Virtual Monitor Research Articles

A novel smart instrument for multilevel alerting and multivariable monitoring of urinary absorption process into a textile medium

This paper presents a novel instrumentation device for instantaneous digital acquisition and processing, of the urine flow absorbed by a textile medium. The proposed device is smart version of a basic instrument studied in previous research works. Arduino framework is used as the development tool of the main C++ instrumentation sketch for ESP32 microchip target. The proposed smart device owes its novelty to many relevant factors including a hardware simplicity of the unary sensor, a multilevel alerting strategy, as well as a multivariable monitoring process. In the wireless side, a serial Bluetooth terminal application is used as driver for smartphone-based virtual monitoring of involved output variables. Furthermore, an experimental workbench built for testing the proposed device is presented. Finally, the technical characteristics and experimental results obtained and presented in the paper, show the innovative nature of the proposed device for bioinstrumentation engineering.

TESTING HUMAN ERRORS IN VIRTUAL REALITY TRAINING

The emergency training of industrial process plant operators is one of the most widely used tools to increase the reliability of human factors to handle an emergency situation. However, the preparation and operation of full-fledged simulators and trainers is very expensive and, therefore, virtual environment tools are used. A question that has not yet been answered is: Can virtual reality match the reliability of other methods of operation and is the same training in virtual reality effective? The experiment was carried out in the three-walled virtual CAVE, with virtual reality glasses, with a computer, a tablet, and a real control panel. Visual stimuli were displayed on the screen of the virtual monitor (green, yellow, and red); auditory stimuli were pure tones with frequencies of 250, 1000 and 4000 Hz. The conclusion should explicitly state if the hypothesis defined for the research has been confirmed and there are significant differences in terms of interface type. Training in virtual reality induces lower operator reliability, but in specific conditions (visual stimuli, virtual reality glasses) can match the reliability of other methods of operation and can be effective.

Experiences pertaining to child nutrition and care provision among early care and education stakeholders, sponsors, and center directors during the COVID-19 pandemic: A multi-method study.

This study used multiple methods (interviews, survey) to assess experiences of stakeholders, sponsors, and center-based early care and education (ECE) program directors pertaining to child nutrition (e.g., provision of nutritious foods, mealtime practices, CACFP administration/use) and the provision of child-care (i.e., day-to-day ECE operations and programming) during the COVID-19 pandemic. Participants included stakeholders from 22 national and state agencies associated with the Child and Adult Care Food Program (CACFP) who also work to promote nutrition and quality child-care, representatives of 17 CACFP sponsor organizations, and 40 center-based ECE program directors who participated in interviews, as well as 100 ECE directors who completed surveys. Data were collected across four states. Thematic analyses of interviews and descriptive methods were used to analyze data collected. Six main themes emerged from stakeholders, sponsors, and ECE program directors' focusing on: experiences during the temporary closure of several ECE programs; additional responsibilities and unanticipated expenses for ECE programs; difficulty in keeping up with constantly changing COVID-19 guidance; encounters during shifts from in-person to virtual training and monitoring; changes to nutrition practices at ECE; and the need to prioritize ECE funding. Findings highlight challenges and supports to ECE programs and could inform future efforts to enhance child-care quality and child nutrition in the U.S. during pandemic situations.

Augmented reality collaborative medical displays (ARC-MeDs) for multi-user surgical planning and intra-operative communication

ABSTRACT Digital Displays are integral to modern systems and serve as the primary visual human-computer interface. A physical monitor is a typical example for showing computer-generated information to a person – as long they are located directly in front of them. In an operating room, however, people may be unable to move freely or communicate only based on verbal communication due to noise pollution. Furthermore, mobile and connected editing and sharing of the same content on the go is currently not readily available. Therefore, we propose Augmented Reality Collaborative Medical Displays for duplicating any displayed content as a virtual monitor hovering in space in the real world. Our method replicates any user input on the virtual representation onto the original physical monitor. We put forward a use case in planning a surgical intervention of the abdomen with intra-operative CT imaging. Moreover, we demonstrate how a medical immersive teleconsultation system utilises our method for meaningful interactions. Finally, we evaluate our method with multiple display resolutions. Based on our observations from the use cases and quantitative evaluation, we believe our proposed concept facilitates the integration of future collaborative medical applications.

Virtual overdose monitoring services: a novel adjunctive harm reduction approach for addressing the overdose crisis.

KEY POINTS In 2021, 21 people in Canada died each day from poisonings associated with unregulated substance use.[1][1] Despite several initiatives to combat the overdose crisis, overdose fatalities continue to rise, particularly since the start of the COVID-19 pandemic. Experts have suggested

P111 Paediatric day-case adeno-tonsillectomy transfer to Hospital-in-the-Home: a new model of care

Abstract Aims Tonsillectomy and adenoidectomy (T&A) is one of the most common paediatric surgical procedures. Post-operatively, children are monitored in hospital for bleeding, SpO2 desaturation, pain and oral intake. We report a new model of care for low-risk children undergoing T&A to transfer to hospital-in-the-home (HITH) on the day of surgery, with the benefits of providing medically-supported recovery at home and reducing healthcare expenditure. Methods Children >/= 5yr, with normal pre-operative overnight oximetry, without co-morbidities/post-operative upper airway obstruction/bleeding and tolerating oral intake were eligible for HITH, between 4-6hr post-T&A. Families were educated on administering adequate pain relief and oral intake. Overnight oximetry was monitored on the first night. Patients were reviewed at home day 1 then via telehealth day 2, before discharge. Results Sixteen patients with mean age 8.2yr (5-13yr) transferred to HITH post-day-case T&A. There were no episodes of desaturation, bleeding or readmission. One patient presented to Emergency day 1 with fever, pain and vomiting, received symptomatic treatment and transfer back to HITH, with discharge day 2. Two patients required one additional telehealth assessment of hydration (1) and pain control (1) on day 3, before discharge. Conclusions This new model of care provides a safe, cost-saving, supported management pathway for low risk paediatric post-T&A cohorts. Eligibility criteria will now expand as we increase virtual monitoring in the low risk cohort, freeing up HITH beds for younger and more complex post T&A patients, and hospital beds for higher risk patients, enabling greater throughput for overwhelmed surgical wait lists.

Thermal Power Plant Turbine Rotor Digital Twin Automation Construction and Monitoring System

Based on the digital twin technology, this article investigates the physical rules fusion model of the turbine rotor operation in thermal power plants, establishes the geometric behavior mapping method of the turbine rotor in the virtual scenario of thermal power plants, and develops a real-time data-driven virtual monitoring system of the rotor operation, which realizes the virtual control of the rotor operation process from the physical and geometric levels, respectively. The 3D model created by Creo was imported into ADAMS in x_t format, constraints were added, and model data input and output interfaces were established in ADAMS software to build its dynamics model. The foundation of the joint simulation with the AMESim model is laid. The information fusion technology based on D-S evidence theory, fusing multisensor data and information from other channels, can more accurately and comprehensively understand and describe the diagnostic object, to make correct judgment and decisions on complex fault diagnosis. We propose an integrated modeling method for multiview control scenarios of manufacturing units based on digital twins and finalize the construction of digital twin models of manufacturing units based on the definition of the multiview model collaboration mechanism, which provides model support for the research of digital twin-driven manufacturing unit control technology. For the twin data perception and interaction problem, a unified architecture-standardized communication protocol is established based on OPC UA technology to solve the problem of difficult data perception and interaction caused by the nonuniform communication interface protocol of different devices on the automated production line. The model change is intended to help improve the visualization level of digital production line monitoring and improve the operating efficiency of the turbine rotor. The experimental results show that the application of digital twin to thermal turbine rotor operation monitoring provides a new method for turbine rotor vibration fault diagnosis; D-S evidence theory can fuse information from multiple aspects of the fault, thus improving the probability of fault diagnosis and reducing uncertainty.

The Application of Virtual Therapeutic Drug Monitoring to Assess the Pharmacokinetics of Imatinib in a Chinese Cancer Population Group

PurposeImatinib is used in gastrointestinal stromal tumours (GIST) and chronic myeloid leukaemia (CML). Oncology patients demonstrate altered physiology compared to healthy adults, e.g. reduced haematocrit, increased α-1 acid glycoprotein, decreased albumin and reduced glomerular filtration rate (GFR), which may influence imatinib pharmacokinetics. Given that Chinese cancer patients often report raised imatinib plasma concentrations and wider inter-individual variability reported in trough concentration when compared to Caucasian cancer patients, therapeutic drug monitoring (TDM) has been advocated. MethodThis study utilised a previously validated a Chinese cancer population and assessed the impact of imatinib virtual-TDM in Chinese and Caucasian cancer populations across a dosing range from 200-800 mg daily. ResultsStaged dose titration to 800 mg daily, resulted in recapitulation to within the target therapeutic range for 50 % (Chinese) and 42.1% (Caucasian) subjects possessing plasma concentration < 550 ng/mL when dosed at 400 mg daily. For subjects with plasma concentrations >1500 ng/mL when dosed at 400 mg daily, a dose reduction to 200 mg once daily was able to recover 67 % (Chinese) and 87.4 % (Caucasian) patients to the target therapeutic range. ConclusionVirtual TDM highlights the benefit of pharmacokinetic modelling to optimising treatments in challenging oncology population groups.

CARDIAC SURGERY VIRTUAL FOLLOW-UP FOR PATIENTS AT HIGH-RISK FOR HOSPITAL READMISSION: DEVELOPMENT OF AN ENHANCED REMOTE TELEMONITORING CARE PLATFORM

CARDIAC SURGERY VIRTUAL FOLLOW-UP FOR PATIENTS AT HIGH-RISK FOR HOSPITAL READMISSION: DEVELOPMENT OF AN ENHANCED REMOTE TELEMONITORING CARE PLATFORM

The Digital Technology in Supporting Nursing Services During The Covid-19 Pandemic: A Literature Review

Digital technology plays an important role in helping health workers and improving health services. During the COVID-19 pandemic, digital technology can be an apt solution in supporting nursing/health services to patients. This study aimed to explain digital technology in terms of its forms, functions, and obstacles when harnessed to support nursing/health services during the COVID-19 pandemic. The research databases were established by sourcing articles from Pubmed, ProQuest, Springer Link, Sage Journals, and Google Scholar, focusing on articles published in 2019-2022. The research results found 5 articles discussing the forms and functions of digital technology, 2 articles discussing the functions and barriers of implementing digital technology, and 4 articles discussing the forms, functions, and barriers of implementing digital technology. Most of the forms of digital technology implementation to support nursing/health services during the COVID-19 pandemic involve virtual visits, online consultations, and monitoring patient conditions remotely. The use of digital technology in supporting nursing/health services during the COVID-19 pandemic affords various gains for health workers, patients, and patient families, which serve as the drive to improve services. In addition, these obstacles can serve as the cornerstones in evaluating the use of digital technology for future improvement. Future studies are suggested to examine one form of digital technology for nursing/health services that already exist.

Проблема понимания моделей смешанного обучения и связанных с ними дидактических условий

The article deals with the problem of the typology of the blended learning models that require the certain didactic conditions. In this regard, the various approaches to classifying blended learning models and determining its didactic nature in American, European and Russian scientific literature are analyzed. A critical view is offered on the research experience of the blended learning modeling, interpretation of the concepts of «the didactic conditions» and «the organizational-didactic model». The purpose of this article is to analyze the scientific understanding of the blended learning models typology and related didactic conditions. This led to the use of the comparative analysis methods and generalization. The results of the study show that the idea of the didactic nature of the blended learning, which combines technological and pedagogical principles, has become permanent in the scientific literature. Blended learning requires developed electronic information environment containing high-quality and diverse content that can form an individual learning trajectory, provide a personal virtual educational space, and monitor and record student learning achievements. And the didactic role of the teacher is also changing, who cannot do without confident IT competencies. He is responsible for shaping the content of the educational program, strengthening the individual approach to learning, and managing the planning of training. Existing attempts to classify blended learning models are, as a rule, incomplete and boil down to identifying a set of modeling criteria. As an illustration, examples of the optimal solutions to the problem of modeling and differentiation of didactic conditions are given, their influence on the teacher’s role and the requirements for a digital educational environment are shown.

Digital Advancements in Retinal Models of Care in the Post-COVID-19 Lockdown Era.

The coronavirus disease-2019 (COVID-19) pandemic introduced unique barriers to retinal care including limited access to imaging modalities, ophthalmic clinicians, and direct medical interventions. These unprecedented barriers were met with the robust implementation of digital advances to aid in monitoring and efficiency of retinal care while taking into the account of public safety. Many of these innovations have been successful in maintaining efficiency and patient satisfaction and are likely to stay to help preserve vision in the future. In this article we highlight these advances implemented during the pandemic including telescreening triage, virtual retinal imaging clinics, at-home optical coherence tomography, mobile phone self-monitoring, and virtual reality monitoring technology. We also discuss advancing innovations including Internet of Things and Blockchain technology that will be critical for further implementation and security of these digital advancements.

Multi-Task Disentangled Autoencoder for Time-Series Data in Glucose Dynamics.

The objective of this study is to propose MD-VAE: a multi-task disentangled variational autoencoders (VAE) for exploring characteristics of latent representations (LR) and exploiting LR for diverse tasks including glucose forecasting, event detection, and temporal clustering. We applied MD-VAE to one virtual continuous glucose monitoring (CGM) data from an FDA-approved Type 1 Diabetes Mellitus simulator (T1DMS) and one publicly available CGM data of real patients for glucose dynamics of Type 1 Diabetes Mellitus. LR captured meaningful information to be exploited for diverse tasks, and was able to differentiate characteristics of sequences with clinical parameters. LR and generative models have received relatively little attention for analyzing CGM data so far. However, as proposed in our study, VAE has the potential to integrate not only current but also future information on glucose dynamics and unexpected events including interactions of devices in the data-driven manner. We expect that our model can provide complementary views on the analysis of CGM data.

Development of a database of kazakhstani digital multicultural content as a means of training future journalists

This article presents the practice of analyzing digital multicultural content and its application in the classes with students from the educational programs: “Digital Journalism” and “Media Technologies”. The choice of the topic is explained by the specifics of the cultural code of the modern student. The purpose of the paper is to study digital multicultural content as a mean of training future media workers using modern IT tools. The article examines the multicultural content of three TV channels and online publications hosted on digital services. The design and structuring of web portals, interface and content are studied. Due to the specifics of the subject of multicultural content, its role in the general information space is determined, and its relevance and relevance among students is described. The author conducts quantitative and qualitative researches of media materials. Based on statistical data, a comparative analysis of the indicators of digital multicultural content for 2018-2021 was carried out and the dynamics was demonstrated, the reasons for the change in indicators were described in detail. A parallel is drawn between the amount of digital content published on television and on Internet resources. Considering the need to prepare students for professional realities and for the purpose of practical orientation of this research, a lexical and compositional analysis of digital multicultural content was carried out. In particular, the study examined genres and forms of materials, lexical features of texts. The means of social interaction of online media representations are defined, which include the constant presentation of traditional media content in a virtual environment and monitoring of activity in the classroom. The structural and typological features of this format of digital journalism are revealed. Based on a qualitative analysis of the content, several trends and conclusions are presented. The information obtained during the study was organized into a database. The methods of working with students described and analyzed in this article are an important material for the development of educational goals of the educational programs “Digital Journalism” and “Media Technologies” in Kazakhstan and can become a methodological basis for the integration of IT technologies into media education. Key words: multicultural content, content analysis, journalistic education, format, media technologies, digital journalism, databases, training means.

Staff and patient experience of the implementation and delivery of a virtual health care home monitoring service for COVID-19 in Melbourne, Australia

BackgroundProvision of virtual health care (VHC) home monitoring for patients who are experiencing mild to moderate COVID-19 illness is emerging as a central strategy for reducing pressure on acute health systems. Understanding the enablers and challenges in implementation and delivery of these programs is important for future implementation and re-design. The aim of this study was to explore the perspectives of staff involved with the implementation and delivery, and the experience of patients managed by, a VHC monitoring service in Melbourne, Australia during the COVID-19 pandemic.MethodsA descriptive qualitative approach informed by naturalist inquiry was used. Staff interviews were analysed using the Consolidated Framework for Implementation Research (CFIR). Patient experience was captured using a survey and descriptive statistics were used to describe categorical responses while content analysis was used to analyse free text responses as they related to the CFIR. Finally, data from the interviews and patient experience were triangulated to see if patient experience validated data from staff interviews.ResultsAll 15 staff were interviewed, and 271 patients were surveyed (42%). A total of four final overarching themes emerged: service implementation enablers, service delivery benefits for patients, fragmentation of care, and workforce strengths. 19 subthemes aligned with 18 CFIR constructs from staff and patient data.ConclusionRapid implementation was enabled through shared resources, dividing implementation tasks between senior personnel, engaging furloughed healthcare staff in design and delivery, and having a flexible approach that allowed for ongoing improvements. Benefits for patients included early identification of COVID-19 deterioration, as well as provision of accurate and trustworthy information to isolate safely at home. The main challenges were the multiple agencies involved in patient monitoring, which may be addressed in the future by attributing responsibility for monitoring to a single agency.

Management of the patient with a wearable cardiac defibrillator in a virtual remote monitoring clinic

Abstract Funding Acknowledgements Type of funding sources: None. Background the risk of sudden cardiac death (SCD) currently represents a severe problem that significantly involves the population. The implantable cardiac defibrillator (ICD) has been used to prevent SCD among patients with a high risk for life-threatening sustained ventricular arrhythmias. However, there are a number of patients at risk for SCD either awaiting a work-up for reversible causes of SCD or with acute contraindications to ICD implantation. Nevertheless, ICD implantation is dependent on defining ventricular substrate, evaluating the future risk of SCD and estimation of the patient’s overall survival. The wearable cardiac defibrillator (WCD) provides an option for protection during this vulnerable period when the risk of SCD is unclear. Methods our virtual device control clinic is managed by 3 cardiovascular technicians and 3 electrophysiologists. From August 2017 to January 2022, we included 29 patients who received WCD, 6 women (21%), with an average age of 66 years. The indications for the use of WCD were: ischemic cardiomyopathy (62,1%) and non-ischemic cardiomyopathy (17,24%),during cardiovascular rehabilitation pending eventual recovery of the ejection fraction (EF), waiting for genetic test result (10,34%) or ICD explant for infection awaiting reimplantation (10,34%).The patient is trained by technician staff to ensure the correct wearing of the WCD, the management of any alarms, the management of the device in case of arrhythmia and shock, as well as the daily replacement of the battery and the management of the remote monitoring system. Results in virtual control device clinic Cardiovascular Technician checks the transmissions from the WCD site: only clinical parameters such as recorded ECGs (manual, asystolic, events detected but not treated and events treated with shock) and patient compliance (wearing hours per day) can be verified.The average wearing duration has been 37 days, with a daily average of 23.1 hours. We received and controlled a total of 1097 transmissions, of which 22 with events, of which 7 were generated for VT, 4 for TSV, 10 for T wave oversensing and 1 for inappropriate Shock; in all these cases, the patient has been contacted by the clinic staff for clinical management. At the end of wearing period, technical staff schedules a check-up with echocardiogram monitoring the EF to evaluate the patient's clinical path. Following the clinical evaluation, a recovery of cardiac function has been possible for 13 patients, without any implantation of ICD, whereas 16 patients underwent a defined implantation of ICD. Conclusions the WCD has been shown to be an effective device in protecting SCD from VT/VF. Despite the small number of patients, it was necessary to take them in charge at the virtual remote monitoring clinic for proper clinical management, which generated a workload increase. Therefore, it will be important to propose a recognition of the service and its reimbursement.

Contribution of Continuous Virtual Monitoring to Hospital Safety, Quality, and Value of Care for COVID-19 Patients.

Introduction: The rapid onset of the COVID-19 pandemic increased hospital admissions and shortages for personal protective equipment (PPE) used to slow the spread of infections. In addition, nurses treating COVID-19 patients have time-consuming guidelines to properly don and doff PPE to prevent the spread. Methods: To address these issues, the Medical University of South Carolina repurposed continuous virtual monitoring (CVM) systems to reduce the need for staff to enter patient rooms. The objective of this study was to identify the economic implications associated with using the CVM program for COVID-19 patients. We employed a time-driven activity-based costing approach to determine time and costs saved by implementing CVM. Results: Over the first 52 days of the pandemic, the use of the CVM system helped providers attend to patients needs virtually while averting 19,086 unnecessary in-person interactions. The estimated cost savings for the CVM program for COVID-19 patients in 2020 were $419,319, not including potential savings from avoided COVID-19 transmissions to health care workers. A total of 19,086 PPE changes were avoided, with savings of $186,661. After accounting for cost of the CVM system, the net savings provided an outstanding return on investment of 20.6 for the CVM program for COVID-19 patient care. Conclusion: The successful and cost saving repurposing of CVM systems could be expanded to other infectious disease applications, and be applied to high-risk groups, such as bone marrow and organ transplant patients.

Impact of Remote Patient Monitoring on Length of Stay for Patients with COVID-19.

Background: Remote patient monitoring (RPM) can be deployed as part of a tiered approach to open up hospital bed availability by allowing earlier discharge of patients with continued virtual monitoring. We describe the impact of RPM on length of stay (LOS) for patients with COVID-19. Methods: We deployed RPM during two COVID-19 surges at a tertiary academic hospital from March to June 2020 as a feasibility pilot to establish the infrastructure for RPM including electronic health record changes and virtual health center (VHC) protocols, and October 2020 to February 2021, during the second surge of COVID-19. Discharging patients received a wearable vital sign monitoring device, allowing real-time data transmission to the VHC using a smart phone application. The data, monitored 24 h a day for 8 days by a technician, had built-in escalation protocols to nurses and/or attending physicians. Results: We compared patients discharged with RPM with those discharged without RPM during both phases using a two-to-one-matched case-control design including age, sex, Charlson comorbidity index, and limited English proficiency. After including discharge with home oxygen therapy as an effect modifier, there was a significant association between shorter LOS and RPM for patients discharging without home oxygen (p = 0.0075) compared with patients not discharging on RPM. Discussion: Our study shows a strong association between a reduction in LOS for patients discharging with RPM but without home oxygen therapy, which can assist with hospital capacity. Conclusions: Home telemonitoring after discharge for patients with COVID-19 may reduce LOS.

Middle East and North African Health Informatics Association (MENAHIA)

The region of the Middle East and North Africa (MENA) is diverse and retains a superior growth potential. It benefits from a privileged geographical location with big markets, a young and growing educated population, and competitive advantages in several industries. Regardless of their differences, countries face shared concerns, most notably in health. In response to the COVID-19 pandemic, MENA countries enact reforms to create a more robust and inclusive digital health systems to increase growth, development, and integrity. Throughout the coordinated containment and mitigation efforts, most of the countries have integrated digital technologies into the health systems. These procedures include digital government initiatives, the introduction of digital health training courses, live video surgeries and virtual patient monitoring, rural and remote telemedicine programs, and the development of a national electronic health records (EHR) system. Each country took necessary actions to address equity, literacy, and development of resilient health systems. The nine featured countries in this report illustrate the diversity among the MENA region and account for major opportunities and achievements as well as promises and challenges that “digital health” presents for its populations.

Routing optimization algorithm for logistics virtual monitoring based on VNF dynamic deployment

Routing optimization algorithm for logistics virtual monitoring based on VNF dynamic deployment