Unraveling a blockchain-based framework towards patient empowerment: A scoping review envisioning future smart health technologies.

The COVID-19 pandemic shows us how crucial patient empowerment can be in the healthcare ecosystem. Now, we know that scientific advancement, technology integration, and patient empowerment need to be orchestrated to realize future smart health technologies. In that effort, this paper unravels the Good (advantages), Bad (challenges/limitations), and Ugly (lacking patient empowerment) of the blockchain technology integration in the Electronic Health Record (EHR) paradigm in the existing healthcare landscape. Our study addresses four methodically-tailored and patient-centric Research Questions, primarily examining 138 relevant scientific papers. This scoping review also explores how the pervasiveness of blockchain technology can help to empower patients in terms of access, awareness, and control. Finally, this scoping review leverages the insights gleaned from this study and contributes to the body of knowledge by proposing a patient-centric blockchain-based framework. This work will envision orchestrating three essential elements with harmony: scientific advancement (Healthcare and EHR), technology integration (Blockchain Technology), and patient empowerment (access, awareness, and control).

Modeling and Validation of Vertical Direction Force Estimation with a Three-Dimensional Force Measurement Instrument Based on a Zero-Compliance Mechanism.

The principle of a zero-compliance mechanism was used to develop a three-dimensional force measurement instrument. In each axis, the point of force is suspended by a zero-compliance mechanism. A vertical axis force estimation operation imitates the structure of a double series magnetic suspension system. An electromagnet directly controls the movement of the first suspended object (floator), which is denoted as a detection point, and indirectly controls the motion of the second floator, which is denoted as a point of force. Indirect control of the point of force is executed by the attractive force of a permanent magnet that is fixed to the bottom part of the detection point. To achieve zero-compliance, a Proportional-Integral-Derivative (PID) control is applied to the point of force, and to make the system stable, a Proportional-Derivative (PD) control is also applied to the detection point. In such suspension conditions, when force is exerted on the point of force, the displacement of the second floator is regulated to maintain its primary position while the detection point displaces in proportion to the applied force. Thus, a zero-compliance condition is maintained at the point of force, and the external force is measured from the linear displacement of the detection point. To restrict the motions of the detection point and the point of force in translation only, they are supported with leaf springs. This paper presents the modeling of the vertical direction force measurement operation of the developed three-axis force estimation instrument, and the theoretical analyses were validated by experiments of force measurement in both the millinewton and micronewton ranges.

Las aguas y sedimentos del río tunecino Hamdoun presentan riesgo de disrupción endocrina / Water and sediment waste rejected in Hamdoun’sriver are major endocrine disrupting system

Diversos estudios recientes sostienen que muchos productos químicos antropogénicos, presentes en el medio ambiente, imitan la acción de hormonas endógenas. Estos disruptores endocrinos pueden originar múltiples efectos adversos en la fauna, como la feminización de peces, la pérdida de capacidad reproductiva, defectos congénitos y, a veces, pueden estar en el origen de algunos tipos de cáncer en el ser humano. La aparición de intersexos en peces de varios ríos europeos se ha atribuido a la exposición a sustancias químicas estrogénicas presentes en los efluentes de estaciones de tratamiento de aguas residuales. Para profundizar en el efecto ambiental de estos contaminantes, hemos investigado la actividad estrogénica, de receptor de hidrocarburo arílico y de receptor X de pregnano, de muestras de agua y sedimentos del río Hamdoun, tomadas aguas arriba y aguas abajo de la zona de vertidos procedentes del área industrial de la región central de Túnez. Mediante un ensayo in vitro de células cancerosas bioluminiscentes que expresan el gen de la luciferasa bajo el control de ciertos elementos con acción hormonal, hemos detectado escasa actividad estrogénica en agua y sedimentos por encima de la zona de vertidos; sin embargo, encontram os fuerte actividad es trogénica, de receptor de hidrocarburo arílico y de receptor X de pregnano en agua y s edimentos río abajo. Con experimentos de com petición demostramos que, predominantemente, las muestras de agua y de sedimentos con actividad estrogénica contienen compuestos con alta y baja afinidad con el ER " recombinante, respectivamente. Estos resultados indican que el agua del río y los sedimentos constituyen un importante sumidero y pueden ser fuente potencial de contaminantes disruptores endocrinos(AU)

In recent years, many studies supported that anthropogenic chemicals occurring in the environment have been shown to mimic the action of endogenous hormones. These endocrine-disrupting chemicals can potentially lead to a host of adverse effects on wildlife, such as the feminization of fish, the lack of reproduction success, birth defects and sometimes they can be the origin of some kind of cancers in human. The occurrence of intersex fish in a number of European rivers has been attributed to the exposure to estrogenic chemicals present in sewage treatment work effluents. To further understand the environmental effect of these contaminants, the estrogenic, aryl hydrocarbon receptor and pregnane X receptor activities of water and sediments were investigated in this study. The water and sediment samples were obtained from upstream and downstream outfalls of the Hamdoun River located in proximity of the industrial area in the centre region of Tunisia. Using an in vitro assay with bioluminescent cancer cells expressing luciferase gene under different hormonal responsive element control, we detected a much lower level of estrogenic activity in water and sediment upstream, however, we found out a strong estrogenic, aryl hydrocarbon receptor and pregnane X receptor activities in water and sediment downstream this river. By using competition experiments, we demonstrated that estrogenic activity found contained mainly compounds with a strong and lower affinitiy in water and sediment respectively with the recombinant ER ". These results suggest that the river water and sediments are a major sink and could be a potential source of endocrine-disrupting chemicals contaminants(AU)