redesign

BACKGROUND: Healthcare systems constantly evolve to improve care quality and resource utilization. One way is implementing Value-Based Healthcare (VBHC) an economic approach. This scoping review aims to identify and describe the literature on VBHC, particularly its psychosocial aspects, to uncover research gaps. METHOD: The review followed the PRISMA guidelines for Scoping Reviews. We took the following 14 steps: (a) defining the research question; (b) identifying relevant studies; (c) selecting studies; (d) 15 mapping data; (e) collecting, synthesizing and reporting results...

As an excellent single-stage object detector based on neural networks, YOLOv5 has found extensive applications in the industrial domain; however, it still exhibits certain design limitations. To address these issues, this paper proposes Efficient Scale Fusion YOLO (ESF-YOLO). Firstly, the Multi-Sampling Conv Module (MSCM) is designed, which enhances the backbone network's learning capability for low-level features through multi-scale receptive fields and cross-scale feature fusion. Secondly, to tackle occlusion issues, a new Block-wise Channel Attention Module (BCAM) is designed, assigning greater weights to channels corresponding to critical information...

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Based on an ethnographically inspired approach, the article examines how the organisation of workspaces shapes healthcare work and its embodied everyday rhythms. The data is gathered in a health station, which has been redesigned. We approach the health station utilizing Henri Lefebvre's (1991) theory on the production of space. The article analyses how the conflicting values of a health station are embodied in the workplace, using Lefebvre's rhythmanalysis and the concept of organisational dressage. The analysis shows tensions between conceived space and lived space with their different rhythms...

Approximately 3.3 billion people live with the threat of Plasmodium vivax malaria. Infection can result in liver-localized hypnozoites, which when reactivated cause relapsing malaria. This work demonstrates that an enzyme-cleavable polymeric prodrug of tafenoquine addresses key requirements for a mass administration, eradication campaign: excellent subcutaneous bioavailability, complete parasite control after a single dose, improved therapeutic window compared to the parent oral drug, and low cost of goods sold (COGS) at less than $1...

This paper investigates the approximate optimal coordination for nonlinear uncertain second-order multi-robot systems with guaranteed safety (collision avoidance) Through constructing novel local error signals, the collision-free control objective is formulated into an coordination optimization problem for nominal multi-robot systems. Based on approximate dynamic programming technique, the optimal value functions and control policies are learned by simplified critic-only neural networks (NNs). Then, the approximated optimal controllers are redesigned using adaptive law to handle the effects of robots' uncertain dynamics...

BACKGROUND: Clinical decision support (CDS) tools that incorporate machine learning-derived content have the potential to transform clinical care by augmenting clinicians' expertise. To realize this potential, such tools must be designed to fit the dynamic work systems of the clinicians who use them. We propose the use of academic detailing-personal visits to clinicians by an expert in a specific health IT tool-as a method for both ensuring the correct understanding of that tool and its evidence base and identifying factors influencing the tool's implementation...

Enzyme engineering, though pivotal across various biotechnological domains, is often plagued by its time-consuming and labor-intensive nature. This review aims to offer an overview of supportive in silico methodologies for this demanding endeavor. Starting from methods to predict protein structures, to classification of their activity and even the discovery of new enzymes we continue with describing tools used to increase thermostability and production yields of selected targets. Subsequently, we discuss computational methods to modulate both, the activity as well as selectivity of enzymes...

The widespread adoption of an agricultural circular economy requires the recovery of resources such as water, organic matter, and nutrients from livestock manure and sanitation. While this approach offers many benefits, we argue this is not without potential risks to human and environmental health that largely stem from the presence of contaminants in the recycled resources (e.g., pharmaceuticals, pathogens). We discuss context specific challenges and solutions across the three themes: (1) contaminant monitoring; (2) collection transport and treatment; and (3) regulation and policy...

BACKGROUND AND PURPOSE: Effective communication skills are essential for all pharmacists, regardless of practice setting. An implicit need in pharmacy education is to emphasize direct application of these skills to future healthcare practice prior to experiential rotations. The aim of this article is to describe how we revised a required first professional year (P1) doctor of pharmacy course to achieve two main goals: 1) improve the course relevance by connecting content to real-world skills; and 2) qualify all pharmacy students at our institution as certified National Diabetes Prevention Program (DPP) lifestyle coaches upon course completion...

OBJECTIVE: The aim of this study was to determine whether a flipped classroom curriculum coupled with case-based learning would improve residents' perceptions of the learning environment, improve education outcomes, and increase faculty engagement. Research suggests that active learning yields better educational results compared with passive learning. However, faculty are more comfortable providing lectures that require only passive participation from learners. METHODS: A council was created to identify issues with the current format of the resident didactic curriculum and to redesign the neurosurgical curriculum and conference per Accreditation Council for Graduate Medical Education (ACGME) requirements...

Interprofessional care obliges different healthcare professions to share decision-making and sometimes, practices. Given established hierarchies, it can be difficult to promote interprofessional care, partly because of the need to reshape professional identities. Despite interest in effective interprofessional care, there is limited research on how professional identity can be mobilised to promote it. A scoping review as well as lexical review of academic publications was conducted to address this void. After searching seven academic databases and screening the identified publications, 22 publications met the inclusion criteria...

BACKGROUND AND PURPOSE: Diversity within the physical therapy profession lags in comparison to the United States population. As the profession strives to diversify, faculty must pay attention to diversity, equity, inclusion, and belonging (DEI-B) in curricular approaches, including classroom materials, instruction, and assessment. With critical application, students from equity-deserving groups (EDGs) can provide unique perspectives to faculty about curricular approaches. Case study purposes were to 1) enable students from EDGs to partner with faculty, as student pedagogical consultants (SPCs), in 2 courses in a Doctor of Physical Therapy program to provide feedback on DEI-B efforts related to curricular approaches and 2) describe the outcomes of SPCs experience...

Triboelectric nanogenerators (TENG) are useful devices for converting mechanical motion into electric current using readily available materials. Though the applications for these devices span across many fields, TENG can be leveraged for mass spectrometry (MS) as inexpensive and effective power supplies for pulsed nanoelectrospray ionization (nESI). The inherently discontinuous spray provided by TENG is particularly useful in scenarios where high sample economy is imperative, as in the case of ultraprecious samples...

The vertebral column represents an essential element for support, mobility, and the protection of the central nervous system. Various pathologies can compromise these vital functions, leading to pain and a decrease in the quality of life. Within the scope of this study, a novel redesign of the Intersomatic Cage, traditionally used in the presence of discopathy, was proposed. The adoption of additive manufacturing technology allowed for the creation of highly complex geometries, focusing on the lumbosacral tract, particularly on the L4-L5 and L5-S1 intervertebral discs...

BACKGROUND: The Eastern Africa Network for Bioinformatics Training (EANBiT) has matured through continuous evaluation, feedback, and codesign. We highlight how the program has evolved to meet challenges and achieve its goals and how experiential learning through mini projects enhances the acquisition of skills and collaboration. We continued to learn and grow through honest feedback and evaluation of the program, trainers, and modules, enabling us to provide robust training even during the Coronavirus disease 2019 (COVID-19) pandemic, when we had to redesign the program due to restricted travel and in person group meetings...

Candida albicans is a prevalent fungal pathogen that displays antibiotic resistance. The polyene antifungal amphotericin B (AmB) has been the gold standard because of its broad antifungal spectra, and its liposomal formulation, AmBisome, has been used widely and clinically in treating fungal infections. Herein, we explored enhancing the antifungal activity of AmBisome by integrating a small chitin-binding domain (LysM) of chitinase A derived from Pteris ryukyuensis . LysM conjugated with a lipid (LysM-lipid) was initially prepared through microbial transglutaminase (MTG)-mediated peptide tag-specific conjugation of LysM with a lipid-peptide substrate...

Fusing multiple sensor perceptions, specifically LiDAR and camera, is a prevalent method for target recognition in autonomous driving systems. Traditional object detection algorithms are limited by the sparse nature of LiDAR point clouds, resulting in poor fusion performance, especially for detecting small and distant targets. In this paper, a multi-task parallel neural network based on the Transformer is constructed to simultaneously perform depth completion and object detection. The loss functions are redesigned to reduce environmental noise in depth completion, and a new fusion module is designed to enhance the network's perception of the foreground and background...

Nursing homes struggle to meet the needs of their residents as they become older and frailer, live with more complex co-morbidity, and are impacted by memory impairment and dementia. Moreover, the nursing home system is overwhelmed with significantly constraining organisational and regulatory demands that stand in the way of achieving resident-focused outcomes. These issues are compounded by the perceptions of poor working environments, poor remuneration, and poor satisfaction amongst staff. The system is beyond the state of 'reform' and requires a fundamental redesign based on first organisational systems understandings: a clearly defined purpose and goal, shared values, and system-wide agreed "simple (or operating) rules"...

BACKGROUND: ICU outcomes are continuing to improve. However, this has not been matched by similar improvements of the ICU bedspace environment, which can detrimentally impact on patient outcomes. Excessive sound and noise, especially, has been linked with adverse and potentially preventable patient outcomes and staff errors. There are many sources of sound in the ICU, with alarms from bedside equipment frequently listed as a main source. The number of alarms is increasing in parallel with the introduction of new and more sophisticated technologies to monitor and support patients...