Current Medical System Research Articles

Patient-Centric Multichain Healthcare Record

In this paper, the authors have amplified the concept that EHRs need to be patient-centric and patient-driven, that is the patient should be the real owner as well as the manager of his medical records. The authors propose patient-centric multichain healthcare record (PCMHR) that implements health records using smart contracts on ethereum blockchain and also utilizes the multichain framework - Polygon. PCMHR can concurrently implement blockchain functionality while addressing the concerns of interoperability among authorized hospitals and patient health information confidentiality that damages our healthcare system. The authors propose a solution to fully decentralize the current medical healthcare system by storing PCMHR on IPFS (InterPlanetary File System) to resolve the limitation of blockchain-based applications in scalability and high cost. The authors have depicted the cost and time analysis of transactions on the polygon framework to give a clear view of this multichain framework and its advantages over the ethereum blockchain.

When Will theFDADo What Is in People’s Best Interests?

ABSTRACTThe national effort to reduce the incidence and severity of cancer and other chronic diseases in the United States has suffered from political influences that undermine the interests of the public. As one example, the medical profession has not made adequate use of nutritional information to improve the health of the population. Daily values for vitamins were established in the United States during World War II, when the goal was to avoid short‐term deficiencies so soldiers could continue to fight. But there is more to health than short‐term survival. Linus Pauling advocated megadoses of vitamin C to reduce the risk of cancer and to improve long‐term health. Despite numerous studies demonstrating that better nutrition and exercise are vital to a longer span of good health, the U.S. Food and Drug Administration (FDA) does not permit claims to be made about the health benefits of specific nutritional supplements. The FDA is responsive to political pressures, including pressures to reduce public knowledge of supplements and their benefits. Pharmaceutical companies contribute to members of Congress to influence health policy. Those companies promote legislation and regulations that favor the use of expensive medical treatments and that limit the provision of cost‐effective public health measures. This article reviews many examples of failures of our current medical system, and methods that could prevent the current expense and suffering in this nation.

Are Australian junior doctors failing to act as health advocates? A qualitative analysis

ObjectiveTo explore junior doctors’ attitudes towards and experiences of health advocacy practice and teaching in Australia. MethodsSemi‐structured interviews were conducted with 15 junior doctors across Australia. Data were thematically analysed. ResultsThree themes were identified: i) participants inconsistently understood and practised health advocacy, with many failing to conduct any advocacy work; ii) distinct factors motivated and enabled participants to undertake health advocacy; however, these were largely unrelated to any formal medical education; iii) the current medical workplace and education system is non‐conducive to health advocacy practice given the numerous barriers faced by junior doctors when engaging with health advocacy. ConclusionsHealth advocacy is generally poorly taught, weakly understood, and rarely performed despite being one of the four core graduate competencies of the Australian Medical Council (AMC). The AMC must clearly define health advocacy and its scope in their outcome statements, and this must be translated into medical education curricula and advocacy opportunities in the workplace. Implications for public healthDoctors are well‐placed to act as public health advocates, yet they are denied the encouragement and training to do so. With the growing burden of complex and sensitive public health issues, junior doctors should be trained and encouraged in health advocacy.

Importance of Athlete Injury Management focusing on Evidence-based Approaches in Indian Physiotherapy Standards

Injuries are common among athletes at any point in their sports carrier. Physiotherapy management plays a vital role in the rehabilitation of athlete injury. Numerous pieces of evidence suggest that quick fix approaches, lack of clinical reasoning skills in injury healing science, and current Indian medical system practising guidelines are the reason for poor quality treatment in India, and it is difficult to provide the best quality treatment as per the athletes’ requirements. A multidisciplinary team along with prompt evidence-based treatment is important in injury management. This article describes the current scenario in Indian physiotherapy as well as the suggestions and recommendations to implement evidence-based strategies for proper injury management among athletes.

중국 AI의사의 의료책임보험제도에 관한 고찰

Since artificial intelligence was proposed in the last century, the technological advancement has been promoting the development of AI doctor, which has already entered the medical life in China. As AI doctors are based on elements such as big data and evolutionary algorithms, they have new knowledge learning capabilities and massive information processing capabilities that far exceed those of human doctors, and can provide patients with more efficient and high-quality medical services. Its accuracy in diagnosing and treating diseases is also much higher than that of human doctors. Thus, AI doctors have bright future in the entire life cycle of medical activities such as medical consultation, intelligent diagnosis, intelligent treatment, and health management. At the same time, the continuous medical damages of AI doctors used in the market indicate that it has a huge potential risk, for the existence of technical black boxes may cause irreversible damage to the personal health of patients. As a financial way to protect victims and diversify social risks, medical liability insurance plays a vital role in promoting the development of new technologies and solving related medical damage. However, our nation's medical liability insurance system is facing difficulties and is currently unable to perform its due function. On the one hand, insufficient compulsory medical liability insurance has led to insufficient coverage, the coverage of insurance is too narrow, and the existing problems of imperfect supporting systems have not yet been resolved, and medical liability insurance has its own development difficulties; More importantly, the participation of AI doctors has a huge impact on the doctor's fault identification and traditional fault liability, and the relationship between the relevant insurance systems is also quite chaotic. Artificial intelligence poses a challenge to the current medical liability insurance legal system, and it is urgent to improve and reform medical liability insurance. In this regard, in the future medical liability insurance, these existing and new problems should be fully considered. The key points are the identification of fault, the introduction of no-fault compensation, and the linking to related insurance systems. This is the main direction for the improvement of the legal system in the future. Specifically, in the future, the improvement of our country's medical liability insurance legal system should conform to the technological development of AI doctors, improve the traditional fault identification, introduce no-fault compensation to reform the traditional principle of single fault, and clarify the relationship between various insurances to relieve the parties. 自上世纪人工智能被提出以来，每一次的技术进步都推动着一波人工智能医生的发展，人工智能医生早已进入中国的医疗生活中,正在广泛应用于医疗活动。基于人工智能医生以大数据和演进算法等要素为基础，其具有远超人类医生的新知识学习能力和海量的信息处理能力，可以更高效更优质地为患者提供医疗服务。其诊断治疗疾病的准确率远高于人类医生，人工智能医生在医疗咨询，智能诊断，智能治疗，健康管理等医疗活动全生命周期都具有光明的发展前景。与此同时，市场上应用的人工智能医生产品不断爆出的医疗损害表明，它具有巨大的潜在风险，由于技术黑箱的存在可能会对患者人身健康造成难以逆转的。作为保护受害人、分散社会风险的金融途径，医疗责任保险在促进新技术发展、解决相关医疗事故中具有至关重要的地位。 然而，中国医疗责任保险制度面临困境，目前难以发挥应有的功能。一方面，医疗责任保险强制性不足自身覆盖率不足，保险范围过于狭隘，相关配套制度也不完善的既有问题尚未得到解决，医疗�

IV Drip Monitoring and Control System

Abstract: Intravenous Drip System is used mainly in hospitals for patients who were dehydrated, nutrient deficient or unable to take medications orally. In our current medical care system, monitoring of patients in a hospital throughout the day is a tiresome process. Sometimes doctors or nurses are too busy, so they cannot monitor each patient. This causes many problems. The health related work should be done properly and with accurate manner. An example of such type of work in our hospital is injecting saline or intravenous fluids into the vein of patient. If the drip system is not monitored on time, it will cause problems like backflow of fluid, blood loss etc. In order to reduce the workload of nursing staff and to overcome such critical situation in the area of an intravenous drip monitoring system, we proposed a system called IV Drip Monitoring and Control System.

Concare – A Teleconsultation System Using IoT in Healthcare

With the rapid growth of the aging world population, proper health care has become a prior issue in all countries; especially during the life altering COVID – 19 pandemics. While everything is getting digitized, the ease in providing medicinal services in an online basis is still a factor in today’s era. Current medical system is expanding by leaps and bounds in the last couple of decades for their considerable aim towards wireless and e-health monitoring systems providing remote monitoring of patients. But the tools used to deal with health conditions are tedious to maintain and limited to specific number of parameters. Incorporating patient’s data into a database and accessing the system in the form of a mobile application with proper medical assurance and diagnosis will demonstrate that this proposed system will be efficient to provide the patient a proper consultation from anywhere. It reduces the number of hospitals visits, saves time, and is convenient for both physician and patient.

Dual-modal nanoplatform integrated with smartphone for hierarchical diabetic detection

On-site screening of diabetes and precise diagnosis of diabetic complications may provide a conduit for early intervention and disease burden reduction. However, stratified metabolic analysis needs designed materials for colorimetric detection of targeted biomarkers and direct metabolic fingerprinting of the native blood. Here, an advanced dual-modal nanoplatform is constructed based on PdPtAu alloys, which serve both as the nanoenzymes in colorimetric sensing for targeted metabolite quantitation and as matrix in laser desorption/ionization mass spectrometry for untargeted metabolic fingerprinting. The platform achieved rapid glucose quantitation toward point-of-care testing of 27 participants and identified diabetic retinopathy from diabetic population with a sensitivity and specificity of 84.6%. We further assessed the generalizability of the nanoplatform for real-case applications, through the captured digital images and computing resources equipped in smartphones. The results advance the design of material-based platforms for stratified metabolic analysis and display promise to fit in the current hierarchical medical system in practice.

Doctors' Work Life Quality and Effect on Job Satisfaction: An Exploratory Study Based on Literature Review

Every day, the health-care system becomes more complicated. It is mostly due to changes in lifestyle, greater demand for patient care, and the effect of technology on the health-care delivery process. Sophisticated devices necessitate specialized knowledge, which necessitates a better and more current medical education system, which, in turn, necessitates a better organizational structure. All of this has an impact on the entire medical profession, as novel difficulties must be met with increasing skill and potential development, as well as increased dedication to the profession, as performance management becomes a major aspect in avoiding professional hazards in various forms. As a result, the entire health policy needs to be updated in order to provide health care professionals, particularly doctors, with enough quality work life and improved job satisfaction in order to improve their performance at work. We try to answer these questions in our research.

A Review of Medical Waste Management Systems in the Republic of Korea for Hospital and Medical Waste Generated from the COVID-19 Pandemic

With the increasing generation of medical waste worldwide, managing medical waste has become crucial, given its potential environmental and public health risks. Previously in the Republic of Korea, medical waste was often mixed with municipal waste and disposed of in residential landfills or unsuitable treatment facilities (e.g., improperly managed incinerators). Environmental regulators and waste producers have made extensive efforts in recent years to improve waste management at healthcare facilities. This study presents an overview of the status of medical waste management in Korea and discusses information on the generation, composition, separation, transportation, and treatment of medical waste. Incineration was confirmed to be the most preferred treatment method for medical waste and was the only one used until late 2005. Large-scale medical waste incinerators are used for treating medical waste from most medical facilities in Korea; however, with increasing regulations on toxic air emissions (e.g., dioxins and furans), air emission standards are being tightened for all existing small-scale incineration facilities without air pollution control. Since medical waste usually contains various plastic materials such as polyvinyl chloride, these incinerators are highly likely to emit toxic air pollutants if improperly operated and managed. Waste minimization and recycling, control of toxic air emissions from medical waste incinerators, and alternative treatment methods to incineration are seen as major challenges. Incineration capacity cannot be expanded as quickly as the rising quantities of medical waste in Korea; thus, there is a growing need to reconsider the overall management system. Accordingly, we examined various medical waste treatment policies and methods that are being implemented in other countries, in addition to the main strategy of waste management. To determine preferable directions for the improvement of the medical waste management system, we investigated and compared the status of domestic and foreign waste management and proposed directions for improvement, focusing on several issues related to the current medical waste management system in Korea.

Проблеми індикативного планування та концепції управління існуючої системи медичного захисту населення України під час проведення контртерористичних операцій

Актуальність. З метою покращання надання екстреної медичної допомоги постраждалим під час проведення контртерористичних операцій в Україні шляхом здійснення аналізу та визначення проблемних питань щодо розбудови сучасної системи медичного захисту населення України, що відповідатиме завданням євроатлантичної інтеграції, було виконано дане дослідження. Матеріали та методи. Матеріалом дослідження були: законодавчі та нормативні акти України урядового та відомчого рівнів стосовно медичного захисту населення в надзвичайних ситуаціях та в особливий період, а також накази та інструкції, чинні в Україні, із питань надання екстреної медичної допомоги. Результати. Розробка організаційної моделі та нормативно-правової бази застосування медико-організаційних заходів із мінімізації наслідків у разі зростання загроз здоров’ю громадян України в особливий період дає змогу визначити концептуальну стратегію щодо впрова­дження адаптованих медико-організаційних технологій до складових системи екстреної медичної допомоги під час проведення контртерористичних операцій з урахуванням сучасних засобів ведення воєнних дій та їх медико-санітарних наслідків. Висновки. Система медичного захисту за обсягом матеріально-технічного та кадрового забезпечення повинна розглядатись як складова національної безпеки держави.

Fragment based drug design

Abstract Rational approaches towards drug development have emerged as one of the most promising ways among the tedious conventional procedures with the aim of redefining the drug discovery process. The need of current medical system is demanding a much precise, faster and reliable approaches in parallel to faster growing technology for development of drugs with more intrinsic action and fewer side effects. Systematic and well-defined diagnostic studies have revealed the specific causes of disease and related targets for drug development. Designing a drug as per the specific target, studying it in-silico prior to its development has been proved as an added benefit to the studies. Many approaches like structure based drug design, fragment based drug design and ligand based drug design are been in practice for the drug discovery and development with the similar fundamental theory. Fragment based drug design utilizes a library of fragments designed specifically for the concerned target and these fragments are studied further before screening with virtual methods as well as with biophysical methods. The process follows a well-defined pathway which moulds a fragment into a perfect drug candidate. In this chapter we have tried to cover all the basic aspects of fragment based drug design and related technologies.

Utilization of Pumpkins [Low fidelity- organic Bench top Simulator's] to Demonstrate Mechanical Injuries Among MBBS Students

Simulation has found its way in the current medical education system. Simulation based teaching or training is very effective and has high receptiveness among students. Simulation are of various types and models for the same are available at variable costs. Simulation based teaching for undergraduates in forensic medicine is need of the hour in the absence or less exposure to medicolegal autopsies and clinical forensic cases. In this paper we had used pumpkins as a teaching model to demonstrate mechanical injuries. Students were given various weapons and was allowed to inflict multiple injuries over the pumpkin under the strict supervision of the faculties. Features of abrasion, incised wound, stab, chops were well demonstrated. While features of laceration, contusions were minimally demonstrated. Pumpkins are cheaper than conventional ballistic dummies or mannequins used of simulation. Concept of simulation based teaching in forensic medicine is in very primitive stage and new ideas must be explored. Thus combination of conventional teaching along with simulation based teaching will have greater reach among students.

Α Tool for Litigation Risk Analysis for Medical Liability Cases

Mistakes in the context of medical care can occur anywhere in the healthcare system. On the one hand, the doctrinal uncertainties, which lie at the heart of the current medical liability system, combined with the inherent uncertainty of medical science and the human body’s complexity, create an extremely “foggy” landscape. On the other hand, litigation is not always effective. Thus, it is essential to cope with the uncertainties in a reasoned way. This paper presents a tool for litigation risk analysis in medical liability cases which permits identification of the multiple uncertainties that will affect the potential outcome and the exploration of their interrelationships. The basic uses, purposes and features of the tool will be presented. In addition, its core advantages as well as and its aims, benefits and financial/social/scientific impact will be discussed.

Perception of medical students towards online learning during COVID-19 pandemic: a cross-sectional study in South Kerala, India

Background: Coronavirus disease 2019 (COVID-19) pandemic has brought major changes in every sector including education. From school to college level, traditional classroom learning was forced to change to online learning. There were many challenges from inexperience to mental and physical health issues. This study aimed to find the perception of medical students about current medical online learning system in south Kerala.Methods: An online survey was conducted in November 2020 using a self-designed pretested questionnaire consisting of three sections: socio demographic profile, a 4-point Likert scale having 29 items to assess the perception of online learning, questions to assess certain parameters like health problems, duration of electronic usage etc. Frequencies, percentages, and descriptive statistics were calculated, and Chi-square test was used for statistical significance.Results: Study showed nearly three-fourth (74%) of students have a negative perception towards online learning. Of the different formats of e-learning used by students during the study period, most preferred were live lectures. Among the participants, more than half (57%) suggested a need for improvement in the quality of classes. Majority (75%) of students agreed that long hours of online classes had caused health problems.Conclusions: Though online learning is the need of the hour; majority of the students have a negative perception towards it which demands an enhancement in its standards and change to a preferred format

Trend of lung cancer surgery, hospital selection, and survival between 2005 and 2016 in South Korea.

BackgroundStudies on the clinical implication of hospital selection for patients with lung cancer are few. Therefore, this study aimed to analyze 2005–2016 data from the Korean national database to assess annual trends of lung cancer surgery and clinical outcomes according to hospital selection.MethodsData of 212 554 patients with lung cancer who underwent upfront surgery were screened. Trends according to sex, age, residence, and income were examined. Descriptive statistics were performed, and p trend values were estimated. The association between survival and hospital selection was assessed using the log‐rank test. A multivariate Cox regression analysis was also performed.ResultsA total of 49 021 patients were included in this study. Surgery was prevalent among men, patients aged 61–75 years, capital area residents, and high‐income patients. However, with the increasing rate of surgery among women, patients aged ≥76 years, city residents, and middle‐income patients, the current distribution of lung cancer surgery could change. The rate of lobectomy among these groups increased. All patients, except those in capital areas, preferred a hospital outside their area of residence (HOR); the number of patients with this tendency also increased. However, this trend was not observed among low‐income patients and those aged ≥76 years. There were significant differences in survival according to hospital selection.ConclusionsThe trend of lung cancer surgery is changing. The current medical system is effective in providing lobectomy for patients including women, aged ≥76 years, city residents, and middle‐income. Increasing tendency to choose an HOR requires further study.

Life after cancer and the communist order: A case study on grassroot patient organization in China

Patient-led organizations have mushroomed in China over the past three decades, but they have not received enough academic attention. This paper aims to explore the survival logic of patient-led organizations and forge a critical analysis of the imbrications of patient life and state power in a non-neoliberal context of contemporary China. Based on seven months of ethnographic fieldwork and 41 interviews, we examine the case of the Shanghai Cancer Recovery Club (SCRC) as an example of a highly mobilized cancer survivorship that evolved from a group practicing Qigong. Unlike its counterparts in the liberal societies, SCRC has a completely different historical process of group formation. Decades ago, Chinese cancer patients believed that pre-modern “Qi” could control cancer, so they gathered to practice Qigong. To unify and better promote Qigong among cancer patients, they later formed a more organized Qigong milieu. After the Qigong fever, Qigong groups formed by cancer patients gradually evolved and registered as an official cancer social organization. Based on the idea of Chinese values of collective living and the revolutionary spirit of communism, SCRC promoted very innovative “group cancer-fighting method” (e.g., grassroots based, large-membership, and motivating slogans). Through these, they have succeeded in building a citywide network that reaches down to the street level. As the oldest and largest patient-led organization in contemporary China, SCRC serves as the Shanghai model that has influenced hundreds of similar patient-led organizations in other cities. We further argue that SCRC has played three roles in the current medical system: as a welfare arm of the government, as a collaborator with medical institutions, and as a mediator between the public and patients.

The interaction of delayed retirement initiative and the multilevel social health insurance system on physical health of older people in China.

With many social challenges posed by an ageing population, the delayed retirement initiative has received wide attention from policymakers. However, China's current multi-level social health insurance system seems not perfect and not ready for the delayed retirement initiative. The public are generally concerned that the benefits of late retirees cannot be well guaranteed. Using data from China Health and Retirement Longitudinal Study (CHARLS) and the chorological design (CHARLS-2015 and -2018 waves), this study finds that (1) late retirement could be beneficial for physical health among older adults; (2) there have disparities between the effects of different social health insurances on physical health among older adults; (3) social health insurances could weaken the benefits of late retirement to physical health among older adults. Results imply that China's current multi-level social medical insurance system may lag behind the proposed delayed retirement initiative and have policy limitations for late retirees.

Impact of the current medical system on the financial stability of world countries and the Republic of Moldova

The economic crises that have occurred worldwide so far have been caused by emerging problems arising from the supply-demand correlation for certain products on the world market. However, the current economic crisis has been caused by the global COVID-19 pandemic. The greatest difficulty has been the impossibility of predicting the crisis that has arisen as a result of the need to introduce urgent restrictive measures to combat the pandemic. The devastating consequences of the crisis caused by COVID-19 were the halt of the world economy and the decline in Global Production, which was recorded by the International Monetary Fund (IMF) in the spring of 2020. The Republic of Moldova faced the overlap of two major crises: first caused by the COVID19 pandemic and second by the severe drought, mentioned as the most severe recession in the last 20 years. As crisis consequence, the Gross Domestic Product (GDP) of the Republic of Moldova estimated for 2020 decreased by about 6.5%.

Embracing healthcare delivery challenges during a pandemic. review from a nodal designated COVID-19 center in qatar

Hospitals and healthcare systems are instrumental in the formulation and delivery of a coordinated response to disaster management especially epidemics. In healthcare policy and strategy formation, there are only trade-offs, which with uncertainty are akin to gambles. National organizations play a key role in pandemics through the expression of physician motivation. Effective strategies can facilitate physician action through economies of scale that lower the costs for physicians to meet both community and patients' needs. Moreover, no matter how well clinicians are motivated and positioned to act, their collective actions are likely to fall short without complementary systems for population-based care that require the operational support of an organization. This review of institutional policy implementation and frameworks intends to highlight how a nodal-designated COVID-19 center in Qatar managed to control the menace by altering its procedural sets and work arrangements to augment an integrated, intrinsic response to a briskly emerging, conceivably complex situation. This outcome was achieved under the guidance of a national leadership team, effectively adapted to its specific challenges by building on current medical evidence, management routines, proficiencies, and health system capacity. This ambitious drive started with the cohesion of services and implementation of evidence-based protocols by assigning a physician-led team to research, strategize and organize improved patient flow and information by arranging analytical compliance and preparedness. Through these service approaches and ongoing efforts, HMGH has realized significant outcome improvements, such as increasing capacity building, reducing healthcare waste, and increasing patient satisfaction rates whilst successfully achieving significantly lower COVID-19 mortality both in terms of absolute numbers and as percent population compared to many developed countries in the world. The strategies outlined in this article might not be all-inclusive or fit other healthcare system models, but they generate a veritable interest to pursue and be subjected to further rigorous study.