable Diseases & determining the strengths, weaknesses, opportunities and threats to improve the quality of activities in the department under research. Materials and Methods: The employed method was Mixed methods (qualitative & quantitative research), on the basis of 10 procedural steps and within 8 sections dealing with evaluated factors;such as 1) organizational and management structure 2) scientific board members 3) students 4) Manpower 5) Space of educational research and health care 6) Equipment 7) curriculum 8) satisfaction of graduates, which were studied using 61 criteria and 172 indicators. Five-point Likert Scale was used for the responses in the questionnaire (1 - 1.75 = undesirable, to 4.2 - 5 completely desirable). Finally the data were analyzed using descriptive statistics indices and the assessment software of the Educational Development Center of TUMS. The instruments used in this method included assessment software, interview, observation and self-prepared questionnaire which consisted of 7 questionnaires and 2 check lists. Finding: The results of the research showed that general average of 8 investigating sections was 56.9% as a rather desirable research work. Conclusions: Therefore, it was concluded that function of the educational management in that group was directly in line with evaluation process, but continuing the process of evaluation seems necessary.

Analysis of Formation in Communicative Competences for the Medical Act in Universidad de Antioquia Medicine School Undergraduate Program

This research study was conducted at the undergraduate program of the Medicine Faculty of Universidad de Antioquia. Its main purpose was to analyze the training in communication skills for the medical act. To this purpose, a triangulation between a representative survey of the students, some interviews and focal groups between students and professors, and an analysis of a curricular document on the contents of communication as a generic skill were done. This study allowed us to conclude that the definition of generic competence in communication cannot be established without the participation of the medicine curriculum actors, and that it is paramount to integrate this learning to this university program. The result of the present study is a proposal to include the communicative competence for the medical act in the curriculum of the Medicine Faculty of Universidad de Antioquia.

Medication Error and Interprofessional Communication-Related Factors Contributing to Hospitalisation in Community-Dwelling Older Adults in Australia

Background: Population ageing is a worldwide phenomenon. It is common for older adults to develop multiple age-related illnesses and the prevalence of multimorbidity increases substantially with age. Multimorbid adults are frequently treated with several concurrent medications and the regimen may be complex requiring multiple steps in the preparation of a medication prior to its administration. Polypharmacy is a concerning trend and older adults have a 100% risk of experiencing adverse drug events when taking ten or more medications concurrently. Discharge summaries communicating the number of medications, changes made to medication regimens during hospitalisations and the requirement for ongoing monitoring in the community are often incomplete. The aim of this study was to investigate contributing factors to medication-related hospitalisation, length of stay or readmission in older community-dwelling persons and examine the quality of discharge summaries. Methods: Descriptive and correlational analyses of demographic, clinical, admission, readmission, length of stay and medication variables were examined in Australia in 2016-2018. Discharge summaries were analysed for completeness, timeliness and interprofessional communication. Results: There were 295 participants, mean age 80 years, 55% were female, taking an average of 11 prescribed medications and with a mean Medication Regimen Complexity Index score of 34. Medication errors that were unrecognised at the time of hospitalisation were present in 19% of the sample. Factors associated with medication error were older age and a longer median length of stay. Fewer than 52% of these older patients had detailed discharge summaries. Conclusion: The prevalence of polypharmacy and medication regimen complexity at admission was high. A high proportion of older adults on medical units may have unrecognised medication errors impacting their admission. Medical discharge summaries are inadequately addressing this issue for patients returning to the care of their family physician.

A Research on the Translation of Medical Literature Under the Guidance of Newmark's Communicative Translation

This is a translation report. The selected source text is a medical experimental report published in September 2018 on Immunobiology, an American academic journal. The content is about the experimental research process and results of AIDS vac?cine, and the target readers are immunologists. According to Newmark's text typology theory, the text intended to convey infor?mation to target readers belongs to informative text, and should be guided by communicative translation. Therefore, the translator completed the translation report under the theoretical guidance of Newmark communicative translation.

Medical errors, infection-control breaches and the use of adulterated and misbranded medical devices

Several well-publicized cases of improper cleaning,disinfection or sterilization of contaminated reusable medical equipment that posed an increased risk of patientto-patient disease transmission were reported within the past few years,resulting in the notification of approximately 20 000 patients.These medical errors,the specific infection-control standards they breached,and assessments of the risk of infection associated with each are discussed.Other topics discussed include the Food and Drug Administration’s(FDA)regulation of medical devices and infection-control products;the use of adulterated,misbranded,and investigational devices;consent decrees and associated Certificates of Medical Necessity;and informed patient consent.Focus is placed on liquid chemical sterilization,its history,and the FDA’s recent censure and discontinuation of a medical device labeled with this claim,namely,the STERIS System 1 processor.Recommendations are provided for healthcare facilities,regulatory agencies,manufacturers of reusable medical devices,and professional healthcare organizations and administrations to improve public health and prevent healthcareassociated infections.

A Review of Implant Intra-Body Communication

With an extending life expectancy and demand for medical healthcare,there are wide-spread and stringent requirements of implantable medical devices(IMDs)development for dia-gnostics,treatments,and therapies by emerging technologies.One of the primary targets for the IMDs is evolving a reliable,speed,and accurate communication method to provide proactive well-ness management and thereby achieve early detection,disease prevention,and even treatments.In-tra-body communication(IBC)is a potential technology envisioning a sensors/actuators network within a human body,which uses the conductive properties of a body and is categorized in the standardized IEEE 802.15.06 protocol.In the present review,the current state-of-art of implant in-tra-body communication has been surveyed.Based on the propagation mechanisms over investig-ated IBC spectrum(i.e.,0.1 MHz-100 MHz),the capacitive and galvanic coupling IBC is con-sidered,where the subfields regarding modeling method(including circuit,numerical,analytical,and filter model),measurement details(including the effect of the electrode,cable,impedance,and instrument),clinical application(including cardiac pacemaker and wireless endoscope),transceiver design(including discrete component and CMOS technology)and media access control(MAC)lay-er design have been introduced or discussed.Furthermore,the open challenges and issues have been explored as an anticipated inspiration for future development.

A Systematic Review of Cultural Preferences for Receiving Medical “Bad News” in the United States

According to the dominant models of medical ethics in the United States and many Western countries, physician disclosure of information such as diagnosis, treatment options, and prognosis is considered an essential precondition for patient informed consent. While being consistent with the principle of patient autonomy stressed in many Western healthcare systems, full disclosure—particularly of life-threatening diagnoses and poor prognoses—is inconsistent with the cultural values of many ethnic communities within the United States. A systematic review of research examining cultural preferences for disclosure of medical “bad news” was conducted. Results suggested that cultural preferences are more heterogeneous than has often been portrayed. Particularly when communicating with patients and families from culturally and ethnically diverse backgrounds, health care professionals should ask about preferences for receiving medical information and making treatment decisions.

Communication Skills Training for Residents: Which Variables Predict Learning of Skills?

Objective: This study aimed to determine variables associated (predictors and correlates) with the learning of assessment and supportive skills in the context of a communication skills training for medical residents. Methods: Learning was measured by comparing residents’ communication skills in a simulated consultation before and after a communication skills training. Communication skills were transcribed and tagged with a computer-assisted program. Potential variables associated with learning (residents’ characteristics, contextual characteristics and pre-training communication skills) were measured before the training and entered in regression analysis. Results: Fifty-six residents followed the training between 2002 and 2006. Poor pre-training assessment and supportive skills predicted the respective learning of these skills. Better assessment skills’ learning was predicted by copings (i.e. lower level of emotional coping), lower levels of self-efficacy and depersonalization. Better supportive skills’ learning was predicted by a lower work experience and associated with a higher training attendance rate. Conclusions: Predictors and correlates of assessment and supportive skills learning were different. Trainers needed to detect certain residents’ characteristics (i.e. depersonalization) in order to optimize assessment skills learning. Trainers needed to be aware that supportive skills are difficult to learn and to teach and may need more training hours.

Secure Model of Medical Data Sharing for Complex Scenarios

In order to secure the massive heterogeneous medical data for the complex scenarios and improve the information sharing efficiency in healthcare system,a distributed medical data ledger model(DMDL)is proposed in this paper.This DMDL model has adopted the blockchain technology including the function decoupling,the distributed consensus,smart contract as well as multi-channel communication structure of consortium blockchain.The DMDL model not only has high adaptability,but also meets the requirements of the medical treatment processes which generally involve multientities,highly private information and secure transaction.The steps for processing the medical data are also introduced.Additionally,the methods for the definition and application of the DMDL model are presented for three specific medical scenarios,i.e.,the management of the heterogeneous data,copyright protection for medical data and the secure utilization of sensitive data.The advantage of the proposed DMDL model is demonstrated by comparing with the models which are being currently adopted in healthcare system.

An Occupational Perspective of Occupational Therapy and the Medical Hegemony System in Malaysia—Exploration for Further Research

Occupational Therapy is critically underdeveloped in many developing countries in Asia. There are many internal and external barriers to the growth of the profession, including lack of willpower and lack of professional representation in the government. This article aims to communicate the postulations for its stagnation across developing countries in Asia. An analytical reflection and historical review of the barriers to the growth of occupational therapy in Malaysia was conducted. Leaders in the field who met the inclusion criteria, collaborated to shape the reconstructions using an occupational reconstruction approach. The reconstruction guided key critical reflections on the roots of daily experiences to relive the cooperative action to problem solve the issues encountered by the profession in Malaysia. Medical hegemony was found as the active suppressor of the health professions, and can be seen as being beyond reproach in the Asian’s medical model that created occupational injustices. These occupational injustices hinder the growth of Occupational Therapy, do not serve the patients, science or the overall healthcare system. Autocratic governance has a debilitating impact on health sciences and its workforce especially around badly oppressed Asian countries. A greater systematic approach is needed to examine the extent, effect, problem solve and remediate the magnitude of injustices over the last decade—to make way for an inclusive and affordable care system.

A 2Mbps Human Body Communication Transceiver Based on Body Antenna Effect

This paper presents a human body communication(HBC)transceiver for wireless body network applications.The transceiver employs on frequency shift keying(FSK)modulation and op-erates in 40 MHz-60 MHz which is the resonant frequency of the human body as an antenna.It achieves high performance and stability through establish passive microstrip line and via models and active device-models.The proposed transceiver is designed and fabricated by FR4 printed cir-cuit board(PCB)process,the transceiver has the ability of configurable data rate up to 2 Mbps and it achieves-86 dBm receiving sensitivity at 2 Mbps data rate.Meanwhile,the transceiver out-put power dynamics range is 34 dB.Furthermore,with a visual interaction interface,the transceiv-er can be agility use in a variety of scenarios.Its measurements are verified on human body.The result shows that the transceiver has ability to send data from person to person by relying on hu-man body antenna radiation.The transceiver shows great prospect in wireless body area networks(WBAN)for telemedicine and emergency communication.

Premodern Intercultural Communication by Reanalyzing the Phrase“Da Yi Jing Cheng(大医精诚)”

Culture is fluid,not static.When one culture meets and blends with another,Westerm academic circles tend to use cultural hybridity to express a mixed state of culture.By reanalyzing the classic texts in relation to“Da Yi Jing Cheng(大医精诚)”,tracing the evolution of traditional medical ethics in history,and combining the knowledge of cultural hybridity,this paper suggests that cultural hybridity is not applicable to the discussion on the phenomenon of intercultural communication in the era before the rise of national states and modernity.A new discourse is needed to express intercultural integration,one that breaks through Western values and embodies the characteristics of Asian civilization.Civilization exchange and mutual learning can become the ideal model of intercultural communication under the background of the“Belt and Road Initiative”.

硝酸银溶液协同改性中心静脉导管覆涂材料的应用性能测试

针对传统中心静脉导管材料抗菌性能和生物相容性较差的问题,提出一种新型医用载银中心静脉导管改性,并对其综合性能进行研究。结果表明,在聚多巴胺中心静脉导管表面的纳米银颗粒成功负载。硝酸银浓度为0.01 mol/L制备的载银中心静脉导管材料(0.01 Ag-DH/CVC)在较低载银含量的条件下表现出良好的抑菌性能和生物相容性,不会对细胞活性和细胞的形态产生影响。制备的载银中心静脉导管用于临床护理应用,在穿刺成功率和并发症发生率方面均明显优于传统PICC导管,表现出良好的医用性能。

商业银行助力银发经济高质量发展路径探析——基于养老产业发展视角

中国老龄化趋势不可避免,并且程度将愈发严重,而当前银发经济无论在需求还是供给端均存在不平衡情况。商业银行作为金融强国建设重要参与者,在推动银发经济尤其是养老服务产业高质量发展方面应投入更多的资源,这不仅是践行金融工作政治性、人民性的必要举措,更是实现自身可持续发展的有效路径。本文从养老金融推动养老需求有效性的提升、针对不同养老形式提供个性化的金融服务、发挥金融科技力量、组建同业联盟、培养专业队伍等方面提出建议,以期为金融服务促进养老产业高质量发展提供参考。

生活方式医学教育在美国的发展

生活方式干预作为慢性病防治首选,已被医学界认可。生活方式医学在美国发展20余年,多家医学院校创新医学课程改革,开展本科与研究生阶段课程、明确专业核心能力培养目标、成立专业性学术组织和认证考核制度。文章旨在介绍生活方式医学教育在美国的发展情况,供同行借鉴。

Adherence to medication: A nation-wide study from the Children's Cancer Hospital, Egypt

AIM: To investigate adherence to medical regimen and predictors for non-adherence among children with cancer in Egypt. METHODS: We administered two study specific questionnaires to 304 parents of children diagnosed with cancer at the Children's Cancer Hospital in Cairo, Egypt, one before the first chemotherapy treatment and the other before the third. The questionnaires were translated to colloquial Egyptian Arabic, and due, to the high illiteracy level in Egypt an interviewer read thequestions in Arabic to each parent and registered the answers. Both questionnaires consisted of almost 90 questions each. In addition, a Case Report Form was filled in from the child's medical journal. The study period consisted of 7 mo(February until September 2008) and we had a participation rate of 97%. Descriptive statistics are presented and Fisher's exact test was used to check for possible differences between the adherent and non-adherent groups. A P-value below 0.05 was considered significant. Software used was SAS version 9.3 for Windows(SAS Institute Inc., Cary, NC, United States).RESULTS: Two hundred and eighty-one(90%) parents answered the second questionnaire, regarding their child's adherence behaviour. Approximately two thirds of the children admitted to their third chemotherapy treatment had received medical recommendations upon discharge from the first or second chemotherapy treatment(181/281, 64%). Sixty-eight percent(123/181) of the parents who were given medical recommendations reported that their child did not follow the recommendations. Two main predictors were found for non-adherence: child resistance(111/123, 90%) and inadequate information(100/123, 81%). In the adherent group, 20% of the parents(n = 12/58) reported trust in their child's doctor while 14 percent 8/58 reported trust in the other health-care professionals. Corresponding numbers for the non-adherent group are 8/123(7%) for both their child's doctor and other health-care professionals. Almost all of the parents expressed a lack of optimism towards the treatment(116/121, 96%), yet they reported an intention to continue with the treatment for two main reasons, for the sake of their child's life(70%)(P = 0.005) and worry that their child would die if they discontinued the treatment(81%)(P < 0.0001).CONCLUSION: Non-adherence to medical regimen is common among children diagnosed with cancer inEgypt, the main reasons being child resistance and inadequate information.

Effect of glaucoma on identification of bottle cap color in ophthalmic medications

A prospective, nonrandomized, observational trial of 60 glaucoma patients to correlate visual acuity and visual field with ability to distinguish bottle cap color of commonly used ophthalmic medications was conducted. A total of 103 eyes from 60 patients(30 women) were evaluated. The mean logMAR acuity was 0.34±0.54(approximately 20/45 Snellen acuity), average Humphrey Visual Field(HVF) mean deviation was-8.58±8.69 dB, mean Ishihara plates(out of 14) were 11.78±4.15, and bottle cap color score(out of 10) was 8.56±2.51. Multiple linear regression analysis revealed an independent correlation of visual acuity(P=0.0137) and Ishihara score(P<0.001) with cap color score, but no significant effect with visual field mean deviation(P>0.05). Glaucoma patients with poor visual acuity, but not necessarily advanced visual field loss, are likely to have difficultly identifying the color of their bottle caps. Physicians should be cognizant of this potential issue when reviewing medications with patients.