UAV Visual and Thermographic Power Line Detection Using Deep Learning.

Inspecting and maintaining power lines is essential for ensuring the safety, reliability, and efficiency of electrical infrastructure. This process involves regular assessment to identify hazards such as damaged wires, corrosion, or vegetation encroachment, followed by timely maintenance to prevent accidents and power outages. By conducting routine inspections and maintenance, utilities can comply with regulations, enhance operational efficiency, and extend the lifespan of power lines and equipment. Unmanned Aerial Vehicles (UAVs) can play a relevant role in this process by increasing efficiency through rapid coverage of large areas and access to difficult-to-reach locations, enhanced safety by minimizing risks to personnel in hazardous environments, and cost-effectiveness compared to traditional methods. UAVs equipped with sensors such as visual and thermographic cameras enable the accurate collection of high-resolution data, facilitating early detection of defects and other potential issues. To ensure the safety of the autonomous inspection process, UAVs must be capable of performing onboard processing, particularly for detection of power lines and obstacles. In this paper, we address the development of a deep learning approach with YOLOv8 for power line detection based on visual and thermographic images. The developed solution was validated with a UAV during a power line inspection mission, obtaining mAP@0.5 results of over 90.5% on visible images and over 96.9% on thermographic images.

Malignant transformation of a long-term ulcer in a patient with leprosy sequelae: a case report.

Marjolin's ulcer (MU) is a rare condition defined as a malignant skin tumor arising from chronic wounds and inflammation. The most common histological findings in MUs are squamous cell carcinomas (SCC) (or spinocellular carcinomas [SPC]), such as basal cell carcinomas (BCC) and malignant melanomas (MM). The aim of this study is to report the case of a patient with sequelae of leprosy who presented malignant transformation in a long-standing ulcer on the right leg, thereby contributing to understanding of the progression and significance of early diagnosis of MU. The MU was diagnosed by incisional biopsy of the lesion and upon obtaining a positive result the patient was referred to an oncology service. Treatment of MU is multidisciplinary and surgical excision is the first therapeutic option. Proper management and surveillance of chronic ulcers by the healthcare team are necessary for early recognition of MU.

Building the Bridge to a Participatory Citizenship: Curricular Integration of Communal Environmental Issues in School Projects Supported by the Internet of Things.

Generally, there is much to praise about the rise in acknowledging the need for young citizens to exercise their rights and duties, but the belief remains that this is not yet entrenched in young citizens' overall democratic involvement. A lack of citizenship and engagement in community issues was revealed by a recent study conducted by the authors in a secondary school from the outskirts of Aveiro, Portugal, during the 2019/2020 school year. Under the umbrella of a Design-Based Research methodological framework, citizen science strategies were implemented in the context of teaching, learning, and assessment, and at the service of the educational project of the target school, in a STEAM approach, and under Domains of Curricular Autonomy activities. The study's findings suggest that to build the bridge for participatory citizenship, teachers should engage students in collecting and analyzing data regarding communal environmental issues in a Citizen Science approach supported by the Internet of Things. The new pedagogies addressing the lack of citizenship and engagement in community issues promoted students' involvement at school and in the community, contributed to inform municipal education policies, and promoted dialogue and communication between local actors.

An Overview of the Nano-Enhanced Phase Change Materials for Energy Harvesting and Conversion.

This review offers a critical survey of the published studies concerning nano-enhanced phase change materials to be applied in energy harvesting and conversion. Also, the main thermophysical characteristics of nano-enhanced phase change materials are discussed in detail. In addition, we carried out an analysis of the thermophysical properties of these types of materials as well as of some specific characteristics like the phase change duration and the phase change temperature. Moreover, the fundamental improving techniques for the phase change materials for solar thermal applications are described in detail, including the use of nano-enhanced phase change materials, foam skeleton-reinforced phase change materials, phase change materials with extended surfaces, and the inclusion of high-thermal-conductivity nanoparticles in nano-enhanced phase change materials, among others. Those improvement techniques can increase the thermal conductivity of the systems by up to 100%. Furthermore, it is also reported that the exploration of phase change materials enhances the overall efficiency of solar thermal energy storage systems and photovoltaic-nano-enhanced phase change materials systems. Finally, the main limitations and guidelines for future research in the field of nano-enhanced phase change materials are summarized.

Cardiologist's exposure to radiation in cath lab measured with InstadoseTMdosimeter.

INTRODUCTION: complex fluoroscopy-guided interventional procedures in cardiology are known to result in higher radiation doses for patients and staff. PURPOSE: to estimate the equivalent dose received in different regions of the cardiologist's body in catheterism (CATH) and percutaneous coronary intervention (PCI) procedures, as well as to evaluate the effectiveness of monitoring the doses in the catheritization laboratory (cath lab) using a direct ion storage dosimeter. MATERIALS AND METHODS: the InstadoseTMand the thermoluminescent dosimeters (TLD-100) were fixed simultaneously in the following regions of the cardiologist's body: near the eyes (left and right), the trunk region (over the lead apron) and the left ankle. Occupational doses were recorded during 86 procedures (60% CATH). RESULTS: catheterization procedures showed third quartile dose values near to the left eye region equal to 0.10 mSv (TLD-100) and 0.12 (InstadoseTM) and for intervention 0.15 mSv (TLD-100 and InstadoseTM). The doses measured in the trunk region, over the lead apron, were about 13% higher for catheterization procedures and 20% higher for intervention procedures compared to left eye region measurements. The Wilcoxon-Mann-Whitney test was applied for unpaired data for all body regions, comparing the data obtained between the TLD-100 and InstadoseTMdosimeters. For CATH and PCI, the responses of the TLD-100 and InstadoseTMdosimeters are considered equal for all analysed regions (p> 0.05) with the exception of the right eye region. CONCLUSION: the InstadoseTMpassive dosimeter can be useful as a complementary assessment in the monitoring of a cardiologist's personal occupational doses in the cath lab.

Benign Metastasizing Leiomyomatosis to the Skin and Lungs, Intravenous Leiomyomatosis, and Leiomyomatosis Peritonealis Disseminata: A Series of Five Cases.

Benign metastasizing leiomyomatosis (BML) is a rare disease that typically occurs in women with a history of uterine leiomyomatosis. Benign metastasizing leiomyomatosis occurs more frequently in the lungs but may also develop in other organs and tissues. Other unusual variants of extra-uterine leiomyomatosis include intravenous leiomyomatosis (IVL) and leiomyomatosis peritonealis disseminata (LPD). In this article, three cases of BML are presented. One case, in a premenopausal woman, presented cutaneous metastases. We also present a case of IVL and a case of LPD, which occurred in postmenopausal women. Given the rarity of BML, IVL, and LPD, the authors reviewed the literature and herein discuss the implications for treatment in all five cases. Evidence for treating BML, IVL, and LPD is still scarce, and data available from our series and other small series seem to point to the patient's hormonal status playing a fundamental part in the treatment plan. Furthermore, a collecting bag when performing excision of uterine leiomyomas may help avoid the potential spreading of leiomyomatosis. Hysterectomized patients with chronic cough, frequent respiratory infections, abdominal discomfort, right heart failure, or non-specific symptoms should be actively screened for BML, IVL, and LPD. Treatment should be individualized according to each patient's hormonal status and desires.

Augmented Reality for Human-Robot Collaboration and Cooperation in Industrial Applications: A Systematic Literature Review.

With the continuously growing usage of collaborative robots in industry, the need for achieving a seamless human-robot interaction has also increased, considering that it is a key factor towards reaching a more flexible, effective, and efficient production line. As a prominent and prospective tool to support the human operator to understand and interact with robots, Augmented Reality (AR) has been employed in numerous human-robot collaborative and cooperative industrial applications. Therefore, this systematic literature review critically appraises 32 papers' published between 2016 and 2021 to identify the main employed AR technologies, outline the current state of the art of augmented reality for human-robot collaboration and cooperation, and point out future developments for this research field. Results suggest that this is still an expanding research field, especially with the advent of recent advancements regarding head-mounted displays (HMDs). Moreover, projector-based and HMDs developed approaches are showing promising positive influences over operator-related aspects such as performance, task awareness, and safety feeling, even though HMDs need further maturation in ergonomic aspects. Further research should focus on large-scale assessment of the proposed solutions in industrial environments, involving the solution's target audience, and on establishing standards and guidelines for developing AR assistance systems.

Programming Robots by Demonstration Using Augmented Reality.

The world is living the fourth industrial revolution, marked by the increasing intelligence and automation of manufacturing systems. Nevertheless, there are types of tasks that are too complex or too expensive to be fully automated, it would be more efficient if the machines were able to work with the human, not only by sharing the same workspace but also as useful collaborators. A possible solution to that problem is on human-robot interaction systems, understanding the applications where they can be helpful to implement and what are the challenges they face. This work proposes the development of an industrial prototype of a human-machine interaction system through Augmented Reality, in which the objective is to enable an industrial operator without any programming experience to program a robot. The system itself is divided into two different parts: the tracking system, which records the operator's hand movement, and the translator system, which writes the program to be sent to the robot that will execute the task. To demonstrate the concept, the user drew geometric figures, and the robot was able to replicate the operator's path recorded.

AI Based Monitoring of Different Risk Levels in COVID-19 Context.

COVID-19 was responsible for devastating social, economic, and political effects all over the world. Although the health authorities imposed restrictions provided relief and assisted with trying to return society to normal life, it is imperative to monitor people's behavior and risk factors to keep virus transmission levels as low as possible. This article focuses on the application of deep learning algorithms to detect the presence of masks on people in public spaces (using RGB cameras), as well as the detection of the caruncle in the human eye area to make an accurate measurement of body temperature (using thermal cameras). For this task, synthetic data generation techniques were used to create hybrid datasets from public ones to train state-of-the-art algorithms, such as YOLOv5 object detector and a keypoint detector based on Resnet-50. For RGB mask detection, YOLOv5 achieved an average precision of 82.4%. For thermal masks, glasses, and caruncle detection, YOLOv5 and keypoint detector achieved an average precision of 96.65% and 78.7%, respectively. Moreover, RGB and thermal datasets were made publicly available.

Evaluating the Single-Shot MultiBox Detector and YOLO Deep Learning Models for the Detection of Tomatoes in a Greenhouse.

The development of robotic solutions for agriculture requires advanced perception capabilities that can work reliably in any crop stage. For example, to automatise the tomato harvesting process in greenhouses, the visual perception system needs to detect the tomato in any life cycle stage (flower to the ripe tomato). The state-of-the-art for visual tomato detection focuses mainly on ripe tomato, which has a distinctive colour from the background. This paper contributes with an annotated visual dataset of green and reddish tomatoes. This kind of dataset is uncommon and not available for research purposes. This will enable further developments in edge artificial intelligence for in situ and in real-time visual tomato detection required for the development of harvesting robots. Considering this dataset, five deep learning models were selected, trained and benchmarked to detect green and reddish tomatoes grown in greenhouses. Considering our robotic platform specifications, only the Single-Shot MultiBox Detector (SSD) and YOLO architectures were considered. The results proved that the system can detect green and reddish tomatoes, even those occluded by leaves. SSD MobileNet v2 had the best performance when compared against SSD Inception v2, SSD ResNet 50, SSD ResNet 101 and YOLOv4 Tiny, reaching an F1-score of 66.15%, an mAP of 51.46% and an inference time of 16.44ms with the NVIDIA Turing Architecture platform, an NVIDIA Tesla T4, with 12 GB. YOLOv4 Tiny also had impressive results, mainly concerning inferring times of about 5 ms.

Genomic Epidemiology of 2015-2016 Zika Virus Outbreak in Cape Verde.

During 2015-2016, Cape Verde, an island nation off the coast of West Africa, experienced a Zika virus (ZIKV) outbreak involving 7,580 suspected Zika cases and 18 microcephaly cases. Analysis of the complete genomes of 3 ZIKV isolates from the outbreak indicated the strain was of the Asian (not African) lineage. The Cape Verde ZIKV sequences formed a distinct monophylogenetic group and possessed 1-2 (T659A, I756V) unique amino acid changes in the envelope protein. Phylogeographic and serologic evidence support earlier introduction of this lineage into Cape Verde, possibly from northeast Brazil, between June 2014 and August 2015, suggesting cryptic circulation of the virus before the initial wave of cases were detected in October 2015. These findings underscore the utility of genomic-scale epidemiology for outbreak investigations.

Updates on malaria epidemiology and profile in Cabo Verde from 2010 to 2019: the goal of elimination.

BACKGROUND: Located in West Africa, Cabo Verde is an archipelago consisting of nine inhabited islands. Malaria has been endemic since the settlement of the islands during the sixteenth century and is poised to achieve malaria elimination in January 2021. The aim of this research is to characterize the trends in malaria cases from 2010 to 2019 in Cabo Verde as the country transitions from endemic transmission to elimination and prevention of reintroduction phases. METHODS: All confirmed malaria cases reported to the Ministry of Health between 2010 and 2019 were extracted from the passive malaria surveillance system. Individual-level data available included age, gender, municipality of residence, and the self-reported countries visited if travelled within the past 30 days, therby classified as imported. Trends in reported cases were visualized and multivariable logistic regression used to assess risk factors associated with a malaria case being imported and differences over time. RESULTS: A total of 814 incident malaria cases were reported in the country between 2010 and 2019, the majority of which were Plasmodium falciparum. Overall, prior to 2017, when the epidemic occurred, 58.1% (95% CI 53.6-64.6) of infections were classified as imported, whereas during the post-epidemic period, 93.3% (95% CI 86.9-99.7) were imported. The last locally acquired case was reported in January 2018. Imported malaria cases were more likely to be 25-40 years old (AOR: 15.1, 95% CI 5.9-39.2) compared to those under 15 years of age and more likely during the post-epidemic period (AOR: 56.1; 95% CI 13.9-225.5) and most likely to be reported on Sao Vicente Island (AOR = 4256.9, 95% CI = 260-6.9e+4) compared to Boavista. CONCLUSIONS: Cabo Verde has made substantial gains in reducing malaria burden in the country over the past decade and are poised to achieve elimination in 2021. However, the high mobility between the islands and continental Africa, where malaria is still highly endemic, means there is a constant risk of malaria reintroduction. Characterization of imported cases provides useful insight for programme and enables better evidence-based decision-making to ensure malaria elimination can be sustained.

Knowledge, attitudes and practices about malaria in Cabo Verde: a country in the pre-elimination context.

BACKGROUND: Malaria in Cape Verde is unstable, with a sporadic and seasonal transmission of low endemicity. In this sense, the community perceptions regarding malaria transmission, their attitudes and practices against the disease are very important to understand and to better develop the best strategical policies to achieve malaria elimination goal. This study aim to assess the knowledge, attitudes and practices (KAP) of Cape Verdean population about malaria, a country in the elimination step of disease. METHODS: A cross-sectional malaria KAP Survey was performed at the household level. A structured open questionnaire was developed and applied to residents of randomly selected households from 5 islands and 15 municipalities in Cape Verde. Correlation analyses were performed using a logistic regression model to determine the factors that are associated with the complete knowledge of the population about malaria. RESULTS: A total of 1953 fully completed questionnaires were analysed, with majority of questionnaires administered in Santiago island (68.3%), mainly in the capital city of Praia, 38.43%. About 88% of the population knew the correct form of transmission, 96% had knowledge that the entire population is at risk of malaria and identified the main symptoms. Regarding the attitudes, 58% seek treatment atthe nearest health structure upon the apparition of the symptoms, 64% in the first 24 h and 88% within the first 48 h. More than 97% have heard about mosquito nets but only 19% used it. In practice, 53% use coils, 45% rely on household sprays and 43% have benefited from IRS. About 90% received information about malaria from media, mainly the TV and the radio (83 and 43%, respectively). In summary, 54% of the population has complete knowledge of the disease. CONCLUSION: The population of Cape Verde has a high level of knowledge about malaria, including its transmission, main symptoms and preventive and control measures. However, some gaps and misunderstandings have been noticed and contribute to the insufficient community involvement in actions against malaria. Therefore, is necessary to increase the knowledge of the population, leading to their full ownership and participation in community actions to contribute to the malaria elimination in the country.

Achievement of malaria pre-elimination in Cape Verde according to the data collected from 2010 to 2016.

BACKGROUND: Malaria, despite being preventable and treatable, continues to be a major public health problem worldwide. The archipelago nation of Cape Verde is in a malaria pre-elimination phase with the highest potential to achieve the target goal of elimination in 2020. METHODS: Nationwide malaria epidemiological data were obtained from the Cape Verde health information system that includes the individual malaria case notification system from all of the country's health structures. Each case is reported to the surveillance service then to the National Malaria Control Programme, which allowed for compilation in the national malaria case database. The database was analysed to assess the origin of the malaria cases, and incidence was calculated from 2010 to 2016 by sex and age. The health centre, health district and month of diagnosis were evaluated, as well as the sex and the age of the patients, allowing a direct descriptive analysis of national data to provide an up-to-date malaria epidemiological profile of the country. Malaria cases were classified as imported or indigenous, and then, geographical analyses were performed using a unique Geographical National Code with Quantum Geographic Information System 2.16.2 software to map the cases by municipalities. The overall temporal evolution of cases was analysed to assess their monthly and yearly variations from 2010 to 2016. RESULTS: Malaria is unstable in Cape Verde, with inter-annual variation and the majority of infections occurring in adult males (> 20 years). The indigenous cases are restricted to Santiago (96%) and Boavista (4%), while imported cases were recorded in all the nine inhabited islands, originating from neighbouring countries with ongoing malaria transmission; from Lusophone countries (25% from Angola, 25% from Guinea-Bissau), followed by the Republic of Senegal (12%) and Equatorial Guinea (10%). In 2010-2012, more imported (93 cases) than indigenous cases (26 cases) were observed; conversely, in 2013 and 2014, more indigenous cases (49) than imported cases (42) were reported. In 2015 there were 20 imported cases and only 7 indigenous cases. Finally, in 2016, there were 47 indigenous cases and 28 imported cases. The mapping of cases by municipality and country of origin was possible with GIS analyses. CONCLUSION: While Cape Verde remains on track to achieve malaria elimination by 2020 owing to the reduction of the annual incidence to below 0.1%, the country still records cases of indigenous and imported malaria. However, the indigenous cases are exclusively confined to the Santiago and Boavista islands, while the imported cases recorded nationwide originate only from the African continent, mainly from adult men from the Lusophone countries. Cape Verde needs to target interventions to remove residual foci on Santiago and Boavista islands to reduce malaria lethality to zero and prevent its reintroduction from African countries via transmission across the archipelago. Cape Verde is a good example of local authority's commitment to tackle malaria and work towards its elimination by strengthening the health and surveillance systems.

Immunoglobulin G elution in protein A chromatography employing the method of chromatofocusing for reducing the co-elution of impurities.

Purification processes for monoclonal Immunoglobulin G (IgG) typically employ protein A chromatography as a capture step to remove most of the impurities. One major concern of the post-protein A chromatography processes is the co-elution of some of the host cell proteins (HCPs) with IgG in the capture step. In this work, a novel method for IgG elution in protein A chromatography that reduces the co-elution of HCPs is presented where a two-step pH gradient is self-formed inside a protein A chromatography column. The complexities involved in using an internally produced pH gradient in a protein A chromatography column employing adsorbed buffering species are discussed though equation-based modeling. Under the conditions employed, ELISA assays show a 60% reduction in the HCPs co-eluting with the IgG fraction when using the method as compared to conventional protein A elution without affecting the IgG yield. Evidence is also obtained which indicates that the amount of leached protein A present in free solution in the purified product is reduced by the new method. Biotechnol. Bioeng. 2017;114: 154-162. © 2016 Wiley Periodicals, Inc.

Interconnection between microstructure and microhardness of directionally solidified binary Al-6wt.%Cu and multicomponent Al-6wt.%Cu-8wt.%Si alloys.

An experimental study has been carried out to evaluate the microstructural and microhardness evolution on the directionally solidified binary Al-Cu and multicomponent Al-Cu-Si alloys and the influence of Si alloying. For this purpose specimens of Al-6wt.%Cu and Al-6wt.%Cu-8wt.%Si alloys were prepared and directionally solidified under transient conditions of heat extraction. A water-cooled horizontal directional solidification device was applied. A comprehensive characterization is performed including experimental dendrite tip growth rates (VL) and cooling rates (TR) by measuring Vickers microhardness (HV), optical microscopy and scanning electron microscopy with microanalysis performed by energy dispersive spectrometry (SEM-EDS). The results show, for both studied alloys, the increasing of TR and VL reduced the primary dendrite arm spacing (l1) increasing the microhardness. Furthermore, the incorporation of Si in Al-6wt.%Cu alloy to form the Al-6wt.%Cu-8wt.%Si alloy influenced significantly the microstructure and consequently the microhardness but did not affect the primary dendritic growth law. An analysis on the formation of the columnar to equiaxed transition (CET) is also performed and the results show that the occurrence of CET is not sharp, i.e., the CET in both cases occurs in a zone rather than in a parallel plane to the chill wall, where both columnar and equiaxed grains are be able to exist.

Assessment of Laparoscopic Skills Performance: 2D Versus 3D Vision and Classic Instrument Versus New Hand-Held Robotic Device for Laparoscopy.

INTRODUCTION AND OBJECTIVES: Laparoscopic surgery has undeniable advantages, such as reduced postoperative pain, smaller incisions, and faster recovery. However, to improve surgeons' performance, ergonomic adaptations of the laparoscopic instruments and introduction of robotic technology are needed. The aim of this study was to ascertain the influence of a new hand-held robotic device for laparoscopy (HHRDL) and 3D vision on laparoscopic skills performance of 2 different groups, naïve and expert. MATERIALS AND METHODS: Each participant performed 3 laparoscopic tasks-Peg transfer, Wire chaser, Knot-in 4 different ways. With random sequencing we assigned the execution order of the tasks based on the first type of visualization and laparoscopic instrument. Time to complete each laparoscopic task was recorded and analyzed with one-way analysis of variance. RESULTS: Eleven experts and 15 naïve participants were included. Three-dimensional video helps the naïve group to get better performance in Peg transfer, Wire chaser 2 hands, and Knot; the new device improved the execution of all laparoscopic tasks (P < .05). For expert group, the 3D video system benefited them in Peg transfer and Wire chaser 1 hand, and the robotic device in Peg transfer, Wire chaser 1 hand, and Wire chaser 2 hands (P < .05). CONCLUSION: The HHRDL helps the execution of difficult laparoscopic tasks, such as Knot, in the naïve group. Three-dimensional vision makes the laparoscopic performance of the participants without laparoscopic experience easier, unlike those with experience in laparoscopic procedures.

Population genetic structure of Bombus terrestris in Europe: Isolation and genetic differentiation of Irish and British populations.

The genetic structure of the earth bumblebee (Bombus terrestris L.) was examined across 22 wild populations and two commercially reared populations using eight microsatellite loci and two mitochondrial genes. Our study included wild bumblebee samples from six populations in Ireland, one from the Isle of Man, four from Britain and 11 from mainland Europe. A further sample was acquired from New Zealand. Observed levels of genetic variability and heterozygosity were low in Ireland and the Isle of Man, but relatively high in continental Europe and among commercial populations. Estimates of Fst revealed significant genetic differentiation among populations. Bayesian cluster analysis indicated that Irish populations were highly differentiated from British and continental populations, the latter two showing higher levels of admixture. The data suggest that the Irish Sea and prevailing south westerly winds act as a considerable geographical barrier to gene flow between populations in Ireland and Britain; however, some immigration from the Isle of Man to Ireland was detected. The results are discussed in the context of the recent commercialization of bumblebees for the European horticultural industry.

Chemistry and biological activity of ramalina lichenized fungi.

Lichens are a form of symbiont between a fungus and an alga or cyanobacterium, which contains a wide variety of organic compounds with certain secondary metabolite classes typical of these organisms. The Ramalina genus has approximately 246 species distributed around the World, of which in this review approximately 118 species with published chemical or biological activity studies of extracts or isolated compounds were cited. From the 153 mentioned compounds, only 27 passed were tested for biological activity, being usnic acid the most studied compound and the one showing the best results in almost all in vitro tests performed, although other compounds also presented excellent results as antimicrobial, antitumor and anti-inflammatory agents, among others. Extracts of several species also presented significant results in performed biological tests, demonstrating the potential that these organisms have, in particular, the gender Ramalina, to produce bioactive molecules that can be used as a model for the production of pharmaceuticals.

The trust-commitment challenge in service quality-loyalty relationships.

PURPOSE: The purpose of this paper is to develop and empirically test a model to examine service quality, satisfaction, trust and commitment as loyalty antecedents in a private healthcare service. DESIGN/METHODOLOGY/APPROACH: The approach was tested using structural equation modelling, involving 175 patients from a private Portuguese healthcare unit, using a revised Service Quality Assessment Scale (SQAS) scale for service quality evaluation. FINDINGS: The scale used to evaluate service quality is valid and meaningful. Service quality proved to be a multidimensional construct and relevant to build satisfaction. The path satisfaction→trust→loyalty was validated, whereas the path satisfaction→commitment→loyalty was not statistically supported. RESEARCH LIMITATIONS/IMPLICATIONS: The revised SQAS scale showed good internal consistency in healthcare context. Further trust-commitment antecedents must be examined in a private healthcare landscape to generalise the findings. PRACTICAL IMPLICATIONS: Healthcare quality managers must explore the service quality dimensions to generate satisfaction among their patients. Developing trust generates positive patient attitudes and loyalty. ORIGINALITY/VALUE: This study explores using the SQAS scale in a private healthcare context. The authors provide further evidence that service quality is an antecedent and different from satisfaction. All the measures used proved to be valid and reliable. Trust and commitment play different roles in their relationship with loyalty.