Smart Healthcare: Technologies and Applications

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Healthcare healthcare	2.8	2.7	2013	19.5 Days	CHF 2700
International Journal of Environmental Research and Public Health ijerph	-	5.4	2004	29.6 Days	CHF 2500
Journal of Clinical Medicine jcm	3.9	5.4	2012	17.9 Days	CHF 2600
Journal of Personalized Medicine jpm	3.4	2.6	2011	17.8 Days	CHF 2600
Applied Sciences applsci	2.7	4.5	2011	16.9 Days	CHF 2400
Technologies technologies	3.6	5.5	2013	19.7 Days	CHF 1600

12 pages, 1418 KiB

Open AccessArticle

Development and Evaluation of a New Self-Administered Near Visual Acuity Chart: Accuracy and Feasibility of Usage

by Hadas Ben-Eli, Eyal Banin, Jaime Levy, Miryam Glik, Sarah Afriat, Yasmin Magal, Rivka Harari, Aviya Benyamin, Shira Shein and Itay Chowers

J. Clin. Med. 2024, 13(7), 2064; https://doi.org/10.3390/jcm13072064 - 02 Apr 2024

Viewed by 583

Abstract

Background: Visual acuity (VA) assessments are crucial in ophthalmology but traditionally rely on in-clinic evaluations. The emergence of telemedicine has spurred interest in creating dependable self-administered VA tests for use beyond standard clinical environments. This study evaluated the practicality and validity of [...] Read more.

Background: Visual acuity (VA) assessments are crucial in ophthalmology but traditionally rely on in-clinic evaluations. The emergence of telemedicine has spurred interest in creating dependable self-administered VA tests for use beyond standard clinical environments. This study evaluated the practicality and validity of a self-administered near VA card test against traditional Snellen and Rosenbaum Pocket Vision Screener (RPVS) methods for home monitoring and enhancing clinical workflow. Methods: In a cross-sectional study, a near VA card (Hadassah Self-Visual Acuity Screener (HSVA)) was developed with written and videotaped instructions for self-use. Patients with a minimal best-corrected VA (BCVA) of 1.0 LogMAR in at least one eye were recruited from ophthalmology and optometry clinics. Outcomes included the mean BCVA difference between the self-administered values and those obtained by the examiner, and correlations between BCVA values obtained by the Snellen, RPVS, HSVA, and previous distance BCVA methods according to the patients’ electronic medical records. Results: A total of 275 participants (mean age: 42.5 ± 19.4 years; range: 18–89 years; 47% female) were included. Test–retest reliability analysis of the HSVA demonstrated a very good correlation and repeatability (n = 38 patients; Rs = 1.0; p < 0.001). Accuracy analysis revealed the mean LogMAR BCVA values of an additional 237 patients obtained by the Snellen, RPVS, and HSVA methods were similar (p = 0.10). The self-test BCVA results obtained by the HSVA agreed with the masked examiner-tested VA results (n = 67 patients; p = 0.17; Rs = 0.87; ICC = 0.96). Similar results were obtained when stratification by median age (42 years) was performed. Bland–Altman analysis of the HSVA and RPVS methods demonstrated a good agreement. To assess whether the HSVA could predict the VA results in the clinically used charts, multivariate analysis was used and revealed that the HSVA predicted the RPVS results (β = 0.91; p = 0.001; R² = 0.88), and the self-test HSVA predicted the Snellen VA results within two lines (β = 0.93; p = 0.01; R² = 0.36). Conclusions: The home-based HSVA assessment exhibited high test–retest reliability, accuracy, and alignment with clinical-standard VA tests. Its efficacy in self-testing mirrored examiner-conducted VA assessments and accurately predicted Snellen VA outcomes, indicating the HSVA’s suitability for self-monitoring in chronic ocular conditions or when access to conventional examinations is limited. The utility of self-administered VA tests may extend beyond ophthalmology and optometry, potentially benefiting primary care, emergency medicine, and neurology. Further research is needed to explore and validate the practical applications of remote VA testing. Full article

(This article belongs to the Topic Smart Healthcare: Technologies and Applications)

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24 pages, 1084 KiB

Open AccessReview

An Architectural Solution to a Biological Problem: A Systematic Review of Lighting Designs in Healthcare Environments

by Seyedeh Nazli Hosseini, James C. Walton, Iman SheikhAnsari, Nicole Kreidler and Randy J. Nelson

Appl. Sci. 2024, 14(7), 2945; https://doi.org/10.3390/app14072945 - 31 Mar 2024

Viewed by 490

Abstract

Neuroscience and biological evidence emphasizes the profound influence of natural light on human health, offering benefits such as reducing fatigue, heightened alertness in healthcare providers, and improving patient outcomes. The objective of this review is to identify scientific studies and research to evaluate [...] Read more.

Neuroscience and biological evidence emphasizes the profound influence of natural light on human health, offering benefits such as reducing fatigue, heightened alertness in healthcare providers, and improving patient outcomes. The objective of this review is to identify scientific studies and research to evaluate and report evidence of indoor lighting conditions’ influence on health outcomes, which can be used to develop lighting designs that align circadian rhythms in healthcare settings. A comprehensive search was conducted to identify rigorous empirical studies focused on the link between interior lighting conditions with health outcomes in the healthcare environment. For a comprehensive review of the existing literature, a four-phased methodology was employed including literature search, screening, and selection. Literature appraisals were conducted to determine the relevance and quality of evidence for each study identified. In addition, using a thematic analysis, patterns were identified, analyzed, and interpreted within the literature review. Accordingly, the results were organized into two main groups interventional human subjects and simulation-based studies. Despite evidence that natural light influences human health and happiness, a synthesis of reviewed studies suggests that the evidence for the benefits of artificial lighting in healthcare settings is less conclusive, with potential factors including variations in lighting design, inconsistent implementation of lighting interventions, and differing sample populations across studies. We conclude with an executive summary suggesting that future research should use standardized metrics and methods to focus on bridging the gap between theoretical understanding and practical application in lighting design for healthcare environments. Collaboration among architects, designers, lighting experts, and healthcare professionals can address these factors contributing to building a stronger evidence-based design for the benefits of artificial lighting in healthcare settings. Full article

(This article belongs to the Topic Smart Healthcare: Technologies and Applications)

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16 pages, 2761 KiB

Open AccessArticle

Enhancing Patient Care in Radiotherapy: Proof-of-Concept of a Monitoring Tool

by Guillaume Beldjoudi, Rémi Eugène, Vincent Grégoire and Ronan Tanguy

Technologies 2024, 12(4), 46; https://doi.org/10.3390/technologies12040046 - 29 Mar 2024

Viewed by 535

Abstract

Introduction: A monitoring tool, named Oncology Data Management (ODM), was developed in radiotherapy to generate structured information based on data contained in an Oncology Information System (OIS). This study presents the proof-of-concept of the ODM tool and highlights its applications to enhance patient [...] Read more.

Introduction: A monitoring tool, named Oncology Data Management (ODM), was developed in radiotherapy to generate structured information based on data contained in an Oncology Information System (OIS). This study presents the proof-of-concept of the ODM tool and highlights its applications to enhance patient care in radiotherapy. Material & Methods: ODM is a sophisticated SQL query which extracts specific features from the Mosaiq OIS (Elekta, UK) database into an independent structured database. Data from 2016 to 2022 was extracted to enable monitoring of treatment units and evaluation of the quality of patient care. Results: A total of 25,259 treatments were extracted. Treatment machine monitoring revealed a daily 11-treatement difference between two units. ODM showed that the unit with fewer daily treatments performed more complex treatments on diverse locations. In 2019, the implementation of ODM led to the definition of quality indicators and in organizational changes that improved the quality of care. As consequences, for palliative treatments, there was an improvement in the proportion of treatments prepared within 7 calendar days between the scanner and the first treatment session (29.1% before 2020, 40.4% in 2020 and 46.4% after 2020). The study of fractionation in breast treatments exhibited decreased prescription variability after 2019, with distinct patient age categories. Bi-fractionation once a week for larynx prescriptions of 35 × 2.0 Gy achieved an overall treatment duration of 47.0 ± 3.0 calendar days in 2022. Conclusions: ODM enables data extraction from the OIS and provides quantitative tools for improving organization of a department and the quality of patient care in radiotherapy. Full article

(This article belongs to the Topic Smart Healthcare: Technologies and Applications)

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14 pages, 2856 KiB

Open AccessArticle

A Comparison between Kinematic Models for Robotic Needle Insertion with Application into Transperineal Prostate Biopsy

by Chiara Zandonà, Andrea Roberti, Davide Costanzi, Burçin Gül, Özge Akbulut, Paolo Fiorini and Andrea Calanca

Technologies 2024, 12(3), 33; https://doi.org/10.3390/technologies12030033 - 01 Mar 2024

Viewed by 1213

Abstract

Transperineal prostate biopsy is the most reliable technique for detecting prostate cancer, and robot-assisted needle insertion has the potential to improve the accuracy of this procedure. Modeling the interaction between a bevel-tip needle and the tissue, considering tissue heterogeneity, needle bending, and tissue/organ [...] Read more.

Transperineal prostate biopsy is the most reliable technique for detecting prostate cancer, and robot-assisted needle insertion has the potential to improve the accuracy of this procedure. Modeling the interaction between a bevel-tip needle and the tissue, considering tissue heterogeneity, needle bending, and tissue/organ deformation and movement is a required step to enable robotic needle insertion. Even if several models exist, they have never been compared on experimental grounds. Based on this motivation, this paper proposes an experimental comparison for kinematic models of needle insertion, considering different needle insertion speeds and different degrees of tissue stiffness. The experimental comparison considers automated insertions of needles into transparent silicone phantoms under stereo-image guidance. The comparison evaluates the accuracy of existing models in predicting needle deformation. Full article

(This article belongs to the Topic Smart Healthcare: Technologies and Applications)

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10 pages, 296 KiB

Open AccessArticle

Telehealth Intervention: A Proposal for a Telemedicine Manual to Ascertain the Civil Disability Status in Italy

by Nicola Di Fazio, Giuseppe Delogu, Donato Morena, Eugenia Carfora, Dalila Tripi, Raffaella Rinaldi, Paola Frati and Vittorio Fineschi

Int. J. Environ. Res. Public Health 2024, 21(3), 253; https://doi.org/10.3390/ijerph21030253 - 22 Feb 2024

Viewed by 1055

Abstract

(1) This paper aims to propose a telematic method for assessing the state of disability by a social worker member of the Medico-Legal Commissions of INPS. (2) We have proceeded to delve into and compare the current methods with new strategies to enhance [...] Read more.

(1) This paper aims to propose a telematic method for assessing the state of disability by a social worker member of the Medico-Legal Commissions of INPS. (2) We have proceeded to delve into and compare the current methods with new strategies to enhance the experience linked to the assessment of the status of disability in terms of timing and accessibility, eliminating the need for a direct visit. (3) The proposed protocol can be applied in cases where patients cannot be physically moved, following a medical visit at home, and when the mere evaluation of documents is sufficient. In both cases, a remote session with the Commission is necessary to fill in the required information about the socio-environmental section. This protocol can be applied to different platforms such as Skype™ since it is free and widely used throughout the country. (4) It should be noted that telemedicine solutions cannot completely replace face-to-face interaction; however, in some limited cases, they can optimize the process and timing, avoiding the need to move or interact only by telephone. Full article

(This article belongs to the Topic Smart Healthcare: Technologies and Applications)

21 pages, 2680 KiB

Open AccessStudy Protocol

Exploring the Remediation of Behavioral Disturbances of Spatial Cognition in Community-Dwelling Senior Citizens with Mild Cognitive Impairment via Innovative Technological Apparatus (BDSC-MCI Project): Protocol for a Prospective, Multi-Center Observational Study

by Davide Maria Cammisuli, Cosimo Tuena, Giuseppe Riva, Claudia Repetto, Nikolai Axmacher, Varnan Chandreswaran, Valeria Isella, Simone Pomati, Stefano Zago, Teresa Difonzo, Giada Pavanello, Lorenzo Augusto Prete, Marco Stramba-Badiale, Alessandro Mauro, Stefania Cattaldo and Gianluca Castelnuovo

J. Pers. Med. 2024, 14(2), 192; https://doi.org/10.3390/jpm14020192 - 08 Feb 2024

Viewed by 1193

Abstract

Spatial navigation (SN) has been reported to be one of the first cognitive domains to be affected in Alzheimer’s disease (AD), which occurs as a result of progressive neuropathology involving specific brain areas. Moreover, the epsilon 4 isoform of apolipoprotein-E (APOE-ε4) has been [...] Read more.

Spatial navigation (SN) has been reported to be one of the first cognitive domains to be affected in Alzheimer’s disease (AD), which occurs as a result of progressive neuropathology involving specific brain areas. Moreover, the epsilon 4 isoform of apolipoprotein-E (APOE-ε4) has been associated with both sporadic and familial late-onset AD, and patients with mild cognitive impairment (MCI) due to AD are more likely to progressively deteriorate. Spatial navigation performance will be examined on a sample of 76 community-dwelling senior citizens (25 healthy controls; 25 individuals with subjective cognitive decline (SCD); and 26 patients with MCI due to AD) via a virtual computer-based task (i.e., the AppleGame) and a naturalistic task (i.e., the Detour Navigation Test—modified version) for which a wearable device with sensors will be used for recording gait data and revealing physiological parameters that may be associated with spatial disorientation. We expect that patients with MCI due to AD and APOE-ε4 carriers will show altered SN performances compared to individuals with SCD and healthy controls in the experimental tasks, and that VR testing may predict ecological performance. Impaired SN performances in people at increased risk of developing AD may inform future cognitive rehabilitation protocols for counteracting spatial disorientation that may occur during elders’ traveling to unfamiliar locations. The research protocol has been approved by the Ethics Committee of the Istituto Auxologico Italiano. Findings will be published in peer-reviewed medical journals and discussed in national and international congresses. Full article

(This article belongs to the Topic Smart Healthcare: Technologies and Applications)

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37 pages, 14719 KiB

Open AccessReview

Comprehensive Study of Compression and Texture Integration for Digital Imaging and Communications in Medicine Data Analysis

by Amit Kumar Shakya and Anurag Vidyarthi

Technologies 2024, 12(2), 17; https://doi.org/10.3390/technologies12020017 - 24 Jan 2024

Cited by 1 | Viewed by 1479

Abstract

In response to the COVID-19 pandemic and its strain on healthcare resources, this study presents a comprehensive review of various techniques that can be used to integrate image compression techniques and statistical texture analysis to optimize the storage of Digital Imaging and Communications [...] Read more.

In response to the COVID-19 pandemic and its strain on healthcare resources, this study presents a comprehensive review of various techniques that can be used to integrate image compression techniques and statistical texture analysis to optimize the storage of Digital Imaging and Communications in Medicine (DICOM) files. In evaluating four predominant image compression algorithms, i.e., discrete cosine transform (DCT), discrete wavelet transform (DWT), the fractal compression algorithm (FCA), and the vector quantization algorithm (VQA), this study focuses on their ability to compress data while preserving essential texture features such as contrast, correlation, angular second moment (ASM), and inverse difference moment (IDM). A pivotal observation concerns the direction-independent Grey Level Co-occurrence Matrix (GLCM) in DICOM analysis, which reveals intriguing variations between two intermediate scans measured with texture characteristics. Performance-wise, the DCT, DWT, FCA, and VQA algorithms achieved minimum compression ratios (CRs) of 27.87, 37.91, 33.26, and 27.39, respectively, with maximum CRs at 34.48, 68.96, 60.60, and 38.74. This study also undertook a statistical analysis of distinct CT chest scans from COVID-19 patients, highlighting evolving texture patterns. Finally, this work underscores the potential of coupling image compression and texture feature quantification for monitoring changes related to human chest conditions, offering a promising avenue for efficient storage and diagnostic assessment of critical medical imaging. Full article

(This article belongs to the Topic Smart Healthcare: Technologies and Applications)

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24 pages, 4277 KiB

Open AccessArticle

An Advanced Solution Based on Machine Learning for Remote EMDR Therapy

by Francesca Fiani, Samuele Russo and Christian Napoli

Technologies 2023, 11(6), 172; https://doi.org/10.3390/technologies11060172 - 06 Dec 2023

Viewed by 1624

Abstract

For this work, a preliminary study proposed virtual interfaces for remote psychotherapy and psychology practices. This study aimed to verify the efficacy of such approaches in obtaining results comparable to in-presence psychotherapy, when the therapist is physically present in the room. In particular, [...] Read more.

For this work, a preliminary study proposed virtual interfaces for remote psychotherapy and psychology practices. This study aimed to verify the efficacy of such approaches in obtaining results comparable to in-presence psychotherapy, when the therapist is physically present in the room. In particular, we implemented several joint machine-learning techniques for distance detection, camera calibration and eye tracking, assembled to create a full virtual environment for the execution of a psychological protocol for a self-induced mindfulness meditative state. Notably, such a protocol is also applicable for the desensitization phase of EMDR therapy. This preliminary study has proven that, compared to a simple control task, such as filling in a questionnaire, the application of the mindfulness protocol in a fully virtual setting greatly improves concentration and lowers stress for the subjects it has been tested on, therefore proving the efficacy of a remote approach when compared to an in-presence one. This opens up the possibility of deepening the study, to create a fully working interface which will be applicable in various on-field applications of psychotherapy where the presence of the therapist cannot be always guaranteed. Full article

(This article belongs to the Topic Smart Healthcare: Technologies and Applications)

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13 pages, 5279 KiB

Open AccessArticle

Immersive VR (Virtual Reality) Simulator for Vein Blood Sampling

by Jun-Seong Kim, Kun-Woo Kim, Seong-Won Yang, Joong-Wha Chung and Seong-Yong Moon

Technologies 2023, 11(6), 158; https://doi.org/10.3390/technologies11060158 - 08 Nov 2023

Viewed by 1858

Abstract

Vein blood sampling is a method of mass blood sampling that involves drawing blood from a vein for blood type discrimination, confirmation of various physiological indicators, disease diagnosis, etc.; it is the most commonly used blood sampling method. An important aspect of vein [...] Read more.

Vein blood sampling is a method of mass blood sampling that involves drawing blood from a vein for blood type discrimination, confirmation of various physiological indicators, disease diagnosis, etc.; it is the most commonly used blood sampling method. An important aspect of vein blood sampling is the search for the exact location of the vein for insertion of the syringe to draw blood. This is influenced by obesity as well as skin and blood vessel conditions in the patient and the experience of the clinical technologist, nurse, and resident who performs the blood sampling. Frequent practice is required to effectively perform blood sampling techniques. However, due to the many limitations of the practice room or laboratory, there is a problem of using only a limited environment and model for clinical practice. As a result, many medical educational institutions have situations in which only fragmentary clinical practices are performed, and it is difficult to practice many blood sampling skills, so they do not provide enough experience to understand the actual skill field. In this paper, we propose a virtual-reality-based vein blood sampling simulator that allows the practice of blood sampling techniques without limitation. The proposed vein blood sampling simulator can operate a 3D model related to vein blood sampling using an HMD controller and a haptic device in a virtual space for vein blood sampling practice by wearing an HMD (head-mounted display). Vein blood sampling can also be practiced through interaction with the patient 3D model. In addition, the effectiveness of a simulator developed for dental students was verified, and as a result of the verification, the potential of the proposed vein blood sampling simulator was confirmed. Full article

(This article belongs to the Topic Smart Healthcare: Technologies and Applications)

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10 pages, 1336 KiB

Open AccessArticle

Comparing Performance and Preference of Visually Impaired Individuals in Object Localization: Tactile, Verbal, and Sonification Cueing Modalities

by Shatha Abu Rass, Omer Cohen, Eliav Bareli and Sigal Portnoy

Technologies 2023, 11(5), 127; https://doi.org/10.3390/technologies11050127 - 16 Sep 2023

Viewed by 1301

Abstract

Audio guidance is a common means of helping visually impaired individuals to navigate, thereby increasing their independence. However, the differences between different guidance modalities for locating objects in 3D space have yet to be investigated. The aim of this study was to compare [...] Read more.

Audio guidance is a common means of helping visually impaired individuals to navigate, thereby increasing their independence. However, the differences between different guidance modalities for locating objects in 3D space have yet to be investigated. The aim of this study was to compare the time, the hand’s path length, and the satisfaction levels of visually impaired individuals using three automatic cueing modalities: pitch sonification, verbal, and vibration. We recruited 30 visually impaired individuals (11 women, average age 39.6 ± 15.0), who were asked to locate a small cube, guided by one of three cueing modalities: sonification (a continuous beep that increases in frequency as the hand approaches the cube), verbal prompting (“right”, “forward”, etc.), and vibration (via five motors, attached to different locations on the hand). The three cueing modalities were automatically activated by computerized motion capture systems. The subjects separately answered satisfaction questions for each cueing modality. The main finding was that the time to find the cube was longer using the sonification cueing (p = 0.016). There were no significant differences in the hand path length or the subjects’ satisfaction. It can be concluded that verbal guidance may be the most effective for guiding people with visual impairment to locate an object in a 3D space. Full article

(This article belongs to the Topic Smart Healthcare: Technologies and Applications)

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14 pages, 1928 KiB

Open AccessArticle

Implementing Innovative Approaches to Improve Health Care Delivery Systems for Integrating Communicable and Non-Communicable Diseases Using Tuberculosis and Diabetes as a Model in Tanzania

by Stellah G. Mpagama, Kenneth C. Byashalira, Nyasatu G. Chamba, Scott K. Heysell, Mohamed Z. Alimohamed, Pendomartha J. Shayo, Albino Kalolo, Anna M. Chongolo, Catherine G. Gitige, Blandina T. Mmbaga, Nyanda E. Ntinginya, Jan-Willem C. Alffenaar, Ib C. Bygbjerg, Troels Lillebaek, Dirk L. Christensen and Kaushik L. Ramaiya

Int. J. Environ. Res. Public Health 2023, 20(17), 6670; https://doi.org/10.3390/ijerph20176670 - 29 Aug 2023

Viewed by 1635

Abstract

Background: Many evidence-based health interventions, particularly in low-income settings, have failed to deliver the expected impact. We designed an Adaptive Diseases Control Expert Programme in Tanzania (ADEPT) to address systemic challenges in health care delivery and examined the feasibility, acceptability and effectiveness of [...] Read more.

Background: Many evidence-based health interventions, particularly in low-income settings, have failed to deliver the expected impact. We designed an Adaptive Diseases Control Expert Programme in Tanzania (ADEPT) to address systemic challenges in health care delivery and examined the feasibility, acceptability and effectiveness of the model using tuberculosis (TB) and diabetes mellitus (DM) as a prototype. Methods: This was an effectiveness-implementation hybrid type-3 design that was implemented in Dar es Salaam, Iringa and Kilimanjaro regions. The strategy included a stepwise training approach with web-based platforms adapting the Gibbs’ reflective cycle. Health facilities with TB services were supplemented with DM diagnostics, including glycated haemoglobin A1c (HbA1c). The clinical audit was deployed as a measure of fidelity. Retrospective and cross-sectional designs were used to assess the fidelity, acceptability and feasibility of the model. Results: From 2019–2021, the clinical audit showed that ADEPT intervention health facilities more often identified median 8 (IQR 6–19) individuals with dual TB and DM, compared with control health facilities, median of 1 (IQR 0–3) (p = 0.02). Likewise, the clinical utility of HbA1c on intervention sites was 63% (IQR:35–75%) in TB/DM individuals compared to none in the control sites at all levels, whereas other components of the standard of clinical management of patients with dual TB and DM did not significantly differ. The health facilities showed no difference in screening for additional comorbidities such as hypertension and malnutrition. The stepwise training enrolled a total of 46 nurse officers and medical doctors/specialists for web-based training and 40 (87%) attended the workshop. Thirty-one (67%), 18 nurse officers and 13 medical doctors/specialists, implemented the second step of training others and yielded a total of 519 additional front-line health care workers trained: 371 nurses and 148 clinicians. Overall, the ADEPT model was scored as feasible by metrics applied to both front-line health care providers and health facilities. Conclusions: It was feasible to use a stepwise training and clinical audit to support the integration of TB and DM management and it was largely acceptable and effective in differing regions within Tanzania. When adapted in the Tanzania health system context, the model will likely improve quality of services. Full article

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12 pages, 1755 KiB

Open AccessArticle

Comparison of Drug-Related Problems in COVID-19 and Non-COVID-19 Patients Provided by a German Telepharmacy Service for Rural Intensive Care Units

by Joachim Andreas Koeck, Sandra Maria Dohmen, Gernot Marx and Albrecht Eisert

J. Clin. Med. 2023, 12(14), 4739; https://doi.org/10.3390/jcm12144739 - 18 Jul 2023

Cited by 1 | Viewed by 1192

Abstract

Telepharmacy is used to bridge the persisting shortage of specialist ward-based pharmacists, particularly in intensive care units (ICU). During the coronavirus disease 2019 (COVID-19), pharmacotherapy was rapidly developed, which resulted in multiple changes of guidelines. This potentially led to a differing risk for [...] Read more.

Telepharmacy is used to bridge the persisting shortage of specialist ward-based pharmacists, particularly in intensive care units (ICU). During the coronavirus disease 2019 (COVID-19), pharmacotherapy was rapidly developed, which resulted in multiple changes of guidelines. This potentially led to a differing risk for drug-related problems (DRPs) in ICUs. In this study, DRPs were detected in telepharmacy consultations of a German state-wide telemedicine network for adult patients in rural ICUs. The analysis included ICUs of ten general care hospitals with a total of 514 patients and 1056 consultations. The aim of this retrospective, observational cohort study was to compare and analyze the DRPs resulting from ICU patients with or without COVID-19. Furthermore, known risk groups for severe COVID-19 progression (organ insufficiency [kidney, liver], obesity, sex, and/or older age) were investigated with their non-COVID-19 counterparts. As a result, in both groups patients with acute renal insufficiency and without renal replacement therapy showed a significantly higher risk of being affected by one or more DRPs compared to patients with normal renal function. In COVID-19 patients, the initial recommendation of therapeutic anticoagulation (ATC-code B01AB ‘Heparin group’) resulted in significantly more DRPs compared to non-COVID-19 patients. Therefore, COVID-19 patients with therapeutic anticoagulation and all ICU patients with renal insufficiency should be prioritized for telepharmacy consultations. Full article

(This article belongs to the Topic Smart Healthcare: Technologies and Applications)

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8 pages, 7970 KiB

Open AccessCommunication

Navigation Guided Biopsy Is as Effective as Frame-Based Stereotactic Biopsy

by Dae Hyun Lim, So Yeon Kim, Young Cheol Na and Jin Mo Cho

J. Pers. Med. 2023, 13(5), 708; https://doi.org/10.3390/jpm13050708 - 23 Apr 2023

Viewed by 1586

Abstract

Background: Stereotactic biopsy is a standard procedure for brain biopsy. However, with advances in technology, navigation-guided brain biopsy has become a well-established alternative. Previous studies have shown that frameless stereotactic brain biopsy is as effective and safe as frame-based stereotactic brain biopsy is. [...] Read more.

Background: Stereotactic biopsy is a standard procedure for brain biopsy. However, with advances in technology, navigation-guided brain biopsy has become a well-established alternative. Previous studies have shown that frameless stereotactic brain biopsy is as effective and safe as frame-based stereotactic brain biopsy is. In this study, the authors evaluate the diagnostic yield and complication rate of frameless intracranial biopsy. Materials and Methods: We reviewed data from biopsy performed patients between March 2014 and April 2022. We retrospectively reviewed medical records, including imaging studies. Various intracerebral lesions were biopsied. Diagnostic yield and post-operative complications were compared with those of frame-based stereotactic biopsy. Results: Forty-two frameless navigation-guided biopsy were performed, and the most common pathology was primary central nervous system lymphoma (35.7%), followed by glioblastoma (33.3%), and anaplastic astrocytomas (16.7%), respectively. The diagnostic yield was 100%. Post-operative intracerebral hematoma occurred in 2.4% of cases, but it was not symptomatic. Thirty patients underwent frame-based stereotactic biopsy, and the diagnostic yield was 96.7%. There was no difference in diagnostic rates between two methods (Fisher’s exact test, p = 0.916). Conclusions: Frameless navigation-guided biopsy is as effective as frame-based stereotactic biopsy is, without causing further complications. We consider that frame-based stereotactic biopsy is no longer needed if frameless navigation-guided biopsy is used. A further study will be needed to generalize our results. Full article

(This article belongs to the Topic Smart Healthcare: Technologies and Applications)

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7 pages, 3930 KiB

Open AccessCommunication

Digital Workflow for Producing Hybrid Posts and Cores

by Paula Perlea, Cosmin Stefanescu, Omar-Andrei Al-Aloul, Cezar Ionita and Alexandru-Eugen Petre

Healthcare 2023, 11(5), 727; https://doi.org/10.3390/healthcare11050727 - 02 Mar 2023

Viewed by 1208

Abstract

A novel and straightforward digital workflow is described to aid clinicians in producing in-office hybrid posts and cores. The method is based on scanning and using the basic module of a computer-assisted design and computer-assisted manufacturing (CAD-CAM) software program for dental applications. The [...] Read more.

A novel and straightforward digital workflow is described to aid clinicians in producing in-office hybrid posts and cores. The method is based on scanning and using the basic module of a computer-assisted design and computer-assisted manufacturing (CAD-CAM) software program for dental applications. The applicability of the technique in a digital workflow is the simplicity of in-office production of a hybrid post and core that can be delivered to the patient in the same day. Full article

(This article belongs to the Topic Smart Healthcare: Technologies and Applications)

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19 pages, 1487 KiB

Open AccessArticle

End-User Assessment of an Innovative Clothing-Based Sensor Developed for Pressure Injury Prevention: A Mixed-Method Study

by Anderson S. Rêgo, Luísa Filipe, Rosana A. Dias, Filipe S. Alves, José Queiroz, Alar Ainla, Luísa M. Arruda, Raul Fangueiro, Maria Bouçanova, Rafael A. Bernardes, Liliana B. de Sousa, Paulo Santos-Costa, João A. Apóstolo, Pedro Parreira and Anabela Salgueiro-Oliveira

Int. J. Environ. Res. Public Health 2023, 20(5), 4039; https://doi.org/10.3390/ijerph20054039 - 24 Feb 2023

Cited by 3 | Viewed by 2928

Abstract

This study aimed to evaluate a clothing prototype that incorporates sensors for the evaluation of pressure, temperature, and humidity for the prevention of pressure injuries, namely regarding physical and comfort requirements. A mixed-method approach was used with concurrent quantitative and qualitative data triangulation. [...] Read more.

This study aimed to evaluate a clothing prototype that incorporates sensors for the evaluation of pressure, temperature, and humidity for the prevention of pressure injuries, namely regarding physical and comfort requirements. A mixed-method approach was used with concurrent quantitative and qualitative data triangulation. A structured questionnaire was applied before a focus group of experts to evaluate the sensor prototypes. Data were analyzed using descriptive and inferential statistics and the discourse of the collective subject, followed by method integration and meta-inferences. Nine nurses, experts in this topic, aged 32.66 ± 6.28 years and with a time of profession of 10.88 ± 6.19 years, participated in the study. Prototype A presented low evaluation in stiffness (1.56 ± 1.01) and roughness (2.11 ± 1.17). Prototype B showed smaller values in dimension (2.77 ± 0.83) and stiffness (3.00 ± 1.22). Embroidery was assessed as inadequate in terms of stiffness (1.88 ± 1.05) and roughness (2.44 ± 1.01). The results from the questionnaires and focus groups’ show low adequacy as to stiffness, roughness, and comfort. The participants highlighted the need for improvements regarding stiffness and comfort, suggesting new proposals for the development of sensors for clothing. The main conclusions are that Prototype A presented the lowest average scores relative to rigidity (1.56 ± 1.01), considered inadequate. This dimension of Prototype B was evaluated as slightly adequate (2.77 ± 0.83). The rigidity (1.88 ± 1.05) of Prototype A + B + embroidery was evaluated as inadequate. The prototype revealed clothing sensors with low adequacy regarding the physical requirements, such as stiffness or roughness. Improvements are needed regarding the stiffness and roughness for the safety and comfort characteristics of the device evaluated. Full article

(This article belongs to the Topic Smart Healthcare: Technologies and Applications)

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11 pages, 4532 KiB

Open AccessArticle

A Novel System for the Detection of Spontaneous Abortion-Causing Aneuploidy and Its Erroneous Chromosome Origins through the Combination of Low-Pass Copy Number Variation Sequencing and NGS-Based STR Tests

by Caixia Lei, Kai Liao, Yuwei Zhao, Zhoukai Long, Saijuan Zhu, Junping Wu, Min Xiao, Jing Zhou, Shuo Zhang, Lianbin Li, Yijian Zhu, Daru Lu, Jingmin Yang and Xiaoxi Sun

J. Clin. Med. 2023, 12(5), 1809; https://doi.org/10.3390/jcm12051809 - 23 Feb 2023

Cited by 1 | Viewed by 1500

Abstract

During the period of 2018–2020, we first combined reported low-pass whole genome sequencing and NGS-based STR tests for miscarriage samples analysis. Compared with G-banding karyotyping, the system increased the detection rate of chromosomal abnormalities in miscarriage samples to 56.4% in 500 unexplained recurrent [...] Read more.

During the period of 2018–2020, we first combined reported low-pass whole genome sequencing and NGS-based STR tests for miscarriage samples analysis. Compared with G-banding karyotyping, the system increased the detection rate of chromosomal abnormalities in miscarriage samples to 56.4% in 500 unexplained recurrent spontaneous abortions. In this study, a total of 386 STR loci were developed on twenty-two autosomes and two sex chromosomes (X and Y chromosomes), which can help to distinguish triploidy, uniparental diploidy and maternal cell contamination and can trace the parental origin of erroneous chromosomes. It is not possible to accomplish this with existing methods of detection in miscarriage samples. Among the tested aneuploid errors, the most frequently detected error was trisomy (33.4% in total and 59.9% in the error chromosome group). In the trisomy samples, 94.7% extra chromosomes were of maternal origin and 5.31% were of paternal origin. This novel system improves the genetic analysis method of miscarriage samples and provides more reference information for clinical pregnancy guidance. Full article

(This article belongs to the Topic Smart Healthcare: Technologies and Applications)

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18 pages, 24993 KiB

Open AccessArticle

Optimizing Large-Scale COVID-19 Nucleic Acid Testing with a Dynamic Testing Site Deployment Strategy

by Xiaozhou He, Li Luo, Xuefeng Tang and Qingyi Wang

Healthcare 2023, 11(3), 393; https://doi.org/10.3390/healthcare11030393 - 30 Jan 2023

Cited by 3 | Viewed by 1252

Abstract

The COVID-19 epidemic has spread worldwide, infected more than 0.6 billion people, and led to about 6 million deaths. Conducting large-scale COVID-19 nucleic acid testing is an effective measure to cut off the transmission chain of the COVID-19 epidemic, but it calls for [...] Read more.

The COVID-19 epidemic has spread worldwide, infected more than 0.6 billion people, and led to about 6 million deaths. Conducting large-scale COVID-19 nucleic acid testing is an effective measure to cut off the transmission chain of the COVID-19 epidemic, but it calls for deploying numerous nucleic acid testing sites effectively. In this study, we aim to optimize the large-scale nucleic acid testing with a dynamic testing site deployment strategy, and we propose a multiperiod location-allocation model, which explicitly considers the spatial–temporal distribution of the testing population and the time-varied availability of various testing resources. Several comparison models, which implement static site deployment strategies, are also developed to show the benefits of our proposed model. The effectiveness and benefits of our model are verified with a real-world case study on the Chenghua district of Chengdu, China, which indicates that the optimal total cost of the dynamic site deployment strategy can be 15% less than that of a real plan implemented in practice and about 2% less than those of the other comparison strategies. Moreover, we conduct sensitivity analysis to obtain managerial insights and suggestions for better testing site deployment in field practices. This study highlights the importance of dynamically deploying testing sites based on the target population’s spatial–temporal distribution, which can help reduce the testing cost and increase the robustness of producing feasible plans with limited medical resources. Full article

(This article belongs to the Topic Smart Healthcare: Technologies and Applications)

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14 pages, 612 KiB

Open AccessArticle

Exploring Caregivers’ Perspectives and Perceived Acceptability of a Mobile-Based Telemonitoring Program to Support Pregnant Women at High-Risk for Preeclampsia in Karachi, Pakistan: A Qualitative Descriptive Study

by Anam Shahil Feroz, Salima Nazim Meghani, Haleema Yasmin, Sarah Saleem, Zulfiqar Bhutta, Hajraa Arshad and Emily Seto

Healthcare 2023, 11(3), 392; https://doi.org/10.3390/healthcare11030392 - 30 Jan 2023

Cited by 1 | Viewed by 1877

Abstract

Very little is known about the perspectives of the caregivers on the use of telemonitoring (TM) interventions in low-middle-income countries. Understanding caregivers’ perspectives on TM interventions is crucial, given that caregiving activities are correlated with the social, emotional, and clinical outcomes among pregnant [...] Read more.

Very little is known about the perspectives of the caregivers on the use of telemonitoring (TM) interventions in low-middle-income countries. Understanding caregivers’ perspectives on TM interventions is crucial, given that caregiving activities are correlated with the social, emotional, and clinical outcomes among pregnant women. This study aims to explore caregivers’ perspectives and perceived acceptability of a mobile phone-based TM program to support pregnant women at high-risk for preeclampsia. A qualitative description design was used to conduct and analyze 28 semi-structured interviews with a diverse group of caregivers. The study was conducted at the Jinnah Post Graduate Medical Center, Karachi, Pakistan. The caregivers were identified through purposive sampling and additional caregivers were interviewed until the point of data saturation. The conventional content analysis technique was used to analyze digital audio recordings of the caregiver interviews. All caregivers embraced the proposed mobile phone-based TM program because they perceived many benefits, including a reduction in caregivers’ anxiety and workload, increased convenience, and cost-effectiveness. However, the caregivers cited several caveats to the future implementation of the TM program including the inability of some women and caregivers to use the TM program and the poor acceptance of the TM system among less educated and non-tech savvy families. Our study recommends developing a TM program to reduce the caregiver stress and workload, designing a context-specific TM program using a user-centric approach, training caregivers on the use of the TM program, sensitizing caregivers on the benefits of the TM program, and developing a low-cost TM program to maximize access. Full article

(This article belongs to the Topic Smart Healthcare: Technologies and Applications)

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9 pages, 1256 KiB

Open AccessArticle

Using xPIRT to Record Pharmacy Interventions: An Observational, Cross-Sectional and Retrospective Study

by Rafael Baptista, Mary Williams and Jayne Price

Healthcare 2022, 10(12), 2450; https://doi.org/10.3390/healthcare10122450 - 05 Dec 2022

Cited by 2 | Viewed by 1479

Abstract

Medication errors and omissions can potentially cause harm, prolong a hospital stay, lead to co-morbidities and even death. Pharmacy interventions (PI) ensure that these errors are identified and addressed, leading to improved patient safety and prescriber practice. Particularly in community hospitals, many only [...] Read more.

Medication errors and omissions can potentially cause harm, prolong a hospital stay, lead to co-morbidities and even death. Pharmacy interventions (PI) ensure that these errors are identified and addressed, leading to improved patient safety and prescriber practice. Particularly in community hospitals, many only having general practitioners and not specialist doctors in their medical teams, PIs assume a strategic role. The PIs recorded throughout 8 months (between November 2021 and June 2022) in the community hospital wards in Powys, Wales, UK, using xPIRT (Pharmacy Intervention Recording Tool), a new pharmacy intervention record toolkit, were subjected to a retrospective analysis. The data were organised by location, drug, severity, acceptance, cost avoidance and intervention type. Significant prescribing errors were identified, which can potentially be different from those recorded in acute settings. Our results also informed on the need for integrated electronic prescribing systems paired with a PI recording tool to address effectively prescribing inaccuracies. Overall, this study was able to identify pharmacy teams as key to improve patient safety and care while contributing to significant cost-savings, through the recording of PI using xPIRT. Full article

(This article belongs to the Topic Smart Healthcare: Technologies and Applications)
(This article belongs to the Section Healthcare Quality and Patient Safety)

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