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Journal of Thoracic Oncology : Official... Sep 2023Considering the established contribution of environmental factors to the development of thoracic malignancies, the inherited susceptibility of these tumors has rarely... (Review)
Review
Considering the established contribution of environmental factors to the development of thoracic malignancies, the inherited susceptibility of these tumors has rarely been explored. However, the recent introduction of next-generation sequencing-based tumor molecular profiling in the real-word setting enabled us to deeply characterize the genomic background of patients with lung cancer with or without smoking-related history, increasing the likelihood of detecting germline mutations with potential prevention and treatment implications. Pathogenic germline variants have been detected in 2% to 3% of patients with NSCLC undergoing next-generation sequencing analysis, whereas the proportion of germline mutations associated with the development of pleural mesothelioma widely varies across different studies, ranging between 5% and 10%. This review provides an updated summary of emerging evidence about germline mutations in thoracic malignancies, focusing on pathogenetic mechanisms, clinical features, therapeutic implications, and screening recommendations for high-risk individuals.
Topics: Humans; Germ-Line Mutation; Lung Neoplasms; Mesothelioma, Malignant; Mesothelioma; Carcinoma, Non-Small-Cell Lung; Genetic Predisposition to Disease
PubMed: 37331604
DOI: 10.1016/j.jtho.2023.05.028 -
Micromachines Jun 2023Sustainable and safe food is an important issue worldwide, and it depends on cost-effective analysis tools with good sensitivity and reality. However, traditional... (Review)
Review
Sustainable and safe food is an important issue worldwide, and it depends on cost-effective analysis tools with good sensitivity and reality. However, traditional standard chemical methods of food safety detection, such as high-performance liquid chromatography (HPLC), gas chromatography (GC), and tandem mass spectrometry (MS), have the disadvantages of high cost and long testing time. Those disadvantages have prevented people from obtaining sufficient risk information to confirm the safety of their products. In addition, food safety testing, such as the bioassay method, often results in false positives or false negatives due to little rigor preprocessing of samples. So far, food safety analysis currently relies on the enzyme-linked immunosorbent assay (ELISA), polymerase chain reaction (PCR), HPLC, GC, UV-visible spectrophotometry, and MS, all of which require significant time to train qualified food safety testing laboratory operators. These factors have hindered the development of rapid food safety monitoring systems, especially in remote areas or areas with a relative lack of testing resources. Surface-enhanced Raman spectroscopy (SERS) has emerged as one of the tools of choice for food safety testing that can overcome these dilemmas over the past decades. SERS offers advantages over chromatographic mass spectrometry analysis due to its portability, non-destructive nature, and lower cost implications. However, as it currently stands, Raman spectroscopy is a supplemental tool in chemical analysis, reinforcing and enhancing the completeness and coverage of the food safety analysis system. SERS combines portability with non-destructive and cheaper detection costs to gain an advantage over chromatographic mass spectrometry analysis. SERS has encountered many challenges in moving toward regulatory applications in food safety, such as quantitative accuracy, poor reproducibility, and instability of large molecule detection. As a result, the reality of SERS, as a screening tool for regulatory announcements worldwide, is still uncommon. In this review article, we have compiled the current designs and fabrications of SERS substrates for food safety detection to unify all the requirements and the opportunities to overcome these challenges. This review is expected to improve the interest in the sensing field of SERS and facilitate the SERS applications in food safety detection in the future.
PubMed: 37512654
DOI: 10.3390/mi14071343 -
Frontiers in Digital Health 2024This umbrella review aims to ascertain the extent to which immersive Virtual Reality (VR) and Augmented Reality (AR) technologies improve specific competencies in...
OBJECTIVE
This umbrella review aims to ascertain the extent to which immersive Virtual Reality (VR) and Augmented Reality (AR) technologies improve specific competencies in healthcare professionals within medical education and training, in contrast to traditional educational methods or no intervention.
METHODS
Adhering to PRISMA guidelines and the PICOS approach, a systematic literature search was conducted across major databases to identify studies examining the use of VR and AR in medical education. Eligible studies were screened and categorized based on the PICOS criteria. Descriptive statistics and chi-square tests were employed to analyze the data, supplemented by the Fisher test for small sample sizes or specific conditions.
ANALYSIS
The analysis involved cross-tabulating the stages of work (Development and Testing, Results, Evaluated) and variables of interest (Performance, Engagement, Performance and Engagement, Effectiveness, no evaluated) against the types of technologies used. Chi-square tests assessed the associations between these categorical variables.
RESULTS
A total of 28 studies were included, with the majority reporting increased or positive effects from the use of immersive technologies. VR was the most frequently studied technology, particularly in the "Performance" and "Results" stages. The chi-square analysis, with a Pearson value close to significance ( = 0.052), suggested a non-significant trend toward the association of VR with improved outcomes.
CONCLUSIONS
The results indicate that VR is a prevalent tool in the research landscape of medical education technologies, with a positive trend toward enhancing educational outcomes. However, the statistical analysis did not reveal a significant association, suggesting the need for further research with larger sample sizes. This review underscores the potential of immersive technologies to enhance medical training yet calls for more rigorous studies to establish definitive evidence of their efficacy.
PubMed: 38550715
DOI: 10.3389/fdgth.2024.1365345 -
Ophthalmic Plastic and Reconstructive...To assess the sensitivity and specificity of superior visual field tests administered in virtual reality (VR) with eye tracking (VR-ET) and without eye tracking (VR 0 )...
PURPOSE
To assess the sensitivity and specificity of superior visual field tests administered in virtual reality (VR) with eye tracking (VR-ET) and without eye tracking (VR 0 ) for the fulfillment of insurance coverage criteria for functional upper eyelid surgery as compared with standard automated perimetry (SAP).
METHODS
This prospective cross-sectional study included 78 eyes from 41 patients with ptosis, brow ptosis, and dermatochalasis undergoing functional upper eyelid surgery evaluation. Participants underwent serial superior visual field tests using SAP and VR 0 or VR-ET in randomized order. Fulfillment of insurance coverage criteria for blepharoplasty was defined as a 30% increase in the grid seen from the untaped to the taped state. The main outcome measure was the sensitivity and specificity of VR 0 , VR-ET, and overall VR in meeting insurance coverage criteria as compared with SAP.
RESULTS
VR had a sensitivity of 84.1% and specificity of 67.6%, with no significant difference between VR 0 and VR-ET. SAP agreed on insurance coverage criteria fulfillment with VR 0 in 28 (71.8%) eyes and with VR-ET in 32 (82.1%) eyes. Insurance coverage criteria fulfillment rates varied significantly by diagnosis on SAP ( p = 0.012) but not VR ( p = 0.059).
CONCLUSIONS
VR may be an alternative to SAP for functional upper eyelid surgery evaluation. Future studies are needed to determine differences in patient satisfaction, testing and waiting time, and test-retest reliability between VR and SAP.
Topics: Humans; Visual Field Tests; Visual Fields; Pilot Projects; Prospective Studies; Reproducibility of Results; Eye-Tracking Technology; Cross-Sectional Studies; Eyelids
PubMed: 36852832
DOI: 10.1097/IOP.0000000000002331 -
Current Neurology and Neuroscience... Mar 2024In this review, we will describe current methods for visual field testing in neuro-ophthalmic clinical practice and research, develop terminology that accurately... (Review)
Review
PURPOSE OF REVIEW
In this review, we will describe current methods for visual field testing in neuro-ophthalmic clinical practice and research, develop terminology that accurately describes patterns of field deficits, and discuss recent advances such as augmented or virtual reality-based perimetry and the use of artificial intelligence in visual field interpretation.
RECENT FINDINGS
New testing strategies that reduce testing times, improve patient comfort, and increase sensitivity for detecting small central or paracentral scotomas have been developed for static automated perimetry. Various forms of machine learning-based tools such as archetypal analysis are being tested to quantitatively depict and monitor visual field abnormalities in optic neuropathies. Studies show that the combined use of optical coherence tomography and standard automated perimetry to determine the structure-function relationship improves clinical care in neuro-ophthalmic disorders. Visual field assessment must be performed in all patients with neuro-ophthalmic disorders affecting the afferent visual pathway. Quantitative visual field analysis using standard automated perimetry is critical in initial diagnosis, monitoring disease progression, and guidance of therapeutic plans. Visual field defects can adversely impact activities of daily living such as reading, navigation, and driving and thus impact quality of life. Visual field testing can direct appropriate occupational low vision rehabilitation in affected individuals.
Topics: Humans; Visual Fields; Artificial Intelligence; Activities of Daily Living; Quality of Life; Optic Nerve Diseases; Visual Field Tests
PubMed: 38289405
DOI: 10.1007/s11910-024-01332-3 -
Patient Education and Counseling Sep 2023A growing population of those affected by serious illness, prognostic uncertainty, patient diversity, and healthcare digitalization pose challenges for the future of...
BACKGROUND/OBJECTIVE
A growing population of those affected by serious illness, prognostic uncertainty, patient diversity, and healthcare digitalization pose challenges for the future of serious illness communication. Yet, there is paucity of evidence to support serious illness communication behaviors among clinicians. Herein, we propose three methodological innovations to advance the basic science of serious illness communication.
RESULTS
First, advanced computation techniques - e.g. machine-learning techniques and natural language processing - offer the possibility to measure the characteristics and complex patterns of audible serious illness communication in large datasets. Second, immersive technologies - e.g., virtual- and augmented reality - allow for experimentally manipulating and testing the effects of specific communication strategies, and interactional and environmental aspects of serious illness communication. Third, digital-health technologies - e.g., shared notes and videoconferences - can be used to unobtrusively observe and manipulate communication, and compare in-person to digitally-mediated communication elements and effects. Immersive and digital health technologies allow integration of physiological measurement (e.g. synchrony or gaze) that may advance our understanding of patient experience.
CONCLUSION/PRACTICE IMPLICATIONS
New technologies and measurement approaches, while imperfect, will help advance our understanding of the epidemiology and quality of serious illness communication in an evolving healthcare environment.
Topics: Humans; Communication; Delivery of Health Care
PubMed: 37207565
DOI: 10.1016/j.pec.2023.107790 -
Journal of Forensic NursingOne in four Americans report experiencing harassment online via social media and interactive gaming, which includes physical threats, stalking, sexual harassment, and... (Review)
Review
BACKGROUND
One in four Americans report experiencing harassment online via social media and interactive gaming, which includes physical threats, stalking, sexual harassment, and sustained harassment.
OBJECTIVE
The aim of this study was to gain understanding of the state of the science surrounding young adults and sexual violence/harassment harms in virtual reality (VR) as well as possible uses of VR to heal and intervene.
METHODS
A scoping review was conducted in early 2023 using the Ovid Synthesis Clinical Evidence Manager and the MEDLINE database. Forty-seven articles met inclusion criteria.
RESULTS
Our review found a growing body of evidence exploring incidents, effects, possible predictors, and initial strategies to prevent sexual violence in VR and to use the modality to positively intervene. Limited research addresses the effects of harms incurred in VR on (re)traumatization of survivors as well as the development and testing of VR tools used to educate, deliver bystander interventions, transform biases and perceptions via embodiment, and promote healing among survivors.
CONCLUSION
Research addressing sexual violence in VR is needed and should build on the existing peripheral science on gaming and social media environments. Forensic nursing is well positioned to advance strategies of health and safety in VR, just as in the physical world. Incorporating forensic nursing avatars in VR and deploying diverse resources targeted for college-age young adults to prevent harms in VR should be explored safely and ethically. Forensic nurses are also positioned to assess for VR-related harms among patients and to work with private and government sectors to influence regulations and policies.
Topics: Humans; Sex Offenses; Sexual Harassment; Virtual Reality; Avatar; Social Environment
PubMed: 38093420
DOI: 10.1097/JFN.0000000000000466 -
Journal of Gerontological Nursing Nov 2023There is a shortage of personnel to provide care for older adults with dementia, and traditional teaching methods could be improved. The teaching method used in the Care... (Randomized Controlled Trial)
Randomized Controlled Trial
There is a shortage of personnel to provide care for older adults with dementia, and traditional teaching methods could be improved. The teaching method used in the Care for Older Adults With Dementia course is mainly theoretical, lacking real-life care scenarios and practical procedural training. In the current study, we developed a virtual reality (VR) teaching system and designed a randomized controlled trial aimed at testing the availability of the VR-assisted teaching system, filling the gap in teaching through care scenarios, enabling students majoring in intelligent health and oldage care service management to have a more positive attitude toward learning, and improving students' knowledge and course satisfaction. This study showed that the developed VR system can meet the initial needs of daily teaching, help students have a more positive attitude toward learning, and improve their academic performance and course satisfaction. [(11), 25-32.].
Topics: Humans; Aged; Virtual Reality; Students; Clinical Competence; Geriatric Nursing; Dementia
PubMed: 37906042
DOI: 10.3928/00989134-20231011-01 -
Advances in Simulation (London, England) Aug 2023Colonoscopy is difficult to learn. Virtual reality simulation training is helpful, but how and when novices should progress to patient-based training has yet to be...
BACKGROUND
Colonoscopy is difficult to learn. Virtual reality simulation training is helpful, but how and when novices should progress to patient-based training has yet to be established. To date, there is no assessment tool for credentialing novice endoscopists prior to clinical practice. The aim of this study was to develop such an assessment tool based on metrics provided by the simulator. The metrics used for the assessment tool should be able to discriminate between novices, intermediates, and experts and include essential checklist items for patient safety.
METHODS
The validation process was conducted based on the Standards for Educational and Psychological Testing. An expert panel decided upon three essential checklist items for patient safety based on Lawshe's method: perforation, hazardous tension to the bowel wall, and cecal intubation. A power calculation was performed. In this study, the Simbionix GI Mentor II simulator was used. Metrics with discriminatory ability were identified with variance analysis and combined to form an aggregate score. Based on this score and the essential items, pass/fail standards were set and reliability was tested.
RESULTS
Twenty-four participants (eight novices, eight intermediates, and eight expert endoscopists) performed two simulated colonoscopies. Four metrics with discriminatory ability were identified. The aggregate score ranged from 4.2 to 51.2 points. Novices had a mean score of 10.00 (SD 5.13), intermediates 24.63 (SD 7.91), and experts 30.72 (SD 11.98). The difference in score between novices and the other two groups was statistically significant (p<0.01). Although expert endoscopists had a higher score, the difference was not statistically significant (p=0.40). Reliability was good (Cronbach's alpha=0.86). A pass/fail score was defined at 17.1 points with correct completion of three essential checklist items, resulting in three experts and three intermediates failing and one novice passing the assessment.
CONCLUSION
We established a valid and reliable assessment tool with a pass/fail standard on the simulator. We suggest using the assessment after simulation-based training before commencing work-based learning.
PubMed: 37563741
DOI: 10.1186/s41077-023-00260-5 -
Eye (London, England) Apr 2024Standard automated perimetery is considered the gold standard for evaluating a patient's visual field. However, it is costly and requires a fixed testing environment. In... (Review)
Review
Standard automated perimetery is considered the gold standard for evaluating a patient's visual field. However, it is costly and requires a fixed testing environment. In response, perimetric devices using virtual reality (VR) headsets have emerged as an alternative way to measure visual fields in patients. This systematic review aims to characterize both novel and established VR headsets in the literature and explore their potential applications within visual field testing. A search was conducted using MEDLINE, Embase, CINAHL, and the Core Collection (Web of Science) for articles published until January 2023. Subject headings and keywords related to virtual reality and visual field were used to identify studies specific to this topic. Records were first screened by title/abstract and then by full text using predefined criteria. Data was extracted accordingly. A total of 2404 records were identified from the databases. After deduplication and the two levels of screening, 64 studies describing 36 VR headset perimetry devices were selected for extraction. These devices encompassed various visual field measurement techniques, including static and kinetic perimetry, with some offering vision rehabilitation capabilities. This review reveals a growing consensus that VR headset perimetry devices perform comparably to, or even better than, standard automated perimetry. They are better tolerated by patients in terms of gaze fixation, more cost-effective, and generally more accessible for patients with limited mobility.
Topics: Humans; Visual Field Tests; Virtual Reality; Visual Fields; Fixation, Ocular; Nervous System Diseases
PubMed: 38036608
DOI: 10.1038/s41433-023-02843-y