Cell Phones in Telehealth and Otolaryngology

Recent advancements of smartphone-based sensing technology for diagnosis, food safety analysis, and environmental monitoring

The emergence of computationally powerful smartphones, relatively affordable high-resolution camera, drones, and robotic sensors have ushered in a new age of advanced sensible monitoring tools. The present review article investigates the burgeoning smartphone-based sensing paradigms, including surface plasmon resonance (SPR) biosensors, electrochemical biosensors, colorimetric biosensors, and other innovations for modern healthcare. Despite the significant advancements, there are still scarcity of commercially available smart biosensors and hence need to accelerate the rates of technology transfer, application, and user acceptability. The application/necessity of smartphone-based biosensors for Point of Care (POC) testing, such as prognosis, self-diagnosis, monitoring, and treatment selection, have brought remarkable innovations which eventually eliminate sample transportation, sample processing time, and result in rapid findings. Additionally, it articulates recent advances in various smartphone-based multiplexed bio sensors as affordable and portable sensing platforms for point-of-care devices, together with statistics for point-of-care health monitoring and their prospective commercial viability.

A Report on the Use of Telehealth in Otolaryngology: In the Pre COVID-19 Era

Objective: To investigate the integration of and barriers to the utilization of telehealth technology and its components (telemedicine, e-Health, m-health) in daily otolaryngologic practice before the SARS CoV-2 (COVID-19) pandemic. Methods: This cross-sectional study was conducted at a tertiary academic center. A national survey of members of the American Academy of Otolaryngology-Head and Neck Surgery was administered. Descriptive analyses were performed to determine how telehealth was employed in otolaryngologists' practices. Results: A total of 184 surveys were completed. Telehealth technology was used by 50% of otolaryngologists surveyed. Regions with the largest percentage of physicians using telehealth were the Mid-Atlantic region (84%) and West Coast (67%). Most otolaryngologists indicated that they were familiar with telehealth or any of its components and how it is used in practice (52-83%), they had heard of telehealth or any of its components but were unsure what the terms specifically entailed (17-42%); 53% were satisfied with their current use of telehealth and electronic medical record (EMR); and 72% were comfortable utilizing smart devices for patient care. Most otolaryngologists (65%) indicated reimbursement as the biggest limitation to implementing telehealth, and 67% believed that typing was a hindrance to EMR utility. Conclusion: Half of the surveyed otolaryngologists used some form of telehealth at the time of the survey. The most commonly cited obstacle to physician adoption of telehealth was reimbursement. Although the adoption of telehealth technology was still limited in the field of otolaryngology based on this study, we are now seeing significant change due to the COVID-19 pandemic.

Global Assessments of the Endockscope System: Long-Term Impact of Cyber Endoscopy

INTRODUCTION

The disproportionate costs of state-of-the-art endoscopic equipment prohibit urologists from performing endoscopy in underserved countries. Given the global prevalence of smartphones, we engineered a $45 alternative endoscope utilizing three-dimensional (3D) printed attachments, an 8x lens, and a 1,000-lumen light-emitting diode (LED) cordless flashlight (Endockscope System (ES)).

MATERIALS AND METHODS

At the 34th World Congress of Endourology in Cape Town, South Africa (WCE 2016; 4-year group) and at the 39th Congress of the Société Internationale d'Urologie in Athens, Greece (SIU 2019; 8-month group), a total of 40 ES kits were distributed free of charge to an international group of urologists. Participants were given instructions and a hands-on demonstration of the device. Urologists given an ES were subsequently asked to complete a survey between June and September 2020 which included questions regarding user satisfaction, comfort, and comparability of the ES to standard endoscopic systems.

RESULTS

Urologists from 23 countries received ES kits. Overall, 10 of 22 urologists (10/22; 45%) from the 4-year group and 18 of 18 urologists (18/18; 100%) from the 8-month group completed the survey. The ES device was used by 80% (8/10) and 83% (15/18) of urologists from the 4-year and the 8-month groups, respectively. Of note, the greatest impact of ES usage was among urologists from the most impoverished countries. Of those who used the ES, 44% (4/9) of urologists from the 4-year cohort and 47% (8/17) from the 8-month cohort reported they were able to perform more endoscopic procedures directly because of the ES. Moreover, 57% (4/7) of the 4-year participants and 67% (10/15) of the 8-month participants found the ES equal or superior in quality to their standard endoscopic equipment.

CONCLUSION

The ES provided an effective and inexpensive system that enabled urologists in resource-challenged countries to successfully perform and expand their use of urological endoscopy.

Current progress on COVID-19 related to biosensing technologies: New opportunity for detection and monitoring of viruses

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COVID-19 infection poses a serious risk to human life by causing acute lung damage.

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Various techniques used to identify and quantify COVID-19 infection.

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Major challenges for containing the spread of COVID-19 is the ability to identify asymptomatic cases.

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Currently available diagnostic methods, biosensing technology developed during COVID-19 infection.

The technologies used for coronavirus testing consist of a pre-existing device developed to examine different pathologies, such as bacterial infections, or cancer biomarkers. However, for the 2019 pandemic, researchers knew that their technology could be modified to detect a low viral load at an early stage. Today, countries around the world are working to control the new coronavirus disease (n-SARS-CoV-2). From this perspective, laboratories, universities, and companies around the world have embarked on a race to develop and produce much-needed test kits. This review has been developed to provide an overview of current trends and strategies in n-SARS-CoV-2 diagnostics based on traditional and new emerging assessment technologies, to continuous innovation. It focuses on recent trends in biosensors to build a fast, reliable, more sensitive, accessible, user-friendly system and easily adaptable technology n-SARS-CoV-2 detection and monitoring. On the whole, we have addressed and identified research evidence supporting the use of biosensors on the premise that screening people for n-SARS-CoV-2 is the best way to contain its spread.

R u a smkn m0m?: Aspects of a Text Messaging Smoking Cessation/Reduction Intervention for Younger Mothers

Introduction: Women who are younger in age are more likely to smoke during pregnancy and postpartum and tend to have less success with cessation/reduction. There is an unmet need for interventions targeted to pregnant and postpartum young women that provide them with support to quit/reduce long-term into the postpartum period and beyond.

Aims: Our study aimed to gain an in-depth understanding of the perspectives of young pregnant and postpartum women of text messaging (TM) as a conduit for smoking cessation/reduction, and to determine the appropriate content, frequency, duration and unique features needed for an effective cessation/reduction TM programme.

Methods: Six focus groups and six telephone interviews were convened with 36 pregnant and postpartum women 16–30 years of age.

Results: Three main themes were identified: 1) topic areas that women would like TM to focus on; 2) the need for messages to be tailored; and 3) the importance for the programme to take a woman-centered approach.

Conclusions: Respondents supported the idea of a TM cessation/reduction intervention and had clear programme recommendations. A personalised, woman-centered TM programme that meets a young woman's unique needs and addresses her concerns through her participation and direction is likely to empower and support her to quit/reduce.

Cellphone-based devices for bioanalytical sciences

During the last decade, there has been a rapidly growing trend toward the use of cellphone-based devices (CBDs) in bioanalytical sciences. For example, they have been used for digital microscopy, cytometry, read-out of immunoassays and lateral flow tests, electrochemical and surface plasmon resonance based bio-sensing, colorimetric detection and healthcare monitoring, among others. Cellphone can be considered as one of the most prospective devices for the development of next-generation point-of-care (POC) diagnostics platforms, enabling mobile healthcare delivery and personalized medicine. With more than 6.5 billion cellphone subscribers worldwide and approximately 1.6 billion new devices being sold each year, cellphone technology is also creating new business and research opportunities. Many cellphone-based devices, such as those targeted for diabetic management, weight management, monitoring of blood pressure and pulse rate, have already become commercially-available in recent years. In addition to such monitoring platforms, several other CBDs are also being introduced, targeting e.g., microscopic imaging and sensing applications for medical diagnostics using novel computational algorithms and components already embedded on cellphones. This report aims to review these recent developments in CBDs for bioanalytical sciences along with some of the challenges involved and the future opportunities.

Endockscope: using mobile technology to create global point of service endoscopy

BACKGROUND AND PURPOSE

Recent advances and the widespread availability of smartphones have ushered in a new wave of innovations in healthcare. We present our initial experience with Endockscope, a new docking system that optimizes the coupling of the iPhone 4S with modern endoscopes.

MATERIALS AND METHODS

Using the United States Air Force resolution target, we compared the image resolution (line pairs/mm) of a flexible cystoscope coupled to the Endockscope+iPhone to the Storz high definition (HD) camera (H3-Z Versatile). We then used the Munsell ColorChecker chart to compare the color resolution with a 0° laparoscope. Furthermore, 12 expert endoscopists blindly compared and evaluated images from a porcine model using a cystoscope and ureteroscope for both systems. Finally, we also compared the cost (average of two company listed prices) and weight (lb) of the two systems.

RESULTS

Overall, the image resolution allowed by the Endockscope was identical to the traditional HD camera (4.49 vs 4.49 lp/mm). Red (ΔE=9.26 vs 9.69) demonstrated better color resolution for iPhone, but green (ΔE=7.76 vs 10.95), and blue (ΔE=12.35 vs 14.66) revealed better color resolution with the Storz HD camera. Expert reviews of cystoscopic images acquired with the HD camera were superior in image, color, and overall quality (P=0.002, 0.042, and 0.003). In contrast, the ureteroscopic reviews yielded no statistical difference in image, color, and overall (P=1, 0.203, and 0.120) quality. The overall cost of the Endockscope+iPhone was $154 compared with $46,623 for a standard HD system. The weight of the mobile-coupled system was 0.47 lb and 1.01 lb for the Storz HD camera.

CONCLUSION

Endockscope demonstrated feasibility of coupling endoscopes to a smartphone. The lighter and inexpensive Endockscope acquired images of the same resolution and acceptable color resolution. When evaluated by expert endoscopists, the quality of the images overall were equivalent for flexible ureteroscopy and somewhat inferior, but still acceptable for flexible cystoscopy.