Video Capabilities Research Articles

Virtual phone clinics in orthopaedics: evaluation of clinical application and sustainability

AimsAdoption of virtual clinics has been accelerated by the COVID-19 pandemic and they will continue to form an integral part of healthcare delivery. Our objective was to evaluate virtual clinics...

2020 ANCC Pathway Award® winner.

2020 ANCC Pathway Award® winner.

Segregating Signaling and Media Planes into Different containers

Scalability is an important aspect of communication networks. With the ascent of SIP and associated modern real-time protocols, IP telephony has become a revolutionary technology in connecting users through real-time voice communications with enabled video and instant messaging capabilities. B2BUA is a SIP server that provides call management and authentication functionality by reformulating the request and routing the traffic to other user agents in the network. It comprises signaling and media entities that handle all control signaling messages and real-time data(media) information respectively. The signaling and entities run as different processes in the same container. Such an architecture encounters a large CPU utilization after a specific number of maximum calls due to increase traffic flowing within the same node. Further Packet processing is CPU intensive and there is a need for an architecture that scales well with increasing traffic without hitting the CPU performance. The paper presents the design of decoupled architecture for Signaling and Media entities by running both the processes in different containers. With such an approach, one Signaling entity can communicate with multiple Media entities or vice versa thereby providing a suitable scalable solution to deal with the increased traffic and further maintaining the system efficiency. The paper is concluded by highlighting the difference between Kubernetes and OpenStack for the proposed architecture

Virtual care revolution: Impact on clinical pharmacy practices in the Department of Veterans Affairs

AbstractFor nearly two decades, the Department of Veterans Affairs (VA) has invested in the development and implementation of telehealth services which comprises video, store and forward services, and remote patient monitoring. Virtual care includes telehealth services along with telephone care and e‐consults. These efforts proved critical in 2020 due to the coronavirus disease 2019 (COVID‐19) pandemic. Expanding implementation of telehealth to the home became an access and safety imperative. This article highlights VA efforts and infrastructure for expansion of telehealth into the home and clinical pharmacy practice integration of virtual care. The acceptance of technology coupled with advancements in legislation, policy, and technologies has resulted in expanded applications within the health care system. While continued expansion of virtual care seems inevitable, there remain challenges to ensuring both access to virtual care and the safety and effectiveness of the care delivered. Looking to the future, there will be a continued need for future research on outcomes associated with virtual care, exploration of the benefits of video capability over telephone care, and cost‐effectiveness.

Access Denied

Access Denied

ДИДАКТИКА РОБОТИ З ВІДЕОМАТЕРІАЛАМИ У ПРОЦЕСІ ВИВЧЕННЯ НІМЕЦЬКОЇ МОВИ

The article considers the linguadidactical possibilities of using video materials in the educational process and substantiates the expediency of their use in German language classes. It is established that working with video materials mainly promotes the development of skills and abilities of listening and speaking, as well as actively contributes to the formation and further development of socio-cultural competence. The use of video in the classroom allows to individualize learning and intensify the selfdirected work of students. The introduction of video materials in the classroom also provides opportunities to create an artificial foreign language environment at any time and stage of study, adds a sense of realism, and promotes the development of audile and memory. Recently, there has been a notable increase of interest in educational videos as an effective means of teaching a foreign language, and the effectiveness of using video in German classes depends on the level of language training of students, thorough thematic selection of films and educational goals. The potential of videos is fully exploited if you integrate different activities. The most active and truly creative form of modern video work is the independent creation and viewing of video episodes. Working with video removes even a small risk of passive-receptive consumption of information, as well as increases the role of independent creative work. Preparatory explanatory conversations about the video are more useful than watching and working on the video itself, which can often only be an occasion for real communication and facilitate further understanding of the film. In addition, the effectiveness of foreign language teaching by this tool is also facilitated by the technical capabilities of video. Methodological processes based on the perception of image and sound can be used to achieve various goals of educational activities, development of creative abilities and skills through exercises for commenting and making dialogues. The use of video contributes to a more effective coverage of new language and subject material, strengthening and practical application of knowledge, the formation of receptive capabilities, executive skills and productive word use. Also, the use of video materials introduces elements of novelty, significantly expands and diversifies classes, increases cognitive activity and motivation of students, interests them in learning a particular topic and a foreign language in general

Fall Prevention and Injury Reduction Utilizing Virtual Sitters in Hospitalized Patients: A Literature Review.

Falls and fall-associated injuries continue to occur in hospitals worldwide. Video monitoring using virtual sitters is a novel, cost-effective concept that has emerged as an intervention to address falls and maintain safety for hospitalized patients. This literature review examines the evidence regarding hospital-associated falls and fall-related injuries when video monitoring and virtual sitters were included as an intervention. Ten observational studies and two quasi-experimental studies (N = 12) were identified for inclusion from the Cumulative Index of Nursing and Allied Health Literature, Scopus, and PubMed databases. Overall, current evidence is focused on fall rates and cost savings. Eight studies demonstrated a fall reduction and the remaining three showed no statistical difference in fall rates with the use of video surveillance or virtual sitters. Cost savings for these interventions are based on the transition from 1:1 observation to virtual sitters; all 12 studies reported decreased overall costs transitioning to virtual sitters. Small sample size and limited studies are the primary limitations of current published evidence. As the novel clinical practice evolves and more hospitals are equipped with video capability, future research with virtual sitters should include expanded patient populations, a focus on fall-related injuries, and examinations of staff safety.

Mobile Health Crowdsensing (MHCS) Intervention on Chronic Disease Awareness: Protocol for a Systematic Review.

BackgroundMobile health crowdsensing (MHCS) involves the use of mobile communication technologies to promote health by supporting health care practices (eg, health data collection, delivery of health care information, or patient observation and provision of care). MHCS technologies (eg, smartphones) have sensory capabilities, such as GPS, voice, light, and camera, to collect, analyze, and share user-centered data (explicit and implicit). The current literature indicates no scientific study related to MHCS interventions for chronic diseases. The proposed systematic review will examine the impact of MHCS interventions on chronic disease awareness.ObjectiveThe objectives of this study are to identify and describe various MHCS intervention strategies applied to chronic disease awareness.MethodsLiterature from various databases, such as MEDLINE, Embase, PsycINFO, CINAHL, and Cochrane Central Register of Controlled Trials, will be examined. Trial registers, reports, grey literature, and unpublished academic theses will also be included. All mobile technologies, such as cell phones, personal digital assistants, and tablets that have short message service, multimedia message service, video, and audio capabilities, will be included. MHCS will be the primary intervention strategy. The search strategy will include keywords such as mHealth, crowdsensing, and awareness among other medical subject heading terms. Articles published from January 1, 1945, to December 31, 2019, will be eligible for inclusion. The authors will independently screen and select studies, extract data, and assess the risk of bias, with discrepancies resolved by an independent party not involved in the study. The authors will assess statistical heterogeneity by examining the types of participants, interventions, study designs, and outcomes in each study, and pool studies judged to be statistically homogeneous. In the assessment of heterogeneity, a sensitivity analysis will be considered to explore statistical heterogeneity. Statistical heterogeneity will be investigated using the chi-square test of homogeneity on Cochrane Q test, and quantified using the I2 statistic.ResultsThe preliminary search query found 1 paper. Further literature search commenced in mid-March 2021 and is to be concluded in April 2021. The proposed systematic review protocol has been registered in PROSPERO (The International Prospective Register of Systematic Reviews; no. CRD42020161435). Furthermore, the use of search data extraction and capturing in Review Manager version 5.3 (Cochrane) commenced in January 2021 and ended in February 2021. Further literature search will begin in mid-March 2021 and will be concluded in April 2021. The final stages will include analyses and writing, which are anticipated to start and be completed in May 2021.ConclusionsThe knowledge derived from this study will inform health care stakeholders—including researchers, policy makers, investors, health professionals, technologists, and engineers—of the impact of MHCS interventions on chronic disease awareness.International Registered Report Identifier (IRRID)PRR1-10.2196/24589

Cognitive Processing Therapy With an Older Woman Veteran During COVID-19: A Case Study

With advances in technology, telehealth has become an acceptable way of conducting psychotherapy. During the COVID-19 pandemic, telehealth and ways to modify treatments for delivery via telehealth have become increasingly important. Researchers and clinicians have issued recommendations on providing telehealth-based care in response to the COVID-19 global pandemic. However, recommendations are limited for audio only telephone-based care, which may be the only option for specific clients. This is a case study of an older adult who completed Cognitive Processing Therapy (CPT) for military sexual trauma. Halfway through her treatment, COVID-19 resulted in transitioning from in-person services to a virtual format. Client X did not have video capabilities aside from her cell phone, and it was determined she would complete treatment via telephone-based sessions. Client X’s outcome data is presented, and the reductions in her PTSD and depressive symptoms provide preliminary support suggesting that telephone-based care may be an acceptable method of receiving CPT. Recommendations for telephone-based CPT are provided.

Reducing Health Disparities with Audio-Only Telemedicine Post-COVID-19

Before the COVID-19 pandemic, traditional telehealth visits required video capability in order to qualify for reimbursement by Medicaid. The 2020 public health emergency declaration temporarily waived this requirement, allowing patients to participate in audio-only telehealth visits. From a public health perspective, telehealth visits reduce crowding at hospitals and health centers, preventing transmission of the SARS-CoV-2 virus. Audio-only telehealth also increases access to healthcare by reducing barriers to both video- and in-person care across different patient populations (varying by age, rurality, availability of safe transportation, and income), and may be the only telehealth option available to patients due to economic or geographic constraints. This paper highlights how access to audio-only telehealth can reduce disparities, and increase patient satisfaction, safety, time-savings, and reduce cost. Significant stakeholder benefits can be realized by continuing Medicaid reimbursement of audio-only telehealth during and beyond the continuing COVID-19 pandemic.

3-D Object Tracking in Panoramic Video and LiDAR for Radiological Source–Object Attribution and Improved Source Detection

Networked detector systems can be deployed in urban environments to aid in the detection and localization of radiological and/or nuclear material. However, effectively responding to and interpreting a radiological alarm using spectroscopic data alone may be hampered by a lack of situational awareness, particularly in complex environments. This study investigates the use of Light Detection and Ranging (LiDAR) and streaming video to enable real-time object detection and tracking, and the fusion of this tracking information with radiological data for the purposes of enhanced situational awareness and increased detection sensitivity. This work presents an object detection, tracking, and novel source–object attribution analysis that is capable of operating in real time. By implementing this analysis pipeline on a custom-developed system that comprises a static 2 in. $\times 4$ in. $\times16$ in. NaI(Tl) detector colocated with a 64-beam LiDAR and four monocular cameras, we demonstrate the ability to accurately correlate trajectories from tracked objects to spectroscopic gamma-ray data in real time and use physics-based models to reliably discriminate between source-carrying and nonsource-carrying objects. In this work, we describe our approach in detail and present a quantitative performance assessment that characterizes the source–object attribution capabilities of both video and LiDAR. Additionally, we demonstrate the ability to simultaneously track pedestrians and vehicles in a mock urban environment and use this tracking information to improve both detection sensitivity and situational awareness using our contextual-radiological data fusion methodology.

Student engagement in the online classroom: comparing preclinical medical student question-asking behaviors in a videoconference versus in-person learning environment.

The COVID‐19 pandemic forced medical schools to rapidly transform their curricula using online learning approaches. At our institution, the preclinical Practice of Medicine (POM) course was transitioned to large‐group, synchronous, video‐conference sessions. The aim of this study is to assess whether there were differences in learner engagement, as evidenced by student question‐asking behaviors between in‐person and videoconferenced sessions in one preclinical medical student course. In Spring, 2020, large‐group didactic sessions in POM were converted to video‐conference sessions. During these sessions, student microphones were muted, and video capabilities were turned off. Students submitted typed questions via a Q&A box, which was monitored by a senior student teaching assistant. We compared student question asking behavior in recorded video‐conference course sessions from POM in Spring, 2020 to matched, recorded, in‐person sessions from the same course in Spring, 2019. We found that, on average, the instructors answered a greater number of student questions and spent a greater percentage of time on Q&A in the online sessions compared with the in‐person sessions. We also found that students asked a greater number of higher complexity questions in the online version of the course compared with the in‐person course. The video‐conference learning environment can promote higher student engagement when compared with the in‐person learning environment, as measured by student question‐asking behavior. Developing an understanding of the specific elements of the online learning environment that foster student engagement has important implications for instructional design in both the online and in‐person setting.

Awake or asleep approach to difficult airway during microlaryngeal surgery

Introduction: Patients presenting for microlaryngeal surgery frequently have a difficult airway. The chosen approach to this airway depends on the pathology and the patient’s symptoms. The Aim of the study is to determine the safest anesthesiological approach to difficult airway during microlaryngeal surgery. Materials and Methods: A prospective cohort study including 200 patients undergoing microlaryngeal surgery in the Department of Otorhinolaryngology at the University Hospital “Queen Giovanna” - ISUL, Sofia, in the period 2014-2019; Medical University-Sofia. Preoperative examination of the larynx is performed in all patients by Storz 8402 ZX fiber optic laryngoscope with video capability. Results and discussion: In 76% of the patients the tumor mass causing obstruction is localized in the area of the larynx, and in 24% of them the tumor mass is localized in the area of the hypopharynx. In 20% of the patients with 3rd degree of laryngeal obstruction an awake tracheostomy is chosen as a primary approach because of impossible intubation. The same approach is chosen in all of the patients presenting with respiratory failure at rest. In 25% of the patients with tumor mass causing hypopharyngeal obstruction an awake tracheostomy is chosen as a primary approach because of impossible intubation. Conclusion The decision to proceed with an awake or asleep approach to an anticipated difficult airway depends on the degree of laryngeal or hypopharyngeal obstruction and the experience of the anesthesiologist.

Coronavirus Disease 2019 Pandemic as Catalyst for Telemedicine Adoption: A Single-Center Experience

Background: Telemedicine use has increased due to stay-at-home orders during the novel coronavirus 2019 pandemic. We explored ambulatory provider's perception on telemedicine.Methods: An anonymized survey was e-mailed to physicians and midlevel providers of our university hospital ambulatory clinics to assess current use, preferences for future use, and satisfaction with televisits.Results: Of all providers, 249 responded (response rate 24%, 121 [48.6%] men, 177 [71.1%] attending physicians, 43 [17.2%] trainees, and 29 [11.6%] midlevel providers). Most respondents (120, 48.2%) belonged to subspecialties in medicine. At the time of the survey, 168 (67.5%) were using telemedicine for less than half of all visits and had video capabilities, of whom 224 (90%) considered it to be effective for return visits and 37 (15%) perceived it to be effective for new patients, 217 (87.1%) wanted to continue with telemedicine practice, and 113 (45.4%) preferred to use telemedicine for more than a quarter of their future patients even after the pandemic. Most (194 [77.9%]) were satisfied with telemedicine and we found no differences among specialties. Those with audio-only visits reported least effectiveness for new patient evaluation (p < 0.001) and overall provider satisfaction (p = 0.02) when compared with others. Those who saw more than a quarter of their patients through televisits desired to increase their future televisits to >50% including new patients (p < 0.001).Conclusions: There is widespread interest in telemedicine in all specialties. Acceptance is high for return visits, but low for new patient visits. Improvement in technology to have both audio and video capability consistently may foster further interest toward increasing telemedicine in the future.

Slower recovery of outpatient clinics than inpatient services for stroke and other neurological diseases after COVID-19 Pandemic.

BackgroundIn this brief report, we investigated the impact of COVID‐19 on outpatient stroke clinics and inpatient services and their recovery process.MethodsWe sent a survey to physicians worldwide through the network of the World Stroke Organization to investigate the impact of COVID‐19 on stroke clinics. To farther along in recovering from the outbreak, we reviewed stroke and other neurology outpatient clinic visits (approximately 50% were stroke related) and the number of inpatient services from December 2019 to July 2020 in a large neurology department in Shanghai, China, where there was no official city lockdown.ResultsWe received 112 valid survey responses from 46 countries, representing all continents except for Antarctica. Only seven of the survey responders (7/112, 6.3%) reported that they have kept their outpatient clinics open as usual, but they did exercise increased precautions for COVID‐19 by following recent guidelines regarding use of personal protective equipment and isolation techniques. The remainder of the respondents have either reduced outpatient clinic services or suspended outpatient clinics completely. Telephone consultation or telemedicine with video capability was used for new patients or follow‐ups, with limited in‐person evaluations when necessary. Outpatient clinic visits and inpatient services from a large tertiary hospital in China decreased dramatically during the peak period of the outbreak, but then rebounded back quickly following the partial or full recovery from the outbreak. Compared with the recovery process of inpatient services, outpatient clinic visits decreased faster and recovered much slower. This is consistent with our global survey data which indicates that some outpatient clinics have rescheduled their outpatient visits for 3 to 6 months.ConclusionsThe COVID‐19 pandemic caused a significant drop of in‐person outpatient visits and inpatient services. Clinic visits recovered slower than inpatient services in stroke and other neurological diseases after the pandemic.

Dynamically Adaptive Fast Motion Estimation Algorithm for HD Video

This paper presents a novel adaptive Fast Motion Estimation (FME) Algorithm, which reduces the number of search points, computational complexity and therefore lowering power consumption, while providing improved quality per watt in FME. The algorithm minimizes computation and storage and from there, power consumption, while trying to preserve quality as much as possible. It is very suitable for hardware implementation, as in a motion co-processor. The pervasiveness of mobile devices with HD video capabilities demands such low power hardware accelerators. The proposed algorithm is a novel method, that can identify the best search pattern within a given region of the HD video frame, based on its motion dynamics to achieve lower power video encoding. The goal is to achieve the best quality with the minimum number of search iterations. The reduced number of checks translates into power savings. The motivation of the presented algorithm is to learn the motion dynamics within a region from a small subset of blocks within that region and apply that knowledge to the remaining large set of blocks in the same region. This adaptiveness makes it robust with respect to the nature of the video. Thus it works equally well with more dynamic and with less dynamic video sequences. The results show that the proposed algorithm can reduce computations by about 4 times compared to other fixed search patterns algorithms, while staying within 1 dB of PSNR results. That equates to about 75% power savings at the expense of not more than 1 dB of PSNR quality loss.

Reflections on adapting group model building scripts into online workshops

Reflections on adapting group model building scripts into online workshops

In Response.

We appreciate the wisdom and experience shared by our colleagues in Italy, one of the earliest hardest-hit areas. We enjoy this opportunity to reply to the thoughtful critique from Sorbello et al.1 We do not have a dedicated intubation location. Intubations typically occur in a cohorted intensive care unit with negative pressure rooms, but might occur in the emergency department or at any location during cardiac arrest. When requested, a coronavirus disease 2019 (COVID-19) rapid response team is activated and summoned to the patient room. This team is comprised of 2 intensive care nurses, a respiratory therapist, and the on-call anesthesiologist. Our preassembled airway kit described in “Your COVID-19 Intubation Kit,”2 enters the room, allowing our anesthesiologist to efficiently proceed with intubation. The code blue cart containing additional airway supplies, a defibrillator, and additional resuscitation medications is brought by the rapid response team each time an intubation occurs. Sorbello et al1 note the absence of rescue airway items in our kit. Additional endotracheal tube sizes, supraglottic airways, endotracheal tube introducers, and a surgical airway kit are available in intensive care units, the emergency department, and the code blue cart. The advantage of this setup is that the items that are most likely required are present in our mobile kit, and we do not introduce surplus supplies into a contaminated environment. A requisite to this setup is excellent communication between the inside and outside of the room for the time-sensitive delivery of critical supplies. We optimize our communication by delegating a point person to obtain the needed supplies and have begun trialing a high-fidelity 2-way communication telemedicine device with audio and video capabilities to facilitate communication between our in-room and out-of-room team members. They also recommend end-tidal capnography. We agree and include end-tidal capnography lines in the kit, which are compatible with our intensive care unit monitors or defibrillators. The sample line is included in our figure.2 A bougie-loaded endotracheal tube was recommended during all videolaryngoscopy attempts. As this is not standard practice at our institution, we do not recommend universal application of this technique, but recognize its utility and defer to each provider. They further propose cohorting all intubations to a dedicated spot, where patients are transported for the sole purpose of intubation, to then be returned to an intensive care unit. This cohorting provides teams with the essential and rescue supplies for airway and hemodynamic resuscitation. It is advantageous to the anesthesiologists by providing a controlled environment, to the patient by optimizing robust resuscitation management, and to the system by encouraging early and continuous assessment of patients potentially requiring intubation. At least in our institutional layout, we have the following concerns with a designated intubation location. Additional time is expended preparing and transferring to this location and can potentially delay the timeliness of an early intubation. The intubation spot requires elective transport of a critically ill hypoxemic patient who might have additional monitoring or respiratory therapy needs. Transport itself is a time fraught with patient complications in critically ill patients, with a high incidence of respiratory events and other adverse events.3–6 Infectious concerns also accompany this approach. Elective transportation to the intubation spot will increase exposure to noninfected staff and patient spaces via direct and indirect contact, droplet, and aerosol,7 especially when done under urgent or emergent conditions. Additionally, this dedicated COVID intubation spot would be exposed to high viral contact, presumably contaminating equipment and supplies, and thus should be limited to only confirmed COVID patients. If used in unconfirmed COVID status patients, the room itself can propagate the spread of disease via indirect contact. Strict infection control may mitigate these risks. Because inherent differences exist in each hospital, each institution must develop an individualized response that fits their needs. The additional ideas presented by Sorbello et al1 are appreciated; “thinking together”8 strengthens our response to the evolving and complex problems of COVID-19. Roberto A. Lopez, MDLeila Zuo, MDT. Miko Enomoto, MDMichael F. Aziz, MDDepartment of Anesthesiology & Perioperative MedicineOregon Health & Health Sciences UniversityPortland, Oregon[email protected]

Making surgery safer in an increasingly digital world: the internet-friend or foe?

The internet has resulted in huge efficiency gains in health care, the ability to deal with massive data accumulation and better manage patient data. However, potential and real pitfalls exist, including breeches in security of data and patient confidentiality, data storage issues, errors, and user interface issues. A MEDLINE review was performed using MeSH terms "health care" and "information technology." Cross-referencing was used to explore the different opportunities and challenges the internet has to offer. As health professionals, we are fast adopting technologies at our fingertips, such as WhatsApp and video capabilities, into our clinical practice to increase productivity and improve patient care. However, the potential security breaches are significant for the health professional and health service. Further, electronic medical records have theoretical advantages to improve patient care, reduce medication errors, and expedite referrals. The downside is a less personalized approach to patient care, as well as the potential for these systems to be even more cumbersome. In regard to the acquisition of knowledge, there is no doubt the internet is our friend. Health care professionals as well as patients have unlimited resources for learning, including podcasts videos, apps, simulators, and wearable devices. Unfortunately, this comes with a risk of misinformation and poorly referenced data with little to no regulation of content. In this increasing digital world, it is our task as health care providers to embrace these new technologies but develop guidelines and control systems to minimize the pitfalls.

Поява відеофільму на українському телебаченні та діяльність Віктора Кісіна. Історичні контексти

In theSoviet Union, video appeared on Central Television in 1960. Fixation on the video was made on Ukrainian television only 4 years later, in 1964. The technical features of the video did not allow for the editing connection of frames in the early stages. There were many other technical difficulties too. But already at this time, the search began on the use of the capabilities of video on Ukrainian television. Particularly interesting along the way are experiments on the artistic possibilities of video. They were conducted by television directors. One of the pioneers was Victor Kisin. These searches were impossible without knowledge of video technology. Together with creative workers, video engineers and technical personnel took an important part in all the work. Thus, a new direction appears alongside the television theater and television film. Victor Kisin defined the important place of the on television as a practitioner and as a theorist. He experimented, searched for new possibilities and forms of existence of on a television screen. The primitive video technique of that time still could not cope with the creative tasks of the director. But the close collaboration of creative and technical staff gave amazing results. Improvement of technology was very slow. But it provided new opportunities. Other forms of art did not have such opportunities. Movies did not give such opportunities. These features were mainly in the field of editing and special effects. The term videofilm appeared on Ukrainian television in efforts of enthusiasts. Later, in 1981, a special department was created for the production of videofilms. Also, the association at the Ukrtelefilm studio produced videofilms.