Smart hospital definition: Academic and industrial perspective.

BACKGROUNDS: Healthcare is a social and economic challenge in many countries, exacerbated by today's increasing demand. Many studies demonstrate that hospitals that move towards smartness, and some of their processes are smart, can provide more appropriate treatments and deal with problems more flexibly. It is axiomatic that implementing smart hospitals and healthcare tools requires a clear objective. However, the concept of a smart hospital lacks a comprehensive and broadly accepted definition, leading to varied interpretations and misconceptions. Many developments touted as 'smart' merely digitize existing hospital environments without truly embracing the full potential of smart technology. Furthermore, research studies have neglected to consider industrial perspectives, which will soon cause a gap between industry and academics in this concept. OBJECTIVES: This research aims to explore the attributes of a smart hospital and use them to propose a definition for it, considering both scholarly and industrial viewpoints. METHOD AND RESULTS: The PRISMA method is employed to select academic and practical papers providing definitions and insights into smart hospitals or healthcare. 17 studies are analyzed, and a total, 83 characteristics are identified to describe the smart hospital. These features are categorized into three primary categories: "technologies", "services", and "goals". The most important features are determined by analyzing the frequencies of these characteristics across all the studies. In the results section, these data are presented in graphical form, highlighting both academic and industrial perspectives separately, as well as a combined analysis. Furthermore, an attempt is made to uncover trends in smart hospitals from 2015 to 2023. CONCLUSION: A comprehensive definition of the smart hospital, encompassing both academic and industrial perspectives, is proposed using the investigated characteristics. This study also presents research opportunities and discusses the existing gap between academia and industry concerning smart hospitals.

First molecular approach to diagnose paediatric pulmonary lophomoniasis: A case series.

A prospective study was conducted from 2017 to 2021 at Bouali Hospital in Mazandaran province, Sari, Iran. Out of 58 patients who were enrolled in our study, lophomoniasis was diagnosed in bronchoalveolar lavage fluid of nine patients, for the first time, using an in-house polymerase chain reaction technique. All patients were treated with metronidazole at 7.5 mg/kg/day every 12 h for 14 days. After 6 months of follow-up, symptoms were fully resolved.

Hospital enterprise Architecture Framework (Study of Iranian University Hospital Organization).

BACKGROUNDS: Nowadays developing smart and fast services for patients and transforming hospitals to modern hospitals is considered a necessity. Living in the world inundated with information systems, designing services based on information technology entails a suitable architecture framework. OBJECTIVES: This paper aims to present a localized enterprise architecture framework for the Iranian university hospital. METHODS AND RESULTS: Using two dimensions of implementation and having appropriate characteristics, the best 17 enterprises frameworks were chosen. As part of this effort, five criteria were selected according to experts' inputs. According to these criteria, five frameworks which had the highest rank were chosen. Then 44 general characteristics were extracted from the existing 17 frameworks after careful studying. Then a questionnaire was written accordingly to distinguish the necessity of those characteristics using expert's opinions and Delphi method. The result showed eight important criteria. In the next step, using AHP method, TOGAF was chosen regarding having appropriate characteristics and the ability to be implemented among reference formats. In the next step, enterprise architecture framework was designed by TOGAF in a conceptual model and its layers. For determining architecture framework parts, a questionnaire with 145 questions was written based on literature review and expert's opinions. The results showed during localization of TOGAF for Iran, 111 of 145 parts were chosen and certified to be used in the hospital. CONCLUSION: The results showed that TOGAF could be suitable for use in the hospital. So, a localized Hospital Enterprise Architecture Modelling is developed by customizing TOGAF for an Iranian hospital at eight levels and 11 parts. This new model could be used to be performed in other Iranian hospitals.

Single nucleotide polymorphisms of IFNγ (+874 A/T) and IFNγR1 (-56 C/T) in Iranian patients with TB.

BACKGROUND: Two important genes for controlling TB are IFNγ and IFNγR1. However, little information exists regarding genetic susceptibility of the Iranian TB population. METHODS: We investigated the single nucleotide polymorphisms (SNPs) in genes of IFNγ (+874 A/T) and IFNγR1 (-56 C/T) and serum level of IFNγ and their influence on TB in patients; 300 patients with TB and 300 healthy controls were enrolled in this study. PCR-restriction fragment length polymorphism was used to identify SNPs and serum level of IFNγ was measured by ELISA. RESULTS: The allelic and the genotypic form of IFNγ+874 A/T SNP of the studied population were not significant (p>0.05). Allele T frequencies of IFNγR1 -56 C/T promoter region in patients with pulmonary TB (PTB) or extrapulmonary TB (EPTB) were significantly greater than allele C. The -56 TT motif of IFNγR1 is associated with both forms of TB (p<0.05). The serum level of IFNγ was significantly higher in patients with TB than in controls, but there was no significant difference between serum level of IFNγ and the studied genotypes (p>0.05). CONCLUSIONS: The cause of active TB in the patients seems to be due to the lack of effective IFNγ function or the lack of effective signaling connection between IFNγ and its receptor in presence of -56 C/T polymorphism in promoter region of IFNγR1 gene.

Surveillance of Antibiotic Consumption Point Prevalence Survey 2014: Antimicrobial Prescribing in Pediatrics Wards of 16 Iranian Hospitals.

BACKGROUND: Antibiotics are among the most commonly prescribed drugs in pediatrics. Due to lack of uniformity in pediatric antimicrobial prescribing and the emergence of antibiotic resistance, appropriate drug utilization studies have been found to be crucial to evaluate whether these drugs are properly used. METHODS: Data were collected between January 2014 and February 2014 in 16 Iranian pediatric hospitals using a standardized method. The point prevalence survey included all inpatient beds. RESULTS: Of 858 children, 571 (66.6%) received one or more antimicrobials. The indications were therapeutic in 60.6%. The parenteral route was used in 92.5% of therapeutic indications. Ceftriaxone was the most prescribed antimicrobials for therapeutic indications (32.4%) and combination-therapy was the most type of therapy in pediatric intelligent care unit (PICU). CONCLUSION: According to results of this study, antibiotics' prescribing in pediatrics wards of Iranian hospitals is empirical. Therefore, for quality improvement of antimicrobial use in children continuous audit process and antibiotic prescriptions require further investigation.

Increased expression of forkhead box protein 3 gene of regulatory T cells in patients with active tuberculosis.

Cell mediated immunity is the most important response against Mycobacterium tuberculosis (MTB). Regulatory T cells (Treg) play a vital role in suppressing the effector T cell response in tuberculosis (TB) patients. Forkhead box protein 3 (Foxp3) is an important regulator of Treg cells development and function. In this study, we showed that the expression of Foxp3 gene in Treg cells is increased in patients with active tuberculosis. In a case-control study, 183 TB patients and 183 controls were recruited according to ethnicity, gender and living area. Then, after isolation of peripheral blood mononuclear cells (PBMCs), FoxP3 gene expression was studied by real-time PCR. The expression of this gene in patients with pulmonary and extra-pulmonary tuberculosis was 2.8 fold higher than normal subjects (CI=1.29±2.37, P≤0.001). Also comparing the patients with pulmonary tuberculosis and the control group, a significant difference was observed (CI=1.81±2.96, P≤0.001). FoxP3 gene expression was 1.5 fold higher in women with pulmonary and extrapulmonary tuberculosis than in men with tuberculosis (CI=0.12±2.01, P=0.02). According to this study, the increased Foxp3 gene expression in patients with TB was observed and this may play as a contributing factor to suppression of Th1-type immune responses.