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Medscape
2 days ago
- Health
- Medscape
Wireless Face e-Tattoo Tracks Mental Strain and Workload
A temporary electronic forehead tattoo that wirelessly measures brainwaves and eye movement may offer an accurate measurement of mental workload (MWL) and mental strain, new research suggested. E-tattoo to track mental workload in real time Using a lightweight battery and thin sensors, the e-tattoo was able to reliably collect electroencephalography (EEG) and electrooculography (EOG) data to estimate MWL in a small study of six participants as they completed increasingly difficult memory tests. The technology is a less bulky and cheaper alternative to conventional brain activity monitors and may help track the mental workload of workers in safety-critical jobs like aviation, air traffic control, and healthcare. Researchers say it also has applications for neurological monitoring of patients with epilepsy or to monitor cognitive decline. 'Our wireless electronic tattoo stands out for its ultrathin, skin-conformal design, which allows for stable EEG/EOG signal acquisition even during dynamic activities like walking or facial movements,' investigator Nanshu Lu, PhD, professor and chair of engineering, The University of Texas at Austin, told Medscape Medical News . 'Unlike other platforms like headbands or glasses, our tattoo is helmet-compatible, low-profile, and uses low-cost disposable materials, making it uniquely suitable for real-world deployment.' The findings were published online on May 29 in the journal Device . Study Details and Performance There is no universally accepted definition of MWL, but it can generally be described as the degree to which a person's working memory capacity and cognitive processes are engaged by an ongoing task, the authors noted. MWL levels can be assessed using subjective self-assessment questionnaires like the post-task NASA Task Load Index, as well as physiological measures such as heart rate, galvanic skin response, EEG, and EOG. The wireless e-tattoo features stretchable serpentine-shaped, graphite-deposited polyurethane electrodes coated with an adhesive poly(3,4-ethylenedioxythiophene) poly-styrene sulfonate composite to reduce impedance and improve adhesion to the skin. The e-tattoo is integrated with a battery-powered flexible printed circuit that transmits EEG and EOG data in real-time via Bluetooth Low Energy. To evaluate the e-tattoo efficacy, the researchers analyzed EEG and EOG signals collected on six healthy participants wearing the wireless forehead e-tattoo during cognitive tasks designed to measure working memory, called dual N-back tasks. Self-assessment using the NASA–Task Load Index, task performance metrics, and physiological features were also collected. Each participant completed a single experiment session lasting approximately 2.5 hours, which included three runs of N-back trials. 'This single-session design was sufficient to train individualized models, although variability between participants was observed, especially in the relative importance of EEG vs EGO features,' Lu said. As the cognitive workload increased, frontal delta- and theta-band powers increased, while alpha-, beta-, and gamma-band powers decreased. The authors noted this is in line with studies linking theta-band power to an increase in working memory load and increasing MWL with a decrease in alpha power and increase in frontal theta power. To test the viability of mental workload estimation using the e-tattoo, the researchers then built a random forest model to predict the level of mental workload experienced by participants during the N -back tasks. They found that the model successfully estimated the mental workload for all N levels for all six participants. 'Key findings of our study show that the wireless forehead e-tattoo reliably captures forehead EEG and EOG signals, and these signals can be used to accurately estimate mental workload during a dual N-back task, which is a widely used standard mental workload test,' Lu said. 'Our model achieved robust classification of cognitive load levels using only minimally processed physiological data.' The Road Ahead For forehead EEG/EOG–driven workload detection, the e-tattoo system is already self-sufficient but integration with other physiological sensors such as heart rate or galvanic skin response could improve accuracy and robustness in mental workload vs mental stress differentiation, Lu noted. 'In medical settings, this technology could be very useful for neurological monitoring, including early detection of cognitive decline, noninvasive epilepsy tracking, and assessing patient engagement during neurorehabilitation,' she said. 'Its comfort and unobtrusiveness make it especially appealing for pediatric or geriatric use.' The temporary e-tattoo also holds a cost advantage over traditional EEG systems, with the e-tattoo chips and battery pack priced at $200 and disposable sensors about $20 each. 'Being low-cost makes the device accessible,' study co-author Luis Sentis, PhD, also from The University of Texas at Austin, said in a news release. 'One of my wishes is to turn the e-tattoo into a product we can wear at home.' Currently, the e-tattoo works only on hairless skin but the researchers are working to combine it with ink-based sensors that work on hair. For this new study, Lu also noted that EEG signals were postprocessed and the predictions done offline. 'To make this technology really valuable, we can and need to achieve real-time mental workload assessment and provide timely micro-interventions, such as visual or audio alerts on the phone or even electro tactile stimulations applied to the skin by the e-tattoo before performance decline or burnout occurs,' she said. 'Evaluating these micro-interventions in real-world applications may prove our EEG system's capacity to significantly improve human-AI collaborations,' Sentis told Medscape Medical News .
Medscape
3 days ago
- Business
- Medscape
Physician Associates Continue to Embrace Telehealth
The use of telehealth continues to grow across the healthcare industry, including among physician associates (PAs). As noted in the American Academy of Physician Associates' (AAPA's) 2025 Salary Report, an annual survey that explores PA pay and practice insights, a remarkable 49% of PAs reported using telemedicine applications as part of their clinical work in the past year. Sean Kolhoff, senior research analyst with AAPA, said these results were not surprising, per se, but do show that there is now a growing acceptance of the efficacy of telehealth in PA practice. 'Compared to pre-COVID estimates of telehealth use among PAs — 9.6% in 2019 — it appears that PAs have been able to adapt the technology to best meet their specific practice needs,' he explained. 'This is emphasized by the specialties that have generally continued to use telehealth post-pandemic: 76.2% in primary care and 56.6% in internal medicine. These specialties perform many tasks, like initial diagnoses and patient follow-ups, that can effectively utilize telehealth.' About Medscape Data Medscape continually surveys physicians and other medical professionals about key practice challenges and current issues, creating high-impact analyses. For example, Medscape's Top 10 Telemedicine-Friendly States 2025 found that States have continued to update telehealth policies since the pandemic. A state's telehealth success also includes available connectivity for patients. States continue to invest in digital infrastructure to enhance connectivity. Tele-social work, tele-rehabilitation, and tele-occupational health are also on the rise. Dane Thomas, PA-C, MMS, a PA who specializes in hematology and oncology, said telemedicine use skyrocketed during the COVID-19 pandemic — and showed its value to healthcare providers and patients alike. 'The rapid adoption of these tools, which were accelerated just out of necessity, helped us see the benefits,' he explained. 'You see that a lot of patients like the flexibility and convenience of telehealth. And, as a provider, it's nice to be easily connected with patients through telehealth. It really gives us more flexibility. When we can see patients from home or from the office a couple days of the week, it lends itself to a better work-life balance.' Critics of telehealth sometimes say that nothing can beat the quality of an in-person appointment. Yet, research studies, particularly in primary care, suggest its use does not negatively affect patient outcomes. And with continuing workforce shortages, as well as concerns about patient access to care, telehealth applications provide a way for PAs, as well as physicians and nurse practitioners, to reach more people. 'I'd love to see it expand more in rural medicine,' said Thomas. 'I think we can give better access to care to patients who live in rural areas with telemedicine. Not just with primary care but also with specialty medicine. As it is, it's just really hard to get doctors in those areas.' Yet, as healthcare organizations consider the best ways to implement telemedicine, Tiffany Ryder, PA-C, said, 'The devil is in the details.' Ryder, who does not use telemedicine in her current role but did conduct appointments online regularly during the pandemic, said many health plans and hospitals are looking at how to best increase access to medical care without sacrificing quality. So, in her nonclinical role, advising those organizations about how to strike such a balance, telehealth, she said, comes up again and again. 'When telehealth should be used really comes down to the details and nuance of the situation you are trying to address,' she said. 'It's definitely not a one-size-all tool that can replace in-person visits.' For example, she said telemedicine works best when there is continuity of care. For patients who have a chronic medical condition and see the same primary care provider regularly, telehealth applications can be of great benefit. 'When you know your provider and they know you, you don't always need to come into the office to have a question answered or a prescription filled,' Ryder explained. 'That not only is more convenient for the patient but it also increases a PA's availability to see other patients who may be coming to urgent care or the emergency room [ER] for a more acute issue.' Furthermore, she said, telemedicine can also act as a 'super-educated triage nurse' to help determine where to best allocate provider resources in emergency and urgent care settings. 'If you are a parent, and your child falls off a bunk bed and hits their head, you don't have the knowledge or skills to make a decision about whether your kid needs to go to the ER,' she said. 'But if you can connect via telehealth with a PA on your way to the ER, tell that person what happened and let them ask those important red flag questions; they can then tell you whether you need to come in or whether you can go home and monitor the situation. You can better manage your provider resources, and I think that's a really great place where telemedicine can shine.' Thomas, for his part, hopes that more organizations will work to identify both the positives and negatives of telehealth use to make sure it is deployed in the right scenarios to enhance patient care. And, as Ryder said, the devil may be in the details of its continued use; both she and Thomas agreed that telehealth adoption will continue to grow in the future. Kolhoff added the AAPA's finding that telehealth use continues to increase speaks to the fact that 'PAs are adaptable to new and emerging technology that can improve the patient's experience and ability to access high-quality healthcare in a timely manner.' 'What the future may look like, no one knows,' he said. 'What we do know is that PAs will continue to adapt to new technologies as needed to ensure that patient needs are being met.'
Medscape
4 days ago
- Business
- Medscape
Understanding Gaps in OS Data for Melanoma Adjuvant Therapy
This transcript has been edited for clarity. Welcome back, everybody. My name is Teresa Amaral, and it's a real pleasure to have you here for this melanoma series on Medscape. We have talked in the last two episodes about the current status of adjuvant therapy and its benefit in patients with stage III melanoma, and in the last episode we discussed the absence of overall survival (OS) benefit. You may question why it is important to have this discussion in terms of the absence of OS benefit or the absence of data on the OS benefit. This absence of data might have three consequences, and I'm going to go through them with you. The first one is associated with reimbursement. The fact that we will need to wait until 2028, most likely, to evaluate the OS benefit from adjuvant therapy compared to placebo in stage III might lead to some discussions in terms of the reimbursement and might lead some agencies to consider whether they would like to continue reimbursing this therapy or not in this setting. Second, in some countries, the absence of OS data is leading to discussions on whether they will fund this therapy or not until there is clear proof that there is an OS benefit. The third point is related to the fact that we don't knowthe patient's individual benefit. We also know that, depending on the stage, we might need to treat more patients to actually have one patient to prevent a recurrence. For example, we know that in patients in stage IIB, we will have to treat between five and nine patients in stage IIB to prevent a recurrence. In patients with stage IIC, we need to treat between four and seven patients to prevent a recurrence. All of these cost-effectiveness analyses are being done by the healthcare agencies, and this obviously needs to be taken into consideration when we are discussing these types of therapiesthat have a benefit in terms of relapse-free survival and distant metastasis-free survival but lack data in terms of OS benefit. Another point is that, despite the fact that all the guidelines have been supporting the use of this therapy in stage III and stage IV — namely the ESMO guidelines and the ASCO guidelines— there is some uncertainty in terms of the OS benefit. This may lead to some difficult discussions and a lack of clear direction in terms of whatpatients should do when they need to make a decision on receiving adjuvant therapy or not. The patients and their treating physicians may struggle with treatment choices due to this uncertainty and the fact that they don't know if there will be a long-term survival impact for this particular patient or not. Here, we come to the first discussion that we had a couple of sessions before, which is the absence of prognostic and predictive biomarkers in this setting. Besides that, we really don't know the impact of these adjuvant treatments in terms of long-term benefitwhen we talk about OS, which might lead to reduced use of these therapies in stage III and stage II. This decline in terms of use of these adjuvant therapies has already been seen in some countries, like in Denmark.
Medscape
4 days ago
- General
- Medscape
Guide Helps Assess Child Abuse–Related Head Injury
The Child and Youth Maltreatment Section of the Canadian Paediatric Society (CPS) has released a new Practice Point for the assessment of children with suspected traumatic head injury related to child maltreatment (THI-CM). This type of injury 'is not rare and frequently results in significant morbidity for the child and family,' the CPS told Medscape Medical News in email correspondence. 'Healthcare providers have important roles to play,' according to the new guidance. These include 'identifying and treating these children, reporting concerns of child maltreatment to child welfare authorities, assessing for associated injuries and medical conditions, supporting children and their families, and communicating medical information clearly to families and other medical, child welfare, and legal professionals.' The Practice Point was published online in Paediatrics & Child Health. 'Red Flags' Although no single injury is pathognomonic for CM, there are several 'red flags' that should prompt a healthcare provider to consider THI-CM, the CPS said. 'These include elements of the history, clinical presentation, and radiographic findings.' Red flags in the history include: No history of a traumatic event Reported mechanism of injury that is incompatible with the injury Injury event incompatible with the child's development Unexplained or unreasonable delay in presenting for medical care Repeated unexplained symptoms suggestive of head injury Red flags in the clinical presentation include: Head injury with apnea Intracranial injury and seizures Intracranial injury and retinal hemorrhages Red flags in the radiographic findings include: Subdural hemorrhages (intracranial, spinal) Cerebral ischemia, often multifocal Cerebral edema Rib fractures Classic metaphyseal fractures (corner or 'bucket handle' fractures in infants) Absent or incompatible history of trauma and: Skull fracture with intracranial injury Long bone fracture(s) with intracranial injury CPS also noted that the term THI-CM 'was chosen through an iterative process to reflect the current language (traumatic head injury) used by health professionals, separated from the opinion on the cause of the injury (level of concern for child maltreatment).' The terms 'shaken baby syndrome,' 'abusive head trauma,' 'non-accidental head injury,' and 'inflicted traumatic brain injury' are no longer recommended for use in Canada, they added. What to Do When Abuse Is Suspected If clinicians are concerned that CM may have occurred, they should approach the case with an open mind, be aware of possible bias, and have compassion for the child and family, according to the Practice Point. Other recommendations include: The patient's medical needs should be managed first, but medicolegal steps should also be considered. Clinicians need to recognize that the differential diagnosis for injuries includes trauma, medical conditions, mimics of injury, or any combination of these. During the physical examination, clinicians should be especially vigilant for seizures, which are common in infants who have sustained a symptomatic head injury due to maltreatment. Laboratory testing can be conducted to assess medical status, screen for unseen injuries, and evaluate for possible medical disorders. A CT scan of an infant or child's head is the neuroimage of first choice, and MRI is an appropriate alternative or adjunct in some cases. Provincial and territorial laws require that clinicians report any concerns of possible CM to their local child welfare agency. The Practice Point also stated that a pediatrician specialized in CM 'can help guide clinical assessment and communication with families, healthcare professionals, child welfare, and law enforcement.' Consultation with other specialists, including critical care, ophthalmology, neurosurgery, neurology, orthopedics, endocrinology, hematology, genetics, and rehabilitation, 'can assist as needed.' Notably, the American Academy of Pediatrics' (AAP's) guidance mirrors that of the CPS, Suzanne Haney, MD, professor of child abuse pediatrics at the University of Nebraska Medical Center and Nebraska Children's Hospital, Omaha, Nebraska, told Medscape Medical News. Suzanne Haney, MD Like the CPS, the AAP does not use the term 'shaken baby syndrome' to describe suspected head trauma due to abuse, she said. 'Instead, we use the term 'abusive head trauma.' Sometimes these kids are shaken, sometimes they're slammed, sometimes shaken and slammed, we don't necessarily know exactly what the forces are, but we do know that it's abusive and was done by someone.' Similar to the new Canadian guidance, Haney suggested advocating for the involvement of a child abuse expert when faced with a situation that suggests CM. 'Studies have shown that when you involve somebody with expertise, you are more likely to get the right diagnosis,' she said. 'Most major medical centers have a child abuse pediatrician, although unfortunately our numbers are far too small. We do have a number of colleagues who may not be board-certified but have a special interest or expertise in this area. So if clinicians can identify somebody in their area who has a special interest in child maltreatment, they can be very helpful.'
Medscape
24-05-2025
- Health
- Medscape
ASCO 2025
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