8 research outputs found
Review on Secure and Efficient IoT-based Healthcare System with the Integration of Machine Learning and Firewalls
No full textThe integration of the Internet of Things (IoT) into healthcare would mean a revolutionized approach in patient monitoring, diagnosis, and treatment, making this quite some development in healthcare delivery. This review has focused on how the integration of IoT with Machine Learning (ML) and stringent security measures tackle the challenging situation of data privacy and cyber threats in healthcare. Current methodologies point toward how essential advanced sensors, cloud computing, and wireless technologies for IoT-based healthcare systems necessary to secure patient data. patient record kept in files and now forward to the cloud database system so that in any case of emergency it could access and keep safe from cyber-attacks, and no one can breach the security of data only authorized user can access. To achieve this security, concern firewalls, encryption technologies are used. These protection systems are applied to block unauthorized access, protect data communication channels, and make private patient information confidential always. IoT-based, ML-enabled systems perform way better in real-time monitoring, predictive analysis, and personalized treatment in contrast with conventional healthcare strategies. This discussion delineates the need for implementation of firewalls and encryption techniques for data security and patient privacy. This critical review underlines that while IoT truly has enormous potential to change healthcare, it will require continuous innovation and rigorous security protocols to help maximize these benefits
REALITY IS NOT THE DEATH OF A TYPICAL SALESMAN BUT THE REVELATION OF EXISTENTIALIST AMERICANISM
No full textThe present paper focuses on the cherished American dream, the reality and the reality manifested. The two have always been poles apart. But with this there is another reality i.e., the willingness of followers to be conned. The best of American Dream is divulged in the Death of the Salesman by Arthur Miller. The more we study profoundly, the eccentric character of a typical salesman Willy Loman, the more unpredictability of the American dreams unfolds itself, layer by layer. That Salesman is not of one cadre of society, rather he has in himself several other strata too. He is typified for middle class, lower middle class and even those who wish to be of any class, to be one with the society. Even, through his character we can make psychoanalysis of people of such character, demeanor or the profession existing all around us. But will it be the psychoanalysis of the man himself or the psychoanalysis of the American Dream personified. Loman’s dysfunctional family, and his own life too, show the seething impressions of standardized life – explicitly, norms of American Success Formula. The tragic death he meets in the end, fixedly focuses on the death of the American Dream itself. But the most drastic aspect of it is the Existentialism, pervaded into the lives of these people taking them to the unrealistic goals
The role of helmet therapy in craniosynostosis: A systematic review
No full textThe aim of this study was to determine the impact of helmet therapy (HT) as a treatment for craniosynostosis, with a focus on the outcomes of skull morphology, reoperation rate, complications of HT, and quality of life of patients who receive it. A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review utilized the PICO format: Does HT following strip craniectomy (SC) improve outcomes (outcome) compared to SC alone (comparison) in patients undergoing craniosynostosis correction (intervention)? Searches were performed from January 1, 2000 to December 31, 2022, using PubMed, Cochrane Library, and Ovid Medline databases. Study quality was evaluated using the National Heart, Lung, and Blood Institute (NHLBI) quality assessment scale. Fourteen studies meeting the inclusion criteria were identified. Among these, 438 patients underwent SC-HT, while 104 patients underwent SC without HT. The preoperative cephalic indices for sagittal craniosynostosis in the HT and non-HT groups were 66.8 and 67.8, respectively, which improved postoperatively to 75 and 76.2, respectively. Limited long-term follow-up hindered a definitive assessment of reoperation rates. Complication rates related to HT were low at approximately 2.9%, primarily consisting of skin irritation. Parental satisfaction was high, correlating with a strong compliance rate. Existing literature does not demonstrate a clear superiority between SC with or without HT for treating nonsyndromic sagittal craniosynostosis. Outcomes appear comparable, but evidence is constrained by the predominance of single-center retrospective studies with limited methodological rigor. There is a pressing need for international multicenter trials to furnish more robust and generalizable findings
Cortical bone architecture of hominid intermediate phalanges reveals functional signals of locomotion and manipulation
No full textDATA AVAILABILITY STATEMENT :
Copies of all scans are curated by the relevant curatorial institutions that are responsible for the original specimens and access can be requested through each institution. The authors confirm that the data supporting the findings of this study are available from the corresponding author upon reasonable request.OBJECTIVES :
Reconstruction of fossil hominin manual behaviors often relies on comparative analyses of extant hominid hands to understand the relationship between hand use and skeletal morphology. In this context, the intermediate phalanges remain understudied. Thus, here we investigate cortical bone morphology of the intermediate phalanges of extant hominids and compare it to the cortical structure of the proximal phalanges, to investigate the relationship between cortical bone structure and inferred loading during manual behaviors.
MATERIALS AND METHODS :
Using micro-CT data, we analyze cortical bone structure of the intermediate phalangeal shaft of digits 2–5 in Pongo pygmaeus (n = 6 individuals), Gorilla gorilla (n = 22), Pan spp. (n = 23), and Homo sapiens (n = 23). The R package morphomap is used to study cortical bone distribution, cortical thickness and cross-sectional properties within and across taxa.
RESULTS :
Non-human great apes generally have thick cortical bone on the palmar shaft, with Pongo only having thick cortex on the peaks of the flexor sheath ridges, while African apes have thick cortex along the entire flexor sheath ridge and proximal to the trochlea. Humans are distinct in having thicker dorsal shaft cortex as well as thick cortex at the disto-palmar region of the shaft.
DISCUSSION :
Variation in cortical bone distribution and properties of the intermediate phalanges is consistent with differences in locomotor and manipulative behaviors in extant great apes. Comparisons between the intermediate and proximal phalanges reveals similar patterns of cortical bone distribution within each taxon but with potentially greater load experienced by the proximal phalanges, even in knuckle-walking African apes. This study provides a comparative context for the reconstruction of habitual hand use in fossil hominins and hominids.H2020 European Research Council;
HORIZON EUROPE Marie Sklodowska-Curie Actions.http://wileyonlinelibrary.com/journal/ajpahj2024AnatomySDG-03:Good heatlh and well-bein
Effect of Attention-Deficit on Self-Efficacy and Academic Performance in Secondary School Going Children: A Comparative Cross-Sectional Study
No full textBackground: Attention deficit poses a significant challenge to students' ability to focus, regulate their behavior, and manage academic tasks effectively. Evidences are present to support the influence of attention deficit on self-efficacy and academic performance among secondary level students. The study aims to identify the relationships between attention deficit, self- efficacy beliefs, and academic outcomes. Objectives: To determine the effect of attention deficit on self-efficacy and academic performance in secondary school going children. Data collection procedure: A sample of 145 students according to inclusion criteria was selected. The mean age of current study population was 15 years, with standard deviation of 0.92. Participants were divided into two groups by ADHD-RS-IV Questionnaire score, i.e., Group 1 without attention deficit with 63 participants in this group and Group 2 with attention deficit with 81 participants in this group. Sample size was calculated using open epi calculator. Non- probability convenient sampling technique was used for recruitment. Attention deficit was assessed using ADHD-RS-IV Questionnaire and Self-efficacy was assessed using SEQ-C Questionnaire. The overall duration of study was 5 months. Welch’s test was used to compare the self-efficacy and academic performance in students with and without attention deficit. Results: The Welch’s test showed highly significant difference (P-Value <0.001) between the two groups. This revealed that the students without attention deficit have higher self-efficacy and academic performance compared to students with attention deficit. Conclusion: The study concluded that there was the difference between self-efficacy and academic performance of students with and without attention deficit. The students who are not attention deficit have high self-efficacy and academic performance and the students who are attention deficit have low self-efficacy and academic performance
Prevalence and Predictors of Depression Amongst Hypertensive Individuals in Karachi, Pakistan
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The burden of bacterial antimicrobial resistance in the WHO Eastern Mediterranean Region 1990–2021: a cross-country systematic analysis with forecasts to 2050
No full textBackgroundAntimicrobial resistance (AMR) is an urgent global crisis and one of the world's most complex challenges. Although there is increasing evidence of its impact on human mortality and morbidity, precise burden estimation has many challenges, and thus far has been elusive for the Eastern Mediterranean Region. Here, we present a comprehensive time-trend analysis of regional and country-level AMR burden estimates in the WHO Eastern Mediterranean Region (EMR), between 1990 and 2021, with forecasts up to 2050. MethodsWe estimated deaths and disability-adjusted life-years (DALYs) attributable to and associated with AMR for 11 infectious syndromes, 22 bacterial pathogens, and 84 pathogen–drug combinations for the WHO EMR and each of its countries from 1990 to 2021. Data were obtained from mortality registries, surveillance systems, hospital records, systematic literature reviews, and other sources. We based our modelling approach on five broad components: the number of deaths in which infection had a role, the proportion of infectious deaths attributable to a given infectious syndrome, the proportion of infectious syndrome deaths attributable to a given pathogen, the percentage of a given pathogen resistant to an antimicrobial drug of interest, and the excess risk of mortality (or duration of an infection) associated with this resistance. These components were then used to estimate the disease burden by using two counterfactual scenarios: deaths and DALYs attributable to AMR (considering an alternative scenario where drug-resistant infections are replaced with susceptible infections), and deaths and DALYs associated with AMR (considering an alternative scenario where infections would not occur at all). Predictive statistical modelling was applied to generate estimates of AMR burden for each country. We also generated AMR burden forecasts up to 2050. We generated 95% uncertainty intervals (UIs) for the final estimates by taking the 2·5th and 97·5th percentiles across 500 draws through the multistage computational pipeline, and models were cross-validated for out-of-sample predictive validity. FindingsWe estimated 380 000 deaths (95% UI 332 000–426 000) associated with bacterial AMR and 92 800 deaths (78 300–111 000) attributable to bacterial AMR in the EMR in 2021. In the past 31 years, there was considerable variation in AMR mortality trends across countries of the region and different age groups. Between 1990 and 2021, associated deaths among children younger than 5 years decreased by 50·0% (38·2–62·0), while those among adults aged 70 and older rose by over 85·7% (95% UI 57·0–115·7). Six pathogens were identified as the primary generators of burden: Streptococcus pneumoniae, Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, Acinetobacter baumannii, and Pseudomonas aeruginosa. A substantial increase in the AMR burden due to S aureus was observed between 1990 (28 200 deaths [21 600–34 000]) and 2021 (49 500 deaths [43 100–56 200]); consequently, in 2021, methicillin-resistant S aureus was a leading pathogen–drug combination for most countries in the region for deaths and DALYs attributable to, and associated with AMR. Somalia had the highest age-standardised mortality rates in the region: for deaths attributable to and associated with AMR per 100 000 population in both 1990 and 2021; conversely, the country with the lowest burden in the EMR was Qatar. By 2050, the number of deaths attributable to AMR in region is forecasted to reach 187 000 (157 000–223 000) and deaths associated with AMR were projected to reach 752 000 (629 000–879 000). InterpretationOur study shows that bacterial AMR has been a serious public health threat in the EMR for more than 30 years, with a substantial fatal and non-fatal burden for priority bacterial pathogens and pathogen–drug combinations. The magnitude of this issue, future projects, and the inadequate response capacity in many countries underscore the need for more stringent regional leadership in this field. The insights gained from this study can direct targeted mitigation strategies for individual countries within the region, aiding in resource allocation and funding decisions, and emphasising the need for collaborative multisectoral endeavours among nations to address this issue. FundingWellcome Trust, and the UK Department of Health and Social Care using aid funding managed by the Fleming Fund.
This work was supported by the Wellcome Trust (A126042) and the UK Department of Health and Social Care using UK aid funding managed by the Fleming Fund (R52354 CN001)
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
No full textBackground: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030. Funding: Wellcome Trust
