Wrong Time Research Articles

SMART MEDICINE REMINDER AND DISPENSER

Because of our specialized understanding in our profession, engineers have a higher duty to address societal problems as they arise. Many individuals today all around the world suffer from common disorders like high blood pressure, diabetes, etc. People with chronic illnesses should take their medications on a regular basis to treat their conditions, but in today's hectic society, many people forget to do so. Elderly people frequently forget to take their medications or take the incorrect medication at the wrong time. The project that we selected is entirely for the health of the elderly and those who regularly take medication. Our solution combines a medication dispenser and a reminder to dispense the right medication at the right time. The whole control activity of the smart medicine reminder is regulated by this system's Arduino UNO board. The voice alarm used by the system to remind the patient to take their medication can be adjusted by the patient or their caretakers. The close relatives of the patient, like son, daughter, wife, husband, mother, or father, can be the voice used in this system. To keep the date and time accurate for the system, we use a real-time clock module. Also, we use a 1x5 keypad to set alarms, and an LCD display is used to show the current time and date as well as to set alarms. The dispensing section uses servo motors to provide the medication efficiently. To remind hospital patients to take their medications on time, this approach can also be utilized in hospitals. This Smart medicine dispensers and reminders are highly helpful in a variety of scenarios, including patient homes, hospitals, COVID wards, and quarantine areas. It may also be incorporated into the system in the patient monitoring system.

Hand injuries with mole gun: A hidden danger.

Mole guns are handmade destructive tools used in the fight against harmful rodents in agricultural areas. Acciden-tal triggering of these tools at the wrong time can result in major hand injuries that impair hand functionality and cause permanent hand disability. This study aims to draw attention to the fact that mole gun injuries cause severe loss of hand functionality and that these tools should be considered within the scope of firearms. Our study is a retrospective, observational cohort study. The demographic characteristics of the patients, the clinical features of the injury, and the surgical methods applied were recorded. The severity of the hand injury was assessed by the Modified Hand Injury Severity Score. The Disabilities of Arm, Shoulder, and Hand Questionnaire was used to evaluate the upper extremity-re-lated disability of the patient. The patients' hand grip strength and palmar and lateral pinch strengths, and functional disability scores were compared with healthy controls. Twenty-two patients with mole gun hand injuries were included in the study. The mean age of the patients was 63.0±16.9 (22-86), and all but one were male. Dominant hand injury was found in more than half of the patients (63.6%). More than half of the patients had major hand injuries (59.1%). The functional disability scores of the patients were significantly higher than the controls, and the grip strengths and palmar pinch strengths were significantly lower. Even after years from the injury, our patients had hand disabilities, and their hand strengths were lower than that of the controls. Public awareness should be raised on this issue, and mole guns should be prohibited and considered in the scope of firearms.

Інвагінація кишечника в дітей: навчання та практика

Intestinal invagination is a mixed form of intestinal obstruction that occurs when one section of the intestine is telescopically immersed in the lumen of another and occurs mainly at the age of 3 months to 1 year, which is 90%, and mortality, according to the literature, ranges from 6 to 14.5%. Despite a sufficient number of scientific and clinical publications on the pages of medical journals regarding the diagnosis and treatment of intestinal intussusception, there are no fake simulators in the training of students and interns, which determines the relevance of this publication. Purpose - to improve the results of diagnosis and treatment of children with intestinal intussusception by analyzing domestic developments and visually studying the mechanism of its development with the help of a simulator both for the purpose of diagnosis and treatment - conservative disinvagination. Results. In today’s conditions, general practitioners and pediatricians are not trained to diagnose intussusception in children, that is, they do not have simple methods of examination. Hospitals usually do not have the equipment to examine and diagnose acute intussusception. In order to eliminate the gaps at the Department of Pediatric Surgery of the Bukovinian State Medical University, a dummy-simulator of intestinal intussusception «Garant» was developed and introduced into the educational process. Training on a simulator allows you to master the practical skills of diagnostics in the conditions of an X-ray room and conservative disinvagination followed by X-ray control. In turn, the development of skills by primary care physicians and pediatric surgeons in diagnosis and treatment will primarily improve the understanding of the onset of the disease and treatment methods. Conclusions. With certain and significant developments regarding the diagnosis and treatment of intestinal intussusception in children, the problem has not been solved, since some children seek help at the wrong time, and as a result of complications - necrosis, peritonitis with organ and multiple organ failure. The use of a scoring system for assessing the stage of invagination makes it possible to systematize the main prognostic indicators of sonographic and dopplerographic studies in order to determine an adequate method of treatment. Practicing the skills of diagnosis and treatment on the self-developed dummy «Garant» allows you to clearly understand the essence and purpose of the measures taken to establish and confirm the diagnosis of intestinal intussusception, evaluate the possibilities of various methods of conservative and surgical treatment and indications for them. No conflict of interests was declared by the authors.

Research on character recognition technology based on deep learning

In the security field, it is necessary to extract the information of each camera in real time. However, due to various reasons, each camera may have wrong shooting time, location and other information during the use process. If it cannot be found in time, it will bring great hidden danger to the security. This research based on CRNN depth learning algorithm to detect and recognize the text information on these pictures, and the results can effectively improve the accuracy of recognition.

HUBUNGAN PENGETAHUAN DAN SUPERVISI DENGAN PENERAPAN PRINSIP ENAM BENAR DALAM PEMBERIAN OBAT OLEH PERAWAT PELAKSANA DI RUANG RAWAT INAP RSI SITI RAHMAH PADANG

Nurses as part of the health care system is responsible for the provision of safe drugs. In order to achieve safe administration, nurses should pay attention to the six principles of client really is true, right drug, right dose, right time, right route, and right documentation. The phenomenon of the field obtained 30% of the drugs that are given are not documented, 15% of the drug is administered in a way that is not right, 23% of the drug is given at a wrong time, 2% of drugs are not given, 12% of the drug is administered at a dose yag right. Factors that affect the application of the principle of six true in drug delivery including knowledge and supervision. The aim of research to determine the relationship of knowledge and supervision with the correct application of the six principles of drug administration by nurses in inpatient unit RSI Siti Rahmah Padang.
 This type of research is analytic survey design using cross sectional study. The population around the nurses in the inpatient unit of 52 people, with a sampling technique using total sampling. Processing the data through the editing stage, coding, entry, and cleaning. Results were analyzed using univariate and bivariate chi square test with 95% confidence level α = 0.05.
 Based on the results, the application of the principle of six true in poor drug delivery (51.9%), while good (48.1%), 53.8% lower nurse's knowledge, while the less well supervised as much as 53.8%. There is a significant relationship between knowledge (p = 0.000) and supervision (0.027) with the correct application of the six principles in drug delivery.To perform an increase in drug administration services, health services should provide training and refresher on the principle of six correct drug administration. This can be done by organizing seminars / symposia and training regarding the professionalism of the administration of drugs and increase overall service.

Moment Preserving Fourier–Galerkin Spectral Methods and Application to the Boltzmann Equation

Spectral methods, thanks to the high accuracy and the possibility of using fast algorithms, represent an effective way to approximate collisional kinetic equations in kinetic theory. On the other hand, the loss of some local invariants can lead to the wrong long time behavior of the numerical solution. We introduce in this paper a novel Fourier-Galerkin spectral method that improves the classical spectral method by making it conservative on the moments of the approximated distribution, without sacrificing its spectral accuracy or the possibility of using fast algorithms. The method is derived directly using a constrained best approximation in the space of trigonometric polynomials and can be applied to a wide class of problems where preservation of moments is essential. We then apply the new spectral method to the evaluation of the Boltzmann collision term, and prove spectral consistency and stability of the resulting Fourier-Galerkin approximation scheme. Various numerical experiments illustrate the theoretical findings.

THE STATUS OF ADHERENCE IN LAMIVUDIN, TENOFOVIR AND DOLUTEGRAVIR USAGE TO TREAT HIV PATIENTS

Objective: To analyze the adherence to treatment with Lamivudin, Tenofovir,Dolutegravir in HIV patients at Long An General Hospital.Subjects and methods: Study of cross-sectional description, no interventionthrough retrospective medical records and interviews with questionnaires on 71 HIV/AIDS patients being treated with a 3-drug ARV regime of Lamivudin, Tenofovir,Dolutegravir including inpatient and outpatient treatment at the Department ofInfectious Diseases, Long An General Hospital.Results: The rate of adherence to ARV of study participants within 7 days beforethe time of interview was 63.4%. In which, 11.3% of patients missed at least onedose of the drug; 22.5% of patients took the medicine at the wrong time over 1 hourat least once; 5.6% of patients took ARV drugs incorrectly at least once. The studyresults showed that the relevant factors for ARV adherence were the patient’s age, theclinical stage before treatment and the home reminder method.Conclusion: The rate of adherence to treatment of ARV in study participants within7 days before the time of interview was 63.4%. Relevant factors for adherence totreatment of ARV were patient age, pre-treatment clinical stage, and home reminders.

Medication administration errors and associated factors among nurses in Addis Ababa federal hospitals, Ethiopia: a hospital-based cross-sectional study

ObjectiveThis study was conducted to assess the magnitude and contributing factors of medication administration errors among nurses in federal hospitals in Addis Ababa, Ethiopia.DesignA hospital-based cross-sectional study design was employed....

Medication errors and associated factors as perceived by nurses working at the national referral hospital in Bhutan

Introduction: A common patient safety issue is medication error and this has remained a serious problem in hospital settings. Medication error occurs at any point of medication process: prescription, transcription, dispensing, and administration. Administration error is the most common type of error occurring among nurses; although nurses play a vital role in preventing harms of prescription and dispensing errors from reaching the patient. Therefore, this study was aimed at assessing medication errors and associated factors as perceived by nurses. Methods: The study was conducted at a tertiary hospital in Bhutan and 225 nurses participated through self-reported questionnaire. Data were double entered and validated in Epidata and analyzed using descriptive commands of statistical software STATA. Results: Among total participants of N = 225, 62.7% reported to have experienced medication error in past six months. Common type of error experienced were omission of dose; wrong time; wrong dose, and administering drugs without physician’s order. Nurses in intensive care units and those caring for pediatric patients reported experiencing more errors. The perceived factors were look-alike drugs, many patients with similar medicines, more medicines to single patient, and oral instructions and acronyms in prescription. Conclusions: The nurses reported to have experienced quite a high rate of medication error. The results may be used by relevant stakeholders in preventing and reducing medication errors, the biggest challenge of patient safety in hospital settings.

Egg-Laying Behavior of Cataglyphis niger Ants Is Influenced More Strongly by Temperature Than Daylength.

Temperature and photoperiod are the two most important factors that affect all aspects of animal life. We conducted two experiments to examine the effect of temperature and photoperiod on egg laying and development in the desert ant Cataglyphis niger. In the first experiment, we examined the effect of decreasing temperatures and shortening daylength on egg-laying behavior. An additional treatment was exposure to natural autumn conditions. Decreasing temperatures impaired egg laying much more than shortening daylength. The effect, however, was rapidly reversible when raising the temperature. When the outdoor treatment was brought inside the lab at a suitable temperature, queens started laying eggs as well. In the second experiment, we first kept the colonies under warmer temperatures and moved them gradually to cooler temperatures, 1-20 days after the eggs were laid. The probability of eggs developing into larvae and pupae under cooler temperatures was positively influenced by the exposure duration to warmer temperatures before the temperature switch. When the eggs developed into larvae, longer exposure to warmer temperatures before the temperature switch led to faster development. However, when the eggs disappeared (and were probably eaten), longer exposure to warmer temperatures before the temperature switch led to slower egg disappearance. We suggest that the decision to lay eggs is reversible to some extent because the workers can consume the eggs if conditions deteriorate. We suggest that this reversibility reduces the cost of laying eggs at the wrong time.

Operating Leverage and Inflation

This article presents a generalization of the concept of operating leverage to include leverage factors/multipliers that can be used to estimate the earnings impact from any changes (including inflation-driven changes) in unit sales, prices, or costs. For a given firm, these price, cost, and sales multipliers may be synchronous or offsetting, resulting in a wide range of net leverage effects. In general, operating leverage increases as sales decline, so that an adverse environment will find a firm confronted with greater leverage reactions—at just the wrong time! The resulting convexity effect can exacerbate the amplitude of any sales-driven earnings cycle. Incorporating specific inflation flow-through factors in the operating leverage/multiplier model allows the earnings impact of different forms of inflation to be more readily envisioned. This more granular approach often leads to surprising results. This article presents examples that illustrate how some forms of inflation can have a positive earnings impact, whereas other combinations can be quite devastating, especially in terms of real earnings.

Machine Learning Models Accurately Predict PTHrP Results But Fail To Predict Physician Behavior

Abstract Quantification of circulating parathyroid hormone-related peptide (PTHrP) aids in the diagnosis of humoral hypercalcemia of malignancy. However, this test is often ordered in settings of low pre-test probability or mistakenly ordered when parathyroid hormone (PTH) was desired. To improve utilization, all PTHrP orders at our institutions are reviewed by a laboratory medicine resident. If the order appears to be inappropriate, the ordering physician is contacted to ask for permission to cancel. In this work, we attempted to automate this labor-intensive review process by developing machine learning models to predict the orders the physician is willing to cancel. We collected 2171 PTHrP orders that were subjected to manual review over the past 10 years. We removed any repeats, leaving 1649 first-time orders. For each order, we assigned a class label of ‘canceled’ or ‘completed’ based upon the notes in the resident’s documentation logs. For each order, we aggregated all data for the patient existing within the laboratory information system at the time of the first order (n = 40 million). Various strategies were applied to impute missing data, including leaving missingness as a feature, fill by medians, k-nearest neighbors, bagged trees, and linear regression. Class imbalances were adjusted using synthetic minority upsampling technique (SMOTE) and adaptive synthetic upsampling (ADASYN) for a final ratio of one:one. The dataset was partitioned into a 70:30 split between training and testing sets with five-fold cross-validation. Several machine learning algorithms were trained, including logistic regression, naive Bayes, random forest, and XGBoost. After training and cross-validation, the models were applied to the held-out test set, and performance was evaluated using the area under the receiver operating characteristic curve (AUC). XGBoost was the best performer at predicting the provider’s likelihood to cancel the test, but with an AUC of only 0.63. Surprised by this poor performance, we devised a second classification task of predicting the PTHrP results (normal vs abnormal, threshold = 4.2 pmol/L) for the subset of orders that were completed (n=1371). Using the same machine learning pipeline described above, we again observed that XGBoost was the best performer, but this time with an AUC of 0.89. The striking performance difference between the models trained on the two different targets suggests that the physician’s willingness to assent to our intervention may be unrelated to existing laboratory data or underlying biology. Likely explanations may include that our intervention is reaching a provider who is not the primary medical decision-maker or the correct provider at the wrong time when they are too busy to revisit details of prior work. In either case, a reflex order set that defines specific criteria for performing PHTrP upfront may be a more effective way to improve utilization.

Evaluating Histone Acetylation in Mouse Hematopoietic Stem and Progenitor Cells Using Chromatin Immunoprecipitation.

Epigenetics is the study of how cells control gene activity without changing the DNA sequence. Various epigenetic processes have been identified, including methylation, acetylation, phosphorylation, and ubiquitylation. Epigenetic processes are natural and essential to cell functions; however, when they occur improperly or at the wrong time, adverse effects can occur. A significant epigenetic process is chromatin modification. Chromatin-DNA complexes can be modified by acetylation, altering chromatin structure to influence gene expression. Stresses to hematopoietic stem and progenitor cells, such as ionizing radiation and aging, have significant effects on genomic function. Understanding epigenetic regulation in hematopoietic cells, particularly under stress, offers the potential for therapeutic intervention. We have utilized Chromatin immunoprecipitation (ChIP) in HSPCs to understand epigenetic regulation in response to ionizing radiation. This technique can be applied reliably to rare hematopoietic cells and offers a powerful tool to explore epigenetic regulation in HSPCs.

Night Meals to Pay Bills: An Immunological Innovation

This objective of this policy opinion article was to address a perspective if chrono-eating can help prevent immunodeficiency diseases by optimizing circadian rhythms of nutrient assimilation and metabolism. In the modern era, eating timing, sequence, and frequency have been modified significantly. People tend to consume fast foods during later times of the circadian phase or almost 24-h period. Rising evidence indicates that eating at wrong times (i.e., evening and night) and inadequate physical activity would lead to suboptimal physiological rhythms of nutrient assimilation and metabolism. This trend is postulated to weaken immunity and cause obesity, diabetes, and other immunodeficiency and autoimmune diseases. These abnormalities are amongst the foremost metabolic disorders worldwide. Eating slowly releasing energy later in the evening and overnight may help optimize immunity. Therefore, chrono-eating is a mounting science that helps optimize circadian food consumption behavior to prevent, or at the very least, reduce immunodeficiency and associated metabolic disorders development.

Prevalence, Causes and Severity of Medication Administration Errors in the Neonatal Intensive Care Unit: A Systematic Review and Meta-Analysis.

Neonates are at greater risk of preventable adverse drug events as compared to children and adults. This study aimed to estimate and critically appraise the evidence on the prevalence, causes and severity of medication administration errors (MAEs) amongst neonates in Neonatal Intensive Care Units (NICUs). A systematic review and meta-analysis was conducted by searching nine electronic databases and the grey literature for studies, without language and publication date restrictions. The pooled prevalence of MAEs was estimated using a random-effects model. Data on error causation were synthesised using Reason's model of accident causation. Twenty unique studies were included. Amongst direct observation studies reporting total opportunity for errors as the denominator for MAEs, the pooled prevalence was 59.3% (95% confidence interval [CI] 35.4-81.3, I2 = 99.5%). Whereas, the non-direct observation studies reporting medication error reports as the denominator yielded a pooled prevalence of 64.8% (95% CI 46.6-81.1, I2 = 98.2%). The common reported causes were error-provoking environments (five studies), while active failures were reported by three studies. Only three studies examined the severity of MAEs, and each utilised a different method of assessment. This is the first comprehensive systematic review and meta-analysis estimating the prevalence, causes and severity of MAEs amongst neonates. There is a need to improve the quality and reporting of studies to produce a better estimate of the prevalence of MAEs amongst neonates. Important targets such as wrong administration-technique, wrong drug-preparation and wrong time errors have been identified to guide the implementation of remedial measures.

Pola Komunikasi Kepala Desa dalam Meningkatkan Kinerja Aparatur di Kantor Desa Gunung Jaya Cisaat Kabupaten Sukabumi

Every individual in the organization is required to always interact with each other, be it communication from top to bottom or vice versa, as well as communication between others. That way, the flow of communication can be effective. In addition, the leadership role is very vital to direct, control, instruct and mobilize every member in the organization, so that the sustainability and goals of the organization can be fully achieved. This kind of communication climate can actually be created in all forms of organization, including government institutions, in this case the village office. Village government as a form of organization certainly cannot be separated from the communication activities carried out by the individuals in it. This study aims to determine organizational communication patterns in improving employee performance at the Gunung Jaya Village Office, organizational communication barriers, and communication strategies in improving employee performance. The research method is descriptive qualitative with data collection techniques of participation observation, observation, and interviews. The results of the research on organizational communication patterns carried out in the Gunung Jaya Village office were carried out formally and informally. Formal communication patterns include downward and upward communication patterns, as well as horizontal. The formal downward communication pattern is carried out once a month, unless there are incidental rules or instructions from the sub-district or district government. There are communication barriers due to overuse of communication tools at the wrong time, delays in conveying information about the implementation of a job or report. Meanwhile, the strategy carried out by the leadership is to improve employee performance by providing direction, input, motivation and encouragement, as well as going directly to the field to provide direct support to employees.

Sleep-promoting neurons remodel their response properties to calibrate sleep drive with environmental demands.

Falling asleep at the wrong time can place an individual at risk of immediate physical harm. However, not sleeping degrades cognition and adaptive behavior. To understand how animals match sleep need with environmental demands, we used live-brain imaging to examine the physiological response properties of the dorsal fan-shaped body (dFB) following interventions that modify sleep (sleep deprivation, starvation, time-restricted feeding, memory consolidation) in Drosophila. We report that dFB neurons change their physiological response-properties to dopamine (DA) and allatostatin-A (AstA) in response to different types of waking. That is, dFB neurons are not simply passive components of a hard-wired circuit. Rather, the dFB neurons intrinsically regulate their response to the activity from upstream circuits. Finally, we show that the dFB appears to contain a memory trace of prior exposure to metabolic challenges induced by starvation or time-restricted feeding. Together, these data highlight that the sleep homeostat is plastic and suggests an underlying mechanism.

EGFR, the Lazarus target for precision oncology in glioblastoma.

The Lazarus effect is a rare condition that happens when someone seemingly dead shows signs of life. The epidermal growth factor receptor (EGFR) represents a target in the fatal neoplasm glioblastoma (GBM) that through a series of negative clinical trials has prompted a vocal subset of the neuro-oncology community to declare this target dead. However, an argument can be made that the core tenets of precision oncology were overlooked in the initial clinical enthusiasm over EGFR as a therapeutic target in GBM. Namely, the wrong drugs were tested on the wrong patients at the wrong time. Furthermore, new insights into the biology of EGFR in GBM vis-à-vis other EGFR-driven neoplasms, such as non-small cell lung cancer, and development of novel GBM-specific EGFR therapeutics resurrects this target for future studies. Here, we will examine the distinct EGFR biology in GBM, how it exacerbates the challenge of treating a CNS neoplasm, how these unique challenges have influenced past and present EGFR-targeted therapeutic design and clinical trials, and what adjustments are needed to therapeutically exploit EGFR in this devastating disease.

Observational study on medication administration errors at a University Hospital in Brazil: incidence, nature and associated factors

BackgroundMedication administration errors are frequent and cause significant harm globally. However, only a few data are available on their prevalence, nature, and severity in developing countries, particularly in Brazil. This study attempts to determine the incidence, nature, and factors associated with medication administration errors observed in a university hospital.MethodsThis was a prospective observational study, conducted in a clinical and surgical unit of a University Hospital in Brazil. Two previously trained professionals directly observed medication preparation and administration for 15 days, 24 h a day, in February 2020. The type of error, the category of the medication involved, according to the anatomical therapeutic chemical classification system, and associated risk factors were analyzed. Multivariate logistic regression was adopted to identify factors associated with errors.ResultsThe administration of 561 drug doses was observed. The mean total medication administration error rate was 36.2% (95% confidence interval 32.3–40.2). The main factors associated with time errors were interruptions. Regarding technique errors, the primary factors observed were the route of administration, interruptions, and workload.ConclusionsHere, we identified a high total medication administration error rate, the most frequent being technique, wrong time, dose, and omission errors. The factors associated with errors were interruptions, route of administration and workload, which agrees well with the results of other national and international studies.

Living at the Wrong Time: Effects of Unmatching Official Time in Portugal and Western Spain.

Simple SummaryHuman rhythmicity is subjected to the workings of the internal circadian clock, but it is also influenced by environmental time (mainly the light-dark cycle) and social timing imposed by the official time at our location, as well as by our work schedule. When a misalignment among these times occurs, an internal order impairment appears, which affects our health. Western Spain (GMT+1/+2) and Portugal (GMT0/+1) share similar longitudes (sun time) but have different official times, and thus they provide a “natural experiment” to assess how this discrepancy affects circadian rhythmicity and sleep in people with no work duties (>65 years). Although sleep duration was not affected, the circadian rhythms in the Portuguese were more robust, especially during weekdays, while higher desynchronization tended to occur in the Spaniards. Once official time was corrected by GMT0, meals took place later in Spain than in Portugal, especially as the day progressed, indicating the possible deleterious effect on circadian system robustness when official time is misaligned with its corresponding geographical time zone.Human circadian rhythmicity is subjected to the internal circadian clock, the sun and social clocks (official time, social/work schedules). The discrepancy among these clocks, as occurs when official time does not match its geographical time zone, may produce circadian disruption. Western Spain (GMT+1/+2) and Portugal (GMT0/+1) share similar longitudes (sun time) but have different official times. This provides a unique opportunity to evaluate the effects of official time on circadian rhythmicity and sleep in elderly and retired populations (with no remunerated duties presumed, although other social commitments may be present) at both locations. Although both populations slept enough for their age (7–8 h), circadian robustness (e.g., interdaily stability, relative amplitude) was greater in Portugal, especially during weekdays, while greater desynchronization (both body temperature vs. motor activity and body temperature vs. light exposure) tended to occur in the Spaniards. Once corrected by GMT0, meals took place later in Spain than in Portugal, especially as the day progresses, and a possible interplay between bed/meal timings and internal desynchronization was found. Our results point to the possible deleterious effect on circadian system robustness when official time is misaligned with its geographical time zone.