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Stosic MB, Kaljevic J, Nikolic B, Tanaskovic M, Kolarov A. Smart Anklet Use to Measure Vascular Health Benefits of Preventive Intervention in a Nature-Based Environment-A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:605. [PMID: 38791819 PMCID: PMC11121026 DOI: 10.3390/ijerph21050605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/23/2024] [Accepted: 05/02/2024] [Indexed: 05/26/2024]
Abstract
The present study aimed to investigate the associations between nature-based intervention and peripheral pulse characteristics of patients with PAOD using new smart technology specifically designed for this purpose. A longitudinal panel study performed between 1 January 2022 and 31 December 2022 included 32 patients diagnosed with peripheral arterial occlusive disease (PAOD) who were treated in the vascular surgeons' hospital "Dobb" in Valjevo. These patients were exposed for six months to moderate-intensity physical activity (MPA) in a nature-based environment. They practiced 150 to 300 min of walking 6 km/h and cycling activities (16-20 km/h) weekly as recommended for patients with chronic conditions and those living with disability. Univariate logistic regression analysis was used to identify factors associated with major improvements in peripheral pulse characteristics of patients with PAOD. After six months of MPA, half of the patients (50%, 16/32) achieved minor, and half of them major improvements in peripheral pulse characteristics. The major improvements were associated with current smoking (OR = 9.53; 95%CI = 1.85-49.20), diabetes (OR = 4.84; 95%CI = 1.09-21.58) and cardiac failure, and concurrent pulmonary disease and diabetes (OR = 2.03; 95%CI = 1.01-4.11). Our pilot study showed that patients with PAOD along with other chronic conditions and risk factors benefited more from continuous physical activity in a nature-based environment.
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Affiliation(s)
- Maja B. Stosic
- Faculty for Health and Business Studies, Singidunum University, 14000 Valjevo, Serbia; (J.K.); (B.N.)
- Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”, Department for HIV, Hepatitis, STIs and Tuberculosis, 11000 Belgrade, Serbia
| | - Jelena Kaljevic
- Faculty for Health and Business Studies, Singidunum University, 14000 Valjevo, Serbia; (J.K.); (B.N.)
| | - Bojan Nikolic
- Faculty for Health and Business Studies, Singidunum University, 14000 Valjevo, Serbia; (J.K.); (B.N.)
| | - Marko Tanaskovic
- Faculty for Technical Science, Singidunum University, 11000 Belgrade, Serbia;
| | - Aleksandar Kolarov
- New Jersey Institute of Technology, Electrical and Computer Engineering Center, Ewing, NJ 07102, USA;
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Konopik J, Blunck D. Development of an Evidence-Based Conceptual Model of the Health Care Sector Under Digital Transformation: Integrative Review. J Med Internet Res 2023; 25:e41512. [PMID: 37289482 PMCID: PMC10288351 DOI: 10.2196/41512] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/14/2022] [Accepted: 04/07/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Digital transformation is currently one of the most influential developments. It is fundamentally changing consumers' expectations and behaviors, challenging traditional firms, and disrupting numerous markets. Recent discussions in the health care sector tend to assess the influence of technological implications but neglect other factors needed for a holistic view on the digital transformation. This calls for a reevaluation of the current state of digital transformation in health care. Consequently, there is a need for a holistic view on the complex interdependencies of digital transformation in the health care sector. OBJECTIVE This study aimed to examine the effects of digital transformation on the health care sector. This is accomplished by providing a conceptual model of the health care sector under digital transformation. METHODS First, the most essential stakeholders in the health care sector were identified by a scoping review and grounded theory approach. Second, the effects on these stakeholders were assessed. PubMed, Web of Science, and Dimensions were searched for relevant studies. On the basis of an integrative review and grounded theory methodology, the relevant academic literature was systematized and quantitatively and qualitatively analyzed to evaluate the impact on the value creation of, and the relationships among, the stakeholders. Third, the findings were synthesized into a conceptual model of the health care sector under digital transformation. RESULTS A total of 2505 records were identified from the database search; of these, 140 (5.59%) were included and analyzed. The results revealed that providers of medical treatments, patients, governing institutions, and payers are the most essential stakeholders in the health care sector. As for the individual stakeholders, patients are experiencing a technology-enabled growth of influence in the sector. Providers are becoming increasingly dependent on intermediaries for essential parts of the value creation and patient interaction. Payers are expected to try to increase their influence on intermediaries to exploit the enormous amounts of data while seeing their business models be challenged by emerging technologies. Governing institutions regulating the health care sector are increasingly facing challenges from new entrants in the sector. Intermediaries increasingly interconnect all these stakeholders, which in turn drives new ways of value creation. These collaborative efforts have led to the establishment of a virtually integrated health care ecosystem. CONCLUSIONS The conceptual model provides a novel and evidence-based perspective on the interrelations among actors in the health care sector, indicating that individual stakeholders need to recognize their role in the system. The model can be the basis of further evaluations of strategic actions of actors and their effects on other actors or the health care ecosystem itself.
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Affiliation(s)
- Jens Konopik
- Institute of Management, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Dominik Blunck
- Institute of Management, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
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3
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Laurisz N, Ćwiklicki M, Żabiński M, Canestrino R, Magliocca P. The Stakeholders' Involvement in Healthcare 4.0 Services Provision: The Perspective of Co-Creation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2416. [PMID: 36767782 PMCID: PMC9914953 DOI: 10.3390/ijerph20032416] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/20/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
Literature research on cocreation in healthcare indicates the theoretical sophistication of research on collaboration between healthcare professionals and patients. Our research continues in the new area of Health 4.0. Cocreation has become an essential concept in the value creation process; by involving consumers in the creation process, better results are achieved regarding product quality and alignment with customer expectations and needs. In addition, consumer involvement in the creation process improves its efficiency. Cocreation allows for more efficient diagnosis and treatment of patients, as well as better and more effective use of the skills and experience of the health workforce. Our main objective is to determine the scope and depth of the cocreation of health services based on modern technological solutions (Health 4.0). We selected four cases involving Health 4.0 solutions, verified the scale and scope of cocreation using them as examples, and used the cocreation matrix. We used literature, case studies, and interviews in our research. Our analysis shows that patients can emerge as cocreators in the value creation process in Health 4.0. This can happen when they are genuinely involved in the process and when they feel responsible for the results. The article contributes to the existing theory of service cocreation by pointing out the limited scope of patient involvement in the service management process. For cocreation in Health 4.0 to increase the effectiveness of medical services, it is necessary to implement the full scope of cocreation and meaningfully empower the patient and medical workers in the creation process. This article verifies the theoretical analysis presented in our team's previous article.
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Affiliation(s)
- Norbert Laurisz
- Department of Public Management, Cracow University of Economics, 31-510 Cracow, Poland
| | - Marek Ćwiklicki
- Department of Public Management, Cracow University of Economics, 31-510 Cracow, Poland
| | - Michał Żabiński
- Department of Public Management, Cracow University of Economics, 31-510 Cracow, Poland
| | - Rossella Canestrino
- Department of Management and Quantitative Studies, Parthenope University of Naples, 80133 Naples, Italy
| | - Pierpaolo Magliocca
- Department of Humanities, Faculty of the Humanities, Literature, Cultural Heritage, and Educational Sciences, University of Foggia, 71122 Foggia, Italy
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Laurisz N, Ćwiklicki M, Żabiński M, Canestrino R, Magliocca P. Co-Creation in Health 4.0 as a New Solution for a New Era. Healthcare (Basel) 2023; 11:healthcare11030363. [PMID: 36766938 PMCID: PMC9913923 DOI: 10.3390/healthcare11030363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/14/2023] [Accepted: 01/20/2023] [Indexed: 02/03/2023] Open
Abstract
Previous research on co-creation in healthcare indicates that the use of co-creation in the design process of health solutions influences their greater acceptance and adaptation, resulting in greater efficiency of health services and higher usability of implemented health solutions. Analysis of adaptation and acceptance of new technologies reveals the problem of misunderstanding and the need for more trust in modern tools implemented in the healthcare system. The remedy may be the use of co-creation in the process of developing modern medical products and services. This article's main purpose is to explore the co-creation process in Health 4.0, which is understood as the development of healthcare through the application of methods and tools of the Fourth Industrial Revolution. The literature review provided insights for an analytical framework-the co-creation matrix. We analyzed the case of the Italian medical platform Paginemediche.it to reveal the actors' engagement in co-creation. The results demonstrated different levels of engagement in improving the efficiency of implementing medical and technological solutions. Both theoretical and practical analysis proved that the co-creation matrix helps more precisely define the scale and scope of co-creation in Health 4.0.
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Affiliation(s)
- Norbert Laurisz
- Department of Public Management, Cracow University of Economics; 31-510 Krakow, Poland
- Correspondence: ; Tel.: +48-12-293-5963
| | - Marek Ćwiklicki
- Department of Public Management, Cracow University of Economics; 31-510 Krakow, Poland
| | - Michał Żabiński
- Department of Public Management, Cracow University of Economics; 31-510 Krakow, Poland
| | - Rossella Canestrino
- Department of Management and Quantitative Studies, Parthenope University of Naples, 80133 Naples, Italy
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Park C, Mishra R, Vigano D, Macagno M, Rossotti S, D’Huyvetter K, Garcia J, Armstrong DG, Najafi B. Smart Offloading Boot System for Remote Patient Monitoring: Toward Adherence Reinforcement and Proper Physical Activity Prescription for Diabetic Foot Ulcer Patients. J Diabetes Sci Technol 2023; 17:42-51. [PMID: 35048739 PMCID: PMC9846414 DOI: 10.1177/19322968211070850] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND A critical factor in healing diabetic foot ulcers is patient adherence to offloading devices. We tested a smart offloading boot (SmartBoot) combined with a smartwatch app and cloud dashboard to remotely monitor patient adherence and activity. In addition, the impact of SmartBoot on balance, gait, and user experience was investigated. METHODS Fourteen volunteers (31.6±8.7 years; 64% female) performed natural activities (eg, sitting, standing, walking) with and without the SmartBoot for approximately 30 minutes. All participants completed balance tests, 10-meter walking tests at slow, normal, and fast pace while wearing the SmartBoot, and a user experience questionnaire. The accuracy of real-time adherence reporting was assessed by comparing the SmartBoot and staff observation. Center of mass (COM) sway and step counts were measured using a validated wearable system. RESULTS Average sensitivity, specificity, and accuracy for adherence and non-adherence were 90.6%, 88.0%, and 89.3%, respectively. The COM sway area was significantly smaller with the SmartBoot than without the SmartBoot regardless of test condition. Step count error was 4.4% for slow waking, 36.2% for normal walking, 16.0% for fast walking. Most participants agreed that the SmartBoot is easy to use, relatively comfortable, nonintrusive, and innovative. CONCLUSIONS To our knowledge, this is the first smart offloading system that enables remote patient monitoring and real-time adherence and activity reporting. The SmartBoot enhanced balance performance, likely due to somatosensory feedback. Questionnaire results highlight SmartBoot's technical and clinical potential. Future studies warrant clinical validation of real-time non-adherence alerting to improve wound healing outcomes in people with diabetic foot ulcers.
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Affiliation(s)
- Catherine Park
- Interdisciplinary Consortium on
Advanced Motion Performance, Michael E. DeBakey Department of Surgery, Baylor
College of Medicine, Houston, TX, USA
- VA HSR&D, Center for Innovations in
Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston,
TX, USA
- Big Data Scientist Training Enhancement
Program, VA Office of Research and Development, Washington, DC, USA
| | - Ramkinker Mishra
- Interdisciplinary Consortium on
Advanced Motion Performance, Michael E. DeBakey Department of Surgery, Baylor
College of Medicine, Houston, TX, USA
| | | | | | | | - Karen D’Huyvetter
- Southwestern Academic Limb Salvage
Alliance, Keck School of Medicine, University of Southern California, Los Angeles,
CA, USA
| | - Jason Garcia
- Southwestern Academic Limb Salvage
Alliance, Keck School of Medicine, University of Southern California, Los Angeles,
CA, USA
| | - David G. Armstrong
- Southwestern Academic Limb Salvage
Alliance, Keck School of Medicine, University of Southern California, Los Angeles,
CA, USA
- National Center for Rehabilitation at
Rancho Los Amigos, Downey, CA, USA
| | - Bijan Najafi
- Interdisciplinary Consortium on
Advanced Motion Performance, Michael E. DeBakey Department of Surgery, Baylor
College of Medicine, Houston, TX, USA
- Bijan Najafi, PhD, Interdisciplinary
Consortium on Advanced Motion Performance, Michael E. DeBakey Department of
Surgery, Baylor College of Medicine, 7200 Cambridge St, Houston, TX 77030, USA.
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6
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Swerdlow M, Shin L, D’Huyvetter K, Mack WJ, Armstrong DG. Initial Clinical Experience with a Simple, Home System for Early Detection and Monitoring of Diabetic Foot Ulcers: The Foot Selfie. J Diabetes Sci Technol 2023; 17:79-88. [PMID: 34719973 PMCID: PMC9846401 DOI: 10.1177/19322968211053348] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Diabetic foot ulcers (DFUs) are a leading cause of disability and morbidity. There is an unmet need for a simple, practical, home method to detect DFUs early and remotely monitor their healing. METHOD We developed a simple, inexpensive, smartphone-based, "Foot Selfie" system that enables patients to photograph the plantar surface of their feet without assistance and transmit images to a remote server. In a pilot study, patients from a limb-salvage clinic were asked to image their feet daily for six months and to evaluate the system by questionnaire at five time points. Transmitted results were reviewed weekly. RESULTS Fifteen patients (10 male) used the system after approximately 5 minutes of instruction. Participants uploaded images on a median of 76% of eligible study days. The system captured and transmitted diagnostic quality images of the entire plantar surface of both feet, permitting clinical-management decisions on a remote basis. We monitored 12 active wounds and 39 pre-ulcerative lesions (five wounds and 13 pre-ulcerative lesions at study outset); we observed healing of seven wounds and reversal of 20 pre-ulcerative lesions. Participants rated the system as useful, empowering, and preferable to their previous methods of foot screening. CONCLUSIONS With minimal training, patients transmitted diagnostic-quality images from home on most days, allowing clinicians to review serial images. This system permits inexpensive home foot screening and monitoring of DFUs. Further studies are needed to determine whether it can reduce morbidity of DFUs and/or the associated cost of care. Artificial intelligence integration could improve scalability.
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Affiliation(s)
- Mark Swerdlow
- Department of Surgery, Southwestern
Academic Limb Salvage Alliance, Keck School of Medicine of University of Southern
California, Los Angeles, CA, USA
- Center to Stream Healthcare in Place,
Keck School of Medicine of University of Southern California, Los Angeles, CA,
USA
| | - Laura Shin
- Department of Surgery, Southwestern
Academic Limb Salvage Alliance, Keck School of Medicine of University of Southern
California, Los Angeles, CA, USA
- Center to Stream Healthcare in Place,
Keck School of Medicine of University of Southern California, Los Angeles, CA,
USA
| | - Karen D’Huyvetter
- Department of Surgery, Southwestern
Academic Limb Salvage Alliance, Keck School of Medicine of University of Southern
California, Los Angeles, CA, USA
- Center to Stream Healthcare in Place,
Keck School of Medicine of University of Southern California, Los Angeles, CA,
USA
| | - Wendy J. Mack
- Department of Population and Public
Health Sciences, Keck School of Medicine of University of Southern California, Los
Angeles, CA, USA
| | - David G. Armstrong
- Department of Surgery, Southwestern
Academic Limb Salvage Alliance, Keck School of Medicine of University of Southern
California, Los Angeles, CA, USA
- Center to Stream Healthcare in Place,
Keck School of Medicine of University of Southern California, Los Angeles, CA,
USA
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7
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Drovandi A, Wong S, Seng L, Crowley B, Alahakoon C, Banwait J, Fernando ME, Golledge J. Remotely Delivered Monitoring and Management of Diabetes-Related Foot Disease: An Overview of Systematic Reviews. J Diabetes Sci Technol 2023; 17:59-69. [PMID: 34008448 PMCID: PMC9846412 DOI: 10.1177/19322968211012456] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Diabetes-related foot disease (DFD) management requires input from multiple healthcare professionals, and has worse outcomes for people living in remote localities by comparison to urban areas. Remotely delivered healthcare may reduce this disparity. This overview summarizes current evidence on the effectiveness, stakeholder perceptions, and cost-effectiveness of remotely delivered healthcare for DFD. METHODS A search of 5 databases was conducted to identify systematic reviews published between January 2000 and June 2020. Eligible reviews were those evaluating remotely delivered monitoring or management of patients at risk of or with active DFD, or clinicians managing these patients. Risk of bias was assessed using the AMSTAR-2 tool. RESULTS Eight reviews were eligible for inclusion, including 88 primary studies and 8509 participants, of which 36 studies involving 4357 participants evaluated remotely delivered monitoring or management of DFD. Only one review had a low risk of bias, with most reviews demonstrating limited search strategies and poor reporting of participants. Evidence on effectiveness was mixed, with meta-analyses demonstrating long-term ulcer healing and mortality were not significantly different between telehealth and standard care groups, although the lower-limb amputation rate was significantly decreased in one meta-analysis. Perceptions of telehealth by patients and clinicians were generally positive, whilst acknowledging limitations relating to access and use. Cost-effectiveness data were limited, with poor reporting preventing clear conclusions. CONCLUSIONS Remotely delivered healthcare of DFD is well received by patients and clinicians, but its effectiveness is unclear. High quality trials are needed to evaluate the risks and benefits of remotely delivered DFD management.
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Affiliation(s)
- Aaron Drovandi
- Queensland Research Centre for
Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook
University, Townsville, Queensland, Australia
| | - Shannon Wong
- College of Medicine and Dentistry,
James Cook University, Townsville, Queensland, Australia
| | - Leonard Seng
- Queensland Research Centre for
Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook
University, Townsville, Queensland, Australia
| | - Benjamin Crowley
- Queensland Research Centre for
Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook
University, Townsville, Queensland, Australia
| | - Chanika Alahakoon
- Queensland Research Centre for
Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook
University, Townsville, Queensland, Australia
| | - Jasmin Banwait
- College of Medicine and Dentistry,
James Cook University, Townsville, Queensland, Australia
| | - Malindu E. Fernando
- Queensland Research Centre for
Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook
University, Townsville, Queensland, Australia
- Ulcer and wound Healing consortium
(UHEAL), Australian Institute of Tropical Health and Medicine, James Cook
University, Townsville, Queensland, Australia
| | - Jonathan Golledge
- Queensland Research Centre for
Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook
University, Townsville, Queensland, Australia
- Ulcer and wound Healing consortium
(UHEAL), Australian Institute of Tropical Health and Medicine, James Cook
University, Townsville, Queensland, Australia
- Department of Vascular and Endovascular
Surgery, Townsville University Hospital, Townsville, Queensland, Australia
- Jonathan Golledge, MChir, Queensland
Research Centre for Peripheral Vascular Disease, College of Medicine and
Dentistry, James Cook University, 1 James Cook Drive, Townsville, Queensland
4811, Australia.
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Validation of a novel iPhone application for evaluating near functional visual acuity. Sci Rep 2022; 12:22342. [PMID: 36572799 PMCID: PMC9791149 DOI: 10.1038/s41598-022-27011-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
Monitoring dynamic changes in near vision is important for early detection of presbyopia. This study assessed the accuracy and reliability of a new smartphone-based application, the Smart Vision Check (SVC), compared with those of a conventional device (AS-28; Kowa, Aichi, Japan), for measuring near functional visual acuity (NFVA). We enrolled 115 healthy volunteers aged ≥ 20 years with bilateral best-corrected visual acuity of ≥ 20/25. The SVC was designed for use on an Apple iPhone SE2 to measure NFVA by tapping on the orientation icon manually. Conventional FVA was measured using the AS-28 with - 2.50 D added to the best distance correction at baseline. There was no significant difference in NFVA-related measurements between the AS-28 and SVC (P > 0.05). The Spearman correlation coefficients of NFVA measurements between the two devices were over 0.60 (P < 0.001). The Bland-Altman plot indicated minimal bias with limits of agreements of ± 0.34 logMAR for NFVA with habitual correction when comparing the AS-28 and SVC. The intraclass correlation coefficient of the repeated SVC-measured NFVA was 0.915 (95% CI 0.800-0.969). In summary, the SVC has the potential to evaluate NFVA in a relatively easy manner. Applied clinically, the SVC can be useful for presbyopia screening.
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9
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Kramer ES, VanWyk J, Holmstrom H. Telehealth and Diabetes Management. Prim Care 2022; 49:631-639. [DOI: 10.1016/j.pop.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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10
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Levine B, Bennett I, Higgins A, Woods D, Papas M, Surampudy A. Use of Voice-Assisted Technology to Enhance the Home Health Care Patient Experience. J Gerontol Nurs 2022; 48:17-24. [DOI: 10.3928/00989134-20221107-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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11
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Merle G, Miclau T, Parent-Harvey A, Harvey EJ. Sensor technology usage in orthopedic trauma. Injury 2022; 53 Suppl 3:S59-S63. [PMID: 36182592 DOI: 10.1016/j.injury.2022.09.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 08/25/2022] [Accepted: 09/08/2022] [Indexed: 02/02/2023]
Abstract
Medicine in general is quickly transitioning to a digital presence. Orthopaedic surgery is also being impacted by the tenets of digital health but there are also direct efforts with trauma surgery. Sensors are the pen and paper of the next wave of data acquisition. Orthopaedic trauma can and will be part of this new wave of medicine. Early sensor products that are now coming to market, or are in early development, will directly change the way we think about surgical diagnosis and outcomes. Sensor development for biometrics is already here. Wellness devices, pressure, temperature, and other parameters are already being measured. Data acquisition and analysis is going to be a fruitful addition to our research armamentarium with the volume of information now available. A combination of broadband internet, micro electrical machine systems (MEMS), and new wireless communication standards is driving this new wave of medicine. The Internet of Things (IoT) [1] now has a subset which is the Internet of Medical Devices [2-5] permitting a much more in-depth dive into patient procedures and outcomes. IoT devices are now being used to enable remote health monitoring, in hospital treatment, and guide therapies. This article reviews current sensor technology that looks to impact trauma care.
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Affiliation(s)
- Géraldine Merle
- École Polytechnique de Montréal, Université de Montréal, Montréal, Canada
| | - Theodore Miclau
- Orthopaedic Trauma Institute, University of Calfornia, School of Medicine, Department of Orthopaedics, San Francisco, USA
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Cho ME, Kim MJ. Smart Homes Supporting the Wellness of One or Two-Person Households. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22207816. [PMID: 36298165 PMCID: PMC9611916 DOI: 10.3390/s22207816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 10/02/2022] [Accepted: 10/10/2022] [Indexed: 05/14/2023]
Abstract
The reduction in face-to-face contact and the increase in time spent at home during the ongoing coronavirus disease pandemic have resulted in increasing interest and demand for smart homes. Further, the rapid increase in the number of one-person and two-person households in Korea recently has led to these becoming representative household types. This study identifies the wellness characteristics of such households and proposes a direction for smart home development to help them lead healthy, happy lives. It focuses on mapping residents' perceptions and experiences to scenarios and on identifying the functions required in smart homes and the technologies needed to provide these functions. It uses data from a survey to investigate and analyze the wellness characteristics of one- and two-person households in five dimensions and develops five scenarios of representative household types. By analyzing the developed scenarios, this study proposes smart homes that support the wellness of such households in six categories: exercise/sports, hobby/entertainment, social communications, occupation/work, self-development/education, and energy conservation. These households are exposed to digital environments from an early age and are familiar with the internet and technologies. Therefore, they are likely to adopt innovative technologies in housing. Thus, the smart home development proposed in this study is a promising strategic approach to housing planning.
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Affiliation(s)
- Myung Eun Cho
- Construction Research Institute, Hanyang University, Seoul 04783, Korea
| | - Mi Jeong Kim
- School of Architecture, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04783, Korea
- Correspondence:
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13
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Akhtar N, Khan N, Qayyum S, Qureshi MI, Hishan SS. Efficacy and pitfalls of digital technologies in healthcare services: A systematic review of two decades. Front Public Health 2022; 10:869793. [PMID: 36187628 PMCID: PMC9523565 DOI: 10.3389/fpubh.2022.869793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 08/08/2022] [Indexed: 01/21/2023] Open
Abstract
The use of technology in the healthcare sector and its medical practices, from patient record maintenance to diagnostics, has significantly improved the health care emergency management system. At that backdrop, it is crucial to explore the role and challenges of these technologies in the healthcare sector. Therefore, this study provides a systematic review of the literature on technological developments in the healthcare sector and deduces its pros and cons. We curate the published studies from the Web of Science and Scopus databases by using PRISMA 2015 guidelines. After mining the data, we selected only 55 studies for the systematic literature review and bibliometric analysis. The study explores four significant classifications of technological development in healthcare: (a) digital technologies, (b) artificial intelligence, (c) blockchain, and (d) the Internet of Things. The novel contribution of current study indicate that digital technologies have significantly influenced the healthcare services such as the beginning of electronic health record, a new era of digital healthcare, while robotic surgeries and machine learning algorithms may replace practitioners as future technologies. However, a considerable number of studies have criticized these technologies in the health sector based on trust, security, privacy, and accuracy. The study suggests that future studies, on technological development in healthcare services, may take into account these issues for sustainable development of the healthcare sector.
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Affiliation(s)
- Nadeem Akhtar
- School of Urban Culture, South China Normal University, Foshan, China
| | - Nohman Khan
- UniKL Business School, Universiti Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Shazia Qayyum
- Institute of Applied Psychology, University of the Punjab, Lahore, Pakistan
| | - Muhammad Imran Qureshi
- Teesside University International Business School, Middlesbrough, United Kingdom,*Correspondence: Muhammad Imran Qureshi
| | - Snail S. Hishan
- Azman Hashim International Business School, Universiti Teknologi, Kuala Lumpur, Malaysia,Independent Researcher, THRIVE Project, Brisbane, QLD, Australia
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14
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Fujio K, Inomata T, Fujisawa K, Sung J, Nakamura M, Iwagami M, Muto K, Ebihara N, Nakamura M, Okano M, Akasaki Y, Okumura Y, Ide T, Nojiri S, Nagao M, Fujimoto K, Hirosawa K, Murakami A. Patient and public involvement in mobile health-based research for hay fever: a qualitative study of patient and public involvement implementation process. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:45. [PMID: 36056430 PMCID: PMC9437402 DOI: 10.1186/s40900-022-00382-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/29/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Smartphones are being increasingly used for research owing to their multifunctionality and flexibility, and crowdsourced research using smartphone applications (apps) is effective in the early detection and management of chronic diseases. We developed the AllerSearch app to gather real-world data on individual subjective symptoms and lifestyle factors related to hay fever. This study established a foundation for interactive research by adopting novel, diverse perspectives accrued through implementing the principles of patient and public involvement (PPI) in the development of our app. METHODS Patients and members of the public with a history or family history of hay fever were recruited from November 2019 to December 2021 through a dedicated website, social networking services, and web briefing according to the PPI Guidebook 2019 by the Japan Agency for Medical Research and Development. Nine opinion exchange meetings were held from February 2020 to December 2021 to collect opinions and suggestions for updating the app. After each meeting, interactive evaluations from PPI contributors and researchers were collected. The compiled suggestions were then incorporated into the app, establishing an active feedback loop fed by the consistently interactive infrastructure. RESULTS Four PPI contributors (one man and three women) were recruited, and 93 items were added/changed in the in-app survey questionnaire in accordance with discussions from the exchange meetings. The exchange meetings emphasized an atmosphere and opportunity for participants to speak up, ensuring frequent opportunities for them to contribute to the research. In March 2020, a public website was created to display real-time outcomes of the number of participants and users' hay-fever-preventative behaviors. In August 2020, a new PPI-implemented AllerSearch app was released. CONCLUSIONS This study marks the first research on clinical smartphone apps for hay fever in Japan that implements PPI throughout its timeline from research and development to the publication of research results. Taking advantage of the distinct perspectives offered by PPI contributors, a step was taken toward actualizing a foundation for an interactive research environment. These results should promote future PPI research and foster the establishment of a social construct that enables PPI efforts in various fields.
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Affiliation(s)
- Kenta Fujio
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Tokyo, 113-0033, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takenori Inomata
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Tokyo, 113-0033, Japan.
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Kumiko Fujisawa
- Department of Public Policy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Jaemyoung Sung
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Tokyo, 113-0033, Japan
| | - Masahiro Nakamura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Tokyo, 113-0033, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan
| | - Masao Iwagami
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Kaori Muto
- Department of Public Policy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Nobuyuki Ebihara
- Department of Ophthalmology, Urayasu Hospital, Juntendo University, Chiba, Japan
| | - Masahiro Nakamura
- Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Mitsuhiro Okano
- Department of Otorhinolaryngology, International University of Health and Welfare, Narita, Japan
| | - Yasutsugu Akasaki
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Tokyo, 113-0033, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuichi Okumura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Tokyo, 113-0033, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takuma Ide
- Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Shuko Nojiri
- Medical Technology Innovation Center, Juntendo University, Tokyo, Japan
| | - Masashi Nagao
- Medical Technology Innovation Center, Juntendo University, Tokyo, Japan
- Department of Orthopedic Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
- School of Health and Sports Science, Juntendo University, Chiba, Japan
| | - Keiichi Fujimoto
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Tokyo, 113-0033, Japan
| | - Kunihiko Hirosawa
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Tokyo, 113-0033, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akira Murakami
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Tokyo, 113-0033, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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15
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Changing Medical Paradigm on Inflammatory Eye Disease: Technology and Its Implications for P4 Medicine. J Clin Med 2022; 11:jcm11112964. [PMID: 35683352 PMCID: PMC9181649 DOI: 10.3390/jcm11112964] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 05/23/2022] [Indexed: 12/10/2022] Open
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16
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From Triboelectric Nanogenerator to Polymer-Based Biosensor: A Review. BIOSENSORS 2022; 12:bios12050323. [PMID: 35624624 PMCID: PMC9138307 DOI: 10.3390/bios12050323] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/09/2022] [Accepted: 05/09/2022] [Indexed: 12/26/2022]
Abstract
Nowadays, self-powered wearable biosensors that are based on triboelectric nanogenerators (TENGs) are playing an important role in the continuous efforts towards the miniaturization, energy saving, and intelligence of healthcare devices and Internets of Things (IoTs). In this review, we cover the remarkable developments in TENG−based biosensors developed from various polymer materials and their functionalities, with a focus on wearable and implantable self-powered sensors for health monitoring and therapeutic devices. The functions of TENGs as power sources for third-party biosensors are also discussed, and their applications in a number of related fields are concisely illustrated. Finally, we conclude the review with a discussion of the challenges and problems of leveraging TENG−based intelligent biosensors.
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17
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Abstract
Digital health principles are starting to be evident in medicine. Orthopaedic trauma surgery is also being impacted —indirectly by all other improvements in the health ecosystem but also in particular efforts aimed at trauma surgery. Data acquisition is changing how evidence is gathered and utilized. Sensors are the pen and paper of the next wave of data acquisition. Sensors are gathering wide arrays of information to facilitate digital health relevance and adoption. Early adaption of sensor technology by the nonlegacy health environment is what has made sensor driven data acquisition so palatable to the normal health care system. As it applies to orthopaedic trauma, current sensor driven diagnostics and surveillance are nowhere near as developed as in the larger medical community. Digital health is being explored for health care records, data acquisition in diagnostics and rehabilitation, wellness to health care translation, intraoperative monitoring, surgical technique improvement, as well as some early-stage projects in long-term monitoring with implantable devices. The internet of things is the next digital wave that will undoubtedly affect medicine and orthopaedics. Internet of things (loT) devices are now being used to enable remote health monitoring and emergency notification systems. This article reviews current and future concepts in digital health that will impact trauma care.
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18
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Woo JH, Kim EC, Kim SM. The Current Status of Breakthrough Devices Designation in the United States and Innovative Medical Devices Designation in Korea for Digital Health Software. Expert Rev Med Devices 2022; 19:213-228. [PMID: 35255755 DOI: 10.1080/17434440.2022.2051479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Artificial Intelligence (AI) is becoming increasingly utilized in the medical device industry as it can address unmet demands in clinical sites and provide more patient treatment options. This study aims to analyze the FDA's Breakthrough Device Program and MFDS' Innovative Medical Device Program, which support regulatory science for innovative medical devices today. Through this study, it is intended to enable prediction of current development trends of Software as a Medical Device (SaMD) and Digital Therapeutics (DTx), which combine AI and technologies to be used in the clinical field soon. AREAS COVERED A systematic search was conducted on the broad topics of "FDA and MFDS Program's SaMD, DTx". A parallel review and update of PubMed, and the official websites were conducted to investigate the regulator's databases, review official press releases of regulatory agencies, and provide detailed descriptions of researchers. EXPERT OPINION The efforts of related stakeholders are needed to expand AI technology to diagnosis, prevention, and treatment technologies for diseases that are difficult to diagnose early or are classified as clinical challenges. It is important to prepare regulatory policies suitable for the rapid pace of technological development and to create an environment where regulatory science can be realized by developers.
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Affiliation(s)
- Jae Hyun Woo
- Research Institute for Commercialization of Biomedical Convergence Technology, Seoul, Republic of Korea.,Medical Device Industry Program in Graduate School, Dongguk University, Seoul, Republic of Korea.,National Institute of Medical Device Safety Information, Seoul, Republic of Korea.,Department of Medical Biotechnology, Dongguk University-Seoul, Seoul, Korea
| | - Eun Cheol Kim
- Research Institute for Commercialization of Biomedical Convergence Technology, Seoul, Republic of Korea.,Medical Device Industry Program in Graduate School, Dongguk University, Seoul, Republic of Korea.,National Institute of Medical Device Safety Information, Seoul, Republic of Korea.,Department of Medical Biotechnology, Dongguk University-Seoul, Seoul, Korea
| | - Sung Min Kim
- Research Institute for Commercialization of Biomedical Convergence Technology, Seoul, Republic of Korea.,Medical Device Industry Program in Graduate School, Dongguk University, Seoul, Republic of Korea.,National Institute of Medical Device Safety Information, Seoul, Republic of Korea.,Department of Medical Biotechnology, Dongguk University-Seoul, Seoul, Korea
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19
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Leroy G, Kauchak D, Kloehn N. Incidence and Impact of Missing Functional Elements on Information Comprehension using Audio and Text. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2022; 2021:697-706. [PMID: 35309000 PMCID: PMC8861712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Audio is increasingly used to communicate health information. Initial evaluations have shown it to be an effective means with many features that can be optimized. This study focuses on missing functional elements: words that relate concepts in a sentence but are often excluded for brevity. They are not easily recognizable without linguistics expertise but can be detected algorithmically. Two studies showed that they are common and affect comprehension. A corpus statistics study with medical (Cochrane sentences, N=44,488) and general text (English and Simple English Wikipedia sentences, N=318,056 each) showed that functional elements were missing in 20-30% of sentences. A user study with Cochrane (N=50) and Wikipedia (N=50) paragraphs in text and audio format showed that more missing functional elements increased perceived difficulty of reading text, with the effect less pronounced with audio, and increased actual difficulty of both written and audio information with less information recalled with more missing elements.
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20
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The Role of New Technological Opportunities and the Need to Evaluate the Activities Performed in the Prevention of Diabetic Foot with Exercise Therapy. MEDICINES 2021; 8:medicines8120076. [PMID: 34940288 PMCID: PMC8706849 DOI: 10.3390/medicines8120076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/22/2021] [Accepted: 11/28/2021] [Indexed: 01/22/2023]
Abstract
The diabetic foot (DF) is one of the most feared conditions among chronic complications of diabetes, which affects a growing number of patients. Although exercise therapy (ET) has always been considered a pillar in the treatment of patients at risk of DF it is not usually used. Several causes can contribute to hindering both the organization of ET protocols for Diabetes Units and the participation in ET programs for patients at different levels of risk of foot ulceration. The risk of favoring the occurrence of ulcers and the absence of clear evidence on the role played by ET in the prevention of ulcers could be considered among the most important causes leading to the low application of ET. The increased availability of new technologies and in particular of systems and devices equipped with sensors can enable the remote monitoring and management of physical activity performed by patients. Consequently, they can become an opportunity for introducing the systematic use of ET for the treatment of patients at risk. Considering the complexity of the clinical conditions that patients at risk or with diabetic foot ulcer can show, the evaluation of how patients perform the ET proposed can consequently be very important. All this can contribute to improving the treatment of patients and avoiding possible adverse effects. The aim of this brief review was to describe that the use of new technologies and the assessment of the execution of the ET proposed allows an important step forward in the management of patients at risk.
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21
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Lucas Y, Niri R, Treuillet S, Douzi H, Castaneda B. Wound Size Imaging: Ready for Smart Assessment and Monitoring. Adv Wound Care (New Rochelle) 2021; 10:641-661. [PMID: 32320356 PMCID: PMC8392100 DOI: 10.1089/wound.2018.0937] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 03/02/2020] [Indexed: 01/02/2023] Open
Abstract
Significance: We introduce and evaluate emerging devices and modalities for wound size imaging and also promising image processing tools for smart wound assessment and monitoring. Recent Advances: Some commercial devices are available for optical wound assessment but with limited possibilities compared to the power of multimodal imaging. With new low-cost devices and machine learning, wound assessment has become more robust and accurate. Wound size imaging not only provides area and volume but also the proportion of each tissue on the wound bed. Near-infrared and thermal spectral bands also enhance the classical visual assessment. Critical Issues: The ability to embed advanced imaging technology in portable devices such as smartphones and tablets with tissue analysis software tools will significantly improve wound care. As wound care and measurement are performed by nurses, the equipment needs to remain user-friendly, enable quick measurements, provide advanced monitoring, and be connected to the patient data management system. Future Directions: Combining several image modalities and machine learning, optical wound assessment will be smart enough to enable real wound monitoring, to provide clinicians with relevant indications to adapt the treatments and to improve healing rates and speed. Sharing the wound care histories of a number of patients on databases and through telemedicine practice could induce a better knowledge of the healing process and thus a better efficiency when the recorded clinical experience has been converted into knowledge through deep learning.
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Affiliation(s)
- Yves Lucas
- PRISME Laboratory, Orléans University, Orléans, France
| | - Rania Niri
- PRISME Laboratory, Orléans University, Orléans, France
- IRF-SIC Laboratory, Ibn Zohr University, Agadir, Morocco
| | | | - Hassan Douzi
- IRF-SIC Laboratory, Ibn Zohr University, Agadir, Morocco
| | - Benjamin Castaneda
- Laboratorio de Imagenes Medicas, Pontificia Universidad Catholica del Peru, Lima, Peru
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22
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Yang F, Wu Q, Hu X, Ye J, Yang Y, Rao H, Ma R, Hu B. Internet-of-Things-Enabled Data Fusion Method for Sleep Healthcare Applications. IEEE INTERNET OF THINGS JOURNAL 2021; 8:15892-15905. [PMID: 35782187 PMCID: PMC8769004 DOI: 10.1109/jiot.2021.3067905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/26/2021] [Accepted: 03/17/2021] [Indexed: 05/09/2023]
Abstract
The Internet of Medical Things (IoMT) aims to exploit the Internet-of-Things (IoT) techniques to provide better medical treatment scheme for patients with smart, automatic, timely, and emotion-aware clinical services. One of the IoMT instances is applying IoT techniques to sleep-aware smartphones or wearable devices' applications to provide better sleep healthcare services. As we all know, sleep is vital to our daily health. What is more, studies have shown a strong relationship between sleep difficulties and various diseases such as COVID-19. Therefore, leveraging IoT techniques to develop a longer lifetime sleep healthcare IoMT system, with a tradeoff between data transferring/processing speed and battery energy efficiency, to provide longer time services for bad sleep condition persons, especially the COVID-19 patients or survivors, is a meaningful research topic. In this study, we propose an IoT-enabled sleep data fusion networks (SDFN) module with a star topology Bluetooth network to fuse data of sleep-aware applications. A machine learning model is built to detect sleep events through an audio signal. We design two data reprocessing mechanisms running on our IoT devices to alleviate the data jam problem and save the IoT devices' battery energy. The experiments manifest that the presented module and mechanisms can save the energy of the system and alleviate the data jam problem of the device.
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Affiliation(s)
- Fan Yang
- School of Information Science and EngineeringLanzhou University Lanzhou 730000 China
- School of Mechanical & Automotive EngineeringSouth China University of Technology Guangzhou 510006 China
| | - Qilu Wu
- School of Information Science and EngineeringLanzhou University Lanzhou 730000 China
| | - Xiping Hu
- School of Information Science and EngineeringLanzhou University Lanzhou 730000 China
- Shenzhen Institutes of Advanced TechnologyChinese Academy of Sciences Shenzhen 518055 China
| | - Jiancong Ye
- South China University of Technology Guangzhou 510006 China
| | - Yuting Yang
- School of Electronics and Information Technology (School of Microelectronics)Sun Yat-sen University Guangzhou 511400 China
| | - Haocong Rao
- School of Information Science and EngineeringShenzhen Institutes of Advanced Technology, Chinese Academy of Sciences Shenzhen 518055 China
| | - Rong Ma
- School of Information Science and EngineeringLanzhou University Lanzhou 730000 China
| | - Bin Hu
- School of Information Science and EngineeringLanzhou University Lanzhou 730000 China
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23
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Kong X, Wang K, Wang S, Wang X, Jiang X, Guo Y, Shen G, Chen X, Ni Q. Real-Time Mask Identification for COVID-19: An Edge-Computing-Based Deep Learning Framework. IEEE INTERNET OF THINGS JOURNAL 2021; 8:15929-15938. [PMID: 35782184 PMCID: PMC8768989 DOI: 10.1109/jiot.2021.3051844] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/20/2020] [Accepted: 01/09/2021] [Indexed: 05/20/2023]
Abstract
During the outbreak of the Coronavirus disease 2019 (COVID-19), while bringing various serious threats to the world, it reminds us that we need to take precautions to control the transmission of the virus. The rise of the Internet of Medical Things (IoMT) has made related data collection and processing, including healthcare monitoring systems, more convenient on the one hand, and requirements of public health prevention are also changing and more challengeable on the other hand. One of the most effective nonpharmaceutical medical intervention measures is mask wearing. Therefore, there is an urgent need for an automatic real-time mask detection method to help prevent the public epidemic. In this article, we put forward an edge computing-based mask (ECMask) identification framework to help public health precautions, which can ensure real-time performance on the low-power camera devices of buses. Our ECMask consists of three main stages: 1) video restoration; 2) face detection; and 3) mask identification. The related models are trained and evaluated on our bus drive monitoring data set and public data set. We construct extensive experiments to validate the good performance based on real video data, in consideration of detection accuracy and execution time efficiency of the whole video analysis, which have valuable application in COVID-19 prevention.
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Affiliation(s)
- Xiangjie Kong
- College of Computer Science and TechnologyZhejiang University of Technology Hangzhou 310023 China
| | - Kailai Wang
- School of SoftwareDalian University of Technology Dalian 116620 China
| | - Shupeng Wang
- Institute of Information EngineeringChinese Academy of Sciences Beijing 100864 China
| | - Xiaojie Wang
- School of Communication and Information EngineeringChongqing University of Posts and Telecommunications Chongqing 400065 China
| | - Xin Jiang
- Second Clinical Medical College (Shenzhen People's Hospital)Jinan University Guangzhou 510632 China
| | - Yi Guo
- Second Clinical Medical College (Shenzhen People's Hospital)Jinan University Guangzhou 510632 China
| | - Guojiang Shen
- College of Computer Science and TechnologyZhejiang University of Technology Hangzhou 310023 China
| | - Xin Chen
- School of SoftwareDalian University of Technology Dalian 116620 China
| | - Qichao Ni
- School of SoftwareDalian University of Technology Dalian 116620 China
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24
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Alharbi A, Abdur Rahman MD. Review of Recent Technologies for Tackling COVID-19. SN COMPUTER SCIENCE 2021; 2:460. [PMID: 34549196 PMCID: PMC8444512 DOI: 10.1007/s42979-021-00841-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/26/2021] [Indexed: 01/09/2023]
Abstract
The current pandemic caused by the COVID-19 virus requires more effort, experience, and science-sharing to overcome the damage caused by the pathogen. The fast and wide human-to-human transmission of the COVID-19 virus demands a significant role of the newest technologies in the form of local and global computing and information sharing, data privacy, and accurate tests. The advancements of deep neural networks, cloud computing solutions, blockchain technology, and beyond 5G (B5G) communication have contributed to the better management of the COVID-19 impacts on society. This paper reviews recent attempts to tackle the COVID-19 situation using these technological advancements.
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Affiliation(s)
- Ayman Alharbi
- Department Of Computer Engineering, College of Computer and Information systems, Umm AL-Qura University, Mecca, Saudi Arabia
| | - MD Abdur Rahman
- Department of Cyber Security and Forensic Computing, College of Computer and Cyber Sciences, University of Prince Mugrin, Madinah, 41499 Saudi Arabia
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25
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Fernando ME, Woelfel SL, Perry D, Najafi B, Khan T, DuBourdieu C, Shin L, Armstrong DG. Dosing Activity and Return to Preulcer Function in Diabetes-Related Foot Ulcer Remission. J Am Podiatr Med Assoc 2021; 111. [PMID: 33783527 DOI: 10.7547/20-166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Diabetes-related foot ulcers are a leading cause of global morbidity, mortality, and health-care costs. People with a history of foot ulcers have a diminished quality of life attributed to limited walking and mobility. One of the largest concerns is ulceration recurrence. Approximately 40% of patients with ulcerations will have a recurrent ulcer in the year after healing, and most occur in the first 3 months after wound healing. Hence, this period after ulceration is called "remission" due to this risk of reulceration. Promoting and fostering mobility is an integral part of everyday life and is important for maintaining good physical health and health-related quality of life for all people living with diabetes. In this short perspective, we provide recommendations on how to safely increase walking activity and facilitate appropriate off-loading and monitoring in people with a recently healed foot ulcer, foot reconstruction, or partial foot amputation. Interventions include monitored activity training, dosed out in steadily increasing increments and coupled with daily skin temperature monitoring, which can identify dangerous "hotspots" prone to recurrence. By understanding areas at risk, patients are empowered to maximize ulcer-free days and to enable an improved quality of life. This perspective outlines a unified strategy to treat patients in the remission period after ulceration and aims to provide clinicians with appropriate patient recommendations based on best available evidence and expert opinion to educate their patients to ensure a safe transition to footwear and return to activity.
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26
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Desai D, Shende P. Integration of Internet of Things with Quantum Dots: A State-of-the-art of Medicine. Curr Pharm Des 2021; 27:2068-2075. [PMID: 33618640 DOI: 10.2174/1381612827666210222113740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/25/2021] [Indexed: 11/22/2022]
Abstract
Internet of Things (IoT) emerges as disruptive innovation and development in the fields of drug delivery and biomedical sciences using on-target active transportation, sensors, wearable devices, real-time diagnostics, etc. Semiconducting fluorescence emitting material, quantum dots on integration with IoT displayed interesting results in the healthcare sector, especially in hospitals and pathological laboratories. Presently, the integrated system is used to improve productivity without the interference of human and offer a cost-effective system. This integrated system can be used for the detection of various diseases like epilepsy, cancer, diabetes, etc., and various biomedical applications like energy storage, lights, sensor technology, light filters, etc. The integrated technology is implemented into the field of medicine for simplifying the approaches in therapeutics and diagnostic applications. The collected and analyzed data are further useful for healthcare professionals to find patient-centric solutions. Artificial Intelligence-aided IoT emerges as a novel technology for transmitting and securing health data. Despite some of the limitations like e-waste and the risk of hacking, an IoT-based QD system will be considered as a modern healthcare provider with life-saving products for enriching the medical quality and real-time accessibility.
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Affiliation(s)
- Drashti Desai
- Shobhaben Pratapbhai Patel School of Pharmacy and Technology Management, SVKM'S NMIMS, Vile Parle (W), Mumbai, India
| | - Pravin Shende
- Shobhaben Pratapbhai Patel School of Pharmacy and Technology Management, SVKM'S NMIMS, Vile Parle (W), Mumbai, India
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27
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Mukati N, Namdev N, Dilip R, Hemalatha N, Dhiman V, Sahu B. Healthcare assistance to COVID-19 patient using internet of things (IoT) enabled technologies. ACTA ACUST UNITED AC 2021; 80:3777-3781. [PMID: 34336599 PMCID: PMC8302836 DOI: 10.1016/j.matpr.2021.07.379] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 07/17/2021] [Indexed: 11/17/2022]
Abstract
The IoT can lead to disruptive healthcare innovation. Research articles on IoT in healthcare and COVID-19 pandemics are thus researched in order to discover the potential of this technology. This literature-based research may help professionals to explore solutions to associated issues and battle the COVID-19 epidemic. Using a process diagram, IoT's significant accomplishments were briefly evaluated. Then seven critical IoT technologies that look useful in healthcare during the COVID-19 Pandemic are identified and illustrated. Finally, in the COVID-19 Pandemic, potential fundamental IoT applications were identified for the medical industry with a short explanation. The present predicament has opened up a fresh avenue to creativity in our everyday lives. The Internet of Things is an up-and-coming technology that enhances and gives better solutions in the medical area, such as appropriate medical record-keeping, sample, device integration, and cause of sickness. IoT's sensor-based technology gives a remarkable ability to lower the danger of intervention in challenging circumstances and is helpful for the pandemic type COVID-19. In the sphere of medicine, IoT's emphasis is on helping to treat diverse COVID-19 situations accurately. It facilitates the work of the surgeon by reducing risks and enhancing overall performance. Using this technology, physicians may readily identify changes in the COVID-19′s vital parameters. These information-based services provide new prospects for healthcare as they advance towards the ideal technique for an information system to adapt world-class outcomes by improving hospital treatment systems. Medical students may now be better taught and led in the future for the identification of sickness. Proper use of IoT may assist handle several medical difficulties such as speed, affordability, and complexity appropriately. It may simply be adapted to track patients' calorific intake and therapy with COVID-19 asthma, diabetes, and arthritis. In COVID-19 pandemic days, this digitally managed health management system may enhance the overall healthcare performance.
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Affiliation(s)
- Naveen Mukati
- Department of Electronics and Communication Engineering, Prestige Institute of Engineering Management and Research, Indore, India
| | - Neha Namdev
- Department of Electronics and Instrumentation Engineering, Shri Govindram Seksaria Institute of Technology and Science, Indore, India
| | - R Dilip
- Acharya Institute of Technology, Department of Mechatronics Engineering, Bengaluru, India
| | - N Hemalatha
- Saveetha School Of Engineering(Simats), Chennai, India
| | - Viney Dhiman
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bharti Sahu
- Department of Computer Engineering, Dr. D.Y. Patil Institute of Technology, Pimpri, Pune18, India
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Rampioni M, Moșoi AA, Rossi L, Moraru SA, Rosenberg D, Stara V. A Qualitative Study toward Technologies for Active and Healthy Aging: A Thematic Analysis of Perspectives among Primary, Secondary, and Tertiary End Users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147489. [PMID: 34299940 PMCID: PMC8308090 DOI: 10.3390/ijerph18147489] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 12/23/2022]
Abstract
It is expected that, by 2050, people aged over 60 in 65 nations will constitute 30% of the total population. Healthy aging is at the top of the world political agenda as a possible means for hindering the collapse of care systems. How can ICT/sensing technology meet older people's needs for active and healthy aging? This qualitative study carried out in Italy and Romania in 2020 involved 30 participants: older adults, caregivers, and stakeholders. Based on a user-centered design approach, this study aimed to understand which requirements of ICT/sensing technologies could match people's needs of active and healthy aging. Findings highlighted that ICT/sensing technology needs to focus on six major themes: (1) learnability, (2) security, (3) independence, empowerment, and coaching values, (4) social isolation, (5) impact of habit, culture, and education variables, and (6) personalized solutions. These themes are consistent with the Active Aging framework and the factors that influence perceived usefulness and potential benefits among older adults. Consequently, this study shows how well-known, but still unresolved, issues affect the field of information and communication technologies (ICTs) to promote active and healthy aging. This suggests that the reinforcement of the public health system, especially considering the pandemic effect, requires a concrete and formidable effort from an interdisciplinary research network.
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Affiliation(s)
- Margherita Rampioni
- IRCCS INRCA—National Institute of Health and Science on Ageing, Innovative Models for Ageing Care and Technology, via S. Margherita 5, 60124 Ancona, Italy; (M.R.); (L.R.)
| | - Adrian Alexandru Moșoi
- Department of Psychology, Education and Teacher Training, Transilvania University of Brasov, B-dul Eroilor 29, 500036 Brașov, Romania;
| | - Lorena Rossi
- IRCCS INRCA—National Institute of Health and Science on Ageing, Innovative Models for Ageing Care and Technology, via S. Margherita 5, 60124 Ancona, Italy; (M.R.); (L.R.)
| | - Sorin-Aurel Moraru
- Department of Automatics and Information Technology, Transilvania University of Brasov, B-dul Eroilor 29, 500036 Brașov, Romania; (S.-A.M.); (D.R.)
| | - Dan Rosenberg
- Department of Automatics and Information Technology, Transilvania University of Brasov, B-dul Eroilor 29, 500036 Brașov, Romania; (S.-A.M.); (D.R.)
| | - Vera Stara
- IRCCS INRCA—National Institute of Health and Science on Ageing, Innovative Models for Ageing Care and Technology, via S. Margherita 5, 60124 Ancona, Italy; (M.R.); (L.R.)
- Correspondence:
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Leite ML, de Loiola Costa LS, Cunha VA, Kreniski V, de Oliveira Braga Filho M, da Cunha NB, Costa FF. Artificial intelligence and the future of life sciences. Drug Discov Today 2021; 26:2515-2526. [PMID: 34245910 DOI: 10.1016/j.drudis.2021.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 05/12/2021] [Accepted: 07/01/2021] [Indexed: 12/23/2022]
Abstract
Over the past few decades, the number of health and 'omics-related data' generated and stored has grown exponentially. Patient information can be collected in real time and explored using various artificial intelligence (AI) tools in clinical trials; mobile devices can also be used to improve aspects of both the diagnosis and treatment of diseases. In addition, AI can be used in the development of new drugs or for drug repurposing, in faster diagnosis and more efficient treatment for various diseases, as well as to identify data-driven hypotheses for scientists. In this review, we discuss how AI is starting to revolutionize the life sciences sector.
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Affiliation(s)
- Michel L Leite
- Genomic Sciences and Biotechnology Program, Universidade Católica de Brasília SGAN 916 Modulo B, Bloco C, 70.790-160, Brasília, DF, Brazil; Department of Molecular Biology, Biological Sciences Institute, University of Brasília, Campus Darcy Ribeiro, Block K, 70.790-900, Brasilia, Federal District, Brazil
| | - Lorena S de Loiola Costa
- Genomic Sciences and Biotechnology Program, Universidade Católica de Brasília SGAN 916 Modulo B, Bloco C, 70.790-160, Brasília, DF, Brazil
| | - Victor A Cunha
- Genomic Sciences and Biotechnology Program, Universidade Católica de Brasília SGAN 916 Modulo B, Bloco C, 70.790-160, Brasília, DF, Brazil
| | - Victor Kreniski
- Apple Developer Academy, Universidade Católica de Brasília, Brasilia, Brazil
| | | | - Nicolau B da Cunha
- Genomic Sciences and Biotechnology Program, Universidade Católica de Brasília SGAN 916 Modulo B, Bloco C, 70.790-160, Brasília, DF, Brazil
| | - Fabricio F Costa
- Genomic Sciences and Biotechnology Program, Universidade Católica de Brasília SGAN 916 Modulo B, Bloco C, 70.790-160, Brasília, DF, Brazil; Apple Developer Academy, Universidade Católica de Brasília, Brasilia, Brazil; Cancer Biology and Epigenomics Program, Ann & Robert H Lurie Children's Hospital of Chicago Research Center and Northwestern University's Feinberg School of Medicine, 2430 N. Halsted St, Box 220, Chicago, IL 60614, USA; MATTER Chicago, 222 W. Merchandise Mart Plaza, Suite 12th Floor, Chicago, IL 60654, USA; Genomic Enterprise, San Diego, CA 92008, USA; Genomic Enterprise, New York, NY 11581, USA.
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Inomata T, Iwagami M, Nakamura M, Shiang T, Yoshimura Y, Fujimoto K, Okumura Y, Eguchi A, Iwata N, Miura M, Hori S, Hiratsuka Y, Uchino M, Tsubota K, Dana R, Murakami A. Characteristics and Risk Factors Associated With Diagnosed and Undiagnosed Symptomatic Dry Eye Using a Smartphone Application. JAMA Ophthalmol 2021; 138:58-68. [PMID: 31774457 DOI: 10.1001/jamaophthalmol.2019.4815] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance The incidence of dry eye disease has increased; the potential for crowdsource data to help identify undiagnosed dry eye in symptomatic individuals remains unknown. Objective To assess the characteristics and risk factors associated with diagnosed and undiagnosed symptomatic dry eye using the smartphone app DryEyeRhythm. Design, Setting, and Participants A cross-sectional study using crowdsourced data was conducted including individuals in Japan who downloaded DryEyeRhythm and completed the entire questionnaire; duplicate users were excluded. DryEyeRhythm was released on November 2, 2016; the study was conducted from November 2, 2016, to January 12, 2018. Exposures DryEyeRhythm data were collected on demographics, medical history, lifestyle, subjective symptoms, and disease-specific symptoms, using the Ocular Surface Disease Index (100-point scale; scores 0-12 indicate normal, healthy eyes; 13-22, mild dry eye; 23-32, moderate dry eye; 33-100, severe dry eye symptoms), and the Zung Self-Rating Depression Scale (total of 20 items, total score ranging from 20-80, with ≥40 highly suggestive of depression). Main Outcomes and Measures Multivariate-adjusted logistic regression analysis was used to identify risk factors for symptomatic dry eye and to identify risk factors for undiagnosed symptomatic dry eye. Results A total of 21 394 records were identified in our database; 4454 users, included 899 participants (27.3%) with diagnosed and 2395 participants (72.7%) with undiagnosed symptomatic dry eye, completed all questionnaires and their data were analyzed. A total of 2972 participants (66.7%) were women; mean (SD) age was 27.9 (12.6) years. The identified risk factors for symptomatic vs no symptomatic dry eye included younger age (odds ratio [OR], 0.99; 95% CI, 0.987-0.999, P = .02), female sex (OR, 1.99; 95% CI, 1.61-2.46; P < .001), pollinosis (termed hay fever on the questionnaire) (OR, 1.35; 95% CI, 1.18-1.55; P < .001), depression (OR, 1.78; 95% CI, 1.18-2.69; P = .006), mental illnesses other than depression or schizophrenia (OR, 1.87; 95% CI, 1.24-2.82; P = .003), current contact lens use (OR, 1.27; 95% CI, 1.09-1.48; P = .002), extended screen exposure (OR, 1.55; 95% CI, 1.25-1.91; P < .001), and smoking (OR, 1.65; 95% CI, 1.37-1.98; P < .001). The risk factors for undiagnosed vs diagnosed symptomatic dry eye included younger age (OR, 0.96; 95% CI, 0.95-0.97; P < .001), male sex (OR, 0.55; 95% CI, 0.42-0.72; P < .001), as well as absence of collagen disease (OR, 95% CI, 0.23; 0.09-0.60; P = .003), mental illnesses other than depression or schizophrenia (OR, 0.50; 95% CI, 0.36-0.69; P < .001), ophthalmic surgery other than cataract surgery and laser-assisted in situ keratomileusis (OR, 0.41; 95% CI, 0.27-0.64; P < .001), and current (OR, 0.64; 95% CI, 0.54-0.77; P < .001) or past (OR, 0.45; 95% CI, 0.34-0.58; P < .001) contact lens use. Conclusions and Relevance This study's findings suggest that crowdsourced research identified individuals with diagnosed and undiagnosed symptomatic dry eye and the associated risk factors. These findings could play a role in earlier prevention or more effective interventions for dry eye disease.
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Affiliation(s)
- Takenori Inomata
- Faculty of Medicine, Department of Ophthalmology, Juntendo University, Tokyo Japan.,Faculty of Medicine, Department of Strategic Operating Room Management and Improvement, Juntendo University, Tokyo, Japan
| | - Masao Iwagami
- Faculty of Medicine, Department of Health Services Research, University of Tsukuba, Ibaraki, Japan
| | - Masahiro Nakamura
- Graduate School of Engineering, Department of Bioengineering, Precision Health, The University of Tokyo, Tokyo, Japan
| | - Tina Shiang
- Department of Radiology, University of Massachusetts Medical School, Worcester, Massachusetts
| | | | - Keiichi Fujimoto
- Faculty of Medicine, Department of Ophthalmology, Juntendo University, Tokyo Japan
| | - Yuichi Okumura
- Faculty of Medicine, Department of Ophthalmology, Juntendo University, Tokyo Japan.,Faculty of Medicine, Department of Strategic Operating Room Management and Improvement, Juntendo University, Tokyo, Japan
| | - Atsuko Eguchi
- Faculty of Medicine, Department of Hospital Administration, Juntendo University, Tokyo, Japan
| | - Nanami Iwata
- Faculty of Medicine, Department of Ophthalmology, Juntendo University, Tokyo Japan
| | - Maria Miura
- Faculty of Medicine, Department of Ophthalmology, Juntendo University, Tokyo Japan
| | - Satoshi Hori
- Faculty of Medicine, Department of Electric Medical Intelligence Management, Juntendo University, Tokyo, Japan
| | - Yoshimune Hiratsuka
- Faculty of Medicine, Department of Ophthalmology, Juntendo University, Tokyo Japan
| | - Miki Uchino
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Reza Dana
- Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Akira Murakami
- Faculty of Medicine, Department of Ophthalmology, Juntendo University, Tokyo Japan
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Zhang X, Du W, Liu F. Effect of all-in-one nursing model on ICU ventilator-associated pneumonia. Am J Transl Res 2021; 13:5080-5086. [PMID: 34150095 PMCID: PMC8205670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/01/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To study the effect of an all-in-one nursing model on ICU ventilator-associated pneumonia (VAP). METHODS A total of 100 ICU patients needing ventilator assistance who were admitted to our hospital from March 2018 to December 2019 were equally randomized into two groups by a lottery system, with 50 cases in each group. Patients in the control group received routine nursing, and patients in the experimental group received all-in-one nursing. The number of ICU VAP patients, time transferring from ICU to an ordinary ward, hospital stay, mechanical ventilation time, nursing efficiency, and the changes of blood pressure, heart rate and oxygen saturation during nursing was compared between the two groups. RESULTS Regarding the number of cases of VAP, the length of stay in the ICU, and the length of hospital stay, and the mechanical ventilation time, the experimental group was markedly shorter than that of the control group (P<0.05). With respect to the effective rates of nursing care, the experimental group (96%) was better than the control group (80%) (P<0.05). When considering the changes of hemodynamic indexes during the nursing process, the two groups exhibited no marked difference (P>0.05). After intervention, the control group was inferior in terms of the oxygen partial pressure and carbon dioxide partial pressure compared to the experimental group (P<0.05). CONCLUSION All-in-one nursing can reduce the incidence of VAP in ICU patients, significantly shorten the length of ICU stay, hospital stay and mechanical ventilation time, thus improving overall nursing efficiency.
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Affiliation(s)
- Xin Zhang
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital Cangzhou, P. R. China
| | - Wenxiu Du
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital Cangzhou, P. R. China
| | - Fang Liu
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital Cangzhou, P. R. China
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Jarl G, van Netten JJ, Lazzarini PA, Crews RT, Najafi B, Mueller MJ. Should weight-bearing activity be reduced during healing of plantar diabetic foot ulcers, even when using appropriate offloading devices? Diabetes Res Clin Pract 2021; 175:108733. [PMID: 33713722 DOI: 10.1016/j.diabres.2021.108733] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 11/17/2020] [Accepted: 02/18/2021] [Indexed: 11/19/2022]
Abstract
Physical activity is an essential part of general health and diabetes management. However, recommending weight-bearing physical activity for people with plantar diabetic foot ulcers is controversial, even when gold standard offloading devices are used, as it is commonly thought to delay healing. We aimed to narratively review relevant studies investigating the relationship between plantar diabetic foot ulcer healing and weight-bearing activity, plantar pressure and device adherence. We defined relevant studies as those from two systematic reviews, along with those identified since using a similar updated Pubmed search strategy. We identified six studies. One study found that more daily steps were associated with worse ulcer healing, three found no significant association between steps and ulcer healing, and in two others the association was unclear. Thus, there is weak evidence for an inverse relationship between weight-bearing physical activity and plantar ulcer healing while utilizing offloading devices. We propose a Diabetic foot Offloading and Activity framework to guide future research to find the optimal balance between the positive and negative effects of weight-bearing activity in the context of foot ulcers. We hope such future studies will shed more conclusive light on the impact of weight-bearing activity on healing of plantar diabetic foot ulcers.
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Affiliation(s)
- Gustav Jarl
- Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
| | - Jaap J van Netten
- Amsterdam UMC, University of Amsterdam, Dept of Rehabilitation, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands; School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia.
| | - Peter A Lazzarini
- Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, Australia; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
| | - Ryan T Crews
- Dr. William M. Scholl College of Podiatric Medicine's Center for Lower Extremity Ambulatory Research (CLEAR) at Rosalind Franklin University, North Chicago, IL, USA.
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Michael J Mueller
- Program in Physical Therapy and Department of Radiology, Washington University School of Medicine in St Louis, St. Louis, MO 63108, USA.
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Haroun A, Le X, Gao S, Dong B, He T, Zhang Z, Wen F, Xu S, Lee C. Progress in micro/nano sensors and nanoenergy for future AIoT-based smart home applications. NANO EXPRESS 2021. [DOI: 10.1088/2632-959x/abf3d4] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Abstract
Self-sustainable sensing systems composed of micro/nano sensors and nano-energy harvesters contribute significantly to developing the internet of things (IoT) systems. As one of the most promising IoT applications, smart home relies on implementing wireless sensor networks with miniaturized and multi-functional sensors, and distributed, reliable, and sustainable power sources, namely energy harvesters with a variety of conversion mechanisms. To extend the capabilities of IoT in the smart home, a technology fusion of IoT and artificial intelligence (AI), called the artificial intelligence of things (AIoT), enables the detection, analysis, and decision-making functions with the aids of machine learning assisted algorithms to form a smart home based intelligent system. In this review, we introduce the conventional rigid microelectromechanical system (MEMS) based micro/nano sensors and energy harvesters, followed by presenting the advances in the wearable counterparts for better human interactions. We then discuss the viable integration approaches for micro/nano sensors and energy harvesters to form self-sustainable IoT systems. Whereafter, we emphasize the recent development of AIoT based systems and the corresponding applications enabled by the machine learning algorithms. Smart home based healthcare technology enabled by the integrated multi-functional sensing platform and bioelectronic medicine is also presented as an important future direction, as well as wearable photonics sensing system as a complement to the wearable electronics sensing system.
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Design of an Interactive Two-Way Telemedicine Service System for Smart Home Care for the Elderly. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:6632865. [PMID: 33936578 PMCID: PMC8060097 DOI: 10.1155/2021/6632865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/25/2021] [Accepted: 03/31/2021] [Indexed: 11/18/2022]
Abstract
In this paper, we deeply analyse and study the interactive telemedicine service system for elderly care in smart homes and design a data summarization method for large concurrent scenarios. The method first parses and reconstructs the data received by the system initially and then stores the reconstructed valid data into the local database, which realizes the fast data summarization under the heavy concurrency scenario. Secondly, a multiformat data adaptation method is designed for the problem that the data to be provided and processed are in various formats. The method uses a unified data format and adaptation process constraints to achieve centralized management of heterogeneous data from multiple sources, which provide a unified data support service for the system and upper-layer applications. Again, to deal with the application problem of highly correlated data, the data-sharing system provides data for each functional component of the telemedicine platform according to business requirements based on standardized data structure and unified storage management. This enables the barrier-free flow of multisource highly correlated data. When the consultation is in progress, the doctor can communicate with the patient with video and audio devices and, at the same time, can access the patient's historical medical records and the medical records uploaded by the patient; after the consultation is completed, the consultation doctor needs to fill in the consultation record. The consultation assistance module can statistically analyse the workload of doctors and other information according to the background data, and the telemedicine system will play an increasingly important role in the medical and health care business.
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Najafi B, Mishra R. Harnessing Digital Health Technologies to Remotely Manage Diabetic Foot Syndrome: A Narrative Review. ACTA ACUST UNITED AC 2021; 57:medicina57040377. [PMID: 33919683 PMCID: PMC8069817 DOI: 10.3390/medicina57040377] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 12/15/2022]
Abstract
About 422 million people worldwide have diabetes and approximately one-third of them have a major risk factor for diabetic foot ulcers, including poor sensation in their feet from peripheral neuropathy and/or poor perfusion to their feet from peripheral artery disease. The current healthcare ecosystem, which is centered on the treatment of established foot disease, often fails to adequately control key reversible risk factors to prevent diabetic foot ulcers leading to unacceptable high foot disease amputation rate, 40% recurrence of ulcers rate in the first year, and high hospital admissions. Thus, the latest diabetic foot ulcer guidelines emphasize that a paradigm shift in research priority from siloed hospital treatments to innovative integrated community prevention is now critical to address the high diabetic foot ulcer burden. The widespread uptake and acceptance of wearable and digital health technologies provide a means to timely monitor major risk factors associated with diabetic foot ulcer, empower patients in self-care, and effectively deliver the remote monitoring and multi-disciplinary prevention needed for those at-risk people and address the health care access disadvantage that people living in remote areas. This narrative review paper summarizes some of the latest innovations in three specific areas, including technologies supporting triaging high-risk patients, technologies supporting care in place, and technologies empowering self-care. While many of these technologies are still in infancy, we anticipate that in response to the Coronavirus Disease 2019 pandemic and current unmet needs to decentralize care for people with foot disease, we will see a new wave of innovations in the area of digital health, smart wearables, telehealth technologies, and “hospital-at-home” care delivery model. These technologies will be quickly adopted at scale to improve remote management of diabetic foot ulcers, smartly triaging those who need to be seen in outpatient or inpatient clinics, and supporting acute or subacute care at home.
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Javaid M, Khan IH. Internet of Things (IoT) enabled healthcare helps to take the challenges of COVID-19 Pandemic. J Oral Biol Craniofac Res 2021; 11:209-214. [PMID: 33665069 PMCID: PMC7897999 DOI: 10.1016/j.jobcr.2021.01.015] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 01/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND/OBJECTIVES The Internet of Things (IoT) can create disruptive innovation in healthcare. Thus, during COVID-19 Pandemic, there is a need to study different applications of IoT enabled healthcare. For this, a brief study is required for research directions. METHODS Research papers on IoT in healthcare and COVID-19 Pandemic are studied to identify this technology's capabilities. This literature-based study may guide professionals in envisaging solutions to related problems and fighting against the COVID-19 type pandemic. RESULTS Briefly studied the significant achievements of IoT with the help of a process chart. Then identifies seven major technologies of IoT that seem helpful for healthcare during COVID-19 Pandemic. Finally, the study identifies sixteen basic IoT applications for the medical field during the COVID-19 Pandemic with a brief description of them. CONCLUSIONS In the current scenario, advanced information technologies have opened a new door to innovation in our daily lives. Out of these information technologies, the Internet of Things is an emerging technology that provides enhancement and better solutions in the medical field, like proper medical record-keeping, sampling, integration of devices, and causes of diseases. IoT's sensor-based technology provides an excellent capability to reduce the risk of surgery during complicated cases and helpful for COVID-19 type pandemic. In the medical field, IoT's focus is to help perform the treatment of different COVID-19 cases precisely. It makes the surgeon job easier by minimising risks and increasing the overall performance. By using this technology, doctors can easily detect changes in critical parameters of the COVID-19 patient. This information-based service opens up new healthcare opportunities as it moves towards the best way of an information system to adapt world-class results as it enables improvement of treatment systems in the hospital. Medical students can now be better trained for disease detection and well guided for the future course of action. IoT's proper usage can help correctly resolve different medical challenges like speed, price, and complexity. It can easily be customised to monitor calorific intake and treatment like asthma, diabetes, and arthritis of the COVID-19 patient. This digitally controlled health management system can improve the overall performance of healthcare during COVID-19 pandemic days.
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Affiliation(s)
- Mohd Javaid
- Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India
| | - Ibrahim Haleem Khan
- School of Engineering Sciences and Technology, Jamia Hamdard, New Delhi, India
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Cruvinel Júnior RH, Ferreira JSSP, Beteli RI, Silva ÉQ, Veríssimo JL, Monteiro RL, Suda EY, Sacco ICN. Foot-ankle functional outcomes of using the Diabetic Foot Guidance System (SOPeD) for people with diabetic neuropathy: a feasibility study for the single-blind randomized controlled FOotCAre (FOCA) trial I. Pilot Feasibility Stud 2021; 7:87. [PMID: 33766146 PMCID: PMC7995736 DOI: 10.1186/s40814-021-00826-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 01/18/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Diabetic neuropathy dramatically affects musculoskeletal structure and function of the lower limbs by impairing their muscle strength and mobility. Specific muscle strengthening through physiotherapy strategies appears to be promising; however, adherence to physiotherapy treatment is low in people with chronic diseases. Thus, an internet-based foot-ankle exercise program was created as a potential telerehabilitation alternative for people with diabetes to improve their self-monitoring and self-care management. This study assessed the feasibility, safety, acceptability, and changes in foot health and neuropathy symptoms in people with diabetes after 12 weeks of the intervention program with the Sistema de Orientação ao Pé diabético - Diabetic Foot Guidance System (SOPeD). METHODS Fourteen individuals were recruited and randomized to either the usual care (control group) or usual care plus an internet-based foot-ankle exercise program through SOPeD (intervention group) three times per week for 12 weeks. For feasibility, we assessed contact and recruitment rates per week; program adherence, determined as completing over 70% of the 36 sessions; and participant satisfaction and safety assessed through a questionnaire and scored on a 5-point Likert scale. We assessed changes in neuropathy symptoms and foot health and functionality from baseline to 12 weeks estimating differences or median of differences and 95% confidence intervals in the intervention group. RESULTS In 24 weeks, of the 822 patients in the database, 192 were contacted, 65 were assessed for eligibility, and 20 were considered eligible. The recruitment rate was 0.83 participants per week. Fourteen out of the 20 eligible participants agreed to participate, resulting in recruitment success of 70%. Adherence to the program was 66.7%, and there was no dropout. Participants' median level of satisfaction was 5.0 (IQR: 4.5-5.0) and perceived safety was 5.0 (IQR: 5.0-5.0). CONCLUSION The internet-based foot-ankle exercise program using SOPeD is feasible, satisfactory, and safe. Although this study had moderate adherence and a zero-dropout rate, recruitment needs to be improved in the larger trial. TRIAL REGISTRATION ClinicalTrials.gov, NCT04011267 . Registered on 8 July 2019.
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Affiliation(s)
- Ronaldo H Cruvinel Júnior
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, São Paulo, São Paulo, 05360-160, Brazil
| | - Jane S S P Ferreira
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, São Paulo, São Paulo, 05360-160, Brazil
| | - Raquel I Beteli
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, São Paulo, São Paulo, 05360-160, Brazil
| | - Érica Q Silva
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, São Paulo, São Paulo, 05360-160, Brazil
| | - Jady L Veríssimo
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, São Paulo, São Paulo, 05360-160, Brazil
| | - Renan L Monteiro
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, São Paulo, São Paulo, 05360-160, Brazil
- Department of Physical Therapy, Federal University of Amapá, Amapá, Brazil
| | - Eneida Y Suda
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, São Paulo, São Paulo, 05360-160, Brazil
- Department of Physical Therapy, Ibirapuera University, São Paulo, SP, Brazil
| | - Isabel C N Sacco
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, São Paulo, São Paulo, 05360-160, Brazil.
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Beach C, Cooper G, Weightman A, Hodson-Tole EF, Reeves ND, Casson AJ. Monitoring of Dynamic Plantar Foot Temperatures in Diabetes with Personalised 3D-Printed Wearables. SENSORS 2021; 21:s21051717. [PMID: 33801346 PMCID: PMC7958320 DOI: 10.3390/s21051717] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/11/2021] [Accepted: 02/23/2021] [Indexed: 12/12/2022]
Abstract
Diabetic foot ulcers (DFUs) are a life-changing complication of diabetes that can lead to amputation. There is increasing evidence that long-term management with wearables can reduce incidence and recurrence of this condition. Temperature asymmetry measurements can alert to DFU development, but measurements of dynamic information, such as rate of temperature change, are under investigated. We present a new wearable device for temperature monitoring at the foot that is personalised to account for anatomical variations at the foot. We validate this device on 13 participants with diabetes (no neuropathy) (group name D) and 12 control participants (group name C), during sitting and standing. We extract dynamic temperature parameters from four sites on each foot to compare the rate of temperature change. During sitting the time constant of temperature rise after shoe donning was significantly (p < 0.05) faster at the hallux (p = 0.032, 370.4 s (C), 279.1 s (D)) and 5th metatarsal head (p = 0.011, 481.9 s (C), 356.6 s (D)) in participants with diabetes compared to controls. No significant differences at the other sites or during standing were identified. These results suggest that temperature rise time is faster at parts of the foot in those who have developed diabetes. Elevated temperatures are known to be a risk factor of DFUs and measurement of time constants may provide information on their development. This work suggests that temperature rise time measured at the plantar surface may be an indicative biomarker for differences in soft tissue biomechanics and vascularisation during diabetes onset and progression.
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Affiliation(s)
- Christopher Beach
- Department of Electrical and Electronic Engineering, The University of Manchester, Manchester M13 9PL, UK;
- Correspondence:
| | - Glen Cooper
- Department of Mechanical, Aerospace and Civil Engineering, The University of Manchester, Manchester M13 9PL, UK; (G.C.); (A.W.)
| | - Andrew Weightman
- Department of Mechanical, Aerospace and Civil Engineering, The University of Manchester, Manchester M13 9PL, UK; (G.C.); (A.W.)
| | - Emma F. Hodson-Tole
- Research Centre for Musculoskeletal Science & Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester M15 6BH, UK; (E.F.H.-T.); (N.D.R.)
| | - Neil D. Reeves
- Research Centre for Musculoskeletal Science & Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester M15 6BH, UK; (E.F.H.-T.); (N.D.R.)
| | - Alexander J. Casson
- Department of Electrical and Electronic Engineering, The University of Manchester, Manchester M13 9PL, UK;
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Bhatia R. Emerging Health Technologies and How They Can Transform Healthcare Delivery. JOURNAL OF HEALTH MANAGEMENT 2021. [DOI: 10.1177/0972063421995025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Health technologies have been and shall always be an integral part of the health system. Appropriate technologies provide solutions to improve healthcare services at an affordable cost. New biomedical, bioengineering and digital technologies continue to swamp the health system and consume a major part of the health budget. National authorities should develop a policy framework that articulates needs, standards and projections of safe and cost-effective technologies in the context of local epidemiological data and the felt needs of communities. Efficient implementation of health technologies requires availability of an adequate number of skilled human resources for health and infrastructure, for maintenance and replacement or for upgradation of these technologies.
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Affiliation(s)
- Rajesh Bhatia
- Former Director, Communicable Diseases, WHO Regional Office for South-East Asia, New Delhi, India
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Muhammad K, Khan S, Ser JD, Albuquerque VHCD. Deep Learning for Multigrade Brain Tumor Classification in Smart Healthcare Systems: A Prospective Survey. IEEE TRANSACTIONS ON NEURAL NETWORKS AND LEARNING SYSTEMS 2021; 32:507-522. [PMID: 32603291 DOI: 10.1109/tnnls.2020.2995800] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Brain tumor is one of the most dangerous cancers in people of all ages, and its grade recognition is a challenging problem for radiologists in health monitoring and automated diagnosis. Recently, numerous methods based on deep learning have been presented in the literature for brain tumor classification (BTC) in order to assist radiologists for a better diagnostic analysis. In this overview, we present an in-depth review of the surveys published so far and recent deep learning-based methods for BTC. Our survey covers the main steps of deep learning-based BTC methods, including preprocessing, features extraction, and classification, along with their achievements and limitations. We also investigate the state-of-the-art convolutional neural network models for BTC by performing extensive experiments using transfer learning with and without data augmentation. Furthermore, this overview describes available benchmark data sets used for the evaluation of BTC. Finally, this survey does not only look into the past literature on the topic but also steps on it to delve into the future of this area and enumerates some research directions that should be followed in the future, especially for personalized and smart healthcare.
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Koelmeyer LA, Moloney E, Boyages J, Sherman KA, Dean CM. Prospective surveillance model in the home for breast cancer-related lymphoedema: a feasibility study. Breast Cancer Res Treat 2021; 185:401-412. [PMID: 33006001 PMCID: PMC7529356 DOI: 10.1007/s10549-020-05953-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/23/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE The aim of this study was to assess the feasibility of delivering a prospective surveillance model in the home over 6 months for women at high risk of developing lymphoedema. METHODS A single-group, intervention study recruited 20 women who had surgical and medical treatment for confirmed node-positive invasive breast cancer and therefore at high risk of developing arm lymphoedema. Participants received a package including Bioimpedance Spectroscopy (BIS) monitoring, lymphoedema education and support to promote self-management and physical activity. RESULTS Participants adhered to BIS monitoring 74% of the time, and felt extremely confident in using the device. By 6 months, mean BIS L-Dex scores had increased from 3.5 (SD 5.6) to 8.4 (SD 11.1); five women (25%) who experienced > + 6.5 increase in L-Dex score were fitted with a compression garment. Self-reported symptoms and distress decreased by 0.4 out of 10 (95% CI 0.1 to 0.7); number of self-management strategies used increased by 0.6 (95% CI 0.1 to 1.2); and planned exercise increased by 2.8 h/week (95% CI 0.4 to 5.2). CONCLUSIONS These findings indicate a prospective surveillance model of care in the home with BIS is feasible and associated with increased self-management. A Phase II randomised trial is warranted as well as research exploring the costs associated with implementing this model of care for high-risk individuals.
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Affiliation(s)
- Louise A Koelmeyer
- Australian Lymphoedema Education, Research and Treatment (ALERT) Program, Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.
| | - Emma Moloney
- Australian Lymphoedema Education, Research and Treatment (ALERT) Program, Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - John Boyages
- Australian Lymphoedema Education, Research and Treatment (ALERT) Program, Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- Icon Cancer Centre, Sydney, NSW, Australia
| | - Kerry A Sherman
- Centre for Emotional Health, Department of Psychology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Catherine M Dean
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
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Siddiqui MF. IoMT Potential Impact in COVID-19: Combating a Pandemic with Innovation. STUDIES IN COMPUTATIONAL INTELLIGENCE 2021:349-361. [DOI: 10.1007/978-981-15-8534-0_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
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INOMATA TAKENORI, SUNG JAEMYOUNG, NAKAMURA MASAHIRO, IWAGAMI MASAO, OKUMURA YUICHI, FUJIO KENTA, AKASAKI YASUTSUGU, FUJIMOTO KEIICHI, YANAGAWA AI, MIDORIKAWA-INOMATA AKIE, NAGINO KEN, EGUCHI ATSUKO, SHOKIROVA HURRRAMHON, ZHU JUN, MIURA MARIA, KUWAHARA MIZU, HIROSAWA KUNIHIKO, HUANG TIANXING, MOROOKA YUKI, MURAKAMI AKIRA. Cross-hierarchical Integrative Research Network for Heterogenetic Eye Disease Toward P4 Medicine: A Narrative Review. JUNTENDO MEDICAL JOURNAL 2021. [DOI: 10.14789/jmj.jmj21-0023-r] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- TAKENORI INOMATA
- Department of Ophthalmology, Juntendo University Graduate School of Medicine
| | - JAEMYOUNG SUNG
- Department of Ophthalmology, Juntendo University Graduate School of Medicine
| | - MASAHIRO NAKAMURA
- Department of Digital Medicine, Juntendo University Graduate School of Medicine
| | - MASAO IWAGAMI
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba
| | - YUICHI OKUMURA
- Department of Ophthalmology, Juntendo University Graduate School of Medicine
| | - KENTA FUJIO
- Department of Ophthalmology, Juntendo University Graduate School of Medicine
| | - YASUTSUGU AKASAKI
- Department of Ophthalmology, Juntendo University Graduate School of Medicine
| | - KEIICHI FUJIMOTO
- Department of Ophthalmology, Juntendo University Graduate School of Medicine
| | - AI YANAGAWA
- Department of Digital Medicine, Juntendo University Graduate School of Medicine
| | | | - KEN NAGINO
- Department of Hospital Administration, Juntendo University Graduate School of Medicine
| | - ATSUKO EGUCHI
- Department of Hospital Administration, Juntendo University Graduate School of Medicine
| | | | - JUN ZHU
- Department of Ophthalmology, Juntendo University Graduate School of Medicine
| | - MARIA MIURA
- Department of Ophthalmology, Juntendo University Graduate School of Medicine
| | - MIZU KUWAHARA
- Department of Ophthalmology, Juntendo University Graduate School of Medicine
| | - KUNIHIKO HIROSAWA
- Department of Ophthalmology, Juntendo University Graduate School of Medicine
| | - TIANXING HUANG
- Department of Ophthalmology, Juntendo University Graduate School of Medicine
| | - YUKI MOROOKA
- Department of Digital Medicine, Juntendo University Graduate School of Medicine
| | - AKIRA MURAKAMI
- Department of Digital Medicine, Juntendo University Graduate School of Medicine
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Rhee SY, Kim C, Shin DW, Steinhubl SR. Present and Future of Digital Health in Diabetes and Metabolic Disease. Diabetes Metab J 2020; 44:819-827. [PMID: 33389956 PMCID: PMC7801756 DOI: 10.4093/dmj.2020.0088] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 08/18/2020] [Indexed: 12/19/2022] Open
Abstract
The use of information and communication technology (ICT) in medical and healthcare services goes beyond everyday life. Expectations of a new medical environment, not previously experienced by ICT, exist in the near future. In particular, chronic metabolic diseases such as diabetes and obesity, have a high prevalence and high social and economic burden. In addition, the continuous evaluation and monitoring of daily life is important for effective treatment and management. Therefore, the wide use of ICTbased digital health systems is required for the treatment and management of these diseases. In this article, we compiled a variety of digital health technologies introduced to date in the field of diabetes and metabolic diseases.
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Affiliation(s)
- Sang Youl Rhee
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
- Department of Digital Health, Scripps Research Translational Institute, La Jolla, CA, USA
| | - Chiweon Kim
- Department of Internal Medicine, Seoul Wise Hospital, Uiwang, Korea
| | - Dong Wook Shin
- Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Korea
| | - Steven R. Steinhubl
- Department of Digital Health, Scripps Research Translational Institute, La Jolla, CA, USA
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Abstract
Dry eye disease (DED) is a chronic, multifactorial ocular surface disorder with multiple etiologies that results in tear film instability. Globally, the prevalence of DED is expected to increase with an aging society and daily use of digital devices. Unfortunately, the medical field is currently unprepared to meet the medical needs of patients with DED. Noninvasive, reliable, and readily reproducible biomarkers have not yet been identified, and the current mainstay treatment for DED relies on symptom alleviation using eye drops with no effective preventative therapies available. Medical big data analyses, mining information from multiomics studies and mobile health applications, may offer a solution for managing chronic conditions such as DED. Omics-based data on individual physiologic status may be leveraged to prevent high-risk diseases, accurately diagnose illness, and improve patient prognosis. Mobile health applications enable the portable collection of real-world medical data and biosignals through personal devices. Together, these data lay a robust foundation for personalized treatments for various ocular surface diseases and other pathologies that currently lack the components of precision medicine. To fully implement personalized and precision medicine, traditional aggregate medical data should not be applied directly to individuals without adjustments for personal etiology, phenotype, presentation, and symptoms.
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Tat T, Libanori A, Au C, Yau A, Chen J. Advances in triboelectric nanogenerators for biomedical sensing. Biosens Bioelectron 2020; 171:112714. [PMID: 33068881 DOI: 10.1016/j.bios.2020.112714] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 12/17/2022]
Abstract
Biomedical sensors have been essential in improving healthcare outcomes over the past 30 years, though limited power source access and user wearability restraints have prevented them from taking a constant and active biomedical sensing role in our daily lives. Triboelectric nanogenerators (TENGs) have demonstrated exceptional capabilities and versatility in delivering self-powered and wear-optimized biomedical sensors, and are paving the way for a novel platform technology able to fully integrate into the developing 5G/Internet-of-Things ecosystem. This novel paradigm of TENG-based biomedical sensors aspires to provide ubiquitous and omnipresent real-time biomedical sensing for us all. In this review, we cover the remarkable developments in TENG-based biomedical sensing which have arisen in the last octennium, focusing on both in-body and on-body biomedical sensing solutions. We begin by covering TENG as biomedical sensors in the most relevant, mortality-associated clinical fields of pneumology and cardiology, as well as other organ-related biomedical sensing abilities including ambulation. We also include an overview of ambient biomedical sensing as a field of growing interest in occupational health monitoring. Finally, we explore TENGs as power sources for third party biomedical sensors in a number of fields, and conclude our review by focusing on the future perspectives of TENG biomedical sensors, highlighting key areas of attention to fully translate TENG-based biomedical sensors into clinically and commercially viable digital and wireless consumer and health products.
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Affiliation(s)
- Trinny Tat
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Alberto Libanori
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Christian Au
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Andy Yau
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Jun Chen
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA.
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Inomata T, Sung J, Nakamura M, Fujisawa K, Muto K, Ebihara N, Iwagami M, Nakamura M, Fujio K, Okumura Y, Okano M, Murakami A. New medical big data for P4 medicine on allergic conjunctivitis. Allergol Int 2020; 69:510-518. [PMID: 32651122 DOI: 10.1016/j.alit.2020.06.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 05/20/2020] [Indexed: 12/16/2022] Open
Abstract
Allergic conjunctivitis affects approximately 15-20% of the global population and can permanently deteriorate one's quality of life (QoL) and work productivity, leading to societal work force costs. Although not fully understood, allergic conjunctivitis is a multifactorial disease with a complex network of environmental, lifestyle, and host contributory risk factors. To effectively enhance the quality of treatment for patients with allergic conjunctivitis, as well as other allergic diseases, the field must first comprehend the pathology underlying various individualized subjective symptoms and stratify the disease according to risk factors and presentations. Such competent stratification and societal reconstruction that targets the alleviation of the damage due to allergic diseases would greatly help ramify personalized treatments and prevent the projected increase in societal costs imposed by allergic diseases. Owing to the rapid advancements in the information and technology sector, medical big data are greatly accessible and useful to decipher the pathophysiology of many diseases. Such data collected through multi-omics and mobile health have been effective for research on chronic diseases including allergic and immune-mediated diseases. Novel big data containing vast and continuous information on individuals with allergic conjunctivitis and other allergic symptoms are being used to search for causative genes of diseases, gain insights into new biomarkers, prevent disease progression, and, ultimately, improve QoL. The individualized and holistic data accrued from new angles using technological innovations are helping the field realize the principles of P4 medicine: predictive, preventive, personalized, and participatory medicine.
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Affiliation(s)
- Takenori Inomata
- Department of Ophthalmology, Juntendo University Faculty of Medicine, Tokyo, Japan; Department of Strategic Operating Room Management and Improvement, Juntendo University Faculty of Medicine, Tokyo, Japan; Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Jaemyoung Sung
- Department of Ophthalmology, Juntendo University Faculty of Medicine, Tokyo, Japan; Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Masahiro Nakamura
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Precision Health, Department of Bioengineering, Graduate School of Engineering, University of Tokyo, Tokyo, Japan
| | - Kumiko Fujisawa
- Department of Public Policy, Human Genome Center, The Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Kaori Muto
- Department of Public Policy, Human Genome Center, The Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Nobuyuki Ebihara
- Department of Ophthalmology, Urayasu Hospital, Juntendo University, Chiba, Japan
| | - Masao Iwagami
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masahiro Nakamura
- Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Kenta Fujio
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuichi Okumura
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mitsuhiro Okano
- Department of Otorhinolaryngology, International University of Health and Welfare, Narita, Japan
| | - Akira Murakami
- Department of Ophthalmology, Juntendo University Faculty of Medicine, Tokyo, Japan; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Gomez-Peralta F, Abreu C, Gomez-Rodriguez S, Cruz-Bravo M, María-Sanchez C, Poza G, Ruiz-Valdepeñas L. Efficacy of Insulclock in Patients with Poorly Controlled Type 1 Diabetes Mellitus: A Pilot, Randomized Clinical Trial. Diabetes Technol Ther 2020; 22:686-690. [PMID: 32069067 PMCID: PMC7640744 DOI: 10.1089/dia.2019.0427] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Insulclock® is an electronic device designed to improve treatment adherence and insulin injection tracking. This randomized, single-center, pilot study assessed the clinical impact of Insulclock on glycemic control and variability, treatment adherence, and satisfaction in patients with uncontrolled type 1 diabetes mellitus (T1DM). We also compared these outcomes between the Active and Masked groups (with or without receiving reminders and app alerts). Sixteen patients completed the study: 10 in the Active group and 6 in the Masked group. Insulclock use was associated with a decrease in mean glucose (-27.0 mg/dL [1.5 mmol/L]; P = 0.013), glucose standard deviation (-14.4 mg/dL [0.8 mmol/L]; P = 0.003), and time above range (-12.5%; P = 0.0026), and an increase in time in range (TIR) (+7%; P = 0.038) in the overall population. The use of app information and alerts in the Active group was associated with an increase in TIR (+8%; P = 0.026). We observed a -3.9 (P = 0.1352) and -5.4 (P = 0.032) reduction per month in the number of missed and mistimed insulin doses in the overall population, respectively. Most of the items of the Insulin Treatment Satisfaction Questionnaire (ITSQ) improved after 4 weeks of Insulclock use. This pilot study points out an improvement in glycemic levels, adherence, and satisfaction in T1DM patients, supporting the development of clinical trials powered to confirm these effects.
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Affiliation(s)
- Fernando Gomez-Peralta
- Endocrinology and Nutrition Unit, Segovia General Hospital, Segovia, Spain
- Address correspondence to: Dr. Fernando Gomez-Peralta, MD, PhD, Endocrinology and Nutrition Unit, Segovia General Hospital, Luis Erik Clavería Neurólogo S.N., 40002 Segovia, Spain
| | - Cristina Abreu
- Endocrinology and Nutrition Unit, Segovia General Hospital, Segovia, Spain
| | | | | | | | - Gema Poza
- Endocrinology and Nutrition Unit, Segovia General Hospital, Segovia, Spain
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Petersen BJ, Bus SA, Rothenberg GM, Linders DR, Lavery LA, Armstrong DG. Recurrence rates suggest delayed identification of plantar ulceration for patients in diabetic foot remission. BMJ Open Diabetes Res Care 2020; 8:8/1/e001697. [PMID: 32998870 PMCID: PMC7528350 DOI: 10.1136/bmjdrc-2020-001697] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/01/2020] [Accepted: 09/05/2020] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Foot ulcers are a common and costly complication of diabetes, and delays in treatment can result in impaired healing, infection, hospitalization, and lower extremity amputation. RESEARCH DESIGN AND METHODS We aimed to determine whether patterns in plantar diabetic foot ulcer (DFU) recurrence coincided with typical intervals between routine preventive care appointments, which would suggest that delays exist between ulcer development and identification. We completed an analysis of existing data from two multicenter studies in 300 total participants. We analyzed unadjusted counts of DFU binned in weekly intervals and defined 'exam periods' as intervals from 2 to 4 weeks, from 6 to 8 weeks, within 1 week of 3 months and within 1 week of 6 months. We tested whether recurrence rates during exam periods were equivalent to rates outside exam periods. We estimated the delay between DFU development and DFU identification such that the rate of development would have been constant. RESULTS During exam periods, a total of 43 DFUs were identified (43/86=50%) despite the fact that these periods represent only 23.5% of follow-up in aggregate. Accounting for censoring, the annualized incidence during exam periods was 0.68 DFU/year (CI 0.48 to 0.89) in contrast to 0.25 DFU/year (CI 0.18 to 0.32) outside exam periods (incidence ratio=2.8, CI 1.8 to 4.3). We estimated delays between DFU occurrence and identification to average 15.3 days (IQR 7.4-23.7 days). CONCLUSIONS These findings have potential implications for practice, particularly related to the value of telehealth and in-home monitoring of patients in diabetic foot remission. Additionally, there are implications for study design, which should consider the impact of interval censoring and attempt to control for confounders related to frequency and timing of exams.
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Affiliation(s)
| | - Sicco A Bus
- Department of Rehabilitation Medicine, University of Amsterdam, Amsterdam, Noord-Holland, Netherlands
| | - Gary M Rothenberg
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | | | - Lawrence A Lavery
- Department of Plastic Surgery, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
| | - David G Armstrong
- Department of Surgery, USC Keck School of Medicine, Los Angeles, California, USA
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Golledge J, Fernando M, Lazzarini P, Najafi B, G. Armstrong D. The Potential Role of Sensors, Wearables and Telehealth in the Remote Management of Diabetes-Related Foot Disease. SENSORS (BASEL, SWITZERLAND) 2020; 20:E4527. [PMID: 32823514 PMCID: PMC7491197 DOI: 10.3390/s20164527] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/29/2020] [Accepted: 08/12/2020] [Indexed: 12/18/2022]
Abstract
Diabetes-related foot disease (DFD), which includes foot ulcers, infection and gangrene, is a leading cause of the global disability burden. About half of people who develop DFD experience a recurrence within one year. Long-term medical management to reduce the risk of recurrence is therefore important to reduce the global DFD burden. This review describes research assessing the value of sensors, wearables and telehealth in preventing DFD. Sensors and wearables have been developed to monitor foot temperature, plantar pressures, glucose, blood pressure and lipids. The monitoring of these risk factors along with telehealth consultations has promise as a method for remotely managing people who are at risk of DFD. This approach can potentially avoid or reduce the need for face-to-face consultations. Home foot temperature monitoring, continuous glucose monitoring and telehealth consultations are the approaches for which the most highly developed and user-friendly technology has been developed. A number of clinical studies in people at risk of DFD have demonstrated benefits when using one of these remote monitoring methods. Further development and evidence are needed for some of the other approaches, such as home plantar pressure and footwear adherence monitoring. As yet, no composite remote management program incorporating remote monitoring and the management of all the key risk factors for DFD has been developed and implemented. Further research assessing the feasibility and value of combining these remote monitoring approaches as a holistic way of preventing DFD is needed.
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Affiliation(s)
- Jonathan Golledge
- Ulcer and wound Healing consortium (UHEAL), Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland 4811, Australia;
- The Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Queensland 4814, Australia
| | - Malindu Fernando
- Ulcer and wound Healing consortium (UHEAL), Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland 4811, Australia;
| | - Peter Lazzarini
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland 4000, Australia;
- Allied Health Research Collaborative, Metro North Hospital and Health Service, Brisbane, Queensland 4006, Australia
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA;
| | - David G. Armstrong
- Southwestern Academic Limb Salvage Alliance (SALSA), Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, CA 90089, USA;
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