Understanding the multidimensional role of medical travel facilitators: A study on competencies and a proposed model.

The recent exponential growth of medical tourism has illuminated the essential but relatively unexamined role of medical travel facilitators (MTFs). MTFs play a crucial role in the success of medical tourism by acting as a bridge between patients and healthcare providers. However, there is a lack of understanding and standardization of the competencies needed to excel in this profession. Therefore, this study aims to reveal and categorize the key MTF competencies through a professional competency model. The research methodology involved a combination of competency classification and thematic content analysis, leveraging insights from 30 healthcare experts. The study is processed through a computer-aided analysis to identify 14 distinct themes and 35 MTF competencies. These findings build up an innovative MTF competency model. This novel model extends the understanding of MTF competencies and is a practical tool for individuals aspiring for MTF roles, promoting their professional development. The findings also suggest a standard for delivering high-quality patient care and meeting the diverse needs of industry stakeholders. The research contributes to both theoretical advancements and practical improvements in the medical tourism industry, with an emphasis on enhancing patient satisfaction and upholding industry standards.

An Effective Methodology for Scoring to Assist Emergency Physicians in Identifying Overcrowding in an Academic Emergency Department in Thailand.

BACKGROUND: Emergency Department (ED) overcrowding is a global concern, with tools like NEDOCS, READI, and Work Score used as predictors. These tools aid healthcare professionals in identifying overcrowding and preventing negative patient outcomes. However, there's no agreed-upon method to define ED overcrowding. Most studies on this topic are U.S.-based, limiting their applicability in EDs without waiting rooms or ambulance diversion roles. Additionally, the intricate calculations required for these scores, with multiple variables, make them impractical for use in developing nations. OBJECTIVE: This study sought to examine the relationship between prevalent ED overcrowding scores such as EDWIN, occupancy rate, and Work Score, and a modified version of EDWIN newly introduced by the authors, in comparison to the real-time perspectives of emergency physicians. Additionally, the study explored the links between these overcrowding scores and adverse events related to ED code activations as secondary outcomes. METHOD: The method described in the provided text is a correlational study. The study aims to examine the relationship between various Emergency Department (ED) overcrowding scores and the real-time perceptions of emergency physicians in every two-hour period. Additionally, it seeks to explore the associations between these scores and adverse events related to ED code activations. RESULTS: The study analyzed 459 periods, with 5.2% having Likert scores of 5-6. EDOR had the highest correlation coefficient (0.69, p < 0.001) and an AUC of 0.864. Only EDOR significantly correlated with adverse events (p = 0.033). CONCLUSION: EDOR shows the most robust link with 'emergency physicians' views on overcrowding. Additionally, elevated EDOR scores correlate with a rise in adverse events. Emergency physicians' perceptionof overcrowding could hint at possible adverse events. Notably, all overcrowding scores have high negative predictive values, efficiently negating the likelihood of adverse incidents.

RBEF: Ransomware Efficient Public Blockchain Framework for Digital Healthcare Application.

These days, the use of digital healthcare has been growing in practice. Getting remote healthcare services without going to the hospital for essential checkups and reports is easy. It is a cost-saving and time-saving process. However, digital healthcare systems are suffering from security and cyberattacks in practice. Blockchain technology is a promising technology that can process valid and secure remote healthcare data among different clinics. However, ransomware attacks are still complex holes in blockchain technology and prevent many healthcare data transactions during the process on the network. The study presents the new ransomware blockchain efficient framework (RBEF) for digital networks, which can identify transaction ransomware attacks. The objective is to minimize transaction delays and processing costs during ransomware attack detection and processing. The RBEF is designed based on Kotlin, Android, Java, and socket programming on the remote process call. RBEF integrated the cuckoo sandbox static and dynamic analysis application programming interface (API) to handle compile-time and runtime ransomware attacks in digital healthcare networks. Therefore, code-, data-, and service-level ransomware attacks are to be detected in blockchain technology (RBEF). The simulation results show that the RBEF minimizes transaction delays between 4 and 10 min and processing costs by 10% for healthcare data compared to existing public and ransomware efficient blockchain technologies healthcare systems.

Automatic Detection of Tuberculosis Using VGG19 with Seagull-Algorithm.

Due to various reasons, the incidence rate of communicable diseases in humans is steadily rising, and timely detection and handling will reduce the disease distribution speed. Tuberculosis (TB) is a severe communicable illness caused by the bacterium Mycobacterium-Tuberculosis (M. tuberculosis), which predominantly affects the lungs and causes severe respiratory problems. Due to its significance, several clinical level detections of TB are suggested, including lung diagnosis with chest X-ray images. The proposed work aims to develop an automatic TB detection system to assist the pulmonologist in confirming the severity of the disease, decision-making, and treatment execution. The proposed system employs a pre-trained VGG19 with the following phases: (i) image pre-processing, (ii) mining of deep features, (iii) enhancing the X-ray images with chosen procedures and mining of the handcrafted features, (iv) feature optimization using Seagull-Algorithm and serial concatenation, and (v) binary classification and validation. The classification is executed with 10-fold cross-validation in this work, and the proposed work is investigated using MATLAB® software. The proposed research work was executed using the concatenated deep and handcrafted features, which provided a classification accuracy of 98.6190% with the SVM-Medium Gaussian (SVM-MG) classifier.

Blockchain Socket Factories with RMI-Enabled Framework for Fine-Grained Healthcare Applications.

The usage of digital and intelligent healthcare applications on mobile devices has grown progressively. These applications are generally distributed and access remote healthcare services on the user's applications from different hospital sources. These applications are designed based on client-server architecture and different paradigms such as socket, remote procedure call, and remote method invocation (RMI). However, these existing paradigms do not offer a security mechanism for healthcare applications in distributed mobile-fog-cloud networks. This paper devises a blockchain-socket-RMI-based framework for fine-grained healthcare applications in the mobile-fog-cloud network. This study introduces a new open healthcare framework for applied research purposes and has blockchain-socket-RMI abstraction level classes for healthcare applications. The goal is to meet the security and deadline requirements of fine-grained healthcare tasks and minimize execution and data validation costs during processing applications in the system. This study introduces a partial proof of validation (PPoV) scheme that converts the workload into the hash and validates it among mobile, fog, and cloud nodes during offloading, execution, and storing data in the secure form. Simulation discussions illustrate that the proposed blockchain-socket-RMI minimizes the processing and blockchain costs and meets the security and deadline requirements of fine-grained healthcare tasks of applications as compared to existing frameworks in work.

Recent development of machine learning-based methods for the prediction of defensin family and subfamily.

Nearly all living species comprise of host defense peptides called defensins, that are crucial for innate immunity. These peptides work by activating the immune system which kills the microbes directly or indirectly, thus providing protection to the host. Thus far, numerous preclinical and clinical trials for peptide-based drugs are currently being evaluated. Although, experimental methods can help to precisely identify the defensin peptide family and subfamily, these approaches are often time-consuming and cost-ineffective. On the other hand, machine learning (ML) methods are able to effectively employ protein sequence information without the knowledge of a protein's three-dimensional structure, thus highlighting their predictive ability for the large-scale identification. To date, several ML methods have been developed for the in silico identification of the defensin peptide family and subfamily. Therefore, summarizing the advantages and disadvantages of the existing methods is urgently needed in order to provide useful suggestions for the development and improvement of new computational models for the identification of the defensin peptide family and subfamily. With this goal in mind, we first provide a comprehensive survey on a collection of six state-of-the-art computational approaches for predicting the defensin peptide family and subfamily. Herein, we cover different important aspects, including the dataset quality, feature encoding methods, feature selection schemes, ML algorithms, cross-validation methods and web server availability/usability. Moreover, we provide our thoughts on the limitations of existing methods and future perspectives for improving the prediction performance and model interpretability. The insights and suggestions gained from this review are anticipated to serve as a valuable guidance for researchers for the development of more robust and useful predictors.

Potent Blockchain-Enabled Socket RPC Internet of Healthcare Things (IoHT) Framework for Medical Enterprises.

Present-day intelligent healthcare applications offer digital healthcare services to users in a distributed manner. The Internet of Healthcare Things (IoHT) is the mechanism of the Internet of Things (IoT) found in different healthcare applications, with devices that are attached to external fog cloud networks. Using different mobile applications connecting to cloud computing, the applications of the IoHT are remote healthcare monitoring systems, high blood pressure monitoring, online medical counseling, and others. These applications are designed based on a client-server architecture based on various standards such as the common object request broker (CORBA), a service-oriented architecture (SOA), remote method invocation (RMI), and others. However, these applications do not directly support the many healthcare nodes and blockchain technology in the current standard. Thus, this study devises a potent blockchain-enabled socket RPC IoHT framework for medical enterprises (e.g., healthcare applications). The goal is to minimize service costs, blockchain security costs, and data storage costs in distributed mobile cloud networks. Simulation results show that the proposed blockchain-enabled socket RPC minimized the service cost by 40%, the blockchain cost by 49%, and the storage cost by 23% for healthcare applications.

Novel DERMA Fusion Technique for ECG Heartbeat Classification.

An electrocardiogram (ECG) consists of five types of different waveforms or characteristics (P, QRS, and T) that represent electrical activity within the heart. Identification of time intervals and morphological appearance of the waves are the major measuring instruments to detect cardiac abnormality from ECG signals. The focus of this study is to classify five different types of heartbeats, including premature ventricular contraction (PVC), left bundle branch block (LBBB), right bundle branch block (RBBB), PACE, and atrial premature contraction (APC), to identify the exact condition of the heart. Prior to the classification, extensive experiments on feature extraction were performed to identify the specific events from ECG signals, such as P, QRS complex, and T waves. This study proposed the fusion technique, dual event-related moving average (DERMA) with the fractional Fourier-transform algorithm (FrlFT) to identify the abnormal and normal morphological events of the ECG signals. The purpose of the DERMA fusion technique is to analyze certain areas of interest in ECG peaks to identify the desired location, whereas FrlFT analyzes the ECG waveform using a time-frequency plane. Furthermore, detected highest and lowest components of the ECG signal such as peaks, the time interval between the peaks, and other necessary parameters were utilized to develop an automatic model. In the last stage of the experiment, two supervised learning models, namely support vector machine and K-nearest neighbor, were trained to classify the cardiac condition from ECG signals. Moreover, two types of datasets were used in this experiment, specifically MIT-BIH Arrhythmia with 48 subjects and the newly disclosed Shaoxing and Ningbo People's Hospital (SPNH) database, which contains over 10,000 patients. The performance of the experimental setup produced overwhelming results, which show around 99.99% accuracy, 99.96% sensitivity, and 99.9% specificity.

EEG Channel Selection Based User Identification via Improved Flower Pollination Algorithm.

The electroencephalogram (EEG) introduced a massive potential for user identification. Several studies have shown that EEG provides unique features in addition to typical strength for spoofing attacks. EEG provides a graphic recording of the brain's electrical activity that electrodes can capture on the scalp at different places. However, selecting which electrodes should be used is a challenging task. Such a subject is formulated as an electrode selection task that is tackled by optimization methods. In this work, a new approach to select the most representative electrodes is introduced. The proposed algorithm is a hybrid version of the Flower Pollination Algorithm and ß-Hill Climbing optimizer called FPAß-hc. The performance of the FPAß-hc algorithm is evaluated using a standard EEG motor imagery dataset. The experimental results show that the FPAß-hc can utilize less than half of the electrode numbers, achieving more accurate results than seven other methods.

A Lightweight Secure Adaptive Approach for Internet-of-Medical-Things Healthcare Applications in Edge-Cloud-Based Networks.

Mobile-cloud-based healthcare applications are increasingly growing in practice. For instance, healthcare, transport, and shopping applications are designed on the basis of the mobile cloud. For executing mobile-cloud applications, offloading and scheduling are fundamental mechanisms. However, mobile healthcare workflow applications with these methods are widely ignored, demanding applications in various aspects for healthcare monitoring, live healthcare service, and biomedical firms. However, these offloading and scheduling schemes do not consider the workflow applications' execution in their models. This paper develops a lightweight secure efficient offloading scheduling (LSEOS) metaheuristic model. LSEOS consists of light weight, and secure offloading and scheduling methods whose execution offloading delay is less than that of existing methods. The objective of LSEOS is to run workflow applications on other nodes and minimize the delay and security risk in the system. The metaheuristic LSEOS consists of the following components: adaptive deadlines, sorting, and scheduling with neighborhood search schemes. Compared to current strategies for delay and security validation in a model, computational results revealed that the LSEOS outperformed all available offloading and scheduling methods for process applications by 10% security ratio and by 29% regarding delays.

A Long Short-Term Memory Biomarker-Based Prediction Framework for Alzheimer's Disease.

The early prediction of Alzheimer's disease (AD) can be vital for the endurance of patients and establishes as an accommodating and facilitative factor for specialists. The proposed work presents a robotized predictive structure, dependent on machine learning (ML) methods for the forecast of AD. Neuropsychological measures (NM) and magnetic resonance imaging (MRI) biomarkers are deduced and passed on to a recurrent neural network (RNN). In the RNN, we have used long short-term memory (LSTM), and the proposed model will predict the biomarkers (feature vectors) of patients after 6, 12, 21 18, 24, and 36 months. These predicted biomarkers will go through fully connected neural network layers. The NN layers will then predict whether these RNN-predicted biomarkers belong to an AD patient or a patient with a mild cognitive impairment (MCI). The developed methodology has been tried on an openly available informational dataset (ADNI) and accomplished an accuracy of 88.24%, which is superior to the next-best available algorithms.

Data identification of determinants affecting the adoption of sustainable construction: The perspective of residential building developers.

This data paper shows the perspectives by developers of housing on factors of the sustainable construction adoption. The Data was collected by using formal Likert scale questionnaire as main instrument. Simple random sampling was used to assign questionnaires to respondents. Data samples were evaluated using index and rating. The data will provide information on the most variables that considered as main factors for sustainable construction adoption. The importance between variables can provide information that will contribute to the expedition of sustainable practise in housing projects in Malaysia.

The Recent Technologies to Curb the Second-Wave of COVID-19 Pandemic.

Different epidemics, specially Coronavirus, have caused critical misfortunes in various fields like monetary deprivation, survival conditions, thus diminishing the overall individual fulfillment. Various worldwide associations and different hierarchies of government fraternity are endeavoring to offer the necessary assistance in eliminating the infection impacts but unfortunately standing up to the non-appearance of resources and expertise. In contrast to all other pandemics, Coronavirus has proven to exhibit numerous requirements such that curated appropriation and determination of innovations are required to deal with the vigorous undertakings, which include precaution, detection, and medication. Innovative advancements are essential for the subsequent pandemics where-in the forthcoming difficulties can indeed be approached to such a degree that it facilitates constructive solutions more comprehensively. In this study, futuristic and emerging innovations are analyzed, improving COVID-19 effects for the general public. Large data sets need to be advanced so that extensive models related to deep analysis can be used to combat Coronavirus infection, which can be done by applying Artificial intelligence techniques such as Natural Language Processing (NLP), Machine Learning (ML), and Computer vision to varying processing files. This article aims to furnish variation sets of innovations that can be utilized to eliminate COVID-19 and serve as a resource for the coming generations. At last, elaboration associated with future state-of-the-art technologies and the attainable sectors of AI methodologies has been mentioned concerning the post-COVID-19 world to enable the different ideas for dealing with the pandemic-based difficulties.

Analysis of Brain MRI Images Using Improved CornerNet Approach.

The brain tumor is a deadly disease that is caused by the abnormal growth of brain cells, which affects the human blood cells and nerves. Timely and precise detection of brain tumors is an important task to avoid complex and painful treatment procedures, as it can assist doctors in surgical planning. Manual brain tumor detection is a time-consuming activity and highly dependent on the availability of area experts. Therefore, it is a need of the hour to design accurate automated systems for the detection and classification of various types of brain tumors. However, the exact localization and categorization of brain tumors is a challenging job due to extensive variations in their size, position, and structure. To deal with the challenges, we have presented a novel approach, namely, DenseNet-41-based CornerNet framework. The proposed solution comprises three steps. Initially, we develop annotations to locate the exact region of interest. In the second step, a custom CornerNet with DenseNet-41 as a base network is introduced to extract the deep features from the suspected samples. In the last step, the one-stage detector CornerNet is employed to locate and classify several brain tumors. To evaluate the proposed method, we have utilized two databases, namely, the Figshare and Brain MRI datasets, and attained an average accuracy of 98.8% and 98.5%, respectively. Both qualitative and quantitative analysis show that our approach is more proficient and consistent with detecting and classifying various types of brain tumors than other latest techniques.

Pharmaceutical mobile application for visually-impaired people in Thailand: development and implementation.

BACKGROUND: Most mobile pharmaceutical applications produced for people with visual disabilities in Thailand fail to meet the required standard due to poor-quality regulations, defective design, lack of user support and impracticality; as a result, visually-impaired people are unable to use them. This research is motivated by the limited use of this technology in primary medical services and its aim is to enable people with disabilities to access effective digital health information. The research objective is to analyse, design and develop a mobile pharmaceutical application with functions that are appropriate for visually-impaired users, and test its usability. RESULTS: Based on the design and development of the application, it contained five necessary functions. When testing the usability and users' satisfaction, it was found that the input or fill of information in the application was of low usability. According to the test results, the medicinal database function was missing 71 times and the voice command function was missing 34 times. Based on users' satisfaction results, users who had the highest level of usage gave higher average scores to users' attitude, users' confidence, user interface and system performance than those with lower levels of usage. The scores of both groups were found to be the same when discussing the implementation of the development. CONCLUSIONS: This mobile application, which was developed based on the use of smart technology, will play an important role in supporting visually-impaired people in Thailand by enhancing the efficacy of self-care. The design and development of the application will ensure the suitability of many functions for visually-impaired users. However, despite the high functional capacity of the application, the gap in healthcare services between the general public and disabled groups will still exist if users have inadequate IT skills.

Smart-Contract Aware Ethereum and Client-Fog-Cloud Healthcare System.

The Internet of Medical Things (IoMT) is increasingly being used for healthcare purposes. IoMT enables many sensors to collect patient data from various locations and send it to a distributed hospital for further study. IoMT provides patients with a variety of paid programmes to help them keep track of their health problems. However, the current system services are expensive, and offloaded data in the healthcare network are insecure. The research develops a new, cost-effective and stable IoMT framework based on a blockchain-enabled fog cloud. The study aims to reduce the cost of healthcare application services as they are processing in the system. The study devises an IoMT system based on different algorithm techniques, such as Blockchain-Enable Smart-Contract Cost-Efficient Scheduling Algorithm Framework (BECSAF) schemes. Smart-Contract Blockchain schemes ensure data consistency and validation with symmetric cryptography. However, due to the different workflow tasks scheduled on other nodes, the heterogeneous, earliest finish, time-based scheduling deals with execution under their deadlines. Simulation results show that the proposed algorithm schemes outperform all existing baseline approaches in terms of the implementation of applications.

Patient triage system for supporting the operation of dispatch centres and rescue teams.

BACKGROUND: The Thai medical application for patient triage, namely Triagist, is an mHealth application designed to support the pre-hospital process. However, since the functions of the application that are necessary for the pre-hospital process have been found not to be fully developed, the addition of a back-end system has been considered to increase its performance and usability. OBJECTIVE: To determine the ability of the previous version to effectively manage the pre-hospital process and analyse the current problems with the pre-hospital operation. Therefore, the new system was developed to support the connection of dispatch centres or operational centres to the Triagist mobile application and system evaluation. METHOD: Design thinking methodology was used to analyse, design and develop a patient triage system to support the pre-hospital process in Thailand based on users' requirements. 68 active members of the rescue teams and emergency medical staff in Chiang Mai and Lampang provinces were recruited to test the reliability of the system based on a prototype application. RESULTS: The new medical mobile application for patient triage in Thailand was validated for use due to containing the two essential functions of Initial Dispatch Code (IDC) geolocation and IDC management. When the system was tested by emergency staff who were responsible for using it, those with the least experience were found to use it better than their highly experienced colleagues. Moreover, in cases where the system had been implemented, it was found to determine the frequency of symptoms, the time period during which cases occurred, and the density of cases in each area. CONCLUSION: This system, which has been developed based on the use of smart technology, will play an important role in supporting emergency services in Thailand by enhancing the efficiency of the pre-hospital process. Emergency centres will receive IDC information from the geolocation system so that they can determine patients' location without undue delay. Emergency services will be able to rapidly prepare the necessary resources and administrative tasks will be supported by linking the dispatch centre to central rescue teams.

Thailand medical mobile application for patients triage base on criteria based dispatch protocol.

BACKGROUND: Before patients are admitted into the emergency department, it is important to undertake a pre-hospital process, both in terms of treatment performance and a request for resources from an emergency unit. The existing system to triage patients in Thailand is not functioning to its full capacity in either the primary medical system or pre-hospital treatment with shortcomings in the areas of speed, features, and appropriate systems. There is a high possibility of issuing a false Initial Dispatch Code (IDC), which will cause the over or underutilisation of emergency resources, such as rescue teams, community hospitals and emergency medical volunteers. METHODS: A usability system design, together with a reliability test, was applied to develop an application to optimise the pre-hospital process, specifically to sort patients, using an IDC to improve the request for emergency resources. The triage mobile application was developed on both iOS and Android operating systems to support patient triage based on Criteria Based Dispatch (CBD). The 25 main symptom categories covered by CBD were used to design and develop the application, and 12 emergency medical staff, including doctors and nurses, were asked to test the system in the aspects of triage protocol correction, triage reliability, usability and user satisfaction. RESULTS: The results of testing the proposed triage application were compared with the time used to triage by experienced staff and it was found that, in non-trauma cases, it was faster and more effective to use the application for emergency operations and to correct the IDC code representation. CONCLUSIONS: The triage application will be utilised to support the pre-hospital process and to classify patients' conditions before they are admitted to the Emergency Department (ED). The application is suitable for users who are not medical emergency staff. Patients with non-trauma symptoms may be a suitable group to use the application in terms of time used to identify IDC for their own symptoms. The use of the application can be beneficial for those who wish to self-identify their symptoms before requesting medical services.

An exploratory study of digital workforce competency in Thailand.

Industry 4.0 and the digital age have dramatically influenced both information technology (IT) job characteristics and IT labor demand. Leaders in higher education must keep up with the situation and accelerate plans to produce graduates with the quality and preparation required to meet industry needs. But based on the existing demand gap, universities are eager to first know which skills the IT-related industries expect from new digital workers. This study, conducted in Thailand, explores the competency of the digital workforce, an issue that was identified as vital to the 2017-2021 national agenda. The research project was divided into two steps. Phase one was to study and identify essential competencies for the digital workforce by first reviewing the literature, then verifying these results through qualitative methodology. Thirty IT experts in IT and related industries were invited to interview sessions. Eventually, after content analysis, 24 competencies were presented. Phase two was to survey the competency expectations of IT experts by using the initial questions generated by Phase One's outcome. 260 questionnaires were analyzed. Exploratory factor analysis (EFA) was selected to cluster the digital workforce competencies that were found. Three significant categories were selected based on Eigenvalue, and the average results of demand were explained. Industries had most expected competencies in the Professional skills and IT knowledge category, followed by the IT technical category and IT management and support category. The top five competencies desired were lifelong learning, personal attitude, teamwork, dependability, and IT foundations. However, there were some slightly different requirements between the IT industry and IT in non-IT industries. The results presented a new perspective that is very useful to Thailand. The academic sector can use these results to shape IT curriculum in order to effectively respond to real demand. In addition, recent graduates or graduating students can study these conclusions and better prepare themselves for future jobs.