Health and Technology最新文献

Data: This study looks at the content on Reddit's COVID-19 community, r/Coronavirus, to capture and understand the main themes and discussions around the global pandemic, and their evolution over the first year of the pandemic. It studies 356,690 submissions (posts) and 9,413,331 comments associated with the submissions, corresponding to the period of 20th January 2020 and 31st January 2021.

Methodology: On each of these datasets we carried out analysis based on lexical sentiment and topics generated from unsupervised topic modelling. The study found that negative sentiments show higher ratio in submissions while negative sentiments were of the same ratio as positive ones in the comments. Terms associated more positively or negatively were identified. Upon assessment of the upvotes and downvotes, this study also uncovered contentious topics, particularly "fake" or misleading news.

Results: Through topic modelling, 9 distinct topics were identified from submissions while 20 were identified from comments. Overall, this study provides a clear overview on the dominating topics and popular sentiments pertaining the pandemic during the first year.

Conclusion: Our methodology provides an invaluable tool for governments and health decision makers and authorities to obtain a deeper understanding of the dominant public concerns and attitudes, which is vital for understanding, designing and implementing interventions for a global pandemic.

Purpose: Smart cities that support the execution of health services are more and more in evidence today. Here, it is mainstream to use IoT-based vital sign data to serve a multi-tier architecture. The state-of-the-art proposes the combination of edge, fog, and cloud computing to support critical health applications efficiently. However, to the best of our knowledge, initiatives typically present the architectures, not bringing adaptation and execution optimizations to address health demands fully.

Methods: This article introduces the VitalSense model, which provides a hierarchical multi-tier remote health monitoring architecture in smart cities by combining edge, fog, and cloud computing.

Results: Although using a traditional composition, our contributions appear in handling each infrastructure level. We explore adaptive data compression and homomorphic encryption at the edge, a multi-tier notification mechanism, low latency health traceability with data sharding, a Serverless execution engine to support multiple fog layers, and an offloading mechanism based on service and person computing priorities.

Conclusions: This article details the rationale behind these topics, describing VitalSense use cases for disruptive healthcare services and preliminary insights regarding prototype evaluation.

Objective: The purpose was to provide uptake and radiation dose estimates to salivary glands (SG) and pathologic lesions following radioiodine therapy (RIT) of differentiated thyroid cancer patients (DTC).

Methods: A group of DTC patients (n = 25) undergoing ¹³¹I therapy joined this study with varying amounts of therapeutic activity. Sequential SPECT/CT scans were acquired at 4 ± 2, 24 ± 2, and 168 ± 3 h following administration of 3497-9250 MBq 131I. An earlier experiment with Acrylic glass body phantom (PET Phantom NEMA 2012 / IEC 2008) was conducted for system calibration including scatter, partial volume effect and count loss correction. Dose calculation was made via IDAC-Dose 2.1 code.

Results: The absorbed dose to parotid glands was 0.04-0.97 Gy/GBq (median: 0.26 Gy/GBq). The median absorbed dose to submandibular glands was 0.14 Gy/GBq (0.05 to 0.56 Gy/GBq). The absorbed dose to thyroid residues was from 0.55 to 399.5 Gy/GBq (median: 21.8 Gy/GBq), and that to distal lesions ranged from 0.78 to 28.0 Gy/GBq (median: 3.12 Gy/GBq). 41% of the thyroid residues received dose > 80 Gy, 18% between 70-80 Gy, 18% between 40-70 Gy, and 23% has dose < 40 Gy. In contrast, 18% of the metastases exhibited a dose > 80 Gy, 9% between 40-60 Gy, and the dose to the vast majority of lesions (64%) was < 40 Gy.

Conclusion: It was inferred that dose estimation after RIT with SPECT/CT is feasible to apply, together with good agreement with published ¹²⁴I PET/CT dose estimates. A broad and sub-effective dose range was estimated for thyroid residues and distal lesions. Moreover, the current methodology might be useful for establishing a dose-effect relationship and radiation-induced salivary glands damage after RIT.

Purpose: Daily monitoring of COVID-19 symptoms/history of contact in hospital staff is useful for ensuring safety in the hospital. An electronic self- assessment tool could be used to monitor staff without using excessive resources and resulting in unnecessary contact. The objective of our study was to describe the results of a self-assessment COVID-19 daily monitor log in hospital employees.

Methods: A description of characteristics of staff who filled the log and follow-up of those who reported symptoms/history of contact was collected. An online self-assessment of COVID-19 symptoms/contact history was developed and used at a hospital in Bahrain. All staff completed the daily COVID-19 log. Data were collected during the month of June 2020.

Results: Out of 47,388 responses, 853 (2%) of staff reported either COVID-19 symptoms/history of contact with diagnosed COVID-19 case. The most frequently reported symptom was sore throat (23%), followed by muscle pain (12.6%). The highest frequency of staff who reported symptoms and/or contact was in nurses. Of those who reported symptoms/contact, 18 were diagnosed with COVID-19. The majority (83.3%) of the infected staff obtained the virus through community transmission, and only 16.7% obtained the virus through hospital transmission.

Conclusion: The electronic self-assessment log for staff during COVID-19 could be used as a safety measure in hospitals. Moreover, the study highlights the importance of targeting community transmission in an effort to increase hospital safety.

Purpose: The emergence of the COVID-19 (SARS-CoV-2) pandemic has led to public health restrictions and a shift towards virtual care and telehealth. The aim of this study was to explore barriers and facilitators of virtual care from the perspective of neurological and psychiatric patients.

Methods: One-on-one interviews were conducted remotely using telephone and online video teleconferencing. There was a total of 57 participants, and a thematic content analysis was conducted using NVivo software.

Results: The two main themes were (1) virtual health service delivery and (2) virtual physician/patient interaction, with subthemes around how virtual care improved accessibility of care for patients and improved patient-centered care; how privacy and technical issues impact patients using virtual care; and the need for relationality and connection between health care providers and patients while using virtual care.

Conclusions: This study showed that virtual care can increase accessibility and efficiency for patients and providers, indicating its potential for ongoing use in the delivery of clinical care. Virtual care was found to be an acceptable mode of healthcare delivery from the perspective of patients; however, there is a continued need for relationship-building between care providers and patients.

Purpose: The aim of this narrative review is to sumarize data about the use and role of telemedicine in maternal fetal medicine (MFM).

Methods: We searched pubmed and scopus to find articles about telemedicine in MFM by using the terms telmedicine or telehealth and maternal fetal medicine.

Results: Telehealth has been widely used for several medical specialties. During the coronavirus disease 2019 (COVID-19) pandemic, telehealth has gained investment and further research. Even though telemedicine in MFM has not been frequently applied, from 2020 onwards it has increased in both implementation and acceptance worldwide. The need to screen the patients in overloaded centers in a pandemic scenario required telemedicine in MFM, which has exhibited consistently good results concerning health and budget. The aim of this study was to review the telehealth programs and research focused on MFM around the world. Few studies have been applied to MFM and even fewer in developing and undeveloped countries. The majority of studies were concentrated in the USA and in Europe.

Conclusion: Further research is needed, especially in non-developed countries, to comprehend the potential role of telemedicine in MFM for improving the life quality of the patients, health professionals, and to be cost-efficient.

Background: Clinical Trials (CTs) remain the foundation of safe and effective drug development. Given the evolving data-driven and personalized medicine approach in healthcare, it is imperative for companies and regulators to utilize tailored Artificial Intelligence (AI) solutions that enable expeditious and streamlined clinical research. In this paper, we identified opportunities, challenges, and potential implications of AI in CTs.

Methods: Following an extensive search in relevant databases and websites, we gathered publications tackling the use of AI and Machine Learning (ML) in CTs from the past 5 years in the US and Europe, including Regulatory Authorities' documents.

Results: Documented applications of AI commonly concern the oncology field and are mostly being applied in the area of recruitment. Main opportunities discussed aim to create efficiencies across CT activities, including the ability to reduce sample sizes, improve enrollment and conduct faster, more optimized adaptive CTs. While AI is an area of enthusiastic development, the identified challenges are ethical in nature and relate to data availability, standards, and most importantly, lack of regulatory guidance hindering the acceptance of AI tools in drug development. However, future implications are significant and are anticipated to improve the probability of success, reduce trial burden and overall, speed up research and regulatory approval.

Conclusion: The use of AI in CTs is in its relative infancy; however, it is a fast-evolving field. As regulators provide more guidance on the acceptability of AI in specific areas, we anticipate the scope of use to broaden and the volume of implementation to increase rapidly.

Blood pressure is an important cardiovascular parameter. Currently, the cuff-based sphygmomanometer is a popular, reliable, measurement method, but blood pressure monitors without cuffs have become popular and are now available without a prescription. Blood pressure monitors must be approved by regulatory authorities. Current cuffless blood pressure (CL-BP) monitors are not suitable for at-home management and prevention of hypertension. This paper proposes simple criteria for over-the-counter CL-BP monitoring. First, the history of the sphygmomanometer and current standard blood pressure protocol are reviewed. The main components of CL-BP monitoring are accuracy during the resting condition, accuracy during dynamic blood pressure changes, and long-term stability. In this proposal we recommend intermittent measurement to ensure that active measurement accuracy mirrors resting condition accuracy. A new experimental protocol is proposed to maintain long-term stability. A medically approved automated sphygmomanometer was used as the standard device in this study. The long-term accuracy of the test device is based on the definition of propagation error, i.e., for an oscillometric automated sphygmomanometer (5 ± 8 mmHg) ± the error for the test device static accuracy (-0.12 ± 5.49 mmHg for systolic blood pressure and - 1.17 ± 5.06 mmHg for diastolic blood pressure). Thus, the long-term stabilities were - 3.38 ± 7.1 mmHg and - 1.38 ± 5.4 mmHg, which satisfied propagation error. Further research and discussion are necessary to create standards for use by manufacturers; such standards should be readily evaluated and ensure high-quality evidence.

Supplementary information: The online version contains supplementary material available at 10.1007/s12553-023-00726-6.