Introducing a Remote Patient Monitoring Usability Impact Model to Overcome Challenges.

Telehealth and remote patient monitoring (RPM), in particular, have been through a massive surge of adoption since 2020. This initiative has proven potential for the patient and the healthcare provider in areas such as reductions in the cost of care. While home-use medical devices or wearables have been shown to be beneficial, a literature review illustrates challenges with the data generated, driven by limited device usability. This could lead to inaccurate data when an exam is completed without clinical supervision, with the consequence that incorrect data lead to improper treatment. Upon further analysis of the existing literature, the RPM Usability Impact model is introduced. The goal is to guide researchers and device manufacturers to increase the usability of wearable and home-use medical devices in the future. The importance of this model is highlighted when the user-centered design process is integrated, which is needed to develop these types of devices to provide the proper user experience.

Cognitive and physiological evaluation of virtual reality training in nursing.

Virtual reality (VR) has increasingly been used in several disciplines, including nursing, a profession in high demand that is now facing a shortage. This study investigated the effectiveness and efficacy of VR hybrid training over traditional training (TR) methods. Sixteen college students were recruited and randomly assigned to get 100% TR or 50% TR and 50% VR (VR50). Participants attended a three-day program with a registered nurse, consisting of lectures and practical lab sessions. Participants' performance, training time, cognitive development, physical development, mental workload, user experience, Students' Satisfaction and Self-Confidence, and team learning were evaluated. The results showed that the VR50 performed as well as, and sometimes even better than the TR group (p-value = 0.043). VR50 group significantly had higher cognitive development and found VR easy to use and attractive (p-value < 0.05). VR-integrated training makes nurses' training more affordable and accessible while providing instant and relevant feedback.Practitioner Summary: This study assessed employment-integrated virtual training in nursing, particularly peri-care, by comparing the performance, cognitive, physical, and mental workload of traditional and integrated VR training groups. The findings of this study provide significant support for incorporating VR training into educational settings.

A review of medical wearables: materials, power sources, sensors, and manufacturing aspects of human wearable technologies.

Wearable technology is a promising and revolutionary technology that is changing some aspects of our standard of living to a great extent, including health monitoring, sport and fitness, performance tracking, education, and entertainment. This article presents a comprehensive literature review of over 160 articles related to state-of-the-art human wearable technologies. We provide a thorough understanding of the materials, power sources, sensors, and manufacturing processes, and the relationships between these to capture opportunities for enhancement and challenges to overcome in wearables. As a result of our review, we have determined the need for the development of a comprehensive, robust manufacturing system alongside specific standards and regulations that take into account wearables' unique characteristics. Seeing the whole picture will provide a frame reference and road map for researchers and industries through the design, manufacturing, and commercialisation of effective, portable, self-powered, multi-sensing ultimate future wearable devices and create opportunities for new innovations and applications.

Applying user-centered design and the Pi-CON methodology for vital signs sensor development.

Although telehealth, and in particular RPM, have demonstrated to drive many benefits, such as reduction in cost and hospital-acquired infections, previous research has shown many usability challenges when patients operate a medical device without supervision of a medical professional. To combat this issue, the Pi-CON methodology is applied to develop a novel sensor with the objective to continuously acquire a patient's vital signs from a distance, without the need to attach any markers or sensors to the patient, and with limited user interaction required. Pi-CON stands for passive, continuous and non-contact, and describes a way to improve the user experience for patients or caregivers that have a need to perform a vital signs measurement themselves, without the presence of a medical professional. The developed sensor utilises radar and optical sensing technologies and transmits acquired data to a cloud-based service where it can be viewed in near real-time by the patient or family members from anywhere via an intuitive user interface. This user interface, as well as the sensor itself were designed based on design needs and requirements to adhere to the user-centered design process. The development of the sensor, including utilised technologies, components, and the user interface are presented, including inspirations for future work.

Bend the Tool, Not the Wrist: An Ergonomic Investigation of Medical Suturing Needle Holder Design and Medical Engineering Solution.

The study aimed to assess a new needle holder grip and head design on medical suturing quality and experience. Generally, suturing remained fundamentally unchanged since its invention, possessing high variability, discomfort, and can be moderately predictable. In this study, 2 grip designs (traditional holder grip and a new slightly curved crescent-shaped grip) and 2 head types (smooth vs knurled) were investigated resulting in 4 groups. Thirty-two medical interns were recruited to participate in this study. Their performances were assessed across time, symmetry, wrist posture, discomfort, and perceived difficulty. Findings revealed that the new grip led to a lesser time, better wrist posture, less discomfort, and difficulty than the traditional grip. More, the new grip with smooth head holder led to more symmetrical and shorter knots than knurled and conventional grip one. Findings are of interest for medical personnel, where it is recommended to use a smooth head and new grip needle holder while suturing for better suturing performance, wrist posture, and hand comfort.

The Interaction Between Physical and Psychosocial Stressors.

Do physical and psychosocial stressors interact to increase stress in ways not explainable by the stressors alone? A preliminary study compared participants' stress response while subjected to a physical stressor (reduced or full physical load) and a predetermined social stressor (confronted by calm or aggressive behavior). Salivary cortisol samples measured endocrine stress. Heart rate variability (HRV) and electrodermal activity (EDA) measured autonomic stress. Perceived stress was measured via discomfort and stress state surveys. Participants with a heavier load reported increased distress and discomfort. Encountering an aggressive individual increased endocrine stress, distress levels, and perceived discomfort. Higher autonomic stress and discomfort were found in participants with heavier physical load and aggressive individuals. The results suggest a relationship where physical load increases the stressfulness of aggressive behavior in ways not explainable by the effects of the stressors alone. Future research is needed to confirm this investigation's findings.

Analysis of Food Hub Commerce and Participation Using Agent-Based Modeling: Integrating Financial and Social Drivers.

OBJECTIVE: Factors influencing long-term viability of an intermediated regional food supply network (food hub) were modeled using agent-based modeling techniques informed by interview data gathered from food hub participants. BACKGROUND: Previous analyses of food hub dynamics focused primarily on financial drivers rather than social factors and have not used mathematical models. METHOD: Based on qualitative and quantitative data gathered from 22 customers and 11 vendors at a midwestern food hub, an agent-based model (ABM) was created with distinct consumer personas characterizing the range of consumer priorities. A comparison study determined if the ABM behaved differently than a model based on traditional economic assumptions. Further simulation studies assessed the effect of changes in parameters, such as producer reliability and the consumer profiles, on long-term food hub sustainability. RESULTS: The persona-based ABM model produced different and more resilient results than the more traditional way of modeling consumers. Reduced producer reliability significantly reduced trade; in some instances, a modest reduction in reliability threatened the sustainability of the system. Finally, a modest increase in price-driven consumers at the outset of the simulation quickly resulted in those consumers becoming a majority of the overall customer base. CONCLUSION: Results suggest that social factors, such as desire to support the community, can be more important than financial factors. APPLICATION: An ABM of food hub dynamics, based on human factors data gathered from the field, can be a useful tool for policy decisions. Similar approaches can be used for modeling customer dynamics with other sustainable organizations.

Biomechanical and performance implications of weapon design: comparison of bullpup and conventional configurations.

OBJECTIVE: Shooter accuracy and stability were monitored while firing two bullpup and two conventional configuration rifles of the same caliber in order to determine if one style of weapon results in superior performance. BACKGROUND: Considerable debate exists among police and military professionals regarding the differences between conventional configuration weapons, where the magazine and action are located ahead of the trigger, and bullpup configuration, where they are located behind the trigger (closer to the user). To date, no published research has attempted to evaluate this question from a physical ergonomics standpoint, and the knowledge that one style might improve stability or result in superior performance is of interest to countless military, law enforcement, and industry experts. METHOD: A live-fire evaluation of both weapon styles was performed using a total of 48 participants. Shooting accuracy and fluctuations in biomechanical stability (center of pressure) were monitored while subjects used the weapons to perform standard drills. RESULTS: The bullpup weapon designs were found to provide a significant advantage in accuracy and shooter stability, while subjects showed considerable preference toward the conventional weapons. CONCLUSION: Although many mechanical and maintenance issues must be considered before committing to a bullpup or conventional weapon system, it is clear in terms of basic human stability that the bullpup is the more advantageous configuration. APPLICATION: Results can be used by competitive shooter, military, law enforcement, and industry experts while outfitting personnel with a weapon system that leads to superior performance.

Comparison of once-daily versus twice-weekly terbinafine administration for the treatment of canine Malassezia dermatitis - a pilot study.

BACKGROUND: Terbinafine, an allylamine antifungal, is used in pulsatile dose regimens for superficial mycoses in human medicine. OBJECTIVES: To compare the clinical efficacy of twice-weekly versus once-daily terbinafine administration to determine whether preliminary proof-of-concept evidence exists for pulsatile administration of terbinafine in the treatment of canine Malassezia dermatitis and to determine whether twice-weekly treatment results in fewer clinical and owner-perceived adverse events. ANIMALS: Twenty client-owned dogs with Malassezia dermatitis. METHODS: In this randomized, single-blinded clinical trial, dogs were randomly assigned to receive terbinafine (30 mg/kg) either once daily for 21 days (n = 10) or once daily on two consecutive days per week for six doses (n = 10). On day 0 and day 21, a mean yeast count was calculated from eight anatomical locations via adhesive tape-strip cytology, clinical lesion scores were assigned to the same locations, and owners assessed pruritus using a visual analog scale. RESULTS: There was no significant difference between treatment groups with respect to the reduction in mean yeast count (P = 0.343) and clinical lesion scores (P = 0.887). Pruritus measured by visual analog scale was significantly decreased in the twice-weekly treatment group compared with the daily treatment group (P = 0.047). Seven of 20 dogs had a clinically measurable or owner-reported adverse event during treatment that included gastrointestinal disturbances, excessive panting and elevated hepatic enzymes, with no significant difference noted between treatment groups. CONCLUSIONS AND CLINICAL IMPORTANCE: This pilot study indicates that twice-weekly terbinafine administration may be an effective alternative treatment for canine Malassezia dermatitis and merits further investigation.

Physical and cognitive effects of virtual reality integrated training.

OBJECTIVE: The objective of this study was to evaluate the cognitive and physical impact of virtual reality (VR) integrated training versus traditional training methods in the domain of weld training. BACKGROUND: Weld training is very important in various industries and represents a complex skill set appropriate for advanced training intervention. As such, there has been a long search for the most successful and most cost-effective method for training new welders. METHOD: Participants in this study were randomly assigned to one of two separate training courses taught by sanctioned American Welding Society certified welding instructors; the duration of each course was 2 weeks. After completing the training for a specific weld type, participants were given the opportunity to test for the corresponding certification. Participants were evaluated in terms of their cognitive and physical parameters, total training time exposure, and welding certification awards earned. Each of the four weld types taught in this study represented distinct levels of difficulty and required the development of specialized knowledge and skills. RESULTS: This study demonstrated that participants in the VR integrated training group (VR50) performed as well as, and in some cases, significantly outperformed, the traditional welding (TW) training group.The VR50 group was found to have a 41.6% increase in overall certifications earned compared with the TW group. CONCLUSION: VR technology is a valuable tool for the production of skilled welders in a shorter time and often with more highly developed skills than their traditionally trained counterparts. APPLICATION: These findings strongly support the use ofVR integrated training in the welding industry.

Perpendicular pull-out force of locking versus non-locking plates in thin cortical bone using a canine mandibular ramus model.

OBJECTIVE: To compare the holding strength of a conventional plate-screw construct with a locking plate-screw construct in the thin cortical bone of the canine mandibular ramus. STUDY DESIGN: Mechanical study. ANIMALS: Paired cadaveric canine mandibles (n = 10 pairs). METHODS: Perpendicular pull-out testing was performed on 2.0-mm limited-contact dynamic compression plate (LC-DCP)-screw constructs and 2.0-mm string-of-pearls (SOP) plate-screw constructs applied to the ramus of the canine mandible. Pull-out force was applied perpendicular to the long axis of the plates. Construct stiffness and load at failure were determined from load-displacement curves and method of failure was determined from high speed digital video recordings. A paired t-test was used to compare mean construct stiffness and load at failure between groups. RESULTS: SOP plate-screw constructs had a significantly higher mean construct stiffness and load at failure than did LC-DCP-screw constructs. LC-DCP constructs failed by screw pull-out while bone slicing and fracture were prominent mechanisms of failure for SOP constructs. CONCLUSIONS: SOP plate-screw constructs sustained a significantly higher perpendicular load at failure than did LC-DCP-screw constructs.