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Perceptions of telemedicine at a pediatric otolaryngology-head and neck surgery program

World Journal of Pediatric Surgery 2022年第4期5卷 282-288页

作者： Claire Gwilt Gregory Metzger Kris Jatana Tran Bourgeois patrick walz The Ohio State University College of Medicine ColumbusOhioUSA Department of Surgery The Ohio State University Wexner Medical CenterColumbusOhioUSA Department of Pediatric Surgery Nationwide Children's HospitalColumbusOhioUSA Department of Pediatric Otolaryngology Nationwide Children's HospitalColumbusOhioUSA Center for Surgical Outcomes Research Nationwide Children's HospitalColumbusOhioUSA Department of Otolaryngology The Ohio State University Wexner Medical CenterColumbusOhioUSA

Objective With few studies investigating the effectiveness of telemedicine(TM)in pediatric otolaryngology(ear,nose,and throat;ENT),its role in clinical practice is unclear.The objective of this study was to investigate provider perspectives regarding utility of TM in pediatric ENT practice.Methods A survey gauging the relative merits of TM visits for common pediatric ENT chief complaints and postoperative visits was distributed to all pediatric ENT providers at a tertiary care,free-standing children’s hospital.Respondents were asked to assess the effectiveness of TM visits compared with in-person visits for completing the following tasks:history collection,physical examination,medical decision-making,and patient counseling.Results Providers rated TM visits as less useful than in-person visits for completing the most predefined tasks but did identify advantages in history taking via TM for the majority of complaints.Compared with providers with≥10 years of experience,those with<10 years of experience found TM to be more effective than the in-person appointment for making clinical decisions for patients presenting with recurrent/chronic pharyngitis,neck masses,and stridor/noisy breathing.Opinions regarding the utility of TM for postoperative visits were mixed,with adenoidectomy,tonsillectomy and superficial procedures being most frequently deemed appropriate for TM.Conclusions The introduction of TM to pediatric ENT faces limitations in detailed examination of areas not accessible without specialized instrumentation.Due to its strength in history taking,results suggest an asynchronous,‘store and forward’encounter followed by an in-person physical examination to confirm the diagnosis and treatment plan could be beneficial.

关键词： pediatric superficial diagnosis

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Leaf Wand for Measuring Chlorophyll Fluorescence on Cylindrical Leaves and Its Application on <i>Juncus roemerianus</i>(Black Needlerush)

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American Journal of Plant Sciences 2012年第1期3卷 75-83页

作者： patrick D. Biber 不详

Chlorophyll fluorescence is a well established technique to rapidly and non-invasively determine photosynthesis parameters in plant leaves. It can be used in both laboratory and field settings, and frequently dark-adaptation of a leaf sample is called for. In the field, this can be accomplished on flat leaves using standard leaf clips supplied by instrument manufacturers. However, not all plant leaves are flat, many are cylindrical or otherwise three-dimensional in shape. The standard leaf clip does not close fully on three-dimensional leaves, therefore, does not allow the sample to be properly dark adapted in the field. A new leaf “wand” was developed that can be slipped over an entire cylindrical leaf or culm of rushes and sedges for both light- and dark-adapted measurements. This new leaf wand is compared to the standard leaf clip (DLC-8) using a walz mini-PAM on Juncus roemerianus(Black needlerush). Results indicate that dark-adapted yield measurements are not significantly different between leaf clips, while light-adapted yields are higher with the leaf wand. The potential sources of difference in the optical path of the excitation light and fluorescence return are discussed and compared between leaf clips. Construction of specialized leaf wands should be considered for any leaves are not flat and therefore that do not fit the standard leaf clip for complete dark-adaptation under field conditions.

关键词： Juncus roemerianus Chlorophyll Fluorescence Leaf Clip Cylindrical Leaf Optical Path Length

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