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Introduction: In order to improve caries detection, invasive methods should not be used and caries detector is useful, and antibacterial solutions can be used as well as a biological method for caries detection. Aim of the present study was to differentiate sound dentin from infectious dentin by two coloring solutions: acid red and povidone iodine. Methods: In this experimental investigation, 140 carious molar teeth were collected. Teeth were kept in normal saline solution in room temperature and were divided into two groups, A and B (70 samples in each group). Teeth in group A were painted by acid red 1% solution and in group B by povidone iodine 10% and the painted points were recorded. After omission of the painted points, all samples of group A were painted by povidone iodine (group C) and all samples of group B by acid red (group D) and the painted points were recorded again. Data was analyzed using chi-square and Mc-Nemar tests. Results: Diagnostic accuracy of acid red for detection of dental caries was more than povidone iodine and the difference was statistically significant (P< 0.05). Conclusion: It was concluded that the coloring power and accuracy of acid red is more than povidone iodine.

Images and videos are widely used to elicit emotions; however, their visual appeal differs from real-world experiences. With virtual reality becoming more realistic, immersive, and interactive, we envision virtual environments to elicit emotions effectively, rapidly, and with high ecological validity. This work presents the first interactive virtual reality dataset to elicit emotions. We created five interactive virtual environments based on corresponding validated 360° videos and validated their effectiveness with 160 participants. Our results show that our virtual environments successfully elicit targeted emotions. Compared with the existing methods using images or videos, our dataset allows virtual reality researchers and practitioners to integrate their designs effectively with emotion elicitation settings in an immersive and interactive way.

Objectives: Hand hygiene has long been promoted as the most effective way to prevent the transmission of infection. However, due to low compliance and low quality of hand hygiene reported in previous studies, constant monitoring of hand hygiene compliance and quality among healthcare workers is crucial. This study investigated the feasibility of using a thermal camera with an RGB camera to detect hand coverage of alcohol-based formulation, thereby monitoring the quality of hand rubbing., Methods: In total, 32 participants were recruited to participate in this study. Participants were required to perform four types of hand rubbing to achieve different coverage of the alcohol-based formulation. After each task, participants' hands were photographed under a thermal camera and an RGB camera, while an ultraviolet (UV) test was used to provide the ground truth of hand coverage of alcohol-based formulation. U-Net was used to segment areas exposed to alcohol-based formulation from thermal images, and system performance was evaluated by comparing differences in coverage between thermal images and UV images in terms of accuracy and Dice coefficient., Results: This system found promising results in terms of accuracy (93.5%) and Dice coefficient (87.1%) when observations took place 10 s after hand rubbing. At 60 s after hand rubbing, accuracy and Dice coefficient were 92.4% and 85.7%., Conclusions: Thermal imaging has potential for accurate, constant and systematic monitoring of the quality of hand hygiene., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The World Health Organization (WHO) recommends a six-step hand hygiene technique. Although multiple studies have reported that this technique yields inadequate skin coverage outcomes, they have relied on manual labeling that provided low-resolution estimations of skin coverage outcomes. We have developed a computational system to precisely quantify hand hygiene outcomes and provide high-resolution skin coverage visualizations, thereby improving hygiene techniques. We identified frequently untreated areas located at the dorsal side of the hands around the abductor digiti minimi and the first dorsal interosseous. We also estimated that excluding Steps 3, 6R, and 6L from the six-step hand hygiene technique leads to cumulative coverage loss of less than 1%, indicating the potential redundancy of these steps. Our study demonstrates that the six-step hand hygiene technique could be improved to reduce the untreated areas and remove potentially redundant steps. Furthermore, our system can be used to computationally validate new proposed techniques, and help optimise hand hygiene procedures., (© 2022. The Author(s).)

Background: The use of location-based data in clinical settings is often limited to real-time monitoring. In this study, we aim to develop a proximity-based localization system and show how its longitudinal deployment can provide operational insights related to staff and patients' mobility and room occupancy in clinical settings. Such a streamlined data-driven approach can help in increasing the uptime of operating rooms and more broadly provide an improved understanding of facility utilization., Objective: The aim of this study is to measure the accuracy of the system and algorithmically calculate measures of mobility and occupancy., Methods: We developed a Bluetooth low energy, proximity-based localization system and deployed it in a hospital for 30 days. The system recorded the position of 75 people (17 patients and 55 staff) during this period. In addition, we collected ground-truth data and used them to validate system performance and accuracy. A number of analyses were conducted to estimate how people move in the hospital and where they spend their time., Results: Using ground-truth data, we estimated the accuracy of our system to be 96%. Using mobility trace analysis, we generated occupancy rates for different rooms in the hospital occupied by both staff and patients. We were also able to measure how much time, on average, patients spend in different rooms of the hospital. Finally, using unsupervised hierarchical clustering, we showed that the system could differentiate between staff and patients without training., Conclusions: Analysis of longitudinal, location-based data can offer rich operational insights into hospital efficiency. In particular, they allow quick and consistent assessment of new strategies and protocols and provide a quantitative way to measure their effectiveness., (©Gabriele Marini, Benjamin Tag, Jorge Goncalves, Eduardo Velloso, Raja Jurdak, Daniel Capurro, Clare McCarthy, William Shearer, Vassilis Kostakos. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 27.10.2020.)

Objectives: Legal analysis can highlight important issues that are relevant when deciding whether a medical technology should be implemented or reimbursed. Literature and studies show that even though the law is an acknowledged part of health technology assessment (HTA), legal issues are rarely considered in practice. One reason for this may be the lack of knowledge about the diversity of legal issues that are relevant for HTA. Therefore, this contribution aims primarily to identify and then explain the relevant legal issues in HTA. This study offers a framework for identifying the legal issues in HTAs in different jurisdictions and provides a basis for further research., Methods: After extensive literature search, the authors review Swiss health law to identify legal issues that are relevant to HTA. The authors then categorize these legal issues using a framework with an inside and outside perspective. Finally, they explain a selection of these legal issues with several examples., Results: This study reveals numerous legal issues that are relevant for HTA and underlines the necessity of incorporating legal analysis in HTAs. The suggested perspectival framework in this study provides a basis to structure the legal analysis. The identified legal issues are relevant in other countries and the perspectival framework is transferable to other jurisdictions., Conclusions: The article underlines the importance of in-depth discussion about the role of law in HTA. It provides a structured overview of the legal issues in HTA and suggests a development of more concrete instruments toward a standardized legal technology assessment.

Background: The rising incidence of melanoma - Switzerland has the highest incidence in Europe - is a major public health challenge. Swiss dermatologist introduced the "Swiss Skin Cancer Day" (SSCD) in 2006, which provides skin cancer screening at no costs. The aim of the study was to describe the participating subjects and their motivation and investigate factors influencing the probability of a clinical diagnosis of skin malignancy., Methods: 150 dermatologists were involved in the SSCD in May 2012. Dermatologists were not remunerated. Participants had the opportunity to show a single skin lesion to a dermatologist at no cost. A questionnaire for each participating subject collected data about subjects' age, sex, risk factors and reason for encounter; furthermore the dermatologist noted down clinical diagnosis and further management. We used descriptive statistics to report characteristics of participants and skin lesions. We built two multiple logistic regression models, one regarding the clinical diagnosis of skin malignancy and one regarding the further management., Results: 5266 subjects (55.6% female) were assessed; in 308 (5.8%) participants a clinical diagnosis of skin malignancy was found. In 1732 participants (32.9%) a clinical follow up or an excision was recommended. In the multiple logistic regression model age, sex, skin phototype and the reason for participation at the SSCD were found as significant risk factors regarding the clinical diagnosis of skin malignancy. Participants with skin cancer risk factors were more likely to get a clinical follow up recommended even if the clinical diagnosis was benign., Conclusion: A self-perceived suspicious lesion was the strongest predictor for a clinical diagnosis of skin malignancy at the SSCD. This suggests that skin self-examination might also work in general population. Future research should focus on better access to a specialist in case a suspicious skin lesion was discovered. Safety and quality of the SSCD should be further investigated, especially concerning the discrepancy between the low number of malignant lesions and the high quantity of participants where further clinical examinations or interventions were recommended.

Significant reasons militate for the implementation of clinical autopsies: On the part of physicians and nurses, there is quality assurance, establishment of legal certainty regarding possible accusations of medical errors and development of treatment methods. On the part of patients and their relatives, there is consolation and relief in cases of unexpected death, insight into genetic dispositions and insurance law concerns, to name only a few. However, a continuing decrease of clinical autopsies can be observed in Switzerland, Germany and Austria. The thesis asserting that the often required informed consent of the deceased during his/her lifetime or of close relatives is a crucial reason for this decrease needs to be called into question due to recent studies. Mainsprings are rather structural reasons, such as the often deficient communication with the patient or close relatives, economic reasons, namely the frequently insufficient remuneration for the clinical autopsy, organizational causes, in particular the repeatedly encountered suboptimal collaboration between the individual departments and the pathology department, the high administrative effort and probably the decreasing appreciation of the clinical autopsy.

Background: To evaluate the safety of acupuncture in a large number of patients receiving conventional health care and, based on these results, to develop a new medical consent form for acupuncture., Methods: The prospective observational study included patients who received acupuncture treatment for chronic osteoarthritis pain of the knee or hip, low back pain, neck pain or headache, allergic rhinitis, asthma, or dysmenorrhoea. After treatment, all patients documented adverse events associated with acupuncture (defined as adverse effects). Patients who reported a need for treatment due to an adverse effect completed an additional standardised questionnaire on the most important adverse effect. Based on this data and considering ethical and legal aspects a new consent form was developed., Results: A total of 229,230 patients received on average 10.2 +/- 3.0 acupuncture treatments. Altogether, 19,726 patients (8.6%) reported experiencing at least one adverse effect and 4,963 (2.2%) reported one which required treatment. Common adverse effects were bleedings or haematoma (6.1% of patients, 58% of all adverse effects), pain (1.7%) and vegetative symptoms (0.7%). Two patients experienced a pneumothorax (one needed hospital treatment, the other observation only). The longest duration of a side effect was 180 days (nerve lesion of the lower limb). The resulting medical consent form consists of five modules: Introduction to acupuncture and moxibustion, Risks of acupuncture treatment, Conditions which can increase the risk, Doctor's statement, and Consent., Conclusion: Acupuncture provided by physicians is a relatively safe treatment and the proposed consent form could support both patients and professionals in the process of obtaining informed consent., (Copyright (c) 2009 S. Karger AG, Basel.)

Background: In the United States, lawsuits against physicians have had an impact on their behaviour, resulting in overdiagnosis and other forms of 'defensive medicine'. Does a similar situation exist in Switzerland? Using prostate-specific antigen (PSA) screening as an example, we surveyed Swiss physicians and assessed the extent to which liability fears influenced their recommendation for testing., Methods: At a continuing medical education conference we distributed a pilot-tested questionnaire to 552 participants. Two hundred and fifty of them (45%) completed the questionnaire., Results: Of the participants, 158 (68%) were general practitioners and 73 (32%) specialists in internal medicine. Seventy-five per cent of both groups recommend regular PSA screening to men older than age 50. Yet only 56% of the general physicians and 53% of the internists believe that PSA measurement is an effective screening method. A substantial proportion of the physicians - 41% of general practitioners and 43% of internists - reported that they sometimes or often recommend this test for legal reasons., Conclusions: Defensive medicine is not a phenomenon particular to the USA, but is also observable in Switzerland. This result is surprising, given that in Switzerland and other European countries, a physician who does not recommend a test or treatment whose effectiveness is controversial need not fear litigation.