Male gyn-oncologists reach conclusions faster, but female gyn-oncologists are more rational, both in high resource and low resource countries

2016 ◽  
Author(s):  
Walter Gotlieb
Keyword(s):  
Low Resource ◽  
High Resource

scholarly journals A framework for designing medical devices resilient to low-resource settings

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Davide Piaggio ◽  
Rossana Castaldo ◽  
Marco Cinelli ◽  
Sara Cinelli ◽  
Alessia Maccaro ◽  
...  
Keyword(s):  
Delphi Study ◽  
Middle Income ◽  
Low Resource Settings ◽  
Health Technologies ◽  
Low Resource ◽  
Middle Income Countries ◽  
High Resource ◽  
International Experts ◽  
Global Population ◽  
Different Parts

Abstract Background To date (April 2021), medical device (MD) design approaches have failed to consider the contexts where MDs can be operationalised. Although most of the global population lives and is treated in Low- and Middle-Income Countries (LMCIs), over 80% of the MD market share is in high-resource settings, which set de facto standards that cannot be taken for granted in lower resource settings. Using a MD designed for high-resource settings in LMICs may hinder its safe and efficient operationalisation. In the literature, many criteria for frameworks to support resilient MD design were presented. However, since the available criteria (as of 2021) are far from being consensual and comprehensive, the aim of this study is to raise awareness about such challenges and to scope experts’ consensus regarding the essentiality of MD design criteria. Results This paper presents a novel application of Delphi study and Multiple Criteria Decision Analysis (MCDA) to develop a framework comprising 26 essential criteria, which were evaluated and chosen by international experts coming from different parts of the world. This framework was validated by analysing some MDs presented in the WHO Compendium of innovative health technologies for low-resource settings. Conclusions This novel holistic framework takes into account some domains that are usually underestimated by MDs designers. For this reason, it can be used by experts designing MDs resilient to low-resource settings and it can also assist policymakers and non-governmental organisations in shaping the future of global healthcare.

Low Resource ASR: The Surprising Effectiveness of High Resource Transliteration

2021 ◽  
Author(s):  
Shreya Khare ◽  
Ashish Mittal ◽  
Anuj Diwan ◽  
Sunita Sarawagi ◽  
Preethi Jyothi ◽  
...  
Keyword(s):  
Low Resource ◽  
High Resource

scholarly journals Report on the Treatment of Hodgkin Lymphoma With ABVD Chemotherapy at Two Rural District Hospitals in Rwanda

2016 ◽  
Vol 2 (3_suppl) ◽  
pp. 67s-67s ◽  
Author(s):  
Rebecca J. DeBoer ◽  
Caitlin D. Driscoll ◽  
Yvan Butera ◽  
Jean Bosco Bigirimana ◽  
Clemence Muhayimana ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Conflicts Of Interest ◽  
Treatment Protocol ◽  
Rural District ◽  
Standard Chemotherapy ◽  
International Partnership ◽  
Low Resource ◽  
High Resource ◽  
District Hospitals ◽  
Abvd Chemotherapy

Abstract 34 Background: While Hodgkin lymphoma (HL) is highly curable with standard chemotherapy in high resource settings, there are few reports of HL treatment in low resource settings. In Rwanda, a treatment protocol using six cycles of ABVD chemotherapy (doxorubicin, bleomycin, vinblastine, dacarbazine) without radiotherapy has been implemented at two rural district hospitals. Here we report on the feasibility of this approach, our patient characteristics, and preliminary outcomes. Methods: We conducted a retrospective cohort study of all patients with biopsy confirmed HL seen at Butaro and Rwinkwavu hospitals between June 2012 and August 2015. Data was extracted from clinical charts and analyzed using descriptive statistics. Results: 43 HL patients were seen at Butaro (n=38) and Rwinkwavu (n=5); 58% male, median age 17 (range 4-54). Five (12%) were HIV positive. Of 22 patients with biopsy specimens evaluated for EBV, 12 (55%) were positive, 9 (41%) negative, and one indeterminate. Most patients were staged with chest x-ray (79%); fewer had liver ultrasound (33%) or CT (9%). With that, Ann Arbor stages were I (28%), II (23%), III (21%), IV (21%), and undetermined (7%). Of 39 patients who started ABVD, 25 (64%) completed all 6 cycles. Median time to completion of the 24 week ABVD regimen was 26.1 weeks (IQR 25-27); 26 patients (67%) experienced at least one treatment delay. Dose reductions were rare. At the time of data extraction, 5 (12%) were still on treatment, 18 (43%) in remission, 2 (5%) alive with relapse, 15 (35%) deceased, and 2 (5%) lost to follow up. Conclusions: Here we demonstrate the feasibility of treating HL with standard chemotherapy in a low resource setting through international partnership. Our preliminary results suggest that a majority of patients who complete treatment may experience a clinically significant remission with this approach. Further data analysis will identify areas for improvement with the hope of increasing sustained remissions. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.

scholarly journals Augmenting Neural Machine Translation through Round-Trip Training Approach

2019 ◽  
Vol 9 (1) ◽  
pp. 268-278 ◽  
Author(s):  
Benyamin Ahmadnia ◽  
Bonnie J. Dorr
Keyword(s):  
Machine Translation ◽  
Training Data ◽  
Training Dataset ◽  
Round Trip ◽  
Neural Machine Translation ◽  
Low Resource ◽  
Translation Quality ◽  
High Resource ◽  
Training Approach ◽  
Language Pair

AbstractThe quality of Neural Machine Translation (NMT), as a data-driven approach, massively depends on quantity, quality and relevance of the training dataset. Such approaches have achieved promising results for bilingually high-resource scenarios but are inadequate for low-resource conditions. Generally, the NMT systems learn from millions of words from bilingual training dataset. However, human labeling process is very costly and time consuming. In this paper, we describe a round-trip training approach to bilingual low-resource NMT that takes advantage of monolingual datasets to address training data bottleneck, thus augmenting translation quality. We conduct detailed experiments on English-Spanish as a high-resource language pair as well as Persian-Spanish as a low-resource language pair. Experimental results show that this competitive approach outperforms the baseline systems and improves translation quality.

Impact of COVID-19 on the system of higher education

2020 ◽  
pp. 12-22
Author(s):  
S.L. Talanov ◽  
◽  
F.Yu. Kushnarev ◽  
D.T. Berezin ◽  
E.S. Rumyantseva ◽  
...  
Keyword(s):  
Higher Education ◽  
Online Survey ◽  
Economic Capital ◽  
Sociological Study ◽  
Large Cities ◽  
Low Resource ◽  
High Resource ◽  
Coronavirus Infection ◽  
The Government ◽  
The Impact

Analyzed is the impact of restrictions on higher educational system introduced by the Government of the Russian Federation in connection with spread of coronavirus infection COVID-19. Sociological study (online survey) was conducted among students, enrolled in budgetary and extra-budgetary forms of education, as well as among graduates of secondary schools (11th classes), located in small, medium and large cities of Yaroslavl region. In addition, video interviews were conducted, using Zoom service among number of applicants, parents of applicants, teachers, positional experts. It was established, that emergence and spread of COVID-19 and limitations, associated with it, made certain adjustments to strategies of applicants and students. Despite all changes that have arisen due to coronavirus infection, only a small part of applicants and students studying on extrabudgetary basis, decided to change their plans. It is concluded, that for significant part of applicants, obtaining higher education is an attempt to continue to remain in a familiar comfortable environment (continuation of “childhood”). Despite constant stresses at school, expectation from prospect of losing a measured, familiar, predictable life is even more stressful. Parents from families, belonging to medium-resource and high-resource groups, as a rule, support decision of their children to keep on studying. In this case, decision to enter university is made long before graduation. Parents from low-resource groups, as a rule, try to give profession, not a higher education. At the same time, it was revealed, that children from families, belonging to low-resource groups, for the most part, anyway note that if they had necessary resources, they would try to get higher education. In addition, the authors conclude, that decision on admission to university is greatly influenced by not at all economic capital of family, how much family’s value, as well as influence of the reference person.

scholarly journals Assessment of Local Supply Chains and Stock Management Practices for Trauma Care Resources in Ghana: A Comparative Cross-Sectional Study

2020 ◽  
Author(s):  
Godfred Boakye ◽  
Adam Gyedu ◽  
Melissa Stewart ◽  
Peter Donkor ◽  
Charles Mock ◽  
...  
Keyword(s):  
Supply Chain ◽  
Resource Availability ◽  
Trauma Care ◽  
Management Practices ◽  
Low Cost ◽  
The United States ◽  
Major Public Health Problem ◽  
Stock Management ◽  
Low Resource ◽  
High Resource

Abstract Background: Injuries are a major public health problem globally. With sound planning and organization, essential trauma care can be reliably provided with relatively low-cost equipment and supplies. However, availability of these resources requires an effective and efficient supply chain and good stock management practices. Therefore, we study aimed to assess trauma care resource-related supply management structures and processes at health facilities in Ghana. By doing so, the findings may allow us to identify specific structures and processes that could be improved to facilitate higher quality and more timely care.Methods: Ten hospitals were purposively selected using results from a previously performed national trauma care capacity assessment of hospitals of all levels in Ghana. Five hospitals with low resource availability and 5 hospitals with high resource availability were assessed using the United States Agency for International Development (USAID) Logistics Indicators Assessment Tool and stock ledger review. Data were described and stock management practices were correlated with resource availability.Results: There were differences in stock management practices between low and high resource availability hospitals, including frequency of reporting and audit, number of stock-outs on day of assessment (median 9 vs 2 stock-outs, range 3 – 57 vs 0 – 9 stock-outs, respectively; p=0.05), duration of stock-outs (median 171 vs 8 days, range 51 – 1,268 vs 0 – 182 days, respectively; p=0.02), and fewer of up-to-date stock cards (24 vs 31 up-to-date stock cards, respectively; p=0.07). Stock-outs were common even among low-cost, essential resources (e.g., nasal cannulas and oxygen masks, endotracheal tubes, syringes, sutures, sterile gloves). Increased adherence to stock management guidelines and higher percentage of up-to-date stock cards were correlated with higher trauma resource availability scores. However, the variance in trauma resource availability scores was poorly explained by these individual factors or when analyzed in a multivariate regression model (r2=0.72; p value for each covariate between 0.17 – 0.34).Conclusions: Good supply chain and stock management practices are correlated with high trauma care resource availability. The findings from this study demonstrate several opportunities to improve stock management practices, particularly at low resource availability hospitals

scholarly journals A fast, resource efficient and reliable rule-based system for COVID-19 symptom identification

JAMIA Open ◽  
2021 ◽  
Author(s):  
Himanshu S Sahoo ◽  
Greg M Silverman ◽  
Nicholas E Ingraham ◽  
Monica I Lupei ◽  
Michael A Puskarich ◽  
...  
Keyword(s):  
Real Time ◽  
Resource Utilization ◽  
Fine Tuning ◽  
Rule Based ◽  
Low Resource ◽  
Annotation System ◽  
High Resource ◽  
Industry Standard ◽  
Depth Analysis ◽  
Current Annotation

Abstract Objective With COVID-19 there was a need for rapidly scalable annotation system that facilitated real-time integration with clinical decision support systems (CDS). Current annotation systems suffer from high resource utilization and poor scalability limiting real-world integration with CDS. A potential solution to mitigate these issues is to use the rule-based gazetteer developed at our institution. Materials and Methods Performance, resource utilization and runtime of the rule-based gazetteer was compared with five annotation systems: BioMedICUS, cTAKES, MetaMap, CLAMP and MedTagger. Results This rule-based gazetteer was fastest, had low resource footprint and similar performance for weighted micro-average and macro-average measures of precision, recall and f1-score compared to other annotation systems. Discussion Opportunities to increase its performance include fine-tuning lexical rules for symptom identification. Additionally, it could run on multiple compute nodes for faster runtime. Conclusion This rule-based gazetteer overcame key technical limitations facilitating real-time symptomatology identification for COVID-19 and integration of unstructured data elements into our CDS. It is ideal for large-scale deployment across a wide variety of health care settings for surveillance of acute COVID-19 symptoms for integration into prognostic modeling. Such a system is currently being leveraged for monitoring of post-acute sequelae of COVID-19 (PASC) progression in COVID-19 survivors. This study conducted the first in-depth analysis and developed a rule-based gazetteer for COVID-19 symptom extraction with the following key features: low processor and memory utilization, faster runtime and similar weighted micro-average and macro-average measures for precision, recall and f1-score compared to industry standard annotation systems. Lay Summary With COVID-19 came an unprecedented need to identify symptoms of COVID-19 patients under investigation (PUIs) in a time sensitive, resource-efficient and accurate manner. While available annotation systems perform well for smaller healthcare settings, they fail to scale in larger healthcare systems where 10,000+ clinical notes are generated a day. This study covers 3 improvements addressing key limitations of current annotation systems. (1) High resource utilization and poor scalability of existing annotation systems. The presented rule-based gazetteer is a high-throughput annotation system for processing high volume of notes, thus, providing opportunity for clinicians to make more informed time-sensitive decisions around patient care. (2) Equally important is our developed rule-based gazetteer performs similar or better than current annotation systems for symptom identification. (3) Due to minimal resource needs of the rule-based gazetteer, it could be deployed at healthcare sites lacking a robust infrastructure where industry standard annotation systems cannot be deployed because of low resource availability.

scholarly journals Assessment of Local Supply Chains and Stock Management Practices for Trauma Care Resources in Ghana: A Comparative Small Sample Cross-Sectional Study

2021 ◽  
Author(s):  
Godfred Boakye ◽  
Adam Gyedu ◽  
Melissa Stewart ◽  
Peter Donkor ◽  
Charles Mock ◽  
...  
Keyword(s):  
Supply Chain ◽  
Resource Availability ◽  
Trauma Care ◽  
Management Practices ◽  
Low Cost ◽  
The United States ◽  
Small Sample ◽  
Stock Management ◽  
Low Resource ◽  
High Resource

Abstract Background: Injuries are a major public health problem globally. With sound planning and organization, essential trauma care can be reliably provided with relatively low-cost equipment and supplies. However, availability of these resources requires an effective and efficient supply chain and good stock management practices. Therefore, we study aimed to assess trauma care resource-related supply management structures and processes at health facilities in Ghana. By doing so, the findings may allow us to identify specific structures and processes that could be improved to facilitate higher quality and more timely care. Methods: Ten hospitals were purposively selected using results from a previously performed national trauma care capacity assessment of hospitals of all levels in Ghana. Five hospitals with low resource availability and 5 hospitals with high resource availability were assessed using the United States Agency for International Development (USAID) Logistics Indicators Assessment Tool and stock ledger review. Data were described and stock management practices were correlated with resource availability. Results: There were differences in stock management practices between low and high resource availability hospitals, including frequency of reporting and audit, number of stock-outs on day of assessment (median 9 vs 2 stock-outs, range 3 – 57 vs 0 – 9 stock-outs, respectively; p=0.05), duration of stock-outs (median 171 vs 8 days, range 51 – 1,268 vs 0 – 182 days, respectively; p=0.02), and fewer of up-to-date stock cards (24 vs 31 up-to-date stock cards, respectively; p=0.07). Stock-outs were common even among low-cost, essential resources (e.g., nasal cannulas and oxygen masks, endotracheal tubes, syringes, sutures, sterile gloves). Increased adherence to stock management guidelines and higher percentage of up-to-date stock cards were correlated with higher trauma resource availability scores. However, the variance in trauma resource availability scores was poorly explained by these individual factors or when analyzed in a multivariate regression model (r 2 =0.72; p value for each covariate between 0.17 – 0.34). Conclusions: Good supply chain and stock management practices are correlated with high trauma care resource availability. The findings from this study demonstrate several opportunities to improve stock management practices, particularly at low resource availability hospitals.

scholarly journals The effect of resource limitation on the temperature dependence of mosquito population fitness

2021 ◽  
Vol 288 (1949) ◽  
Author(s):  
Paul J. Huxley ◽  
Kris A. Murray ◽  
Samraat Pawar ◽  
Lauren J. Cator
Keyword(s):  
Disease Transmission ◽  
Resource Limitation ◽  
Adult Size ◽  
Population Modelling ◽  
Juvenile Mortality ◽  
Low Resource ◽  
Vector Borne Disease ◽  
High Resource ◽  
Optimal Resource ◽  
Vector Borne

Laboratory-derived temperature dependencies of life-history traits are increasingly being used to make mechanistic predictions for how climatic warming will affect vector-borne disease dynamics, partially by affecting abundance dynamics of the vector population. These temperature–trait relationships are typically estimated from juvenile populations reared on optimal resource supply, even though natural populations of vectors are expected to experience variation in resource supply, including intermittent resource limitation. Using laboratory experiments on the mosquito Aedes aegypti , a principal arbovirus vector, combined with stage-structured population modelling, we show that low-resource supply in the juvenile life stages significantly depresses the vector's maximal population growth rate across the entire temperature range (22–32°C) and causes it to peak at a lower temperature than at high-resource supply. This effect is primarily driven by an increase in juvenile mortality and development time, combined with a decrease in adult size with temperature at low-resource supply. Our study suggests that most projections of temperature-dependent vector abundance and disease transmission are likely to be biased because they are based on traits measured under optimal resource supply. Our results provide compelling evidence for future studies to consider resource supply when predicting the effects of climate and habitat change on vector-borne disease transmission, disease vectors and other arthropods.

scholarly journals The effect of resource limitation on the temperature-dependence of mosquito population fitness

2020 ◽  
Author(s):  
Paul J. Huxley ◽  
Kris A. Murray ◽  
Samraat Pawar ◽  
Lauren J. Cator
Keyword(s):  
Disease Transmission ◽  
Development Time ◽  
Natural Populations ◽  
Resource Limitation ◽  
Population Level ◽  
Adult Size ◽  
Population Modelling ◽  
Juvenile Mortality ◽  
Low Resource ◽  
High Resource

ABSTRACTLaboratory-derived temperature dependencies of life history traits are increasingly being used to make mechanistic predictions for how climatic warming will affect vector-borne disease dynamics, partially by affecting abundance dynamics of the vector population. These temperature-trait relationships are typically estimated from populations reared on optimal resource supply, even though natural populations of vectors are expected to experience variation in resource supply, including intermittent resource limitation. Using laboratory experiments on the mosquito Aedes aegypti, a principal arbovirus vector, combined with stage-structured population modelling, we show that low-resource supply significantly depresses the vector’s maximal population growth rate across the entire temperature range (22-32°C) and causes it to peak at a lower temperature than at high-resource supply. This effect is primarily driven by an increase in juvenile mortality and development time, combined with an exaggerated decrease in adult size with temperature at low-resource supply. Our study suggests that projections of vector abundance and disease transmission based on laboratory studies are likely to substantially underestimate how resource supply can modulate the temperature-dependency of population-level fitness through its influence on juvenile survival and development time. Our results provide compelling evidence for future studies to consider resource supply when predicting the effects of climate and habitat change on disease vectors and transmission.

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