International Journal of Telemedicine and Applications最新文献

Introduction: Online video consultation (VC) use in pediatric care has increased recently, particularly following the COVID-19 pandemic. However, understanding parental perspectives on VC use with pediatricians, especially across geographical regions, remains crucial for effective VC implementation and reducing healthcare disparities. Methods: This mixed methods study combined an online survey (n = 96) and two focus groups (n = 17) to examine parental perceptions of VC with pediatricians in Israel. Based on the Telehealth Usability Questionnaire, the survey assessed user experience, usefulness, and satisfaction. Focus groups explored themes related to children's experiences, remote diagnosis, patient-physician communication, and VC use during emergencies. Results: While 82% of parents believed that VC saved time and 67% felt it improved access to healthcare, only 50% thought it met their healthcare needs. Parents in peripheral regions rated the usefulness of VC higher than those in central areas, particularly during times of security concerns. However, central region parents reported better user experiences. Parents with prior VC experience showed higher satisfaction and future use intention than non-preusers. Focus groups revealed that children often felt more comfortable with VC due to the familiar home environment, although parents expressed concerns about remote diagnosis accuracy and physician communication quality. Discussion: Our findings highlight geographic disparities in VC adoption and emphasize the need for targeted interventions to improve technical support and infrastructure in peripheral regions. While VC shows promise for enhancing healthcare accessibility, particularly during emergencies, success requires addressing technical barriers, strengthening privacy measures, and establishing clear guidelines for remote pediatric care delivery.

Background: Telepathology and digital pathology are increasingly utilised for routine diagnostics globally, improving patient safety and diagnostic efficiency. No research exists on the adoption of digital pathology in South Africa. Understanding the current use can help understand implementation needs and ensure equitable access to this modern diagnostic tool. This can help realise the technology's benefits across the diverse communities in South Africa. Methods: This was a nonexperimental descriptive study. Primary quantitative data were collected via a questionnaire distributed to South African histopathologists in August 2023. The questionnaire focused on participants' demographic information and the use of digital pathology by histopathologists in South Africa. Descriptive data analysis was performed. Results: The study comprised 71 histopathologists, representing 23% of all registered histopathologists in the country. There was a near-equal distribution of female and male histopathologists. Most of the participating histopathologists worked in the private sector. Nearly all of the histopathologists surveyed indicated some exposure to digital pathology (99%). Most participants use digital pathology for external quality assurance and training. The use of digital pathology as a routine diagnostic tool was noted by 22% of participants, although only 3% reported daily use. Conclusion: The current use and adoption of digital pathology by South African histopathologists are comparable to the international community. By increasing the use of digital pathology for routine diagnostic use, we can enhance the accuracy of diagnoses and improve healthcare outcomes for patients and healthcare professionals.

Telerobotic spinal surgery (TSS) has emerged as a transformative approach for spinal interventions that combines robotics and telecommunication to enable remote surgery with enhanced precision and accessibility. This technology can potentially address the challenges of complex spinal conditions by providing minimally invasive solutions and delivering specialized surgical expertise across geographical boundaries. However, technical complexities related to communication and latency, haptic feedback, and system integration need to be addressed. Ethical and regulatory considerations also require careful navigation. Despite these challenges, the limited number of available clinical studies demonstrates the feasibility and efficacy of TSS, particularly with the use of 5G technology. Further research and clinical trials are needed to fully evaluate and validate the outcomes and effectiveness of TSS. With ongoing efforts in research and development, TSS has the potential to revolutionize spine surgery and improve patient care. In this review, we present the role and the challenges of TSS in spinal surgery.

Background: Low birth weight remains a health concern in the Special Region of Yogyakarta, Indonesia. Effective management of low birth weight cases is crucial, yet community-based health programs face challenges in addressing this issue. Purpose: This study is aimed at exploring the needs, experience, and perspectives of healthcare providers regarding low birth weight prevention programs. Methods: This was a qualitative descriptive study. Data were collected from June to December 2023 in Kulon Progo District, Yogyakarta, Indonesia. Data were collected through a focus group discussion with nine midwives. Triangulation was conducted with 12 breastfeeding mothers, one nutritionist, and one head of the primary health center through in-depth interviews. Each discussion and interview were recorded, transcribed, and subjected to thematic analysis to identify key themes. Results: Three themes were discovered in this study: programmatic initiatives of healthcare providers; poor knowledge, attitude, and practice with limited resources and access; enhancing the use of teleconsultations. Programmatic initiatives from primary healthcare centers have focused on preventing low birth weight through targeted outreach, education, and prenatal care for at-risk mothers. However, the persistent challenge of insufficient human resources for health has hindered the effectiveness and reach of these efforts. To enhance LBW prevention strategies, the needs of digital technology by integrating digital tools and electronic health records are imperative. Conclusion: Effectively managing low birth weight requires utilization of technology to strengthen healthcare interventions. Digital solutions enhance communication, broaden service reach, and enable timely support, especially in underserved areas. Incorporating these tools into health programs improves the delivery and accessibility of care, presenting a valuable approach to advancing maternal and child health outcomes.

Orthotic treatment, particularly for ankle injuries, often relies on devices such as ankle-foot orthoses (AFOs) to support and stabilize the foot and ankle. Given the high prevalence of lower extremity injuries, especially in sports, and the diagnostic challenges faced by clinicians, there is a pressing need for intelligent systems that aid in accurate assessment and personalized management. Misdiagnosis and suboptimal treatment of ankle conditions, including fractures and sprains, can lead to long-term complications and hinder recovery. This study presents TeleOrtho, a knowledge-based expert system designed to provide personalized diagnosis, treatment recommendations, and recovery plans for ankle injuries, integrating transcutaneous electrical nerve stimulation (TENS) therapy to enhance rehabilitation. The system was implemented using Flutter for cross-platform deployment and Python for expert rule modeling, and it features a user-friendly interface for both clinicians and patients. Diagnostic accuracy and treatment pathways were validated through two published case scenarios, confirming the system's alignment with medical guidelines. Static and dynamic testing demonstrated consistent functionality, and initial usability assessment indicated high user satisfaction (average SUS score: 85.3/100). The expert system reliably identified injury types based on structured symptom input and suggested individualized recovery plans. These results affirm the potential of TeleOrtho to reduce diagnostic errors, improve therapy adherence, and enhance clinical decision-making. Future work will focus on integrating imaging analysis, expanding the knowledge base to include additional orthopedic conditions, and conducting clinical trials for broader validation.

Introduction: Telerehabilitation can enhance delivery and acceptance of the home exercise program. This study evaluated the feasibility, safety, and signal of efficacy of a tele-assisted home exercise program for improving balance and functional mobility in persons with Parkinson's disease (TELEPORT-PD). Methods: Eight participants underwent six sessions of physiotherapist-supervised and tailored multimodal exercise over smartphone videoconference through WhatsApp Messenger over 2 weeks. Feasibility was assessed through adherence and retention rates, and safety was assessed through self-reported adverse events. Balance was measured using the Berg Balance Scale (BBS) and Activity-specific Balance Confidence (ABC) scale, while functional mobility was assessed using Timed-Up-and-Go (TUG) test and 5-times Sit-To-Stand (5STS) test, at baseline and at the end of 2 weeks. Results: The adherence and retention rates were 100%, and no serious adverse events were reported. Significant improvements were noted in the change scores of BBS (11.23 points; p = 0.014), ABC (14.21%; p = 0.014), TUG (-2.21 s; p = 0.007), and 5STS (-3.11 s; p = 0.007). All participants provided positive feedback and expressed their interest to continue the program. Conclusion: TELEPORT-PD appears to be feasible, safe, and acceptable, while demonstrating improvements in balance and functional mobility. Trial Registration: Clinical Trials Registry of India: CTRI/2022/09/045345.

The satisfaction level of patients and physicians with telemedicine services should be comparable to on-site visits if this technology is to be widely adopted. The degree of satisfaction can be used to assess the performance of any healthcare service. Therefore, in this cross-sectional study, we used a five-point Likert scale to evaluate the level of satisfaction with telemedicine by administering survey questionnaires to both patients and physicians online residing across Saudi Arabia. The questionnaires were divided into three parts: consent and summary, demographics, and the survey questions to determine satisfaction level with telemedicine. All statistical analysis was performed using SPSS Version 27. The results showed high satisfaction levels with telemedicine services by both patients and physicians where the age and gender of participants were influential in determining this outcome. Residential areas affected satisfaction levels with telemedicine in physicians but not in patients. Previous experiences with these services influenced the satisfaction of patients with those having previous experience reporting higher satisfaction. However, when the degree of satisfaction between patients and physicians was compared, the results were insignificant showing that the overall perception towards telemedicine usage is similar between healthcare providers and receivers. To conclude, our study showed that the experiences of patients and physicians with telemedicine services are satisfactory; however, certain areas regarding telemedicine usage warrant further improvement.

The study of ambient movement guidance encompasses a multidisciplinary approach to facilitating and guiding individuals, particularly older adults, within their living environments. This involves integration of ambient sensors, such as motion detectors, cameras, or IoT devices, to monitor the movements and activities of individuals in real time. By leveraging these sensors, the system can predict and anticipate the expected movements of the person, allowing for proactive ambient guidance and support. In addition to ambient guidance, robots can also play a role in leading individuals by interfacing through audio prompts or visual cues through their daily activities. However, despite advancements in sensor technology and robotic assistance, uncertainties persist in the monitoring and prediction of movements. These uncertainties can arise from various sources, including sensor noise, occlusions, environmental changes, and inherent variability in human behavior. Addressing these uncertainties requires probabilistic modeling techniques based on partially observable hidden Markov models (POHMMs) and various of its extensions such as POMDP, to effectively capture the dynamic nature of movement patterns and incorporate uncertainty into the decision-making process. This paper presents a detailed overview study of probabilistic framework and how its various interpretation can be used in developing an ambient movement guiding system for supporting individuals, particularly older, in support of ageing-in-place paradigms.

The growing prevalence of acute lymphoblastic leukemia cancer worldwide underlines the critical need for early and more precise detection to counter this deadly disease. This study presents a robust SqueezeNet-enhanced machine learning framework for automatically screening and classifying histopathological images for acute lymphoblastic leukemia. This work employs a deep learning (DL)-based SqueezeNet integrated with three machine learning (ML) models including neural network (NN), logistic regression (LR), and random forest (RF) for diagnosis. Combining DL and ML algorithms addresses the complexity of understanding histopathological images and the classification process. Evaluation metrics computed for acute lymphoblastic leukemia reveal a good classification accuracy (CA) of 99.3%. Results are further validated by confusion matrix (CM), calibration plot (CP), receiver operating characteristic (ROC) analysis, and comparative analysis with previous techniques. The proposed method has the potential to transform healthcare with more accurate diagnosis. It provides a robust framework for the classification of acute lymphoblastic leukemia, facilitating timely treatment options for patients.

Study Evaluation: The bibliometric analysis of the published results of the alpha-synuclein (α-syn) detection study in the peripheral tissues of patients with Parkinson's disease was carried out by us to study scientific activity and scientific productivity, to measure the quantitative and qualitative characteristics of scientific publications, author productivity, and citation of works, as well as the degree of interrelation between authors, journals, institutes, and countries. Purpose: This study is aimed at bibliometrically analyzing the results of studies on the detection of α-syn in peripheral tissue biopsy of patients with Parkinson's disease from 2013 to 2023. Methods: The data was extracted from the Scopus database collection using an inclusive search strategy. Performance analysis and science mapping were conducted using RStudio v.4.3.1 with the bibliometrix R-package. The analyzed data encompassed trends in publication and citation and the identification of leading institutions, primary sources, authors, and collaborative countries. Results: A total of 124 relevant studies from 53 different sources were thoroughly analyzed. The analysis included the materials of 843 authors, which together gave an impressive average of 37.67 citations per document over the past decade. The annual growth rate in this area of research, according to calculations, was 10.84%, indicating a steady increase in the number of publications over the study period. The huge volume of research results is highlighted by the inclusion of 231 unique keywords of authors. Conclusion: Studies on the detection of pathological α-syn in peripheral tissues for early morphological verification of the diagnosis of Parkinson's disease are relevant in clinical neurology. α-syn detected in the skin biopsy of patients on the basis of this study and data from the world literature meets the requirements for biomarkers.