Topic Editors

Department of Rehabilitation, Città di Pavia Hospital, 27100 Pavia, Italy
Facoltà di Medicina, Università di Pavia, 27100 Pavia, Italy
1. Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
2. Department of Industrial Engineering, University of Rome Tor Vergata, 00133 Rome, Italy

The Use of New Technologies for Health and Clinical Practice

Abstract submission deadline
25 April 2025
Manuscript submission deadline
25 July 2025
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41819

Topic Information

Dear Colleagues,

Technology has the potential to promote healthy lifestyles by reducing sedentary behaviors in both healthy and pathological populations. The use of new, valid, and accurate technologies and their continued study and progression allow clinicians and trainers to improve patients' evaluations and tailor training or rehabilitation programs, thereby ensuring individualized, targeted care. In particular, the use of online technology is a relatively new approach to delivering healthcare assistance, especially following the outbreak of COVID-19. This issue encourages in-depth studies and literature reviews that highlight the role of technologies in the promotion of health and healthy behaviors in general and pathological populations.

Dr. Luca Marin
Dr. Matteo Vandoni
Dr. Vittoria Carnevale
Topic Editors

Keywords

  • technology
  • online technologies
  • healthcare
  • health evaluation
  • health care
  • health promotion

Participating Journals

Journal Name Impact Factor CiteScore Launched Year First Decision (median) APC
Healthcare
healthcare
2.8 2.7 2013 19.5 Days CHF 2700 Submit
Journal of Clinical Medicine
jcm
3.9 5.4 2012 17.9 Days CHF 2600 Submit

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Published Papers (30 papers)

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23 pages, 1092 KiB  
Review
System-Wide Thromboprophylaxis Interventions for Hospitalized Patients at Risk of Venous Thromboembolism: Focus on Cross-Platform Clinical Decision Support
by Nikolaos Tsaftaridis, Mark Goldin and Alex C. Spyropoulos
J. Clin. Med. 2024, 13(7), 2133; https://doi.org/10.3390/jcm13072133 - 07 Apr 2024
Viewed by 338
Abstract
Thromboprophylaxis of hospitalized patients at risk of venous thromboembolism (VTE) presents challenges owing to patient heterogeneity and lack of adoption of evidence-based methods. Intuitive practices for thromboprophylaxis have resulted in many patients being inappropriately prophylaxed. We conducted a narrative review summarizing system-wide thromboprophylaxis [...] Read more.
Thromboprophylaxis of hospitalized patients at risk of venous thromboembolism (VTE) presents challenges owing to patient heterogeneity and lack of adoption of evidence-based methods. Intuitive practices for thromboprophylaxis have resulted in many patients being inappropriately prophylaxed. We conducted a narrative review summarizing system-wide thromboprophylaxis interventions in hospitalized patients. Multiple interventions for thromboprophylaxis have been tested, including multifaceted approaches such as national VTE prevention programs with audits, pre-printed order entry, passive alerts (either human or electronic), and more recently, the use of active clinical decision support (CDS) tools incorporated into electronic health records (EHRs). Multifaceted health-system and order entry interventions have shown mixed results in their ability to increase appropriate thromboprophylaxis and reduce VTE unless mandated through a national VTE prevention program, though the latter approach is potentially costly and effort- and time-dependent. Studies utilizing passive human or electronic alerts have also shown mixed results in increasing appropriate thromboprophylaxis and reducing VTE. Recently, a universal cloud-based and EHR-agnostic CDS VTE tool incorporating a validated VTE risk score revealed high adoption and effectiveness in increasing appropriate thromboprophylaxis and reducing major thromboembolism. Active CDS tools hold promise in improving appropriate thromboprophylaxis, especially with further refinement and widespread implementation within various EHRs and clinical workflows. Full article
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11 pages, 1911 KiB  
Article
Clinical Application of an Augmented Reality Navigation System for Transforaminal Epidural Injection: A Randomized Controlled Trial
by Yookyung Jang, Sunghwan Lim, Sunhee Lee, Lee Gyeong Je, Taesan Kim, Subin Joo, Joonho Seo, Deukhee Lee and Jae Chul Koh
J. Clin. Med. 2024, 13(7), 1992; https://doi.org/10.3390/jcm13071992 - 29 Mar 2024
Viewed by 332
Abstract
Objectives: Augmented reality (AR) navigation systems are emerging to simplify and enhance the precision of medical procedures. Lumbosacral transforaminal epidural injection is a commonly performed procedure for the treatment and diagnosis of radiculopathy. Accurate needle placement while avoiding critical structures remains a challenge. [...] Read more.
Objectives: Augmented reality (AR) navigation systems are emerging to simplify and enhance the precision of medical procedures. Lumbosacral transforaminal epidural injection is a commonly performed procedure for the treatment and diagnosis of radiculopathy. Accurate needle placement while avoiding critical structures remains a challenge. For this purpose, we conducted a randomized controlled trial for our augmented reality navigation system. Methods: This randomized controlled study involved 28 patients, split between a traditional C-arm guided group (control) and an AR navigation guided group (AR-NAVI), to compare procedure efficiency and radiation exposure. The AR-NAVI group used a real-time tracking system displaying spinal structure and needle position on an AR head-mounted display. The procedural time and C-arm usage (radiation exposure) were measured. Results: All patients underwent successful procedures without complications. The AR-NAVI group demonstrated significantly reduced times and C-arm usage for needle entry to the target point (58.57 ± 33.31 vs. 124.91 ± 41.14, p < 0.001 and 3.79 ± 1.97 vs. 8.86 ± 3.94, p < 0.001). Conclusions: The use of the AR navigation system significantly improved procedure efficiency and safety by reducing time and radiation exposure, suggesting a promising direction for future enhancements and validation. Full article
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12 pages, 6343 KiB  
Article
Combination of BeGraft and Solaris Stent Grafts for the Covered Endovascular Reconstruction of Aortic Bifurcation—BS-CERAB Technique
by Enrique M. San Norberto, Álvaro Revilla, José A. Brizuela, Isabel Del Blanco, Ángel Flores and James H. Taylor
J. Clin. Med. 2024, 13(7), 1925; https://doi.org/10.3390/jcm13071925 - 26 Mar 2024
Viewed by 238
Abstract
Background: This study examines the impact of the use of the combination of BeGraft and Solaris stent grafts on the outcomes during the covered endovascular reconstruction of aortic bifurcation (BS-CERAB) technique and extension to the iliac arteries. Methods: Consecutive patients with [...] Read more.
Background: This study examines the impact of the use of the combination of BeGraft and Solaris stent grafts on the outcomes during the covered endovascular reconstruction of aortic bifurcation (BS-CERAB) technique and extension to the iliac arteries. Methods: Consecutive patients with aortoiliac occlusive disease who underwent endovascular treatment using BS-CERAB between January 2020 and December 2023 were included. Patient demographics, symptoms, lesion characteristics, and procedural and follow-up details were collected and analyzed. Perioperative complications and reinterventions were also identified. Results: A total of 42 patients met the inclusion criteria (32 men, 76.2%, median age 72 years, range 59–85). Indications for treatment were intermittent claudication (42.9%) and critical limb ischemia (57.1%). Procedure success was achieved in all cases. The median patient follow-up time was 14 months (1–36). One patient died at a 10-month follow-up due to lung cancer. The mean pre-operative ABI increased from 0.37 ± 0.19 before intervention to 0.71 ± 1.23 post-operatively at 12 months (p = 0.037). The estimated primary patency rates at 3, 6, and 12 months were 90.5%, 85.7%, and 81.0% and primary assisted patency rates were 90.5%, 90.5%, and 85.7%, respectively. Secondary patency was 95.2% at 3 and 6 months and 90.5% at a 12-month follow-up. Active cancer (p = 0.023, OR 2.12 95%CI 1.14–3.25) was a risk factor for restenosis. Conclusions: This mid-term experience shows that the CERAB technique using the combination of BeGraft and Solaris stents grafts, for the endovascular treatment of severe aortoiliac atherosclerotic disease, may allow an effective reconstruction of the aortic bifurcation and iliac arteries related to high-patency and lower-reintervention rates. Full article
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13 pages, 437 KiB  
Article
Predicting the Length of Mechanical Ventilation in Acute Respiratory Disease Syndrome Using Machine Learning: The PIONEER Study
by Jesús Villar, Jesús M. González-Martín, Cristina Fernández, Juan A. Soler, Alfonso Ambrós, Lidia Pita-García, Lorena Fernández, Carlos Ferrando, Blanca Arocas, Myriam González-Vaquero, José M. Añón, Elena González-Higueras, Dácil Parrilla, Anxela Vidal, M. Mar Fernández, Pedro Rodríguez-Suárez, Rosa L. Fernández, Estrella Gómez-Bentolila, Karen E. A. Burns, Tamas Szakmany, Ewout W. Steyerberg and the PredictION of Duration of mEchanical vEntilation in ARDS (PIONEER) Networkadd Show full author list remove Hide full author list
J. Clin. Med. 2024, 13(6), 1811; https://doi.org/10.3390/jcm13061811 - 21 Mar 2024
Viewed by 511
Abstract
Background: The ability to predict a long duration of mechanical ventilation (MV) by clinicians is very limited. We assessed the value of machine learning (ML) for early prediction of the duration of MV > 14 days in patients with moderate-to-severe acute respiratory [...] Read more.
Background: The ability to predict a long duration of mechanical ventilation (MV) by clinicians is very limited. We assessed the value of machine learning (ML) for early prediction of the duration of MV > 14 days in patients with moderate-to-severe acute respiratory distress syndrome (ARDS). Methods: This is a development, testing, and external validation study using data from 1173 patients on MV ≥ 3 days with moderate-to-severe ARDS. We first developed and tested prediction models in 920 ARDS patients using relevant features captured at the time of moderate/severe ARDS diagnosis, at 24 h and 72 h after diagnosis with logistic regression, and Multilayer Perceptron, Support Vector Machine, and Random Forest ML techniques. For external validation, we used an independent cohort of 253 patients on MV ≥ 3 days with moderate/severe ARDS. Results: A total of 441 patients (48%) from the derivation cohort (n = 920) and 100 patients (40%) from the validation cohort (n = 253) were mechanically ventilated for >14 days [median 14 days (IQR 8–25) vs. 13 days (IQR 7–21), respectively]. The best early prediction model was obtained with data collected at 72 h after moderate/severe ARDS diagnosis. Multilayer Perceptron risk modeling identified major prognostic factors for the duration of MV > 14 days, including PaO2/FiO2, PaCO2, pH, and positive end-expiratory pressure. Predictions of the duration of MV > 14 days showed modest discrimination [AUC 0.71 (95%CI 0.65–0.76)]. Conclusions: Prolonged MV duration in moderate/severe ARDS patients remains difficult to predict early even with ML techniques such as Multilayer Perceptron and using data at 72 h of diagnosis. More research is needed to identify markers for predicting the length of MV. This study was registered on 14 August 2023 at ClinicalTrials.gov (NCT NCT05993377). Full article
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8 pages, 2144 KiB  
Brief Report
A Novel Ear Impression-Taking Method Using Structured Light Imaging and Machine Learning: A Pilot Proof of Concept Study with Patients’ Feedback on Prototype
by Kenneth Wei De Chua, Hazel Kai Hui Yeo, Charmaine Kai Ling Tan, Jose C. Martinez, Zhi Hwee Goh, Stylianos Dritsas and Robert E. Simpson
J. Clin. Med. 2024, 13(5), 1214; https://doi.org/10.3390/jcm13051214 - 21 Feb 2024
Viewed by 532
Abstract
Introduction: Taking an ear impression is a minimally invasive procedure. A review of existing literature suggests that contactless methods of scanning the ear have not been developed. We proposed to establish a correlation between external ear features with the ear canal and with [...] Read more.
Introduction: Taking an ear impression is a minimally invasive procedure. A review of existing literature suggests that contactless methods of scanning the ear have not been developed. We proposed to establish a correlation between external ear features with the ear canal and with this proof of concept to develop a prototype and an algorithm for capturing and predicting ear canal information. Methods: We developed a novel prototype using structured light imaging to capture external images of the ear. Using a large database of existing ear impression images obtained by traditional methods, correlation analyses were carried out and established. A deep neural network was devised to build a predictive algorithm. Patients undergoing hearing aid evaluation undertook both methods of ear impression-taking. We evaluated their subjective feedback and determined if there was a close enough objective match between the images obtained from the impression techniques. Results: A prototype was developed and deployed for trial, and most participants were comfortable with this novel method of ear impression-taking. Partial matching of the ear canal could be obtained from the images taken, and the predictive algorithm applied for a few sample images was within good standard of error with proof of concept established. Discussion: Further studies are warranted to strengthen the predictive capabilities of the algorithm and determine optimal prototype imaging positions so that sufficient ear canal information can be obtained for three-dimensional printing. Ear impression-taking may then have the potential to be automated, with the possibility of same-day three-dimensional printing of the earmold to provide timely access. Full article
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10 pages, 231 KiB  
Article
Articulating Video Stylet Compared to Other Techniques for Endotracheal Intubation in Normal Airways: A Simulation Study in Consultants with No Prior Experience
by Simone Messina, Federica Merola, Cristina Santonocito, Marco Sanfilippo, Giulia Sanfilippo, Federica Lombardo, Andrea Bruni, Eugenio Garofalo, Paolo Murabito and Filippo Sanfilippo
J. Clin. Med. 2024, 13(3), 728; https://doi.org/10.3390/jcm13030728 - 26 Jan 2024
Viewed by 514
Abstract
Simulation for airway management allows for acquaintance with new devices and techniques. Endotracheal intubation (ETI), most commonly performed with direct laryngoscopy (DL) or video laryngoscopy (VLS), can be achieved also with combined laryngo-bronchoscopy intubation (CLBI). Finally, an articulating video stylet (ProVu) has been [...] Read more.
Simulation for airway management allows for acquaintance with new devices and techniques. Endotracheal intubation (ETI), most commonly performed with direct laryngoscopy (DL) or video laryngoscopy (VLS), can be achieved also with combined laryngo-bronchoscopy intubation (CLBI). Finally, an articulating video stylet (ProVu) has been recently introduced. A single-center observational cross-sectional study was performed in a normal simulated airway scenario comparing DL, VLS-Glidescope, VLS-McGrath, CLBI and ProVu regarding the success rate (SR) and corrected time-to-intubation (cTTI, which accounts for the SR). Up to three attempts/device were allowed (maximum of 60 s each). Forty-two consultants with no experience with ProVu participated (15 ± 9 years after training completion). The DL was significantly faster (cTTI) than all other devices (p = 0.033 vs. VLSs, and p < 0.001 for CLBI and Provu), no differences were seen between the two VLSs (p = 0.775), and the VLSs were faster than CLBI and ProVu. Provu had a faster cTTI than CLBI (p = 0.004). The DL and VLSs showed similar SRs, and all the laryngoscopes had a higher SR than CLBI and ProVu at the first attempt. However, by the third attempt, the SR was not different between the DL/VLSs and ProVu (p = 0.241/p = 0.616); ProVu was superior to CLBI (p = 0.038). In consultants with no prior experience, ProVu shows encouraging results compared to DL/VLSs under simulated normal airway circumstances and further studies are warranted. Full article
12 pages, 6625 KiB  
Article
Early and Mid-Term Outcomes of Using the Chimney Technique in Redo Mitral Valve Replacement in Patients with a Small Mitral Annulus
by Mingyuan Yang, Laichun Song, Yong Xiao and Liang Tao
J. Clin. Med. 2024, 13(1), 270; https://doi.org/10.3390/jcm13010270 - 03 Jan 2024
Viewed by 618
Abstract
The outcomes of redo mitral valve replacement (Re-MVR) in a small mitral annulus with the use of the chimney technique are not well documented. The purpose of this study is to present our early experience with this group of patients, illustrating the periop-erative [...] Read more.
The outcomes of redo mitral valve replacement (Re-MVR) in a small mitral annulus with the use of the chimney technique are not well documented. The purpose of this study is to present our early experience with this group of patients, illustrating the periop-erative complications and mortality outcomes. From 2019 to 2020, 77 consecutive patients underwent Re-MVR with the use of the chimney technique because of a small mitral annulus. To evaluate heart structural integrity and clinical outcomes, postoperative clinical data and echocardiograms were examined. The mean age was 56.7 ± 15.98 years. All patients underwent mitral valve surgery, of which 62 were mitral valve replacements, 7 mitral valve repairs, and 8 double valve replacements. The preoperative mitral valve mean gradient was 18.07 ± 9.40 mmHg, and the postoperative mitral prosthesis size was 28.51 ± 1.22 mm. The median increment of mitral size enlargement was 4 (0, 6) valve sizes. The mean mitral gradient coming out of the operating room was 10.34 ± 2.12 mmHg, and at the follow-up echocardiogram performed at 3 years after the procedure, it was 10.36 ± 1.70 mmHg. One-year survival was 93.3%, while the 4-year survival rate was 89.3%, with no reoperation. The use of the chimney technique in small mitral valve re-mitral valve replacement results in larger valve sizes. Moreover, the mean gradients over the mitral valve are acceptable both intraoperatively and over time. Full article
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13 pages, 3454 KiB  
Article
Lung Ultrasound Elastography by SWE2D and “Fibrosis-like” Computed Tomography Signs after COVID-19 Pneumonia: A Follow-Up Study
by Carlos Paredes-Manjarrez, Francisco J. Avelar-Garnica, Andres Tlacaelel Balderas-Chairéz, Jorge Arellano-Sotelo, Ricardo Córdova-Ramírez, Eliseo Espinosa-Poblano, Alejandro González-Ruíz, Juan Carlos Anda-Garay, José Adan Miguel-Puga and Kathrine Jáuregui-Renaud
J. Clin. Med. 2023, 12(24), 7515; https://doi.org/10.3390/jcm12247515 - 05 Dec 2023
Viewed by 832
Abstract
The aim of this study was to assess the shear wave velocity by LUS elastography (SWE2D) for the evaluation of superficial lung stiffness after COVID-19 pneumonia, according to “fibrosis-like” signs found by Computed Tomography (CT), considering the respiratory function. Seventy-nine adults participated in [...] Read more.
The aim of this study was to assess the shear wave velocity by LUS elastography (SWE2D) for the evaluation of superficial lung stiffness after COVID-19 pneumonia, according to “fibrosis-like” signs found by Computed Tomography (CT), considering the respiratory function. Seventy-nine adults participated in the study 42 to 353 days from symptom onset. Paired evaluations (SWE2D and CT) were performed along with the assessment of arterial blood gases and spirometry, three times with 100 days in between. During the follow-up and within each evaluation, the SWE2D velocity changed over time (MANOVA, p < 0.05) according to the extent of “fibrosis-like” CT signs by lung lobe (ANOVA, p < 0.05). The variability of the SWE2D velocity was consistently related to the first-second forced expiratory volume and the forced vital capacity (MANCOVA, p < 0.05), which changed over time with no change in blood gases. Covariance was also observed with age and patients’ body mass index, the time from symptom onset until hospital admission, and the history of diabetes in those who required intensive care during the acute phase (MANCOVA, p < 0.05). After COVID-19 pneumonia, SWE2D velocity can be related to the extent and regression of “fibrotic-like” involvement of the lung lobes, and it could be a complementary tool in the follow-up after COVID-19 pneumonia. Full article
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13 pages, 524 KiB  
Article
The Effects of a Simulation-Based Patient Safety Education Program on Compliance with Patient Safety, Perception of Patient Safety Culture, and Educational Satisfaction of Operating Room Nurses
by OkBun Park, MiYang Jeon, MiSeon Kim, ByeolAh Kim and HyeonCheol Jeong
Healthcare 2023, 11(21), 2824; https://doi.org/10.3390/healthcare11212824 - 25 Oct 2023
Cited by 1 | Viewed by 1149
Abstract
Background: Operating rooms (ORs) are healthcare areas that are high-risk regarding patient safety (PS). The prevention of PS errors such as wrong-site surgery, medication errors, and patient falls is important in the OR. Causes such as having insufficient information, not taking enough care [...] Read more.
Background: Operating rooms (ORs) are healthcare areas that are high-risk regarding patient safety (PS). The prevention of PS errors such as wrong-site surgery, medication errors, and patient falls is important in the OR. Causes such as having insufficient information, not taking enough care and precautions, and inattention may lead to errors. Ensuring PS in an organization depends on the composition of a PS culture. Method: This study, as equivalent-control-group pretest–posttest research, aimed to develop and apply a simulation-based patient safety education program for operating room nurses and then to examine the influence of the program on patient safety management and compliance. Participants included a total of 45 operating room nurses: 22 in the experimental group and 23 in the control group. In the program, each member of the experimental and control groups underwent two 60 min sessions for a total of 120 min. Person-to-person individual lectures and simulation-based practice were provided to the experimental group, whereas booklets and person-to-person individual lectures were provided to the control group. Compliance with patient safety, the perception of patient safety culture, and satisfaction were measured using a structured Likert questionnaire. Intervention effects were analyzed using a t-test and ANCOVA. Results: As a result of the analysis, we found that the experimental group was significantly higher in terms of compliance with patient safety (p = 0.021), the perception of patient safety culture (p = 0.039), and education satisfaction (p < 0.001) than the control group. Conclusions: The results indicate that implementing a simulation-based patient safety education program can improve the patient safety competency of operating room nurses and, ultimately, prevent patient safety accidents in the operating room. Full article
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14 pages, 924 KiB  
Article
Enhancing Primary Care for Nursing Home Patients with an Artificial Intelligence-Aided Rational Drug Use Web Assistant
by Tuğba Yılmaz, Şükran Ceyhan, Şeyma Handan Akyön and Tarık Eren Yılmaz
J. Clin. Med. 2023, 12(20), 6549; https://doi.org/10.3390/jcm12206549 - 16 Oct 2023
Cited by 1 | Viewed by 944
Abstract
Polypharmacy can result in drug–drug interactions, severe side-effects, drug–disease interactions, inappropriate medication use in the elderly, and escalating costs. This study aims to evaluate nursing home residents’ medication regimens using a rational drug use web assistant developed by researchers to mitigate unnecessary medication [...] Read more.
Polypharmacy can result in drug–drug interactions, severe side-effects, drug–disease interactions, inappropriate medication use in the elderly, and escalating costs. This study aims to evaluate nursing home residents’ medication regimens using a rational drug use web assistant developed by researchers to mitigate unnecessary medication usage. This analytical, cross-sectional study included data from nursing home residents recently recorded in a training family health center. Sociodemographic information, medical conditions, and prescribed medications of all patients in the nursing home (n = 99) were documented. Medications were assessed using an artificial intelligence-aided rational drug use web assistant. Instances of inappropriate drug use and calculations of contraindicated drug costs were also recorded. The study revealed that 88.9% (n = 88) of patients experienced polypharmacy, with a mean value of 6.96 ± 2.94 drugs per patient. Potential risky drug–drug interactions were present in 89.9% (n = 89) of patients, contraindicated drug–drug interactions in 20.2% (n = 20), and potentially inappropriate drug use in 86.9% (n = 86). Plans to discontinue 83 medications were estimated to reduce total direct medication costs by 9.1% per month. After the assessment with the rational drug use web assistant, the number of drugs that patients needed to use and polypharmacy decreased significantly. This study concludes that the rational drug use web assistant application, which is more cost-effective than the traditional manual method, assisted by artificial intelligence, and integrated into healthcare services, may offer substantial benefits to family physicians and their geriatric patients. Full article
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13 pages, 2939 KiB  
Article
Characteristics and Effectiveness of Mobile- and Web-Based Tele-Emergency Consultation System between Rural and Urban Hospitals in South Korea: A National-Wide Observation Study
by WooSung Choi, YongSu Lim, Tag Heo, SungMin Lee, Won Kim, Sang-Chul Kim, YeonWoo Kim, JaeHyuk Kim, Hyun Kim, HyungIl Kim, TaeHun Lee and Chol Kim
J. Clin. Med. 2023, 12(19), 6252; https://doi.org/10.3390/jcm12196252 - 28 Sep 2023
Viewed by 702
Abstract
(1) Background: The government of South Korea has established a nationwide web- and mobile-based emergency teleconsultation network by designating urban and rural hospitals. The purpose of this study is to analyze the characteristics and effectiveness of the tele-emergency system in South Korea. (2) [...] Read more.
(1) Background: The government of South Korea has established a nationwide web- and mobile-based emergency teleconsultation network by designating urban and rural hospitals. The purpose of this study is to analyze the characteristics and effectiveness of the tele-emergency system in South Korea. (2) Methods: Tele-emergency consultation cases from May 2015 to December 2018 were analyzed in the present study. The definition of a tele-emergency in the present study is an emergency consultation between doctors in rural and urban hospitals via a web- and mobile-based remote emergency consultation system (RECS). Consultations through an RECS are grouped into three categories: medical procedure or treatment guidance, image interpretation, and transportation requests. The present study analyzed the characteristics of the tele-emergency system and the reduction in unnecessary transportation (RUT). (3) Results: A total of 2604 cases were analyzed in the present study from 2985 tele-emergency consultation cases. A total of 381 cases were excluded for missing data. Consultations for image interpretation were the most common in trauma cases (71.3%), while transfer requests were the most common in non-trauma cases (50.3%). Trauma patients were more frequently admitted to rural hospitals or discharged and followed up with at rural hospitals (20.3% vs. 40.5%) after consultations. In terms of disease severity, non-severe cases were statistically higher in trauma cases (80.6% vs. 59.4%; p < 0.001). The RUT was statistically highly associated with trauma cases (60.8% vs. 42.8%; p < 0.001). In an analysis that categorized cases by region, a statistically higher proportion of transportation was used in island regions (69.9% vs. 49.5%; p < 0.003). More RUT was associated with non-island regions (30.1% vs. 50.5%; p = 0.001). (4) Conclusions: The tele-emergency system had a great role in reducing unnecessary patient transportation in non-severe trauma cases and non-island rural area emergency cases. Further research is needed for a cost/benefit analysis and clinical outcomes. Full article
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12 pages, 1476 KiB  
Article
Treatment of Vulvovaginal Laxity by Electroporation: The Jett Plasma Medical for Her II Study
by Tomas Fait, Tivadar Baltazár, Leona Bubenickova, Jan Kestranek, Martin Stepan, Miroslav Muller and Pavel Turcan
J. Clin. Med. 2023, 12(19), 6234; https://doi.org/10.3390/jcm12196234 - 27 Sep 2023
Viewed by 896
Abstract
Introduction: Vaginal laxity is a widespread and undertreated medical condition associated especially with vaginal parity. Aim: To evaluate the efficacy and safety of electroporation therapy treatment of vulvovaginal laxity by the Jett Plasma for Her II device. Methods: The Jett Plasma for Her [...] Read more.
Introduction: Vaginal laxity is a widespread and undertreated medical condition associated especially with vaginal parity. Aim: To evaluate the efficacy and safety of electroporation therapy treatment of vulvovaginal laxity by the Jett Plasma for Her II device. Methods: The Jett Plasma for Her II Study is a multicentric, prospective, randomized, single-blinded, and controlled study. Women presenting with vaginal laxity were randomized to receive electroporation therapy delivered to the vaginal tissue (active—82 patients) vs. therapy with zero intensity (placebo—9 patients). Results: A total of 91 subjects whose average age was 48.69 ± 10.89 were included. Due to the results of a one-way analysis of variance, it may be concluded that in the case of the vaginal laxity questionnaire (VLQ), there is a statistically significant difference between actively treated patients and the placebo group (F1,574 = 46.91; p < 0.001). In the case of the female sexual function index (FSFI), a one-way ANOVA test also showed a statistically significant difference between the actively treated patients and the placebo group (F1,278 = 7.97; p = 0.005). In the case of the incontinence impact questionnaire-7 (IIQ-7), a one-way ANOVA test showed a statistically significant difference between the actively treated patients and the placebo group (F1,384 = 15.51; p < 0.001). It confirms that improvement of vaginal laxity is conjoined with benefits in symptoms of urinary incontinence. Biopsy performed after the end of the treatment shows an increase in the vaginal mucosa thickness by an average of 100.04% in the active group. The treatment was well tolerated with no adverse events. No topical anesthetics were required. Conclusions: Treatments of vulvovaginal laxity by electroporation therapy achieved significant and sustainable 12-month effectiveness. Responses to the questionnaires also suggest subjective improvement in self-reported sexual function, incontinence, sexual satisfaction, and urogenital distress. Full article
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14 pages, 1185 KiB  
Review
Effectiveness of mHealth Interventions for Monitoring Antenatal Care among Pregnant Women in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis
by Manisha Mishra, Debasini Parida, Jogesh Murmu, Damini Singh, Tanveer Rehman, Jaya Singh Kshatri and Sanghamitra Pati
Healthcare 2023, 11(19), 2635; https://doi.org/10.3390/healthcare11192635 - 27 Sep 2023
Cited by 1 | Viewed by 1243
Abstract
Antenatal care (ANC) is essential in maternal and child health since it provides care to pregnant women from conception through to labour in order to ensure a safe pregnancy and childbirth. In recent years, mobile health (mHealth) interventions have emerged as a promising [...] Read more.
Antenatal care (ANC) is essential in maternal and child health since it provides care to pregnant women from conception through to labour in order to ensure a safe pregnancy and childbirth. In recent years, mobile health (mHealth) interventions have emerged as a promising solution to improve maternal and child health outcomes in low- and middle-income countries (LMICs). The present study aimed to conduct a systematic review and meta-analysis of trials to evaluate the effectiveness of mHealth interventions to monitor prenatal care among pregnant women in LMICs. A systematic literature review was conducted using the databases CINHAL, Embase, MEDLINE, and PsycINFO on the effectiveness of mHealth interventions in monitoring the antenatal care of pregnant women. The study selection, data extraction of the included articles, and quality appraisal were assessed. Our study included six studies considering 7886 participants. All articles were from low- and middle-income countries (LMICs). Antenatal mothers who used a mobile health intervention were more likely (RR = 1.66, 95%CI = 1.07–2.58, I2 = 98%) to attend ANC check-ups when compared with the women who did not use any mobile health applications or did not receive any short message services. mHealth technologies are being utilised more and more to increase care accessibility and improve maternal and fetal health. Policymakers should prioritise the integration of mHealth interventions into maternal healthcare services in LMICs, ensuring that they are cost-effective, accessible, and sustainable and that healthcare workers are trained to deliver these interventions effectively. Full article
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14 pages, 1771 KiB  
Article
Acupotomy in Korean Medicine Doctors: A Preliminary Survey on Experiences, Perceptions, and Clinical Usage Status
by Hyungsun Jun, Sang-Hoon Yoon, Myungseok Ryu, Hyocheong Chae, Hongmin Chu, Jungtae Leem and Tae-Hun Kim
Healthcare 2023, 11(18), 2577; https://doi.org/10.3390/healthcare11182577 - 18 Sep 2023
Cited by 1 | Viewed by 1017
Abstract
Acupotomy is a widely used medical intervention in traditional East Asian medicine, and efforts are being made to improve its effectiveness and safety. As a first step toward establishing more standardized procedural guidelines, a survey was conducted to explore the current clinical practice [...] Read more.
Acupotomy is a widely used medical intervention in traditional East Asian medicine, and efforts are being made to improve its effectiveness and safety. As a first step toward establishing more standardized procedural guidelines, a survey was conducted to explore the current clinical practice status and perceived adverse events (AEs) by Korean Medicine (KM) practitioners. The survey was developed via expert consensus and included information on clinical usage, perception, and the AEs experienced. The largest acupotomy society in Korea, which consists of 185 KM doctors, participated in an online survey conducted in September 2021. Of the 185 KM doctors, 107 (57.8%) responded. Musculoskeletal and connective tissue diseases accounted for 80.8% of suggested indications by KM doctors. Regarding the detailed procedure, there were considerable discrepancies between KM doctors. The most frequent acupotomy-related AEs observed by KM practitioners were bruises (77.3%), fatigue (57.7%), pain (51.8%), and hematoma (51.8%). Only 1.8% of the respondents answered that they had experienced severe AEs. Survey respondents answered that the use of imaging devices during acupotomy and the development of clinical practice guidelines are the most necessary policy requirements for promoting the use and ensuring the safety of acupotomy. To the best of our knowledge, this study marks the initial exploration into the KM physicians’ clinical usage status, AEs experienced, and their requests for standardized guidelines and expanded health insurance coverage concerning acupotomy. Further research should include qualitative studies to assess patient experience and prospective observational studies to examine the effects of operator skills and treatment modalities on AEs and adherence. Full article
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10 pages, 385 KiB  
Systematic Review
Efficacy of Laser Therapy on Paralysis and Disability in Patients with Facial Palsy: A Systematic Review of Randomized Controlled Trials
by Jung-Hyun Kim, Bonhyuk Goo and Sang-Soo Nam
Healthcare 2023, 11(17), 2419; https://doi.org/10.3390/healthcare11172419 - 29 Aug 2023
Viewed by 1270
Abstract
(1) Background: Facial palsy is a common health issue which leads to sequelae and disability. This systematic review aimed to assess the efficacy of laser therapy for the treatment of facial palsy. (2) Methods: Only randomized controlled trials comparing the effectiveness of laser [...] Read more.
(1) Background: Facial palsy is a common health issue which leads to sequelae and disability. This systematic review aimed to assess the efficacy of laser therapy for the treatment of facial palsy. (2) Methods: Only randomized controlled trials comparing the effectiveness of laser therapy to non-laser intervention, no intervention, or placebo were searched for. Relevant studies were searched in seven electronic databases. Studies that examined the use of laser modalities for facial palsy management, with or without acupuncture, were also included. Two authors independently read and scored the methodological quality of the selected texts, and any disagreement was resolved by discussion or by intervention from the third author. (3) Results and conclusions: With five full-text articles, a methodological quality for each included study was assessed (kappa coefficient = 0.75). The laser therapy group in the mean difference measuring FDI showed an effect size of 8.15 compared to the control group; while measuring the paralysis score, an advantage was disclosed with an effect size of 0.22 compared to the control group. Full article
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13 pages, 291 KiB  
Article
Nurses’ Attitudes and Factors Affecting Use of Electronic Health Record in Saudi Arabia
by Awatif M. Alrasheeday, Bushra Alshammari, Sameer A. Alkubati, Eddieson Pasay-an, Monirah Albloushi and Awayed M. Alshammari
Healthcare 2023, 11(17), 2393; https://doi.org/10.3390/healthcare11172393 - 25 Aug 2023
Viewed by 2048
Abstract
(1) Background: Nurses’ attitudes toward electronic health records (EHRs) is a very valuable issue that needs to be evaluated, understood, and considered one of the main factors that can lead to its improvement or handicap its implementation. This study aimed to assess nurses’ [...] Read more.
(1) Background: Nurses’ attitudes toward electronic health records (EHRs) is a very valuable issue that needs to be evaluated, understood, and considered one of the main factors that can lead to its improvement or handicap its implementation. This study aimed to assess nurses’ attitudes toward EHRs and associated factors that affect the implementation of EHRs in different hospitals in Saudi Arabia. (2) Methods: A cross-sectional study was utilized to collect data from 297 nurses working in public hospitals and primary healthcare centers in Ha’il Province from January to May 2023. Data were collected using the Nurses’ Attitudes Towards Computerization questionnaire and a sociodemographic and work-related characteristics sheet. (3) Results: Most of the participants’ attitude scores (81.1%, n = 241) were more than or equal to 60, representing positive attitudes, whereas 18.9% (n = 56) of the nurses’ scores were less than 60, which is interpreted as negative attitudes. There was a significant relationship between nurses’ attitudes toward EHRs and a participants’ sex, where males had a more positive attitude than females (p < 0.001). Particularly, young nurses and those who had previous computer experience had a more positive attitude than older nurses and those who had no computer experience (p = 0.044 and < 0.001, respectively). Saudi nurses holding a master’s degree had significantly more positive attitudes toward EHRs than non-Saudi nurses holding a bachelor’s or diploma degree (p = 0.007 and 0.048, respectively). Nurses with less experience (less than five years) in the nursing field had a significantly positive attitude. Multiple linear regression showed that sex (p = 0.038), level of education (p = 0.001), and previous computer experience (p < 0.001) were independent factors of nurses’ knowledge of EHRs. (4) Conclusion: The majority of nurses had positive overall attitudes toward using EHRs. Nurses who are Saudi nationals, male, younger, have previous computer experience, and have less than five years of experience had a more positive attitude toward EHRs than nurses who are non-Saudi, female, older, have no computer experience, have bachelor’s or diploma degree, and have less than five years of experience, respectively. Sex, education level, and previous computer experience were independent factors of nurses’ knowledge of EHRs. Full article
11 pages, 585 KiB  
Article
The Effectiveness of a Smartphone Application for Tinnitus Relief
by Hye Yoon Seol, Mini Jo and Il Joon Moon
Healthcare 2023, 11(17), 2368; https://doi.org/10.3390/healthcare11172368 - 22 Aug 2023
Viewed by 1100
Abstract
Background: There has been a growing interest in the provision of smartphone- or internet-based tinnitus management. Studies have shown a positive impact of the smartphone applications on tinnitus symptoms. However, research into a relatively long-term effect of these applications on tinnitus relief as [...] Read more.
Background: There has been a growing interest in the provision of smartphone- or internet-based tinnitus management. Studies have shown a positive impact of the smartphone applications on tinnitus symptoms. However, research into a relatively long-term effect of these applications on tinnitus relief as well as sound preferences has been sparse. This study explored the potential benefit of a tinnitus application in tinnitus relief over a period of six months. Methods: Twenty-two participants with subjective tinnitus were enrolled in the study. Puretone audiometry, tinnitus pitch and loudness matching, stress assessment, and questionnaires were completed at the initial visit and three and six months after the first visit. The participants used the tinnitus application for six months. Results: A significant reduction in subjective tinnitus loudness and annoyance and subjective stress level was observed. The Tinnitus Handicap Inventory scores were also significantly decreased after six months. The participants also reported high satisfaction with the application. Music and environmental sounds were the most preferred sound stimuli. Conclusions: The findings of this study demonstrate the potential benefit of the tinnitus application for tinnitus improvement. Full article
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13 pages, 837 KiB  
Article
Virtual Reality Simulation for Advanced Infection Control Education in Neonatal Intensive Care Units: Focusing on the Prevention of Central Line-Associated Bloodstream Infections and Ventilator-Associated Infections
by Jimin Ryu and Mi Yu
Healthcare 2023, 11(16), 2296; https://doi.org/10.3390/healthcare11162296 - 14 Aug 2023
Viewed by 1159
Abstract
This study examined the effects of a virtual reality simulation for advanced infection control education in neonatal intensive care units (VR_AICENICU) on nurses’ infection control knowledge and performance confidence. We examined nurses’ presence, empathy, and program satisfaction using a non-equivalent control group pre-post [...] Read more.
This study examined the effects of a virtual reality simulation for advanced infection control education in neonatal intensive care units (VR_AICENICU) on nurses’ infection control knowledge and performance confidence. We examined nurses’ presence, empathy, and program satisfaction using a non-equivalent control group pre-post design. Nurses were divided into an experimental group (n = 20) experiencing VR simulation and routine NICU practice and a control group (n = 20) with routine NICU practice. The VR_AICENICU program comprised three scenarios: high-risk medication with lipid solution, dressing and management for peripheral inserted central line, and aspiration prevention and skincare management during ventilator use for premature infants. Data were collected between February and July 2022. The experimental group showed significantly greater improvements in infection control knowledge and performance confidence compared to the pre-test. The average scores of presence, empathy, and program satisfaction of the experimental group were 4.39 ± 0.36, 4.33 ± 0.75, and 4.90 ± 0.31, respectively. The VR_AICENICU program has implications for the education needs of nurses working in NICUs and enhances their knowledge and performance of infection control. Future studies should apply the VR_AICENICU program to different severity grades of NICU patients and develop additional VR programs. Full article
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12 pages, 2689 KiB  
Communication
New Intermittent Urinary Micro-Hole Zone Catheter Shows Enhanced Performance in Emptying the Bladder: A Randomised, Controlled Crossover Study
by Malene Hornbak Landauro, Lotte Jacobsen, Fabio Tentor, Troels Pedersen, Cecilie Rovsing, Omar Feix do Nascimento and Michael Kennelly
J. Clin. Med. 2023, 12(16), 5266; https://doi.org/10.3390/jcm12165266 - 13 Aug 2023
Cited by 2 | Viewed by 1532
Abstract
Urinary tract infections (UTIs) are common and troublesome complications of clean intermittent catheterisation (CIC) in individuals suffering from incomplete bladder emptying, which may exacerbate the underlying disease and lead to hospitalisation. Aside from the design of the intermittent catheter and its handling, a [...] Read more.
Urinary tract infections (UTIs) are common and troublesome complications of clean intermittent catheterisation (CIC) in individuals suffering from incomplete bladder emptying, which may exacerbate the underlying disease and lead to hospitalisation. Aside from the design of the intermittent catheter and its handling, a recent review highlighted residual urine as one of several UTI risk factors. A new urinary intermittent catheter with multiple micro-holes has been developed for improved bladder emptying. In a controlled crossover study, adult male CIC users were randomised for a health care professional-led catheterisation with the new micro-hole zone catheter (MHZC) and a conventional eyelet catheter (CEC) in two individual test visits to compare the number of flow-stops and the residual urine at the first flow-stop as co-primary endpoints. In 42 male CIC users, the MHZC resulted in significantly fewer flow-stop episodes compared to the CEC (mean 0.17, 95% CI [0.06, 0.45] vs. mean 1.09, 95% CI [0.75, 1.6], respectively; p < 0.001) and significantly less residual urine at the first flow-stop (mean 5.10 mL, SE [1.14] vs. mean 39.40 mL, SE [9.65], respectively; p < 0.001). No adverse events were observed in this study. The results confirm the enhanced performance of the MHZC compared to a CEC, ensuring an uninterrupted free urine flow with no need to reposition the catheter until the bladder is thoroughly empty. Full article
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10 pages, 543 KiB  
Article
Use of the Free Endometriosis Risk Advisor App as a Non-Invasive Screening Test for Endometriosis in Patients with Chronic Pelvic Pain and/or Unexplained Infertility
by Camran Nezhat, Ellie Armani, Hsuan-Chih Carolina Chen, Zahra Najmi, Steven R. Lindheim and Ceana Nezhat
J. Clin. Med. 2023, 12(16), 5234; https://doi.org/10.3390/jcm12165234 - 11 Aug 2023
Cited by 1 | Viewed by 1211
Abstract
Endometriosis is a prevalent condition that affects millions of individuals globally, leading to various symptoms and significant disruptions to their quality of life. However, the diagnosis of endometriosis often encounters delays, emphasizing the pressing need for non-invasive screening. This retrospective cross-sectional study aimed [...] Read more.
Endometriosis is a prevalent condition that affects millions of individuals globally, leading to various symptoms and significant disruptions to their quality of life. However, the diagnosis of endometriosis often encounters delays, emphasizing the pressing need for non-invasive screening. This retrospective cross-sectional study aimed to evaluate the utility of the Endometriosis Risk Advisor (EndoRA) mobile application in screening for endometriosis in patients with chronic pelvic pain and/or unexplained infertility. The study consisted of 293 patients who met specific criteria: they were English-speaking individuals with chronic pelvic pain and/or unexplained infertility, owned smartphones, and had no prior diagnosis of endometriosis. The results demonstrated that the EndoRA score exhibited a high sensitivity of 93.1% but a low specificity of 5.9% in detecting endometriosis. The positive predictive value was 94.1%, while the negative predictive value was 5.0%. Although the study had limitations and potential selection bias, its findings suggest that EndoRA can serve as a valuable screening tool for high-risk individuals, enabling them to identify themselves as being at an increased risk for endometriosis. EndoRA’s non-invasive nature, free access, and easy accessibility have the potential to streamline evaluation and treatment processes, thereby empowering individuals to seek timely care and ultimately improving patient outcomes and overall well-being. Full article
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11 pages, 616 KiB  
Systematic Review
Augmented and Virtual Reality for Preoperative Trauma Planning, Focusing on Orbital Reconstructions: A Systematic Review
by Kathia Dubron, Maarten Verbist, Reinhilde Jacobs, Raphael Olszewski, Eman Shaheen and Robin Willaert
J. Clin. Med. 2023, 12(16), 5203; https://doi.org/10.3390/jcm12165203 - 10 Aug 2023
Cited by 3 | Viewed by 1037
Abstract
Background: This systematic review summarizes recent literature on the use of extended reality, including augmented reality (AR), mixed reality (MR), and virtual reality (VR), in preoperative planning for orbital fractures. Methods: A systematic search was conducted in PubMed, Embase, Web of Science and [...] Read more.
Background: This systematic review summarizes recent literature on the use of extended reality, including augmented reality (AR), mixed reality (MR), and virtual reality (VR), in preoperative planning for orbital fractures. Methods: A systematic search was conducted in PubMed, Embase, Web of Science and Cochrane on 6 April 2023. The included studies compared extended reality with conventional planning techniques, focusing on computer-aided surgical simulation based on Computed Tomography data, patient-specific implants (PSIs), fracture reconstruction of the orbital complex, and the use of extended reality. Outcomes analyzed were technical accuracy, planning time, operative time, complications, total cost, and educational benefits. Results: A total of 6381 articles were identified. Four articles discussed the educational use of VR, while one clinical prospective study examined AR for assisting orbital fracture management. Conclusion: AR was demonstrated to ameliorate the accuracy and precision of the incision and enable the better identification of deep anatomical tissues in real time. Consequently, intraoperative imaging enhancement helps to guide the orientation of the orbital reconstruction plate and better visualize the precise positioning and fixation of the PSI of the fractured orbital walls. However, the technical accuracy of 2–3 mm should be considered. VR-based educational tools provided better visualization and understanding of craniofacial trauma compared to conventional 2- or 3-dimensional images. Full article
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13 pages, 1581 KiB  
Article
The Effectiveness of a Multimodal Brain Empowerment Program in Mild Cognitive Impairment: A Single-Blind, Quasi-Randomized Experimental Study
by Wonjun Oh, Haeun Park, Mark Hallett and Joshua (Sung) H. You
J. Clin. Med. 2023, 12(15), 4895; https://doi.org/10.3390/jcm12154895 - 26 Jul 2023
Viewed by 973
Abstract
The present study aimed to determine a multimodal brain empowerment (MBE) program to mitigate the modifiable risk factors in mild cognitive impairment (MCI), and its therapeutic effects are unknown. MBE encompassing (1) tDCS, light therapy, computerized cognitive therapy (TLC) and (2) robot-assisted gait [...] Read more.
The present study aimed to determine a multimodal brain empowerment (MBE) program to mitigate the modifiable risk factors in mild cognitive impairment (MCI), and its therapeutic effects are unknown. MBE encompassing (1) tDCS, light therapy, computerized cognitive therapy (TLC) and (2) robot-assisted gait training, music therapy, and core exercise (REM) interventions were randomly assigned to 20 healthy young adults and 20 older adults with MCI. The electroencephalography (EEG) power spectrum and topographic event-related synchronization (ERS) analysis were used to assess intervention-related changes in neural activity during the MBE program. Outcome: The EEG results demonstrated that both multimodal TLC and REM decreased delta waves and increased theta, alpha, and beta waves (p < 0.001). ERS showed increased neural activation in the frontal, temporal, and parietal lobes during TLC and REM. Such enhanced neural activity in the region of interest supports potential clinical benefits in empowering cognitive function in both young adults and older adults with MCI. Full article
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17 pages, 2603 KiB  
Review
Effectiveness of Digital Physiotherapy Practice Compared to Usual Care in Long COVID Patients: A Systematic Review
by María-José Estebanez-Pérez, Rocío Martín-Valero, Maria Jesus Vinolo-Gil and José-Manuel Pastora-Bernal
Healthcare 2023, 11(13), 1970; https://doi.org/10.3390/healthcare11131970 - 07 Jul 2023
Cited by 1 | Viewed by 1180
Abstract
Long COVID syndrome has been recognized as a public health problem. Digital physiotherapy practice is an alternative that can better meet the needs of patients. The aim of this review was to synthesize the evidence of digital physiotherapy practice in Long COVID patients. [...] Read more.
Long COVID syndrome has been recognized as a public health problem. Digital physiotherapy practice is an alternative that can better meet the needs of patients. The aim of this review was to synthesize the evidence of digital physiotherapy practice in Long COVID patients. A systematic review was carried out until December 2022. The review was complemented by an assessment of the risk of bias and methodological quality. A narrative synthesis of results was conducted, including subgroup analyses by intervention and clinical outcomes. Six articles, including 540 participants, were selected. Five articles were considered of high enough methodological quality. Parallel-group, single-blind, randomized controlled trials were the most commonly used research design. Tele-supervised home-based exercise training was the most commonly used intervention. Great heterogeneity in clinical outcomes and measurement tools was found. A subgroup analysis showed that digital physiotherapy is effective in improving clinical outcomes. Significant differences in favor of digital interventions over usual care were reported. Nevertheless, discrepancies regarding effectiveness were found. Improvements in clinical outcomes with digital physiotherapy were found to be at least non-inferior to usual care. This review provides new evidence that digital physiotherapy practice is an appropriate intervention for Long COVID patients, despite the inherent limitations of the review. Registration: CRD42022379004. Full article
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12 pages, 2025 KiB  
Article
Digital Online Patient Informed Consent for Anesthesia before Elective Surgery—Recent Practice in Europe
by Claudia Neumann, Nadine Straßberger-Nerschbach, Achilles Delis, Johannes Kamp, Alexandra Görtzen-Patin, Dishalen Cudian, Andreas Fleischer, Götz Wietasch, Mark Coburn, Ehrenfried Schindler, Grigorij Schleifer and Maria Wittmann
Healthcare 2023, 11(13), 1942; https://doi.org/10.3390/healthcare11131942 - 05 Jul 2023
Viewed by 904
Abstract
Background: Digitalization in the health system is a topic that is rapidly gaining popularity, and not only because of the current pandemic. As in many areas of daily life, digitalization is becoming increasingly important in the medical field amid the exponential rise in [...] Read more.
Background: Digitalization in the health system is a topic that is rapidly gaining popularity, and not only because of the current pandemic. As in many areas of daily life, digitalization is becoming increasingly important in the medical field amid the exponential rise in the use of computers and smartphones. This opens up new possibilities for optimizing patient education in the context of anesthesia. The main aim of this study was to assess the implementation of remote consent in Europe. Methods: An online survey entitled “Digital online Patient Informed Consent for Anesthesia before Elective Surgery. Recent practice in Europe,” with a total of 27 questions, was sent by the European Society of Anesthesiology and Intensive Care (ESAIC) to their members in 47 European countries. To assess the effect of the economy on digitalization and legal status with regard to anesthesia consent, data were stratified based on gross domestic product per capita (GDPPC). Results: In total, 23.1% and 37.2% of the 930 participants indicated that it was possible to obtain consent online or via telephone, respectively. This observation was more often reported in countries with high GDPPC levels than in countries with low GDPPC levels. Furthermore, 27.3% of the responses for simple anesthesia, 18.7% of the responses for complex anesthesia, and 32.2% of the responses for repeated anesthesia indicated that remote consent was in accordance with the law, and this was especially prevalent in countries with high GDPPC. Concerning the timing of consent, patients were informed at least one day before in 67.1% of cases for simple procedures and in 85.2% of cases for complex procedures. Conclusion: Even European countries with high GDPPC use remote informed consent only in a minority of cases, and most of the time for repeated anesthetic procedures. This might reflect the inconsistent legal situation and inhomogeneous medical technical structures across Europe. Full article
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8 pages, 705 KiB  
Article
Pneumatic Compression Combined with Standard Treatment after Total Hip Arthroplasty and Its Effects on Edema of the Operated Limb and on Physical Outcomes: A Pilot Clinical Randomized Controlled Study
by Vittoria Carnevale Pellino, Alessandro Gatti, Matteo Vandoni, Pamela Patanè, Massimiliano Febbi, Stefania Ballarin, Caterina Cavallo and Luca Marin
J. Clin. Med. 2023, 12(12), 4164; https://doi.org/10.3390/jcm12124164 - 20 Jun 2023
Cited by 1 | Viewed by 1410
Abstract
Total hip arthroplasty (THA) is one of the most successful orthopedic procedures and is highly effective at improving function and quality of life. However, patients commonly experience edema immediately after hospitalization and also after discharge, which can lead to health consequences and a [...] Read more.
Total hip arthroplasty (THA) is one of the most successful orthopedic procedures and is highly effective at improving function and quality of life. However, patients commonly experience edema immediately after hospitalization and also after discharge, which can lead to health consequences and a lower quality of life. For these reasons, the aim of this study (NCT05312060) was to evaluate the effectiveness of a specific intermittent leg pneumatic compression on lower limb edema and physical outcomes in patients after total hip arthroplasty, compared to standard conservative treatment. A total of 47 patients were enrolled and randomly allocated into two groups: the pneumatic compression group (PG = 24) and the control group (CG = 23). The CG performed the standard venous thromboembolism therapy, which included pharmacological prophylaxis, compressive stockings, and electrostimulation, while the PG combined pneumatic compression with standard VTE therapy. We evaluated thigh and calf circumferences, knee and ankle ranges of motion, pain, and walking autonomy. Our results showed a greater reduction in thigh and calf circumferences for PG (p < 0.001), while other outcomes were similar for the two groups (p > 0.05). The combination of standard therapy with pneumatic leg compression was more effective at reducing lower limb edema and thigh and calf circumferences than standard treatment. Our results suggest that pressotherapy treatment is a valuable and efficient option for managing lower limb edema after THA. Full article
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24 pages, 427 KiB  
Article
Putting the Gaming Experience at the Center of the Therapy—The Video Game Therapy® Approach
by Francesco Bocci, Ambra Ferrari and Marcello Sarini
Healthcare 2023, 11(12), 1767; https://doi.org/10.3390/healthcare11121767 - 15 Jun 2023
Cited by 1 | Viewed by 11438
Abstract
Video games have been increasingly used as a form of therapy for various mental health conditions. Research has shown that video games can be used to treat conditions such as depression, anxiety, PTSD, and addiction. One of the main benefits of video games [...] Read more.
Video games have been increasingly used as a form of therapy for various mental health conditions. Research has shown that video games can be used to treat conditions such as depression, anxiety, PTSD, and addiction. One of the main benefits of video games in therapy is that they can provide a sense of engagement and immersion that traditional therapy methods may lack. Additionally, video games can teach valuable skills such as problem solving, decision making, and coping strategies. Video games can also simulate real-life scenarios, allowing individuals to practice and improve social skills in a safe and controlled environment. Furthermore, video games can provide feedback and track progress objectively and quantifiably. This paper proposes an approach, the Video Game Therapy® (VGT®) approach, where game experience is put at the center of the therapy in a tailored way, connecting the individual patient’s personality, the therapy’s goals, and the suggested type of video game through the Myers Briggs Type Indicator (MBTI).VGT®’s core assumption is that playing video games could facilitate patients in reaching conditions where traditional methodologies and therapeutic approaches could work best. VGT® was elaborated according to the Adlerian therapy vision and, consequently, the different phases of Adlerian therapy and VGT® match. Despite the use of video games in psychotherapy might have some adverse effects in specific cases, VGT® is currently used in three associations with positive results in promoting emotional experimentation and literacy, social feeling, sense of identity, and activating cognitive processes. Future developments include expanding the use of VGT® further to validate such results from a statistical point of view. Full article
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11 pages, 268 KiB  
Article
Psychiatric Nurses’ Knowledge and Practice Barriers to Administering Long-Acting Injectable (LAI) Antipsychotics in Taiwan: A Mixed-Methods Study
by Yao-Yu Lin, Wen-Li Hou and Mei-Ling Lin
Healthcare 2023, 11(12), 1670; https://doi.org/10.3390/healthcare11121670 - 06 Jun 2023
Viewed by 1076
Abstract
Long-acting antipsychotic injections require that psychiatric nurses choose the proper injection site and technique to avoid harming patients. This research conducted a mixed-method study to examine the long-acting injectable antipsychotic (LAI) knowledge, practice, and administrative barriers in a sample of 269 psychiatric nurses [...] Read more.
Long-acting antipsychotic injections require that psychiatric nurses choose the proper injection site and technique to avoid harming patients. This research conducted a mixed-method study to examine the long-acting injectable antipsychotic (LAI) knowledge, practice, and administrative barriers in a sample of 269 psychiatric nurses from 3 public psychiatric hospitals in Taiwan. Self-report questionnaires showed female nurses exhibiting higher scores and older nurses demonstrating more knowledge. The dorsogluteal (DG) site was the most widely used for injections, with 57.6% of nurses using the Z-track method. Qualitative data analysis was performed on 20 psychiatric nurses who chose the DG site as their preferred injection site. There were two key themes. The first was a gap between the nurses’ knowledge of LAI administration and their actual practice. The second needed more confidence and training in using the ventrogluteal injection site. These results highlight the need for continued education and training to improve LAI practice among psychiatric nurses. Full article
9 pages, 562 KiB  
Article
Perinatal Outcome of Singletons Born after Using a Simplified Low-Cost IVF Culture System and All Singletons Born in Flanders (Belgium) between 2012 and 2020
by Willem Ombelet, Régine Goemaes, Elizaveta Fomenko and Rudi Campo
J. Clin. Med. 2023, 12(11), 3683; https://doi.org/10.3390/jcm12113683 - 26 May 2023
Viewed by 1068
Abstract
Background: We developed a simplified IVF culture system (SCS) which has proven to be effective and safe in a selected IVF cohort. Methods: Preterm birth (PTB) and low birth weight (LBW) of 175 singletons born after using the SCS, 104 after fresh embryo [...] Read more.
Background: We developed a simplified IVF culture system (SCS) which has proven to be effective and safe in a selected IVF cohort. Methods: Preterm birth (PTB) and low birth weight (LBW) of 175 singletons born after using the SCS, 104 after fresh embryo transfer (ET), and 71 after frozen embryo transfer, were compared with all singletons born in Flanders between 2012 and 2020 conceived after natural conception, ovarian stimulation (OS), and assisted reproduction (IVF/ICSI). Findings: The proportion of preterm (<37 weeks) births was significantly higher in the case of IVF or ICSI, followed by hormonal treatment, compared to spontaneous pregnancies. There was no significant difference in PTB between SCS and any of the other groups. Concerning the average birth weight we found no significant difference between singletons born after natural conception and SCS. However, a significant difference in average birth weight was found between SCS singletons and singletons born after IVF, ICSI and hormonal treatment, with a significantly higher birth weight in the SCS group. This difference was also observed in the proportion of babies weighing less than 2500 g, with significantly more LBW babies in the IVF and ICSI group compared to the SCS newborns. Interpretation: Taking into account the small series, PTB and LBW rates in SCS singletons were found to be comparable with singletons born after natural conception. Compared to babies born after ovarian stimulation and IVF/ICSI, SCS singletons had a lower PTB and LBW rates, although the differences were not significant for PTB. Our results confirm previous reports on reassuring perinatal outcomes after using the SCS technology. Full article
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11 pages, 2259 KiB  
Article
Reliability and Validity of a Portable Traction Dynamometer in Knee-Strength Extension Tests: An Isometric Strength Assessment in Recreationally Active Men
by Danielle Garcia, Ivo Vieira de Sousa Neto, Yuri de Souza Monteiro, Denis Pinheiro Magalhães, Gleison Miguel Lissemerki Ferreira, Roberto Grisa, Jonato Prestes, Bruno Viana Rosa, Odilon Abrahin, Tatiane Meire Martins, Samuel Estevam Vidal, Rosimeire de Moura Andrade, Rodrigo Souza Celes, Nicholas Rolnick and Dahan da Cunha Nascimento
Healthcare 2023, 11(10), 1466; https://doi.org/10.3390/healthcare11101466 - 18 May 2023
Cited by 1 | Viewed by 1647
Abstract
Background: the study determined the validity and reliability of measurements obtained using the portable traction dynamometer (PTD) (E-Lastic, E-Sports Solutions, Brazil) and the reproducibility between evaluators (precision) in the evaluation of the isometric muscle strength of the knee extensors of healthy male adults, [...] Read more.
Background: the study determined the validity and reliability of measurements obtained using the portable traction dynamometer (PTD) (E-Lastic, E-Sports Solutions, Brazil) and the reproducibility between evaluators (precision) in the evaluation of the isometric muscle strength of the knee extensors of healthy male adults, compared to measurements obtained with the “gold standard” computerized dynamometer (CD) (Biodex System 3, Nova York, NY, USA). Methods: we evaluated sixteen recreationally active men (29.50 ± 7.26 years). The test–retest reliability of both equipment to determine quadriceps strength, agreement analysis, and the minimal important difference were verified. Results: excellent test–retest interrater reliability was observed for absolute and relative measurements, with a low absolute error for both sets of equipment and excellent validity of the PTD against the CD, as verified by linear regression and Pearson’s correlation coefficient. Conclusions: PTD is a valid and reliable instrument for assessing the isometric strength of knee extensors, with results similar to the isometric CD “gold standard”. Full article
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Project Report
Assessing and Improving Provider Knowledge for a Cardiothoracic Intensive Care Unit Electronic Dashboard Initiative
by April Garlejo, Jacob Bonner, Ashley Paddock, John Park, Nolan Lyda, Ahmed Zaky and Susan McMullan
Healthcare 2023, 11(8), 1136; https://doi.org/10.3390/healthcare11081136 - 15 Apr 2023
Viewed by 1249
Abstract
Background: Electronic dashboards measure intensive care unit (ICU) performance by tracking quality indicators, especially pinpointing sub-standard metrics. This helps ICUs scrutinize and change current practices in an effort to improve failing metrics. However, its technological value is lost if end users are unaware [...] Read more.
Background: Electronic dashboards measure intensive care unit (ICU) performance by tracking quality indicators, especially pinpointing sub-standard metrics. This helps ICUs scrutinize and change current practices in an effort to improve failing metrics. However, its technological value is lost if end users are unaware of its importance. This results in decreased staff participation, leading to unsuccessful initiation of the dashboard. Therefore, the purpose of this project was to improve cardiothoracic ICU providers’ understanding of electronic dashboards by providing an educational training bundle in preparation for an electronic dashboard initiation. Methods: A Likert survey assessing providers’ knowledge, attitudes, skills, and application of electronic dashboards was conducted. Subsequently, an educational training bundle, consisting of a digital flier and laminated pamphlets, was made available to providers for four months. After bundle review, providers were assessed using the same pre-bundle Likert survey. Results: A comparison of summated scores from pre-bundle (mean = 38.75) and post-bundle surveys (mean = 46.13) yielded an increased summated score overall (mean = 7.38, p ≤ 0.001). Conclusion: An educational bundle improved providers’ understanding and increased their likelihood of using electronic dashboards upon its initiation. Further studies are needed to continue increasing staff participation such as providing specific education to navigate the interface for data retrieval and interpretation. Full article
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