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Bulletin of the World Health... Jul 2024To examine how a general inpatient satisfaction survey functions as a hospital performance measure.
OBJECTIVE
To examine how a general inpatient satisfaction survey functions as a hospital performance measure.
METHODS
We conducted a mixed-methods pilot study of the Hospital Consumer Assessment of Health Providers and Systems survey in Odisha, India. We divided the study into three steps: cognitive testing of the survey, item testing with exploratory factor analysis and content validity indexing. Cognitive testing involved 50 participants discussing their interpretation of survey items. The survey was then administered to 507 inpatients across five public hospitals in Odisha, followed by exploratory factor analysis. Finally, we interviewed 15 individuals to evaluate the content validity of the survey items.
FINDINGS
Cognitive testing revealed that six out of 18 survey questions were not consistently understood within the Odisha inpatient setting, highlighting issues around responsibilities for care. Exploratory factor analysis identified a six-factor structure explaining 66.7% of the variance. Regression models showed that interpersonal care from doctors and nurses had the strongest association with overall satisfaction. An assessment of differential item functioning revealed that patients with a socially marginalized caste reported higher disrespectful care, though this did not translate into differences in reported satisfaction. Content validity indexing suggested that discordance between experiences of disrespectful care and satisfaction ratings might be due to low patient expectations.
CONCLUSION
Using satisfaction ratings without nuanced approaches in value-based purchasing programmes may mask poor-quality interpersonal services, particularly for historically marginalized patients. Surveys should be designed to accurately capture true levels of dissatisfaction, ensuring that patient concerns are not hidden.
Topics: Humans; India; Patient Satisfaction; Female; Male; Adult; Middle Aged; Value-Based Purchasing; Pilot Projects; Surveys and Questionnaires; Hospitals, Public; Factor Analysis, Statistical; Quality of Health Care; Young Adult
PubMed: 38933484
DOI: 10.2471/BLT.24.290519 -
Frontiers in Oncology 2024Precise segmentation of Odontogenic Cystic Lesions (OCLs) from dental Cone-Beam Computed Tomography (CBCT) is critical for effective dental diagnosis. Although...
OBJECTIVES
Precise segmentation of Odontogenic Cystic Lesions (OCLs) from dental Cone-Beam Computed Tomography (CBCT) is critical for effective dental diagnosis. Although supervised learning methods have shown practical diagnostic results in segmenting various diseases, their ability to segment OCLs covering different sub-class varieties has not been extensively investigated.
METHODS
In this study, we propose a new supervised learning method termed OCL-Net that combines a Multi-Scaled U-Net model, along with an Auto-Adapting mechanism trained with a combined supervised loss. Anonymous CBCT images were collected retrospectively from one hospital. To assess the ability of our model to improve the diagnostic efficiency of maxillofacial surgeons, we conducted a diagnostic assessment where 7 clinicians were included to perform the diagnostic process with and without the assistance of auto-segmentation masks.
RESULTS
We collected 300 anonymous CBCT images which were manually annotated for segmentation masks. Extensive experiments demonstrate the effectiveness of our OCL-Net for CBCT OCLs segmentation, achieving an overall Dice score of 88.84%, an IoU score of 81.23%, and an AUC score of 92.37%. Through our diagnostic assessment, we found that when clinicians were assisted with segmentation labels from OCL-Net, their average diagnostic accuracy increased from 53.21% to 55.71%, while the average time spent significantly decreased from 101s to 47s (P<0.05).
CONCLUSION
The findings demonstrate the potential of our approach as a robust auto-segmentation system on OCLs in CBCT images, while the segmented masks can be used to further improve OCLs dental diagnostic efficiency.
PubMed: 38933446
DOI: 10.3389/fonc.2024.1379624 -
Cureus Jun 2024Although rare, acute compartment syndrome may develop as a simple elbow dislocation after reduction without initial motor, sensory, or peripheral circulatory...
Although rare, acute compartment syndrome may develop as a simple elbow dislocation after reduction without initial motor, sensory, or peripheral circulatory abnormalities. This report describes a rare case of this condition. Acute compartment syndrome remains a potential complication, even in a simple elbow dislocation without apparent initial abnormalities, and should be explained to patients. A peripheral nerve block during reduction may mask symptoms and delay recognition of acute compartment syndrome. This case highlights the importance of vigilant monitoring for acute compartment syndrome following reduction of simple elbow dislocations, especially when a peripheral nerve block is used during reduction.
PubMed: 38933345
DOI: 10.7759/cureus.63145 -
Frontiers in Medicine 2024The aim of this study is to determine the steps of a training program utilizing Head-Mounted Display (HMD) based Virtual Reality Technology to enhance nursing students'...
Designing and implementing a training program on surgical hand scrubbing, wearing surgical cap and surgical mask, gowning, and gloving using HMD-based virtual reality technologies for nursing students: an exploration of student perceptions.
OBJECTIVE
The aim of this study is to determine the steps of a training program utilizing Head-Mounted Display (HMD) based Virtual Reality Technology to enhance nursing students' skills in surgical hand scrubbing, wearing surgical cap and surgical mask, gowning and gloving, and to evaluate students' perceptions toward the program.
METHODS
The study aimed to investigate the potential applications of HMD-Based Virtual Reality Technology in Surgical Hand Scrubbing, Wearing Surgical Cap and Surgical Mask, Gowning and Gloving Program for nursing students, as well as students' perceptions toward this technology. The research was conducted with a focus group consisting of second-year nursing students in Osmaniye/Turkey, between January and June 2022, and the training program was implemented in five stages: Analysis, Design, Development, Implementation, and Evaluation. The program was evaluated with a focus group of nursing students. Focus group discussions were conducted to provide insights into students' experiences, feedback, and perceptions of the program.
RESULTS
A vast majority of participants (92.5%) reported feeling fully immersed in the operating room environment during the virtual reality (VR) experience. Notably, all students acknowledged the potential of HMD-Based Virtual Reality Technology to enrich their understanding of surgical hand scrubbing, wearing surgical cap and surgical mask, gowning and gloving procedures, surpassing conventional instructional models. While many participants found the experience exhilarating (85.1%), a considerable portion reported a decline in engagement after repeated exposures (88.8%). Overall, participants welcomed the integration of VR technology into education, expressing optimism about its capacity to facilitate additional instructional modules (74.4%). Moreover, they conveyed satisfaction with the opportunity to engage with the VR application, emphasizing its significant educational value (81.4%).
CONCLUSION
Based on these findings, we can suggest that virtual reality technology has the potential to have an impact on nursing students' education. The majority of students expressing a sense of presence in the operating room highlights the value of this method in education. However, the reported boredom after repeated experiences by most participants underscores the importance of diversifying the program and introducing innovative approaches to keep students engaged.
PubMed: 38933115
DOI: 10.3389/fmed.2024.1364465 -
[Pulmonary PET /CT image instance segmentation based on dense interactive feature fusion Mask RCNN].Sheng Wu Yi Xue Gong Cheng Xue Za Zhi =... Jun 2024There are some problems in positron emission tomography/ computed tomography (PET/CT) lung images, such as little information of feature pixels in lesion regions,...
There are some problems in positron emission tomography/ computed tomography (PET/CT) lung images, such as little information of feature pixels in lesion regions, complex and diverse shapes, and blurred boundaries between lesions and surrounding tissues, which lead to inadequate extraction of tumor lesion features by the model. To solve the above problems, this paper proposes a dense interactive feature fusion Mask RCNN (DIF-Mask RCNN) model. Firstly, a feature extraction network with cross-scale backbone and auxiliary structures was designed to extract the features of lesions at different scales. Then, a dense interactive feature enhancement network was designed to enhance the lesion detail information in the deep feature map by interactively fusing the shallowest lesion features with neighboring features and current features in the form of dense connections. Finally, a dense interactive feature fusion feature pyramid network (FPN) network was constructed, and the shallow information was added to the deep features one by one in the bottom-up path with dense connections to further enhance the model's perception of weak features in the lesion region. The ablation and comparison experiments were conducted on the clinical PET/CT lung image dataset. The results showed that the APdet, APseg, APdet_s and APseg_s indexes of the proposed model were 67.16%, 68.12%, 34.97% and 37.68%, respectively. Compared with Mask RCNN (ResNet50), APdet and APseg indexes increased by 7.11% and 5.14%, respectively. DIF-Mask RCNN model can effectively detect and segment tumor lesions. It provides important reference value and evaluation basis for computer-aided diagnosis of lung cancer.
Topics: Humans; Lung Neoplasms; Positron Emission Tomography Computed Tomography; Lung; Algorithms; Image Processing, Computer-Assisted; Neural Networks, Computer
PubMed: 38932539
DOI: 10.7507/1001-5515.202309026 -
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi =... Jun 2024Self-powered wearable piezoelectric sensing devices demand flexibility and high voltage electrical properties to meet personalized health and safety management needs....
Self-powered wearable piezoelectric sensing devices demand flexibility and high voltage electrical properties to meet personalized health and safety management needs. Aiming at the characteristics of piezoceramics with high piezoelectricity and low flexibility, this study designs a high-performance piezoelectric sensor based on multi-phase barium titanate (BTO) flexible piezoceramic film, namely multi-phase BTO sensor. The substrate-less self-supported multi-phase BTO films had excellent flexibility and could be bent 180° at a thickness of 33 μm, and exhibited good bending fatigue resistance in 1 × 10 bending cycles at a thickness of 5 μm. The prepared multi-phase BTO sensor could maintain good piezoelectric stability after 1.2 × 10 piezoelectric cycle tests. Based on the flexibility, high piezoelectricity, wearability, portability and battery-free self-powered characteristics of this sensor, the developed smart mask could monitor the respiratory signals of different frequencies and amplitudes in real time. In addition, by mounting the sensor on the hand or shoulder, different gestures and arm movements could also be detected. In summary, the multi-phase BTO sensor developed in this paper is expected to develop convenient and efficient wearable sensing devices for physiological health and behavioral activity monitoring applications.
Topics: Titanium; Humans; Barium Compounds; Monitoring, Physiologic; Wearable Electronic Devices; Equipment Design
PubMed: 38932526
DOI: 10.7507/1001-5515.202404016 -
Vaccines Jun 2024Approved COVID-19 vaccines primarily induce neutralizing antibodies targeting the receptor-binding domain (RBD) of the SARS-CoV-2 spike (S) protein. However, the...
Approved COVID-19 vaccines primarily induce neutralizing antibodies targeting the receptor-binding domain (RBD) of the SARS-CoV-2 spike (S) protein. However, the emergence of variants of concern with RBD mutations poses challenges to vaccine efficacy. This study aimed to design a next-generation vaccine that provides broader protection against diverse coronaviruses, focusing on glycan-free S2 peptides as vaccine candidates to overcome the low immunogenicity of the S2 domain due to the N-linked glycans on the S antigen stalk, which can mask S2 antibody responses. Glycan-free S2 peptides were synthesized and attached to SARS-CoV-2 virus-like particles (VLPs) lacking the S antigen. Humoral and cellular immune responses were analyzed after the second booster immunization in BALB/c mice. Enzyme-linked immunosorbent assay revealed the reactivity of sera against SARS-CoV-2 variants, and pseudovirus neutralization assay confirmed neutralizing activities. Among the S2 peptide-conjugated VLPs, the S2.3 (N1135-K1157) and S2.5 (A1174-L1193) peptide-VLP conjugates effectively induced S2-specific serum immunoglobulins. These antisera showed high reactivity against SARS-CoV-2 variant S proteins and effectively inhibited pseudoviral infections. S2 peptide-conjugated VLPs activated SARS-CoV-2 VLP-specific T-cells. The SARS-CoV-2 vaccine incorporating conserved S2 peptides and CoV-2 VLPs shows promise as a universal vaccine capable of generating neutralizing antibodies and T-cell responses against SARS-CoV-2 variants.
PubMed: 38932406
DOI: 10.3390/vaccines12060676 -
Pharmaceutics Jun 2024The objective of the present investigation was to evidence the skin retardation phenomenon of lidocaine by gluconic acid as an inactive ingredient involved in...
The objective of the present investigation was to evidence the skin retardation phenomenon of lidocaine by gluconic acid as an inactive ingredient involved in citrate-crosslinking chitosan nanoparticles. Lidocaine hydrochloride was loaded in nanoparticles based on chitosan, fabricated by using a water-in-oil microemulsion as a template and citric acid as an ionic cross-linker. Gluconic acid (pentahydroxy hexanoic acid) was added during the fabrication and compared with caproic acid, a non-hydroxy hexanoic acid. The chitosan nanoparticulate systems were characterized for mean particle size, particle size distribution, and zeta potential. The pentahydroxy hexanoic acid decreased the zeta potential to a significantly lower value than those obtained from both plain citrate and citrate-hexanoic acid formulations. The relatively lower value implies that gluconate ions are partly attached to the nanoparticle's surface and mask its positively charged groups. It was also noted that the in vitro percutaneous permeation flux of lidocaine significantly decreased when gluconate-containing chitosan nanoparticles were applied, i.e., 6.1 ± 1.5 μg‧cm‧h without gluconic acid to 3.4 ± 2.3 μg‧cm‧h with gluconic acid. According to this result, it is suggested that gluconate ions played a role in retarding drug permeation through the skin, probably by calcium chelation in the , which in turn stimulated lamellar body secretion, lipid synthesis, and intracellular release of Ca from the endoplasmic reticulum.
PubMed: 38931951
DOI: 10.3390/pharmaceutics16060831 -
Sensors (Basel, Switzerland) Jun 2024This research focuses on developing an artificial vision system for a flexible delta robot manipulator and integrating it with machine-to-machine (M2M) communication to...
This research focuses on developing an artificial vision system for a flexible delta robot manipulator and integrating it with machine-to-machine (M2M) communication to optimize real-time device interaction. This integration aims to increase the speed of the robotic system and improve its overall performance. The proposed combination of an artificial vision system with M2M communication can detect and recognize targets with high accuracy in real time within the limited space considered for positioning, further localization, and carrying out manufacturing processes such as assembly or sorting of parts. In this study, RGB images are used as input data for the MASK-R-CNN algorithm, and the results are processed according to the features of the delta robot arm prototype. The data obtained from MASK-R-CNN are adapted for use in the delta robot control system, considering its unique characteristics and positioning requirements. M2M technology enables the robot arm to react quickly to changes, such as moving objects or changes in their position, which is crucial for sorting and packing tasks. The system was tested under near real-world conditions to evaluate its performance and reliability.
PubMed: 38931576
DOI: 10.3390/s24123792 -
Micromachines Jun 2024Microfabrication technology with quartz crystals is gaining importance as the miniaturization of quartz MEMS devices is essential to ensure the development of portable...
Microfabrication technology with quartz crystals is gaining importance as the miniaturization of quartz MEMS devices is essential to ensure the development of portable and wearable electronics. However, until now, there have been no reports of dimension compensation for quartz device fabrication. Therefore, this paper studied the wet etching process of Z-cut quartz crystal substrates for making deep trench patterns using Au/Cr metal hard masks and proposed the first quartz fabrication dimension compensation strategy. The size effect of various sizes of hard mask patterns on the undercut developed in wet etching was experimentally investigated. Quartz wafers masked with initial vias ranging from 3 μm to 80 μm in width were etched in a buffered oxide etch solution (BOE, HF:NHF = 3:2) at 80 °C for prolonged etching (>95 min). It was found that a larger hard mask width resulted in a smaller undercut, and a 30 μm difference in hard mask width would result in a 17.2% increase in undercut. In particular, the undercuts were mainly formed in the first 5 min of etching with a relatively high etching rate of 0.7 μm/min (max). Then, the etching rate decreased rapidly to 27%. Furthermore, based on the etching width compensation and etching position compensation, new solutions were proposed for quartz crystal device fabrication. And these two kinds of compensation solutions were used in the fabrication of an ultra-small quartz crystal tuning fork with a resonant frequency of 32.768 kHz. With these approaches, the actual etched size of critical parts of the device only deviated from the designed size by 0.7%. And the pattern position symmetry of the secondary lithography etching process was improved by 96.3% compared to the uncompensated one. It demonstrated significant potential for improving the fabrication accuracy of quartz crystal devices.
PubMed: 38930754
DOI: 10.3390/mi15060784