RESUMO
PURPOSE: Mobile health (mHealth) technology has increased dramatically in the wake of the pandemic. Less research has focused on people with mobility impairing (PMI) disabilities. This study determined the prevalence of mHealth use among PMI adults during the COVID-19 escalation and examines demographic, health and COVID-19 concerns correlates. METHODS: PMI adults (N = 304) completed an online survey investigating mHealth use and COVID-19 concerns related to food access in June of 2020. Smartphone and mHealth use were measured with an adapted version of the survey used in the Pew Internet & American Life project. Descriptive and multivariable analyses were conducted to determine associations of demographics, health status, and COVID-19 concerns with mHealth use. About two-thirds (N = 201) of the sample were mHealth users (owned a smartphone and engaged in health-promoting behaviors with the smartphone; e.g., sought online information, tracked health behaviors, used patient portals). RESULTS: Having hypertension was associated with higher mHealth use, and having higher COVID-19 concerns about food access was associated with higher mHealth use. Those who used mHealth were also more engaged with smartphone apps for communication, services, and entertainment. Only the association between educational attainment and mHealth use remained significant after adjusting for other covariates in multivariable logistic regression models. DISCUSSION: PMIs continue to need support in the use of mHealth technology to help maximize access to potentially important tools for rehabilitation and health management. There is a need to continue to investigate mHealth and its applications for people with disabilities.Implications for RehabilitationMany people with mobility impairing disabilities may be missing opportunities for mHealth rehabilitation and healthcare.COVID-19 has widened existing gaps in access and use of mHealth technology among people with mobility impairing disabilities.Focused education is needed to help people with disabilities exploit the full range of services of their smartphones to increase access to care, social connectivity, and other important goods and services to enhance rehabilitation and health management.
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COVID-19, Aplicativos Móveis, Telemedicina, Adulto, Humanos, COVID-19/epidemiologia, Smartphone, Nível de SaúdeRESUMO
BACKGROUND/AIMS: To improve the accuracy of pterygium screening and detection through smartphones, we established a fusion training model by blending a large number of slit-lamp image data with a small proportion of smartphone data. METHOD: Two datasets were used, a slit-lamp image dataset containing 20 987 images and a smartphone-based image dataset containing 1094 images. The RFRC (Faster RCNN based on ResNet101) model for the detection model. The SRU-Net (U-Net based on SE-ResNeXt50) for the segmentation models. The open-cv algorithm measured the width, length and area of pterygium in the cornea. RESULTS: The detection model (trained by slit-lamp images) obtained the mean accuracy of 95.24%. The fusion segmentation model (trained by smartphone and slit-lamp images) achieved a microaverage F1 score of 0.8981, sensitivity of 0.8709, specificity of 0.9668 and area under the curve (AUC) of 0.9295. Compared with the same group of patients' smartphone and slit-lamp images, the fusion model performance in smartphone-based images (F1 score of 0.9313, sensitivity of 0.9360, specificity of 0.9613, AUC of 0.9426, accuracy of 92.38%) is close to the model (trained by slit-lamp images) in slit-lamp images (F1 score of 0.9448, sensitivity of 0.9165, specificity of 0.9689, AUC of 0.9569 and accuracy of 94.29%). CONCLUSION: Our fusion model method got high pterygium detection and grading accuracy in insufficient smartphone data, and its performance is comparable to experienced ophthalmologists and works well in different smartphone brands.
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Túnica Conjuntiva/anormalidades, Pterígio, Smartphone, Humanos, Pterígio/diagnóstico, Córnea, Lâmpada de FendaRESUMO
PURPOSE: We aimed to investigate the nursing process linkages formed by Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC) according to the primary NANDA-I diagnoses by registered nurses (RNs), customized to nursing home (NH) residents in Korea, using a developed smartphone application for NH RNs. METHODS: This is a retrospective descriptive study. Applying quota sampling, a total of 51 NHs from all operating 686 NHs hiring RNs participated in this study. Data were collected from June 21 to July 30, 2022. Data on NANDA-I, NIC, NOC (NNN) of nurses applied to the NH residents were collected through a developed smartphone application. The application consists of general organization and residents' characteristics, NANDA-I, NIC, and NOC. RNs selected randomly up to 10 residents and NANDA-I with risk factors and related factors over the past 7 days, followed by all applied interventions out of 82 NIC. RNs then evaluated residents through 79 selected NOC. RESULTS: We found the frequently used NANDA-I diagnoses, Nursing Interventions Classifications and Nursing Outcomes and Classifications applied for NH residents by RNs and developed the top five NOC linkages used to build care plan. CONCLUSION: It is time to pursue high-level evidence and reply to the questions raised in NH practice using NNN with high technology. The outcomes for patients and nursing staff are improved by the continuity of care made possible by uniform language. IMPLICATIONS FOR NURSING PRACTICE: NNN linkages should be used to construct and utilize the coding system of electronic health records or electronic medical records in Korean long-term care facilities.
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Enfermeiras e Enfermeiros, Terminologia Padronizada em Enfermagem, Humanos, Diagnóstico de Enfermagem, Estudos Retrospectivos, Smartphone, Casas de Saúde, América do NorteRESUMO
Cognitive interventions are helpful in the non-pharmacological management of Primary progressive aphasia (PPA) and other neurodegenerative disorders of cognition, by helping patients to compensate for their cognitive deficits and improve their functional independence. In this study, we examined the effectiveness of cognitive rehabilitation based on the use of mobile device technology in PPA. The aim of this research study was to determine if BL, a patient with semantic variant PPA (svPPA) and severe anomia, was able to learn using specific smartphone functions and an application to reduce her word finding difficulties. She was trained during the intervention sessions on a list of target pictures to measure changes in picture naming performance. Errorless learning was applied during learning. BL quickly learned to use smartphone functions and the application over the course of the intervention. She significantly improved her anomia for trained pictures, and to a lesser extent for untrained semantically related pictures. Picture naming performance was maintained six months after the intervention, and she continued to use her smartphone regularly to communicate with family members and friends. This study confirms that smartphone use can be learned in PPA, which can help reduce the symptoms of anomia and improve communication skills.
Assuntos
Afasia Primária Progressiva, Afasia, Feminino, Humanos, Anomia/etiologia, Smartphone, Afasia Primária Progressiva/reabilitação, Afasia/reabilitação, SemânticaRESUMO
Simple and sensitive detection of cardiac biomarkers is of great significance for early diagnosis and prevention of acute myocardial infarction (AMI). Here, a ratiometric fluorescent nanohybrids probe (AuNCs-QDs) was synthesized through the coupling of bovine serum albumin-functionalized gold nanoclusters (AuNCs) with CdSe/ZnS quantum dots (QDs) to realize simple and sensitive detection of cardiac biomarker myoglobin (Mb). The AuNCs-QDs probe shows pink fluorescence under UV light, with two emission peaks at 468 nm and 630 nm belonging to QDs and AuNCs, respectively. Importantly, the presence of Mb caused fluorescence quenching of the blue-emitting QDs, thereby inhibiting the fluorescence resonance energy transfer (FRET) process between QDs and AuNCs, and reducing the fluorescence intensity ratio (F468/F630) of AuNCs-QDs probe effectively. As the concentration of Mb increases, the ratiometric fluorescent probe also exhibits a visible fluorescence color change. The detection limit was as low as 4.99 µg/mL, and the response of the probe to Mb showed a good linear relationship up to 0.52 mg/mL. Moreover, the probe has excellent specificity for Mb. Besides, the AuNCs-QDs has been applied to detect Mb of urine samples. More importantly, we also developed an AuNCs-QDs probe modified smartphone-aided paper-based strip for on-site monitoring of Mb. As far as we know, this is the first report of a smartphone-aided paper-based strip for on-site quick monitoring of Mb, which provides a useful approach for AMI biomarker monitoring and may can be extended to other medical diagnostics.
Assuntos
Nanopartículas Metálicas, Pontos Quânticos, Mioglobina, Smartphone, Espectrometria de Fluorescência, Corantes Fluorescentes, Ouro, BiomarcadoresRESUMO
Food safety concerns about the authenticity of soy product freshness have increased due to high demand from public. Developing an accurate and convenient monitoring method for freshness authenticity is crucial for safeguarding food safety. From this motive, this study employed PtPd NPs to encapsulate tetraphenylethylene (TPE) for engineering an AIE-based fluorescent nanozyme (PtPd NPs@TPE) with oxidase-like activity, achieving the ratiometric fluorescence monitoring of putrescine (PUT) to judge the freshness authenticity of soy products. In this design, PUT acted as an antioxidant and inhibited the oxidation process of PtPd NPs@TPE to o-phenylenediamine (OPD), leading to the reduction of oxidative product 2,3-diaminophenothiazine (DAP) alone with the weaken of yellow fluorescence from DAP at 552 nm and bright of bule fluorescence from PtPd NPs@TPE at 442 nm. On this basis, a ratiometric fluorescence strategy integrated with smartphone-based sensor was developed for PUT with acceptable results to combat food freshness fraud of soy products.
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Oxirredutases, Smartphone, Fluorescência, Oxirredução, Espectrometria de Fluorescência/métodos, Corantes FluorescentesRESUMO
Smartphone-based technology for electrocardiographic recording is now part of the new concept of mobile health in both human and veterinary medicine. Although smartphone-based ECG for electrocardiographic screening in dogs is reliable, one-lead ECG devices have mainly been evaluated. This prospective study assessed the feasibility and the diagnostic reliability of a new smartphone-based six-lead electrocardiograph (smECG) in dogs, in comparison to a standard six-lead electrocardiograph (stECG). All ECG tracings were blindly reviewed by an expert operator, who judged whether tracings were acceptable for interpretation, performed the electrocardiographic measurements, and assigned a diagnosis. The agreement in the electrocardiographic interpretation and diagnosis between smECG and stECG was assessed using the Bland-Altman test and Cohen's k test. The study included 108 client-owned dogs. The tracings obtained by the smECG were interpretable in 100 % of cases. No clinically relevant differences between smECG and stECG were found in the assessment of heart rate, interval duration, and QRS mean electrical axis. The smECG tended to underestimate the amplitude of the P and R waves. Perfect agreement was found in the detection of sinus rhythm, atrial fibrillation, ventricular arrhythmias, atrioventricular blocks, and bundle branch blocks. Our study suggests that the tested smartphone-based six-lead ECG is a clinically reliable device for the assessment of heart rate and heart rhythm in dogs, and thus could be used in a clinical setting in dogs and for telemedicine.
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Fibrilação Atrial, Doenças do Cão, Humanos, Cães, Animais, Smartphone, Estudos Prospectivos, Reprodutibilidade dos Testes, Eletrocardiografia/veterinária, Fibrilação Atrial/diagnóstico, Fibrilação Atrial/veterinária, Doenças do Cão/diagnósticoRESUMO
Smartphone use is nearly ubiquitous, with 93% of adults among economically developed countries, including the United States, Canada, Israel, and South Korea owning a smartphone (Taylor & Silver, 2019). Multiple studies have demonstrated the distracting effects of smartphone notifications on behavioral measures of cognition. Fewer studies have examined the effects of notifications on neural activity underlying higher-level cognitive processes or behavioral inductions to reduce smartphone-related distraction. Using EEG spectral frequency power densities, we assessed the effects of smartphone notifications (vs. control trials) on engagement of attentional shifting processes involved in cognitive control during a Navon Letter visual oddball task. Participants were randomly assigned to a brief mindfulness induction (N = 44) or a neutral narration control condition (N = 43). Overall, participants had lower theta-band power, but higher alpha- and beta-band power densities on target letter trials preceded by smartphone notifications. Additionally, participants in the mindfulness (vs. control) condition had a larger attention shifting oddball assessed via theta power density and theta/beta ratio (TBR) values-reflecting increased engagement of cognitive control-particularly on smartphone notification (vs. control) trials. Altogether, these results provide evidence supporting the idea that smartphone notifications can decrease activity of neural correlates of cognitive control, and offer the promise of a brief mindfulness induction to buffer against the effects of smartphone notifications on cognitive control. The findings indicate a need for further research on mindfulness inductiosn as a means to reduce potential distraction caused by smartphones.
Assuntos
Atenção Plena, Adulto, Humanos, Atenção Plena/métodos, Smartphone, Atenção/fisiologia, CogniçãoRESUMO
Vitamin C-rich foods can improve mood; however, the timecourse of these benefits is unknown. This study utilised intensive longitudinal smartphone surveys from a three-armed placebo-controlled trial to determine mood-related changes following supplementation with vitamin C (250 mg tablet/d), kiwifruit (2 SunGold™ kiwifruit/d) or a placebo (1 tablet/d). Secondary data were analysed from the KiwiC for Vitality trial (Trial ID: ACTRN12617001031358). Adults (n 155, 63 % female, aged 18-35 years) with low plasma vitamin C (<40 µmol/l) completed a 14-d lead-in, 28-d intervention and 14-d washout. Participants self-reported vitality (SF-36), mood (POMS total mood disturbance), flourishing (flourishing scale), sleep quality, sleep quantity and physical activity every second day using smartphone surveys. Plasma vitamin C, measured fortnightly, reached saturation after 2 weeks of vitamin C or kiwifruit supplementation. Kiwifruit supplementation improved vitality and mood within 4 days, peaking around 14-16 days, and improved flourishing from day 14. Vitamin C marginally improved mood until day 12. Incremental AUC analyses revealed significant overall effects of kiwifruit consumption on vitality and mood compared with placebo, which were stronger than effects for vitamin C tablets, but attenuated when adjusting for covariates. Sensitivity analyses of participants with low baseline vitamin C status revealed improved mood (vitamin C and kiwifruit) and flourishing (kiwifruit only). This is the first study to use intensive smartphone surveys to model the day-to-day timecourse of mood-related states following vitamin C intervention and highlights the value of using smartphone surveys to reveal the temporal changes in mood-related outcomes following nutrient supplementation.
Assuntos
Ácido Ascórbico, Smartphone, Adulto, Feminino, Humanos, Masculino, Afeto, Suplementos Nutricionais, VitaminasRESUMO
OBJECTIVE: The aim of the TELESUR-GDM study was to demonstrate the non-inferiority of the onset of maternal, fÅtal, and neonatal complications for patients with gestational diabetes mellitus (GDM) monitored by myDiabby Healthcareâ (app group) compared to patients with a classical glycaemic blood monitoring by diary (control group). MATERIALS AND METHODS: TELESUR-GDM was a retrospective, monocentric, and non-inferiority study including 349 patients in the app group and 295 patients in the control group. The primary outcome was a composite score based on maternal, foetal, and neonatal complications. The statistical analysis used chi square or Student t tests for categorical or continuous variables, and Dunnett-Gent test for non-inferiority. RESULTS: In the app and control groups, 46.3 % and 53.7 % of the patients respectively, observed complications. Non-inferiority of telemonitoring by application vs diary was confirmed (odds ratio=0.79 [95 % CI 0.58;1.07], P < 0.001). Caesarean section, labour induction, and insulin treatment rates were: 20 vs 23 % (P = 0.4), 36 vs 28 % (P = 0.047), and 22 vs 23 % (P = 0.8) in the app vs control group, respectively. Macrosomia, intrauterine growth restriction, neonatal hypoglycaemia, and neonatal jaundice rates were: 4.3 vs 6.1 % (P = 0.4), 6.9 vs 3.1 % (P = 0.04), 1.7 vs 14 % (P < 0.001), and 8.6 vs 1.0 % (P < 0.001), in the app versus control group, respectively. CONCLUSION: GDM glycaemic telemonitoring compared to patients with classic glycaemic monitoring by diary was not inferior in terms of maternal, fÅtal, and neonatal complications. Neonatal hypoglycaemia, a life-threatening event, was significantly reduced despite the observation of more neonatal jaundice cases.
Assuntos
Diabetes Gestacional, Hipoglicemia, Icterícia Neonatal, Aplicativos Móveis, Recém-Nascido, Gravidez, Humanos, Feminino, Estudos Retrospectivos, Cesárea, Smartphone, Hipoglicemia/epidemiologia, Hipoglicemia/prevenção & controle, Atenção à Saúde, Resultado da Gravidez/epidemiologiaRESUMO
Smartphone-based technology for ECG recording has recently spread as a complementary tool for electrocardiographic screening and monitoring in adult horses and in other animal species. The present study aimed to assess the feasibility and accuracy of a smartphone-based ECG in healthy foals. This was a prospective observational study (authorization n. 45,865/2016) including 22 foals aged less than 21 days. A reference standard base-apex ECG (rECG) was acquired, and a smartphone ECG (sECG) was recorded immediately after by using a smartphone-based single lead electrocardiograph. All ECG tracings were evaluated in a blind fashion by a single board-certified cardiologist, who judged whether the tracings were acceptable for interpretation and performed ECG measurements and diagnosis. The Spearman correlation coefficient, the Cohen's k test and the Bland-Altman test were used to assess the agreement between sECG and rECG. All sECG tracings were acceptable for interpretation. All foals showed sinus rhythm on both rRCG and sECG tracings, with perfect agreement in heart rate classification (κ = 0.87; p < 0.001). No clinically relevant differences were found in the assessment of waves and intervals duration. Concerning P wave and QRS complex polarity, the percentage of agreement between rECG and sECG was 78% and 83%, respectively. About ECG tracing quality, rECG and sECG showed a substantial agreement (κ = 0.624; p < 0.001). In conclusion, the smartphone-based ECG device tested in the present study recorded good quality single-lead ECG tracings in foals, reliable for heart rate and ECG measurements, but different polarity of P waves and QRS complexes was found in some foals in comparison to rECG.
Assuntos
Arritmias Cardíacas, Doenças dos Cavalos, Smartphone, Cavalos, Animais, Eletrocardiografia/veterinária, Arritmias Cardíacas/diagnóstico, Arritmias Cardíacas/veterinária, Frequência Cardíaca, Estudos ProspectivosRESUMO
ABSTRACT: Heredia-Elvar, JR, Juan-Recio, C, Prat-Luri, A, Barbado, D, Ríos-Calonge, Jdl, and Vera-Garcia, FJ. Exercise intensity progressions and criteria to prescribe core stability exercises in young physically active men: a smartphone accelerometer-based study. J Strength Cond Res 38(2): 266-273, 2024-The establishment of core stability (CS) exercise intensity progressions in sport and clinical settings is normally based on subjective criteria. Therefore, this study aimed to develop exercise intensity progressions for some of the most common CS exercises through smartphone accelerometry and to analyze the effect of the subjects' lumbopelvic postural control on these progressions. Fifty-seven healthy young physically active male students performed 7 isometric variations of front bridge, back bridge, side bridge, and bird-dog exercises with a smartphone accelerometer placed on the pelvis. Mean pelvic accelerations were calculated during each variation to evaluate the lumbopelvic postural control challenge imposed on the subjects as an index of exercise intensity of difficulty. For the bridge exercises, long bridging produced higher pelvic accelerations than short bridging, bridging with single-leg support was more intense than bridging with double-leg support (even with both legs on a hemisphere ball for the back and front bridge), and the most difficult variations were those performed on a Swiss ball, mainly the variations with single-leg support. For the bird-dog exercise, the 2-point positions were more intense than the 3-point positions, the variations performed with a knee on the hemisphere ball produced higher pelvic accelerations than similar variations performed with the forearm on the hemisphere ball, and the variations with limb motions generated higher pelvic accelerations than similar variations performed without limb motions. Although the CS exercise progressions were very similar across subjects, our results showed the need to individualize the prescription of the CS exercise progressions based on the subjects' lumbopelvic postural control level.
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Estabilidade Central, Smartphone, Humanos, Masculino, Acelerometria, Eletromiografia, Terapia por Exercício, Extremidade InferiorRESUMO
Hydrogen sulfide (H2S) is a toxic contaminant and has great influence on many physiological processes. Due to various pathophysiological roles and environmental pollution problems, it is necessary to construct and develop simple and portable monitoring sensors for the precise detection of H2S. Herein, we developed a smartphone-adapted dual-mode detection platform by integrating the colorimetric and photothermal imaging analysis into a metal-organic framework-based chip (ZIF-8/Cu). Due to the nanoconfinement effect of ZIF-8, small-sized plasmonic CuS could be in-situ formed during the detection procedure of H2S and endowed the chips with excellent photothermal properties. By constructing a smartphone-adapted photothermal imager, the metal-organic framework-based chip could achieve a portable photothermal imaging analysis of H2S. Moreover, as the formed CuS was a good peroxidase-like nanozyme, the chips could also be used to trigger the enzymic catalytic reaction toward the chromogenic reaction of 3,3',5,5'-tetramethylbenzidine (TMB)-H2O2, thus providing another colorimetric sensing mode by using a smartphone App. In this smartphone-adapted visualization platform, the portable chemosensors could simultaneously achieve double detection modes at one electrode, which provided a new pathway for the accurate detection of H2S and circumvented the false-positive or negative errors during the detection process. Besides, by using the finite difference time domain (FDTD) simulation method, the in-depth mechanism, including the plasmonic effect and spatial electromagnetic field distribution, was explored to provide a possible reason for the excellent sensing performance of the dual-mode visualization platform. This work provides a new insight into the construction of the accurate, portable and smart sensing platform in the visual screening of H2S.
Assuntos
Estruturas Metalorgânicas, Smartphone, Peróxido de Hidrogênio, Catálise, ColorimetriaRESUMO
Here we present the findings of the pilot phase of the SmartCrisis 2.0 Randomized Clinical Trial. This pilot study aimed to explore the feasibility and acceptability of a safety plan contained in a smartphone app. Our sample consisted patients with a history of recent suicidal behaviour who installed a smartphone-based safety plan. To explore the satisfaction with of the safety plan, two patient satisfaction surveys were conducted: one qualitative and one quantitative. To explore the objective use of the safety plan, we gained access to texts contained in the safety plans completed by the patients. Participation rate was 77%, while 48.9% patients completed both satisfaction surveys at the end of the pilot phase. N = 105 successfully installed the safety plan. In a scale from 1 to 10, users rated the usefulness of the security plan at 7.4, the usability at 8.9, the degree to which they would recommend it to others at 8.6 and the overall satisfaction with the project including evaluations at 9.6. The most widely completed tab was warning signs. Feeling sad or lonely was the warning sign most commonly reported by patients. The second most completed tab was internal coping strategies. Walking or practicing any other exercise was the strategy most commonly resorted to. Our smartphone-based safety plan appears to be a feasible intervention. Data obtained from this pilot study showed high participation rates and high acceptability by patients. This, together with the general satisfaction with the project, supports its implementation in the clinical practice.
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Aplicativos Móveis, Smartphone, Humanos, Ideação Suicida, Projetos Piloto, Satisfação do PacienteRESUMO
BACKGROUND/OBJECTIVES: An affordable and scalable screening model is critical for undetected glaucoma. The study evaluated the performance of an offline, smartphone-based AI system for the detection of referable glaucoma against two benchmarks: specialist diagnosis following full glaucoma workup and consensus image grading. SUBJECTS/METHODS: This prospective study (tertiary glaucoma centre, India) included 243 subjects with varying severity of glaucoma and control group without glaucoma. Disc-centred images were captured using a validated smartphone-based fundus camera analysed by the AI system and graded by specialists. Diagnostic ability of the AI in detecting referable Glaucoma (Confirmed glaucoma) and no referable Glaucoma (Suspects and No glaucoma) when compared to a final diagnosis (comprehensive glaucoma workup) and majority grading (image grading) by Glaucoma specialists (pre-defined criteria) were evaluated. RESULTS: The AI system demonstrated a sensitivity and specificity of 93.7% (95% CI: 87.6-96.9%) and 85.6% (95% CI:78.6-90.6%), respectively, in the detection of referable glaucoma when compared against final diagnosis following full glaucoma workup. True negative rate in definite non-glaucoma cases was 94.7% (95% CI: 87.2-97.9%). Amongst the false negatives were 4 early and 3 moderate glaucoma. When the same set of images provided to the AI was also provided to the specialists for image grading, specialists detected 60% (67/111) of true glaucoma cases versus a detection rate of 94% (104/111) by the AI. CONCLUSION: The AI tool showed robust performance when compared against a stringent benchmark. It had modest over-referral of normal subjects despite being challenged with fundus images alone. The next step involves a population-level assessment.
Assuntos
Retinopatia Diabética, Glaucoma, Humanos, Inteligência Artificial, Estudos Prospectivos, Smartphone, Retinopatia Diabética/diagnóstico, Programas de Rastreamento/métodos, Glaucoma/diagnósticoRESUMO
Maleic hydrazide (MH) is a plant growth regulator, herbicide, and sprout inhibitor used to improve the growth and quality of certain vegetables and fruits, unfortunately, MH has genotoxic and carcinogenic effects; thus, MH residues in food need to be analyzed. Herein, magnetic molecularly imprinted polymers (MagMIP) were synthesized by radical polymerization in just 30 min using a microwave for rapid and selective extraction of MH. The colorimetric detection of MH using the immobilized Folin Ciocalteau's reagent (FCR) on 96-well microplate via smartphone sensor exhibits useful sensitivity for MH with a limit of detection (LOD = 0.6 ppm) which is far lower than the maximum residue limits (higher than 5 ppm). The immobilized FCR was stored dry at two different storage conditions at +4 °C and room temperature without losing its performance over six months. The coupling MagMIP-extraction/clean-up and smartphone determination were tested towards food samples (i.e., potatoes, and carrots), obtaining good recovery (79-96 %), high repeatability (RSD 4.5 %; n = 10), and high selectivity for MH determination.
Assuntos
Hidrazida Maleica, Impressão Molecular, Hidrazida Maleica/análise, Polímeros Molecularmente Impressos, Smartphone, Colorimetria, Fenômenos Magnéticos, Extração em Fase Sólida, AdsorçãoRESUMO
Diarrheal diseases are a major cause of morbidity and mortality in children worldwide and a significant contributor to antimicrobial resistance. In the absence of laboratory diagnostics to establish diarrhea etiology, electronic clinical decision support tools can help physicians make informed treatment decisions for children with diarrhea. In Bangladesh, we assessed the feasibility and acceptability of an electronic Diarrhea Etiology Prediction algorithm (DEP tool) embedded into a rehydration calculator, which was designed to help physicians manage children with diarrhea, including decisions on antibiotic use. A team of Bangladeshi anthropologists conducted in-depth interviews with physicians (N = 13) in three public hospitals in Bangladesh about their experience using the tool in the context of a pilot trial. Physicians expressed positive opinions of the DEP tool. Participants perceived the tool to be simple and easy to use, with structured guidance on collecting and entering clinical data from patients. Significant strengths of the tool were as follows: standardization of protocol, efficiency of clinical decision-making, and improved clinical practice. Participants also noted barriers that might restrict the widespread impact of the tool, including physicians' reluctance to use an electronic tool for clinical decision-making, increasing work in overburdened healthcare settings, unavailability of a smartphone, and patients' preferences for antibiotics. We conclude that an electronic clinical decision support tool is a promising method for improving diarrheal management and antibiotic stewardship. Future directions include developing and implementing such a tool for informal healthcare physicians in low-resource settings, where families may first seek care for pediatric diarrhea.
Assuntos
Smartphone, Telemedicina, Humanos, Criança, Bangladesh, Diarreia/diagnóstico, Diarreia/tratamento farmacológico, Antibacterianos/uso terapêuticoRESUMO
OBJECTIVE: The neurobehavioral underpinnings of binge-eating disorder (BED), co-occurring with obesity (OB), are largely unknown. This research project conceptualizes BED as a disorder with dysfunctional emotion regulation (ER) linked with changes in central noradrenaline (NA) transmission and NA-modulated neuronal networks. METHODS: We expect abnormalities in NA activity in both BED and OB, but most pronounced in BED. We expect these abnormalities to be modifiable through state-of-the-art ER intervention, specifically in BED. To assess the role of NA transmission, we will quantify changes in NA transporter (NAT) availability using the highly NAT-specific [11 C]methylreboxetin (MRB) and positron emission tomography-magnetic resonance imaging (PET-MRI) that allows measuring molecular and neuronal changes before and after an ER intervention. Individual 12-session smartphone-supported acceptance-based behavioral therapy will be conducted to improve ER. Thirty individuals with OB and BED (OB + BED), 30 individuals with OB without BED (OB - BED), and 20 individuals with normal weight will undergo assessments of NAT availability and neuronal network activity under rest and stimulated conditions, clinical interviews, self-report questionnaires on eating behavior, ER, mental and physical health, and quality of life, and neuropsychological tests on executive function. Afterwards, in an experimental randomized-controlled design, individuals with OB + BED and OB - BED will be allocated to smartphone-supported ER intervention versus a waitlist and re-assessed after 10 weeks. DISCUSSION: By obtaining biological and behavioral markers, the proposed study will disentangle the involvement of NAT and the central NA system in the modulation of emotion-supporting neuronal networks that influence eating behavior. Neurobehavioral mechanisms of change during an ER intervention will be determined. TRIAL REGISTRATION: German Clinical Trials Register (DRKS): DRKS00029367. PUBLIC SIGNIFICANCE: This study investigates the central noradrenaline system by using hybrid brain imaging in conjunction with emotion regulation as a putative core biological mechanism in individuals with obesity with or without binge-eating disorder that is targeted by emotion regulation intervention. The results will provide a molecular signature beyond functional imaging biomarkers as a predictive biomarker toward precision medicine for tailoring treatments for individuals with binge-eating disorders and obesity.
Assuntos
Transtorno da Compulsão Alimentar, Regulação Emocional, Humanos, Transtorno da Compulsão Alimentar/diagnóstico por imagem, Transtorno da Compulsão Alimentar/terapia, Transtorno da Compulsão Alimentar/psicologia, Smartphone, Qualidade de Vida, Obesidade/complicações, Obesidade/diagnóstico por imagem, Obesidade/terapia, Terapia Comportamental, Norepinefrina, NeuroimagemRESUMO
OBJECTIVE: This feasibility study aimed to assess the acceptability of using smartphone notifications to modify the medication beliefs of people with gout. We evaluated the feasibility and acceptability of a smartphone application using the Technology Acceptance Model. We explored adherence rate differences and outcomes between the intervention and control groups. METHODS: Fifty-two patients with gout who were prescribed allopurinol were randomly assigned to either active control (n = 24) or intervention group (n = 28). Over 3 months, both groups used the study app on their smartphones. The active control group received notifications about general health advice, whereas the intervention group received adherence-targeted notifications. The feasibility and acceptability of the smartphone app was measured through semistructured interviews. Adherence rate was assessed through serum urate levels and missed doses at 3 timepoints: baseline, 3 months (post intervention), and 6 months (follow-up). RESULTS: The smartphone app demonstrated high feasibility, with strong participant retention and compliance. The participants expressed high levels of satisfaction with the app's user-friendliness and content, highlighting its acceptability. Both groups showed a significant reduction in missed doses over time (P < 0.05), but no significant differences in serum urate levels were found between the groups. Patients who received adherence-targeted notifications reported finding it more convenient to take allopurinol and expressed higher overall treatment satisfaction throughout the study. CONCLUSION: Adherence-targeted notifications have the potential to be an effective and scalable approach to supporting medication adherence in patients with gout. Further research is needed with larger samples to refine the components of the intervention and explore its optimal implementation.
Assuntos
Gota, Aplicativos Móveis, Humanos, Smartphone, Alopurinol/uso terapêutico, Estudos de Viabilidade, Ácido Úrico, Adesão à MedicaçãoRESUMO
We developed and tested a smartphone-based intervention, FutureU, that aims to stimulate future-oriented thinking and behavior by strengthening the degree to which people identify with their future self. In order to examine the potential of this intervention prototype and opportunities for further optimization, we evaluated 1) the immediate and long-term efficacy of the intervention, and 2) intervention effects after each of three intervention modules. To this end, we conducted a randomized controlled pilot study among first-year university students (N = 176). Results showed a decrease in goal commitment immediately after the intervention. At 3-months follow-up, trends showed an increase in future orientation and in self-efficacy. During the intervention, there was a positive effect on vividness of the future self after the first module. Although there is scope for improvement, the findings highlight the potential of the intervention to increase people's future-oriented thinking and behavior.
