medical technology

医疗技术
  • 文章类型: Journal Article
    在19世纪末,X射线机的出现助长了美国医学对技术的依赖,改变医院和医疗行业。X射线制造商追求新生的医院市场,因为竞争和专利纠纷加速了X射线机的改装。医院采用了笨重的新机器和雇用的X射线摄影师,但是随着不守规矩的仪器稳定下来,加入新的放射学专业的医生减少了机器故障排除的工作量,并促进了他们医学上合格的x光解释。本文从边界工作的角度构建了早期医学射线照相,强调医生之间的话语,X射线摄影师,医院管理人员争相在放射科学和照相工艺之间建立特权分界。最终,放射科医生通过利用x光机的自动化和利用从摄影客观性到合格解释的认识转变来取代x光摄影师。通过关注X射线并入医院这一被忽视的方面,这项工作为利用机械化和权威医学解释如何改变专业界限提供了独特的视角。
    At the end of the nineteenth century, the advent of x-ray machines fueled American medicine\'s reliance on technology, transforming hospitals and the medical profession. X-ray manufacturers pursued the nascent hospital market as competition and patent feuds accelerated x-ray machine modifications. Hospitals incorporated clunky new machines and employed x-ray photographers, but as the unruly apparatus stabilized, physicians joining the new specialty of radiology discounted the toils of machine troubleshooting and promoted their medically qualified x-ray interpretations. This article frames early medical radiography in terms of boundary work, highlighting how discourse among physicians, x-ray photographers, and hospital administrators vied to establish a privileged demarcation between radiological science and photographic craft. Ultimately, radiologists supplanted x-ray photographers by leveraging the automation of x-ray machines and capitalizing on the epistemic shift from photographic objectivity to qualified interpretations. By focusing on this overlooked aspect of x-ray incorporation into hospitals, this work provides a unique perspective on how harnessing mechanization and authoritative medical interpretations can shift professional boundaries.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:美容医学传统上依靠临床量表来客观评估基线外观和治疗结果。然而,量表主要集中在有限的美学领域,这些量表固有的主观解释可能导致可变性,这破坏了标准化工作。
    目的:共识会议旨在建立AI在美学医学中的应用指南。
    方法:2024年2月,人工智能共识小组,由各种专业的国际专家组成,召开会议审议美学医学中的人工智能。该方法包括共识前调查和会议期间的迭代共识过程。
    结果:AI在美学医学中的实施在加强患者评估和咨询方面取得了充分共识,确保标准化护理。人工智能在防止过度校正方面的作用得到了认可,同时需要经过验证的客观面部评估。重点是使用面部美学指数(FAI)等指标进行全面的面部美学评价,面部青年指数(FYI),和皮肤质量指数(SQI)。这些评价是性别特异性的,并且在基线处排除化妆覆盖的皮肤。年龄和性别,以及病人的祖先根,被认为是人工智能评估过程不可或缺的部分,强调走向个性化,精确的治疗。
    结论:共识会议确定,人工智能将通过规范患者评估和咨询来显著改善美学医学,强烈支持防止过度纠正和提倡验证,客观的面部评估。利用FAI等指数,仅供参考,SQI允许按性别区分,年龄调整后的评估,并坚持不化妆的基线以确保准确性。
    BACKGROUND: Aesthetic medicine has traditionally relied on clinical scales for the objective assessment of baseline appearance and treatment outcomes. However, the scales focus on limited aesthetic areas mostly and subjective interpretation inherent in these scales can lead to variability, which undermines standardization efforts.
    OBJECTIVE: The consensus meeting aimed to establish guidelines for AI application in aesthetic medicine.
    METHODS: In February 2024, the AI Consensus Group, comprising international experts in various specialties, convened to deliberate on AI in aesthetic medicine. The methodology included a pre-consensus survey and an iterative consensus process during the meeting.
    RESULTS: AI\'s implementation in Aesthetic Medicine has achieved full consensus for enhancing patient assessment and consultation, ensuring standardized care. AI\'s role in preventing overcorrection is recognized, alongside the need for validated objective facial assessments. Emphasis is placed on comprehensive facial aesthetic evaluations using indices such as the Facial Aesthetic Index (FAI), Facial Youth Index (FYI), and Skin Quality Index (SQI). These evaluations are to be gender-specific and exclude makeup-covered skin at baseline. Age and gender, as well as patients\' ancestral roots, are to be considered integral to the AI assessment process, underlining the move towards personalized, precise treatments.
    CONCLUSIONS: The consensus meeting established that AI will significantly improve aesthetic medicine by standardizing patient assessments and consultations, with a strong endorsement for preventing overcorrection and advocating for validated, objective facial assessments. Utilizing indices such as the FAI, FYI, and SQI allows for gender-specific, age adjusted evaluations and insists on a makeup-free baseline for accuracy.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    从根本上说,精确肿瘤学说明了肿瘤的分子谱分析可以阐明其生物学行为的途径,多样性,以及通过识别不同的基因突变可能的结果,蛋白质水平,和其他支持癌症进展的生物标志物。下一代测序成为当前临床实践中诊断和治疗指导不可或缺的诊断工具。如今,组织分析受益于通过综合基因组分析和液体活检等方法的进一步支持。然而,肿瘤领域的精准医学存在特定的障碍,例如成本效益平衡和广泛的可及性,特别是在低收入和中等收入国家。一个关键问题是如何有效地将下一代测序扩展到所有癌症患者,从而赋予治疗决策权力。关注还延伸到组织样本的质量和保存,以及卫生技术的评估。此外,随着技术的进步,正在开发新的下一代测序评估,包括碎片组学的研究。因此,我们的目标是描述下一代测序的主要用途,讨论它的\'应用程序,局限性,和未来的路径在肿瘤学。
    Fundamentally precision oncology illustrates the path in which molecular profiling of tumors can illuminate their biological behavior, diversity, and likely outcomes by identifying distinct genetic mutations, protein levels, and other biomarkers that underpin cancer progression. Next-generation sequencing became an indispensable diagnostic tool for diagnosis and treatment guidance in current clinical practice. Nowadays, tissue analysis benefits from further support through methods like comprehensive genomic profiling and liquid biopsies. However, precision medicine in the field of oncology presents specific hurdles, such as the cost-benefit balance and widespread accessibility, particularly in countries with low- and middle-income. A key issue is how to effectively extend next-generation sequencing to all cancer patients, thus empowering treatment decision-making. Concerns also extend to the quality and preservation of tissue samples, as well as the evaluation of health technologies. Moreover, as technology advances, novel next-generation sequencing assessments are being developed, including the study of Fragmentomics. Therefore, our objective was to delineate the primary uses of next-generation sequencing, discussing its\' applications, limitations, and prospective paths forward in Oncology.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    为了评估可穿戴相机在医学检查中的实用性,我们创建了一个基于医生视图的视频考试问题和解释,调查结果表明,这些相机可以增强医学检查的评估和教育能力。
    UNASSIGNED: To assess the utility of wearable cameras in medical examinations, we created a physician-view video-based examination question and explanation, and the survey results indicated that these cameras can enhance the evaluation and educational capabilities of medical examinations.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Editorial
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    患有1型糖尿病的儿童及其照顾者面临着许多挑战,以应对这种复杂疾病的不可预测性。尽管管理糖尿病的负担仍然很大,新技术减轻了一些负担,并使1型糖尿病儿童能够实现更严格的血糖管理,而不必担心过多的低血糖。单独使用连续血糖监测仪可改善预后,被认为是儿科1型糖尿病管理的标准护理。同样,自动胰岛素输送(AID)系统已被证明对2岁以下的儿童是安全有效的。使用AID不仅可以改善血糖水平,还可以改善1型糖尿病儿童及其照顾者的生活质量,如果可用且负担得起,则应强烈考虑所有1型糖尿病青年。这里,我们回顾了在儿科人群中使用糖尿病技术的关键数据,并讨论了儿童和青少年特有的管理问题.
    Children with type 1 diabetes and their caregivers face numerous challenges navigating the unpredictability of this complex disease. Although the burden of managing diabetes remains significant, new technology has eased some of the load and allowed children with type 1 diabetes to achieve tighter glycaemic management without fear of excess hypoglycaemia. Continuous glucose monitor use alone improves outcomes and is considered standard of care for paediatric type 1 diabetes management. Similarly, automated insulin delivery (AID) systems have proven to be safe and effective for children as young as 2 years of age. AID use improves not only blood glucose levels but also quality of life for children with type 1 diabetes and their caregivers and should be strongly considered for all youth with type 1 diabetes if available and affordable. Here, we review key data on the use of diabetes technology in the paediatric population and discuss management issues unique to children and adolescents.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    患者参与临床试验对于医疗保健的发展至关重要。在招募患有急性疾病的试验参与者方面存在一些挑战。基于注册表的随机DAPA-MI临床试验招募了住院期间因心肌梗死的患者,并提供了带有智能瓶盖的研究药物,该瓶盖使用无线技术传输监测数据。这项访谈研究旨在调查患者参与临床试验的经验以及他们对新瓶盖技术的态度。
    参与DAPA-MI试验的一部分患者来自瑞典的四家医院。进行了半结构化访谈,并使用清单内容分析进行了分析。
    视频访谈包括21名患者(4名女性和17名男性)。中位年龄为59岁(范围44-80)。确定了四类患者的经历。贡献的意愿包括患者对参与的积极态度以及参与开发和研究的一部分。对信息的感知强调了口头信息的价值以及反思时间的重要性。处于脆弱状态,突显了在急性医疗条件下感知和记忆能力的受损。对新技术的适应描述了智能瓶盖评估依从性的总体积极经验。
    患者参与试验的经历总体上是积极的,但在急性心肌梗死中发现了一些挑战。智能瓶盖被广泛接受,尽管有些处理困难。
    UNASSIGNED: The participation of patients in clinical trials is crucial for the development of healthcare. There are several challenges in the recruitment of trial participants with acute medical conditions. The registry-based randomized DAPA-MI clinical trial recruited patients during hospitalization for myocardial infarction and provided study drugs in bottles with smart caps that used wireless technology to transmit monitoring data. This interview study aimed to investigate patients\' experience of participation in a clinical trial and their attitude to the new bottle cap technology.
    UNASSIGNED: A subset of patients participating in the DAPA-MI trial were recruited from four hospitals in Sweden. Semi-structured interviews were conducted and analysed using manifest content analysis.
    UNASSIGNED: Video interviews were performed including 21 patients (four women and 17 men). The median age was 59 years (range 44-80). Four categories of patients\' experiences were identified. A willingness to contribute consisted of patients\' positive attitudes to participation and to be a part of development and research. The perception of information emphasized the value of the oral information as well as the importance of time for reflection. Be in a vulnerable condition highlighted the impaired ability to perceive and remember in the acute medical condition. Adaptation to a new technology described the overall positive experiences of the smart bottle cap to evaluate adherence.
    UNASSIGNED: Patients\' experiences of trial participation were in general positive but some challenges in the acute setting of a myocardial infarction were revealed. The smart bottle cap was well accepted, despite some handling difficulties.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:随着许多机器人手术设备正在开发中并即将进入市场,机器人辅助手术领域正在迅速发展。目前,没有普遍接受的语言来标记不同的机器人系统。为了促进这种交流,我们创造了什么,根据我们的知识,组织和分类用于内窥镜检查的手术机器人的手术机器人技术的第一个分类,腹腔镜和胸腔镜。
    方法:我们编制了一份旨在用于内窥镜检查的手术机器人清单,腹腔镜检查,和/或通过搜索美国的胸腔镜检查,欧洲,香港,Japan,和韩国认可的设备数据库。添加了在2023年机器人外科学会年会上展示的设备。我们还系统地回顾了任何现有手术机器人分类或分类的文献。然后,我们创建了一个由8名外科医生和2名工程师组成的多学科委员会,以构建我们搜索中包含的设备的拟议分类。
    结果:我们确定了40个用于内窥镜检查的机器人手术系统,腹腔镜和/或胸腔镜。拟议的分类将机器人设备组织在建筑方面,端口设计,和配置(模块化推车,多臂集成推车,表连接或臂表集成)。
    结论:用于内窥镜检查的机器人手术设备的3级分类,腹腔镜和/或胸腔镜系统地描述了机器人设备的重要特征。
    BACKGROUND: The field of robotic-assisted surgery is rapidly growing as many robotic surgical devices are in development and about to enter the market. Currently, there is no universally accepted language for labeling the different robotic systems. To facilitate this communication, we created what is, to our knowledge, the first classification of surgical robotic technologies that organizes and classifies surgical robots used for endoscopy, laparoscopy and thoracoscopy.
    METHODS: We compiled a list of surgical robots intended to be used for endoscopy, laparoscopy, and/or thoracoscopy by searching United States, European, Hong Kong, Japan, and Korean databases for approved devices. Devices showcased at the 2023 Annual Meeting for the Society of Robotic Surgery were added. We also systematically reviewed the literature for any existing surgical robotic classifications or categorizations. We then created a multidisciplinary committee of 8 surgeons and 2 engineers to construct a proposed classification of the devices included in our search.
    RESULTS: We identified 40 robotic surgery systems intended to be used for endoscopy, laparoscopy and/or thoracoscopy. The proposed classification organizes robotic devices with regard to architecture, port design, and configuration (modular carts, multi-arm integrated cart, table-attachable or arm-table integration).
    CONCLUSIONS: This 3-level classification of robotic surgical devices used for endoscopy, laparoscopy and/or thoracoscopy describes important characteristics of robotic devices systematically.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    获得医疗技术是普遍获得护理的关键组成部分;然而,儿童技术的进步历来落后于成人。市场规模小,解剖和生理变异性,以及法律和道德影响对开发和商业化儿科生物医学创新构成了独特的障碍。这些挑战在低资源环境(LRS)中被放大,往往缺乏适当的监管监督,支持服务合同,和供应链能力。COVID-19大流行暴露了传统医疗技术行业模式的缺陷,同时也促进技术开发和传播的开源方法。开源途径-产品可以自由许可分发和修改-解决了关键设备的关键短缺。相关地,我们认为,开源方法可以加速儿科全球卫生技术的发展。开源方法可以独立于经济因素而适应临床挑战,拥抱低成本制造技术,并且可以高度定制。此外,不同的利益相关者,包括家属和病人,被授权参与合作社区的实践。如何规范发展,制造,开源技术的分发仍然是一个正在进行的探索领域。对民主化创新的需求必须与针对儿科特定解决方案的安全和质量的必要性进行仔细平衡。这是可以实现的,在某种程度上,通过国家监管机构和分散网络之间的密切协调,产品可以进行同行评审和测试。总之,开源在为所有儿童推进更公平和可持续的医疗创新方面具有巨大潜力。
    Access to medical technologies is a critical component of universal access to care; however, the advancement of technologies for children has historically lagged behind those for adults. The small market size, anatomic and physiologic variability, and legal and ethical implications pose unique barriers to developing and commercialising paediatric biomedical innovations. These challenges are magnified in low-resource settings (LRS), which often lack appropriate regulatory oversight, support for service contracts, and supply chain capacity. The COVID-19 pandemic exposed shortcomings in the traditional industry model for medical technologies, while also catalysing open-source approaches to technology development and dissemination. Open-source pathways - where products are freely licenced to be distributed and modified - addressed key shortages in critical equipment. Relatedly, we argue that open-source approaches can accelerate paediatric global health technology development. Open-source approaches can be tailored to clinical challenges independent of economic factors, embrace low-cost manufacturing techniques, and can be highly customisable. Furthermore, diverse stakeholders, including families and patients, are empowered to participate in collaborative communities of practice. How to regulate the development, manufacture, and distribution of open-source technologies remains an ongoing area of exploration. The need for democratised innovation must be carefully balanced against the imperatives of safety and quality for paediatric-specific solutions. This can be achieved, in part, through close coordination between national regulatory agencies and decentralised networks where products can be peer-reviewed and tested. Altogether, there is significant potential for open source to advance more equitable and sustainable medical innovations for all children.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    斯坦福生物设计以需求为中心的框架可以指导医疗保健创新者成功采用“确定,发明和实施“框架”并开发新的医疗保健创新产品,以满足患者的需求。本范围审查探讨了斯坦福生物设计框架在医疗保健创新培训和新型医疗保健创新产品开发中的应用。从各自的成立日期到2023年4月,共搜索了七个电子数据库:PubMed,Embase,CINAHL,PsycINFO,WebofScience,Scopus,ProQuest论文,和全球主题。本审查是根据系统审查的首选报告项目和范围审查的荟萃分析扩展进行报告的,并以Arksey和O'Malley的范围审查框架为指导。研究结果使用Braun和Clarke的主题分析框架进行分析。从26篇文章中确定了三个主题和八个次主题。主要主题是:(1)在医疗保健创新上留下印记,(2)成功背后的秘密,(3)下一步。斯坦福生物设计框架指导医疗保健创新团队开发新的医疗产品,并通过培训计划和新产品的开发实现更好的患者健康结果。采用斯坦福生物设计方法的培训计划被发现在提高学员的创业精神方面是成功的,创新,和领导技能,应继续得到推广。为了帮助创新者将他们新开发的医疗产品商业化,额外的支持,例如为早期创业公司获得资金,让临床医生和用户参与产品测试和验证,并且需要为新的医疗保健产品建立新的指南和协议。
    The Stanford Biodesign needs-centric framework can guide healthcare innovators to successfully adopt the \'Identify, Invent and Implement\' framework and develop new healthcare innovations products to address patients\' needs. This scoping review explored the application of the Stanford Biodesign framework for healthcare innovation training and the development of novel healthcare innovative products. Seven electronic databases were searched from their respective inception dates till April 2023: PubMed, Embase, CINAHL, PsycINFO, Web of Science, Scopus, ProQuest Dissertations, and Theses Global. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews and was guided by the Arksey and O\'Malley\'s scoping review framework. Findings were analyzed using Braun and Clarke\'s thematic analysis framework. Three themes and eight subthemes were identified from the 26 included articles. The main themes are: (1) Making a mark on healthcare innovation, (2) Secrets behind success, and (3) The next steps. The Stanford Biodesign framework guided healthcare innovation teams to develop new medical products and achieve better patient health outcomes through the induction of training programs and the development of novel products. Training programs adopting the Stanford Biodesign approach were found to be successful in improving trainees\' entrepreneurship, innovation, and leadership skills and should continue to be promoted. To aid innovators in commercializing their newly developed medical products, additional support such as securing funds for early start-up companies, involving clinicians and users in product testing and validation, and establishing new guidelines and protocols for the new healthcare products would be needed.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

公众号