A study establishing sensitivity and accuracy of smartphone photography in ophthalmologic community outreach programs: Review of a smart eye camera

Purpose: Diseases affecting the cornea are a major cause of corneal blindness globally. The pressing issue we are facing today is the lack of diagnostic devices in rural areas to diagnose these conditions. The aim of the study is to establish sensitivity and accuracy of smartphone photography using a smart eye camera (SEC) in ophthalmologic community outreach programs. Methods: In this pilot study, a prospective non?randomized comparative analysis of inter?observer variability of anterior segment imaging recorded using an SEC was performed. Consecutive 100 patients with corneal pathologies, who visited the cornea specialty outpatient clinic, were enrolled. They were examined with a conventional non?portable slit lamp by a cornea consultant, and the diagnoses were recorded. This was compared with the diagnoses made by two other consultants based on SEC videos of the anterior segment of the same 100 patients. The accuracy of SEC was accessed using sensitivity, specificity, PPV, and NPV. Kappa statistics was used to find the agreement between two consultants by using STATA 17.0 (Texas, USA). Results: There was agreement between the two consultants to diagnosing by using SEC. Above 90% agreements were found in all the diagnoses, which were statistically significant (P?value < 0.001). More than 90% sensitivity and a negative predictive value were found. Conclusion: SEC can be used successfully in the community outreach programs like field visits, eye camps, teleophthalmology, and community centers, where either a clinical setup is lacking or ophthalmologists are not available.

CHALLENGES IN IMPLEMENTING SMART ENERGY METERS IN INDIA

Introduction: Smart Energy Meter (SEM) is an electronic device used to measure, record and transmit the consumption of electricity, gas or water. The smart energy meter is a vital component of a smart grid, which is an advanced power distribution infrastructure that uses digital communication technology to monitor, control and optimize the ow of electricity between power producers and consumers. India, like other developing countries, faces several challenges in the implementation of smart energy meters. This paper examines the challenges in implementing smart energy meters in India and proposes solutions to overcome these challenges.

Sustainable Urban Planning and Smart City Concept in Haryana

The aim of the present paper is to focus the Sustainable Urban Development or the Smart Cities in relation to Haryana in present Scenario. Sustainability can be defined as the practice of reserving resources for future generation without any harm to the nature and other components. In the recent years, Haryana has seen a natural progression in its development story. As the big villages turning into towns, and towns transforming into cities. But it's the time for the state to transform its cities into smart and sustainable cities for the smart urbanization. Though urbanization brings a lot of challenges that can act as a barrier to growth of urbanization or the smart cities. The people move to urban centers in such of jobs and employments and hopefully the better life. Urbanization is change of residence which is geographically expressed as mobility or migration resulted by a way of life called urbanism. It is the proven fact, that the trend has a straight correlation with growth.

Prevalence of smart phone addiction among medical students

Background: The use of smart phone is very common specially in young individuals. Excessive use leads to smart phone addiction, which may have harmful effect on the health of individuals. Aims and Objectives: The aim of our study is to assess the smart phone usage in 1st-year medical students. Materials and Methods: In this cross-sectional study, we have included 187 students from 1st-year MBBS. Out of which 125 (66.84%) are boys and 62 (33.16%) are girls in age group of 18–22 years. All the data were collected in Google form. We have used smart phone addiction scale long version. The Google form was filled by students who are willing to participate in this study. Result: We have found that out of total 187 students, 96 (51.34%) students having high smart phone use, out of which 68 (54.40%) are boys and 28 (45.16%) are girls while 91 (48.66%) students having low smart phone use, out of which 57 (45.60%) are boys and 34 (54.84%) are girls. Conclusion: The high smart phone usages present in the student can be prevented by specific intervention programs at college level.

Heart Smart Diabetes Care

The world is growing smarter day by day, and so is health care. In spite of innumerable inventions and tech-tools, however, we struggle to contain chronic illnesses like diabetes and heart disease. We need to work together and design a rational, scientific and socially sustainable Heart Smart diabetes care ecosystem, with Heart Smart management strategies, to ensure happiness and harmony in persons who live with diabetes.

Health Technology Use in Noncommunicable Disorders: Challenges and Opportunities in India

Health care in India is undergoing a rapid change from its historical focus on acute disease management to a focus more on chronic and continuous care-based model for noncommunicable disorders. Health technology could be a game changer as it has a potential to optimize costs and effectively manage such operations. IT solutions are likely to become an integral part of process management, patient care and the hospital management information system in future. This brief communication describes the key enablers and limitations of using health technology in chronic diseases in developing countries like India.

Heart Smart Diabetes Care

The world is growing smarter day by day, and so is health care. In spite of innumerable inventions and tech-tools, however, we struggle to contain chronic illnesses like diabetes and heart disease. We need to work together and design a rational, scientific and socially sustainable Heart Smart diabetes care ecosystem, with Heart Smart management strategies, to ensure happiness and harmony in persons who live with diabetes.

Application of electronic head-mounted display aids in low vision rehabilitation / 中华实验眼科杂志

As society ages and the number of people with low vision grows, the need for low vision rehabilitation for patients is increasing.The electronic head-mounted display (HMD) aids is a new type of low vision aids, which can be divided into different types such as monocular, binocular, virtual reality (VR) and augmented reality (AR). The performance of electronic HMD visual aids is important in their development and evaluation, including improved illumination, contrast ratio, resolution, and expanded vision field.VR devices have higher resolution and richer image modes, which can effectively improve central vision acuity and contrast sensitivity, and are more suitable for static applications.AR devices do not block the patients' habitual field of vision and do not destroy stereoscopic vision, which are more suitable for dynamic applications.With the development of VR and AR display technology in recent years, electronic HMD aids have made great progress in functionality, portability and aesthetics.In most of the research, the application population of electronic HMD aids are patients with low central vision.Electronic HMD aids can improve their visual acuity, contrast sensitivity and reading ability by enlarging pictures, improving illumination and contrast ratio and enhancing contour.For patients with peripheral visual field defects, electronic HMD aids, especially AR devices, can significantly expand their peripheral visual field without blocking original visual field.However, the improvement of electronic HMD aids on daily activities, especially athletic ability, needs further research.This article summarized the types, performance and application progress of electronic HMD aids in patients with low vision.

Comparison of early postoperative visual quality between SMILE and SPT-TransPRK / 中华实验眼科杂志

Objective:To investigate the differences and changes in early postoperative visual quality after small incision lenticule extraction (SMILE) and smart pulse technology-assisted transepithelial photorefractive keratectomy (SPT-TransPRK).Methods:A cohort study was performed.A total of 92 patients (92 eyes) who underwent corneal laser refractive surgery were enrolled in Dalian Third People's Hospital Affiliated to Dalian Medical University from February 2021 to May 2021.The data from the right eye were collected for analysis.The patients were divided into SMILE group (40 patients, 40 eyes) and SPT-TransPRK group (52 patients, 52 eyes). Preoperative, 1- and 3-month postoperative visual acuity were measured to calculate the effectiveness, which was defined as the ratio of postoperative uncorrected visual acuity (UCVA) to preoperative best corrected visual acuity.Refraction was measured by an AR-1 autorefractor.Corneal higher-order aberration (HOA) including total HOA, spherical aberration and coma was measured by Sirius corneal topographer.Objective scatter index (OSI), modulation transfer function cut-off frequency (MTF cut-off), Strehl ratio (SR), simulated contrast visual acuity VA100 (day), VA20 (dusk) and VA9 (night) were measured via OQAS II visual quality analysis system.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Dalian Third People's Hospital Affiliated to Dalian Medical University (No.2019-KT-010). Written informed consent was obtained from each subject.Results:There was no significant difference in 3-month postoperative UCVA and effectiveness between the two groups ( Z=0.880, P=0.380; t=0.920, P=0.058). Patients in SPT-TransPRK group showed mild hyperopia 3 months after surgery.Preoperative, 1- and 3-month postoperative total corneal HOA was (0.47±0.18), (0.70±0.22) and (0.74±0.19)μm in SMILE group, and (0.40±0.14), (0.98±0.35) and (0.94±0.22)μm in SPT-TransPRK group respectively, showing statistically significant differences ( Fgroup=13.851, P=0.001; Ftime=29.960, P<0.001). Preoperative, 1- and 3-month postoperative spherical aberration was (-0.20±0.09), (-0.44±0.14) and (-0.44±0.15)μm in SMILE group, and (-0.20±0.10), (-0.71±0.23) and (-0.75±0.20)μm in SPT-TransPRK group respectively, showing statistically significant differences ( Fgroup=31.037, P<0.001; Ftime=48.005, P<0.001). The postoperative total corneal HOA and spherical aberration were increased in both groups compared with before surgery, with statistically significant differences (all at P<0.05). The 1- and 3-month postoperative total corneal HOA and spherical aberrations were smaller in SMILE group than in SPT-TransPRK group, and the differences were statistically significant (all at P<0.05). The 1- and 3-month postoperative coma were increased in both groups compared with before surgery, showing statistically significant differences (all at P<0.05). In SMILE group, 1-month postoperative OSI was higher and 1-month postoperative MTF cut-off, SR, and VA9 were lower than those before surgery, and 3-month postoperative OSI was higher and 3-month postoperative SR and VA9 were lower than those before surgery, showing statistically significant differences (all at P<0.05). In SPT-TransPRK group, 1-month postoperative OSI was higher and 1-month postoperative MTF cut-off, SR, VA100, VA20, and VA9 were lower than those before surgery, showing statistically significant differences (all at P<0.05). There was no significant difference in OSI, MTF cut-off, SR, VA100, VA20, and VA9 between 3 months postoperatively and before surgery in the SPT-TransPRK group (all at P>0.05). There was no significant difference in coma, OSI, MTF cut-off, SR, VA100, VA20, and VA9 between two groups (all at P>0.05). Conclusions:Both SMILE and SPT-TransPRK are effective methods for correcting myopia and they have comparable visual quality.Compared with SPT-TransPRK, corneal total HOA and spherical aberration are smaller after SMILE.

Evaluation of the effect of the traditional ward wisdom upgrade based on the Internet of Things platform / 中国实用护理杂志

Objective:To upgrade the wisdom of traditional wards through the internet of things platform to achieve intelligent and refined management of wards, and to evaluate the effect of the upgrade.Methods:In June 2020, the convenience sampling method was used to selecte two wards of the cardiology department of Shandong First Medical University as the pilot units of the affiliated provincial Hospital to implement the intelligent ward management mode. Based on the principle of easy transformation, easy construction and easy maintenance, on the basis of realizing the full coverage of the internet of things, the hardware and software system were connected to complete the intelligent upgrade of the traditional ward, and the structured observation and semi-structured interview methods were adopted to evaluate the upgraded work efficiency and the use experience of patients.Results:The time spent on vital sign collection and recording, nursing risk assessment and time spent, and signage production and hanging were (4.24 ± 0.87), (4.07 ± 0.86) and 0 min respectively, which were effectively reduced than those before the upgrade (6.50 ± 2.95), (4.73 ± 1.62) and (1.13 ± 0.43) min, with statistically significant differences ( t=8.04, 3.99, 28.96, all P<0.01). The results of semi-structured interviews showed that patients perceived the smart ward as intelligent, saving manpower and waiting time; simple to operate, improving the experience of healthcare workers and patients in using it; and untimely system updates. Conclusions:The wisdom upgrade of traditional wards can help refine patient management, improve work efficiency, and improve the experience of health care workers and patients in using them, which will be continuously improved in future development and can provide practical paths for reference for the wisdom upgrade of similar wards.

Comparison of visual quality after refractive surgery between smart pulse technology-assisted transepithelial photorefractive keratectomy of 1 050Hz ablation frequency and small incision lenticule extraction / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the visual quality between smart pulse technology-assisted(SPT)transepithelial photorefractive keratectomy(TransPRK)of 1 050Hz ablation frequency and small incision lenticule extraction(SMILE)for myopia and astigmatism.METHODS: A total of 138 cases(248 eyes)who received corneal refractive surgery in the Eye Hospital of Chengdu University of TCM were enrolled from July 2020 to January 2021. The patients were divided into TransPRK group(64 cases, 123 eyes)and SMILE group(74 cases, 125 eyes)according to the surgical method. The follow-up duration was 6mo. Strehl ratio(SR)and high-order aberration at 6mm pupil diameter measured by Sirius anterior segment integrated analyzer and LogMAR visual acuity were recorded at different preoperative and postoperative time points.RESULTS: The uncorrected visual acuity(UCVA)of TransPRK group was worse than SMILE group at 1wk and 1mo after surgery(all P<0.05), but UCVA was better in TransPRK group at 6mo after surgery(P<0.05). SR in TransPRK group was lower than that in SMILE group at 1wk and 1mo after surgery(all P<0.05). There was no significant difference in SR between the two groups at 3 and 6mo after surgery(P=0.968, 0.433). At 1wk after surgery, there was no significant difference in coma between the two groups(P=0.554). At 1, 3, and 6mo after surgery, coma in the TransPRK group was lower than that in SMILE group(all P<0.05). At 1wk, 1 and 3mo after surgery, the trefoil aberration in TransPRK group was higher than that in SMILE group(all P<0.05). At 6mo after surgery, there was no significant difference in trefoil aberration between the two groups(P=0.167). At 6mo after surgery, UCVA of TransPRK group and SMILE group were -0.13±0.05 and -0.11±0.08, respectively, which were better than the best corrected visual acuity(BCVA)before surgery(-0.07±0.05 and -0.07±0.05; all P<0.05). Furthermore, the SR of both groups was higher than that before surgery(all P<0.05).CONCLUSION: Both SPT-assisted TransPRK of 1 050Hz ablation frequency and SMILE can achieve better visual acuity after refractive surgery, while SMILE has better visual quality at 1wk and 1mo after surgery. However, SPT-assisted TransPRK of 1 050Hz ablation frequency has better visual acuity at 6mo after surgery than SMILE, and the coma is smaller.

Development of shared traditional Chinese medicine pharmacy from the perspective of primary medical care / 中国药房

In order to make the shared traditional Chinese medicine （TCM） pharmacy develop more efficiently and normatively at the grass-roots level， using the “shared TCM pharmacy” as the retrieval word， this paper uses the literature research method to retrieve the reports， documents and policies from CNKI， the websites of people’s governments at all levels， the official websites of the State Administration of Traditional Chinese Medicine， people.com， China News Network， Xinhua News and other platforms before May 20， 2022， sort out the development mode and history of two “Internet plus” TCM pharmacies， namely “shared TCM pharmacies” and “smart TCM pharmacies”， and compare them with each other. Combined with the actual work of community hospitals and community service centers （stations）， the necessity and advantages （such as reducing the costs of the intermediate links of drug circulation and standardizing the grass-roots drug use process） of the development of “shared TCM pharmacy” are obtained from the perspective of primary medical care. Combined with the current situation of the promotion and application of shared TCM pharmacy in county medical communities， it is concluded that the shared TCM pharmacy should be further constructed from four aspects： improving the work process of drug centralized procurement under the background of normalization， improving the compatibility and synchronization of the whole process dispensing information system module， unifying pharmaceutical services and personnel training， defining the authority of data query and clarifying the boundaries of patient privacy to further build a shared TCM pharmacy. Finally， it integrates information technology， summarizes the definition of shared TCM pharmacy and its future construction direction， and provides reference for the next development of shared TCM pharmacy at the grass-roots level.

Data-driven engineering framework with AI algorithm of Ginkgo Folium tablets manufacturing

Smart manufacturing still remains critical challenges for pharmaceutical manufacturing. Here, an original data-driven engineering framework was proposed to tackle the challenges. Firstly, from sporadic indicators to five kinds of systematic quality characteristics, nearly 2,000,000 real-world data points were successively characterized from Ginkgo Folium tablet manufacturing. Then, from simplex to the multivariate system, the digital process capability diagnosis strategy was proposed by multivariate Cpk integrated Bootstrap-t. The Cpk of Ginkgo Folium extracts, granules, and tablets were discovered, which was 0.59, 0.42, and 0.78, respectively, indicating a relatively weak process capability, especially in granulating. Furthermore, the quality traceability was discovered from unit to end-to-end analysis, which decreased from 2.17 to 1.73. This further proved that attention should be paid to granulating to improve the quality characteristic. In conclusion, this paper provided a data-driven engineering strategy empowering industrial innovation to face the challenge of smart pharmaceutical manufacturing.

Design and Research of Wearable Fall Protection Device for the Elderly / 中国医疗器械杂志

A protective device was designed that can be worn on the elderly, which consists of protective airbag, control box and protective mechanism. The combined acceleration, combined angular velocity and human posture angle are selected as the parameters to determine the fall, and the threshold algorithm and SVM algorithm are used to detect the fall. The protective mechanism is an inflatable device based on CO2 compressed air cylinder, and the equal-width cam structure is applied to its transmission part to improve the puncture efficiency of the compressed gas cylinder. A fall experiment was designed to obtain the combined acceleration and angular velocity eigenvalues of fall actions (forward fall, backward fall and lateral fall) and daily activities (sitting-standing, walking, jogging and walking up and down stairs), showing that the specificity and sensitivity of the protection module reached 92.1% and 84.4% respectively, which verified the feasibility of the fall protection device.

A segurança como fator-chave para a cidade inteligente, a confiança dos cidadãos e o uso de tecnologias / La seguridad como factor clave para la ciudad inteligente, la confianza de los ciudadanos y el uso de las tecnologías / Security as a key factor for the smart city, citizens' trust, and the use of technologies

Resumo As cidades inteligentes vêm crescendo ao redor do mundo, impulsionadas por inovações tecnológicas. Com elas surgem diversas oportunidades, mas também novas ameaças à segurança e privacidade do usuário nessa realidade interconectada. Este estudo tem como objetivo investigar a percepção de segurança e confiança na tecnologia por parte dos cidadãos e como esta afeta a propensão ao seu uso e, consequentemente, à vida na cidade inteligente. Para tanto, conduziu-se um survey (n = 601), por meio do método PLS-SEM, para testar as hipóteses formuladas. Os resultados obtidos confirmam que o modelo proposto demonstra ser consistente. As relações "confiança e segurança subjetiva" e "segurança objetiva e privacidade de dados" obtiveram relações mais consistentes, assegurando a forte influência das barreiras "tangíveis" e "intangíveis" da percepção de segurança. Dessa forma, para obter e manter a confiança dos usuários, as instituições por trás da tecnologia precisam estar atentas à opinião deles e da sociedade, de forma a manter uma boa reputação para que possam, assim, perpetuar uma percepção positiva de segurança. Conclui-se, assim, que o conceito de segurança adquire uma nova dimensão no contexto da cidade inteligente por ser um componente crucial para toda a sua base e estar intimamente ligado à tecnologia, além de se apresentar como uma preocupação fundamental para os governos e as entidades que buscam implementar soluções e aplicações do conceito.

Resumen Las ciudades inteligentes están creciendo en todo el mundo, impulsadas por las innovaciones tecnológicas. Con ellas surgen diversas oportunidades, pero también nuevas amenazas a nuestra seguridad y privacidad en esta realidad interconectada. Este estudio tiene como objetivo investigar la percepción de los ciudadanos sobre la seguridad y la confianza en las tecnologías y cómo afectan la propensión a usarlas y, en consecuencia, la vida en la ciudad inteligente. Para ello, se realizó una encuesta (n = 601) utilizando el método PLS-SEM para contrastar las hipótesis formuladas. Los resultados obtenidos confirman que el modelo propuesto resulta ser consistente. Las relaciones 'confianza y seguridad subjetiva' y 'seguridad objetiva y privacidad de datos' obtuvieron relaciones más consistentes, confirmando la fuerte influencia de las barreras 'tangibles' e 'intangibles' de la percepción de seguridad. De esta forma, para obtener y mantener la confianza de los usuarios, las instituciones que están detrás de las tecnologías deben estar atentas a su opinión y a la de la sociedad a los efectos de mantener una buena reputación, para que puedan, así, mantener una percepción positiva de la seguridad. Se concluye que el concepto de seguridad adquiere una nueva dimensión en el contexto de la ciudad inteligente, ya que es un componente crucial de toda su base, estrechamente vinculado a la tecnología además de presentarse como una preocupación fundamental para los gobiernos y entidades que buscan implementar soluciones conceptuales y aplicaciones.

Abstract Smart cities are growing around the world, driven by technological innovations. With them come several opportunities and new threats to our security and privacy in this interconnected reality. This study investigates citizens' perception of security and trust in technologies and how they affect the propensity to use them and, consequently, life in the smart city. Therefore, a survey was conducted (n = 601) using the PLS-SEM method to test the formulated hypotheses. The results obtained confirm that the proposed model proves to be consistent. The relationships between 'trust and subjective security' and 'objective security and data privacy' obtained stronger relationships, confirming the strong influence of the 'tangible' and 'intangible' barriers of the perception of security. Thus, to obtain and maintain users' trust, the institutions behind the technologies need to be attentive to the opinion of their users and society to keep a good reputation and a positive perception of security. The users' opinion is a crucial component of smart cities' entire base, closely linked to technology, and presents as a fundamental concern for governments and entities that seek to implement concept solutions and applications.

In vitro activity of imipenem/relebactam against non-Morganellaceae Enterobacterales and Pseudomonas aeruginosa in Latin America: SMART 2018‒2020

Abstract Carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa are being isolated from patient specimens with increasing frequency in Latin America and worldwide. The current study provides an initial description of the in vitro activity of imipenem/relebactam (IMR) against non-Morganellaceae Enterobacterales (NME) and P. aeruginosa infecting hospitalized patients in Latin America. From 2018 to 2020, 37 clinical laboratories in nine Latin American countries participated in the SMART global surveillance program and contributed 15,466 NME and 3408 P aeruginosa isolates. MICs for IMR and seven comparators were determined using CLSI broth microdilution and interpreted by CLSI M100 (2022) breakpoints. β-lactamase genes were identified in selected isolate subsets. IMR (96.9% susceptible), amikacin (95.9%), meropenem (90.7%), and imipenem (88.7%) were the most active agents against NME. Among piperacillin/tazobactam-nonsusceptible NME (n= 4124), 90.4% of isolates were IMR-susceptible (range by country, 97.2 [Chile] to 67.0% [Guatemala]) and among meropenem-nonsusceptible NME isolates (n= 1433), 74.0% were IMR-susceptible (94.1% [Puerto Rico] to 5.1% [Guatemala]). Overall, 6.3% of all collected NME isolates carried a KPC (metallo-β-lactamase [MBL]-negative), 1.8% an MBL, 0.4% an OXA-48-like carbapenemase (MBL-negative), and 0.1% a GES carbapenemase (MBL-negative). Amikacin (85.2% susceptible) and IMR (80.1%) were the most active agents against P. aeruginosa; only 56.5% of isolates were imipenem-susceptible. Relebactam increased susceptibility to imipenem by 22.0% (from 23.9% to 45.9%) in piperacillin/tazobactam-nonsusceptible isolates (n= 1031) and by 35.5% (from 5.5% to 41.0%) in meropenem-nonsusceptible isolates (n= 1128). Overall, 7.6% of all collected P. aeruginosa isolates were MBL-positive and 0.7% carried a GES carbapenemase. In conclusion, in 2018‒2020, almost all NME (97%) and most P. aeruginosa(80%) isolates from Latin America were IMR-susceptible. Continued surveillance of the in vitro activities of IMR and comparator agents against Gram-negative pathogens, and monitoring for β-lactamase changes (in particular for increases in MBLs), is warranted.

A case report on SMART-EST action plan with lifestyle medicine approach in the non-pharmacologic management of the metabolic syndrome

@#Obesity and overweight are considered health risks for non-communicable diseases. Most clinical practice guidelines suggest lifestyle modification as the primary management and as an adjunct to pharmacologic treatment. Using the SMART-EST goaloriented action plan and lifestyle medicine may improve weight reduction outcomes. The case presented had clinical criteria (3/5) for metabolic syndrome, diagnosed previously as obese stage II, asthma moderately uncontrolled, prediabetes, and mild dyslipidemia. Baseline weight and waist-to-hip ratio were taken and interpreted as obese stage II with a very severe risk for comorbidity. The diagnostics used were fasting plasma glucose, lipid profile, HbA1c, and 2-D echocardiography on the eight months of intervention only. Using the SMART-EST action plan plus Lifestyle medicine approaches as non-pharmacologic management for metabolic syndrome. There was an 11.4 % reduction in weight, improved fasting glucose, lipid profile, and 2-D echocardiography within the eight months of intervention.

Smart Phone Chat Apps for Teaching and Assessment in Orthopaedic Residency Training

@#Introduction: Smart Phone Chat Apps (SPCA) is an integral part of people’s daily routine including orthopaedic education. SPCA facilitates efficient communication and learner-based management especially now as remote flexible learning is becoming the new norm in this COVID-19 pandemic medical training. The study described the use of a chat app (Viber) as experienced by residents and consultants in the Section of Adult Orthopaedics of the institution of the principal author. It described the mode and dynamics of the chat discussion amongst its participants, its perceived usefulness in teaching and learning specifically its relevance and applicability, its potential as a supplementary assessment tool, as well as its perceived effects. Materials and methods: This is a phenomenological study and strictly adhered to data privacy. The principal author conducted a participant observation of residents’ threemonth clinical rotation at the study site. Mobile phone screenshots of the chat interactions and focus group discussions with consultants and residents were done. Residents were also requested to complete a questionnaire. All qualitative data were iteratively content analysed and emerging themes were summarised using NViVO-12. Frequencies and percentage distribution were used to analyse quantitative data. Results: Respondents included eleven senior, four junior residents, and nine consultants. Results show that SPCA is a useful, applicable, and relevant teaching and assessment tool. Influxes of multiple ideas per case were discussed realtime as the chat exchanges and interactions helped in the planning of the surgical management and eventual decisionmaking. SPCA also served as an effective surgical case log and online library, as well as an efficient, rapid, economical mode of information dissemination. The residents reported that it helped in developing their emotional maturity through self-reflection and self-criticism in the performance of their cases. The consultants concurred and added that they too were updated professionally in certain fields in orthopaedics. Conclusion: The SPCA is a helpful, relevant, and acceptable adjunct teaching and learning tool for clinical teaching and can be, to a certain extent, a supplementary formative assessment tool of the resident’s communication skills, work ethics, initiative, and diligence.

Construction of an electronic medical record sharing convenience service platform based on blockchain / 中华医院管理杂志

Blockchain technology has the advantages of decentralization, secure sharing and tamper resistance, and high privacy, which can solve the current problem of sharing electronic medical records in medical institutions in China. A tertiary hospital established an electronic medical record sharing services convenience service platform based on blockchain in collaboration with China mobile gansu company in September 2021. The hardware architecture of the platform consisted of a hospital data warehouse, a local front-end computer and a blockchain platform. The functional architecture included platform front-end services, the blockchain electronic medical record archiving and service platform. The technical architecture included the underlying blockchain, service layer, interface layer and application layer, which was embedded with asymmetric encryption technology, hash algorithm, smart contract and other technical means, ensuring data ownership and on-demand, controllable, real-time and secure sharing of data. Since the operation of the platform in September 2021, as of October 2022, a tertiary hospital had accumulated 21 545 patient medical records on the chain. The overall operation of the platform was smooth, achieving reliable storage and secure sharing of patient electronic medical records, providing reference for further promoting the interconnection trusted sharing of electronic medical records in medical institutions in China.

Comparative study of nerve conduction parameters in peripheral nerves of upper limb (dominant hand) in mobile users with different usage time and type

Background: With the advancement in digital world, but smart phone usage has increased among all age groups but youngsters are involved in heavy gaming on smart phones which has led to increased risk of ill-effects especially on eyes and hands. Aim and Objectives: The study was designed to study the ill-effects of excessive usage if smart phones on peripheral nerves of hands especially of dominant hand among young adults. Materials and Methods: Nerve conduction study was performed on 100 young adults who were divided into three groups on the basis of mobile usage time. Nerve conduction velocities as well as distal latencies of motor and sensory nerves of the dominant hand were measured among different groups. Results: One-way ANOVA test was applied to study the results among different groups. Although no significant difference in conduction velocity or latency was observed in motor or sensory nerves among three groups, Ulnar sensory conduction velocity has been found to be slow as well as distal latency was found to be prolonged in third group with heavy usage of smart phones as compared to other groups. Conclusion: The reason for the above results could be due to less usage time in hours as well as in years due to which no significance differences were observed in conduction velocity/distal latency in our study. Hence, further studies are suggested with more sample size and more usage time in terms of years as well as in hours.