• 【浴室电子秤和血压计在量化数字后前脊髓压强时的可靠性和并行性。】 复制标题 收藏 收藏
    DOI:10.3233/THC-130741 复制DOI
    作者列表:Teslim OA,Olayinka A,Michael E,Adesoji AR,Oluwole AT
    BACKGROUND & AIMS: PURPOSE:The main objective of this study was to determine the reliability and concurrent validity of using Modified Sphygmomanometer (sphyg) and body weighing scale to determine the magnitude of pressure and body weight change during digital spinal examination. SUBJECTS:One hundred and twenty apparently healthy subjects were recruited. METHODS:Weighing scale was used to measure the body weight of the investigator while Mercury sphygmomanometer was used to measure the pressure exerted. There was test re-test interval of 2 weeks. Data were analysed by descriptive statistic and Pearson product moment correlation. RESULTS:The result showed that there was significant correlation between the weight change (WC) values obtained on the weighing scale on day 1 and 2 (r=0.91). Also, there was significant correlation between Pressure obtained in the sphygmomanometer on day 1 and 2 (r=0.94). Similarly, there was significant correlation between the WC and Pressure Change (PC), (r=-0.49). The participant's age, height, weight and BMI contributed significantly as predictors for both BWC and PC change respectively. CONCLUSION:This study concluded that weighing scale and Mercury sphygmomanometer are reliable and valid to determine the magnitude of pressure applied during DPAP.
    背景与目标: 目的:本研究的主要目的是确定使用改良血压计和体重计确定数字化脊柱检查过程中压力和体重变化幅度的可靠性和同时有效性。
    受试者:招募了一百二十名看起来健康的受试者。
    方法:用体重计测量研究者的体重,用水银血压计测量施加的压力。重新测试间隔为2周。通过描述性统计和皮尔逊乘积矩相关性分析数据。
    结果:结果表明,第1天和第2天在体重秤上获得的体重变化(WC)值之间存在显着相关性(r = 0.91)。同样,第1天和第2天在血压计中获得的压力之间也存在显着相关性(r = 0.94)。同样,WC和压力变化(PC)之间也存在显着相关性(r = -0.49)。参与者的年龄,身高,体重和BMI分别是BWC和PC改变的预测指标。
    结论:本研究得出结论,称重秤和水银血压计对于确定DPAP期间施加的压力大小是可靠且有效的。
  • 2 Aggressive digital papillary adenocarcinoma. 复制标题 收藏 收藏

    【侵袭性数字乳头状腺癌。】 复制标题 收藏 收藏
    DOI:10.1016/0190-9622(90)70215-4 复制DOI
    作者列表:Ceballos PI,Penneys NS,Acosta R
    BACKGROUND & AIMS: :Aggressive digital papillary adenocarcinoma is a rare neoplasm of eccrine sweat gland origin. An acral location and a high recurrence rate are characteristic features. Its histopathologic features are distinctive, and the tumor expresses carcinoembryonic and S-100 protein antigens. We demonstrated immunoreactivity of the tumor to ferritin antibody, a new immunohistologic marker for sweat gland malignancies.
    背景与目标: :侵袭性数字乳头状腺癌是内分泌汗腺起源的罕见肿瘤。骨部位和高复发率是特征性特征。其组织病理学特征是独特的,并且肿瘤表达癌胚和S-100蛋白抗原。我们证明了肿瘤对铁蛋白抗体的免疫反应性,铁蛋白抗体是汗腺恶性肿瘤的一种新的免疫组织学标记。
  • 【平视手术中数字图像增强的定量评估。】 复制标题 收藏 收藏
    DOI:10.1038/s41598-019-52492-z 复制DOI
    作者列表:Akiyama K,Watanabe K,Fukui M,Higuchi H,Noda T
    BACKGROUND & AIMS: :Image-processing is an advantage of heads-up surgery and expected to facilitate ophthalmic surgeries. To evaluate image-processing quantitatively, we analyzed the surgical images of twenty eyes that underwent vitrectomy with internal limiting membrane (ILM) peeling assisted by Brilliant Blue G (BBG). Still images of the peeling procedure were obtained from the surgical video, and the color difference was calculated between two adjacent spots inside and outside the ILM-peeling contour, i.e., without and with BBG staining, respectively. The color differences were compared between the two settings with and without image-processing, delivered by an algorithm to enhance the color and contrast. Color differences were calculated using two methods: the Euclidean distance based on RGB values (RGB distance) and the Delta-E00 formula provided by the International Commission on Illumination. In five cases, minimum light intensities required to recognize the contour of ILM-peeling were compared during surgeries between the two settings with and without enhancement. Image-processing increased the mean color difference significantly (P < 0.001) from 15.47 and 4.49 to 34.03 and 8.00, respectively, for the RGB distance and Delta-E00. The minimum light intensity was reduced from 15 to 5 on average by image-enhancement. These results showed image-processing enhances color differences and reduces light intensities during vitrectomy.
    背景与目标: :图像处理是平视手术的一个优势,有望促进眼科手术。为了定量评估图像处理,我们分析了二十只眼睛的手术图像,这些眼睛接受了玻璃内切除术,并用Brilliant Blue G(BBG)辅助进行了内部限制膜(ILM)剥离。从外科手术视频中获得了脱皮过程的静止图像,并计算了ILM脱皮轮廓的内部和外部两个相邻点之间的色差,即分别不使用BBG染色和使用BBG染色。通过算法来增强色彩和对比度,比较了在有图像处理和没有图像处理的两种设置之间的色差。使用两种方法计算色差:基于RGB值的欧几里德距离(RGB距离)和国际照明委员会提供的Delta-E00公式。在五种情况下,在手术过程中,在有和没有增强的情况下,在两种设置之间比较了识别ILM剥离轮廓所需的最小光强度。对于RGB距离和Delta-E00,图像处理将平均色差分别从15.47和4.49显着增加(P <0.001)到34.03和8.00。通过图像增强,最小光强度平均从15降低到5。这些结果表明,在玻璃体切割术中,图像处理可增强色差并降低光强度。
  • 【数字病理和转录组学分析的整合将肿瘤浸润淋巴细胞的空间密度与对BRAF抑制剂的临床反应联系起来。】 复制标题 收藏 收藏
    DOI:10.3389/fonc.2020.00757 复制DOI
    作者列表:Ziemys A,Kim M,Menzies AM,Wilmott JS,Long GV,Scolyer RA,Kwong L,Holder A,Boland G
    BACKGROUND & AIMS: :Metastatic melanoma is one of the most immunogenic malignancies due to its high rate of mutations and neoantigen formation. Response to BRAF inhibitors (BRAFi) may be determined by intratumoral immune activation within melanoma metastases. To evaluate whether CD8+ T cell infiltration and distribution within melanoma metastases can predict clinical response to BRAFi, we developed a methodology to integrate immunohistochemistry with automated image analysis of CD8+ T cell position. CD8+ distribution patterns were correlated with gene expression data to identify and quantify "hot" areas within a tumor. Furthermore, the relative activation of CD8+cells, based on transcriptomic analysis, and their relationship to other CD8+ T cells and non-CD8+ cells within the tumor suggested a less crowded distribution of cells around activated CD8+ T cells. Furthermore, the relative activation of these CD8+ T cells was associated with improved clinical outcomes and decreased tumor cell proliferation. This study demonstrates the potential of digital pathomics to incorporate immune cell spatial distribution within metastases and RNAseq analysis to predict clinical response to BRAF inhibition in metastatic melanoma.
    背景与目标: :转移性黑素瘤由于其高突变率和新抗原形成而成为最具免疫原性的恶性肿瘤之一。对BRAF抑制剂(BRAFi)的反应可以通过黑色素瘤转移瘤内的肿瘤内免疫激活来确定。为了评估黑色素瘤转移中CD8 T细胞的浸润和分布是否可以预测对BRAFi的临床反应,我们开发了一种方法,将免疫组织化学与CD8 T细胞位置的自动图像分析相结合。 CD8分布模式与基因表达数据相关联,以鉴定和量化肿瘤内的“热”区域。此外,基于转录组学分析,CD8细胞的相对活化及其与肿瘤内其他CD8 T细胞和非CD8细胞的关系表明,活化的CD8 T细胞周围的细胞分布较少。此外,这些CD8 T细胞的相对活化与改善的临床结果和减少的肿瘤细胞增殖有关。这项研究证明了数字病理学在转移中结合免疫细胞空间分布和RNAseq分析来预测转移性黑色素瘤对BRAF抑制的临床反应的潜力。
  • 【评估护理学学生的在线解剖学和生理学数字混合学习模式。】 复制标题 收藏 收藏
    DOI:10.1097/CIN.0000000000000639 复制DOI
    作者列表:Barbagallo MS,Porter JE,Lamunu M
    BACKGROUND & AIMS: :Blended online and digital learning includes a variety of activities that combine engaging classroom-based education with online learning. The aim of this study is to evaluate undergraduate students' perceptions of a blended online and digital curriculum for anatomy and physiology in the nursing degree program. A quantitative methodology was used with a sample of 100 undergraduate nursing students from a single Australian University. Descriptive statistics are and presented in this article. Of the 100 participants, 90% were enrolled in the standard mode compared to 10% in a flexible mode of delivery. Results indicated that 29% of participants preferred laboratory classes as having the most impact. Participants (46%) also agreed that recorded lectures were useful, with 36% indicating that the online platform was easy to navigate going as far as wanting more online quizzes (49%). More than half of the participants (54%) acknowledged that anatomy and physiology was important for their future careers. The blended online and digital learner preferences in delivering anatomy and physiology-related courses should be adjusted in order for learning to be effective for undergraduate students in the future.
    背景与目标: :混合的在线和数字学习包括将课堂教学与在线学习相结合的各种活动。这项研究的目的是评估本科生对护理学位课程中有关解剖学和生理学的在线和数字混合课程的看法。定量方法用于来自单个澳大利亚大学的100名本科护理学生的样本。本文将介绍描述性统计信息。在100名参与者中,有90%以标准模式注册,而在灵活交付模式中则为10%。结果表明,有29%的参与者更喜欢实验室课程,因为其影响最大。参与者(46%)也同意录制的讲座非常有用,有36%的参与者表示,在线平台易于浏览,甚至需要更多在线测验(49%)。一半以上的参与者(54%)承认,解剖学和生理学对他们的未来职业很重要。应调整在线和数字学习者在提供解剖学和生理学相关课程方面的偏好,以使学习在将来对本科生有效。
  • 【用于数字组织反卷积的损失函数学习。】 复制标题 收藏 收藏
    DOI:10.1089/cmb.2019.0462 复制DOI
    作者列表:Görtler F,Schön M,Simeth J,Solbrig S,Wettig T,Oefner PJ,Spang R,Altenbuchinger M
    BACKGROUND & AIMS: : The gene expression profile of a tissue averages the expression profiles of all cells in this tissue. Digital tissue deconvolution addresses the following inverse problem: given the expression profile y of a tissue, what is the cellular composition c of that tissue? If X is a matrix whose columns are reference profiles of individual cell types, the composition c can be computed by minimizing ℒ ( y - X c ) for a given loss function ℒ . Current methods use predefined all-purpose loss functions. They successfully quantify the dominating cells of a tissue, while often falling short in detecting small cell populations. In this study we use training data to learn the loss function ℒ along with the composition c . This allows us to adapt to application-specific requirements such as focusing on small cell populations or distinguishing phenotypically similar cell populations. Our method quantifies large cell fractions as accurately as existing methods and significantly improves the detection of small cell populations and the distinction of similar cell types.
    背景与目标:
    组织的基因表达谱将组织中所有细胞的表达谱平均化。数字组织反卷积解决了以下反问题:给定表达谱
    ÿ
    组织的细胞组成是什么
    C
    那张纸巾?如果
    X
    是一个矩阵,其列是各个细胞类型,组成的参考资料
    C
    可以通过最小化来计算





    ÿ
    --
    X
    C




    对于给定的损失函数



    。当前的方法使用预定义的通用损失函数。他们成功地量化了组织中占主导地位的细胞,而在检测小细胞群体时常常不尽人意。在这项研究中,我们使用训练数据来学习损失函数



    连同组成
    C
    。这使我们能够适应特定于应用程序的要求,例如专注于小细胞群体或区分表型相似的细胞群体。我们的方法与现有方法一样准确地定量了大细胞部分,并显着改善了小细胞群体的检测和相似细胞类型的区分。
  • 【门诊卒中视频游戏康复(VIGoROUS):一项针对在家中游戏化约束诱发的运动疗法进行慢性上肢偏瘫康复的多中心比较有效性试验的协议。】 复制标题 收藏 收藏
    DOI:10.1186/s12883-017-0888-0 复制DOI
    作者列表:Gauthier LV,Kane C,Borstad A,Strahl N,Uswatte G,Taub E,Morris D,Hall A,Arakelian M,Mark V
    BACKGROUND & AIMS: BACKGROUND:Constraint-Induced Movement therapy (CI therapy) is shown to reduce disability, increase use of the more affected arm/hand, and promote brain plasticity for individuals with upper extremity hemiparesis post-stroke. Randomized controlled trials consistently demonstrate that CI therapy is superior to other rehabilitation paradigms, yet it is available to only a small minority of the estimated 1.2 million chronic stroke survivors with upper extremity disability. The current study aims to establish the comparative effectiveness of a novel, patient-centered approach to rehabilitation utilizing newly developed, inexpensive, and commercially available gaming technology to disseminate CI therapy to underserved individuals. Video game delivery of CI therapy will be compared against traditional clinic-based CI therapy and standard upper extremity rehabilitation. Additionally, individual factors that differentially influence response to one treatment versus another will be examined. METHODS:This protocol outlines a multi-site, randomized controlled trial with parallel group design. Two hundred twenty four adults with chronic hemiparesis post-stroke will be recruited at four sites. Participants are randomized to one of four study groups: (1) traditional clinic-based CI therapy, (2) therapist-as-consultant video game CI therapy, (3) therapist-as-consultant video game CI therapy with additional therapist contact via telerehabilitation/video consultation, and (4) standard upper extremity rehabilitation. After 6-month follow-up, individuals assigned to the standard upper extremity rehabilitation condition crossover to stand-alone video game CI therapy preceded by a therapist consultation. All interventions are delivered over a period of three weeks. Primary outcome measures include motor improvement as measured by the Wolf Motor Function Test (WMFT), quality of arm use for daily activities as measured by Motor Activity Log (MAL), and quality of life as measured by the Quality of Life in Neurological Disorders (NeuroQOL). DISCUSSION:This multi-site RCT is designed to determine comparative effectiveness of in-home technology-based delivery of CI therapy versus standard upper extremity rehabilitation and in-clinic CI therapy. The study design also enables evaluation of the effect of therapist contact time on treatment outcomes within a therapist-as-consultant model of gaming and technology-based rehabilitation. TRIAL REGISTRATION:Clinicaltrials.gov, NCT02631850 .
    背景与目标: 背景:约束诱导运动疗法(CI疗法)被证明可以减少残疾,增加受影响的手臂/手的使用,并促进卒中后上肢偏瘫的患者的大脑可塑性。随机对照试验始终证明,CI疗法优于其他康复范例,但只有大约120万患有上肢残疾的慢性卒中幸存者中的一小部分可以使用CI疗法。当前的研究旨在建立一种以患者为中心的新型康复方法的相对有效性,该方法利用新开发的,廉价的和可商购的游戏技术将CI疗法传播给服务欠缺的个人。 CI疗法的视频游戏交付将与传统的基于临床的CI疗法和标准的上肢康复进行比较。另外,将检查对一种治疗方法与另一种治疗方法有不同影响的个体因素。
    方法:本方案概述了采用平行分组设计的多站点随机对照试验。将在四个地点招募24名患有中风后慢性偏瘫的成年人。参与者被随机分为四个研究组之一:(1)传统的基于临床的CI治疗;(2)作为治疗师的顾问视频游戏CI疗法;(3)作为治疗师的顾问视频游戏CI疗法,并通过其他治疗师联系远程康复/视频咨询,以及(4)标准的上肢康复。经过6个月的随访,分配给标准上肢康复条件的患者转入独立的视频游戏CI治疗,然后进行治疗师咨询。所有干预措施均在三个星期内完成。主要结局指标包括通过沃尔夫运动功能测试(WMFT)进行的运动改善,通过运动活动日志(MAL)进行的日常活动的手臂使用质量以及通过神经系统疾病的生活质量进行的生活质量评估( NeuroQOL)。
    讨论:该多站点RCT旨在确定基于家庭技术的CI疗法与标准上肢康复和诊所CI疗法的比较效果。该研究设计还可以在以博弈和技术为基础的康复治疗师-顾问模型中评估治疗师接触时间对治疗结果的影响。
    试用注册:Clinicaltrials.gov,NCT02631850。
  • 【十二指肠类癌的带状结扎切除术(带视频)。】 复制标题 收藏 收藏
    DOI:10.1016/j.gie.2007.01.029 复制DOI
    作者列表:Gomez V,Groce JR,Xaio SY,Bhutani MS,Raju GS
    BACKGROUND & AIMS: -2
    背景与目标: -2
  • 【美国青少年中数字技术与物质使用之间的关联:2018年监测未来调查的结果。】 复制标题 收藏 收藏
    DOI:10.1016/j.drugalcdep.2020.108124 复制DOI
    作者列表:Kaur N,Rutherford CG,Martins SS,Keyes KM
    BACKGROUND & AIMS: OBJECTIVE:Social media and other digital technology use facilitate connection among adolescents, but also may reinforce norms and substance-related content from peers and advertisers. We use nationally representative data to examine the association between digital technology and past 30-day use of alcohol, cannabis, and vaping. METHODS:Data were drawn from the 2018 Monitoring the Future survey of US adolescents (N = 44,482). Poisson regressions estimated the association between hours/day of technology use and past 30-day use of alcohol, cannabis, and vaping adjusting for grade, sociodemographics, and other past-year drug use. RESULTS:Across grades, mean hours of social media/day was 3.06 (standard deviation = 2.90), past 30-day alcohol, cannabis, flavor vaping, cannabis vaping, and nicotine vaping were 15.7 %, 12.6 %, 10.6 %, 4.9 %, and 11.2 %, respectively. Digital technology use that required interaction with others was associated with increased risk of past 30-day drinking, cannabis use, and vaping. For example, social media 3+ hours/day was associated with past 30-day drinking (adjusted relative risk [aRR]: 1.99, 95 % CI: 1.65, 2.41). The magnitude of association was consistent across texting, phone calls, and video chatting, which were all more strongly associated with substance use than with activities that do not require interaction such as gaming and watching videos. CONCLUSION:Digital technology that facilitates interaction among adolescents, such as texting and social media, is associated with past substance use. Magnitudes of association are consistent across substances, supporting the hypothesis that networks of adolescents are social drivers of substance use, rather than the technology itself.
    背景与目标: 目的:社交媒体和其他数字技术的使用促进了青少年之间的联系,但也可能加强了来自同龄人和广告商的规范和与物质有关的内容。我们使用具有国家代表性的数据来​​检查数字技术与过去30天的酒精,大麻和电子烟的使用之间的关联。
    方法:数据来自2018年美国青少年监控未来调查(N = 44,482)。 Poisson回归估计了技术使用的小时数/天与过去30天的酒精,大麻使用和根据等级,社会人口统计学和其他过去一年的药物使用情况进行调整的雾化之间的关联。
    结果:在所有年级中,每天社交媒体的平均小时数为3.06(标准偏差= 2.90),过去30天的酒精,大麻,味雾,大麻雾和尼古丁雾化分别为15.7%,12.6%,10.6%,4.9% ,和11.2%。需要与他人互动的数字技术使用与过去30天喝酒,使用大麻和吸毒的风险增加有关。例如,每天3小时的社交媒体与过去30天的饮酒相关(调整后的相对风险[aRR]:1.99,95%CI:1.65,2.41)。在短信,电话和视频聊天之间,关联的程度是一致的,与不需要使用游戏和观看视频等不需要互动的活动相比,与吸食毒品的关联更紧密。
    结论:促进青少年之间互动的数字技术,例如短信和社交媒体,与过去的毒品使用有关。各种物质之间的关联程度是一致的,支持以下假设:青少年网络是物质使用的社会驱动力,而不是技术本身。
  • 【数字性点蚀对全身性硬化症患者的影响和关联:一项初步研究。】 复制标题 收藏 收藏
    DOI:10.1080/03009742.2019.1683888 复制DOI
    作者列表:Nolan E,Manning J,Heal C,Moore T,Herrick AL
    BACKGROUND & AIMS: :Objective: Despite being a cardinal clinical sign of systemic sclerosis (SSc), digital pitting has been little studied. Our objective was to test, in a pilot study, the hypothesis that pitting is painful and associated with digital vascular disease severity.Method: Fifty patients with SSc were recruited: 25 with and 25 without digital pitting. Fingertip pain was assessed on a 0-10 scale. Thermography of both hands assessed surface temperature, allowing calculation of the distal-dorsal difference (temperature gradient) for each finger. Nailfold capillaroscopy was performed in each finger using a dermatoscope, and graded on a 0-3 scale (0 = normal; 3 = grossly abnormal).Results: In the 25 patients with digital pitting, 65 fingers in total were affected (mainly the index and middle fingers). Pain scores were higher in 'pitting' patients [median 4 (interquartile range 3-8) vs 0 (0-2), p < 0.001], and pitting patients reported that pitting impacted on activities of everyday living. Temperature gradients along the fingers did not differ significantly between patients with and without pitting (p = 0.248). Pitting patients were more likely to have 'grossly abnormal' capillaries than those without pitting, and less likely to have 'no/mild' nailfold capillary changes.Conclusions: Digital pitting is painful and impacts on hand function. Capillaroscopy findings provide further support for an association between pitting and severity of digital vascular change. Larger, more comprehensive studies are required to examine the pathophysiology of pitting and to pave the way to therapeutic intervention, ideally including preventive strategies.
    背景与目标: :目的:尽管是全身性硬化症(SSc)的主要临床体征,但对数字麻点的研究很少。我们的目的是在一项初步研究中测试以下观点:麻点疼痛且与数字血管疾病的严重程度有关。方法:招募了50名SSc患者:25名有数字麻点的患者和25名无数字麻点的患者。指尖疼痛的评估范围为0-10。两只手的热像仪可以评估表面温度,从而可以计算出每个手指的远端-背侧差异(温度梯度)。使用皮镜在每根手指上进行针状毛细血管镜检查,并以0-3评分(0 =正常; 3 =严重异常)进行分级。结果:在25例数字化点蚀患者中,总共有65根手指受到影响(主要是指和中指)。 '麻点'患者的疼痛评分较高[中位数4(四分位间距3-8)vs 0(0-2),p <0.001],并且麻点患者报告麻点影响日常生活活动。带有和不带有点蚀的患者之间沿手指的温度梯度差异不显着(p = 0.248)。点蚀患者比没有点蚀的患者更有可能出现“严重异常”的毛细血管,并且没有“无/轻微”的指甲皱纹毛细血管改变的结论。结论:数字化点蚀是痛苦的,并且会影响手部功能。毛细血管镜检查结果为点蚀与数字血管变化严重程度之间的关联提供了进一步的支持。需要更大,更全面的研究来检查点蚀的病理生理,并为治疗干预铺平道路,理想情况下应包括预防策略。
  • 11 [Digital public health-an overview]. 复制标题 收藏 收藏

    【[数字公共卫生-概述]。】 复制标题 收藏 收藏
    DOI:10.1007/s00103-019-03078-7 复制DOI
    作者列表:Zeeb H,Pigeot I,Schüz B,Leibniz-WissenschaftsCampus Digital Public Health Bremen.
    BACKGROUND & AIMS: :The rapid development and proliferation of digital health technologies have not only changed the medical professions, but offer great potential for public health, particularly in health promotion and disease prevention.At the same time, this emerging field is also characterized by conceptual and terminological fuzziness, a marked lack of high-quality evidence, and an absence of an honest discussion of unintended consequences and side effects. Further challenges for digital public health lie in the fact that the development of new health technologies is mainly driven by technological progress and less by evidence-based needs and research in public health.In this overview paper, we aim at conceptually denoting the field of digital public health, using principal public health functions as guiding principles. We discuss some current applications of digital health technologies in fulfilling public health functions and propose a needs-based development of digital health technologies.We will further address specific challenges to digital public health, in particular socio-economic differences in the usage of and profiting from digital health technologies, data protection and privacy issues, as well as ethical issues.
    背景与目标: :数字健康技术的迅速发展和扩散不仅改变了医学专业,而且为公共卫生提供了巨大的潜力,特别是在健康促进和疾病预防方面。与此同时,这一新兴领域还具有概念和术语模糊性的特点。 ,明显缺乏高质量的证据,也没有对意想不到的后果和副作用进行诚实的讨论。数字公共卫生的进一步挑战在于,新卫生技术的发展主要是由技术进步驱动的,而不是由基于证据的需求和公共卫生研究驱动的。公共卫生,以主要公共卫生职能为指导原则。我们讨论了数字卫生技术在履行公共卫生职能方面的当前应用,并提出了基于需求的数字卫生技术开发。我们将进一步解决数字公共卫生方面的具体挑战,尤其是使用和从中获利的社会经济差异数字医疗技术,数据保护和隐私问题以及道德问题。
  • 【乳腺癌中Ki-67的自动化评估:使用虚拟三重染色和全玻片成像的数字图像分析实用程序。】 复制标题 收藏 收藏
    DOI:10.1111/his.14140 复制DOI
    作者列表:Hida AI,Omanovic D,Pedersen L,Oshiro Y,Ogura T,Nomura T,Kurebayashi J,Kanomata N,Moriya T
    BACKGROUND & AIMS: AIMS:Precise evaluation of proliferative activity is essential for the stratified treatment of luminal-type breast cancer (BC). Immunohistochemical staining of Ki-67 has been widely used to determine proliferative activity and is recognised to be a useful prognostic marker. However, there remains discussion concerning the methodology. We aimed to develop an automated and reliable Ki-67 assessment approach for invasive BC. MATERIALS AND RESULTS:A retrospective study was designed to include two cohorts consisting of 152 and 261 consecutive patients with luminal-type BC. Representative tissue blocks following surgery were collected, and three serial sections were stained automatically with Ki-67, pan-cytokeratin and p63. The whole slides were scanned digitally and aligned using VirtualTripleStaining - an extension to the VirtualDoubleStaining™ technique provided by Visiopharm software. The aligned files underwent automated invasive cancer detection, hot-spot identification and Ki-67 counting. The automated scores showed a significant positive correlation with the pathologists' scores (r = 0.82, P < 0.0001). Among selected patients with curative surgery and standard adjuvant therapies (n = 130), the digitally assessed low Ki-67 group (<20%) demonstrated a significantly better prognosis (breast cancer-specific survival, P = 0.030; hazard ratio = 0.038) than the high Ki-67 group. CONCLUSIONS:Digital image analysis yielded similar results to the scores determined by experienced pathologists. The prognostic utility was verified in our cohort, and an automated process is expected to have high reproducibility. Although some pitfalls were confirmed and thus need to be monitored by laboratory staff, the application could be utilised for the assessment of BC.
    背景与目标: 目的:精确评估增殖活性对于管腔型乳腺癌(BC)的分层治疗至关重要。 Ki-67的免疫组织化学染色已被广泛用于确定增殖活性,并被认为是有用的预后标志物。但是,仍然存在有关该方法的讨论。我们旨在为侵入性BC开发一种自动化且可靠的Ki-67评估方法。
    材料与结果:一项回顾性研究旨在包括两个队列,分别由152例和261例腔内型BC患者组成。收集手术后的代表性组织块,并用Ki-67,泛细胞角蛋白和p63自动对三个连续切片进行染色。整个幻灯片都进​​行了数字扫描,并使用VirtualTripleStaining(Visiopharm软件提供的VirtualDoubleStaining™技术的扩展)进行了对齐。对齐后的文件进行了自动浸润癌检测,热点识别和Ki-67计数。自动评分显示与病理学家评分显着正相关(r = 0.82,P <0.0001)。在选定的具有根治性手术和标准辅助疗法的患者中(n = 130),经数字评估的低Ki-67组(<20%)表现出更好的预后(乳腺癌特异性生存率,P = 0.030;危险比= 0.038)比高Ki-67组高。
    结论:数字图像分析得出的结果与经验丰富的病理学家确定的分数相似。预后的效用已在我们的队列中得到验证,并且自动化过程有望具有很高的可重复性。尽管确定了一些陷阱,因此需要由实验室工作人员进行监控,但该应用程序可用于评估BC。
  • 【从业者评论:与儿童和年轻人的数字心理健康技术的共同设计。】 复制标题 收藏 收藏
    DOI:10.1111/jcpp.13258 复制DOI
    作者列表:Bevan Jones R,Stallard P,Agha SS,Rice S,Werner-Seidler A,Stasiak K,Kahn J,Simpson SA,Alvarez-Jimenez M,Rice F,Evans R,Merry S
    BACKGROUND & AIMS: BACKGROUND:There is increasing interest in digital technologies to help improve children and young people's mental health, and the evidence for the effectiveness for these approaches is rising. However, there is concern regarding levels of user engagement, uptake and adherence. Key guidance regarding digital health interventions stress the importance of early user input in the development, evaluation and implementation of technologies to help ensure they are engaging, feasible, acceptable and potentially effective. Co-design is a process of active involvement of stakeholders, requiring a change from the traditional approaches to intervention development. However, there is a lack of literature to inform the co-design of digital technologies to help child and adolescent mental health. METHODS:We reviewed the literature and practice in the co-design of digital mental health technologies with children and young people. We searched Medline, PsycInfo and Web of Science databases, guidelines, reviews and reference lists, contacted key authors for relevant studies, and extracted key themes on aspects of co-design relevant to practice. We supplemented this with case studies and methods reported by researchers working in the field. RESULTS:We identified 25 original articles and 30 digital mental health technologies that were designed/developed with children and young people. The themes identified were as follows: principles of co-design (including potential stakeholders and stages of involvement), methods of involving and engaging the range of users, co-designing the prototype and the challenges of co-design. CONCLUSIONS:Co-design involves all relevant stakeholders throughout the life and research cycle of the programme. This review helps to inform practitioners and researchers interested in the development of digital health technologies for children and young people. Future work in this field will need to consider the changing face of technology, methods of engaging with the diversity in the user group, and the evaluation of the co-design process and its impact on the technology.
    背景与目标: 背景:人们对数字技术越来越感兴趣,以帮助改善儿童和年轻人的心理健康,并且这些方法的有效性的证据越来越多。然而,存在关于用户参与,吸收和遵守的水平的担忧。有关数字健康干预的关键指南强调了用户在技术开发,评估和实施中的早期投入的重要性,以帮助确保它们具有吸引力,可行性,可接受性和潜在有效性。协同设计是利益相关者积极参与的过程,需要从传统方法向干预开发的转变。但是,缺乏文献来指导数字技术的协同设计,以帮助儿童和青少年的心理健康。
    方法:我们回顾了与儿童和年轻人共同设计数字心理健康技术的文献和实践。我们搜索了Medline,PsycInfo和Web of Science数据库,指南,评论和参考列表,联系了主要作者进行相关研究,并提取了与实践相关的协同设计方面的关键主题。我们用该领域研究人员报道的案例研究和方法来补充这一点。
    结果:我们确定了25篇针对儿童和年轻人设计/开发的原创文章和30项数字心理健康技术。所确定的主题如下:共同设计的原则(包括潜在的利益相关者和参与阶段),吸引和吸引用户范围的方法,共同设计原型以及共同设计的挑战。
    结论:协同设计涉及计划的整个生命周期和研究周期中的所有相关利益相关者。这篇评论有助于向对儿童和年轻人的数字医疗技术发展感兴趣的从业者和研究人员提供信息。该领域的未来工作将需要考虑技术的变化面貌,应对用户群多样性的方法以及对协同设计过程及其对技术的影响的评估。
  • 【回顾性观察性研究:与传统外科手术计划相比,双颌正颌外科手术中颌骨复位的准确度与数字外科手术计划的准确性进行了回顾性观察研究。】 复制标题 收藏 收藏
    DOI:10.3390/jcm9061840 复制DOI
    作者列表:Barone M,De Stefani A,Baciliero U,Bruno G,Gracco A
    BACKGROUND & AIMS: BACKGROUND:Technological progress has led to the transition to digital methods to perform surgical planning and to obtain surgical splints with CAD/CAM technologies. The present study aimed to compare the accuracy of jaw repositioning in bimaxillary orthognathic surgery using traditional and digital surgical planning in skeletal class III patients. METHODS:This study included 60 skeletal class III patients divided into two groups based on the method used to perform surgical planning: traditional (T, n = 30) and digital (D, n = 30). For each patient, a 2D presurgical Visual Treatment Objective (VTO) was prepared and the outcome of the surgery was compared with that planned by using determined cephalometric measurements (ANB, SNA, SNB, Ar-Go-Me, S-Ar-Go). Statistical analysis showed that the measurements planned and those obtained after surgery were equivalent in Group D. For Group T, the analysis showed equivalence only for one of the considered measurements (ANB). By comparing the results of the two groups, Group D presented a lower level of error than Group T. CONCLUSIONS:Digital surgical planning performed significantly better in terms of accuracy of jaw repositioning than the traditional protocol.
    背景与目标: 背景:技术进步已导致向数字方法的转变,以执行手术计划并使用CAD / CAM技术获得手术夹板。本研究旨在比较传统的和数字化外科手术计划在三级骨骼正畸患者中双颌正颌外科手术中颌骨重新定位的准确性。
    方法:这项研究包括60例III类骨骼肌患者,根据执行手术计划的方法分为两组:传统(T,n = 30)和数字(D,n = 30)。为每位患者准备了二维手术前视觉治疗目标(VTO),并通过确定的头颅测量值(ANB,SNA,SNB,Ar-Go-Me,S-Ar-Go)将手术结果与计划的结果进行了比较。统计分析表明,计划的测量值和手术后获得的测量值在D组中是相同的。对于T组,分析仅显示了一种考虑的测量值(ANB)的等效性。通过比较两组的结果,D组的错误水平低于T组。
    结论:在数字化外科手术计划方面,与传统手术方案相比,颌骨重新定位的准确性显着提高。
  • 【老年人对两种自我管理的预防跌倒家庭锻炼计划的偏爱,坚持和经验:数字计划和纸质手册之间的比较。】 复制标题 收藏 收藏
    DOI:10.1186/s12877-020-01592-x 复制DOI
    作者列表:Mansson L,Lundin-Olsson L,Skelton DA,Janols R,Lindgren H,Rosendahl E,Sandlund M
    BACKGROUND & AIMS: BACKGROUND:Fall prevention exercise programmes are known to be effective, but access to these programmes is not always possible. The use of eHealth solutions might be a way forward to increase access and reach a wider population. In this feasibility study the aim was to explore the choice of programme, adherence, and self-reported experiences comparing two exercise programmes - a digital programme and a paper booklet. METHODS:A participant preference trial of two self-managed fall prevention exercise interventions. Community-dwelling adults aged 70 years and older exercised independently for four months after one introduction meeting. Baseline information was collected at study start, including a short introduction of the exercise programme, a short physical assessment, and completion of questionnaires. During the four months intervention period, participants self-reported their performed exercises in an exercise diary. At a final meeting, questionnaires about their experiences, and post-assessments, were completed. For adherence analyses data from diaries were used and four subgroups for different levels of participation were compared. Exercise maintenance was followed up with a survey 12 months after study start. RESULTS:Sixty-seven participants, with mean age 77 ± 4 years were included, 72% were women. Forty-three percent chose the digital programme. Attrition rate was 17% in the digital programme group and 37% in the paper booklet group (p = .078). In both groups 50-59% reported exercise at least 75% of the intervention period. The only significant difference for adherence was in the subgroup that completed ≥75% of exercise duration, the digital programme users exercised more minutes per week (p = .001). Participants in both groups were content with their programme but digital programme users reported a significantly higher (p = .026) degree of being content, and feeling supported by the programme (p = .044). At 12 months follow-up 67% of participants using the digital programme continued to exercise regularly compared with 35% for the paper booklet (p = .036). CONCLUSIONS:Exercise interventions based on either a digital programme or a paper booklet can be used as a self-managed, independent fall prevention programme. There is a similar adherence in both programmes during a 4-month intervention, but the digital programme seems to facilitate long-term maintenance in regular exercise. TRIAL REGISTRATION:ClinTrial: NCT02916849.
    背景与目标: 背景:防坠落锻炼程序众所周知是有效的,但并非总是可以使用这些程序。使用电子卫生保健解决方案可能是增加获取机会并覆盖更广泛人群的一种方式。在此可行性研究中,目的是通过比较两个练习程序(一个数字程序和一个纸质手册)来探索程序,依从性和自我报告的经验的选择。
    方法:两项自我管理的预防摔倒运动干预措施的参与者偏好试验。一次介绍会后,年龄70岁以上的社区居民成年人独立运动了四个月。在研究开始时就收集了基线信息,包括对运动计划的简短介绍,简短的身体评估以及问卷的填写。在四个月的干预期内,参与者在运动日记中自我报告了他们进行的运动。在最后一次会议上,完成了有关他们的经历和评估后的问卷调查。为了进行依从性分析,使用了来自日记的数据,并比较了不同参与程度的四个亚组。在研究开始后12个月,对运动维持情况进行了调查。
    结果:67名参与者,平均年龄77±4岁,其中72%为女性。 43%的人选择了数字节目。数字程序组的人员流失率为17%,纸质手册组的人员流失率为37%(p = 0.078)。在两组中,有50-59%的人报告至少在干预期进行了75%的运动。依从性的唯一显着差异是在完成≥75%的运动时间的亚组中,数字程序用户每周运动更多分钟(p = .001)。两组中的参与者都对他们的节目感到满意,但是数字节目用户报告的满意程度明显较高(p = .026),并且感觉受到该节目的支持(p = .044)。在12个月的随访中,使用数字程序的参与者中有67%的人继续定期锻炼,而纸质手册的参与者为35%(p = 0.036)。
    结论:基于数字程序或纸质手册的运动干预措施可以用作自我管理,独立的预防摔倒程序。这两个程序在为期4个月的干预中都遵循类似的原则,但是数字程序似乎有助于定期锻炼的长期维护。
    试验注册:临床试验:NCT02916849。

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