An IoT-Based Data-Driven Real-Time Monitoring System for Control of Heavy Metals to Ensure Optimal Lettuce Growth in Hydroponic Set-Ups.

Heavy metal concentrations that must be maintained in aquaponic environments for plant growth have been a source of concern for many decades, as they cannot be completely eliminated in a commercial set-up. Our goal was to create a low-cost real-time smart sensing and actuation system for controlling heavy metal concentrations in aquaponic solutions. Our solution entails sensing the nutrient concentrations in the hydroponic solution, specifically calcium, sulfate, and phosphate, and sending them to a Machine Learning (ML) model hosted on an Android application. The ML algorithm used in this case was a Linear Support Vector Machine (Linear-SVM) trained on top three nutrient predictors chosen after applying a pipeline of Feature Selection methods namely a pairwise correlation matrix, ExtraTreesClassifier and Xgboost classifier on a dataset recorded from three aquaponic farms from South-East Texas. The ML algorithm was then hosted on a cloud platform which would then output the maximum tolerable levels of iron, copper and zinc in real time using the concentration of phosphorus, calcium and sulfur as inputs and would be controlled using an array of dispensing and detecting equipments in a closed loop system.

"Selling" chronic pain: physiotherapists' lived experiences of communicating the diagnosis of chronic nonspecific lower back pain to their patients.

Introduction: Chronic nonspecific lower back pain (CNSLBP) is a common musculoskeletal condition which can be a source of significant distress and disability for patients. Approaches to managing CNSLBP have been explored in healthcare literature, as has the importance of communication in physiotherapy practice. However, no previous studies have explored clinicians' experiences of communicating their understanding of this diagnosis to their patients.Methods: A qualitative research design, using hermeneutic phenomenological methodology, was employed. Five participants were purposively recruited for the research and data collected via semi-structured interviews. Interpretative phenomenological analysis (IPA) methods were used to analyze the data. Emergent, super-ordinate and master themes were developed to help convey the qualitative significant meanings of the lived-through experiences.Findings: Three master themes were identified, with each comprising two sub-themes. These were: 1) Patient-centeredness (1a. Understanding the patient; and 1b. emotional awareness and adaptability); 2) Getting patients "on board" (2a. the "selling" process; and 2b. paternalism and the clinician's perspective); and 3) Dealing with conflict and uncertainty (3a. fear of interpersonal conflict; and 3b. personal doubts and uncertainty).Conclusions: Personal conflicts were identified between clinicians' descriptions of their wishes to "sell" their own perspectives to patients while simultaneously wanting to demonstrate a patient-focused approach and avoid the interpersonal conflicts which arose from clashes with patients' beliefs. Building a good initial rapport, showing empathy and adapting approaches in response to perceptions of patients' reactions were perceived as strategies to help mitigate the risks of failed communication, but this was something for which participants felt unprepared by their prior training.

Current national initiatives and policies to control drug costs in Europe: UK perspective.

Healthcare represents a significant proportion of UK government expenditure leading to the introduction of a number of reforms to contain costs while improving the quality and efficiency of care. Equity is also a core principle. These objectives have led to the institution of a number of central initiatives including National Institute for Clinical Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), and the National Service Frameworks (NSFs). NICE has met with variable success, with a number of activities and measures proposed to enhance its contribution. Other measures recently instituted to improve quality and efficiency include risk sharing arrangements, prescribing incentive schemes coupled with academic detailing, and outcome guarantee schemes. Ongoing reforms will continue with an aging population and pressure on resources.