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1.
Soins ; 65(845): 20-22, 2020 May.
Artigo em Francês | MEDLINE | ID: mdl-32862958

RESUMO

Over 40 patients benefited from remote iconographic follow-up of wounds in an oncology centre. This system is piloted by three expert nurses. They carry out an initial analysis of the photographs received, seek medical expertise if necessary and liaise with the city's professionals. This system makes it possible to expertly accompany professionals and patients while avoiding unnecessary travel. The satisfaction survey conducted in 2018 established full satisfaction of patients and professionals (> 95%) and a guarantee in terms of the safety and quality of care of the wounds.


Assuntos
Assistência ao Convalescente/métodos , Institutos de Câncer , Satisfação do Paciente/estatística & dados numéricos , Consulta Remota/métodos , Ferimentos e Lesões/terapia , Pesquisas sobre Serviços de Saúde , Humanos , Enfermagem Oncológica , Fotografação , Projetos Piloto
3.
JMIR Mhealth Uhealth ; 8(8): e19433, 2020 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-32795985

RESUMO

BACKGROUND: Dental visits are unpleasant; sometimes, patients only seek treatment when they are in intolerable pain. Recently, the novel coronavirus (COVID-19) pandemic has highlighted the need for remote communication when patients and dentists cannot meet in person. Gingivitis is very common and characterized by red, swollen, bleeding gums. Gingivitis heals within 10 days of professional care and with daily, thorough oral hygiene practices. If left untreated, however, its progress may lead to teeth becoming mobile or lost. Of the many medical apps currently available, none monitor gingivitis. OBJECTIVE: This study aimed to present a characterization and development model of a mobile health (mHealth) app called iGAM, which focuses on periodontal health and improves the information flow between dentists and patients. METHODS: A focus group discussed the potential of an app to monitor gingivitis, and 3 semistructured in-depth interviews were conducted on the use of apps for monitoring gum infections. We used a qualitative design process based on the Agile approach, which incorporated the following 5 steps: (1) user story, (2) use cases, (3) functional requirements, (4) nonfunctional requirements, and (5) Agile software development cycles. In a pilot study with 18 participants aged 18-45 years and with different levels of health literacy, participants were given a toothbrush, toothpaste, mouthwash, toothpicks, and dental floss. After installing iGAM, they were asked to photograph their gums weekly for 4 weeks. RESULTS: All participants in the focus group believed in the potential of a mobile app to monitor gingivitis and reduce its severity. Concerns about security and privacy issues were discussed. From the interviews, 2 themes were derived: (1) "what's in it for me?" and (2) the need for a take-home message. The 5 cycles of development highlighted the importance of communication between dentists, app developers, and the pilot group. Qualitative analysis of the data from the pilot study showed difficulty with: (1) the camera, which was alleviated with the provision of mouth openers, and (2) the operation of the phone, which was alleviated by changing the app to be fully automated, with a weekly reminder and an instructions document. Final interviews showed satisfaction. CONCLUSIONS: iGAM is the first mHealth app for monitoring gingivitis using self-photography. iGAM facilitates the information flow between dentists and patients between checkups and may be useful when face-to-face consultations are not possible (such as during the COVID-19 pandemic).


Assuntos
Assistência Odontológica/métodos , Gengivite/prevenção & controle , Aplicativos Móveis , Fotografação , Telemedicina , Adolescente , Adulto , Infecções por Coronavirus/epidemiologia , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Satisfação do Paciente/estatística & dados numéricos , Projetos Piloto , Pneumonia Viral/epidemiologia , Pesquisa Qualitativa , Interface Usuário-Computador , Adulto Jovem
5.
JMIR Mhealth Uhealth ; 8(8): e19529, 2020 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-32716894

RESUMO

With all 50 US states reporting cases of coronavirus disease (COVID-19), people around the country are adapting and stepping up to the challenges of the pandemic; however, they are also frightened, anxious, and confused about what they can do to avoid exposure to the disease. Usual habits have been interrupted as a result of the crisis, and consumers are open to suggestions and strategies to help them change long-standing attitudes and behaviors. In response, a novel and innovative mobile communication capability was developed to present health messages in English and Spanish with links to fotonovelas (visual stories) that are accessible, easy to understand across literacy levels, and compelling to a diverse audience. While SMS text message outreach has been used to build health literacy and provide social support, few studies have explored the benefits of SMS text messaging combined with visual stories to influence health behaviors and build knowledge and self-efficacy. In particular, this approach can be used to provide vital information, resources, empathy, and support to the most vulnerable populations. This also allows providers and health plans to quickly reach out to their patients and members without any additional resource demands at a time when the health care system is severely overburdened.


Assuntos
Infecções por Coronavirus/prevenção & controle , Comunicação em Saúde/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Envio de Mensagens de Texto , Infecções por Coronavirus/epidemiologia , Difusão de Inovações , Comportamentos Relacionados com a Saúde , Letramento em Saúde/estatística & dados numéricos , Humanos , Fotografação , Pneumonia Viral/epidemiologia , Estados Unidos/epidemiologia
7.
J Environ Manage ; 269: 110779, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32560998

RESUMO

The purpose of this research is to apply visitor employed photography (VEP) to recreation management to develop indicators of the wildlife viewing experience. VEP and semi-structured interviews were used at a popular polar bear viewing destination in the Arctic National Wildlife Refuge (Arctic Refuge). Visitors to the Arctic Refuge who participated in an on-site semi-structured interview were asked to participate in a VEP procedure after their visit. A sample of 24 semi-structured interviews, and 17 VEP responses were collected and compared to test the utility of VEP to develop indicators of the wildlife viewing experience. Results indicate that VEP offers additional and unique types of information from semi-structured interviews for identifying indicators of the wildlife viewing experience. Potential indicators that emerged from VEP include 'time spent on the water viewing polar bears', and the 'number of vessels in view.' Indicators emerged exclusively from the VEP procedure, demonstrating the utility of VEP for recreation management and scientific inquiry.


Assuntos
Ursidae , Animais , Animais Selvagens , Regiões Árticas , Fotografação , Recreação
8.
J Am Acad Dermatol ; 83(3): 958-959, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32531304
9.
Stud Health Technol Inform ; 270: 1389-1390, 2020 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-32570673

RESUMO

The aim of this study was to investigate the validity and reliability of range of motion measurement via smartphone applications. This literature review included 26 articles after the selection process. The validity and reliability analysis showed good mean results (ICC or r >0.83). Thus, in clinical practice, photographic, goniometric and inclinometric smartphone applications can be used to measure joint angle, but with caution for cervical, hip and shoulder motions.


Assuntos
Aplicativos Móveis , Smartphone , Fotografação , Amplitude de Movimento Articular , Reprodutibilidade dos Testes
10.
J Dtsch Dermatol Ges ; 18(7): 692-697, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32597015

RESUMO

BACKGROUND AND OBJECTIVES: The incidence of melanoma is rising and prevention plays an important role. Multiple nevi as well as a medical history of melanoma are important risk factors. In affected patients, a two-step algorithm consisting of total-body photography (TBP) and sequential digital dermatoscopy (SDD) is a helpful diagnostic tool. PATIENTS AND METHODS: This was a retrospective observational study that lasted six years in order to evaluate the significance of the two-step algorithm. Cases were evaluated based on distinct dermoscopic patterns and statistical analyses were performed with the latest version of SPSS. RESULTS: 6020 dermoscopic images of 214 patients were included. TBP was performed at a mean interval of 16.9 months (SD ± 1.43 months), while SDD was performed every 9.9 months (SD ± 1.68 months). The number needed to excise was 4.6 and the number needed to monitor was 548. Excisions were mostly performed because dynamic changes were observed. A total of eleven melanomas were detected and had a mean tumor thickness of 0.44 mm (SD ± 0.15 mm; range 0.2-0.6 mm). CONCLUSIONS: Invasive melanomas had a tumor thickness of less than 0.6 mm, thus providing evidence of an effective strategy for early melanoma detection. Excisions of benign nevi were minimized as indicated by a low number needed to excise.


Assuntos
Algoritmos , Dermoscopia/métodos , Melanoma/diagnóstico , Fotografação , Neoplasias Cutâneas/diagnóstico , Humanos , Melanoma/patologia , Estudos Retrospectivos , Neoplasias Cutâneas/patologia , Fatores de Tempo
11.
PLoS One ; 15(6): e0234334, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32525908

RESUMO

BACKGROUND: Onychomycosis is the most common nail disorder and is associated with diagnostic challenges. Emerging non-invasive, real-time techniques such as dermoscopy and deep convolutional neural networks have been proposed for the diagnosis of this condition. However, comparative studies of the two tools in the diagnosis of onychomycosis have not previously been conducted. OBJECTIVES: This study evaluated the diagnostic abilities of a deep neural network (http://nail.modelderm.com) and dermoscopic examination in patients with onychomycosis. METHODS: A prospective observational study was performed in patients presenting with dystrophic features in the toenails. Clinical photographs were taken by research assistants, and the ground truth was determined either by direct microscopy using the potassium hydroxide test or by fungal culture. Five board-certified dermatologists determined a diagnosis of onychomycosis using the clinical photographs. The diagnosis was also made using the algorithm and dermoscopic examination. RESULTS: A total of 90 patients (mean age, 55.3; male, 43.3%) assessed between September 2018 and July 2019 were included in the analysis. The detection of onychomycosis using the algorithm (AUC, 0.751; 95% CI, 0.646-0.856) and that by dermoscopy (AUC, 0.755; 95% CI, 0.654-0.855) were seen to be comparable (Delong's test; P = 0.952). The sensitivity and specificity of the algorithm at the operating point were 70.2% and 72.7%, respectively. The sensitivity and specificity of diagnosis by the five dermatologists were 73.0% and 49.7%, respectively. The Youden index of the algorithm (0.429) was also comparable to that of the dermatologists' diagnosis (0.230±0.176; Wilcoxon rank-sum test; P = 0.667). CONCLUSIONS: As a standalone method, the algorithm analyzed photographs taken by non-physician and showed comparable accuracy for the diagnosis of onychomycosis to that made by experienced dermatologists and by dermoscopic examination. Large sample size and world-wide, multicentered studies should be investigated to prove the performance of the algorithm.


Assuntos
Aprendizado Profundo , Dermoscopia , Dermatoses do Pé/diagnóstico , Onicomicose/diagnóstico , Adulto , Algoritmos , Sistemas Computacionais , Dermatologistas , Diagnóstico por Computador , Erros de Diagnóstico , Feminino , Dermatoses do Pé/diagnóstico por imagem , Dermatoses do Pé/microbiologia , Humanos , Hidróxidos , Masculino , Pessoa de Meia-Idade , Técnicas de Tipagem Micológica , Redes Neurais de Computação , Onicomicose/diagnóstico por imagem , Onicomicose/microbiologia , Fotografação , Compostos de Potássio , Valor Preditivo dos Testes , Estudos Prospectivos , Adulto Jovem
12.
PLoS One ; 15(5): e0232583, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32392215

RESUMO

A modern color filter array (CFA) output is rendered into the final output image using a demosaicing algorithm. During this process, the rendered image is affected by optical and carrier cross talk of the CFA pattern and demosaicing algorithm. Although many CFA patterns have been proposed thus far, an image-quality (IQ) evaluation system capable of comprehensively evaluating the IQ of each CFA pattern has yet to be developed, although IQ evaluation items using local characteristics or specific domain have been created. Hence, we present an IQ metric system to evaluate the IQ performance of CFA patterns. The proposed CFA evaluation system includes proposed metrics such as the moiré robustness using the experimentally determined moiré starting point (MSP) and achromatic reproduction (AR) error, as well as existing metrics such as color accuracy using CIELAB, a color reproduction error using spatial CIELAB, structural information using the structure similarity, the image contrast based on MTF50, structural and color distortion using the mean deviation similarity index (MDSI), and perceptual similarity using Haar wavelet-based perceptual similarity index (HaarPSI). Through our experiment, we confirmed that the proposed CFA evaluation system can assess the IQ for an existing CFA. Moreover, the proposed system can be used to design or evaluate new CFAs by automatically checking the individual performance for the metrics used.


Assuntos
Algoritmos , Aumento da Imagem , Cor , Aumento da Imagem/instrumentação , Aumento da Imagem/métodos , Sistema Métrico , Fotografação/instrumentação , Fotografação/métodos
14.
Nat Commun ; 11(1): 2091, 2020 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-32350256

RESUMO

Real-time imaging of countless femtosecond dynamics requires extreme speeds orders of magnitude beyond the limits of electronic sensors. Existing femtosecond imaging modalities either require event repetition or provide single-shot acquisition with no more than 1013 frames per second (fps) and 3 × 102 frames. Here, we report compressed ultrafast spectral photography (CUSP), which attains several new records in single-shot multi-dimensional imaging speeds. In active mode, CUSP achieves both 7 × 1013 fps and 103 frames simultaneously by synergizing spectral encoding, pulse splitting, temporal shearing, and compressed sensing-enabling unprecedented quantitative imaging of rapid nonlinear light-matter interaction. In passive mode, CUSP provides four-dimensional (4D) spectral imaging at 0.5 × 1012 fps, allowing the first single-shot spectrally resolved fluorescence lifetime imaging microscopy (SR-FLIM). As a real-time multi-dimensional imaging technology with the highest speeds and most frames, CUSP is envisioned to play instrumental roles in numerous pivotal scientific studies without the need for event repetition.


Assuntos
Imageamento Tridimensional , Microscopia de Fluorescência , Dinâmica não Linear , Fotografação , Fatores de Tempo
16.
PLoS One ; 15(5): e0232492, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32413032

RESUMO

Coyotes (Canis latrans) and kit foxes (Vulpes macrotis) are desert canids that share ecological similarities, but have disparate histories with anthropogenic pressure that may influence their responses towards novel stimuli. We used remote cameras to investigate response to novel stimuli for these two species. We predicted that coyotes (heavily pressured species) would be more wary towards novel stimuli on unprotected land (canid harvest activities are permitted) than in protected areas (canid harvest activities are not permitted), whereas kit foxes (less pressured species) would exhibit no difference. We examined differences in the investigative behaviors at 660 scent stations in both protected and unprotected areas. Coyotes showed no differences between protected and unprotected land and were generally more wary than kit foxes, supporting our prediction. Kit foxes were more investigative on protected land, contrary to our expectations. Our study provides evidence that anthropogenic pressure can alter the behaviors of wildlife species.


Assuntos
Comportamento Animal/fisiologia , Coiotes/fisiologia , Raposas/fisiologia , Animais , Animais Selvagens/fisiologia , Clima Desértico , Espécies em Perigo de Extinção , Comportamento Exploratório/fisiologia , Odorantes , Feromônios/fisiologia , Fotografação , Tecnologia de Sensoriamento Remoto , Especificidade da Espécie , Utah
17.
Quintessence Int ; 51(6): 510-518, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32424377

RESUMO

Digital photography has already established its irrefutable importance in today's world. It is becoming an indispensable tool in various fields. In dentistry specifically, photography can be employed in several ways that can be beneficial to the patient and the dental community. It allows a simple and clear depiction of an otherwise abstract concept, but high-quality pictures are always required. The evolution of mobile cameras has made an enormous impact on digital photography and its accessibility: high-quality pictures can now be easily taken. This article explains the assets of smartphone cameras' evolution and how it led to the conception of Smile Lite Mobile Dental Photography. Applications of dental photography are presented, such as documentation and communication with the laboratory technician and the patient. Mobile dental photography is not confined to dentistry but can also be used for artistic purposes. (Quintessence Int 2020;51:510-518; doi: 10.3290/j.qi.a44365; Originally published (in German) in Quintessenz Zahnmedizin 2019(12);70:1408-1417).


Assuntos
Documentação , Fotografia Dentária , Comunicação , Humanos , Fotografação , Sorriso
19.
Nat Med ; 26(6): 900-908, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32424212

RESUMO

Skin conditions affect 1.9 billion people. Because of a shortage of dermatologists, most cases are seen instead by general practitioners with lower diagnostic accuracy. We present a deep learning system (DLS) to provide a differential diagnosis of skin conditions using 16,114 de-identified cases (photographs and clinical data) from a teledermatology practice serving 17 sites. The DLS distinguishes between 26 common skin conditions, representing 80% of cases seen in primary care, while also providing a secondary prediction covering 419 skin conditions. On 963 validation cases, where a rotating panel of three board-certified dermatologists defined the reference standard, the DLS was non-inferior to six other dermatologists and superior to six primary care physicians (PCPs) and six nurse practitioners (NPs) (top-1 accuracy: 0.66 DLS, 0.63 dermatologists, 0.44 PCPs and 0.40 NPs). These results highlight the potential of the DLS to assist general practitioners in diagnosing skin conditions.


Assuntos
Aprendizado Profundo , Diagnóstico Diferencial , Dermatopatias/diagnóstico , Acne Vulgar/diagnóstico , Adulto , Afro-Americanos , Nativos do Alasca , Americanos Asiáticos , Carcinoma Basocelular/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Dermatite Seborreica/diagnóstico , Dermatologistas , Eczema/diagnóstico , Grupo com Ancestrais do Continente Europeu , Feminino , Foliculite/diagnóstico , Hispano-Americanos , Humanos , Índios Norte-Americanos , Ceratose Seborreica/diagnóstico , Masculino , Melanoma/diagnóstico , Pessoa de Meia-Idade , Profissionais de Enfermagem , Grupo com Ancestrais Oceânicos , Fotografação , Médicos de Atenção Primária , Psoríase/diagnóstico , Neoplasias Cutâneas/diagnóstico , Telemedicina , Verrugas/diagnóstico
20.
Cochrane Database Syst Rev ; 5: CD012947, 2020 05 28.
Artigo em Inglês | MEDLINE | ID: mdl-32468576

RESUMO

BACKGROUND: Primary angle closure glaucoma (PACG) accounts for 50% of glaucoma blindness worldwide. More than three-quarters of individuals with PACG reside in Asia. In these populations, PACG often develops insidiously leading to chronically raised intraocular pressure and optic nerve damage, which is often asymptomatic. Non-contact tests to identify people at risk of angle closure are relatively quick and can be carried out by appropriately trained healthcare professionals or technicians as a triage test. If the test is positive, the person will be referred for further specialist assessment. OBJECTIVES: To determine the diagnostic accuracy of non-contact tests (limbal anterior chamber depth (LACD) (van Herick test); oblique flashlight test; scanning peripheral anterior chamber depth analyser (SPAC), Scheimpflug photography; anterior segment optical coherence tomography (AS-OCT), for identifying people with an occludable angle. SEARCH METHODS: We searched the following bibliographic databases 3 October 2019: CENTRAL; MEDLINE; Embase; BIOSIS; OpenGrey; ARIF and clinical trials registries. The searches were limited to remove case reports. There were no date or language restrictions in the searches. SELECTION CRITERIA: We included prospective and retrospective cross-sectional, cohort and case-control studies conducted in any setting that evaluated the accuracy of one or more index tests for identifying people with an occludable angle compared to a gonioscopic reference standard. DATA COLLECTION AND ANALYSIS: Two review authors independently performed data extraction and quality assessment using QUADAS2 for each study. For each test, 2 x 2 tables were constructed and sensitivity and specificity were calculated. When four or more studies provided data at fixed thresholds for each test, we fitted a bivariate model using the METADAS macro in SAS to calculate pooled point estimates for sensitivity and specificity. For comparisons between index tests and subgroups, we performed a likelihood ratio test comparing the model with and without the covariate. MAIN RESULTS: We included 47 studies involving 26,151 participants and analysing data from 23,440. Most studies were conducted in Asia (36, 76.6%). Twenty-seven studies assessed AS-OCT (analysing 15,580 participants), 17 studies LACD (7385 participants), nine studies Scheimpflug photography (1616 participants), six studies SPAC (5239 participants) and five studies evaluated the oblique flashlight test (998 participants). Regarding study quality, 36 of the included studies (76.6%) were judged to have a high risk of bias in at least one domain.The use of a case-control design (13 studies) or inappropriate exclusions (6 studies) raised patient selection concerns in 40.4% of studies and concerns in the index test domain in 59.6% of studies were due to lack of masking or post-hoc determination of optimal thresholds. Among studies that did not use a case-control design, 16 studies (20,599 participants) were conducted in a primary care/community setting and 18 studies (2590 participants) in secondary care settings, of which 15 investigated LACD. Summary estimates were calculated for commonly reported parameters and thresholds for each test; LACD ≤ 25% (16 studies, 7540 eyes): sensitivity 0.83 (95% confidence interval (CI) 0.74, 0.90), specificity 0.88 (95% CI 0.84, 0.92) (moderate-certainty); flashlight (grade1) (5 studies, 1188 eyes): sensitivity 0.51 (95% CI 0.25, 0.76), specificity 0.92 (95% CI 0.70, 0.98) (low-certainty); SPAC (≤ 5 and/or S or P) (4 studies, 4677 eyes): sensitivity 0.83 (95% CI 0.70, 0.91), specificity 0.78 (95% CI 0.70, 0.83) (moderate-certainty); Scheimpflug photography (central ACD) (9 studies, 1698 eyes): sensitivity 0.92 (95% CI 0.84, 0.96), specificity 0.86 (95% CI 0.76, 0.93) (moderate-certainty); AS-OCT (subjective opinion of occludability) (13 studies, 9242 eyes): sensitivity 0.85 (95% CI 0.76, 0.91); specificity 0.71 (95% CI 0.62, 0.78) (moderate-certainty). For comparisons of sensitivity and specificity between index tests we used LACD (≤ 25%) as the reference category. The flashlight test (grade 1 threshold) showed a statistically significant lower sensitivity than LACD (≤ 25%), whereas AS-OCT (subjective judgement) had a statistically significant lower specificity. There were no statistically significant differences for the other index test comparisons. A subgroup analysis was conducted for LACD (≤ 25%), comparing community (7 studies, 14.4% prevalence) vs secondary care (7 studies, 42% prevalence) settings. We found no evidence of a statistically significant difference in test performance according to setting. Performing LACD on 1000 people at risk of angle closure with a prevalence of occludable angles of 10%, LACD would miss about 17 cases out of the 100 with occludable angles and incorrectly classify 108 out of 900 without angle closure. AUTHORS' CONCLUSIONS: The finding that LACD performed as well as index tests that use sophisticated imaging technologies, confirms the potential for this test for case-detection of occludable angles in high-risk populations. However, methodological issues across studies may have led to our estimates of test accuracy being higher than would be expected in standard clinical practice. There is still a need for high-quality studies to evaluate the performance of non-invasive tests for angle assessment in both community-based and secondary care settings.


Assuntos
Técnicas de Diagnóstico Oftalmológico , Glaucoma de Ângulo Fechado/diagnóstico , Triagem/métodos , Câmara Anterior/diagnóstico por imagem , Viés , Estudos de Casos e Controles , Intervalos de Confiança , Técnicas de Diagnóstico Oftalmológico/estatística & dados numéricos , Gonioscopia/normas , Humanos , Seleção de Pacientes , Fotografação/métodos , Fotografação/estatística & dados numéricos , Estudos Prospectivos , Padrões de Referência , Estudos Retrospectivos , Sensibilidade e Especificidade , Tomografia de Coerência Óptica
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