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Copyright of Acta Facultatis Medicae Naissensis is the property of Nis University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Compacted granular columns are frequently used to mitigate construction difficulties over soft soil deposits through a combination of densification, increasing load-bearing capacity and improvement in consolidation features. The behaviour of granular columns under vertical loading has been well recognised; however, this research is aimed to investigate the behaviour of granular column-reinforced soft soil subjected to shear stress. In this contribution, large-scale direct shear tests were performed, and the influence of undrained shear strength of clay, diameter of granular column and relative density of aggregates was examined. In general, the use of granular column has been shown to improve the shear resistance of the composite ground, which was found to be much significant at lower undrained shear strength of the soft clay. Increasing density of aggregates from Dr = 50% to 90% caused a large portion of the shear stress to be sustained by the accumulated friction of aggregates as the internal friction angle of the treated clay increased from 0 to 28°. In addition, test results revealed that the use of highly compacted column yields a lowered shear displacement at failure, which was indirect evidence of stiffness improvement of the composite ground. [ABSTRACT FROM AUTHOR]

Background and Aim: Recently, coronavirus has become a major cause of death and hospital admission worldwide. This study was aimed to assess the factors associated with the presentation via ambulance and time to in-hospital death or discharge from the hospital using a multilevel joint modeling approach. Materials and Methods: In this historical cohort study, hospitalized patients with COVID-19 were included from 34 medical centers in Khuzestan province, Iran, from February 18th, 2020, to January 5th, 2021. Joint model analysis was used to assess the impact of demographic and clinical characteristics on the mode of hospital presentation and time to death/discharge from hospitals in Khuzestan province, Iran. Results: Among 22,356 patients, 14.2% presented to the hospital via ambulance, and 11.2% died in the hospital. The odds of ambulance use was higher in patients with older age, male sex, comorbidities including respiratory disease, diabetes, cancer, and drug abuse, and symptoms such as respiratory distress and loss of consciousness. Older age, male sex, a higher burden of comorbidities, symptoms of chest pain, respiratory distress, and loss of consciousness, and admission to intensive care unit were predictors of in-hospital mortality. The median survival time was longer for patients with COVID-19 who selfpresented to the hospital compared to those who presented with ambulance (31 vs 20 days; log-rank P<0.001). Conclusion: Several demographic and clinical factors were found to predict the EMS utilization and in-hospital mortality in patients hospitalized with COVID-19 and can be used for risk-stratification. Controlling for the predictors of ambulance use in COVID-19 infection may help improve patient outcomes. [ABSTRACT FROM AUTHOR]

One of the challenges when transitioning from International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) to International Classification of Diseases, 11th Revision (ICD-11) is to ensure clinical coding accuracy.To determine the accuracy of clinical coding with ICD-11 in comparison with ICD-10 and identify causes of coding errors in real clinical coding environments.The study was conducted prospectively in two general hospitals. Medical records of discharged inpatients were coded by hospital clinical coders with both ICD-11 and ICD-10 on different days. These medical records were recoded by five mentors. Codes assigned by mentors were used as the gold standard for the evaluation of accuracy.The accuracy of ICD-10 and ICD-11 coding for 1578 and 2168 codes was evaluated. Coding accuracy was 89.1% and 74.2% for ICD-10 and ICD-11. In ICD-11, the lowest accuracy was observed in chapters 22 (injuries), 10 (ear) and 11 (circulatory) (51.1%, 53.8% and 62.7%, respectively). In both ICD-10 and ICD-11, the most important cause of the coding errors was clinical coders’ mistakes (79.5% and 81.8% for ICD-10 and ICD-11, respectively).Accuracy of clinical coding with ICD-11 was lower relative to ICD-10. Hence, it is essential to carry out initial preparations, particularly the training of clinical coders based on their needs, as well as the necessary interventions to enhance the documentation of medical records according to ICD-11 before or simultaneous with the country-wide implementation.Clinical coders need complete training, especially in using extension codes and post-coordination coding. Local ICD-11 guidelines based on the needs of local users and reporting policies should be developed. Furthermore, documentation guidelines based on ICD-11 requirements should be developed. [ABSTRACT FROM AUTHOR]

Background: Rural health houses constitute a major provider of some primary health services in the villages of Iran. Given the challenges of providing health services in rural areas, health houses should be established based on the criteria of health network systems (HNSs). The value of these criteria and their precedence over others have not yet been thoroughly investigated. The present study was conducted to propose a model for improving the distribution of rural health houses in HNSs. Methods: The present applied study was conducted in Khuzestan province in the southwest of Iran in 2014-2016. First, the descriptive and spatial data required were collected and entered into ArcGIS after modifications, and the Geodatabase was then created. Based on the criteria of the HNS and according to experts' opinions, the main criteria and the sub-criteria for an optimal site selection were determined. To determine the criteria's coefficient of importance (ie, their weight), the main criteria and the sub-criteria were compared in pairs according to experts' opinions. The results of the pairwise comparisons were entered into Expert Choice and the weight of the main criteria and the sub-criteria were determined using the analytic hierarchy process (AHP). The application layers were then formed in geographic information system (GIS). A model was ultimately proposed in the GIS for the optimal distribution of rural health houses by overlaying the weighting layers and the other layers related to villages and rural health houses. Results: Based on the experts' opinions, six criteria were determined as the main criteria for an optimal site selection for rural health houses, including welfare infrastructures, population, dispersion, accessibility, corresponding routes, distance to the rural health center and the absence of natural barriers to accessibility. Of the main criteria proposed, the highest weight was given to "population" (0.506). The priorities suggested in the proposed model for establishing rural health houses are presented within five zoning levels -from excellent to very poor. Conclusion: The results of the study showed that the proposed model can help provide a better picture of the distribution of rural health houses. The GIS is recommended to be used as a means of making the HNS more efficient. [ABSTRACT FROM AUTHOR]

Background: Security and privacy of electronic information systems are critical issues for consumers and service providers. Blockchain is considered as a security tool in today's technology. The current research focuses on the opportunities and challenges of using blockchain technology in medical information management. Objective: The aim of this study is to determine the opportunities and challenges of using blockchain technology in medical information management. Material and Methods: The current review study was conducted using a library method in the period between 2012 to 2022. The articles were reviewed by searching the keywords Blockchain Technology, Healthcare, and Electronic Medical Record in Pubmed, Google Scholar, IEEE Xplore, Science Direct, and Researchgate databases. Results: Blockchain Technology plays an important role in the management of information records (e-medicine through proposed platforms such as medrec (decentralized approach to manage permissions, share data between health stakeholders, and create knowledge from the level of information access) FHIRChain (fast health interoperability records + blockchain). Also, ongoing efforts have been made to overcome limitations in scalability, security, and privacy in order to improve stakeholder confidence in the use of this technology and increase its adoption in healthcare. Conclusion: The effectiveness of this technology, focusing on the safe sharing of electronic file data and reducing the possibility of theft and manipulation, decentralized storage, recording and tracking data, and eliminating data transmission intermediaries, is one of the most important results obtained from this research. [ABSTRACT FROM AUTHOR]

Background: Designing mobile applications is one of the tools to increase the awareness of patients and the care team. A self-care application can be a good choice to help people gain awareness and improve treatment. Objective: The aim of the present study was to identify the minimum data set for designing a mobile-based application for obesity management in children. Material and Methods: In this descriptive-analytical article, data collection has been done by library and internet method. The research population included 30 nutritionists who were selected by simple sampling. The research tool was a questionnaire that the researcher prepared in four sections: demographic data, evaluation data, treatment recommendations and practical capabilities. Validity and reliability were confirmed using content validity ratio (CVR) and Delphi method, respectively. Results: The minimum data set (MDS) required for childhood obesity management was designed based on data from WHO guidelines and expert opinions. The importance of this proposed MDS was calculated for demographic data 100%, assessment data 88.33%, treatment recommendations 97.67% and functional capabilities 88.94%.. Conclusion: Identifying the minimum data set for the prevention and control of obesity in children from the point of view of experts will be effective in improving applications in this field. This MDS has two data sections: The first part is used to understand the evaluation framework and use of treatment methods and the second part is used as the patient's personal file to store a set of data. [ABSTRACT FROM AUTHOR]

Background: Providing immediate assistance to people in medical emergencies and natural disasters are one of the biggest rescue challenges. The widespread use of smartphones and their capabilities has created the opportunity to use their capabilities to assist in the rescue. Many countries have developed apps to help rescue. Objective: This study aimed to identify Android-based rescue Mobile applications in Iran, also study their structure and content. Material and Methods: This was a cross-sectional study. The population of the study consisted of all Android apps related to the rescue in Iran. First, by searching Google, Google Play (Google App Store), Bazaar (Persian app store) and others Persian apps stores all related rescue applications were identified and the applications downloaded, installed and evaluated. The application evaluation tool was a researcher-made checklist. The collected data were analyzed using descriptive statistics in Microsoft Excel 2019 software. Results: In total, 65 Iranian rescue apps for Android were identified. The apps fell into three general categories, including first aid training apps, disaster response training such as earthquakes, and emergency rescue requests. The automatic location detection of the person and the possibility of asking for help in emergencies was available in only three apps. The use of most rescue apps was completely free (84%). Very few of these apps were developed by rescue organizations such as the Red Crescent or the fire department (17%). Also, a review of app stores showed that most apps had less than 500 active downloads (86%). Conclusion: The ability to detect the geographical location of the injured person, automatic calls to emergency centers or family, notification of the latest news in natural disasters, etc. are the most important features of a rescue app that did not exist in most rescue Mobile applications in Iran. Therefore, it is recommended that the Iranian Crisis Management Organization, in cooperation with other organizations involved in rescue, design a national rescue app. [ABSTRACT FROM AUTHOR]