Availability of published evidence on coverage, cost components, and funding support for digitalisation of infectious disease surveillance in Africa, 2003-2022: a systematic review.

BACKGROUND: The implementation of digital disease surveillance systems at national levels in Africa have been challenged by many factors. These include user applicability, utility of IT features but also stable financial support. Funding closely intertwines with implementations in terms of geographical reach, disease focus, and sustainability. However, the practice of evidence sharing on geographical and disease coverage, costs, and funding sources for improving the implementation of these systems on the continent is unclear. OBJECTIVES: To analyse the key characteristics and availability of evidence for implementing digital infectious disease surveillance systems in Africa namely their disease focus, geographical reach, cost reporting, and external funding support. METHODS: We conducted a systematic review of peer-reviewed and grey literature for the period 2003 to 2022 (PROSPERO registration number: CRD42022300849). We searched five databases (PubMed, MEDLINE over Ovid, EMBASE, Web of Science, and Google Scholar) and websites of WHO, Africa CDC, and public health institutes of African countries. We mapped the distribution of projects by country; identified reported implementation cost components; categorised the availability of data on cost components; and identified supporting funding institutions outside Africa. RESULTS: A total of 29 reports from 2,033 search results were eligible for analysis. We identified 27 projects implemented in 13 countries, across 32 sites. Of these, 24 (75%) were pilot projects with a median duration of 16 months, (IQR: 5-40). Of the 27 projects, 5 (19%) were implemented for HIV/AIDs and tuberculosis, 4 (15%) for malaria, 4 (15%) for all notifiable diseases, and 4 (15%) for One Health. We identified 17 cost components across the 29 reports. Of these, 11 (38%) reported quantified costs for start-up capital, 10 (34%) for health personnel compensation, 9 (31%) for training and capacity building, 8 (28%) for software maintenance, and 7(24%) for surveillance data transmission. Of 65 counts of external funding sources, 35 (54%) were governmental agencies, 15 (23%) foundations, and 7 (11%) UN agencies. CONCLUSIONS: The evidence on costing data for the digitalisation of surveillance and outbreak response in the published literature is sparse in quantity, limited in detail, and without a standardised reporting format. Most initial direct project costs are substantially donor dependent, short lived, and thus unsustainable.

Digital advance care planning with severe mental illness: a retrospective observational cohort analysis of the use of an electronic palliative care coordination system.

BACKGROUND: People living with severe mental illness (SMI) face significant health inequalities, including in palliative care. Advance Care Planning (ACP) is widely recommended by palliative care experts and could reduce inequalities. However, implementing ACP with this group is challenging. Electronic Palliative Care Coordination Systems such as Coordinate my Care (CMC) have been introduced to support documentation and sharing of ACP records with relevant healthcare providers. This study explores the use of CMC amongst those with SMI and aims to describe how those with a primary diagnosis of SMI who have used CMC for ACP, and makes recommendations for future research and policy. METHOD: A retrospective observational cohort analysis was completed of CMC records created 01/01/2010-31/09/2021 where the service user had a primary diagnosis of SMI, with no exclusions based on comorbidities. Descriptive statistics were used to report on characteristics including: age, diagnosis, individual prognosis and resuscitation status. Thematic analysis was used to report on the content of patients' statements of preference. RESULTS: 1826 records were identified. Of this sample most (60.1%) had capacity to make treatment decisions, 47.8% were aged under 70, 86.7% were given a prognosis of 'years' and most (63.1%) remained for full cardio-pulmonary resuscitation in the event of cardio-pulmonary arrest. Records with completed statements of preferences (20.3%) contained information about preferences for physical and mental health treatment care as well as information about patient presentation and capacity, although most were brief and lacked expression of patient voice. DISCUSSION: Compared to usual CMC users, the cohort of interest are relatively able, younger people using CMC to make long-term plans for active physical and mental health treatment. ADM is a service user-driven process, and so it was expected that authentic patient voice would be expressed within statements of preference, however this was mostly not achieved. CONCLUSIONS: This digital tool is being used by people with SMI but to plan for more than palliative care. This cohort and supporting professionals have used CMC to plan for longer term physical and mental healthcare. Future research and policy should focus on development of tailored digital tools for people with SMI to plan for palliative, physical and mental healthcare and support expression of patient voice.

Implementing digital systems to facilitate genetic testing for hereditary cancer syndromes: An observational study of 4 clinical workflows.

PURPOSE: National efforts have prioritized the identification of effective methods for increasing case ascertainment and delivery of evidence-based health care for individuals at elevated risk for hereditary cancers. METHODS: This study examined the uptake of genetic counseling and testing following the use of a digital cancer genetic risk assessment program implemented at 27 health care sites in 10 states using 1 of 4 clinical workflows: (1) traditional referral, (2) point-of-care scheduling, (3) point-of-care counseling/telegenetics, and (4) point-of-care testing. RESULTS: In 2019, 102,542 patients were screened and 33,113 (32%) were identified as at high risk and meeting National Comprehensive Cancer Network genetic testing criteria for hereditary breast and ovarian cancer, Lynch syndrome, or both. Among those identified at high risk, 5147 (16%) proceeded with genetic testing. Genetic counseling uptake was 11% among the sites with workflows that included seeing a genetic counselor before testing, with 88% of patients proceeding with genetic testing after counseling. Uptake of genetic testing across sites varied significantly by clinical workflow (6% referral, 10% point-of-care scheduling, 14% point-of-care counseling/telegenetics, and 35% point-of-care testing, P < .0001). CONCLUSION: Study findings highlight the potential heterogeneity of effectiveness attributable to different care delivery approaches for implementing digital hereditary cancer risk screening programs.

Teaching Digital Electronics during the COVID-19 Pandemic via a Remote Lab.

Practical knowledge is essential for engineering education. With the COVID-19 pandemic, new challenges have arisen for remote practical learning (e.g., collaborations/experimentations with real equipment when face-to-face offerings are not possible). In this context, LabEAD is a remote lab project that aims to provide practical knowledge learning opportunities for Brazilian engineering students. This article describes how engineering project management methods consisting of application domains, requirement identification, technical solution specification, implementation, and delivery phases, were applied to the development of an Internet of Things (IoT) remote lab architecture. The distributed computing environment allows integration between students' smartphones and IoT devices deployed in campus labs and in student residences. The code is open-source for facilitated replication and reuse, and the remote lab was built in six months to enable six experiments for the digital electronics lab during the COVID-19 pandemic, covering all the experiments of the original face-to-face offering. More than 70% of the 32 students preferred remote labs over simulations, and only 2 were not approved in the digital electronics course offered remotely.Student perceptions collected by questionnaires showed that they could successfully specify, develop, and present their projects using the remote lab infrastructure in four weeks.

Next-Generation Personalized Medicine: Implementation of Variability Patterns for Overcoming Drug Resistance in Chronic Diseases.

Chronic diseases are a significant healthcare problem. Partial or complete non-responsiveness to chronic therapies is a significant obstacle to maintaining the long-term effect of drugs in these patients. A high degree of intra- and inter-patient variability defines pharmacodynamics, drug metabolism, and medication response. This variability is associated with partial or complete loss of drug effectiveness. Regular drug dosing schedules do not comply with physiological variability and contribute to resistance to chronic therapies. In this review, we describe a three-phase platform for overcoming drug resistance: introducing irregularity for improving drug response; establishing a deep learning, closed-loop algorithm for generating a personalized pattern of irregularity for overcoming drug resistance; and upscaling the algorithm by implementing quantified personal variability patterns along with other individualized genetic and proteomic-based ways. The closed-loop, dynamic, subject-tailored variability-based machinery can improve the efficacy of existing therapies in patients with chronic diseases.

Analysis of the Challenges of Artificial Intelligence of Things (AIoT) for the Smart Supply Chain (Case Study: FMCG Industries).

In today's competitive world, supply chain management is one of the fundamental issues facing businesses that affects all an organization's activities to produce products and provide services needed by customers. The technological revolution in supply chain logistics is experiencing a significant wave of new innovations and challenges. Despite the current fast digital technologies, customers expect the ordering and delivery process to be faster, and as a result, this has made it easier and more efficient for organizations looking to implement new technologies. "Artificial Intelligence of Things (AIoT)", which means using the Internet of Things to perform intelligent tasks with the help of artificial intelligence integration, is one of these expected innovations that can turn a complex supply chain into an integrated process. AIoT innovations such as data sensors and RFID (radio detection technology), with the power of artificial intelligence analysis, provide information to implement features such as tracking and instant alerts to improve decision making. Such data can become vital information to help improve operations and tasks. However, the same evolving technology with the presence of the Internet and the huge amount of data can pose many challenges for the supply chain and the factors involved. In this study, by conducting a literature review and interviewing experts active in FMCG industries as an available case study, the most important challenges facing the AIoT-powered supply chain were extracted. By examining these challenges using nonlinear quantitative analysis, the importance of these challenges was examined and their causal relationships were identified. The results showed that cybersecurity and a lack of proper infrastructure are the most important challenges facing the AIoT-based supply chain.

Component placement accuracy of two digital intraoperative fluoroscopy supplementation systems in direct anterior total hip arthroplasty.

INTRODUCTION: Intraoperative fluoroscopy (IF) may increase accuracy of component placement when performing direct anterior approach total hip arthroplasty (THA), however, unguided IF continues to produce inconsistent results. Supplementation of IF, with a digital grid (Grid) system or digital overlay (Overlay), may increase component placement accuracy. The purpose of this study was to compare component placement accuracy following THA when IF was supplemented with the Grid or Overlay technique. MATERIALS AND METHODS: Acetabular abduction and anteversion, with leg length discrepancy (LLD) and global hip offset (GHO) were retrospectively evaluated for unilateral and bilateral THA patients from 6-week post-operative radiographs. Target component placement were GHO and LLD < 10 mm, abduction 45° ± 10° and anteversion 15° ± 10° for Overlay and 17° ± 10° for Grid. Differences between the Overlay and Grid were determined by univariate analyses. RESULTS: The Overlay and Grid groups included 178 patients (217 hips) and 262 patients (317 hips), respectively. Target placement with the Overlay and Grid was achieved for GHO in 98.3% and 95.7% of cases (p = 0.108), LLD in 100% and 98.4% of cases (p = 0.121), cup abduction in 98.2% and 97.4% of cases (p = 0.384), and cup anteversion in 97.7% and 71.1% of cases (p < 0.001), respectively. Surgical time was significantly longer in Overlay compared to Grid (Unilateral 77.5 ± 14.1 min and 68.8 ± 12.2; p < 0.001; Bilateral 184.6 ± 27.0 min and 165.5 ± 23.1; p < 0.001, respectively). CONCLUSION: Although no difference was found between the Grid and the Overlay cohorts for LLD, GHO or abduction angle, the Overlay resulted in greater accuracy for acetabular component anteversion angle, with only a slight decrease in surgical efficiency.

Improving Diuretic Response in Heart Failure by Implementing a Patient-Tailored Variability and Chronotherapy-Guided Algorithm.

Heart failure is a major public health problem, which is associated with significant mortality, morbidity, and healthcare expenditures. A substantial amount of the morbidity is attributed to volume overload, for which loop diuretics are a mandatory treatment. However, the variability in response to diuretics and development of diuretic resistance adversely affect the clinical outcomes. Morevoer, there exists a marked intra- and inter-patient variability in response to diuretics that affects the clinical course and related adverse outcomes. In the present article, we review the mechanisms underlying the development of diuretic resistance. The role of the autonomic nervous system and chronobiology in the pathogenesis of congestive heart failure and response to therapy are also discussed. Establishing a novel model for overcoming diuretic resistance is presented based on a patient-tailored variability and chronotherapy-guided machine learning algorithm that comprises clinical, laboratory, and sensor-derived inputs, including inputs from pulmonary artery measurements. Inter- and intra-patient signatures of variabilities, alterations of biological clock, and autonomic nervous system responses are embedded into the algorithm; thus, it may enable a tailored dose regimen in a continuous manner that accommodates the highly dynamic complex system.

Why Are Digital Health Care Systems Still Poorly Designed, and Why Is Health Care Practice Not Asking for More? Three Paths Toward a Sustainable Digital Work Environment.

Knowledge of how to design digital systems that are ergonomically sound, high in usability, and optimized for the user, context, and task has existed for some time. Despite this, there are still too many examples of new digital health care systems that are poorly designed and that could negatively affect both the work environment of health care staff and patient safety. This could be because of a gap between the theoretical knowledge of design and ergonomics and the practical implementation of this knowledge in procuring and developing digital health care systems. Furthermore, discussions of digitalization are often at a general level and risk neglecting the nature of direct interaction with the digital system. This is problematic since it is at this detailed level that work environment and patient safety issues materialize in practice. In this paper, we illustrate such issues with two scenarios concerned with contemporary electronic health care records, based on field studies in two health care settings. We argue that current methods and tools for designing and evaluating digital systems in health care must cater both to the holistic level and to the details of interaction and ergonomics. It must also be acknowledged that health care professionals are neither designers nor engineers, so expectations of them during the development of digital systems must be realistic. We suggest three paths toward a more sustainable digital work environment in health care: (1) better tools for evaluating the digital work environment in the field; (2) generic formulations of qualitative requirements related to usability and for adaptation to the user, context, and task, to be used in procurement; and (3) the introduction of digital ergonomics as an embracing concept capturing several of the ergonomic challenges (including physical, cognitive, and organizational aspects) involved in implementing and using digital systems.

Datasets from the evaluation of the adoption and use of digital technologies in China museums.

The datasets described in this article were collected as a result of 5 months of funded study, carried out between 23rd January 2017 and 30th May 2017 within China. The study evaluated the adoption and use of digital technologies such as Augmented Reality (AR), Virtual Reality (VR), Projection Displays, Interactive 2D (i2D), Interactive 3D (i3D), Mobile Exhibits, and any unexpected interactive devices in the miscellaneous category. The datasets were collected from 22 sites and China's national and local museums across 15 different cities from which 807 samples of observations were obtained. In total, 36 separate digital systems were observed. 21 variables related to the use of digital technologies mapping the length of interaction, engagement, quality of contents and types of systems, age groups, sexes, and the number of participants and whether they were individuals or in groups were collated in the datasets reported here.

Pruebas automatizadas a la electrónica en un sistema de detectores de microbandas para rayos x de energía dual / Automated testing of microstripdetectors readout system for x-ray dual energy

Para la radiografía digital se requieren circuitos que realicen la recepción y procesamiento de señales nucleares de múltiples canales simultáneamente. Estos circuitos se deben someter a pruebas para caracterizar su funcionamiento. En este trabajo se describen pruebas automatizadas para controlar por software desde una computadora personal la caracterización de un sistema basado en circuitos integrados específicos del tipo RX64DTH con detectores de microbandas y se muestran los resultados.

Circuits that carry out the signal acquisition and processing by multiple channels are required in digital radiography. These circuits should be tested in order to characterize their performance. This paper describes an automated system to control (by a software, from a personal computer) the characterization of a system based on RX64DTH specific integrated circuits with microstrip detectors. The results are shown.

O tutor em Educação a Distância: análise ergonômica das interfaces mediadoras / The tutor in Distance Learning: ergonomic analysis of mediating interfaces

Na Educação a Distância (EaD), o processo pedagógico pode ser mediado por aplicativos informatizados, muitas vezes utilizando a Internet como via de acesso. Essa mediação contribui para o aprimoramento da relação ensino-aprendizagem e estrutura o papel dos diferentes atores dessa relação. O objetivo do presente estudo é investigar o impacto do uso de ferramentas informatizadas na atividade dos tutores de cursos via Internet. A amostra foi composta por 4 tutores, com características distintas. Utilizou-se a Análise Ergonômica do Trabalho e foram realizadas entrevistas, análises de interação e observações, o que permitiu a elaboração de uma crônica da atividade dos tutores. Os resultados apontam a incerteza e variabilidade das demandas dos alunos e o impacto das ferramentas informatizadas na atividade. Discute-se a necessidade de compreender quem é o tutor na EaD, fornecendo parâmetros para a concepção de ferramentas que facilitem o trabalho.

In Distance Learning, the educational process can be mediated by digital systems, often using Internet as access medium. This mediation contributes to the enhancement of the teaching-learning relationship and structures the role of the different actors in it. This study's goal is investigating the impact of the use of digital tools in tutors' activities in online courses. The sample was defined by 4 tutors with distinct characteristics. Work Ergonomic Analysis was used, and interviews, interaction analysis and observations were made, which allowed the creation of a chronicle about the tutors' activities. The results points to the uncertainty and variability of the student's demands and the impact of the digital tools on the activity. The necessity of comprehending the tutor's role in D.L., giving parameters to the concept of tools that facilitate the work, is discussed.

The NIST Automated Computer Time Service.

The NIST Automated Computer Time Service (ACTS) is a telephone time service designed to provide computers with telephone access to time generated by the National Institute of Standards and Technology at accuracies approaching 1 ms. Features of the service include automated estimation by the transmitter of the telephone-line delay, advanced alert for changes to and from daylight saving time, and advanced notice of insertion of leap seconds. The ASCII-character time code operates with most standard modems and computer systems. The system can be used to set computer clocks and simple hardware can also be developed to set non-computer clock systems.