Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Lung cancer patients experience various symptoms during treatment. Although pulmonary rehabilitation is an effective way to improve these symptoms, limited medical environment makes it difficult to provide seamless adequate rehabilitation for lung cancer patients. Objective: This study aims to investigate the effects of pulmonary rehabilitation for patients with non-small cell lung cancer by means of a personalized pulmonary rehabilitation program that uses real-time mobile patient health data. Methods: A prospective clinical trial was conducted with 64 non-small cell lung cancer patients aged between 20 and 80 years, diagnosed with lung cancer at Asan Medical Center. A 12-week personalized pulmonary rehabilitation program was administered to investigate the efficacy of the rehabilitation app developed. The participants were randomized into the fixed exercise or fixed-interactive exercise group. At 6 weeks, changes in walking distances during 6 minutes (6MWD) and grade of dyspnea (mMRC), and at 12weeks those in QoL and service satisfaction, were observed. Paired T-test were used for analysis of the variables. Results: An mHealth pulmonary rehabilitation app and real-time patient monitoring website were developed. Significant changes were observed in the intervention group at 12 weeks for 6MWT from 433.43±65.60m to 471.25±75.69m (p=0.001), and 0.94±0.66 to 0.61±0.82 (p=0.017) for mMRC. The intervention showed a significant improvement in the quality of life (EQ-VAS) in compared to the baseline (p=0.002) Conclusions: A personalized mHealth-based pulmonary rehabilitation app for recording and monitoring real-time health data of patients with non-small cell lung cancer can plays a supplementary role in traditional center-based rehabilitation programs. Our clinical trial results support the use of this technology to encourage changes in 6MWT and to improve mMRC.

Background: Electromagnetic navigation bronchoscopy (ENB) is a useful method to obtain tissue for peripheral lung nodules. We aimed to understand the diagnostic yield and safety profile in high‐risk pulmonary nodules that cannot be accessed by percutaneous transthoracic needle biopsy.Methods: In this single‐center retrospective study, we reviewed patients who underwent ENB for high‐risk pulmonary nodules. All procedures were performed under moderate sedation using intravenous midazolam and fentanyl.Results: A total of 100 pulmonary nodules in 90 patients were subjected to ENB between October 2018 and May 2020. The median age of the study population was 66 (59–73). The mean diameter of the lung nodules was 27.9 mm. The diagnostic yield of ENB‐guided biopsy was 53.0%. Although the nodule size (odds ratio: 1.055, p = 0.007) and positive bronchus sign (odds ratio: 2.918, p = 0.020) were associated with the diagnostic yield during univariate analysis, nodule size was the only independent variable on the multivariable analysis. Interestingly, the diagnostic yield showed an upward trend after 60 cases, from 45%–65%. Procedure‐related complications were reported in 16 cases; among these, pneumothorax occurred in three cases, and four cases experienced moderate bleeding. No instance of major bleeding or death was linked to ENB‐guided biopsy.Conclusion: ENB‐guided biopsy for high‐risk pulmonary nodules demonstrated an acceptable diagnostic yield and good safety profile. Moreover, the diagnostic yield was associated with nodule size and procedure experience.

Mobile and tablet apps, ubiquitous and pervasive computing, wearable computing and domotics for health.

Objective : The purpose of this study was to evaluate the efficacy of the anterior approach following intraoperative reduction under general anesthesia in patients with cervical facet fracture and dislocation. Methods : Twenty-three patients with single level cervical facet fracture and dislocation who were subjected to the anterior approach alone following immediate intraoperative reduction under general anesthesia from March 2013 to December 2017 were enrolled in this study. Neurological status, clinical outcome, and radiological studies were evaluated preoperatively, postoperatively, and during the follow-up period. Results : The cohort comprised 15 men and eight women with a mean age of 57 years (from 24 to 81). All patients were operated on within the first 8 hours following the injury. After gentle manual reduction or closed reduction with Gardner-Wells traction, under general anesthesia monitored by somatosensory-evoked potentials, all operations were successfully completed using the anterior approach alone except in two patients, who had a risk of over-distraction. In them, a satisfactory gentle manual reduction or closed reduction was not possible, and required open posterior reduction of the locked facets followed by anterior cervical discectomy and fusion. In one patient, screw retropulsion was observed in 1 month after surgery. There were no reduction-related complications or neurological aggravations after surgery. All patients showed evidence of stability at the instrumented level at the final follow-up (mean follow-up, 12 months). Conclusion : Anterior approach following intraoperative reduction monitored by somatosensory-evoked potentials under general anesthesia for cervical dislocation and locked facets is a relatively safe and effective alternative when cervical alignment is achieved by intraoperative reduction.