Evaluating Align\u27s Effectiveness as a Telemedicine Physical Therapy App for Treating Neck Pain in Office Workers

Background:  With rising healthcare costs that affect each patient\u27s health and well-being, neck pain is emerging as a significant public health concern. One-year prevalence rates of cervical pain are significantly greater in computer professionals than in the overall population, indicating that they represent a particular population at high risk of developing neck discomfort. Patient-driven and patient-centred treatment must be included. One new development in healthcare is the use of mobile applications for management. The ability of mobile health (mHealth) to transcend geographical and temporal limitations and reach patients and healthcare professionals at any time and place makes it a preferred way of healthcare delivery. Nevertheless, there is scientific evidence for only a few mobile healthcare management applications. Objectives: To evaluate the usability and effectiveness of “Align” a mobile-based physical therapy application for treating office workers\u27 neck pain. Methodology: Participants in this experimental descriptive study were enrolled after being assessed for inclusion criteria, and had pre- and post-assessments for outcome measurements, after which the intervention protocol was obtained via the smartphone mobile app. Twelve sessions in total over two weeks. Results:  A decrease in the Numerical Pain Rating Scale scores (p<0.005) indicated a significant reduction in neck pain among the participants (N=107) who finished the intervention protocol. The Neck Disability score also showed a significant improvement, dropping by 4 points (p<0.005). Participants also demonstrated higher Positive Functioning Inventory and Postural Awareness scores (p<0.005). Conclusion: This study demonstrates the beneficial effects of the created mobile application for physical therapy for neck pain. The encouraging outcomes point to the necessity of additional research, such as randomised controlled trials, to determine how beneficial mobile applications are compared to standard clinical care. DOI: https://doi.org/10.52783/jchr.v13.i6.198

Schizophrenia copy number variants and associative learning

Large-scale genomic studies have made major progress in identifying genetic risk variants for schizophrenia. A key finding from these studies is that there is an increased burden of genomic copy number variants (CNVs) in schizophrenia cases compared with controls. The mechanism through which these CNVs confer risk for the symptoms of schizophrenia, however, remains unclear. One possibility is that schizophrenia risk CNVs impact basic associative learning processes, abnormalities of which have long been associated with the disorder. To investigate whether genes in schizophrenia CNVs impact on specific phases of associative learning we combined human genetics with experimental gene expression studies in animals. In a sample of 11 917 schizophrenia cases and 16 416 controls, we investigated whether CNVs from patients with schizophrenia are enriched for genes expressed during the consolidation, retrieval or extinction of associative memories. We show that CNVs from cases are enriched for genes expressed during fear extinction in the hippocampus, but not genes expressed following consolidation or retrieval. These results suggest that CNVs act to impair inhibitory learning in schizophrenia, potentially contributing to the development of core symptoms of the disorder

Measurement of placental depth during time domain NIRS using deep learning

MAESTROS is a state-of-the-art in-house developed multi-wavelength time-domain NIRS system. Using NIRS to measure in-vivo placenta oxygenation non-invasively at the bedside could potentially provide valuable insights into the health status of the pregnancy. However, the variable depth of the placenta in the abdomen results in reliability issues for monitoring with NIR. Here, a deep learning model is presented to estimate the placental depth using the Distribution of Time of Flight (DTOF) measurements from the MAESTROS system. The model trained with 108 cases predicted the placental depth in 20 test cases with a mean error of 0.42 cm and a strong statistical correlation between predicted values and the measurements from the ultrasound scans. The model was 100% accurate when identifying the 20% of cases where the placenta is deeper than 3 cm, where the depth is great enough to undermine NIRS. The model could be used to alert TD-NIRS operators early in the acquisition about placental depth or could assist with data cleaning in study analysis. Furthermore, a technique for explainable Artificial Intelligence was applied to provide insight into the features of the DTOF data used by the model to predict placental depth, which were consistent with expectations based on the physics and anatomy of this application

High Burden of Unrecognized Atrial Fibrillation in Rural India: An Innovative Community-Based Cross-Sectional Screening Program

BACKGROUND: Atrial fibrillation, the world\u27s most common arrhythmia, is a leading risk factor for stroke, a disease striking nearly 1.6 million Indians annually. Early detection and management of atrial fibrillation is a promising opportunity to prevent stroke but widespread screening programs in limited resource settings using conventional methods is difficult and costly. OBJECTIVE: The objective of this study is to screen people for atrial fibrillation in rural western India using a US Food and Drug Administration-approved single-lead electrocardiography device, Alivecor. METHODS: Residents from 6 villages in Anand District, Gujarat, India, comprised the base population. After obtaining informed consent, a team of trained research coordinators and community health workers enrolled a total of 354 participants aged 50 years and older and screened them at their residences using Alivecor for 2 minutes on 5 consecutive days over a period of 6 weeks beginning June, 2015. RESULTS: Almost two-thirds of study participants were 55 years or older, nearly half were female, one-third did not receive any formal education, and more than one-half were from households earning less than US $2 per day. Twelve participants screened positive for atrial fibrillation yielding a sample prevalence of 5.1% (95% CI 2.7-8.7). Only one participant had persistent atrial fibrillation throughout all of the screenings, and 9 screened positive only once. CONCLUSIONS: Our study suggests a prevalence of atrial fibrillation in this Indian region (5.1%) that is markedly higher than has been previously reported in India and similar to the prevalence estimates reported in studies of persons from North America and Europe. Historically low reported burden of atrial fibrillation among individuals from low and middle-income countries may be due to a lack of routine screening. Mobile technologies may help overcome resource limitations for atrial fibrillation screening in underserved and low-resource settings

Microscopic Analysis For Water Stressed By High Electric Fields In The Prebreakdown Regime

Analysis of the electrical double layer at the electrode-water interface for voltages close to the breakdown point has been carried out based on a static, Monte Carlo approach. It is shown that strong dipole realignment, ion-ion correlation, and finite-size effects can greatly modify the electric fields and local permittivity (hence, leading to optical structure) at the electrode interface. Dramatic enhancements of Schottky injection, providing a source for electronic controlled breakdown, are possible. It is also shown that large pressures associated with the Maxwell stress tensor would be created at the electrode boundaries. Our results depend on the ionic density, and are in keeping with recent observations. A simple, perturbative analysis shows that high field regions with a sharp variation in permittivity can potentially be critical spots for instability initiation. This suggests that the use of polished electrodes, or composite materials, or alternative nonpolar liquids might help enhance high-voltage operation

A multimodal approach identifies lactate as a central feature of right ventricular failure that is detectable in human plasma

BackgroundIn PAH metabolic abnormalities in multiple pathways are well-recognized features of right ventricular dysfunction, however, prior work has focused mainly on the use of a single “omic” modality to describe a single deranged pathway. We integrated metabolomic and epigenomic data using transcriptomics in failing and non-failing RVs from a rodent model to provide novel mechanistic insight and translated these findings to accessible human specimens by correlation with plasma from PAH patients.MethodsStudy was conducted in a doxycycline-inducible BMPR2 mutant mouse model of RV failure. Plasma was collected from controls and PAH patients. Transcriptomic and metabolomic analyses were done on mouse RV tissue and human plasma. For mouse RV, we layered metabolomic and transcriptomic data for multiple metabolic pathways and compared our findings with metabolomic and transcriptomic data obtained for human plasma. We confirmed our key findings in cultured cardiomyocyte cells with BMPR2 mutation.ResultsIn failing mouse RVs, (1) in the glycolysis pathway, glucose is converted to lactate via aerobic glycolysis, but may also be utilized for glycogen, fatty acid, and nucleic acid synthesis, (2) in the fatty acid pathway, FAs are accumulated in the cytoplasm because the transfer of FAs to mitochondria is reduced, however, the ß-oxidation pathway is likely to be functional. (3) the TCA cycle is altered at multiple checkpoints and accumulates citrate, and the glutaminolysis pathway is not activated. In PAH patients, plasma metabolic and transcriptomic data indicated that unlike in the failing BMPR2 mutant RV, expression of genes and metabolites measured for the glycolysis pathway, FA pathway, TCA cycle, and glutaminolysis pathway were increased. Lactate was the only metabolite that was increased both in RV and circulation. We confirmed using a stable isotope of lactate that cultured cardiomyocytes with mutant BMPR2 show a modest increase in endogenous lactate, suggesting a possibility of an increase in lactate production by cardiomyocytes in failing BMPR2 mutant RV.ConclusionIn the failing RV with mutant BMPR2, lactate is produced by RV cardiomyocytes and may be secreted out, thereby increasing lactate in circulation. Lactate can potentially serve as a marker of RV dysfunction in PAH, which warrants investigation