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Journal of Gastrointestinal and Liver... Jun 2024Endoscopy simulators are primarily designed to provide training in interventions performed during procedures. Peri-interventional tasks such as checking patient data,...
BACKGROUND AND AIMS
Endoscopy simulators are primarily designed to provide training in interventions performed during procedures. Peri-interventional tasks such as checking patient data, filling out forms for team time-out, patient monitoring, and performing sedation are often not covered. This study assesses the face, content, and construct validity of the ViGaTu (Virtual Gastro Tutor) immersive virtual reality (VR) simulator in teaching these skills.
METHODS
71 nurses and physicians were invited to take part in VR training. The participants experienced an immersive VR simulation of an endoscopy procedure, including setting up the endoscopic devices, checking sign-in and team time-out forms, placing monitoring devices, and performing sedation. The actions performed by the participants and their timing were continuously recorded. Face and content validity, as well as the System Usability Scale (SUS), were then assessed.
RESULTS
43 physicians and 28 nurses from 43 centers took a mean of 27.8 min (standard deviation ± 14.42 min) to complete the simulation. Seventy-five percent of the items for assessing face validity were rated as realistic, and 60% of items assessing content validity and usefulness of the simulation for different learning goals were rated as useful by the participants (four out of five on a Likert scale). The SUS score was 70, demonstrating a high degree of usability. With regard to construct validity, experienced endoscopy staff were significantly faster in setting up the endoscope tower and instruments than beginners.
CONCLUSIONS
This multicenter study presents a new type of interdisciplinary endoscopy training system featuring peri-interventional tasks and sedation in an immersive VR environment.
Topics: Humans; Virtual Reality; Clinical Competence; Simulation Training; Reproducibility of Results; Female; Adult; Male; Endoscopy, Gastrointestinal; Nurses; Middle Aged; Physicians
PubMed: 38944875
DOI: 10.15403/jgld-5440 -
International Journal of Cardiology Jun 2024Guidelines recommend insertable cardiac monitor (ICM) in the early phases of the evaluation of unexplained syncope (US) syncope, when an arrhythmic etiology is...
AIMS
Guidelines recommend insertable cardiac monitor (ICM) in the early phases of the evaluation of unexplained syncope (US) syncope, when an arrhythmic etiology is suspected. We examined the diagnostic yield of the last generation ICM (LG-ICM) to establish the causes of US, by assessing in the clinical practice the incidence of: relevant arrhythmia diagnosis, syncope recurrences and CM-guided cardiac electronic device (CIED) implantation. We investigated also baseline patient characteristics associated to an increased risk of relevant arrhythmias and of syncope recurrence.
METHODS
Data prospectively collected from consecutive patients receiving LG-ICM for investigation of US or presyncope in our institution between November 2020 and January 2023 were analyzed.
RESULTS
A total of 109 patients (mean age 64.4 ± 16.1 years, 40.4% women) with US or pre-syncope episodes underwent implantation of the LG-ICM. During a mean follow-up of 11.7 ± 8.1 months, LG-ICM diagnostic yield was 42% . In particular, LG-ICM detected cardiac arrhythmias in 29 (27%) patients (in 6 out of them during a syncope recurrence) and to exclude the arrhythmic origin of the syncope in additional 19 (17%) patients. LG-ICM guided the implantation of a CIED in 16 (15%) US patients, due to the diagnosis of asystole or severe bradycardia. Age ≥ 65 years (p = 0.012) and atrial arrhythmia history (p = 0.004) are significant independent predictors of arrhythmic diagnoses performed by LG-ICM, while CAD is predictor of syncope recurrence (bordering on statistical significance, p = 0.056).
CONCLUSIONS
The diagnostic yield of LG-ICM in US syncope is comparable to those of ILR and previous generation ICM. The advantages of LG-ICM should be sought in lower hospital workload necessary to manage ICM data. Age ≥ 65 years and atrial arrhythmia history are independent predictors of significant ICM-detected arrhythmias.
PubMed: 38944347
DOI: 10.1016/j.ijcard.2024.132301 -
Biomedicine & Pharmacotherapy =... Jun 2024The integration of biochips with AI opened up new possibilities and is expected to revolutionize smart healthcare tools within the next five years. The combination of... (Review)
Review
The integration of biochips with AI opened up new possibilities and is expected to revolutionize smart healthcare tools within the next five years. The combination of miniaturized, multi-functional, rapid, high-throughput sample processing and sensing capabilities of biochips, with the computational data processing and predictive power of AI, allows medical professionals to collect and analyze vast amounts of data quickly and efficiently, leading to more accurate and timely diagnoses and prognostic evaluations. Biochips, as smart healthcare devices, offer continuous monitoring of patient symptoms. Integrated virtual assistants have the potential to send predictive feedback to users and healthcare practitioners, paving the way for personalized and predictive medicine. This review explores the current state-of-the-art biochip technologies including gene-chips, organ-on-a-chips, and neural implants, and the diagnostic and therapeutic utility of AI-assisted biochips in medical practices such as cancer, diabetes, infectious diseases, and neurological disorders. Choosing the appropriate AI model for a specific biomedical application, and possible solutions to the current challenges are explored. Surveying advances in machine learning models for biochip functionality, this paper offers a review of biochips for the future of biomedicine, an essential guide for keeping up with trends in healthcare, while inspiring cross-disciplinary collaboration among biomedical engineering, medicine, and machine learning fields.
PubMed: 38943990
DOI: 10.1016/j.biopha.2024.116997 -
Korean Journal of Radiology Jul 2024In Korea, radiology has been positioned towards the early adoption of artificial intelligence-based software as medical devices (AI-SaMDs); however, little is known...
OBJECTIVE
In Korea, radiology has been positioned towards the early adoption of artificial intelligence-based software as medical devices (AI-SaMDs); however, little is known about the current usage, implementation, and future needs of AI-SaMDs. We surveyed the current trends and expectations for AI-SaMDs among members of the Korean Society of Radiology (KSR).
MATERIALS AND METHODS
An anonymous and voluntary online survey was open to all KSR members between April 17 and May 15, 2023. The survey was focused on the experiences of using AI-SaMDs, patterns of usage, levels of satisfaction, and expectations regarding the use of AI-SaMDs, including the roles of the industry, government, and KSR regarding the clinical use of AI-SaMDs.
RESULTS
Among the 370 respondents (response rate: 7.7% [370/4792]; 340 board-certified radiologists; 210 from academic institutions), 60.3% (223/370) had experience using AI-SaMDs. The two most common use-case of AI-SaMDs among the respondents were lesion detection (82.1%, 183/223), lesion diagnosis/classification (55.2%, 123/223), with the target imaging modalities being plain radiography (62.3%, 139/223), CT (42.6%, 95/223), mammography (29.1%, 65/223), and MRI (28.7%, 64/223). Most users were satisfied with AI-SaMDs (67.6% [115/170, for improvement of patient management] to 85.1% [189/222, for performance]). Regarding the expansion of clinical applications, most respondents expressed a preference for AI-SaMDs to assist in detection/diagnosis (77.0%, 285/370) and to perform automated measurement/quantification (63.5%, 235/370). Most respondents indicated that future development of AI-SaMDs should focus on improving practice efficiency (81.9%, 303/370) and quality (71.4%, 264/370). Overall, 91.9% of the respondents (340/370) agreed that there is a need for education or guidelines driven by the KSR regarding the use of AI-SaMDs.
CONCLUSION
The penetration rate of AI-SaMDs in clinical practice and the corresponding satisfaction levels were high among members of the KSR. Most AI-SaMDs have been used for lesion detection, diagnosis, and classification. Most respondents requested KSR-driven education or guidelines on the use of AI-SaMDs.
Topics: Humans; Republic of Korea; Artificial Intelligence; Surveys and Questionnaires; Societies, Medical; Radiology; Software
PubMed: 38942455
DOI: 10.3348/kjr.2023.1246 -
Journal of Colloid and Interface Science Jun 2024In this study, we present a nanocomposite hydrogel designed for skin motion sensing. The hydrogel is based on poly(acrylamide) crosslinked with gold nanoparticles...
In this study, we present a nanocomposite hydrogel designed for skin motion sensing. The hydrogel is based on poly(acrylamide) crosslinked with gold nanoparticles covalently bound to the polymer matrix, yielding a robust, highly elastic and conductive material. The choice of amino acid derivative - N,N'-diacryloylcystine salt (BISS) - as a crosslinker allows for the introduction of gold nanoparticles, due to the presence of sulfide groups in its structure. During the nanoparticle modification process, covalent bonds between gold and sulfur atoms are formed as the disulfide bond is cleaved. In result of this self-assembly process, a multifunctional Au-BISS crosslinker is formed, enhancing the material's mechanical properties and introducing electrical conductivity. To confer anti-freezing properties and limit water evaporation, a binary mixture of water and glycerol was used. The resultant hydrogel exhibits high elasticity, strain sensitivity across a wide strain range and various types of deformation (elongation, bending, compression) with exceptional response time (120 ms) and recovery time (90 ms). The material's cold-resistance, resilience, and conductivity make it well-suited for real-time monitoring of joint movements and speech recognition, with potential applications in electronic skin and healthcare monitoring devices.
PubMed: 38941933
DOI: 10.1016/j.jcis.2024.06.186 -
Journal of Chromatography. A Jun 2024The greater and more widespread use of chemicals, either from industry or daily use, is leading to an increase in the discharge of these substances into the environment.... (Review)
Review
The greater and more widespread use of chemicals, either from industry or daily use, is leading to an increase in the discharge of these substances into the environment. Some of these are known to be hazardous to humans and the environment and are regulated, but there is a large and increasing number of substances which pose a potential risk even at low concentration and are not controlled. In this context, new techniques and methodologies are being developed to deal with this concern. Miniaturized liquid chromatography (LC) emerges as a greener and more sensitive alternative to conventional LC. Furthermore, advances in instrument miniaturization have made possible the development of portable LC instrumentation which may become a promising tool for in-situ monitoring. This work reviews the environmental applications of miniaturized LC over the last 15 years and discusses the different instrumentation, including off- and on-line pretreatment techniques, chromatographic conditions, and contributions to the environmental knowledge.
PubMed: 38941795
DOI: 10.1016/j.chroma.2024.465101 -
Journal of Medical Internet Research Jun 2024Previous mobile health (mHealth) studies have revealed significant links between depression and circadian rhythm features measured via wearables. However, the...
BACKGROUND
Previous mobile health (mHealth) studies have revealed significant links between depression and circadian rhythm features measured via wearables. However, the comprehensive impact of seasonal variations was not fully considered in these studies, potentially biasing interpretations in real-world settings.
OBJECTIVE
This study aims to explore the associations between depression severity and wearable-measured circadian rhythms while accounting for seasonal impacts.
METHODS
Data were sourced from a large longitudinal mHealth study, wherein participants' depression severity was assessed biweekly using the 8-item Patient Health Questionnaire (PHQ-8), and participants' behaviors, including sleep, step count, and heart rate (HR), were tracked via Fitbit devices for up to 2 years. We extracted 12 circadian rhythm features from the 14-day Fitbit data preceding each PHQ-8 assessment, including cosinor variables, such as HR peak timing (HR acrophase), and nonparametric features, such as the onset of the most active continuous 10-hour period (M10 onset). To investigate the association between depression severity and circadian rhythms while also assessing the seasonal impacts, we used three nested linear mixed-effects models for each circadian rhythm feature: (1) incorporating the PHQ-8 score as an independent variable, (2) adding seasonality, and (3) adding an interaction term between season and the PHQ-8 score.
RESULTS
Analyzing 10,018 PHQ-8 records alongside Fitbit data from 543 participants (n=414, 76.2% female; median age 48, IQR 32-58 years), we found that after adjusting for seasonal effects, higher PHQ-8 scores were associated with reduced daily steps (β=-93.61, P<.001), increased sleep variability (β=0.96, P<.001), and delayed circadian rhythms (ie, sleep onset: β=0.55, P=.001; sleep offset: β=1.12, P<.001; M10 onset: β=0.73, P=.003; HR acrophase: β=0.71, P=.001). Notably, the negative association with daily steps was more pronounced in spring (β of PHQ-8 × spring = -31.51, P=.002) and summer (β of PHQ-8 × summer = -42.61, P<.001) compared with winter. Additionally, the significant correlation with delayed M10 onset was observed solely in summer (β of PHQ-8 × summer = 1.06, P=.008). Moreover, compared with winter, participants experienced a shorter sleep duration by 16.6 minutes, an increase in daily steps by 394.5, a delay in M10 onset by 20.5 minutes, and a delay in HR peak time by 67.9 minutes during summer.
CONCLUSIONS
Our findings highlight significant seasonal influences on human circadian rhythms and their associations with depression, underscoring the importance of considering seasonal variations in mHealth research for real-world applications. This study also indicates the potential of wearable-measured circadian rhythms as digital biomarkers for depression.
Topics: Humans; Seasons; Female; Circadian Rhythm; Male; Wearable Electronic Devices; Adult; Longitudinal Studies; Depression; Middle Aged; Retrospective Studies; Telemedicine
PubMed: 38941600
DOI: 10.2196/55302 -
PloS One 2024The reactor coolant pump is a key equipment in a nuclear power plant. If the leakage exceeds a certain threshold, it may cause reactor overheating and shutdown. The...
The reactor coolant pump is a key equipment in a nuclear power plant. If the leakage exceeds a certain threshold, it may cause reactor overheating and shutdown. The reactor coolant pump leakage fault usually has two problems: corrosion and scaling. Accurately and efficiently diagnosing the leakage fault mode as early as possible and predicting its remaining useful life (RUL) are important for taking timely maintenance measures. In this paper, an integrated method is proposed. First, the cross-sectional area of the first seal is extracted as a fault indicator. The motivation is that corrosion may enlarge the cross-sectional area, and scaling may reduce the cross-sectional area. Based on the fluid mechanics theory, an integrated model with several uncertain parameters is established among the cross-sectional area, temperature, and leakage at the inlet and outlet of the first seal. In the diagnosing process, a modified change-detection method is proposed to detect the starting point of degradation. Then, the unknown parameters in the previous relation are estimated, and the degrading data before the starting point of degradation are used to diagnose the leakage fault mode. Second, a time-series model of the autoregressive integrated moving average (ARIMA) is established to predict the remaining useful life based on the degrading data after the starting point of degradation. Finally, the leakage degrading data from six reactor coolant pumps of a nuclear power plant is used to perform the leakage fault mode diagnosis and life prediction with degradation point detection error rates not exceeding 4%, fault mode diagnosis correction rates 100% and practical RUL predicting results, which proves that the proposed integrated method is accurate and efficient. The proposed integrated method combines the advantages of both the physical model diagnosis and the data-driven model diagnosis and innovatively make use of the quantity of flow from the output side of the primary pump as the monitoring indicator and the cross-sectional area as the characteristic index together to diagnose the leakage fault mode happened to the seal and predict its RUL, which can meet the needs of actual operation and maintenance to ensure a healthy and stable operation of the pump and prevent unexpected shutdowns of nuclear power plants and serious accidents.
Topics: Nuclear Power Plants; Models, Theoretical; Nuclear Reactors; Equipment Failure; Equipment Failure Analysis
PubMed: 38941331
DOI: 10.1371/journal.pone.0304652 -
Reconciling Coulter Counter and laser diffraction particle size analysis for aquaculture monitoring.Environmental Monitoring and Assessment Jun 2024The disaggregated inorganic grain size (DIGS) of bottom sediment analyzed with a Coulter Counter (CC) has been used to show that the fraction of sediment deposited in...
The disaggregated inorganic grain size (DIGS) of bottom sediment analyzed with a Coulter Counter (CC) has been used to show that the fraction of sediment deposited in flocs (floc fraction) increased in both the near and far field after the introduction of open cage salmon aquaculture, altering benthic habitat and species composition. As a result, DIGS was identified as a potential indicator of regional environmental changes due to aquaculture. Laser diffraction is an attractive alternative to the CC because of its greater efficiency and larger size range. To determine if a laser diffraction instrument, Beckman-Coulter LS 13 320 (LS), could replace the CC within a Canadian national aquaculture monitoring program, the DIGS of 581 samples from five different regions in eastern Canada were analyzed with an LS and a CC. Results show that the LS could not be used to calculate floc fraction. Instead, % sortable silt and the volume % of inorganic particles < 16 µm were evaluated as alternative proxies for fine sediment properties. LS and CC values for these parameters were correlated, but they were significantly different and the relationship between the instruments was dependent on the area sampled. The LS did not capture variations between areas seen in the CC DIGS data. Where the DIGS from the CC found no sorting in the finest size classes, all the LS samples had similar size distributions characterized by smooth modal peaks. The LS and CC both return values that can be used to monitor changes in the deposition of fine-grained sediment, but the LS cannot determine changes in floc deposition and caution is required if comparing different sedimentary environments.
Topics: Aquaculture; Environmental Monitoring; Particle Size; Geologic Sediments; Canada; Animals; Lasers
PubMed: 38940996
DOI: 10.1007/s10661-024-12786-w -
Journal of Clinical Hypertension... Jun 2024Extreme cold exposure has been widely considered as a cardiac stress and may result in cardiac function decompensation. This study was to examine the risk factors that...
Extreme cold exposure has been widely considered as a cardiac stress and may result in cardiac function decompensation. This study was to examine the risk factors that contribute to changes in cardiovascular indicators of cardiac function following extreme cold exposure and to provide valuable insights into the preservation of cardiac function and the cardiac adaptation that occur in real-world cold environment. Seventy subjects were exposed to cold outside (Mohe, mean temperature -17 to -34°C) for one day, and were monitored by a 24-h ambulatory blood pressure device and underwent echocardiography examination before and after extreme cold exposure. After exposure to extreme cold, 41 subjects exhibited an increase in ejection fraction (EF), while 29 subjects experienced a decrease. Subjects with elevated EF had lower baseline coefficients of variation (CV) in blood pressure compared to those in the EF decrease group. Additionally, the average real variability (ARV) of blood pressure was also significantly lower in the EF increase group. Multivariate regression analysis indicated that both baseline CV and ARV of blood pressure were independent risk factors for EF decrease, and both indicators proved effective for prognostic evaluation. Correlation analysis revealed a correlation between baseline blood pressure CV and ARV, as well as EF variation after exposure to extreme cold environment. Our research clearly indicated that baseline cardiovascular indicators were closely associated with the changes in EF after extreme cold exposure. Furthermore, baseline blood pressure variability could effectively predict alterations in left cardiac functions when individuals were exposed to extreme cold environment.
PubMed: 38940288
DOI: 10.1111/jch.14862