Virtual Teleconferencing Research Articles

The medical conference – is there a better way?

The Climate Emergency is one of the foremost challenges of the 21st century. One of the areas in which the medical profession has been slow to adapt has been in the conduct of conferences. The most significant environmental cost arises from the travel of delegates to the conference venue, often via short or long-haul flight. Ways to address this may include more environmentally conscious location-choice, allowing for more sustainable modes of transport to and from the venue, ‘hub and spoke’ model international conferences, and increased use of virtual teleconferencing or ‘hybrid’ models. The environmental impact of catering, single use consumables, merchandise etc. all needs to be considered and addressed. Carbon offsetting via the purchase of carbon credits, or by other means, should be considered by all conference organisers. Although all measures to address climate change tend to be incremental, it is imperative that we as a profession act sooner rather than later.

Identifying Factors That Would Make it Easier for People Who Are Experiencing Homelessness to Manage Their Diabetes: Prioritizing Needs Using a Participatory Action Research Approach

Experiencing homelessness can create numerous barriers to diabetes management. Often, it is difficult to identify barriers most relevant to those managing diabetes while experiencing homelessness. Participatory action research (PAR), which empowers people who have lived experience of diabetes and homelessness (co-researchers) is one approach to better prioritize these barriers. Our objective is to use PAR approaches to prioritize needs of a lived experience group in Calgary, Alberta, using virtual teleconferencing.

One-Year Toxicity of Ultrahypofractionated Breast Radiotherapy (+/- Sequential Boost) and a Survey of Patient Experience

Purpose/Objective(s)In March 2020, a 1-week hypofractionated adjuvant breast radiotherapy schedule, 26 Gy in 5 fractions, was implemented to reduce the risk of COVID 19 virus for patients and staff without compromising on cancer outcomes. This prospective observational study aims to report late toxicities at 1-year and to confirm feasibility and acceptability of this new schedule for patients.Materials/Methods– Patient reported outcome measures were recorded at baseline, 3 months, 6 months and 1 year following treatment completion. The presence of breast pain, swelling, hypersensitivity and skin problems, arm or shoulder pain, restricted arm movement and arm swelling were recorded using the EORTC QLQ BR45. Virtual teleconferencing without video was utilized at baseline, 3 months, 6 months and 1-year. Patients were invited to use video at the 1-year assessment for a physician-based assessment. To assess the experience of patients, a survey including 12 questions related to understanding, experiences of and benefits of ultrahypofractionated radiotherapy was developed and patients were invited to participate at the 1-year consultation.ResultsIn total, 135 consecutive patients were enrolled Mar - Aug 2020. 121/135 (90%) patients completed the 1-year toxicity assessment and at least one other assessment. 30/121 (25%) patients received a sequential boost. The majority of patients reported no toxicity or a mild toxicity at all three time points, 76% (83/109) at 3 months, 76% (82/108) at 6 months, and 82% (99/121) at 1-year. At 1 year 17% (20/121) of patients reported a moderate toxicity, the most common being breast pain (6/121). 2% (2/121) of patients reported a marked toxicity, both reported multiple marked toxicities including appearance of breast, firmness and skin changes. For the 30 patients who received a boost a moderate toxicity was reported by 17% (5/30) at 1 year and 3% (1/30) reported a marked toxicity. There was one confirmed case of ipsilateral recurrence at 1-year. Only 30/121 patients were open to using video for the 1-year physician-based assessment. Regarding patient reported experience 90% (101/112) felt informed about the 1-week radiotherapy schedule, and 88% (99/112) felt informed about possible side effects and 94% (105/122) felt supported by the medical team throughout their treatment course. Only 49% (55/112) reported they would have been open to video consultations.ConclusionMost patients undergoing ultrahypofractionated breast radiotherapy experience no toxicities or mild toxicities. These data suggest that adding a sequential boost following 26 Gy in 5 fractions to the whole breast is safe and does not lead to unacceptable 1-year toxicity. Patient satisfaction with ultrahypofractionated treatment and virtual consultations without video was high. However, less than half of patients may be open to virtual consultations and breast examination using video.

Simulation-based emergency medicine education in the era of physical distancing.

BackgroundThe COVID‐19 pandemic posed significant challenges to traditional simulation education. Because simulation is considered best practice for competency‐based education, emergency medicine (EM) residencies adapted and innovated to accommodate to the new pandemic normal. Our objectives were to identify the impact of the pandemic on EM residency simulation training, to identify unique simulation adaptations and innovations implemented during the pandemic, and to analyze successes and failures through existing educational frameworks to offer guidance on the use of simulation in the COVID‐19 era.MethodsThe Society for Academic Emergency Medicine (SAEM)’s Simulation Academy formed the SimCOVID task force to examine the impact of COVID‐19 on simulation didactics. A mixed‐methods approach was employed. A literature search was conducted on the subject and used to develop an exploratory survey that was distributed on the Simulation Academy Listserv. The results were subjected to thematic analysis and examined through existing educational frameworks to better understand successes and failures and then used to generate suggestions on the use of simulation in the COVID‐19 era.ResultsThirty programs responded to the survey. Strategies reported included adaptations to virtual teleconferencing and small‐group in situ training with a focus on procedural training and COVID‐19 preparedness. Successful continuation or relaunching of simulation programs was predicated on several factors including willingness for curricular pivots through rapid iterative prototyping, embracing teleconferencing software, technical know‐how, and organizational and human capacity. In specific instances the use of in situ simulation for COVID‐19 preparedness established the view of simulation as a “value add” to the organization.ConclusionsWhereas simulation educator's responses to the COVID‐19 pandemic can be better appreciated through the lens of iterative curricular prototyping, their successes and failures depended on existing expertise in technological, pedagogical, and content knowledge. That knowledge needed to exist and synergize within a system that had the human and organizational capacity to prioritize and invest in strategies to respond to the rapidly evolving crisis in a proactive manner. Going forward, administrators and educators will need to advocate for continued investment in human and organizational capacity to support simulation‐based efforts for the evolving clinical and educational landscape.

A virtual teleconferencing system based on face detection and 3D animation in a low‐bandwidth environment

AbstractIn this article, we proposed a novel teleconferencing system that combines a facial muscle model and the techniques of face detection and facial feature extraction to synthesize a sequence of life‐like face animation. The proposed system can animate realistic 3D face images in a low‐bandwidth environment to support virtual videoconferencing. Based on the technique of feature extraction, a face detection algorithm for the virtual conferencing system is proposed in this article. In the proposed face detection algorithm, the YCbCr skin color model is used to detect the possible face area of the image; the feature points of the face is determined by using the symmetry property of the face and the gray level characteristics of the eyes and the mouth. According to the positions of the feature points on a facial image, we can compute the transformation values of the feature points. These values will then be sent via a network from the sender's side to the receiver's side frame by frame. We can synthesize the realistic facial animations on the receiver's side based on these. Experimental results show that the proposed system can achieve a practical animated face‐to‐face virtual conference with good facial expressions and a low‐bandwidth requirement. © 2010 Wiley Periodicals, Inc. Int J Imaging Syst Technol, 20, 323–332, 2010

特集 マルチメディア時代の画像処理 物理的定義に基づいた時変ホモトピーを用いた３次元顔面像の表情と動作の生成

Time-varying homotopy was developed by defining time in topological homotopy. It achieved real time natural animation of 3D human faces in a virtual teleconferencing system which is part of a virtual teleconferencing system. At that stage, however, time-varying homotopy had not yet been defined physically. To fill this gap, I invented physical time-varying homotopy, which is based on digital control theory. It becomes possible to animate CG (Computer Graphics) objects more naturally in real time. Moreover, I suggest that digital control theory and digital signal processing are useful for applications in virtual teleconferencing systems and general CG animation.