#journal of clinical monitoring and computing

[jcsmicasereports]

Aspiration pneumonia due to anesthesia digestive endoscopy under COVID-19: a case report by Xin Wang in Journal of Clinical Case Reports Medical Images and Health Sciences

Abstract

Background: Digestive endoscopy is an important test for early cancer screening. The most serious complication during the examination was aspiration pneumonia. However, these patients currently do not receive much attention.

Case report: A woman was brought to the Emergency Department because of fever. Chest computed tomography revealed consolidation of the lower left lung, so the patient was diagnosed with aspiration pneumonia after anesthesia digestive endoscopy. we collected Bronchoalveolar lavage (BALF) for testing of metagenomic next generation sequencing (mNGS). The result of mNGS was normal. After 7 days of medical treatment, the pneumonia subsided.

Conclusion: This case reminded us that digestive endoscopy under sedation carried a risk of aspiration pneumonia in even healthy patients. When COVID-19 prevalent, we should make a definitive diagnosis of patients with fever as soon as possible and improve etiological tests to prevent delays.

Keywords: Aspiration pneumonia, Digestive endoscopy, Case report

Introduction

Digestive endoscopy is an important test for early cancer screening. As the test is uncomfortable so more and more people choose general anesthesia. The most serious complication during the examination was aspiration pneumonia due to reflux and aspiration.

However, these patients do not currently attract much attention, especially from anesthesiologists. Here, we report a healthy nurse who had undergone digestive endoscopy, aspiration pneumonia developed during induction of general anesthesia under COVID-19.

Case Report

A woman was brought to the Emergency Department of the Center Hospital of Jinan because of fever. She got aspirated and developed severe shortness and chest pain. History of anesthesia digestive endoscopy 1 day ago, accompanied by vomiting. Her past medical history was unremarkable, she denied cigarette smoking, and has no history of allergy, anaphylaxis or bronchial asthma. Upon arrival at the hospital, she was connected to the monitor and put on humidified oxygen. On examination, she was severely distressed, blood pressure of 120/60mmHg, pulse rate of 108 beats per minute, oxygen saturation of 95% at room air, and respiratory rate of 26 breaths per minute, temperature of 39 degrees. On physical examination, wet rales were heard in the lower left lung. Blood gas analysis showed pH 7.45, partial pressure of carbon- dioxide 36.00 mmHg and partial pressure of oxygen 71.00 mmHg with 2 L/min oxygen via nasal cannula. The peripheral white blood cell count (9940/μL) and C-reactive protein level (78.5mg/h) were slightly high. The results of blood coagulation function test, biochemistry tests, myocardial enzymes, urinalysis and stool analysis were normal. Chest computed tomography revealed consolidation of the lower left lung.

Under COVID-19, in order to rule out the atypical pathogen infection and assist the patient in expulsion of inhaled substances, we performed tracheoscopy. Flexible bronchoscope showed injured and edematous surfaces of the large airways. Bronchoalveolar lavage was performed from the posterior segmental bronchus of the upper lower of her left lung. A cell count of the bronchoalveolar lavage fluid (BALF) revealed57.5% macrophages, 28.0% neutrophils, 11.0% lymphocytes, and 3.5% eosinophils. The total BALF cell count was 4.2 × 106/mL. No bacteria or fungus was isolated from cultures of BALF. we collected BALF for testing of metagenomic next generation sequencing (mNGS). The result of mNGS was normal.

During hospitalization, the patient received piperacillin/ tazobactam to prevent bacterial pneumonia，hormonal anti-inflammatory and bronchodilators to improve the bronchospasm or wheezing.

After 7 days of medical treatment, the pneumonia subsided, blood, sputum cultures revealed negative findings. and she was discharged in a stable condition. The Fig. 2 was the chest CT of review.

Discussion

The possibility of aspiration pneumonia was considered based on the rapid onset of the patient, the absence of previous upper respiratory infection and chest CT findings. The patient's clinical manifestations, chest CT and hematological examination results further confirmed the hypothesis. The patient's symptoms improved after early treatment with oxygen therapy, anti-infection and hormone anti-inflammatory therapy, which was also consistent with previous research results (1).

Chest CT of aspiration pneumonia often shows multifocal consolidation or patchy ground-glass opacity (2). Because the patient was in left decubitus at the time of digestive endoscopy, so gastric contents flowed back into the left side, then large exudate shadows can be seen in the lower lobe of the left lung. We all know, Aspiration of large amounts of gastric acid will result in the induction of a chemical injury to the airways and lung parenchyma. Aspiration is recognized as an independent risk factor for the subsequent development of pneumonia or acute lung injury or acute respiratory distress syndrome (ALI/ARDS). (3)

Our patient developed dyspnea and hypoxemia. In order to prevent further exacerbation of lung injury, we treated with hydrocortisone. The other study suggested that, in bronchi-aspiration, Steroids are not proven to improve outcome or reduce mortality (4). After hormone therapy, the patient's symptoms of dyspnea and hypoxemia were significantly improved. There were any adverse reactions. However, it remains to be discussed whether hormones can be used as a routine treatment for aspiration pneumonia.

Conflict of interest statement

All authors have read and approve the final manuscript.

Author contribution statement    

Wang Jing wrote the manuscript, conceived and designed the report; Cui JY collected and prepared the images; Wang X reviewed and confirmed the final version of the manuscript.

Ethics statement

The authors declare that appropriate written informed consent was obtained for the publication of this manuscript and accompanying images.

[crimsonpublishers-medical]

Healthcare Critical Knowledge Monitor System Model: Healthcare Knowledge Capture Component Specification

Healthcare Critical Knowledge Monitor System Model: Healthcare Knowledge Capture Component Specification- Crimson Publishers

The constant evolution of Information and Communication Technologies brings new opportunities with multiple forms of communication, therefore new ways of sharing knowledge. In healthcare practice, being updated it’s extremely important in order to provide a better service. The growth of multiple sources of knowledge, mostly supported by technology, gives more opportunity to achieve it. Another way to be updated is sharing knowledge with partners and communities, which is becoming part of the healthcare organizations culture (i.e. Electronic Health Record systems). Healthcare organizations manage with personal information concerning to patients such as clinical treatment, clinical history, drug administration, diseases casuistic, among others; and from many sources, such as patient’s feedback, knowledge from suppliers, knowledge from Internet sources, knowledge from decision support systems and inference knowledge (e.g. knowledge from data mining techniques) that are supported by computer based systems and therefore, demands cautious when are ethical and legal aspects involved. The Critical Knowledge Monitor System Model, proposed, allows knowledge sharing in a controlled ambient and could be a part of the answer to this paradigm that healthcare organizations face. To implement the Critical Knowledge Monitor System model we’ll need, to capture knowledge in multiple forms in healthcare organizations, to accomplish it knowledge engineering techniques such as text mining techniques, Information retrieval, ontology construction, among others, should be applied. Since not all knowledge manage by healthcare organizations could be considered critical (or much critical), it’s necessary to use specific clinical constructs, such as sensitivity and, we believe, combining it with information security principles CIA and Privacy we could assess documents and classify them as critical to the healthcare organization.

For more open access journals in crimson publishers Please click on link: https://crimsonpublishers.com

For more articles on Research in Medical & Engineering Sciences Please click on link: https://crimsonpublishers.com/rmes/

[rojgarbharat]

Name of Post:

Amity University Teaching Non Teaching Recruitment 2024

Post Date:05/05/2024Short Information :Amity University invites has Recently Recruit to the Pro Vice-Chancellor,Deans,Directors,Associate Professor/ Professor,Non-Teaching Faculty Recruitment 2024.

Amity University, Bihar

Teaching & Non Teaching Job Recruitment 2024

WWW.ROJGARBHARAT.INFO

Application Fee

 No Need.

Important Dates

Job Posted : 05/05/2025

Last Date : NA

Job Location

MUMBAI, LUCKNOW, JAIPUR, GURUGRAM, GWALIOR, RAIPUR, BENGALURU, KOLKATA, RANCHI, PATNA AND MOHALI

Job Title: Details

Pro Vice-Chancellor

Deans

Directors

Associate Professor/ Professor

Non-Teaching Faculty:

Admission Counsellors

Accounts Department

Manager HR (Talent Acquisition)

Manager HR CHRIS)

Digital Marketing

Incubation Manager

Performance Marketing

Social Media Management

Content Marketing

Department :

DIRECTORS FOR INSTITUTIONS IN THE FOLLOWING DISCIPLINES: • School of Applied Science • School of Architecture & Interior Design • School of Business • School of Engineering & Technology • School of Fashion Technology • School of Fine Arts • School of Foreign Languages • School of Hospitality • School of Law • School of Liberal Arts • School of Mass Comm. • School of Paramedical Sciences • School of Performing Arts • College of Commerce & Finance • College of Nursing • Institute of Biotechnology • Institute of Psychology & Allied Sc. • Institute of Pharmacy • Institute of Information Technology • Medical School • Film School • Institute of Clinical Psychology

DIRECTORS FOR FOLLOWING DEPARTMENTS: • Academic Monitoring & Support • Admissions • Outreach • Human Resources • International Engagement • IPR • Marketing • Open Learning Resources • Internal Quality Assurance • Academic Coordination • Controller of Examination • Accreditation & Ranking • Hostels and Security • Administration • Registrar • Placements and Industry Integration • Corporate Communications and PR

DEANS FOR FOLLOWING DEPARTMENTS: • Academics • Research • International Affairs • Student Welfare Preference will be given to the candidates applying for the position of Directors with exposure in Foreign Universities and strong research and administrative track record

PROFESSORS/ ASSOCIATE PROFESSORS IN: • Applied Sciences • Architecture & Planning • Artificial intelligence • Clinical Psychology • Commerce • Cyber Security • Design • Data Science • Economics • Education • Engineering (Aerospace, Biomedical, Computer Science/IT, Chemical, Civil, Electrical, ECE, Mechanical) • English • Environmental Sc. • Fashion Technology • Finance • Fine Arts • Food Technology • Forensic Science • Hospitality • Humanities and Social Sciences • Interior Design • International Business • Journalism & Mass Communication • Languages (Chinese, Spanish, German, French, Japanese, Russian) • Law • Management (Finance, HR, Marketing, Qualitative Techniques, Strategy) • Machine Learning • Medical and Allied Sciences (Audiology & Speech Language Pathology, Dietetics & Nutrition, Orthodontics, Clinical Optometry, Medical Lab Technology, Clinical Research, Public Health, Hospital Administration) • Nanotechnology • Performing Arts • Nursing • Pharmacy • Physical Education & Sports Sc. • Psychology and Behavioural Sc. • Special Education • Robotics • Travel & Tourism

Employment Type

Full Time.

Qualification Details

As per UGC norms. Ph.D.

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[jcmarchi]

Transforming Clinical Recording of Deep Brain Activity with a New Take on Sensor Manufacturing - Technology Org

New Post has been published on https://thedigitalinsider.com/transforming-clinical-recording-of-deep-brain-activity-with-a-new-take-on-sensor-manufacturing-technology-org/

Transforming Clinical Recording of Deep Brain Activity with a New Take on Sensor Manufacturing - Technology Org

Sensors built with a new manufacturing approach are capable of recording activity deep within the brain from large populations of individual neurons–with a resolution of as few as one or two neurons–in humans as well as a range of animal models, according to a study published in the issue of the journal Nature Communications.

The Integrated Electronics and Biointerfaces Laboratory (IEBL) at the University of California San Diego leads the research team.

The approach is unique in several ways. It relies on ultra-thin, flexible, and customizable probes made of clinical-grade materials and equipped with sensors that can record extremely localized brain signals. Because the probes are much smaller than today’s clinical sensors, they can be placed extremely close to one another, allowing for high-resolution sensing in specific areas at unprecedented depths within the brain. 

These ultra-thin, flexible and customizable probes, are made of clinical-grade materials. Image credit: David Baillot/UC San Diego Jacobs School of Engineering

Currently, the probes can record with up to 128 channels, while today’s state-of-the-art clinical probes have only 8 to 16 channels. In future, the innovative manufacturing approach the researchers developed can expand the number of channels to thousands per probe, dramatically enhancing physicians’ ability to acquire, analyze and understand brain signals at a higher resolution. 

This technology is a first step towards wireless monitoring of patients with treatment-resistant epilepsy for extended periods–up to 30 days–as they go about their daily lives. Beyond treatment-resistant epilepsy, the potential applications are much broader, including helping people with Parkinson’s disease, movement disorders, obsessive-compulsive disorder, obesity, treatment-resistant depression, high-impact chronic pain and other disorders.

While the Nature Communications paper reports brain-recording data only, the system has been developed to both record brain activity and provide electrical stimulation to precise locations. In fact, the team is building on previous – and ongoing – work that uses this scalable, thin-film manufacturing approach to create brain-computer interfaces that record activity and deliver therapeutic electrical stimulation to the surface of the brain cortex. 

The probes are monolithic, meaning that their individual components are layered on top of one another to create a single, cohesive unit, and do not require manual assembly of additional wires to conduct recordings.

The new recording system is both extremely customizable and scalable to manufacture, thanks to thin-film technology derived from the semiconductor and digital-display screen industries. As such, the probes are extremely compact–15 micron thick, or about 1/5th the thickness of a human hair–minimizing the differences between the material properties of the probe and the brain.

“We developed an entirely different manufacturing method for thin-film electrodes that can reach deep brain structures – at a depth that is necessary for therapeutic reasons – enabling reproducible, customizable, and high-throughput production of electrodes but with a high spatial resolution and channel count despite a thinner electrode body. Additionally, the electrode insertion is compatible with existing surgical techniques in the operating room, lowering the barrier for their adoption in clinical procedures,” said UC San Diego electrical engineering professor Shadi Dayeh, the corresponding author on the new paper. 

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The design, manufacture, experimental testing and analysis of results from this system was performed by a cross-disciplinary team of engineers, surgeons, and medical researchers from UC San Diego; Harvard Medical School and Massachusetts General Hospital; and Oregon Health and Science University.

Dayeh advises two of the three first authors on the paper: UC San Diego postdoctoral researcher Keundong Lee and UC San Diego graduate student researcher Yun Goo Ro. Angelique C. Paulk, also a first author, is a researcher at Massachusetts General Hospital and Harvard Medical School in a group led by neurologist Dr. Sydney Cash. 

Toward a 30 day wireless brain-recording system

The kind of system researchers developed is needed in order to identify the very specific regions of the brain that are triggering seizures caused by treatment-resistant epilepsy. To meet this goal, the team is working toward their vision of a brain-monitoring system with sensors both inserted deep within the brain and sensors on the surface of the brain.

These sensors will communicate wirelessly with a small computer system in a wireless cap, which a person could wear for extended periods of time. This cap would provide wireless power and the computational infrastructure to capture the brain signals being recorded from a person’s brain for 30 days. 

From left: Keundong Lee, a postdoctoral fellow at UC San Diego, and one of the paper’s first authors, and Shadi Dayeh, a professor in the UC San Diego Department of Electrical and Computer Engineering and the paper’s corresponding author. They are looking at an electrode under the microscope.

“We are currently focused on applying the technology to patients with treatment-resistant epilepsy. The ultimate goal is to advance the system and related required technologies by 2026 to give patients access to a wireless system that allows them to move freely within the hospital environment and then at home, without being tethered to any machinery, while cortical and deep brain structures are monitored continuously for up to 30 days,” Dayeh said. 

The system is called the UC San Diego Micro-stereo-electro-encephalography (µSEEG). The technology that is used to create the device can be manufactured at high volume and low cost because it is derived from existing technologies to manufacture digital display screens, an approach that was originally created by the semiconductor industry.

This unique manufacturing process also allows for a series of unique features for these depth electrodes (see sidebar).

Experimental subjects

The electrodes are equipped with 128 sensors that can record extremely localized brain signals and 16 stimulation contacts that can deliver clinical grade stimulation currents and that can additionally record brain signals.

In the new paper, the team reports the functioning of the new system in two human patients. The team also presents data from a series of different animal models including successful recordings from rat barrel cortex in both acute and chronic settings; recording of the somatosensory cortex in an anesthetized pig; and recordings in non-human primates at different depths inside the brain. 

The data on the successful functioning of the device in humans were collected, with all proper approvals and consent, during already scheduled tumor-removal surgeries. During an unrelated pause in the surgery, clinicians inserted the new depth probes into brain tissue that was about to be removed. 

“In a true test of the translational feasibility of the µSEEG,” the authors write in the Nature Communications paper, referring to the technical term for their device, “we acutely implanted short 64 channel µSEEG electrodes in the middle temporal gyrus in two separate human patient participants undergoing temporal lobe resection for clinical reasons. With each participant, we inserted a single 64 channel short µSEEG device into tissue, which the clinical team determined would be resected.” The recordings lasted 10 minutes and were able to record ongoing spontaneous activity.

Comments from authors on the paper

The electrodes can record brain activity as deep as 10 cm/4 in inside the brain. They are just 15 micron thick, or one-fifth the width of a human hair, and 1.2 millimeters wide

Dr. Keundong Lee (First author #1), Postdoctoral Fellow at IEBL, UC San Diego

It has been a long journey since 2015 to develop a robust, human-grade depth electrode that can be used in clinical practice. Finally, we have discovered an innovative manufacturing technique to create the µSEEG probe, which can assist with high resolution and minimally invasive diagnosis of epilepsy, and potentially treatment for epilepsy and other indications, in the future. 

Beyond epilepsy, continuous monitoring of brain activity at such high resolution could allow us to find biomarkers for other conditions, including perhaps treatment-resistant depression.

Dr.  Angelique Paulk (First author  #2), Instructor in Neurology at Massachusetts General Research Institute and Harvard Medical School

Our lab has worked with the Dayeh lab for almost a decade to bring this innovative technology to fruition. Around 2018, we tested the laminar version of the UC San Diego microSEEG in two patients at MGH. Through iterative feedback that we and Drs. Sharona Ben-Haim, Ahmed Raslan, Mark Richardson, and Ziv Williams provided to inform probe fabrication, we are now happy with the end result that we feel is much closer to clinical use. We were excited to test the longer version in non-human primates here at MGH and to record the activity of single neurons with these devices.  

Dr. Yun Goo Ro (First author #3), PhD graduate from the IEBL, UC San Diego

My research on this electrode was both exciting and challenging as we had to come up with new ways of implementing a scalable electrode with operating principles that are compatible with clinical use. It is very exciting to see my PhD research extended to long electrodes to maximize their clinical impact and I am proud to see the potential of my PhD inventions translate from the benchtop to the bedside. 

Dr. Sydney Cash, MD, Professor of Neurology, Massachusetts General Hospital and Harvard Medical School

These new electrode systems are really exciting. They are designed in a way, which can be easily used in the clinical setting yet provide a level of resolution not seen before. There is no question in my mind that this will help us understand both normal brain function and pathology much better and will lead to new ways to help people suffering from epilepsy and a variety of other neurological problems. 

Dr. Sharona Ben-Haim, MD, Associate Professor of Neurological Surgery, UC San Diego School of Medicine and Surgical Director of Epilepsy, UC San Diego Health 

This new electrode technology is exciting for a large variety of reasons, including its capacity for recording at unprecedented resolution. The future ability of this system to record wirelessly from the brain of epilepsy patients undergoing intracranial EEG evaluation has the potential to dramatically change our current clinical practice. Currently, patients who undergo this type of evaluation remain in the hospital for the duration of the study, where we try to capture where their unique seizures originate during a period of time that typically lasts from 7-21 days. During this time patients are tethered to their hospital beds by the wired cords from the current clinical electrode system. This new technology has the capacity to potentially allow us to send these patients home, freeing them from a long hospital stay, and potentially allowing us to record for longer periods of time and obtain more robust information to help us ultimately treat their seizures with more precision and resolution than previously possible.

Dr. Eric Halgren, Professor of Radiology, Neurosciences, and Psychiatry, UC San Diego

With current electrodes we can only hear the roar of the crowd. The new electrodes will allow us to discern individual voices, and we can begin to learn their language, which is the basic vocabulary of thought.

Dr. Ahmed Raslan, MD, Professorand Vice Chair of Neurological Surgery, Oregon Health and Sciences University

The new depth electrodes combine two unique features: the much higher resolution of recording contacts combined with stimulation capability, which would improve our ability to understand -and potentially change/treat- neural circuits in parts of the brain that are not accessible by surface or penetrating interfaces and at a much higher resolution than current depth electrodes; a strategy that unlocks decades-long trade offs, and, the wireless connectivity which opens the door to recording from humans in an unrestricted environment allowing sampling of various types of behavior. This new electrode is a platform neural interface that can both read and write into the brain in experimental and clinical environments, as such the potential uses and applications are unlimited.

[embedded content]

Features of the UC San Diego Micro-stereo-eletro-encephalography (µSEEG)

The probes can be up to 10 cm in length, allowing for access to structures deep within the brain.

The probes are incredibly thin: just 15 micron thick, or one-fifth the width of a human hair, and 1.2 millimeters wide

When inserted into brain tissue, the probe lined with sensors has a thickness that is smaller than technologies currently in clinical use. This smaller thickness means less brain tissue is damaged when the probe is inserted.

Brain-signal recording electrodes can be placed 60 micrometers apart, which is far closer to each other than technologies currently in clinical use.

Probes with up to 128 brain-signal-recording channels (electrodes) were demonstrated, compared to 8 to 16 recording channels in today’s broadly used clinical depth electrodes. 

The small size of the electrodes allows for extremely localized brain-signal recording, as precise as the signal coming from the individual activity of one or two neurons. They can also record local field potentials, which is aggregate activity of many neurons within a brain region.

The electrode sensors are able to record precise areas of the brain over both short and long time periods. 

The electrodes work well: they record brain activity triggered by stimulating a body part, and they record the brain dynamics known to occur during anesthesia.

The system allowed for simultaneous recording of the cortex of the brain and signals from individual neurons deep within the brain. The researchers were able to correlate the general brain activity to what was happening at the single-neuron level. 

The system allows monitoring the dynamics of brain activity instantaneously, allowing visualization of the propagation of the activity across cortical layers with precision with time.

Cost-effective, scalable manufacturing of the new system is in direct contrast to the expensive and time-consuming manual assembly required for the systems currently in clinical use. All other known experimental depth electrodes require some amount of manual assembly as well. 

Source: UCSD

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[mit]

James Fujimoto, Eric Swanson, and David Huang win Lasker Award

Professor and two additional MIT affiliates honored for influential work on optical coherence tomography, which allows rapid detection of retinal disease, among other applications.

Mary Beth Gallagher | Jane Halpern | School of Engineering | Department of Electrical Engineering and Computer Science

The Lasker Foundation has named James Fujimoto ’79, SM ’81, PhD ’84, the Elihu Thomson Professor in Electrical Engineering and principal investigator in the Research Laboratory of Electronics (RLE), a recipient of the 2023 Lasker-DeBakey Clinical Medical Research Award for his groundbreaking work on optical coherence tomography. Fujimoto shares the award with Eric Swanson SM ’84, a research affiliate at MIT’s Research Laboratory of Electronics and mentor for the MIT Deshpande Center for Technological Innovation, and David Huang PhD ’93, professor of ophthalmology at Oregon Health and Science University.

Considered one of the most prestigious prizes for biomedical research, the Lasker Awards celebrate individuals who have “made major advances in the understanding, diagnosis, treatment, cure, and prevention of human disease.” A large percentage of Lasker Award recipients have gone on to win a Nobel Prize.  

According to the Lasker Foundation citation, Fujimoto, Huang, and Swanson are being honored “for the invention of optical coherence tomography (OCT), a technology that revolutionized ophthalmology — allowing rapid detection of diseases of the retina that impair vision.” An animated video describing the work is available here.

“I am honored to be included among the recipients of this award,” says Fujimoto. “OCT represents the decades-long effort of a multidisciplinary partnership involving scientists, engineers, the clinical community, and industry. We are grateful for the opportunity to help to improve patient care and sincerely thank the Lasker Foundation.”

Prior to the invention of OCT, the standard methods of diagnosing ophthalmic disease were limited. In the early 1990s, Fujimoto, an electrical engineer and expert in advanced laser technologies, collaborated with satellite communications engineer Swanson — then at MIT Lincoln Laboratory — and MD-PhD student Huang to devise a better way to diagnose diseases. Using an optical technique known as interferometry, they developed a technology that could image the three dimensional microscopic structure of the living retina for the first time.  

Their work, published in 1991 in the journal Science, revolutionized the field of ophthalmology and enabled a more precise way to detect disease and monitor treatment. Additional co-authors on this paper are Charles P. Lin, Joel S. Schuman, William G. Stinson, Warren Chang, Michael R. Hee, Thomas Flotte, Kenton Gregory, and Carmen A. Puliafito.

Revolutionizing ophthalmology with echoes of light

To understand how optical coherence tomography works, it’s useful to consider other imaging methods which use echoes. “OCT is an optical analogue of ultrasound or radar,” explains Fujimoto. “Instead of sound, it measures echo delays of reflected or scattered light in order to image the subsurface microstructure in tissues or materials in situ.”

The short wavelength of light allows for microscopic resolution of the images generated by OCT, but using light — as opposed to sound, which travels slower and has longer wavelengths — introduces thorny technological problems.

“The speed of light is extremely fast,” notes Fujimoto. “Light from the moon travels to earth in 1.3 seconds. So, in order to measure echo time delay over the very small dimensions in biological tissues, you need extremely high-resolution measurement technology.” 

Here, Fujimoto, Swanson, and Huang found that their differing backgrounds enhanced their problem-solving capabilities. 

“OCT uses many of the advances that were developed in high-speed optical communications,” explains Fujimoto. One of the team’s realizations was that infrared light provided good penetration of human tissues and interferometry could achieve the required high resolution and sensitivity. This made it possible to measure the “echo time” of reflected or scattered infrared light waves, thus creating a microscopic-resolution, three-dimensional image of subsurface structures inside tissues.

Performing Optical Biopsy

Importantly, the technology is not a substitute for ultrasound, CT or MRI, but rather a different tool with unique and complementary strengths. MRI, CT and ultrasound can penetrate deep into the body to create a full-body image, but have limited resolution. OCT can perform “optical biopsy,” imaging subsurface structure with microscopic resolution, without the need to excise and process specimens. OCT has limited imaging depth in tissues other than the eye, but can be combined with other optical instruments to image inside the body.

OCT could not have been developed without interdisciplinary collaboration with clinician scientists. Carmen Puliafito and Joel Schuman, then at the New England Eye Center and Tufts University School of Medicine, respectively, led the first clinical studies developing OCT in diabetic retinopathy, age related macular degeneration and glaucoma. These studies helped define the future clinical applications of OCT and commercialization in ophthalmology.

Retinal imaging became the largest application of OCT; in ophthalmologists’ offices worldwide, it is now considered the standard of care for diagnosing and monitoring eye disease. OCT has also helped improve understanding of disease mechanisms and accelerated development of new pharmaceutical treatments.

Many ophthalmologists say that OCT allows the non-specialist to detect disease with the sensitivity approaching that of a specialist. Diseases such as diabetic retinopathy, age-related macular degeneration, and glaucoma which may not produce noticeable symptoms at an early stage, can be detected and treated before there is irreversible vision loss.  

Now, applications of OCT are being developed for even broader public usage outside of ophthalmology clinics. “In the future it will be possible to screen for diseases by having an automated OCT exam in local drug stores. The eye is a window on health – in addition to vision impairing eye diseases, OCT can enable detection of systemic disease such as diabetes and neurological conditions. The impact on public health could be immense,” explains Fujimoto.

OCT also has applications far beyond ophthalmology. The team quickly realized that fiber optics could be used to extend OCT’s reach into deeper areas of the body, imaging through catheters, endoscopes, and laparoscopes.

Intravascular imaging is the second largest application of OCT and was developed in collaboration with Mark Brezinski, a cardiologist at the Massachusetts General Hospital and Harvard Medical School. Brezinski demonstrated that OCT could detect unstable atherosclerotic plaques which cause heart attacks and led many of the first studies demonstrating OCT for optical biopsy.

“There are tissues that are not typically biopsied, such as retina, coronary arteries, nerves, and brain where OCT can provide information on pathology in situ and in real-time,” says Fujimoto. “Another application is surgical guidance — you can see beneath the tissue surface to avoid sensitive nerves and blood vessels before making an incision.”

With many research groups and clinics developing technology and applications, OCT stands as a shining example of the potential of interdisciplinary, and international, scientific cooperation. “Interdisciplinary collaboration is very popular now, but it was relatively uncommon in the 1990s, when OCT was first developed,” explains Fujimoto.

The success of OCT and its growing list of applications, is, for Fujimoto, a powerful reminder of the importance of cross-disciplinary work. “In medicine, as well as in many other fields, there is increasing use of technologies, including advanced hardware and analysis technologies as well as AI. Modern medicine can draw upon these technologies to advance patient care and reduce mortality.”

[inspireofficespace1]

Significance Of Advanced Analytics In The Healthcare Industry

Analytics In The Healthcare Industry

Healthcare data management is a process of analyzing large volumes of data from multiple sources

It enables healthcare administrators to gain a holistic view of their patients, resulting in improved health outcomes and more personalized treatments.

The healthcare arena continues to become increasingly complex and competitive, so the right tools and strategies are needed to make use of the data available.

Organizations are now able to leverage data to understand exactly what their patients need.

The Analytics’ Role In Changing Healthcare Industry:

Healthcare companies across the US have started introducing technologies such as PACS imaging systems, Telemedicine Services, and EMRs in order to make sense of both structured and unstructured data inputs.

It is therefore important to identify methods that can learn from this data for operational, financial, and clinical purposes.

Genome analyzers and other analytics tools can assist in deciphering information and understanding only what is required, thereby improving patient care.

Healthcare organizations can put the insights gathered from different sources to different uses.

Our statistical data analysis services help acquire quality data which leads to better decision-making.

1. Disease Monitoring and Preventive Measures:

Healthcare analysts work diligently to analyze both structured and unstructured data such as social media posts and text messages, turning the data into actionable insights that can improve health outcomes.

The use of mobile devices has also made it easier to monitor trends in the spread of diseases through GPS.

To do this, they examine data trends while watching for any disease outbreaks, allowing caregivers to provide the necessary treatments or respond to medical emergencies.

Based on the analyzed results we develop preventive strategies, medications, and vaccinations

Previously, tracking diseases was difficult due to a lack of timely data and a lack of experts with computational backgrounds for epidemic planning.

With big data analytics however, however, epidemics can now be tracked – for example, Nexstrain is a tool that allows users to share.

2. Create better diagnostic and therapeutic approaches:

The advantages of healthcare industry informatics and predictive analytics: Creating personalized wellness services tailored to individual patients, which can help to improve their health.

We can also identify programs and procedures that don’t yield the desired outcomes, so these are excluded from our wellness packages

We always rely on the newest medical studies from both peer-reviewed journals and databases when predicting patient outcomes.

Additionally, we use artificial intelligence to create output profiles (algorithms), based on data from previous patients, for a prediction model which can help new patients receive new diagnoses.

3. Creating an R&D pipeline that is quicker, leaner, and more productive:

Medication delivery to a patient can be challenging.

It takes a long time and is difficult to design a medicine, analyse it thoroughly in clinical trials, and then get FDA approval.

Every pharmaceutical manufacturer and healthcare professionals must properly complete this process before delivering medications to patients.

Businesses employ healthcare industry analytics, computational approaches, and predictive modelling to reduce the amount of time a medicine spends in the R&D pipeline.

The benefits are outlined below:

Advanced analytics are essential for developing a low-attrition, leaner, faster, and more effective R&D pipeline and searching for ways to stimulate the drug discovery process in order to enhance patient wellbeing.

Experiment with different methods to prevent clinical trial failures and boost patient recruitment.

Analytics’s Value in Disease Prevention and Intervention:

Disease prediction and preventative measures always go hand in hand with data analysis services for statistics.

By doing so, organizations would be able to identify patients who are at a high risk of developing chronic diseases early on and offer them better outcomes, sparing them from having to deal with serious health problems.

Financial Risk Control:

I often use Artificial intelligence in managing financial risks

According to a survey by Hospitals & Health Networks. The main financial barrier to the success of the fee-for-service contract model. It is the length of time required to evaluate patient outcomes

Misuse & Fraud:

Analytics and data could help catch fraud and violent crime.

Fraud in the healthcare industry can come in many different shapes. Sizes from honest mistakes like inaccurate billing to pointless medical testing. Fraudulent assertions that lead to improper payments, and so forth.

Big Data assists in identifying patterns that may indicate potential fraud and abuse in healthcare insurance.

Operations:

Technology has steadily become more prevalent in healthcare as a tool for decision-making.

With improved technology infrastructure and appropriate data analysis, it assists in making important operational decisions.

Reforming healthcare industry:

Health organisations will use analytics to promote healthcare industry programmes, leading to a large payment restructure.

By pressuring the current hospital-centric delivery model to offer value rather than volume. Results rather than activities, it is powerful enough to bring about significant changes.

Conclusion:

Predictive analytics and big data aid in decision-making, leading in more enticing collaborations between healthcare professionals and patients.

Fostering long-term constructive engagement, minimizing the risk of chronic disease, and avoiding readmission are essential.

By observing and analysing organized and unstructured data, organizations can prevent epidemics, cut death rates, and predict illnesses.

when artificial intelligence, data processing, and machine learning IoT are coupled, it is easy to give patients proactive treatment

[jcmicr]

Duodenal polyp a rare cause of repeated vomiting by Lahfidi Amal in Journal of Clinical and Medical Images, Case Reports 

Clinical Image Description

A 50-year-old man without ATCD who suffers from dyspepsia and frequent vomiting, prompting him to seek medical help. There were no abnormalities found during the clinical evaluation. A CT scan of the abdomen was ordered to identify a duodenal polyp that was limiting the digestive light (Figure 1).

Figure 1: A duodenal endoluminal polyploid tissue process of 21 x 23 mm is shown on a transverse (A) and coronal (B) abdominal CT following contrast injection (orange arrow).

Peutz-Jeghers syndrome (PJS), juvenile polyposis, Cowden's disease, familial adenomatous polyposis, and Gardner's syndrome are polyposis syndromes that affect the duodenum [1]. Duodenal polyps are more common in children with polyposis syndromes, the majority of which are asymptomatic, according to a retrospective research in a pediatric population (aged 21 years) [2]. In the pediatric age group, duodenal polyps are seldom seen during standard high endoscopy (EGD) and radiographic investigations. In contrast, a recent study of adults using EGD and autopsy found a prevalence of up to 4.6 % [2]. Abdominal pain, vomiting, gastrointestinal bleeding, anemia, and intussusception or obstruction are among the symptoms [1, 2]. In comparison to the jejunum and ileum, duodenal disorders have received little attention in the imaging literature [1]. The exploration of the duodenum, which is still mostly examined by video endoscopy, has changed dramatically as a result of recent breakthroughs in imaging. However, advances in computed tomography (CT) and magnetic resonance imaging (MR) have made it easier to detect and characterize anomalies in the genesis of duodenal masses [1]. They are used to assess intraluminal content, the duodenum wall, and the extraduodenal area. The scanner, in combination with optimum intestinal distension and intravenous iodine contrast, provides for a thorough examination of the duodenum. Similarly, MRI has been demonstrated to be useful in diagnosing a wide spectrum of duodenal disorders when combined with duodenal distension and intravenous administration of a gadolinium-based contrast agent [1]. For the detection and characterization of a wide spectrum of duodenal lesions generating masses, CT remains the preferred imaging modality [1]. Large polyps (> 15 mm) might cause small intestinal blockage, thus it's important to keep an eye on them to see which ones need to be removed [1]. Protocols for monitoring are still being debated. Important polyps (big polyps with a proclivity for intussusception or blockage) are detected by endoscopy [1].

Surveillance in patients with polyposis syndromes was the most common reason for EGD; most of these patients were asymptomatic at the time of their EGD. In patients without polyposis syndrome, the most prevalent reason for EGD was stomach pain and vomiting [2]. CT and MRI can theoretically be used to monitor patients with many polyps and determine the best treatment, which could include endoscopic, enteroscopic, or surgical ablation, or a combination of these methods [1].

Competing Interests: The authors declare that they have no links of interest.

For more details : https://jcmimagescasereports.org/author-guidelines/ 

[fancyranchskeletonpalace]

MBBS in Bangladesh-Kumudini Women's Medical College

Kumudini Women’s Medical College (KWMC) was established in the year 2001 under the patronage Kumudini Welfare Trust.

Kumudini Women’s Medical College has been granted the permission by the Ministry of Health & Family Welfare, Government of the People’s Republic of Bangladesh and Affiliation by the University of Dhaka.

Recognition achieved by Bangladesh Medical and Dental council (BM & DC) and National Commission of India.

The college campus constitutes a huge area of the ‘Kumudini Complex’ – the campus of the Kumudini Women’s medical College has 110 acres of land with greeneries. The College Campus is located in Mirzapur, Tangail, Bangladesh.

This college is Located in Dhaka,

Bangladesh

Distance of the college is 70 km northwest of Dhaka. The college campus is connected by Railways and Roadways.

The campus of the medical College includes:

Medical College Building

Hospital Building

Hostel Buildings (6 multi-storeyed hostels)

Student Mess and Canteen with a separate Dining for International students

Accommodation for Academic and Clinical Staff

Shri Rai Bahadur Ranada Prasad Shaha the founder of Kumudini welfare Trust, established Kumudini Hospital with 750 beds in 1944. Presently the hospital has a capacity 1050 beds, organized according to departments and service units.

The main hospital is a three-storied structure building with a surface area of 131,300 sq. ft. The college building is about 500 feet long and has a two-storied structure having a surface area of 50,000 square feet seated adjacent to the main hospital building.

The hospital compound consists of distinct building blocks for inpatient services, outpatient services and other administrative and support services.

This Medical College is well equipped with adequate facilities for utilizing modern and effective instructional teaching-learning methods and has aids in accordance with the curriculum.

The academic environment nurtures development of faculties for improving quality of education through continuous monitoring and rigorous evaluation system.

Physical infrastructure within the college and its affiliated hospital provides appropriate spaces for lecture, demonstrations, tutorials, practical and bed side clinical teaching.

It has well-built laboratories, tutorial halls for small group discussion and a huge spacious dissection hall with a museum, library with wide reading room, students’ common room, canteen, and fair price shop.

Kumudini Women’s Medical College library is situated on the first floor of the college building. The library provides seating arrangement for 150 students at one time. The opening hours of the library is from 8:00 am in the morning to 9:00 pm in the evening on all working days.

There is a separate reading room for the teachers. The library has an enormous number of academic and reference books of different discipline and specialties.

It also has medicinal books and scientific journals and international periodicals. Photocopying is also available at subsidized rate. In addition to this, the library is also equipped with computers and internet facility for browsing references and e- book, etc.

The College campus is absolutely residential and has adequate accommodation for all the students who seeks admission in the college. It has separate dining rooms, study rooms and club rooms. There are five hostels with a total of 1011 seats. One of the hostels is for the foreign students with air condition & refrigerator facilities.

A modern hostel complex with six buildings is under constructions which shall accommodate 1440 students.

[crimsonpublishersobesityjourna]

Artificial Intelligence Techniques as Potential Tools for Large Scale Surveillance and Interventions for Obesity-Crimson Publishers

Artificial Intelligence Techniques as Potential Tools for Large Scale Surveillance and Interventions for Obesity by Alice Z Guo in Interventions in Obesity & Diabetes

Obesity and diabetes are two metabolic disorder diseases, which are strictly correlated. The diagnosis and surveillance of obesity is crucial for public health management, policy making, and interventions. Current practices are mainly based on individuals’ visits to hospitals or clinics to get the measurement and diagnosis for obesity and diabetes, or with telephone calls and personal interviews for surveillance. We advocate that with advances in artificial intelligence (AI), there is great potential to perform obesity diagnosis and surveillance with AI technologies. The key approaches are based on taking pictures or photos of human faces or bodies by using camera sensors, performing computational analysis of the photos, and obtaining the body mass index (BMI) estimation. These AI technologies make it possible to accomplish a large scale diagnosis and monitoring of public health conditions. Furthermore, these technologies also make it possible for interventions with large populations, aided by Internet connections and smart phones for communications. In this article, the aforementioned idea is presented with a brief overview and summary of the currently available AI technologies, opening a window for an innovative way to perform diagnosis, surveillance, and interventions for obesity.

For more Open access journals in Crimson Publishers, please click on the link: https://crimsonpublishers.com/

For more articles in Journal of  Diabetes and Obesity, please click on below link: https://crimsonpublishers.com/iod/

Follow On Linkedin : https://linkedin.com/in/chyler-henley-ba9623175

Follow On Medium : https://medium.com/crimson-publishers/crimson-publishers-journals-f29e22da8f5c

Please click on high impact journals in Crimson Publishers

[recruitingjobsincanada]

Recruiting Jobs In Canada

Are you seeking out Recruiting Jobs In Canada for the employment carrier in 2021? Or, do you want a job consultancy carrier in Canada? If sure, then accurate information for you. To get a higher task and employment provider to your favourite vicinity like Toronto, Vancouver, Edmonton, Calgary and lots of extra. They are the pinnacle and high-quality recruiters in Canada in 2021.

if you are attempting to find jobs in Canada for foreigners, then those recruitment employers in Canada will assist you to discover the nice jobs for you in the favored vicinity.

The primary factor extra complex than getting the right staffing and skills in Canada is dealing with employment arrangements for foreign people. Canada has visible sizable increase in the infrastructure, power, improvement and method industries in recent years.

That increase has generated massive demand for exceedingly knowledgeable, trained and skilled specialists, which include engineers, executives, researchers, chemists, and architects.

There has been an growth in Canadian employers hiring foreign people for those skilled and regularly revel in-intensive positions. it may be hard to locate the right recruiters and expertise.

Why to seek advice from an Employment organisation to discover a job?

In keeping with the survey, extra than ninety percentage of agencies in Canada use recruitment businesses to lease personnel. Recruiting consultancy to play a mediator role in assisting organizations to discover the satisfactory skills and people to discover the right job.

In contrast to company recruiters, recruiters at hiring corporations have access to all forms of jobs at multiple businesses protecting an extensive spectrum of industries and task positions. If corporations and your opposition are the use of them, you must be too. Right here are a few points of motives to seek advice from an employment employer for both the employers and task seekers.

CAN save you TIME AND stress

try OUT JOBS earlier than YOU commit

potential FOR more options

IT’S less complicated to say NO

only practice TO serious businesses trying to lease

REPRESENTATIVES ARE notably inspired TO GET YOU positioned

THEY recognize THE proper human beings

help AND assist

At secondary 10 careers of the destiny school and college graduations, it’s entirely expected to listen to an audio system asking children to follow their passion. The notion is that inside the occasion that you attempt to earn sufficient to pay the payments carrying out something you adore, you’ll paintings greater diligently at it, and achievement and flourishing will follow. 

but in truth, it doesn’t typically workout that manner. At the off chance that the field you feel generally active about is in decay, like journalism, seeking after it is able to imply severa long durations of battle, definitely attempting to get and maintain a line of labor. also, if the positions you’re ready to find out don’t pay a living pay, you could revel in taking care of the bills on any occasion, when you’re applied.

software program Developer

software program engineers plan and compose the product that sudden spikes in call for devices like computers and smartphones. a few engineers make programs for precise duties, while others paintings on the working frameworks used by networks and working structures. Software improvement consists of finding out what customers need, making plans and trying out software to deal with the ones troubles, making actions up to greater hooked up tasks, and maintaining up and documenting the software improvement technique to make certain it maintains to work efficiently afterward.

scientific and fitness offerings manager

hospital therapy is a main and convoluted business. Giving attention to patients is simply critical for it. There’s additionally paintings of making plans preparations, gathering payments, retaining clinical records, and organizing with different fitness offerings companies. clinical and fitness managers regulate each such sporting event, leaving medical care companies with greater possibilities for their sufferers.

Postsecondary instructor

Any trainer who teaches students beyond the excessive college level may be termed as a postsecondary teacher. 10 careers of destiny those teachers can teach any problem but the demand is rising speedy for scientific, commercial enterprise, and nursing teachers. alongside teaching lessons, postsecondary teachers often take part in studies, distribute books and papers, and set off students about choosing a university foremost and accomplishing their expert goals.

Nurse Practitioner

A nurse practitioner, or NP, is a type of nurse with greater instruction and more authority than a registered nurse (RN). in place of honestly helping experts, NPs can carry out a full-size lot of a consultant’s capacities themselves. A NP can analyze illnesses, advise meds, and deal with an affected person’s trendy attention.

financial supervisor

Each employer, from a nook supermarket to a Fortune 500 company, wishes to manage cash. at the off chance that the commercial enterprise is adequately huge, it would hire a financial manager to manipulate that facet of the commercial enterprise. The financial supervisor monitors an affiliation’s pay and spending, looking for processes to amplify advantages and diminish expenses. They make monetary reviews, oversee ventures, and help direct the affiliation’s drawn-out economic targets.

management Analyst

management professionals, in any other case referred to as management specialists, help companies discover approaches to run all of the more proficiently. they arrive into an enterprise and note its methods, speak with a team of workers, and have a look at economic statistics. At that point, they encourage supervisors at the maximum talented technique to lower charges (for example, by using the same paintings with much less fee) or lift earning (as an example, by using expanding the degree of an object an organisation can supply in a day).

physical Therapist

physical therapists help people with wounds or sicknesses that cause ache and affect motion. They use techniques like stretches or distinctive sports and body control to assist patients with enhancing their portability and lessen torment.

creation manager 

On the point when you pass a creation site, you often see severa production workers fascinated by the involved profession of a building. creation supervisors aren’t commonly obvious on the scene, but, they’re generally there in the back of it. From taking into consideration the underlying rate issue to directing people to make certain the work is up to code, they’re associated with each segment of the shape cycle.

statistics security Analyst

groups rent statistics safety analysts to guard their laptop networks and frameworks from cybercrime. Those professionals introduce antivirus programming and distinct shields to make certain records are being covered, look ahead to protection penetrates and examine them once they show up and intermittently take a look at the community to look for holes a programmer should abuse. They likewise make recovery plans that intend to assist the networks with getting their framework operating within the event of an assault. Which could consist of removing harmful software programs from the computers and reestablishing statistics from backups.

laptop and information structures supervisor 

A pc and records frameworks manager is answerable for all the laptop-associated sporting events inner an organization or other association. The paintings can include analyzing pc desires, prescribing actions as much as the framework, introducing and keeping up computers and programming, and coordinating other laptop-related experts, like programming engineers and records protection investigators. 

[camj27]

Parkinson’s Disease and the Internet of Things

Healthcare and the internet of things.

Introduction

The healthcare industry has been evolving to meet the needs of the rapidly changing digital environment. The industry has utilised the use of emerging technologies to enhance productivity and ultimately improve patient experience and quality of life.

In this blog, I will be focusing on the Internet of things or IoT. So, what is the internet of things? The basic concept behind IoT is that everyday objects interconnect with each other through a networked system. These objects often are equipped with ubiquitous intelligence (Xia et al., 2012). The healthcare industry used IoT extensively, creating its branch called the medical internet of things (mIoT). This technology implements wireless sensors in medical equipment, combining with the internet integrating, hospital, patient, and medical records, promoting a new medical model (Hu, Shen, and Xie, 2013).    

The treatment of Parkinson's disease incorporating the medical internet of things will be at the heart of this blog. PD is a condition in which parts of the brain become progressively damaged over many years. One of the most detrimental and noticeable symptoms of this disease is the involuntary shaking of particular parts of the body, also known as a tremor (NHS Choices, 2019).  

Theory behind the Technology

The underlying treatments using IoT to treat PD are through wearable technology, home monitoring, and digital versions of standardised clinical tests. Wearable sensors are being specifically designed to capture disease traits that are prevalent in PD such as, tremor episodes, gait patterns, and activity levels. These devices can be hooked up to the internet through data aggregators, where the information is sent to medical and research databases and is then sent back to the patient in the form of visual and other sensorial cues. (Pasluosta et al., 2012). The relationship between IoT and the healthcare system can be shown in figure 1.

The traditional treatment of PD patients must attend clinical appointments to assess their postural instability and tremor level. The costs of this involve patient transportation, consultation, and hospital resources. The opportunity to perform at-home procedures using sensors and the IoT would reduce these costs significantly. Also, standard assessments of PD from a clinician can often be subjective. This makes the patients’ health dependant on the clinician’s experience and expertise. If a form of sensory technology can be implemented, more objective results may be found (Romero, Chatterjee, and Armentano, 2016). An IoT remote treatment model can be shown in figure 2. 

Albani et al. (2019) researched the effectiveness of a multi-sensor approach in treating PD. These strategies aimed to reduce the frequency of follow-up appointments for PD patients. And improve the accuracy of results. They concluded that the proposed solution of sensor wearable technology significantly improved the assessment of PD. Providing a decentralised, more accurate, and cost-effective method of treating PD. 

Application of technology

After consulting the academic theory surrounding the IoT and its role in the medical internet of things, it is important to examine which institutions have been successful in implementing this technology.  Intel has partnered with the Michael Fox Foundation for Parkinson’s research to find tech-enabled solutions to PD. The project aimed to produce a mobile application and IoT platform to support large case studies of objective sampled sensory data for people with PD (Cohen, Bataille, and Martig, 2016).  Intel used on-the-shelf wrist-worn smartwatches and built an application around them which is downloaded on a smartphone and calibrated with the watch. These devices also share data with the Fox Foundation servers. The smartwatches served two functions: to track patient activity, tremors and pass data to the ‘enterprise data hub’ for big data analysis. The Fox mobile app is a big part of this product. The layout of the application is shown in figure 3. The mobile app allows users to input information about their medication and medication schedule. The data is stored in the cloud for analysis and storage (Intel corporation 2015).

Challenges

 With any promising technological outbreak and achievement, challenges always present themselves. The medical internet of things and the treatment of PD is no different. Dimitrov (2016) highlighted five key capabilities a leading IoT system must have:

Simple connectivity, making it easier to     connect devices and scale through cloud base services for data analysis.

Easy device management, improve asset     availability, and reduce maintenance costs.

Information Ingestion, intelligently transform     and store IoT data.

Informative analytics, make informed decisions     based on large volumes of IoT data to optimise procedures. And to apply     real time analytics to monitor current conditions and respond accordingly.

Reduced risk, react to notifications, and     isolate any incidents generated from the company environment from any     device/console.    

 Reflections

Reflecting on this blog discussion it is clear that the IoT/ mIoT can have a positive impact on the battle against PD. In particular, the use of wearable technology. And how this can collaborate with the IoT to produce objective results, making cost savings for health organisations all over the world. With an aging population, PD is likely to become more prominent. An effective IoT system allows for a decentralised approach making significant improvements in Hospital efficiency and patient conditions. The Intel and Fox app is exciting, and it's fascinating to see where this sort of technology can go and the differences it can make to people's lives in the health industry.

References

Albani, G., Ferraris, C., Nerino, R., Chimienti, A., Pettiti, G., Parisi, F., Ferrari, G., Cau, N., Cimolin, V., Azzaro, C., Priano, L. and Mauro, A. (2019). An Integrated Multi-Sensor Approach for the Remote Monitoring of Parkinson’s Disease. Sensors, 19(21), p.4764.

Chatterjee, P. and Armentano, R.L., 2015, December. Internet of things for a smart and ubiquitous eHealth system. In 2015 international conference on computational intelligence and communication networks (CICN) (pp. 903-907). IEEE.

Cohen, S., Bataille, L.R. and Martig, A.K. (2016). Enabling breakthroughs in Parkinson’s disease with wearable technologies and big data analytics. mHealth, 2, pp.20–20.

Dimitrov, D.V. (2016). Medical Internet of Things and Big Data in Healthcare. Healthcare Informatics Research, 22(3), p.156.

Hu, F., Xie, D. and Shen, S., 2013, August. On the application of the internet of things in the field of medical and health care. In 2013 IEEE international conference on green computing and communications and IEEE Internet of Things and IEEE cyber, physical and social computing (pp. 2053-2058). IEEE.

Intel Corporation, Michael J. Fox Foundation. Using wearable technology to advanced Parkinson’s Research 2015. Available online: www.intel.com/content/dam/www/public/us/en/documents/white-papers/using-wearable-technology-mjff.pdf

NHS Choices (2019). Overview - Parkinson’s disease. [online] NHS. Available at: https://www.nhs.uk/conditions/parkinsons-disease/.

Pasluosta, C.F., Gassner, H., Winkler, J., Klucken, J. and Eskofier, B.M. (2015). An Emerging Era in the Management of Parkinson’s Disease: Wearable Technologies and the Internet of Things. IEEE Journal of Biomedical and Health Informatics, [online] 19(6), pp.1873–1881. Available at: https://ieeexplore.ieee.org/abstract/document/7169494/ [Accessed 23 Feb. 2020].

Romero, L.E., Chatterjee, P. and Armentano, R.L. (2016). An IoT approach for integration of computational intelligence and wearable sensors for Parkinson’s disease diagnosis and monitoring. Health and Technology, 6(3), pp.167–172.

Xia, F., Yang, L.T., Wang, L. and Vinel, A. (2012). Internet of Things. International Journal of Communication Systems, 25(9), pp.1101–1102.

[kumarsukesh]

10 tips for successful weight loss

Being overweight or hefty can prompt a scope of medical issues. Albeit various "trend" eats less carbs are accessible, a decent way of life and nutritious eating routine are the way to invigorating living and better weight control

1. Eat changed, brilliant, healthfully thick nourishments

Stimulating suppers and bites should frame the establishment of the human eating regimen. A basic method to make a feast plan is to ensure that every supper comprises of 50% products of the soil, 25 percent entire grains, and 25 percent protein. Complete fiber admission should be 25–30 grams (g) day by day.

Kill trans fats from the eating regimen, and limit the admission of soaked fats, which has a solid connection with the rate of coronary illness.

All things considered, individuals can burn-through monounsaturated unsaturated fats (MUFA) or polyunsaturated unsaturated fats (PUFA), which are sorts of unsaturated fat.

The accompanying nourishments are invigorating and frequently wealthy in supplements:

new leafy foods

fish

vegetables

nuts

seeds

entire grains, for example, earthy colored rice and cereal

Nourishments to try not to eat include:

nourishments with added oils, margarine, and sugar

greasy red or prepared meats

prepared products

bagels

white bread

handled nourishments

At times, eliminating certain nourishments from the eating regimen may make an individual become lacking in some essential nutrients and minerals. A nutritionist, dietitian, or another medical services proficient can prompt an individual how to get enough supplements while they are following a health improvement plan.

2. Keep a food and weight journal

Self-checking is a basic factor in effectively getting in shape. Individuals can utilize a paper journal, portable application, or devoted site to record each thing of food that they devour every day. They can likewise quantify their advancement by recording their weight consistently.

The individuals who can follow their accomplishment in little additions and distinguish actual changes are considerably more prone to adhere to a weight reduction routine.

Individuals can likewise monitor their weight record (BMI) utilizing a BMI mini-computer

3. Take part in normal active work and exercise

Normal exercise is imperative for both physical and emotional wellness. Expanding the recurrence of actual work in a trained and deliberate manner is regularly significant for effective weight reduction.

One hour of moderate-power movement every day, for example, lively strolling, is ideal. In the event that one hour out of each day is preposterous, the Mayo Clinic proposes that an individual should focus on at least 150 minutes consistently.

Individuals who are not for the most part genuinely dynamic ought to gradually expand the measure of activity that they do and steadily increment its power. This methodology is the most supportable approach to guarantee that standard exercise turns into a piece of their way of life.

Similarly that recording dinners can mentally assist with weight reduction, individuals may likewise profit by monitoring their active work. Numerous free versatile applications are accessible that track an individual's calorie balance after they log their food admission and exercise.

On the off chance that the possibility of a full exercise appears to be threatening to somebody who is new to work out, they can start by doing the accompanying exercises to build their activity levels:

using the stairwell

raking leaves

strolling a canine

cultivating

moving

playing outside games

stopping farther away from a structure entrance

People who have an okay of coronary illness are probably not going to require clinical appraisal in front of beginning an activity routine.

In any case, earlier clinical assessment might be prudent for certain individuals, incorporating those with diabetes. Any individual who is uncertain about safe degrees of activity ought to address a medical care proficient.

4. Dispense with fluid calories

It is conceivable to burn-through many calories daily by drinking sugar-improved pop, tea, juice, or liquor. These are known as "vacant calories" since they give additional energy content without offering any healthful advantages.

Except if an individual is burning-through a smoothie to supplant a supper, they should intend to adhere to water or unsweetened tea and espresso. Adding a sprinkle of new lemon or orange to water can give flavor.

Try not to confuse lack of hydration with hunger. An individual can regularly fulfill sensations of yearning between booked dinner times with a beverage of water.

5. Measure servings and control parcels

Eating a lot of any food, even low-calorie vegetables, can bring about weight pick up.

Consequently, individuals ought to abstain from assessing a serving size or eating food straightforwardly from the bundle. It is smarter to utilize estimating cups and serving size guides. Speculating prompts overestimating and the probability of eating a bigger than-needed part.

The accompanying size correlations can be valuable for checking food consumption when eating out:

three-fourths of a cup is a golf ball

one-portion of a cup is a tennis ball

1 cup is a baseball

1 ounce (oz) of nuts is a free modest bunch

1 teaspoon is 1 playing pass on

1 tablespoon is a thumb tip

3 oz of meat is a deck of cards

1 cut is a DVD

These sizes are not careful, however they can help an individual moderate their food admission when the right apparatuses are not accessible.

6. Eat carefully

Numerous individuals profit by careful eating, which includes being completely mindful of why, how, when, where, and what they eat.

Settling on more empowering food decisions is an immediate result of getting more on top of the body.

Individuals who practice careful eating additionally attempt to eat all the more gradually and relish their food, focusing on the taste. Making a feast keep going for 20 minutes permits the body to enroll the entirety of the signs for satiety.

It is critical to zero in on being fulfilled after a dinner instead of full and to remember that many "all characteristic" or low-fat nourishments are not really a restorative decision.

Individuals can likewise consider the accompanying inquiries with respect to their feast decision:

Is it acceptable "esteem" for the calorie cost?

Will it give satiety?

Are the fixings empowering?

On the off chance that it has a name, what amount fat and sodium does it contain?

7. Boost and sign control

Numerous social and ecological signals may energize pointless eating. For instance, a few people are bound to gorge while sitting in front of the TV. Others experience difficulty passing a bowl of sweets to another person without taking a piece.

By monitoring what may trigger the longing to nibble on void calories, individuals can consider approaches to change their everyday practice to restrict these triggers.

8. Plan ahead

Loading a kitchen with diet-accommodating nourishments and making organized supper plans will bring about more critical weight reduction.

Individuals hoping to get more fit or keep it off should free their kitchen from handled or lousy nourishments and guarantee that they have the fixings available to make straightforward, fortifying dinners. Doing this can forestall brisk, spontaneous, and thoughtless eating.

Arranging food decisions prior to getting to get-togethers or cafés may likewise make the cycle simpler.

9. Look for social help

Grasping the help of friends and family is a vital piece of an effective weight reduction venture.

A few people may wish to welcome companions or relatives to go along with them, while others may like to utilize web-based media to share their advancement.

Different roads of help may include:

a positive informal organization

gathering or individual advising

practice clubs or accomplices

worker help programs at work

10. Remain positive

Weight reduction is a progressive cycle, and an individual may feel debilitate if the pounds don't drop off at an incredible rate that they had foreseen.

Every so often will be more diligently than others when adhering to a weight reduction or upkeep program. An effective get-healthy plan requires the person to continue on and not surrender when self-change appears to be excessively troublesome.

A few people may have to reset their objectives, possibly by changing the absolute number of calories they are expecting to eat or changing their activity designs.

The significant thing is to keep an inspirational standpoint and be persevering in running after beating the hindrances to effective weight reduction

[trimtonepills]

Tips for successful weight loss

Being overweight or fat can prompt a scope of medical conditions. Albeit various "trend" abstains from food are accessible, a fair way of life and nutritious eating routine are the way to invigorating living and better weight control.

As indicated by the Centers for Disease Control and Prevention, around 93.3 million grown-ups in the United States had weight in 2015–2016. This number is comparable to 39.8 percent of the populace.

Conveying overabundance body weight can expand the danger of genuine medical conditions, including coronary illness, hypertension, and type 2 diabetes.

Crash eats less carbs are not an economical arrangement, whatever advantages their advocates may guarantee them to have. To both shed pounds securely and support that weight reduction after some time, it is fundamental to make steady, perpetual, and gainful way of life changes.

Individuals can get in shape and keep up this misfortune by making a few reachable strides. These incorporate the accompanying:

1. Eat changed, beautiful, healthfully thick nourishments

Fortifying suppers and bites should frame the establishment of the human eating routine. A straightforward method to make a supper plan is to ensure that every dinner comprises of 50% leafy foods, 25 percent entire grains, and 25 percent protein. All out fiber admission ought to be 25–30 grams (g) every day.

Wipe out trans fats from the eating regimen, and limit the admission of immersed fats, which has a solid connection with the rate of coronary illness.

Rather, individuals can expend monounsaturated unsaturated fats (MUFA) or polyunsaturated unsaturated fats (PUFA), which are sorts of unsaturated fat.

The accompanying nourishments are energizing and frequently wealthy in supplements:

new foods grown from the ground

fish

vegetables

nuts

seeds

entire grains, for example, earthy colored rice and cereal

Nourishments to abstain from eating include:

nourishments with included oils, margarine, and sugar

greasy red or prepared meats

heated products

bagels

white bread

prepared nourishments

At times, eliminating certain nourishments from the eating regimen may make an individual become lacking in some fundamental nutrients and minerals. A nutritionist, dietitian, or another medical care proficient can prompt an individual how to get enough supplements while they are following a health improvement plan.

2. Keep a food and weight journal

Self-observing is a basic factor in effectively getting more fit. Individuals can utilize a paper journal, versatile application, or committed site to record each thing of food that they devour every day. They can likewise quantify their advancement by recording their weight consistently.

The individuals who can follow their achievement in little additions and recognize physical changes are substantially more liable to adhere to a weight reduction routine.

Individuals can likewise monitor their weight record (BMI) utilizing a BMI mini-computer.

3. Participate in customary physical movement and exercise

Customary exercise is fundamental for both physical and emotional wellness. Expanding the recurrence of physical movement in a restrained and deliberate manner is frequently significant for effective weight reduction diet pills.

One hour of moderate-power action every day, for example, lively strolling, is ideal. In the event that one hour out of each day is absurd, the Mayo Clinic recommends that an individual should focus on at least 150 minutes consistently.

Individuals who are not normally truly dynamic ought to gradually expand the measure of activity that they do and slowly increment its force. This methodology is the most manageable approach to guarantee that normal exercise turns into an aspect of their way of life.

[jcmicr]

Duodenal polyp a rare cause of repeated vomiting by  Lahfidi Ama in Journal of Clinical and Medical Images, Case Reports  

Clinical Image Description

A 50-year-old man without ATCD who suffers from dyspepsia and frequent vomiting, prompting him to seek medical help. There were no abnormalities found during the clinical evaluation. A CT scan of the abdomen was ordered to identify a duodenal polyp that was limiting the digestive light (Figure 1).

Figure 1: A duodenal endoluminal polyploid tissue process of 21 x 23 mm is shown on a transverse (A) and coronal (B) abdominal CT following contrast injection (orange arrow).

Peutz-Jeghers syndrome (PJS), juvenile polyposis, Cowden's disease, familial adenomatous polyposis, and Gardner's syndrome are polyposis syndromes that affect the duodenum [1]. Duodenal polyps are more common in children with polyposis syndromes, the majority of which are asymptomatic, according to a retrospective research in a pediatric population (aged 21 years) [2]. In the pediatric age group, duodenal polyps are seldom seen during standard high endoscopy (EGD) and radiographic investigations. In contrast, a recent study of adults using EGD and autopsy found a prevalence of up to 4.6 % [2]. Abdominal pain, vomiting, gastrointestinal bleeding, anemia, and intussusception or obstruction are among the symptoms [1, 2]. In comparison to the jejunum and ileum, duodenal disorders have received little attention in the imaging literature [1]. The exploration of the duodenum, which is still mostly examined by video endoscopy, has changed dramatically as a result of recent breakthroughs in imaging. However, advances in computed tomography (CT) and magnetic resonance imaging (MR) have made it easier to detect and characterize anomalies in the genesis of duodenal masses [1]. They are used to assess intraluminal content, the duodenum wall, and the extraduodenal area. The scanner, in combination with optimum intestinal distension and intravenous iodine contrast, provides for a thorough examination of the duodenum. Similarly, MRI has been demonstrated to be useful in diagnosing a wide spectrum of duodenal disorders when combined with duodenal distension and intravenous administration of a gadolinium-based contrast agent [1]. For the detection and characterization of a wide spectrum of duodenal lesions generating masses, CT remains the preferred imaging modality [1]. Large polyps (> 15 mm) might cause small intestinal blockage, thus it's important to keep an eye on them to see which ones need to be removed [1]. Protocols for monitoring are still being debated. Important polyps (big polyps with a proclivity for intussusception or blockage) are detected by endoscopy [1].

Surveillance in patients with polyposis syndromes was the most common reason for EGD; most of these patients were asymptomatic at the time of their EGD. In patients without polyposis syndrome, the most prevalent reason for EGD was stomach pain and vomiting [2]. CT and MRI can theoretically be used to monitor patients with many polyps and determine the best treatment, which could include endoscopic, enteroscopic, or surgical ablation, or a combination of these methods [1].

Competing Interests: The authors declare that they have no links of interest.

For more details : https://jcmimagescasereports.org/author-guidelines/ 

[fancyranchskeletonpalace]

MBBS in Bangladesh-Kumudini Women's Medical College

Kumudini Women’s Medical College (KWMC) was established in the year 2001 under the patronage Kumudini Welfare Trust.

Kumudini Women’s Medical College has been granted the permission by the Ministry of Health & Family Welfare, Government of the People’s Republic of Bangladesh and Affiliation by the University of Dhaka.

Recognition achieved by Bangladesh Medical and Dental council (BM & DC) and National Commission of India.

The college campus constitutes a huge area of the ‘Kumudini Complex’ – the campus of the Kumudini Women’s medical College has 110 acres of land with greeneries. The College Campus is located in Mirzapur, Tangail, Bangladesh.

This college is Located in Dhaka,

Bangladesh

Distance of the college is 70 km northwest of Dhaka. The college campus is connected by Railways and Roadways.

The campus of the medical College includes:

Medical College Building

Hospital Building

Hostel Buildings (6 multi-storeyed hostels)

Student Mess and Canteen with a separate Dining for International students

Accommodation for Academic and Clinical Staff

Shri Rai Bahadur Ranada Prasad Shaha the founder of Kumudini welfare Trust, established Kumudini Hospital with 750 beds in 1944. Presently the hospital has a capacity 1050 beds, organized according to departments and service units.

The main hospital is a three-storied structure building with a surface area of 131,300 sq. ft. The college building is about 500 feet long and has a two-storied structure having a surface area of 50,000 square feet seated adjacent to the main hospital building.

The hospital compound consists of distinct building blocks for inpatient services, outpatient services and other administrative and support services.

This Medical College is well equipped with adequate facilities for utilizing modern and effective instructional teaching-learning methods and has aids in accordance with the curriculum.

The academic environment nurtures development of faculties for improving quality of education through continuous monitoring and rigorous evaluation system.

Physical infrastructure within the college and its affiliated hospital provides appropriate spaces for lecture, demonstrations, tutorials, practical and bed side clinical teaching.

It has well-built laboratories, tutorial halls for small group discussion and a huge spacious dissection hall with a museum, library with wide reading room, students’ common room, canteen, and fair price shop.

Kumudini Women’s Medical College library is situated on the first floor of the college building. The library provides seating arrangement for 150 students at one time. The opening hours of the library is from 8:00 am in the morning to 9:00 pm in the evening on all working days.

There is a separate reading room for the teachers. The library has an enormous number of academic and reference books of different discipline and specialties.

It also has medicinal books and scientific journals and international periodicals. Photocopying is also available at subsidized rate. In addition to this, the library is also equipped with computers and internet facility for browsing references and e- book, etc.

The College campus is absolutely residential and has adequate accommodation for all the students who seeks admission in the college. It has separate dining rooms, study rooms and club rooms. There are five hostels with a total of 1011 seats. One of the hostels is for the foreign students with air condition & refrigerator facilities.

A modern hostel complex with six buildings is under constructions which shall accommodate 1440 students.

[and-then-there-were-n0ne]

In the economic sphere too, the ability to hold a hammer or press a button is becoming less valuable than before. In the past, there were many things only humans could do. But now robots and computers are catching up, and may soon outperform humans in most tasks. True, computers function very differently from humans, and it seems unlikely that computers will become humanlike any time soon. In particular, it doesn’t seem that computers are about to gain consciousness, and to start experiencing emotions and sensations. Over the last decades there has been an immense advance in computer intelligence, but there has been exactly zero advance in computer consciousness. As far as we know, computers in 2016 are no more conscious than their prototypes in the 1950s. However, we are on the brink of a momentous revolution. Humans are in danger of losing their value, because intelligence is decoupling from consciousness.

Until today, high intelligence always went hand in hand with a developed consciousness. Only conscious beings could perform tasks that required a lot of intelligence, such as playing chess, driving cars, diagnosing diseases or identifying terrorists. However, we are now developing new types of non-conscious intelligence that can perform such tasks far better than humans. For all these tasks are based on pattern recognition, and non-conscious algorithms may soon excel human consciousness in recognising patterns. This raises a novel question: which of the two is really important, intelligence or consciousness? As long as they went hand in hand, debating their relative value was just a pastime for philosophers. But in the twenty-first century, this is becoming an urgent political and economic issue. And it is sobering to realise that, at least for armies and corporations, the answer is straightforward: intelligence is mandatory but consciousness is optional.

Armies and corporations cannot function without intelligent agents, but they don’t need consciousness and subjective experiences. The conscious experiences of a flesh-and-blood taxi driver are infinitely richer than those of a self-driving car, which feels absolutely nothing. The taxi driver can enjoy music while navigating the busy streets of Seoul. His mind may expand in awe as he looks up at the stars and contemplates the mysteries of the universe. His eyes may fill with tears of joy when he sees his baby girl taking her very first step. But the system doesn’t need all that from a taxi driver. All it really wants is to bring passengers from point A to point B as quickly, safely and cheaply as possible. And the autonomous car will soon be able to do that far better than a human driver, even though it cannot enjoy music or be awestruck by the magic of existence.

Indeed, if we forbid humans to drive taxis and cars altogether, and give computer algorithms monopoly over traffic, we can then connect all vehicles to a single network, and thereby make car accidents virtually impossible. In August 2015, one of Google’s experimental self-driving cars had an accident. As it approached a crossing and detected pedestrians wishing to cross, it applied its brakes. A moment later it was hit from behind by a sedan whose careless human driver was perhaps contemplating the mysteries of the universe instead of watching the road. This could not have happened if both vehicles were steered by interlinked computers. The controlling algorithm would have known the position and intentions of every vehicle on the road, and would not have allowed two of its marionettes to collide. Such a system will save lots of time, money and human lives – but it will also do away with the human experience of driving a car and with tens of millions of human jobs.

Some economists predict that sooner or later, unenhanced humans will be completely useless. While robots and 3D printers replace workers in manual jobs such as manufacturing shirts, highly intelligent algorithms will do the same to white-collar occupations. Bank clerks and travel agents, who a short time ago were completely secure from automation, have become endangered species. How many travel agents do we need when we can use our smartphones to buy plane tickets from an algorithm?

Stock-exchange traders are also in danger. Most trade today is already being managed by computer algorithms, which can process in a second more data than a human can in a year, and that can react to the data much faster than a human can blink. On 23 April 2013, Syrian hackers broke into Associated Press’s official Twitter account. At 13:07 they tweeted that the White House had been attacked and President Obama was hurt. Trade algorithms that constantly monitor newsfeeds reacted in no time, and began selling stocks like mad. The Dow Jones went into free fall, and within sixty seconds lost 150 points, equivalent to a loss of $136 billion! At 13:10 Associated Press clarified that the tweet was a hoax. The algorithms reversed gear, and by 13:13 the Dow Jones had recuperated almost all the losses.

Three years previously, on 6 May 2010, the New York stock exchange underwent an even sharper shock. Within five minutes – from 14:42 to 14:47 – the Dow Jones dropped by 1,000 points, wiping out $1 trillion. It then bounced back, returning to its pre-crash level in a little over three minutes. That’s what happens when super-fast computer programs are in charge of our money. Experts have been trying ever since to understand what happened in this so-called ‘Flash Crash’. We know algorithms were to blame, but we are still not sure exactly what went wrong. Some traders in the USA have already filed lawsuits against algorithmic trading, arguing that it unfairly discriminates against human beings, who simply cannot react fast enough to compete. Quibbling whether this really constitutes a violation of rights might provide lots of work and lots of fees for lawyers.

And these lawyers won’t necessarily be human. Movies and TV series give the impression that lawyers spend their days in court shouting ‘Objection!’ and making impassioned speeches. Yet most run-of-the-mill lawyers spend their time going over endless files, looking for precedents, loopholes and tiny pieces of potentially relevant evidence. Some are busy trying to figure out what happened on the night John Doe got killed, or formulating a gargantuan business contract that will protect their client against every conceivable eventuality. What will be the fate of all these lawyers once sophisticated search algorithms can locate more precedents in a day than a human can in a lifetime, and once brain scans can reveal lies and deceptions at the press of a button? Even highly experienced lawyers and detectives cannot easily spot deceptions merely by observing people’s facial expressions and tone of voice. However, lying involves different brain areas to those used when we tell the truth. We’re not there yet, but it is conceivable that in the not too distant future fMRI scanners could function as almost infallible truth machines. Where will that leave millions of lawyers, judges, cops and detectives? They might need to go back to school and learn a new profession.

When they get in the classroom, however, they may well discover that the algorithms have got there first. Companies such as Mindojo are developing interactive algorithms that not only teach me maths, physics and history, but also simultaneously study me and get to know exactly who I am. Digital teachers will closely monitor every answer I give, and how long it took me to give it. Over time, they will discern my unique weaknesses as well as my strengths. They will identify what gets me excited, and what makes my eyelids droop. They could teach me thermodynamics or geometry in a way that suits my personality type, even if that particular way doesn’t suit 99 per cent of the other pupils. And these digital teachers will never lose their patience, never shout at me, and never go on strike. It is unclear, however, why on earth I would need to know thermodynamics or geometry in a world containing such intelligent computer programs.

Even doctors are fair game for the algorithms. The first and foremost task of most doctors is to diagnose diseases correctly, and then suggest the best available treatment. If I arrive at the clinic complaining about fever and diarrhoea, I might be suffering from food poisoning. Then again, the same symptoms might result from a stomach virus, cholera, dysentery, malaria, cancer or some unknown new disease. My doctor has only five minutes to make a correct diagnosis, because this is what my health insurance pays for. This allows for no more than a few questions and perhaps a quick medical examination. The doctor then cross-references this meagre information with my medical history, and with the vast world of human maladies. Alas, not even the most diligent doctor can remember all my previous ailments and check-ups. Similarly, no doctor can be familiar with every illness and drug, or read every new article published in every medical journal. To top it all, the doctor is sometimes tired or hungry or perhaps even sick, which affects her judgement. No wonder that doctors often err in their diagnoses, or recommend a less-than-optimal treatment.

Now consider IBM’s famous Watson – an artificial intelligence system that won the Jeopardy! television game show in 2011, beating human former champions. Watson is currently groomed to do more serious work, particularly in diagnosing diseases. An AI such as Watson has enormous potential advantages over human doctors. Firstly, an AI can hold in its databanks information about every known illness and medicine in history. It can then update these databanks every day, not only with the findings of new researches, but also with medical statistics gathered from every clinic and hospital in the world.

Secondly, Watson can be intimately familiar not only with my entire genome and my day-to-day medical history, but also with the genomes and medical histories of my parents, siblings, cousins, neighbours and friends. Watson will know instantly whether I visited a tropical country recently, whether I have recurring stomach infections, whether there have been cases of intestinal cancer in my family or whether people all over town are complaining this morning about diarrhoea.

Thirdly, Watson will never be tired, hungry or sick, and will have all the time in the world for me. I could sit comfortably on my sofa at home and answer hundreds of questions, telling Watson exactly how I feel. This is good news for most patients (except perhaps hypochondriacs). But if you enter medical school today in the expectation of still being a family doctor in twenty years, maybe you should think again. With such a Watson around, there is not much need for Sherlocks.

This threat hovers over the heads not only of general practitioners, but also of experts. Indeed, it might prove easier to replace doctors specialising in a relatively narrow field such as cancer diagnosis. For example, in a recent experiment a computer algorithm diagnosed correctly 90 per cent of lung cancer cases presented to it, while human doctors had a success rate of only 50 per cent. In fact, the future is already here. CT scans and mammography tests are routinely checked by specialised algorithms, which provide doctors with a second opinion, and sometimes detect tumours that the doctors missed.

A host of tough technical problems still prevent Watson and its ilk from replacing most doctors tomorrow morning. Yet these technical problems – however difficult – need only be solved once. The training of a human doctor is a complicated and expensive process that lasts years. When the process is complete, after ten years of studies and internships, all you get is one doctor. If you want two doctors, you have to repeat the entire process from scratch. In contrast, if and when you solve the technical problems hampering Watson, you will get not one, but an infinite number of doctors, available 24/7 in every corner of the world. So even if it costs $100 billion to make it work, in the long run it would be much cheaper than training human doctors.

And what’s true of doctors is doubly true of pharmacists. In 2011 a pharmacy opened in San Francisco manned by a single robot. When a human comes to the pharmacy, within seconds the robot receives all of the customer’s prescriptions, as well as detailed information about other medicines taken by them, and their suspected allergies. The robot makes sure the new prescriptions don’t combine adversely with any other medicine or allergy, and then provides the customer with the required drug. In its first year of operation the robotic pharmacist provided 2 million prescriptions, without making a single mistake. On average, flesh-and-blood pharmacists get wrong 1.7 per cent of prescriptions. In the United States alone this amounts to more than 50 million prescription errors every year!

Some people argue that even if an algorithm could outperform doctors and pharmacists in the technical aspects of their professions, it could never replace their human touch. If your CT indicates you have cancer, would you like to receive the news from a caring and empathetic human doctor, or from a machine? Well, how about receiving the news from a caring and empathetic machine that tailors its words to your personality type? Remember that organisms are algorithms, and Watson could detect your emotional state with the same accuracy that it detects your tumours.

This idea has already been implemented by some customer-services departments, such as those pioneered by the Chicago-based Mattersight Corporation. Mattersight publishes its wares with the following advert: ‘Have you ever spoken with someone and felt as though you just clicked? The magical feeling you get is the result of a personality connection. Mattersight creates that feeling every day, in call centers around the world.’ When you call customer services with a request or complaint, it usually takes a few seconds to route your call to a representative. In Mattersight systems, your call is routed by a clever algorithm. You first state the reason for your call. The algorithm listens to your request, analyses the words you have chosen and your tone of voice, and deduces not only your present emotional state but also your personality type – whether you are introverted, extroverted, rebellious or dependent. Based on this information, the algorithm links you to the representative that best matches your mood and personality. The algorithm knows whether you need an empathetic person to patiently listen to your complaints, or you prefer a no-nonsense rational type who will give you the quickest technical solution. A good match means both happier customers and less time and money wasted by the customer-services department.

The most important question in twenty-first-century economics may well be what to do with all the superfluous people. What will conscious humans do, once we have highly intelligent non-conscious algorithms that can do almost everything better?

Throughout history the job market was divided into three main sectors: agriculture, industry and services. Until about 1800, the vast majority of people worked in agriculture, and only a small minority worked in industry and services. During the Industrial Revolution people in developed countries left the fields and herds. Most began working in industry, but growing numbers also took up jobs in the services sector. In recent decades developed countries underwent another revolution, as industrial jobs vanished, whereas the services sector expanded. In 2010 only 2 per cent of Americans worked in agriculture, 20 per cent worked in industry, 78 per cent worked as teachers, doctors, webpage designers and so forth. When mindless algorithms are able to teach, diagnose and design better than humans, what will we do?

This is not an entirely new question. Ever since the Industrial Revolution erupted, people feared that mechanisation might cause mass unemployment. This never happened, because as old professions became obsolete, new professions evolved, and there was always something humans could do better than machines. Yet this is not a law of nature, and nothing guarantees it will continue to be like that in the future. Humans have two basic types of abilities: physical abilities and cognitive abilities. As long as machines competed with us merely in physical abilities, you could always find cognitive tasks that humans do better. So machines took over purely manual jobs, while humans focused on jobs requiring at least some cognitive skills. Yet what will happen once algorithms outperform us in remembering, analysing and recognising patterns?

The idea that humans will always have a unique ability beyond the reach of non-conscious algorithms is just wishful thinking. True, at present there are numerous things that organic algorithms do better than non-organic ones, and experts have repeatedly declared that something will ‘for ever’ remain beyond the reach of non-organic algorithms. But it turns out that ‘for ever’ often means no more than a decade or two. Until a short time ago, facial recognition was a favourite example of something which even babies accomplish easily but which escaped even the most powerful computers on earth. Today facial-recognition programs are able to recognise people far more efficiently and quickly than humans can. Police forces and intelligence services now use such programs to scan countless hours of video footage from surveillance cameras, tracking down suspects and criminals.

In the 1980s when people discussed the unique nature of humanity, they habitually used chess as primary proof of human superiority. They believed that computers would never beat humans at chess. On 10 February 1996, IBM’s Deep Blue defeated world chess champion Garry Kasparov, laying to rest that particular claim for human pre-eminence.

Deep Blue was given a head start by its creators, who preprogrammed it not only with the basic rules of chess, but also with detailed instructions regarding chess strategies. A new generation of AI uses machine learning to do even more remarkable and elegant things. In February 2015 a program developed by Google DeepMind learned by itself how to play forty-nine classic Atari games. One of the developers, Dr Demis Hassabis, explained that ‘the only information we gave the system was the raw pixels on the screen and the idea that it had to get a high score. And everything else it had to figure out by itself.’ The program managed to learn the rules of all the games it was presented with, from Pac-Man and Space Invaders to car racing and tennis games. It then played most of them as well as or better than humans, sometimes coming up with strategies that never occur to human players.

Computer algorithms have recently proven their worth in ball games, too. For many decades, baseball teams used the wisdom, experience and gut instincts of professional scouts and managers to pick players. The best players fetched millions of dollars, and naturally enough the rich teams got the cream of the market, whereas poorer teams had to settle for the scraps. In 2002 Billy Beane, the manager of the low-budget Oakland Athletics, decided to beat the system. He relied on an arcane computer algorithm developed by economists and computer geeks to create a winning team from players that human scouts overlooked or undervalued. The old-timers were incensed by Beane’s algorithm transgressing into the hallowed halls of baseball. They said that picking baseball players is an art, and that only humans with an intimate and long-standing experience of the game can master it. A computer program could never do it, because it could never decipher the secrets and the spirit of baseball.

They soon had to eat their baseball caps. Beane’s shoestring-budget algorithmic team ($44 million) not only held its own against baseball giants such as the New York Yankees ($125 million), but became the first team ever in American League baseball to win twenty consecutive games. Not that Beane and Oakland could enjoy their success for long. Soon enough, many other baseball teams adopted the same algorithmic approach, and since the Yankees and Red Sox could pay far more for both baseball players and computer software, low-budget teams such as the Oakland Athletics now had an even smaller chance of beating the system than before.

In 2004 Professor Frank Levy from MIT and Professor Richard Murnane from Harvard published a thorough research of the job market, listing those professions most likely to undergo automation. Truck drivers were given as an example of a job that could not possibly be automated in the foreseeable future. It is hard to imagine, they wrote, that algorithms could safely drive trucks on a busy road. A mere ten years later, Google and Tesla not only imagine this, but are actually making it happen.

In fact, as time goes by, it becomes easier and easier to replace humans with computer algorithms, not merely because the algorithms are getting smarter, but also because humans are professionalising. Ancient hunter-gatherers mastered a very wide variety of skills in order to survive, which is why it would be immensely difficult to design a robotic hunter-gatherer. Such a robot would have to know how to prepare spear points from flint stones, how to find edible mushrooms in a forest, how to use medicinal herbs to bandage a wound, how to track down a mammoth and how to coordinate a charge with a dozen other hunters. However, over the last few thousand years we humans have been specialising. A taxi driver or a cardiologist specialises in a much narrower niche than a hunter-gatherer, which makes it easier to replace them with AI.

Even the managers in charge of all these activities can be replaced. Thanks to its powerful algorithms, Uber can manage millions of taxi drivers with only a handful of humans. Most of the commands are given by the algorithms without any need of human supervision. In May 2014 Deep Knowledge Ventures – a Hong Kong venture-capital firm specialising in regenerative medicine – broke new ground by appointing an algorithm called VITAL to its board. VITAL makes investment recommendations by analysing huge amounts of data on the financial situation, clinical trials and intellectual property of prospective companies. Like the other five board members, the algorithm gets to vote on whether the firm makes an investment in a specific company or not.

Examining VITAL’s record so far, it seems that it has already picked up one managerial vice: nepotism. It has recommended investing in companies that grant algorithms more authority. With VITAL’s blessing, Deep Knowledge Ventures has recently invested in Silico Medicine, which develops computer-assisted methods for drug research, and in Pathway Pharmaceuticals, which employs a platform called OncoFinder to select and rate personalised cancer therapies.

As algorithms push humans out of the job market, wealth might become concentrated in the hands of the tiny elite that owns the all-powerful algorithms, creating unprecedented social inequality. Alternatively, the algorithms might not only manage businesses, but actually come to own them. At present, human law already recognises intersubjective entities like corporations and nations as ‘legal persons’. Though Toyota or Argentina has neither a body nor a mind, they are subject to international laws, they can own land and money, and they can sue and be sued in court. We might soon grant similar status to algorithms. An algorithm could then own a venture-capital fund without having to obey the wishes of any human master.

If the algorithm makes the right decisions, it could accumulate a fortune, which it could then invest as it sees fit, perhaps buying your house and becoming your landlord. If you infringe on the algorithm’s legal rights – say, by not paying rent – the algorithm could hire lawyers and sue you in court. If such algorithms consistently outperform human fund managers, we might end up with an algorithmic upper class owning most of our planet. This may sound impossible, but before dismissing the idea, remember that most of our planet is already legally owned by non-human inter-subjective entities, namely nations and corporations. Indeed, 5,000 years ago much of Sumer was owned by imaginary gods such as Enki and Inanna. If gods can possess land and employ people, why not algorithms?

So what will people do? Art is often said to provide us with our ultimate (and uniquely human) sanctuary. In a world where computers replace doctors, drivers, teachers and even landlords, everyone would become an artist. Yet it is hard to see why artistic creation will be safe from the algorithms. Why are we so sure computers will be unable to better us in the composition of music? According to the life sciences, art is not the product of some enchanted spirit or metaphysical soul, but rather of organic algorithms recognising mathematical patterns. If so, there is no reason why non-organic algorithms couldn’t master it.

David Cope is a musicology professor at the University of California in Santa Cruz. He is also one of the more controversial figures in the world of classical music. Cope has written programs that compose concertos, chorales, symphonies and operas. His first creation was named EMI (Experiments in Musical Intelligence), which specialised in imitating the style of Johann Sebastian Bach. It took seven years to create the program, but once the work was done, EMI composed 5,000 chorales à la Bach in a single day. Cope arranged a performance of a few select chorales in a music festival at Santa Cruz. Enthusiastic members of the audience praised the wonderful performance, and explained excitedly how the music touched their innermost being. They didn’t know it was composed by EMI rather than Bach, and when the truth was revealed, some reacted with glum silence, while others shouted in anger.

EMI continued to improve, and learned to imitate Beethoven, Chopin, Rachmaninov and Stravinsky. Cope got EMI a contract, and its first album – Classical Music Composed by Computer – sold surprisingly well. Publicity brought increasing hostility from classical-music buffs. Professor Steve Larson from the University of Oregon sent Cope a challenge for a musical showdown. Larson suggested that professional pianists play three pieces one after the other: one by Bach, one by EMI, and one by Larson himself. The audience would then be asked to vote who composed which piece. Larson was convinced people would easily tell the difference between soulful human compositions, and the lifeless artefact of a machine. Cope accepted the challenge. On the appointed date, hundreds of lecturers, students and music fans assembled in the University of Oregon’s concert hall. At the end of the performance, a vote was taken. The result? The audience thought that EMI’s piece was genuine Bach, that Bach’s piece was composed by Larson, and that Larson’s piece was produced by a computer.

Critics continued to argue that EMI’s music is technically excellent, but that it lacks something. It is too accurate. It has no depth. It has no soul. Yet when people heard EMI’s compositions without being informed of their provenance, they frequently praised them precisely for their soulfulness and emotional resonance.

Following EMI’s successes, Cope created newer and even more sophisticated programs. His crowning achievement was Annie. Whereas EMI composed music according to predetermined rules, Annie is based on machine learning. Its musical style constantly changes and develops in reaction to new inputs from the outside world. Cope has no idea what Annie is going to compose next. Indeed, Annie does not restrict itself to music composition but also explores other art forms such as haiku poetry. In 2011 Cope published Comes the Fiery Night: 2,000 Haiku by Man and Machine. Of the 2,000 haikus in the book, some are written by Annie, and the rest by organic poets. The book does not disclose which are which. If you think you can tell the difference between human creativity and machine output, you are welcome to test your claim.

In the nineteenth century the Industrial Revolution created a huge new class of urban proletariats, in the twenty-first century we might witness the creation of a new massive class: people devoid of any economic, political or even artistic value, who contribute nothing to the prosperity, power and glory of society.

In September 2013 two Oxford researchers, Carl Benedikt Frey and Michael A. Osborne, published ‘The Future of Employment’, in which they surveyed the likelihood of different professions being taken over by computer algorithms within the next twenty years. The algorithm developed by Frey and Osborne to do the calculations estimated that 47 per cent of US jobs are at high risk. For example, there is a 99 per cent probability that by 2033 human telemarketers and insurance underwriters will lose their jobs to algorithms. There is a 98 per cent probability that the same will happen to sports referees, 97 per cent that it will happen to cashiers and 96 per cent to chefs. Waiters – 94 per cent. Paralegal assistants – 94 per cent. Tour guides – 91 per cent. Bakers – 89 per cent. Bus drivers – 89 per cent. Construction labourers – 88 per cent. Veterinary assistants – 86 per cent. Security guards – 84 per cent. Sailors – 83 per cent. Bartenders – 77 per cent. Archivists – 76 per cent. Carpenters – 72 per cent. Lifeguards – 67 per cent. And so forth. There are of course some safe jobs. The likelihood that computer algorithms will displace archaeologists by 2033 is only 0.7 per cent, because their job requires highly sophisticated types of pattern recognition, and doesn’t produce huge profits. Hence it is improbable that corporations or government will make the necessary investment to automate archaeology within the next twenty years.

Of course, by 2033 many new professions are likely to appear, for example, virtual-world designers. But such professions will probably require much more creativity and flexibility than your run-of-the-mill job, and it is unclear whether forty-year-old cashiers or insurance agents will be able to reinvent themselves as virtual-world designers (just try to imagine a virtual world created by an insurance agent!). And even if they do so, the pace of progress is such that within another decade they might have to reinvent themselves yet again. After all, algorithms might well outperform humans in designing virtual worlds too. The crucial problem isn’t creating new jobs. The crucial problem is creating new jobs that humans perform better than algorithms.

- Yuval Noah Harari, The Great Decoupling in Homo Deus: A Brief History of Tomorrow