The current status of noninvasive intracranial pressure monitoring: A literature review.

Elevated intracranial pressure (ICP) is a life-threatening condition that must be promptly diagnosed. However, the gold standard methods for ICP monitoring are invasive, time-consuming, and they involve certain risks. To address these risks, many noninvasive approaches have been proposed. This study undertakes a literature review of the existing noninvasive methods, which have reported promising results. The experimental base on which they are established, however, prevents their application in emergency conditions and thus none of them are capable of replacing the traditional invasive methods to date. On the other hand, contemporary methods leverage Machine Learning (ML) which has already shown unprecedented results in several medical research areas. That said, only a few publications exist on ML-based approaches for ICP estimation, which are not appropriate for emergency conditions due to their restricted capability of employing the medical imaging data available in intensive care units. The lack of such image-based ML models to estimate ICP is attributed to the scarcity of annotated datasets requiring directly measured ICP data. This ascertainment highlights an active and unexplored scientific frontier, calling for further research and development in the field of ICP estimation, particularly leveraging the untapped potential of ML techniques.

Translation and Validation of Digital Competence Indicators in Greek for Health Professionals: A Cross-Sectional Study.

BACKGROUND: it is widely accepted that living in the digital transformation era, the need to develop and update new professional skills and tools in health sectors is crucially important. Therefore, this study aimed to explore the reliability and validity of the Digital Competence Indicators tool in assessing the digital skills of Greek health professionals. METHODS: in this cross-sectional study, 494 health professionals, including doctors (175) and registered nurses (319) working in four Greek hospitals were recruited and willingly participated using a convenience-sampling method. The original framework of Digital Competence Indicators was translated from English to Greek based on guidelines for cross-cultural adaptation of questionnaires. The validity of the tool was explored using confirmatory factor analysis (CFA) to verify the fit of the model using inductive techniques. The instrument reliability was confirmed using Cronbach's alpha (α) and McDonald's Omega coefficients. RESULTS: the reliability was estimated at 0.826 (Cronbach's-α) and 0.850 (McDonald's Omega-ω). The indicators of CFA were all calculated within an ideal range of acceptance. Specifically, the CFA comparative fit index produced the following adjustment indices: x2/df = 1.152 (p = 0.037), CFI = 0.997, Lewis index (TLI) = 0.966, and root mean square error of approximation (RMSEA) = 0.018. CONCLUSIONS: The present study demonstrated that the Digital Competence Indicator instrument has high reliability, internal consistency, and construct validity and, therefore, it is suitable for measuring digital skills of health professionals.

Combining Device-Aided Therapies in Parkinson's Disease: A Case Series and a Literature Review.

BACKGROUND: Deep brain stimulation (DBS), levodopa-carbidopa intestinal gel (LCIG) and subcutaneous apomorphine infusion are device-aided therapies (DATs) for advanced Parkinson's disease (PD). We present a case series from the Cretan PD Registry who required 2 DATs for optimal management along with a systematic review of similar studies. CASES: From 2009 to 2020, we retrospectively studied all PD patients who were simultaneously treated with 2 DATs. Six patients on DBS required an infusion treatment for persisting or re-emergent fluctuations because of disease progression. Two patients on LCIG infusion received DBS as a levodopa-sparing strategy because of drug-induced complications. Fluctuations and quality of life improved in all patients. LITERATURE REVIEW: We identified 4 case series, 1 prospective and 1 retrospective study that included a total of 50 DBS-treated patients who required an infusion therapy. Improvement in motor outcomes, assessed in different ways, was a constant finding. CONCLUSIONS: Selected PD patients on 1 DAT may experience additional benefit from a second DAT, for several reasons along the course of their disease. Although infusion therapies optimize dopaminergic drug delivery in fluctuating DBS-treated patients, DBS added on LCIG treatment has an additive symptomatic effect that allows levodopa dose reduction in patients with drug-induced side effects.