A Feasibility Study of Telementoring for Identifying the Appendix Using Smartphone-Based Telesonography

We investigated the feasibility of the clinical application of novice-practitioner-performed/offsite-mentor-guided ultrasonography for identifying the appendix. A randomized crossover study was conducted using a telesonography system that can transmit the ultrasound images displayed on the ultrasound monitor (ultrasound sequence video) and images showing the practitioner’s operations (background video) to a smartphone without any interruption in motion over a Long-Term Evolution (LTE) network. Thirty novice practitioners were randomly assigned to two groups. The subjects in group A (n?=?15) performed ultrasonography for the identification of the appendix under mentoring by an onsite expert, whereas those in group B (n?=?15) performed the same procedure under mentoring by an offsite expert. Each subject performed the procedure on three simulated patients. After a 4-week interval, they performed the procedure again under the other type of mentoring. A total of 90 ultrasound examinations were performed in each scenario. The primary outcomes were the success rate for identifying the appendix and the time required to identify the appendix. The success rates for identifying the appendix were 91.1 % (82/90) in onsite-mentored ultrasonography and 87.8 % (79/90) in offsite-mentored ultrasonography; both rates were high, and there was no significant difference (p?=?0.468) between them. The time required in the case of offsite mentoring (median, 242.9 s; interquartile range (IQR), 238.2) was longer than that for onsite mentoring (median, 291.4 s; IQR, 200.9); however, the difference was not significant (p?=?0.051). It appears that offsite mentoring can allow novice onsite practitioners to perform ultrasonography as effectively as they can under onsite mentoring, even for examinations that require proficiency in rather complex practices, such as identifying the appendix.     

A Feasibility Study of Smartphone-Based Telesonography for Evaluating Cardiac Dynamic Function and Diagnosing Acute Appendicitis with Control of the Image Quality of the Transmitted Videos

Our aim was to prove the feasibility of the remote interpretation of real-time transmitted ultrasound videos of dynamic and static organs using a smartphone with control of the image quality given a limited internet connection speed. For this study, 100 cases of echocardiography videos (dynamic organ)—50 with an ejection fraction (EF) of ≥50 s and 50 with EF <50 %—and 100 cases of suspected pediatric appendicitis (static organ)—50 with signs of acute appendicitis and 50 with no findings of appendicitis—were consecutively selected. Twelve reviewers reviewed the original videos using the liquid crystal display (LCD) monitor of an ultrasound machine and using a smartphone, to which the images were transmitted from the ultrasound machine. The resolution of the transmitted echocardiography videos was reduced by approximately 20 % to increase the frame rate of transmission given the limited internet speed. The differences in diagnostic performance between the two devices when evaluating left ventricular (LV) systolic function by measuring the EF and when evaluating the presence of acute appendicitis were investigated using a five-point Likert scale. The average areas under the receiver operating characteristic curves for each reviewer’s interpretations using the LCD monitor and smartphone were respectively 0.968 (0.949–0.986) and 0.963 (0.945–0.982) (P?=?0.548) for echocardiography and 0.972 (0.954–0.989) and 0.966 (0.947–0.984) (P?=?0.175) for abdominal ultrasonography. We confirmed the feasibility of remotely interpreting ultrasound images using smartphones, specifically for evaluating LV function and diagnosing pediatric acute appendicitis; the images were transferred from the ultrasound machine using image quality-controlled telesonography.     

血管介入式全身热疗计划软件的研制

血管介入式全身热疗有望在晚期和扩散型肿瘤的治疗中发挥重要作用,相应临床手术的高效实施需要发展治疗计划软件来指导加热剂量的精确给定。本文从已经过验证的人体全身生物传热房室模型出发,开发出一套基于C#.Net与Matlab COM组件的计算机软件。在Matlab中完成热量守恒和差分离散,实现人体全身热效应的数值计算和后处理功能;在C#.Net中通过Heath Carter体型及成分评估策略、IO文件操作、Solidworks丰富了前处理自定义操作、可视化效果后处理和报告功能。本软件对全身热疗的基本问题提出了系统化的解决方案并将其分解为前处理、计算、后处理等几大模块并建立了评估的基本流程,计算案例成功地将全身热疗计划评估通过友好软件用户接口进行了标准化。     

指纹识别技术发展现状

利用生物特征进行身份识别已成为目前信息安全领域的研究热点,指纹识别技术随着计算机图形学技术的飞速发展已取得巨大的进步。对近20年来指纹识别技术的发展状况进行综述,重点介绍指纹图像的采集、图像的增强、特征提取及匹配、图像的存储与数据库应用等指纹识别中的关键技术,阐述这些关键技术的实现原理,并分析不同技术方法的优缺点。     

Spanish-Language Consumer Health Information Technology Interventions: A Systematic Review

BackgroundAs consumer health information technology (IT) becomes more thoroughly integrated into patient care, it is critical that these tools are appropriate for the diverse patient populations whom they are intended to serve. Cultural differences associated with ethnicity are one aspect of diversity that may play a role in user-technology interactions.ObjectiveOur aim was to evaluate the current scope of consumer health IT interventions targeted to the US Spanish-speaking Latino population and to characterize these interventions in terms of technological attributes, health domains, cultural tailoring, and evaluation metrics.MethodsA narrative synthesis was conducted of existing Spanish-language consumer health IT interventions indexed within health and computer science databases. Database searches were limited to English-language articles published between January 1990 and September 2015. Studies were included if they detailed an assessment of a patient-centered electronic technology intervention targeting health within the US Spanish-speaking Latino population. Included studies were required to have a majority Latino population sample. The following were extracted from articles: first author’s last name, publication year, population characteristics, journal domain, health domain, technology platform and functionality, available languages of intervention, US region, cultural tailoring, intervention delivery location, study design, and evaluation metrics.ResultsWe included 42 studies in the review. Most of the studies were published between 2009 and 2015 and had a majority percentage of female study participants. The mean age of participants ranged from 15 to 68. Interventions most commonly focused on urban population centers and within the western region of the United States. Of articles specifying a technology domain, computer was found to be most common; however, a fairly even distribution across all technologies was noted. Cancer, diabetes, and child, infant, or maternal health were the most common health domains targeted by consumer health IT interventions. More than half of the interventions were culturally tailored. The most frequently used evaluation metric was behavior/attitude change, followed by usability and knowledge retention.ConclusionsThis study characterizes the existing body of research exploring consumer health IT interventions for the US Spanish-speaking Latino population. In doing so, it reveals three primary needs within the field. First, while the increase in studies targeting the Latino population in the last decade is a promising advancement, future research is needed that focuses on Latino subpopulations previously overlooked. Second, preliminary steps have been taken to culturally tailor consumer health IT interventions for the US Spanish-speaking Latino population; however, focus must expand beyond intervention content. Finally, the field should work to promote long-term evaluation of technology efficacy, moving beyond intermediary measures toward measures of health outcomes.     

少年儿童自尊发展影响因素综述

目的总结影响少年儿童自尊发展因素。方法在国内关于自尊发展及影响因素研究文献的基础上,系统总结了影响少年儿童自尊发展影响因素。结果影响因素包括:家庭因素,自身因素,学校因素,社会文化因素,并指出当前自尊研究的不足,提出了相应培养少年儿童自尊的方法措施。结论个人因素和社会因素共同影响少儿自尊发展。     

智障儿童游戏研究进展

本文论述了游戏对智障儿童发展的意义、智障儿童的游戏发展水平及影响因素,分析了已有的研究成果和未来的研究方向,论证了开展智障儿童游戏相关研究的必要性。     

Planning for the next pandemic of influenza

Worldwide influenza pandemics have occurred at irregular and unpredictable intervals throughout history and it is confidently expected that they will continue to occur in the future. It is now recognised that these pandemics result when avian influenza A viruses succeed in adaptation to and transmission between humans. The impact of pandemic influenza is substantial in terms of morbidity, mortality and economic cost and there is the potential for serious social disruption. Influenza vaccines remain the most effective defence against influenza but will be in short supply during a pandemic, as will the new specific anti-influenza drugs, due to the lead-time required for production and rapid spread of the virus. To minimise the impact of pandemics it is imperative to maximise the availability of both vaccines and antivirals and to ensure that they are used optimally. This requires planning at both the international and national levels. The World Health Organization has, therefore, developed a staged plan for responding to a pandemic threat which is based principally on its surveillance program. It has also prepared guidelines to assist national agencies in their planning. However, there may be further options for increasing our preparedness which should also be considered.     

School community in disaster: Planning for intervention

Psychologists' intervention in school disasters, as well as in community disasters affecting a school population, entails a major departure from their traditional role. This article presents a preliminary model for disaster intervention in schools, reconceptualized from the preventive model (Caplan, 1964) underlying community mental health intervention and modified to meet the specific needs of the school organization in disaster. The implementation of the model's principles is outlined, and the implications for communitybased intervention are discussed.     

胸腔引流装置的进展

胸腔引流常用于外伤性或自发性气胸、血胸、脓胸以及心胸手术后,其目的是排除胸腔内的液体、气体和血液,恢复和保持胸腔内负压、维持纵隔的正常位置、促使术侧肺迅速膨胀、防止感染。该文介绍了国内外的胸腔引流技术的发展,从简单的单瓶式到双瓶(腔)式、三瓶(腔)式、四腔式以至干式等。后二种型式的引流装置将是今后发展的必然趋势。     

临床后装放射治疗计划系统的研究进展

后装放疗技术的发展和治疗计划系统的研究进展紧密相关.后装系统中最关键的技术是医学图像可视化,治疗计划剂量的优化等.本文就这二个关键技术进行了分类综述,介绍了各种方法的原理和最新进展,并介绍了当前最为先进的后装治疗计划系统.     

视疲劳主观测量研究发展综述

视觉疲劳在现代生活中非常普遍,不仅会降低视觉效能,甚至可引发眼部和头颈肩疾病以及心理问题。因而,视疲劳测量一直是视觉工效学和临床眼科的重要研究内容。针对视疲劳主观测量发展中的标准、信度和耗时等难题,回顾近30年来相关的研发和使用。根据设计过程和参数特点将其分为经典、专业和新型等3大类,分别介绍其最新发展现状;说明主流量表的特点和优劣及其瓶颈问题,阐述对内“融客于主”、智能适应和对外场景拓展及体系集成等发展建议。最后,展望了视疲劳主观测量的未来发展趋势和新兴研究方向。     

Gene Therapy for Fabry Disease: A Review of the Literature

Fabry disease is an X-linked lysosomal storage disorder caused by a deficiency of the lysosomal enzyme, α-galactosidase A. The lack of adequate enzymatic activity results in a systemic accumulation of neutral glycosphingolipids, predominantly globotriaosylceramide, in the lysosomes of, especially, endothelial and smooth muscle cells of blood vessels. Enzyme replacement therapy is at present the only available specific treatment for Fabry disease; however, this therapy has important drawbacks. Gene-mediated enzyme replacement is a reasonable and highly promising approach for the treatment of Fabry disease. It corresponds to a single gene disorder in which moderately low levels of enzyme activity should be sufficient for clinical efficacy and, thanks to cross-correction mechanisms, the transfection of a small number of cells will potentially correct distant cells too. This article summarizes the studies that have been carried out concerning gene therapy for the treatment of Fabry disease. We briefly review the literature from earlier studies in the 1990s to the current achievements.     

Development of Executive Function and Attention in Preterm Children: A Systematic Review

We report on a systematic review of studies of executive function and attention in preterm children. Using meta-analysis, we confirm this is an area of weakness for preterm children, and show that the extent of difficulties is influenced by gestational age (GA), age at test, and skill under investigation. Effect size for selective and sustained attention and inhibition is related to GA. For studies with mean GA ≥ 26 weeks, selective attention skills catch up with age, phonemic fluency skills are increasingly delayed, and ongoing deviance is shown for shifting skills (when assessed with specific measures). Implications for research and practice are discussed.