A Bilayer SnO2/MoS2-Coated Evanescent Wave Fiber Optic Sensor for Acetone Detection-An Experimental Study.

The need for sensors that measure the acetone content of exhaled breath for diabetes severity has recently increased. Clinical researchers have reported less than 0.8 ppm acetone concentration in the exhaled breath of an average individual, while that for a diabetic patient is higher than 1.8 ppm. This work reports the development of two sets of evanescent wave-based fiber optic sensor coated with SnO2 thin film and bilayer of SnO2/MoS2 to detect different acetone concentrations (0-250 ppm). In each set, we have studied the effect of clad thickness (chemical etch time 5min, 10 min, 15 min, 25 min, 40 min, and complete clad removal) to optimize the clad thickness for a better response. In Set 1, SnO2 thin film was used as the sensing layer, while in Set 2 a bilayer of SnO2 thin film/ MoS2 was used. Enhanced sensor response of ~23.5% is observed in the Set 2 probe with a response and recovery time of ~14 s/~17 s. A SnO2/MoS2-coated sensor prototype is developed using LEDs of different wavelength and intensity detector; its potential to detect different concentrations of acetone is tested. X-ray Diffraction (XRD), Scanning Electron Microscope (SEM), Ultraviolet (UV) Spectroscopy, and Ellipsometry were used to study the structural, morphological and optical properties of the sensing layers. The present study indicates that the SnO2/MoS2-coated sensor has the potential to create a handheld sensor system for monitoring diabetes.

Clinical algorithms for the management of intrapartum maternal urine abnormalities.

AIM: To develop evidence-based clinical algorithms for management of common intrapartum urinary abnormalities. POPULATION: Women with singleton, term pregnancies in active labour and immediate postnatal period, at low risk of complications. SETTING: Healthcare facilities in low- and middle-income countries. SEARCH STRATEGY: A systematic search and review were conducted on the current guidelines from WHO, NICE, ACOG and RCOG. Additional search was done on PubMed and The Cochrane Database of Systematic Reviews up to May 2020. CASE SCENARIOS: Four common intrapartum urinary abnormalities were selected: proteinuria, ketonuria, glycosuria and oliguria. Using reagent strip testing, glycosuria was defined as ≥2+ on one occasion or of ≥1+ on two or more occasions. Proteinuria was defined as ≥2+ and presence of ketone indicated ketonuria. Oliguria was defined as hourly urine output ≤30 ml. Thorough initial assessment using history, physical examination and basic investigations helped differentiate most of the underlying causes, which include diabetes mellitus, dehydration, sepsis, pre-eclampsia, shock, anaemia, obstructed labour, underlying cardiac or renal problems. A clinical algorithm was developed for each urinary abnormality to facilitate intrapartum management and referral of complicated cases for specialised care. CONCLUSIONS: Four simple, user-friendly and evidence-based clinical algorithms were developed to enhance intrapartum care of commonly encountered maternal urine abnormalities. These algorithms may be used to support healthcare professionals in clinical decision-making when handling normal and potentially complicated labour, especially in low resource countries. TWEETABLE ABSTRACT: Evidence-based clinical algorithms developed to guide intrapartum management of commonly encountered urinary abnormalities.

Intrapartum care algorithms for liquor abnormalities: oligohydramnios, meconium, blood and purulent discharge.

AIM: To construct evidence-based algorithms for the assessment and management of common amniotic fluid abnormalities detected during labour. POPULATION: Low-risk singleton, term pregnant women in labour. SETTING: Birth facilities in low- and middle-income countries. SEARCH STRATEGY: We searched international guidelines published by the American College of Obstetricians and Gynecologists (ACOG), the National Institute for Health and Care Excellence (NICE), the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), the Royal College of Obstetricians and Gynaecologists (RCOG), the Society of Obstetrics and Gynaecology (SOGC) and the World Health Organization (WHO). We also searched The Cochrane Library and MEDLINE up to 20 January 2020 using keywords for relevant systematic reviews and randomised trials. CASE SCENARIOS: We developed evidence-based intrapartum care algorithms for four case scenarios: oligohydramnios; meconium-stained amniotic fluid; bloody amniotic fluid or vaginal bleeding; and purulent amniotic fluid or discharge. These conditions may be associated with fetal and /or maternal morbidity. Differential diagnosis includes uteroplacental insufficiency, fetal growth restriction, fetal distress, abruption, placenta or vasa praevia, uterine rupture and intra-amniotic infection, respectively. Algorithms include how to assess for, diagnose and manage these conditions. CONCLUSIONS: Four algorithms are presented, to provide a systematic approach and guidance on the clinical management for the following amniotic fluid abnormalities: oligohydramnios; meconium-stained liquor; bloody amniotic fluid or vaginal bleeding; and purulent amniotic fluid or discharge. These algorithms may be beneficial in supporting clinical decision making, particularly in low-resource settings. TWEETABLE ABSTRACT: Evidence based algorithms for management of common amniotic fluid abnormalities seen during labour.

Constructing evidence-based clinical intrapartum care algorithms for decision-support tools.

AIM: To describe standardised iterative methods used by a multidisciplinary group to develop evidence-based clinical intrapartum care algorithms for the management of uneventful and complicated labours. POPULATION: Singleton, term pregnancies considered to be at low risk of developing complications at admission to the birthing facility. SETTING: Health facilities in low- and middle-income countries. SEARCH STRATEGY: Literature reviews were conducted to identify standardised methods for algorithm development and examples from other fields, and evidence and guidelines for intrapartum care. Searches for different algorithm topics were last updated between January and October 2020 and included a combination of terms such as 'labour', 'intrapartum', 'algorithms' and specific topic terms, using Cochrane Library and MEDLINE/PubMED, CINAHL, National Guidelines Clearinghouse and Google. CASE SCENARIOS: Nine algorithm topics were identified for monitoring and management of uncomplicated labour and childbirth, identification and management of abnormalities of fetal heart rate, liquor, uterine contractions, labour progress, maternal pulse and blood pressure, temperature, urine and complicated third stage of labour. Each topic included between two and four case scenarios covering most common deviations, severity of related complications or critical clinical outcomes. CONCLUSIONS: Intrapartum care algorithms provide a framework for monitoring women, and identifying and managing complications during labour and childbirth. These algorithms will support implementation of WHO recommendations and facilitate the development by stakeholders of evidence-based, up to date, paper-based or digital reminders and decision-support tools. The algorithms need to be field tested and may need to be adapted to specific contexts. TWEETABLE ABSTRACT: Evidence-based intrapartum care clinical algorithms for a safe and positive childbirth experience.

Objective function based ranking method for selection of optimal beam angles in IMRT.

We propose a novel method for the selection of optimal beam angles in Intensity Modulated Radiation Therapy (IMRT). The proposed approach uses an objective function based metric called "target-to-critical organ objective function ratio" to find out the optimal gantry angles. The beams are ranked based on this metric and are accordingly chosen for IMRT optimization. We have used the Pinnacle TPS (Philips Medical System V 16.2) for performing the IMRT optimization. In order to validate our approach, we have applied it in four clinical cases: Head and Neck, Lung, Abdomen and Prostate. Basically, for all clinical cases, two set of plans were created with same clinical objectives, namely Equal angle plan (EA Plan) and Suitable angle Plan (SA Plan). In the EA plans, the beam angles were placed in an equiangular manner starting from the gantry angle of 0°. In the corresponding SA plans, the beam angles were decided using the guidance provided by the algorithm. The reduction in OAR mean dose and max dose obtained in SA plans is about 3 to 16% and 3 to 15% respectively depending upon the treatment site while obtaining equal target coverage as compared to their EA counterparts. It takes approximately 15-25 min to find the optimal beam angles. The results obtained from the clinical cases indicate that the plan quality is considerably improved when the beam angles are optimized using the proposed method.

Nursing Informatics as a Specialization in India: Present and Future.

Nurse informatics specialist is the new concept in India moreover it's a kind of challenge in the highly populated All India Institute of medical sciences, a quaternary care premium medical institute in India to digitalise all the medical / administrative paper work. The paper emphasizes on nature of duties for nursing Informatics practicner, desirable skills, challenges and finally implementing nursing Informatics concept in India, in All india Institute of Medical sciences. For the first time the nursing informatics concept is used and implemented in India, and I am the part of this concept. I will be further sharing my experiences of Nursing informatics practice in India.

Core outcome sets for prevention and treatment of postpartum haemorrhage: an international Delphi consensus study.

OBJECTIVE: To develop core outcome sets (COS) for studies evaluating interventions for (1) prevention and (2) treatment of postpartum haemorrhage (PPH), and recommendations on how to report the COS. DESIGN: A two-round Delphi survey and face-to-face meeting. POPULATION: Healthcare professionals and women's representatives. METHODS: Outcomes were identified from systematic reviews of PPH studies and stakeholder consultation. Participants scored each outcome in the Delphi on a Likert scale between 1 (not important) and 9 (critically important). Results were discussed at the face-to-face meeting to agree the final COS. Consensus at the meeting was defined as ≥ 70% of participants scoring the outcome as critically important (7-9). Lectures, discussion and voting were used to agree how to report COS outcomes. MAIN OUTCOME MEASURES: Outcomes from systematic reviews and consultations. RESULTS: Both Delphi rounds were completed by 152/205 (74%) participants for prevention and 143/197 (73%) for treatment. For prevention of PPH, nine core outcomes were selected: blood loss, shock, maternal death, use of additional uterotonics, blood transfusion, transfer for higher level of care, women's sense of wellbeing, acceptability and satisfaction with the intervention, breastfeeding, and adverse effects. For treatment of PPH, 12 core outcomes were selected: blood loss, shock, coagulopathy, hysterectomy, organ dysfunction, maternal death, blood transfusion, use of additional haemostatic intervention, transfer for higher level of care, women's sense of wellbeing, acceptability and satisfaction with the intervention, breastfeeding, and adverse effects. Recommendations were developed on how to report these outcomes where possible. CONCLUSIONS: These COS will help standardise outcome reporting in PPH trials. TWEETABLE ABSTRACT: Core outcome sets for PPH: nine core outcomes for PPH prevention and 12 core outcomes for PPH treatment.

The origin and stability of nanostructural hierarchy in crystalline solids.

The structural hierarchy exhibited by materials on more than one length scale can play a major part in determining bulk material properties. Understanding the hierarchical structure can lead to new materials with physical properties tailored for specific applications. We have used a combined experimental and phase-field modeling approach to explore such a hierarchical structure at nanoscale for enhanced coarsening resistance of ordered γ' precipitates in an experimental, multicomponent, high-refractory nickel-base superalloy. The hierarchical microstructure formed experimentally in this alloy is composed of a γ matrix with γ' precipitates that contain embedded, spherical γ precipitates, which do not directionally coarsen during high-temperature annealing but do delay coarsening of the larger γ' precipitates. Chemical mapping via atom probe tomography suggests that the supersaturation of Co, Ru, and Re in the γ' phase is the driving force for the phase separation, leading to the formation of this hierarchical microstructure. Representative phase-field modeling highlights the importance of larger γ' precipitates to promote stability of the embedded γ phase and to delay coarsening of the encompassing γ' precipitates. Our results suggest that the hierarchical material design has the potential to influence the high-temperature stability of precipitate strengthened metallic materials.

Pyogenic Liver Abscess Caused by Methicillin-Susceptible Staphylococcus aureus in a 21-Year-Old Male.

Liver abscesses are the most common types of visceral abscesses. Pyogenic liver abscesses, a particular type of liver abscesses, are uncommonly encountered. We present a rare case of pyogenic liver abscess caused by methicillin-susceptible Staphylococcus aureus in a young man. A 21-year- old man presented from prison to the hospital with fever, nausea, vomiting, diarrhea, and abdominal pain for five days. Labs were significant for leukocytosis with predominant neutrophilia and elevated liver enzymes. CT abdomen with contrast revealed an 8.4 cm multiloculated right hepatic mass extending to the kidney. Patient was started on broad spectrum antibiotics, given septic presentation. Peripheral blood cultures returned positive for methicillin-susceptible Staphylococcus aureus (MSSA). The culture from percutaneous drainage also revealed MSSA. He received a total of four weeks of IV Nafcillin therapy along with drainage of his abscess via percutaneous catheter. Follow-up revealed clinical resolution. This case highlights the importance of obtaining an aspirate from the liver abscess to better guide treatment strategy. Clinicians must consider broadening antibiotic coverage to include gram-positive organisms if the patient presents with severe illness and risk factors for Staphylococcus aureus infections.

Pseudohyponatraemia secondary to hyperlipidaemia in obstructive jaundice.

A 44-year-old man with uncontrolled diabetes and chronic pancreatitis presented with abdominal pain, jaundice and unintentional weight loss. Laboratory investigations were significant for hyponatraemia, an obstructive pattern of liver enzymes. Imaging was consistent with intrahepatic and extrahepatic biliary obstruction, and endoscopic evaluation revealed a long common bile duct stricture. Intravascular volume depletion, beer potomania and syndrome of inappropriate antidiuretic hormone (with concern for biliary or pancreatic malignancy) were considered in the work-up for the aetiology of the hyponatraemia. After 4 days of conventional treatment, hyponatraemia persisted. Lipid panel obtained revealed very high levels of total cholesterol. The patient underwent a successful biliary diversion and reconstruction surgery. Follow-up after 3 months showed a clinically stable patient with resolution of elevated liver enzymes, hyperlipidaemia and hyponatraemia. We illustrate this rare case of hyponatraemia secondary to hyperlipidaemia in obstructive biliary cholestasis. It is important for physicians to thoroughly investigate the aetiology of hyponatraemia at its onset.

Chronic dietary oxalate nephropathy after intensive dietary weight loss regimen.

BACKGROUND: Hyperoxaluria has been associated with nephrolithiasis as well as acute and chronic kidney disease. We present a case of end stage renal failure caused by excessive dietary oxalate intake in a dietary weight loss regimen. CASE PRESENTATION: A 51-year-old Caucasian male with the past medical history of type 2 diabetes mellitus, gout, hypertension and morbid obesity was referred to the primary care clinic after being found pale and easily fatigued. The patient had lost 36 kg over a 7-month period by implementing exercise and intense dietary measures that included 6 meals of spinach, kale, berries, and nuts. Physical examination revealed a blood pressure of 188/93 mm Hg with sunken eyes and dry mucus membranes. Laboratory workup was notable for blood urea nitrogen of 122 mg/dL, creatinine of 12 mg/dL, and estimated glomerular filtration rate (eGFR) of 4.4 mL/min/1.73m2. Patient denied any history of renal disease or renal stones, or taking herbal products, non-steroidal anti-inflammatory drugs, antifreeze (ethylene glycol), or any type of "diet pills." Family history was unremarkable for any renal diseases. After failing intravenous fluid resuscitation, patient was started on maintenance hemodialysis. Abdominal imaging was consistent with chronic renal parenchymal disease with no evidence of nephrolithiasis. Renal biopsy revealed numerous polarized oxalate crystal deposition and diabetic nephropathy class IIA. At this point the patient was instructed to adopt a low oxalate diet. A 24-hour urine collection was remarkable for pH 4.7, citrate <50 mg, and oxalate 46 mg. Importantly, serum oxalate level was undetectable. Repeat renal biopsy 5 months later while patient was still on maintenance hemodialysis revealed persistence of extensive oxalate crystal deposition. Patient has been referred for evaluation for renal transplantation. CONCLUSIONS: Clinicians need to maintain a high index of suspicion for dietary hyperoxaluria as a potential etiology for acute or chronic kidney failure, particularly in patients pursuing intensive dietary weight loss intervention.

Challenges and Hurdles of eHealth Implementation in Developing Countries.

UNLABELLED: Health informatics has the potential to improve the security and quality of patient care, but its impact has varied between developed and developing countries. Related to this, the objective of this study is to identify the challenges and hurdles to improve eHealth in developing countries. We surveyed experts to discover their opinions about five general questions: economic support by Government for eHealth, Government education or training projects in the field, issues related to cultural or educational problems for the implementation of eHealth, policies in terminology or messaging standards and eHealth status policies for long periods. The respondents answered affirmatively in these proportions: 1. Economic support policies 58%, 2. Training policies 25%, 3. Cultural and educational problems 95%, 4. Standards policies, 38%, 5. Policies for long periods, 50% CONCLUSION: Our survey has shown that the important problems that need to be addressed in order to implement e-Health in developing countries are firstly, cultural and educational, secondly, economic resources and thirdly policies for long periods.

Determination of solute site occupancies within γ' precipitates in nickel-base superalloys via orientation-specific atom probe tomography.

The analytical limitations in atom probe tomography such as resolving a desired set of atomic planes, for solving complex materials science problems, have been overcome by employing a well-developed unique and reproducible crystallographic technique, involving synergetic coupling of orientation microscopy with atom probe tomography. The crystallographic information in atom probe reconstructions has been utilized to determine the solute site occupancies in Ni-Al-Cr based superalloys accurately. The structural information in atom probe reveals that both Al and Cr occupy the same sub-lattice within the L12-ordered γ' precipitates to form Ni3(Al,Cr) precipitates in a Ni-14Al-7Cr (at%) alloy. Interestingly, the addition of Co, which is a solid solution strengthener, to a Ni-14Al-7Cr alloy results in the partial reversal of Al site occupancy within γ' precipitates to form (Ni,Al)3(Al,Cr,Co) precipitates. This unique evidence of reversal of Al site occupancy, resulting from the introduction of other solutes within the ordered structures, gives insights into the relative energetics of different sub-lattice sites when occupied by different solutes.

Impact of cerebral redistribution on neurodevelopmental outcome in small-for-gestational-age or growth-restricted babies: a systematic review.

OBJECTIVES: To review systematically the evidence on impact of cerebral redistribution, as assessed by fetal middle cerebral artery (MCA) Doppler, on neurological outcomes in small-for-gestational-age (SGA) or growth-restricted fetuses. METHODS: For this systematic review, MEDLINE was searched for all controlled studies reporting neurological outcomes in SGA or growth-restricted babies with cerebral redistribution based on MCA Doppler indices, from inception to September 2013. We used relative risk or odds ratios, with 95% CI, to identify the association of cerebral redistribution with neurological outcomes. RESULTS: The search yielded 1180 possible citations, of which nine studies were included in the review, with a total of 1198 fetuses. Definitions of SGA and cerebral redistribution were variable, as was study quality. Data could not be synthesized in meta-analyses because of heterogeneity in outcome reporting. Cerebral redistribution was not associated with increased risk of intraventricular hemorrhage in neonates (five studies; n = 806). When present in preterm fetuses, cerebral redistribution was associated with normal Neonatal Behavioral Assessment Scale (NBAS) scores at 40 weeks (one study; n = 62) but abnormal psychomotor development at 1 year of age on the Bayley scale (one study; n = 172). When present in term SGA fetuses, cerebral redistribution was associated with increased risk of motor and state organizational problems on NBAS (two studies; n = 158), and lower mean percentile scores in communication and problem solving at 2 years of age on the Ages and Stages Questionnaire (one study; n = 125). CONCLUSIONS: SGA fetuses with cerebral redistribution may be at higher risk of neurodevelopmental problems. More data are needed from adequately controlled studies with long-term follow-up before conclusions can be drawn. If these findings are true, there is a need to re-evaluate timing of delivery in the management of SGA fetuses, particularly when cerebral redistribution is found at term gestation.

Probing the crystallography of ordered Phases by coupling of orientation microscopy with atom probe tomography.

The determination of atomic scale structural and compositional information using atom probe tomography is currently limited to elemental solids and dilute alloys. In the present article, a unique coupling of orientation microscopy and atom probe tomography successfully facilitates the crystallographic study of non-dilute alloy systems, with high evaporation fields. This reproducible methodology affords a new perspective to the conventional atom probe tomography of ordered precipitate strengthened superalloys. The high accuracy in crystallographic site-specific sample preparation results in high spatial resolution in APT, which has been demonstrated in Co-base superalloys. The practical applications of this technique can be extended to accurately characterize the nature of buried order/disorder interfaces at the atomic scale, as well as the site occupancies associated with different solute atoms in multi-component superalloys.

Choice of primary outcomes in randomised trials and systematic reviews evaluating interventions for preterm birth prevention: a systematic review.

BACKGROUND: The inappropriate and inconsistent selection of primary outcomes (POs) in randomised controlled trials (RCTs) and systematic reviews (SRs) can make evidence difficult to interpret, limiting its usefulness to inform clinical practice. OBJECTIVES: To systematically review the choice and consistency of POs in RCTs and SRs of preventative interventions for preterm birth. SEARCH STRATEGY: Cochrane Pregnancy and Childbirth Group's Specialised Register of trials and a full list of published reviews and protocols. SELECTION CRITERIA: Full reports of RCTs for preterm birth prevention published after CONSORT (January 1997-January 2011), and Cochrane Reviews and protocols relevant to preterm birth prevention, for the same period. DATA COLLECTION AND ANALYSIS: For RCTs, the PO was the outcome used for sample size calculation. For SRs, we included all outcomes listed as 'primary'. Two review authors selected studies and double-checked the data for accuracy. RESULTS: Seventy-two different POs were reported by 103 RCTs. The three most common POs were based on length of gestation, with preterm birth before 37 weeks of gestation being the most common (18/103, 18%). Few RCTs chose perinatal morbidity (4/103) or mortality (1/103), or their composites (5/103), as POs. In 33 Cochrane Reviews, 29 different POs were reported. The three most common POs were based on death or morbidity in the baby, with death of the baby being the most common (22/33, 67%). POs were variably defined. CONCLUSIONS: There is a lack of consistency in the choice and definitions of POs in clinical research related to preterm birth prevention. SRs are more likely to report morbidity and mortality as POs, whereas RCTs tend to use length of gestation. Researchers are urged to review the outcomes reported in RCTs and SRs in their respective areas of interest to highlight discrepancies and facilitate the development of core outcome sets.

Fetal hemoglobin and alpha thalassemia modulate the phenotypic expression of HbSD-Punjab.

INTRODUCTION: HbSD-Punjab (HbSD) is a less common form of sickle cell disease (SCD) and discrimination between HbSD and HbSS is not possible on alkaline electrophoresis because the two variants overlap in the compound heterozygous state. There are only a few publications consisting mostly of case reports. Thus, the phenotypic expression of HbSD and its modifiers has not been studied. METHODS: We studied the phenotypic expression of 42 cases of HbSD (the largest number of subjects ever included in this kind of study) and compared them with 84 HbSS cases matched for age, sex, and caste. Further, we evaluated the influence of HbF concentration and alpha thalassemia on the phenotypic expressions of HbSD, namely the frequency of VOC and degree of hemolysis. RESULTS: The frequencies of VOC were similar in both the groups. The markers of hemolysis such as total bilirubin, unconjugated bilirubin, and LDH were higher where as HbF concentration was significantly low in HbSD. There was a negative correlation between HbF concentration and risk of VOC in the HbSD. The total hemoglobin level and hematocrit were significantly high, and the MCV and MCH were significantly low in HbSD with alpha thalassemia. Alpha thalassemia had no influence on the frequency of VOC and severity of hemolysis in HbSD. CONCLUSION: HbF reduced the frequency of VOC but had no influence on the hemolytic markers in HbSD. HbSD with alpha thalassemia was associated with hypohromic and microcytic features of red blood cells.

A proautophagic antiviral role for the cellular prion protein identified by infection with a herpes simplex virus 1 ICP34.5 mutant.

The cellular prion protein (PrP) often plays a cytoprotective role by regulating autophagy in response to cell stress. The stress of infection with intracellular pathogens can stimulate autophagy, and autophagic degradation of pathogens can reduce their replication and thus help protect the infected cells. PrP also restricts replication of several viruses, but whether this activity is related to an effect on autophagy is not known. Herpes simplex virus 1 (HSV-1) effectively counteracts autophagy through binding of its ICP34.5 protein to the cellular proautophagy protein beclin-1. Autophagy can reduce replication of an HSV-1 mutant, Δ68H, which is incapable of binding beclin-1. We found that deletion of PrP in mice complements the attenuation of Δ68H, restoring its capacity to replicate in the central nervous system (CNS) to wild-type virus levels after intracranial or corneal infection. Cultured primary astrocytes but not neurons derived from PrP(-/-) mice also complemented the attenuation of Δ68H, enabling Δ68H to replicate at levels equivalent to wild-type virus. Ultrastructural analysis showed that normal astrocytes exhibited an increase in the number of autophagosomes after infection with Δ68H compared with wild-type virus, but PrP(-/-) astrocytes failed to induce autophagy in response to Δ68H infection. Redistribution of EGFP-LC3 into punctae occurred more frequently in normal astrocytes infected with Δ68H than with wild-type virus, but not in PrP(-/-) astrocytes, corroborating the ultrastructural analysis results. Our results demonstrate that PrP is critical for inducing autophagy in astrocytes in response to HSV-1 infection and suggest that PrP positively regulates autophagy in the mouse CNS.

Using Personal Handheld Computing Devices for Personalizing Healthcare. A Contribution from the IMIA Working Group on Telehealth.

OBJECTIVES: Telehealth has an increasing role in future healthcare. This paper seeks to define and understand recent advances in provision of tele-healthcare through use of personal handheld computing devices, and suggests how such personalized solutions offer further opportunities for progress. METHODS: We considered the current status of personal handheld computing devices for personalizing healthcare, through review of examples in the literature and web sources. RESULTS: We have identified the following four generic roles for personal handheld computing devices in personalized healthcare: educational, social networking and games, monitoring with notifications/ reminders, and online/offline tele-consultations. We discuss examples of these in two settings: healthcare facilities and patient home. CONCLUSION: Advances in latest handheld computing devices have made tele-healthcare more personalized and increasingly possible even in the absence of the care provider.