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Requirements, Challenges, and Key Components to Improve Onboard Medical Care Using Maritime Telemedicine: Narrative Review. 使用海上远程医疗改善船上医疗护理的要求、挑战和关键组成部分:叙述综述。
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-01-01 DOI: 10.1155/2023/9389286
Niloofar Mohammadzadeh, Marsa Gholamzadeh

Introduction: Telemedicine has been able to bring healthcare services to all people in far locations such as the sea. Our main objective was to overview the main features, challenges, and requirements of applying telemedicine at sea.

Methods: The electronic search includes all types of papers published in English. It was performed in four databases with keywords to Feb 2023. Next, main categories were defined to extract major concepts. By mapping extracted themes, maritime telemedicine concepts were represented in two conceptual models.

Results: After screening the papers based on title and abstract, 18 articles remained. They can be divided into 13 categories based on their clinical domains. Out of 18 reviewed articles, six articles were published in 2020. The greatest number of studies with five articles was conducted in France. Evidence showed that maritime telemedicine service can be provided to all kinds of ships. Regarding clinical domains, the greatest demand belonged to primary care problems (5 papers) and general health assessment (4 papers). Challenges were divided into four main categories. Moreover, the required services and equipment in four categories were described too. Finally, a conceptual model is represented for providing telemedicine services at sea using satellite Internet.

Conclusion: Despite the existing challenges in providing the required equipment and resources for the implementation of maritime medicine, it has an important role in providing better care for seafarers without time limitations.

远程医疗已经能够将医疗保健服务带给远在海上的所有人。我们的主要目标是概述在海上应用远程医疗的主要特点、挑战和要求。方法:电子检索包括所有类型的英文论文。它在四个数据库中执行,关键字为2023年2月。其次,定义主要类别,提取主要概念。通过映射提取的主题,将海上远程医疗概念表示为两个概念模型。结果:根据题目和摘要对论文进行筛选,剩余18篇。他们可以根据他们的临床领域分为13类。在被评审的18篇文章中,有6篇发表于2020年。5篇论文的研究最多的是法国。有证据表明,海上远程医疗服务可以提供给各种类型的船舶。在临床领域,需求量最大的是初级保健问题(5篇)和一般健康评估(4篇)。挑战主要分为四类。此外,还说明了四类所需的服务和设备。最后,提出了利用卫星互联网提供海上远程医疗服务的概念模型。结论:尽管在提供实施海上医疗所需的设备和资源方面存在挑战,但它在不受时间限制地为海员提供更好的护理方面具有重要作用。
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引用次数: 0
Sharing and Cooperation of Improved Cross-Entropy Optimization Algorithm in Telemedicine Multimedia Information Processing. 改进的交叉熵优化算法在远程医疗多媒体信息处理中的共享与协作。
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-01-01 DOI: 10.1155/2023/7353489
Hongjiao Wu

In order to improve the efficiency of medical multimedia information sharing, this paper combines cloud computing technology and SOA (service-oriented architecture) technology to build a medical multimedia information sharing system. Building a medical information sharing platform requires integrating information resources stored in information systems of medical institutions and nonmedical information systems related to medical information and forming a huge resource pool. It is important to mine and analyze the information resources in the resource pool to realize the sharing and interaction of medical information. To this end, this paper proposes a gain-adaptive control algorithm with online adjustable parameters and investigates the extension of the mutual entropy optimization algorithm in the control domain and its integrated processing capability in the process of medical multimedia information processing. In addition, this paper constructs a medical multimedia information sharing and collaboration platform with medical multimedia information sharing and telemedicine as the core and verifies the effectiveness of the platform through experiments. The simulation results and comparison results with other systems prove that the system in this paper can realize fast data processing, retrieve and analyze massive data, and meet the demand of remote intelligent diagnosis under the premise of safety and stability. Meanwhile, the system in this paper can help hospitals achieve fast and accurate diagnosis, which has strong theoretical and practical values.

为了提高医疗多媒体信息共享的效率,本文将云计算技术与SOA(面向服务的体系结构)技术相结合,构建了一个医疗多媒体信息共享系统。构建医疗信息共享平台,需要整合存储在医疗机构信息系统中的信息资源和与医疗信息相关的非医疗信息系统中的信息资源,形成巨大的资源池。对资源池中的信息资源进行挖掘和分析,是实现医学信息共享与交互的重要手段。为此,本文提出了一种参数在线可调的增益自适应控制算法,并研究了互熵优化算法在控制域的扩展及其在医疗多媒体信息处理过程中的综合处理能力。此外,本文构建了以医学多媒体信息共享和远程医疗为核心的医学多媒体信息共享与协作平台,并通过实验验证了平台的有效性。仿真结果以及与其他系统的对比结果证明,本文系统能够在保证安全稳定的前提下,实现快速的数据处理、海量数据的检索和分析,满足远程智能诊断的需求。同时,本系统能够帮助医院实现快速、准确的诊断,具有较强的理论和实用价值。
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引用次数: 0
Musculoskeletal Telemedicine Trends Preceding the COVID-19 Pandemic and Potential Implications of Rapid Telemedicine Expansion. 2019冠状病毒病大流行前的肌肉骨骼远程医疗趋势和快速远程医疗扩张的潜在影响。
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-01-01 DOI: 10.1155/2023/9900145
Sara N Kiani, Logan D Cho, Jashvant Poeran, Lauren Wilson, Haoyan Zhong, Madhu Mazumdar, Jiabin Liu, Alejandro Gonzalez Della Valle, Stavros G Memtsoudis

Introduction: Telemedicine was rapidly deployed at the onset of the COVID-19 pandemic. Little has been published on telemedicine in musculoskeletal care prior to the COVID-19 pandemic. This study is aimed at characterizing trends in telemedicine for musculoskeletal care preceding the COVID-19 pandemic.

Methods: This retrospective study used insurance claims from the Truven MarketScan database. Musculoskeletal-specific outpatient visits from 2014 to 2018 were identified using the musculoskeletal major diagnostic category ICD-10 codes. Telemedicine visits were categorized using CPT codes and Healthcare Common Procedure Coding Systems. We described annual trends in telemedicine in the overall dataset and by diagnosis grouping. Multivariable logistic regression modeling estimated the association between patient-specific and telemedicine visit variables and telemedicine utilization.

Results: There were 36,672 musculoskeletal-specific telemedicine visits identified (0.020% of all musculoskeletal visits). Overall, telemedicine utilization increased over the study period (0% in 2014 to 0.05% in 2018). Orthopedic surgeons had fewer telemedicine visits than primary care providers (OR 0.57, 95% CI 0.55-0.59). The proportion of unique patients utilizing telemedicine in 2018 was higher in the south (OR 2.28, 95% CI 2.19-2.38) and west (OR 5.58, 95% CI 5.36-5.81) compared to the northeast. Those with increased comorbidities and lower incomes and living in rural areas had lower rates of telemedicine utilization.

Conclusions: From 2014 to 2018, there was an increase in telemedicine utilization for musculoskeletal visits, in part due to insurance reimbursement and telemedicine regulation. Despite this increase, the rates of telemedicine utilization are still lowest in some of the groups that could derive the most benefit from these services. Establishing this baseline is important for assessing how the roll-out of telemedicine during the pandemic impacted how/which patients and providers are utilizing telemedicine today.

导语:2019冠状病毒病大流行伊始,远程医疗得到了迅速部署。在2019冠状病毒病大流行之前,很少有关于肌肉骨骼护理远程医疗的文章发表。本研究旨在描述COVID-19大流行之前肌肉骨骼护理远程医疗的趋势。方法:本回顾性研究使用来自Truven MarketScan数据库的保险索赔。使用肌肉骨骼主要诊断类别ICD-10代码对2014年至2018年的肌肉骨骼特异性门诊就诊进行识别。使用CPT代码和卫生保健通用程序编码系统对远程医疗就诊进行分类。我们在总体数据集和诊断分组中描述了远程医疗的年度趋势。多变量logistic回归模型估计了患者特异性和远程医疗访问变量与远程医疗利用之间的关联。结果:确定了36672例肌肉骨骼特异性远程医疗就诊(占所有肌肉骨骼就诊的0.020%)。总体而言,远程医疗的使用率在研究期间有所增加(2014年为0%,2018年为0.05%)。骨科医生的远程医疗就诊次数少于初级保健提供者(OR 0.57, 95% CI 0.55-0.59)。2018年使用远程医疗的独特患者比例在南部(OR 2.28, 95% CI 2.19-2.38)和西部(OR 5.58, 95% CI 5.36-5.81)高于东北部。那些合并症增加、收入较低和生活在农村地区的人远程医疗的使用率较低。结论:从2014年到2018年,由于保险报销和远程医疗监管,肌肉骨骼就诊的远程医疗利用率有所增加。尽管有这种增长,但在一些可以从这些服务中获得最大利益的群体中,远程医疗的使用率仍然最低。建立这一基线对于评估大流行期间远程医疗的推出如何影响当今患者和提供者如何/哪些人利用远程医疗非常重要。
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引用次数: 1
Introduction of Telemedicine in a Prehospital Emergency Care Setting: A Pilot Study. 院前急救环境中远程医疗的引入:一项试点研究。
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-01-01 DOI: 10.1155/2023/1171401
Christophe Jobé, Pierre-Nicolas Carron, Pierre Métrailler, Jean-Marc Bellagamba, Alexandre Briguet, Line Zurcher, Fabrice Dami

Background: Advances in information and communication technology have led to telemedicine applications that could support paramedics in the prehospital field. In an effort to optimise the available resources like prehospital emergency physicians (PHP), the State Health Services of a Swiss state decided to launch a pilot study on the feasibility of using telemedicine in the prehospital emergency setting.

Objective: The primary objective was to measure the number of missions completed without technical problems with remote PHP support through telemedicine (tele-PHP). The secondary objectives were to evaluate the safety of this protocol and to describe the actions and decisions that clinicians can make by using tele-PHP.

Methods: This was a prospective observational pilot study on all missions involving the dispatch of ground PHP or tele-PHP. The severity score, dispatch criteria, actions, and decisions made by ground PHP and tele-PHP were collected.

Results: PHP were dispatched simultaneously with an ambulance on 478 occasions, including 68 (14%) situations that started directly with tele-PHP. Among those situations, three had to be transformed into on-site PHP missions after the on-site evaluation by paramedics. Fifteen missions were cancelled by paramedics once they were on site, and six missions encountered a connection issue. Forty-four PHP missions that were dispatched simultaneously with paramedics were completed by tele-PHP only without any connection problems. Paramedics and PHP estimated that actions or decisions were provided by PHP in 66% of the on-site PHP missions and 34% of the tele-PHP missions.

Conclusions: This is the first experience of tele-PHP regarding PHP dispatch in Switzerland. Despite the small number of missions carried out, tele-PHP could be used for well-selected situations to reduce the need for a PHP on site.

背景:信息和通信技术的进步导致了远程医疗的应用,可以支持院前领域的护理人员。为了优化院前急救医生等现有资源,瑞士一个州的国家卫生服务局决定开展一项关于在院前急救环境中使用远程医疗可行性的试点研究。目的:主要目的是衡量通过远程医疗(tele-PHP)在远程PHP支持下无技术问题完成任务的数量。次要目标是评估该方案的安全性,并描述临床医生可以通过使用远程php做出的行动和决定。方法:这是一项前瞻性观察试点研究,涉及地面PHP或远程PHP调度的所有任务。收集地面PHP和远程PHP的严重程度评分、调度标准、行动和决策。结果:与救护车同时出动的有478例,其中68例(14%)是直接由远程出动的。在这些情况中,有三个在医务人员进行现场评价后必须改为现场PHP特派团。医护人员一到现场就取消了15个任务,6个任务遇到了连接问题。与护理人员同时派遣的44个PHP任务仅通过远程PHP完成,没有任何连接问题。护理人员和PHP估计,在66%的现场PHP任务和34%的远程PHP任务中,PHP提供了行动或决策。结论:这是瑞士首次使用远程PHP进行PHP调度。尽管执行的任务数量很少,但可以在经过精心挑选的情况下使用远程PHP,以减少对现场PHP的需要。
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引用次数: 3
Telehealth and Transformation of Nursing Care in Saudi Arabia: A Systematic Review. 沙特阿拉伯远程医疗与护理转型:系统综述。
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2022-09-24 eCollection Date: 2022-01-01 DOI: 10.1155/2022/8426095
Ibrahim Al Baalharith, Mona Al Sherim, Sarah Hamad G Almutairi, Azizah Saleh Alhaggas Albaqami

Introduction: Technological advancements have transformed nursing care, quality, and education across the globe. In the Kingdom of Saudi Arabia (KSA), the inventions and adoption of mobile technologies such as an e-health application (app) called SEHA continue to revolutionize the healthcare system in the country.

Purpose: The present systematic review is aimed at examining the technological impact on nursing in Saudi Arabia. The study provides a comprehensive analysis of telehealth and its role in nursing quality, nursing practice, and education.

Methods: The present study adopted a literature review methodology by deriving data from journal articles from different databases, for example, Web Science, Google Scholar, CINAHL, MEDLINE, and PubMed databases. Inclusive years for the search ranged from 2016 to 2022. A total of eight articles were found dovetailing to meet the research objectives and answer research questions.

Result: After appraising and analyzing the research, the present review found that (Abolfotouh et al., 2019) telehealth in nursing is loosely researched; (Ahmed et al., 2021) telehealth impacts nursing practice and quality by fostering nurse-patient communication promoting positive outcomes, seamless nursing care, and positive experiences; and (Albahri et al., 2021) telehealth and telemedicine is a central tenet of contemporary nursing education and practice.

Conclusion: From these findings, this analysis informed three key recommendations: the need to integrate telehealth into the nursing curriculum, telehealth training, and reskilling among healthcare workers (HCWs) in KSA and further primary studies focusing predominantly on telenursing. Overall, telehealth remains a fundamental transformation of nursing practice that forms a central ideology in the contemporary nursing process.

技术进步已经改变了全球范围内的护理、质量和教育。在沙特阿拉伯王国(KSA),名为SEHA的电子医疗应用程序(app)等移动技术的发明和采用继续革新该国的医疗保健系统。目的:本系统综述旨在研究沙特阿拉伯护理技术的影响。该研究提供了一个全面的分析远程医疗及其在护理质量,护理实践和教育中的作用。方法:本研究采用文献综述法,从Web Science、Google Scholar、CINAHL、MEDLINE和PubMed等不同数据库的期刊文章中获取数据。搜索年份从2016年到2022年不等。共发现八篇文章相吻合,以满足研究目标和回答研究问题。结果:经过对研究的评价和分析,本综述发现(Abolfotouh et al., 2019)护理中的远程医疗研究较少;(Ahmed et al., 2021)远程医疗通过促进护患沟通,促进积极结果、无缝护理和积极体验,影响护理实践和质量;(Albahri et al., 2021)远程医疗和远程医疗是当代护理教育和实践的核心原则。结论:根据这些发现,本分析提出了三个关键建议:需要将远程医疗纳入护理课程、远程医疗培训、在沙特阿拉伯的卫生保健工作者(HCWs)中进行再培训,以及进一步主要关注远程护理的初步研究。总的来说,远程医疗仍然是护理实践的根本转变,在当代护理过程中形成了一种核心意识形态。
{"title":"Telehealth and Transformation of Nursing Care in Saudi Arabia: A Systematic Review.","authors":"Ibrahim Al Baalharith,&nbsp;Mona Al Sherim,&nbsp;Sarah Hamad G Almutairi,&nbsp;Azizah Saleh Alhaggas Albaqami","doi":"10.1155/2022/8426095","DOIUrl":"https://doi.org/10.1155/2022/8426095","url":null,"abstract":"<p><strong>Introduction: </strong>Technological advancements have transformed nursing care, quality, and education across the globe. In the Kingdom of Saudi Arabia (KSA), the inventions and adoption of mobile technologies such as an e-health application (app) called SEHA continue to revolutionize the healthcare system in the country.</p><p><strong>Purpose: </strong>The present systematic review is aimed at examining the technological impact on nursing in Saudi Arabia. The study provides a comprehensive analysis of telehealth and its role in nursing quality, nursing practice, and education.</p><p><strong>Methods: </strong>The present study adopted a literature review methodology by deriving data from journal articles from different databases, for example, Web Science, Google Scholar, CINAHL, MEDLINE, and PubMed databases. Inclusive years for the search ranged from 2016 to 2022. A total of eight articles were found dovetailing to meet the research objectives and answer research questions.</p><p><strong>Result: </strong>After appraising and analyzing the research, the present review found that (Abolfotouh et al., 2019) telehealth in nursing is loosely researched; (Ahmed et al., 2021) telehealth impacts nursing practice and quality by fostering nurse-patient communication promoting positive outcomes, seamless nursing care, and positive experiences; and (Albahri et al., 2021) telehealth and telemedicine is a central tenet of contemporary nursing education and practice.</p><p><strong>Conclusion: </strong>From these findings, this analysis informed three key recommendations: the need to integrate telehealth into the nursing curriculum, telehealth training, and reskilling among healthcare workers (HCWs) in KSA and further primary studies focusing predominantly on telenursing. Overall, telehealth remains a fundamental transformation of nursing practice that forms a central ideology in the contemporary nursing process.</p>","PeriodicalId":45630,"journal":{"name":"International Journal of Telemedicine and Applications","volume":"2022 ","pages":"8426095"},"PeriodicalIF":4.4,"publicationDate":"2022-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33516263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multifactor Authentication for Smart Emergency Medical Response Transporters. 智能医疗应急响应载体的多因素认证。
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2022-09-23 eCollection Date: 2022-01-01 DOI: 10.1155/2022/5394942
Turki Alghamdi, Fayez Gebali, Fares Salem

Securing telehealth IoT infrastructure is essential to provide high-level medical care and prevent cyberattacks. A vulnerable stage in IoT telehealth is while the patient is being transported to a healthcare facility, the transporter could be an ambulance or an air ambulance. In this paper, we propose a multifactor authentication scheme to secure the system when the patient is in transit to the healthcare facility. We apply this scheme to an ambulance, using physical unclonable functions (PUFs) embedded in the ambulance to facilitate authentication and secure key exchange. We validated the security of the proposed scheme using formal and informal security analysis. The analysis supports our claim that the proposed scheme protects against many types of attacks.

确保远程医疗物联网基础设施的安全对于提供高水平医疗服务和防止网络攻击至关重要。物联网远程医疗的一个脆弱阶段是,当患者被运送到医疗机构时,运输工具可能是救护车或空中救护车。在本文中,我们提出了一个多因素身份验证方案,以便在患者前往医疗机构的途中保护系统。我们将此方案应用于救护车,使用嵌入在救护车中的物理不可克隆函数(puf)来促进身份验证和安全密钥交换。我们使用正式和非正式的安全性分析验证了所提议方案的安全性。分析支持了我们的说法,即所提出的方案可以防止多种类型的攻击。
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引用次数: 1
An Enhanced Posture Prediction-Bayesian Network Algorithm for Sleep Posture Recognition in Wireless Body Area Networks 一种用于无线体域网络睡眠姿势识别的增强型姿势预测贝叶斯网络算法
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2022-05-28 DOI: 10.1155/2022/3102545
A. Roshini, K. Kiran
Wireless body area networks have taken their unique recognition in providing consistent facilities in health monitoring. Several studies influence physiological signal monitoring through a centralized approach using star topology in regular activities like standing, walking, sitting, and running which are considered active postures. Unlike regular activities like walking, standing, sitting, and running, the in-bed sleep posture monitoring of a subject is highly necessary for those who have undergone surgery, victims of breathing problems, and victims of COVID-19 for whom oxygen imbalance is a major issue as the mortality rate in sleep is high due to unattended patients. Suggestions from the medical field state that the patients with the above-mentioned issues are highly suggested to follow the prone sleep posture that enables them to maintain the oxygen level in the human body. A distributed model of communication is used where mesh topology is used for the data packets to be carried in a relay fashion to the sink. Heartbeat rate (HBR) and image monitoring of the subject during sleep are closely monitored and taken as input to the proposed posture prediction-Bayesian network (PP-BN) to predict the consecutive postures to increase the accuracy rate of posture recognition. The accuracy rate of the model outperforms the existing classification and prediction algorithms which take the cleaned dataset as input for better prediction results.
无线身体区域网络在提供一致的健康监测设施方面获得了独特的认可。几项研究通过在站立、行走、坐着和跑步等被视为活动姿势的常规活动中使用星形拓扑结构的集中方法来影响生理信号监测。与散步、站立、坐着和跑步等常规活动不同,对于那些接受过手术的人、呼吸问题的受害者和新冠肺炎患者来说,床上睡眠姿势监测是非常必要的,因为无人看管的患者导致睡眠中的死亡率很高,因此氧气失衡是他们的主要问题。医学界的建议指出,强烈建议有上述问题的患者采用俯卧的睡眠姿势,以保持人体内的氧气水平。使用分布式通信模型,其中网状拓扑用于以中继方式传送到信宿的数据分组。密切监测受试者在睡眠期间的心跳率(HBR)和图像监测,并将其作为所提出的姿势预测贝叶斯网络(PP-BN)的输入,以预测连续的姿势,从而提高姿势识别的准确率。该模型的准确率优于现有的分类和预测算法,后者以清理后的数据集作为输入,以获得更好的预测结果。
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引用次数: 3
Efficacy of Telemedicine Utilization for Cardiac Outpatients' Care during the Pandemic of COVID-19: A Large Center Experience in the Wave of the Pandemic. COVID-19大流行期间远程医疗在心脏门诊护理中的应用效果:大流行浪潮中的大中心体验
IF 3.1 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2022-05-17 eCollection Date: 2022-01-01 DOI: 10.1155/2022/4156436
Wesam A Alhejily

Introduction: Synchronous telemedicine using teleconferencing may play a role in clinical care. In a tertiary care center, video conferencing-enhanced virtual clinics were established via a new application platform. They were introduced during COVID-19 pandemic to connect patients to trained health-care providers via a secured line. While maintaining patients' privacy, they were theorized to offer effective communications and continuous clinical care. In this cross-sectional cohort study, we ought to examine the impact of service and the assistance they may offer to cardiac patients in the outpatient setup.

Methods: A prospective cohort study looking at all video-conferencing virtual clinics' visits during the pandemic with primary focus on cardiac outpatient clinic, addressing primary endpoints of need for admission or emergency visits from cardiac demises during the pandemic and secondary endpoint of patient satisfaction based on patients' experiences.

Results: A total of 6000 live care video-based chats were made over 10 months period from March 10th, 2020, to January 30th, 2021, among which 277 patients were evaluated in the virtual cardiac clinic, of these 193 (69.7%) were males, with mean age of 48 ± 15.60 (22.3%), patients were requested to present to clinic for further evaluation and testing, 20 (7.2%) patients were asked to visit the emergency room, of whom 8 (2.8%) patients were hospitalized. All 8 were admitted for high-risk findings that require immediate medical attention, 4/8 underwent cardiac catheterization, mean duration of admission was 2 ± 1 days. When compared to regular walk-in care, there was a statistical difference in admission rate and emergency visits p = 0.001 and p = 0.0001, respectively, both were statistically higher in the virtual clinic. The satisfaction rate in a 5-scale grading system was 97% of 4 and above recommending the continuation of the service beyond pandemic time.

Conclusions: Video-enhanced virtual cardiology clinic works safely and efficiently during COVID-19 pandemic with a difference in admission rate and ER visits when compared to walk-in clinic. It can be used during nonpandemic time to reduce load on hospital and clinic crowdedness. It also decreases the chances of COVID-19 transmission indirectly by reenforcing physical distance.

引言使用电话会议的同步远程医疗可能在临床护理中发挥作用。在一个三级护理中心,通过一个新的应用平台建立了视频会议增强型虚拟诊所。它们是在新冠肺炎大流行期间引入的,通过安全线路将患者与训练有素的医疗保健提供者联系起来。在维护患者隐私的同时,他们被认为可以提供有效的沟通和持续的临床护理。在这项横断面队列研究中,我们应该检查服务的影响以及他们在门诊设置中可能为心脏病患者提供的帮助。方法一项前瞻性队列研究,观察了疫情期间所有视频会议虚拟诊所的就诊情况,主要关注心脏门诊,解决了疫情期间心脏病患者入院或急诊需求的主要终点,以及基于患者体验的患者满意度的次要终点。结果从2020年3月10日到2021年1月30日,在10个月的时间里,共进行了6000次基于视频的实时护理聊天,其中277名患者在虚拟心脏诊所接受了评估,其中193名(69.7%)为男性,平均年龄为48±15.60(22.3%),患者被要求到诊所进行进一步评估和测试,20名(7.2%)患者被要求到急诊室就诊,其中8名(2.8%)患者住院治疗。所有8人都因高风险发现而入院,需要立即就医,4/8人接受了心导管插入术,平均入院时间为2±1 天。与常规预约护理相比,入院率和急诊就诊率分别存在统计学差异,p=0.001和p=0.0001,在虚拟诊所中这两个数字在统计学上都更高。在5级评分系统中,4级及以上的满意度为97%,建议在疫情期间后继续提供服务。结论视频增强虚拟心脏病诊所在新冠肺炎大流行期间安全有效地工作,与非预约诊所相比,入院率和急诊就诊率有所不同。它可以在非流行时期使用,以减少医院和诊所拥挤的负担。它还通过重新建立物理距离间接降低了新冠肺炎传播的机会。
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引用次数: 0
A Smart Chatbot for Interactive Management in Beta Thalassemia Patients 用于β地中海贫血患者交互管理的智能聊天机器人
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2022-05-11 DOI: 10.1155/2022/9734518
Alma Mohammed Alturaiki, H. Banjar, A. Barefah, Salwa A. Alnajjar, S. Hindawi
Background β-thalassemia is an inherited blood disorder that affects the production of hemoglobin molecules owing to the reduction or absence of beta chains. Transfusion therapy has had a key role in extending the lifespan of β-thalassemia patients. This life-saving therapy is linked to numerous assessments and complications that now comprise most thalassemia management considerations. Consequently, many patients do not receive adequate information about the required assessments, as indicated by evidence-based medical guidelines. Patients with β-thalassemia may benefit from chatbots that follow up on their condition and that provide the required assessment information. Self-management will hopefully have a positive impact on health outcomes. Objectives This study aims to develop a chatbot that can assist in the management of β-thalassemia by providing the assessment information required to monitor patients' statuses. Methods The chatbot operated as a messaging system. A question/answer system was created based on knowledge pertaining to β-thalassemia assembled from experts, medical guidelines, and articles. Recommendations regarding the patient's follow-up assessment are made based on the answers. Results A prototype was implemented to demonstrate how the chatbots could dynamically and flexibly provide the assessment information required to follow up on and monitor patients. A small sample of adults with β-thalassemia used the chatbot to examine the system's usability and perceived utility. A system usability scale and utility scale were implemented to complete a post-test survey. The chatbots were considered by 34 patients, of whom the majority (72%) found them easy to use, while more than 90% of patients considered their use beneficial. Most of the participants agreed that the chatbots could improve their knowledge about their β-thalassemia assessments. Conclusion Our findings suggest that chatbots can be beneficial to the development of recommended tests and management related to the assessment of β-thalassemia.
背景β-地中海贫血是一种遗传性血液病,由于β链的减少或缺失而影响血红蛋白分子的产生。输血治疗在延长β地中海贫血患者的寿命方面发挥了关键作用。这种挽救生命的疗法与许多评估和并发症有关,这些评估和并发症现在是地中海贫血管理的主要考虑因素。因此,正如循证医学指南所表明的那样,许多患者没有得到关于所需评估的充分信息。β-地中海贫血患者可能会从聊天机器人中受益,聊天机器人可以跟踪他们的病情并提供所需的评估信息。自我管理有望对健康结果产生积极影响。目的本研究旨在开发一种聊天机器人,通过提供监测患者状态所需的评估信息,帮助管理β-地中海贫血。方法聊天机器人作为一个消息系统运行。根据专家、医学指南和文章收集的有关β-地中海贫血的知识,创建了一个问答系统。根据这些答案提出有关患者后续评估的建议。结果实现了一个原型,以演示聊天机器人如何动态、灵活地提供跟踪和监测患者所需的评估信息。一小部分患有β地中海贫血的成年人使用聊天机器人来检查该系统的可用性和感知效用。系统可用性量表和效用量表用于完成测试后调查。34名患者考虑了聊天机器人,其中大多数(72%)认为它们很容易使用,而超过90%的患者认为它们的使用是有益的。大多数参与者一致认为,聊天机器人可以提高他们对β-地中海贫血评估的了解。结论我们的研究结果表明,聊天机器人有利于制定与β-地中海贫血评估相关的推荐测试和管理。
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引用次数: 2
Malaria Diagnosis Using a Lightweight Deep Convolutional Neural Network 基于轻量级深度卷积神经网络的疟疾诊断
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2022-04-15 DOI: 10.1155/2022/4176982
Varun Magotra, Mukesh Kumar Rohil
The applications of AI in the healthcare sector are increasing day by day. The application of convolutional neural network (CNN) and mask-region-based CNN (Mask-RCCN) to the medical domain has really revolutionized medical image analysis. CNNs have been prominently used for identification, classification, and feature extraction tasks, and they have delivered a great performance at these tasks. In our study, we propose a lightweight CNN, which requires less time to train, for identifying malaria parasitic red blood cells and distinguishing them from healthy red blood cells. To compare the accuracy of our model, we used transfer learning on two models, namely, the VGG-19 and the Inception v3. We train our model in three different configurations depending on the proportion of data being fed to the model for training. For all three configurations, our proposed model is able to achieve an accuracy of around 96%, which is higher than both the other models that we trained for the same three configurations. It shows that our model is able to perform better along with low computational requirements. Therefore, it can be used more efficiently and can be easily deployed for detecting malaria cells.
人工智能在医疗保健领域的应用日益增多。卷积神经网络(CNN)和基于掩模区域的CNN (Mask-RCCN)在医学领域的应用给医学图像分析带来了革命性的变化。cnn主要用于识别、分类和特征提取任务,并且在这些任务中表现出色。在我们的研究中,我们提出了一种轻量级的CNN,它需要更少的训练时间,用于识别疟疾寄生红细胞并将其与健康红细胞区分开来。为了比较我们模型的准确性,我们在两个模型上使用迁移学习,即VGG-19和Inception v3。我们在三种不同的配置中训练我们的模型,这取决于输入模型进行训练的数据的比例。对于这三种配置,我们提出的模型能够达到96%左右的精度,这比我们为相同的三种配置训练的其他模型都要高。结果表明,该模型在较低的计算需求下具有较好的性能。因此,它可以更有效地使用,并且可以很容易地用于检测疟疾细胞。
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引用次数: 8
期刊
International Journal of Telemedicine and Applications
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