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Encouraging the use of mobile technology for the effective delivery of medical education and clinical training 鼓励利用移动技术有效提供医学教育和临床培训
Pub Date : 2020-04-01 DOI: 10.4103/digm.digm_28_20
S. Shrivastava, P. Shrivastava
Considering the extensive use of mobile devices by medical teachers, undergraduate students, postgraduate residents, and patients, it becomes an indispensable need to deploy mobile technologies in various areas of the health professions education, medical training, and patient care. The purpose of the current review is to explore the scope and utility of mobile technology in ensuring the effective delivery of medical education and clinical teaching. An extensive search of all materials related to the topic was carried out in the PubMed search engine and a total of 15 articles were selected based on their suitability with the current review objectives and analyzed. The use of mobile technologies creates a gamut of educational experiences and learning opportunities for medical students and thereby enhances the efficiency and effectiveness of the learning process. The adoption of mobile technology in medical training is more of a student-centered approach and ensures active engagement of the students with an ultimate goal to become a competent health-care professional. In conclusion, in the best interest of the medical students, it is high time to employ mobile-based applications and technologies in the period of medical training as it is expected to play an important role in the accomplishment of learning outcomes and patient care.
考虑到医学教师、本科生、研究生住院医师和患者广泛使用移动设备,在卫生专业教育、医疗培训和患者护理的各个领域部署移动技术成为不可或缺的需求。本综述的目的是探讨移动技术在确保有效提供医学教育和临床教学方面的范围和效用。在PubMed搜索引擎中广泛搜索与该主题相关的所有材料,根据其与当前综述目标的适合性,共选择15篇文章进行分析。移动技术的使用为医学生创造了广泛的教育经验和学习机会,从而提高了学习过程的效率和效果。在医疗培训中采用移动技术更多的是以学生为中心的方法,并确保学生积极参与,最终目标是成为一名称职的卫生保健专业人员。总之,为了医学生的最大利益,现在是时候在医疗培训期间使用基于移动的应用程序和技术了,因为它有望在实现学习成果和患者护理方面发挥重要作用。
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引用次数: 0
Magnetic resonance imaging-guided focused ultrasound robotic system with the subject placed in the prone position 受试者俯卧的磁共振成像引导聚焦超声机器人系统
Pub Date : 2020-01-01 DOI: 10.4103/digm.digm_2_20
C. Damianou, M. Giannakou, G. Menikou, L. Ioannou
Background: In this article, a medical robotic system that performs magnetic resonance imaging-guided focused ultrasound surgery ablation is presented. The main innovation of this robotic system is that all the actuators are placed outside the water container. The transducer is immersed in water through an arm which is attached to the angular stage. Materials and Methods: The system includes three linear and one angular stage. The device uses piezoelectric motors for each motion stage. The accuracy was achieved with optical encoders. A focused transducer operated at 1 MHz with a radius of curvature of 10 cm and a diameter of 4 cm was used. A polyacrylamide gel was used to assess the ultrasound protocol. Results: The system was tested in the magnetic resonance imaging (MRI) environment and was proved to be a magnetic resonance compatible. The accuracy of the system was tested, and it was found that spatial steps of 0.2 mm can be safely and reliably achieved. With this robotic system, it is possible to access many organs that ultrasound penetrates with the patient placed in a prone position. Conclusion: The proposed robotic system can be modified so that it can be used for other applications. One example of an alternative application is MRI-guided biopsy. Another application is to replace the transducer arm with a radio frequency (RF) device to perform MRI guided RF ablation. Finally, the maneuverability of the robotic system can be enhanced further by attaching another angular stage to the system.
背景:本文介绍了一种磁共振成像引导聚焦超声手术消融的医疗机器人系统。这个机器人系统的主要创新之处在于所有的执行器都放在水容器的外面。换能器通过连接在角级上的臂浸入水中。材料与方法:该系统包括三个线性阶段和一个角度阶段。该装置在每个运动阶段使用压电马达。精度是通过光学编码器实现的。聚焦换能器工作频率为1 MHz,曲率半径为10 cm,直径为4 cm。使用聚丙烯酰胺凝胶来评估超声方案。结果:该系统在磁共振成像(MRI)环境下进行了测试,证明该系统是磁共振兼容的。对系统的精度进行了测试,发现可以安全可靠地实现0.2 mm的空间步长。有了这个机器人系统,当病人处于俯卧位置时,超声波可以穿透许多器官。结论:提出的机器人系统可以修改,使其可以用于其他应用。另一种应用是mri引导活检。另一种应用是用射频(RF)装置替换换能器臂,以执行MRI引导的射频消融。最后,通过在系统上附加另一个角度级,可以进一步提高机器人系统的可操作性。
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引用次数: 10
An appeal for the business sector to join hands with public health authorities in the battle against coronavirus disease 2019 pandemic. 呼吁企业界与公共卫生部门携手抗击2019年冠状病毒病大流行。
Pub Date : 2020-01-01 DOI: 10.4103/digm.digm_5_20
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava

The coronavirus disease 2019 (COVID-19) outbreak has transformed into a global public health emergency and a pandemic, which has demonstrated very high risk of global transmission. The business and commerce sector have been advised to come forward by the government primarily because these businesses have a crucial role in interrupting the chain of transmission and thus reduce the likelihood of community transmission. Any interventions on their part will not only minimize the current risk of acquiring the infection by the employees, but will also play a significant part in reducing the impact on the business itself and the national economy as a whole. Simultaneously, the business sector should be totally dedicated towards the formulation of an emergency response plan in their workplace. In conclusion, the ongoing COVID-19 pandemic is a global health and community-level emergency and it cannot be effectively contained without the persistent support of all the stakeholders, including the business sector. The need of the hour is that the business sector should plan and implement aggressive and evidence-based actions to safeguard the lives of their employees, customers and the community at large.

2019冠状病毒病(COVID-19)疫情已演变为全球突发公共卫生事件和大流行,具有极高的全球传播风险。政府已建议工商业部门挺身而出,主要是因为这些企业在阻断传播链、从而减少社区传播可能性方面发挥着关键作用。他们采取的任何干预措施不仅可以最大限度地减少员工感染的风险,而且还可以在减少对企业本身和整个国民经济的影响方面发挥重要作用。同时,商业部门应完全致力于在其工作场所制定应急计划。总而言之,当前的COVID-19大流行是全球卫生和社区层面的紧急情况,如果没有包括商业部门在内的所有利益攸关方的持续支持,就无法有效遏制疫情。当务之急是,商业部门应该计划并实施积极的、以证据为基础的行动,以保障员工、客户和整个社区的生命安全。
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引用次数: 0
How to make medical information comparable and searchable 如何使医疗信息具有可比性和可检索性
Pub Date : 2020-01-01 DOI: 10.4103/digm.digm_4_20
W. Orthuber
For accurate digital representation of original (e.g. medical) information we have to recall that any information is selection from a common set of possibilities. This one dimensional or multidimensional set is called “domain”. Letters and language vocabulary are only special examples of domains which lead to non-reproducible digital representation. Since introduction of the internet, however, it is technically feasible to define domains online. These “adapted domains” can be optimized in dependence of the application (e.g. medical diagnosis). Then all relevant features of the original information in this application can be represented and transported digitally by comparable and searchable “Domain Vectors” (DVs). This would be important e.g. for medical decision support, therefore the introduction of Domain Vectors is urgently recommended. The setup of a comfortable internet presence for definition of adapted domains (and Domain Vectors) would be a first step for this.
为了准确地用数字表示原始(如医疗)信息,我们必须记住,任何信息都是从一组常见的可能性中选择的。这个一维或多维集合被称为“域”。字母和语言词汇只是导致不可复制数字表示的领域的特殊例子。然而,自从互联网出现以来,在线定义域名在技术上是可行的。这些“自适应域”可以根据应用程序(例如医疗诊断)进行优化。然后,该应用程序中原始信息的所有相关特征都可以通过可比较和可搜索的“域向量”(DV)进行数字表示和传输。这对于医疗决策支持非常重要,因此迫切建议引入领域矢量。为适应的域(和域向量)的定义建立一个舒适的互联网存在将是实现这一目标的第一步。
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引用次数: 4
Epidemic preparedness for COVID-19: A major challenge! 新冠肺炎的防疫工作:一项重大挑战!
Pub Date : 2020-01-01 DOI: 10.4103/digm.digm_11_20
Priya Gogia, Veena Melwani, Satish Melwani, Rahul Gogia
Epidemic outbreaks and biological disasters pose serious challenges to the country due to enormous population and weak public health system; to combat the same, we need epidemic preparedness. The steps of epidemic preparedness embrace and incorporate to anticipate, prevent, prepare, detect, and respond. The four stages of the present epidemic COVID-19 have been described. The requirement of proper coordination among the epidemiologist, clinician, laboratory personnel, and health educator is sum and substance of it. Levels for epidemic preparedness inculcate preparation at four levels including central, state, local, and health facility. The impact of epidemic has adverse health, social, as well as economic implications.
人口众多,公共卫生体系薄弱,疫情暴发和生物灾害给国家带来严峻挑战;为了应对同样的情况,我们需要做好流行病防范工作。流行病防范的步骤包括预测、预防、准备、发现和应对。本文描述了新冠肺炎疫情的四个阶段。流行病学家、临床医生、实验室人员和健康教育者之间适当协调的要求是它的总和和实质。流行病防范级别分为四个级别,包括中央、州、地方和卫生机构。这种流行病的影响对健康、社会和经济都有不利影响。
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引用次数: 0
Simulating patient matching to clinical trials using a property rights blockchain 使用产权bbb模拟临床试验的患者匹配
Pub Date : 2020-01-01 DOI: 10.4103/digm.digm_30_19
Jay Bergeron, Anh-Duong Nguyen, C. Alt, Nicole Brewster, Le Quoc Cuong, Thomas Krohn, Vi-Minh Luong, Michael Nguyen, A. Telenti, Jennifer Wulff, Sean Moss-Pultz
Objective: Biomedical data processing generally requires the secure stepwise transfer of sensitive personal information across multiple parties. Mediating such operations using distributed secure digital ledgers, i.e., blockchains, is investigated in this article. Materials and Methods: The bitmark property rights blockchain was used to simulate the process of assessing individuals for enrollment to specific clinical trials. In the scenario presented, a sponsor publishes a recruitment call for a clinical trial and patients signal their willingness to participate in the trial through blockchain transactions. The blockchain creates and maintains digital references of the medical data assets of prospective study participants as well as digital property certificates for assigning access rights to corresponding medical data assets. Trial matching services review the patient blockchain records and recommend study participants that are likely to meet the enrollment criteria of recruiting clinical trials. Digital certificates assign transient access rights to the data assets of the prospective study participants. These certificates are transferred to pertinent matching services and sponsors, allowing these organizations to examine the candidacy of each prospective study participant. Results: The trial matching simulation demonstrates that property rights blockchains can implement complicated multiparty interactions, such as those associated with medical data exchange, without supplemental peer-to-peer communications. Conclusions: Blockchain-based data marketplaces of the type described, when coupled with data-controlled virtual infrastructure environments (i.e., Medical Data Trusts), provide a viable model for managing the transfer, provenance, and processing of individual health information.
目的:生物医学数据处理通常需要跨多方安全地逐步转移敏感个人信息。本文研究了使用分布式安全数字账本(即区块链)来中介此类操作。材料和方法:比特标记产权区块链用于模拟评估个人参加特定临床试验的过程。在所呈现的场景中,赞助商发布临床试验招募电话,患者通过区块链交易表示愿意参与试验。区块链创建并维护潜在研究参与者的医疗数据资产的数字参考,以及用于分配相应医疗数据资产访问权的数字财产证书。试验匹配服务审查患者区块链记录,并推荐可能符合招募临床试验注册标准的研究参与者。数字证书为潜在研究参与者的数据资产分配临时访问权限。这些证书被转交给相关的匹配服务机构和赞助商,使这些组织能够审查每个潜在研究参与者的候选资格。结果:试验匹配模拟表明,产权区块链可以在没有补充对等通信的情况下实现复杂的多方交互,例如与医疗数据交换相关的交互。结论:所述类型的基于区块链的数据市场,与数据控制的虚拟基础设施环境(即医疗数据信托)相结合,为管理个人健康信息的传输、来源和处理提供了一个可行的模型。
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引用次数: 2
Maintaining oxygen supply in hospitals treating coronavirus disease 2019 cases 2019冠状病毒病医院维持供氧
Pub Date : 2020-01-01 DOI: 10.4103/digm.digm_8_20
S. Shrivastava, P. Shrivastava
The role of oxygen therapy in the management of coronavirus disease 2019 (COVID-19) cases is extremely crucial and all steps should be taken to ensure its availability in adequate amount in all the health care establishments treating the patients. The clinical data obtained from China revealed that out of the overall reported cases, 15% severe cases and 5% critically ill patients will require oxygen therapy. Moreover, it is essential to estimate the requirement of oxygen in the hospital and it can be done by using the essential supply forecast tool. In conclusion, in order to improve the treatment outcomes of COVID-19 patients, it is crucial to ensure the supply of high quality medical-grade oxygen to the severe and critically-ill group of patients. In addition, the hospitals should prepare for improving the oxygen surge capacity to meet the needs of sudden rise in the number of cases.
氧气疗法在2019冠状病毒病(新冠肺炎)病例管理中的作用极为关键,应采取一切措施确保在所有治疗患者的医疗机构中提供足够的氧气。从中国获得的临床数据显示,在全部报告病例中,15%的重症病例和5%的危重症患者将需要氧气治疗。此外,估计医院的氧气需求是必要的,可以通过使用必要的供应预测工具来完成。总之,为了改善新冠肺炎患者的治疗效果,确保为重症和危重症患者提供高质量的医用氧气至关重要。此外,医院应为提高氧气激增能力做好准备,以满足病例数量突然上升的需求。
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引用次数: 0
Rheumatoid pain models in rodents and the application of dynamic weight-bearing test 啮齿类动物类风湿性疼痛模型及动态负重试验的应用
Pub Date : 2020-01-01 DOI: 10.4103/digm.digm_7_20
Dawei Geng, Liming Wang, N. Liu, Jian Qin
Rheumatoid arthritis (RA) is an autoimmune systemic disease of unknown etiology, characterized by chronic inflammation and synovial infiltration of immune cells. Pain is one of the most dominant symptoms for patients with RA, which affects the health and quality of life. Animal models are helpful to study the pathogenesis of RA and related factors and mechanisms of RA-induced pain, which may aid in the development of new and better treatment strategies. Several animal models of RA have been validated to predict for efficacy in humans that include collagen type II-induced arthritis in rats and mice, adjuvant-induced arthritis in rats, and antigen induced arthritis in several species. However, the quantitative evaluation of pain in animal models is technically challenging. Until recent years, behavior methods are used to characterize acute and chronic pain stages by observing behavioral changes in preclinical arthritis models. Significant progress has been made in pain assessment with the development of nonreflexive tools, dynamic weight-bearing (DWB) apparatus was developed for the measurement of pain in rodents by capturing weight-bearing and surface distribution of the paws. In this article, we summarize several classical animal models of rheumatoid pain as well as discussion of the advantages and disadvantages of DWB test for spontaneous pain used in these models.
类风湿性关节炎(RA)是一种病因不明的自身免疫性系统性疾病,以慢性炎症和免疫细胞滑膜浸润为特征。疼痛是RA患者最主要的症状之一,影响健康和生活质量。动物模型有助于研究RA的发病机制以及RA引起疼痛的相关因素和机制,有助于开发新的更好的治疗策略。RA的几种动物模型已被验证可预测对人类的疗效,包括大鼠和小鼠中II型胶原诱导的关节炎、大鼠中佐剂诱导的关节痛和几种物种中抗原诱导的关节病。然而,在动物模型中对疼痛进行定量评估在技术上具有挑战性。直到最近几年,行为方法还被用来通过观察临床前关节炎模型中的行为变化来表征急性和慢性疼痛阶段。随着非弹性工具的开发,疼痛评估取得了重大进展,开发了动态负重(DWB)装置,通过捕捉爪子的负重和表面分布来测量啮齿动物的疼痛。在这篇文章中,我们总结了几种典型的类风湿性疼痛动物模型,并讨论了DWB试验在这些模型中用于自发性疼痛的优缺点。
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引用次数: 0
Magnetic resonance image-guided focused ultrasound robotic system with four computer-controlled axes with endorectal access designed for prostate cancer focal therapy 具有四个计算机控制轴、直肠内通道的磁共振图像引导聚焦超声机器人系统,设计用于前列腺癌局灶治疗
Pub Date : 2020-01-01 DOI: 10.4103/digm.digm_1_20
M. Giannakou, G. Menikou, K. Ioannides, C. Damianou
Background: A magnetic resonance image (MRI)-guided robotic system dedicated for prostate cancer (PC) was produced that carries a small spherically focused, single-element, ultrasonic transducer which can be potentially utilized endorectally. Materials and Methods: The developed robotic device utilizes four computer-controlled axes. An agar-based phantom was developed, which included a cavity that mimics the rectum geometry. Experiments with the system were performed in a 1.5T MRI system using the gel phantom. The transducer has a diameter of 18 mm, operates with 3 MHz, and focuses energy at 40 mm. Results: The functionality of the robot was assessed by means of magnetic resonance thermometry, demonstrating sufficient heating in both axes of operation (linear and angular). Conclusions: A functional MRI-guided robotic system was produced, which can create significant and controlled thermal exposures. The intention is to use the proposed device endorectally in the future for the focal treatment of PC.
背景:制造了一种磁共振成像(MRI)引导的癌症(PC)机器人系统,该系统携带一个小型球形聚焦单元件超声换能器,可用于直肠内。材料和方法:开发的机器人设备利用四个计算机控制的轴。开发了一种基于琼脂的体模,其中包括一个模仿直肠几何形状的空腔。该系统的实验在1.5T MRI系统中使用凝胶体模进行。该换能器直径为18毫米,工作频率为3兆赫,能量聚焦在40毫米。结果:通过磁共振测温法评估了机器人的功能,证明在两个工作轴(线性和角度)上都有足够的加热。结论:制作了一个功能性MRI引导的机器人系统,该系统可以产生显著且可控的热暴露。其目的是在未来将所提出的装置用于前列腺癌的局部治疗。
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引用次数: 3
The promise of virtual reality in health-care education and training: It's all in the neuroscience 虚拟现实在医疗保健教育和培训方面的前景:这一切都在神经科学领域
Pub Date : 2019-10-01 DOI: 10.4103/digm.digm_26_19
Todd Maddox, T. Fitzpatrick
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引用次数: 2
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Digital medicine
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