Aplicativos como ferramenta de educação em saúde para portadores de diabetes mellitus: o que está disponível na língua portuguesa? / Apps as a health education tool for people with diabetes mellitus: what is available in Portuguese?

Resumo Os aplicativos de saúde para dispositivos móveis se revelam como uma ferramenta importante para a educação em saúde para apoiar o tratamento de diferentes doenças, como o diabetes mellitus (DM). Nesse sentido, esta pesquisa analisa as funcionalidades dos aplicativos existentes na língua portuguesa destinados a auxiliar pessoas com DM. Foi realizada uma busca sistemática para identificação dos aplicativos por meio dos indexadores "Controle de diabetes", "Diabetes", "Glicose" e "Insulina" nos sistemas operacionais Android e iOS. Foram encontrados 576 aplicativos, porém, apenas 63 (10,9%) atenderam aos critérios de inclusão. De acordo com sua funcionalidade, os aplicativos apresentaram as seguintes possibilidades de uso: 13 educativos; 12 monitoram atividade física; 18 contêm diário alimentar; 28 contam carboidratos; 34 monitoram a insulina; 49 monitoram a glicemia; 33 apresentam gráficos; 9 alertam sobre a presença de hipo ou hiperglicemia; 17 lembram coleta de glicemia; e 5 apresentaram receitas culinárias. As funcionalidades que auxiliam na mudança de comportamento e individualizam estratégias de tratamento ainda são incipientes. Sugere-se o desenvolvimento de ferramentas auxiliares para interação dos aplicativos com seus usuários e a comprovação da sua eficácia.

Abstract Health applications for mobile devices are an important tool for a health education to support the treatment of different diseases, such as diabetes mellitus (DM). In this sense, this research analyzes the functionalities of existing applications in Portuguese aimed at helping people with DM. A systematic search was performed to identify the applications by the descriptors "Diabetes control," "Diabetes," "Glucose," and "Insulin" in Android and iOS operating systems. A total of 576 applications were found, but only 63 (10.9%) met the inclusion criteria. According to their functionality, the apps presented the following possibilities of use: 13 are educational; 12 monitor physical activity; 18 contain a food diary; 28 count carbohydrates; 34 monitor insulin; 49 monitor blood glucose; 33 present graphs; 9 warn about the presence of hypo or hyperglycemia; 17 recall blood glucose collection; and 5 present culinary recipes. Functionalities that assist in behavior change and that individualize treatment strategies are still incipient. We suggest the development of auxiliary tools for interaction of applications with their users and the proof of their effectiveness.

The digital transformation of hepatology: The patient is logged in.

The rise in innovative digital health technologies has led a paradigm shift in health care toward personalized, patient-centric medicine that is reaching beyond traditional brick-and-mortar facilities into patients' homes and everyday lives. Digital solutions can monitor and detect early changes in physiological data, predict disease progression and health-related outcomes based on individual risk factors, and manage disease intervention with a range of accessible telemedicine and mobile health options. In this review, we discuss the unique transformation underway in the care of patients with liver disease, specifically examining the digital transformation of diagnostics, prediction and clinical decision-making, and management. Additionally, we discuss the general considerations needed to confirm validity and oversight of new technologies, usability and acceptability of digital solutions, and equity and inclusivity of vulnerable populations.

Adoption of Advanced Microneurosurgical Technologies: An International Survey.

BACKGROUND: Operating microscopes and adjunctive technologies are continually refined to advance microneurosurgical care. How frequently these advances are used is unknown. In the present study, we assessed the international adoption of microneurosurgical technologies and discussed their value. METHODS: A 27-question electronic survey was distributed to cerebrovascular neurosurgeon members of U.S., European, and North American neurosurgical societies and social media networks of cerebrovascular and skull base neurosurgeons. The survey encompassed the surgeons' training background, surgical preferences, and standard microneurosurgical practices. RESULTS: Of the respondents, 56% (53 of 95) were attendings, 74% (70 of 95) were in their first 10 years of practice, and 67% (63 of 94) practiced at an academic teaching hospital. Vascular, endovascular, and skull base fellowships had been completed by 38% (36 of 95), 27% (26 of 95), and 32% (30 of 95) of the respondents, respectively. Most respondents did not use an exoscope (78%; 73 of 94), a mouthpiece (61%; 58 of 95), or foot pedals (56%; 55 of 94). All 95 respondents used a microscope, and 71 (75%) used Zeiss microscopes. Overall, 57 neurosurgeons (60%) used indocyanine green for aneurysms (n = 54), arteriovenous malformations (n = 43), and dural arteriovenous fistulas (n = 42). Most (80%; 75 of 94) did not use fluorescence. The respondents with a vascular-focused practice more commonly used indocyanine green, Yellow 560 fluorescence, and intraoperative 2-dimensional digital subtraction angiography. The respondents with a skull base-focused practice more commonly used foot pedals and an endoscope-assist device. CONCLUSIONS: The results from the present survey have characterized the current adoption of operative microscopes and adjunctive technologies in microneurosurgery. Despite numerous innovations to improve the symbiosis between neurosurgeon and microscope, their adoption has been underwhelming. Future advances are essential to improve surgical outcomes.

Digital Technology Application for Improved Responses to Health Care Challenges: Lessons Learned From COVID-19.

While COVID-19 is still ongoing and associated with more than 5 million deaths, the scope and speed of advances over the past year in terms of scientific discovery, data dissemination, and technology have been staggering. It is not a matter of "if" but "when" we will face the next pandemic, and how we leverage technology and data management effectively to create flexible ecosystems that facilitate collaboration, equitable care, and innovation will determine its severity and scale. The aim of this review is to address emerging challenges that came to light during the pandemic in health care and innovations that enabled us to adapt and continue to care for patients. The pandemic highlighted the need for seismic shifts in care paradigms and technology with considerations related to the digital divide and health literacy for digital health interventions to reach full potential and improve health outcomes. We discuss advances in telemedicine, remote patient monitoring, and emerging wearable technologies. Despite the promise of digital health, we emphasise the importance of addressing its limitations, including interpretation challenges, accuracy of findings, and artificial intelligence-driven algorithms. We summarise the most recent recommendation of the Virtual Care Task Force to scaling virtual medical services in Canada. Finally, we propose a model for optimal implementation of health digital innovations with 5 tenets including data management, data security, digital biomarkers, useful artificial intelligence, and clinical integration.

Evaluating the performance of drug-repurposing technologies.

Drug-repurposing technologies are growing in number and maturing. However, comparisons to each other and to reality are hindered because of a lack of consensus with respect to performance evaluation. Such comparability is necessary to determine scientific merit and to ensure that only meaningful predictions from repurposing technologies carry through to further validation and eventual patient use. Here, we review and compare performance evaluation measures for these technologies using version 2 of our shotgun repurposing Computational Analysis of Novel Drug Opportunities (CANDO) platform to illustrate their benefits, drawbacks, and limitations. Understanding and using different performance evaluation metrics ensures robust cross-platform comparability, enabling us to continue to strive toward optimal repurposing by decreasing the time and cost of drug discovery and development.

Artificial intelligence-enhanced drug design and development: Toward a computational precision medicine.

Artificial Intelligence (AI) relies upon a convergence of technologies with further synergies with life science technologies to capture the value of massive multi-modal data in the form of predictive models supporting decision-making. AI and machine learning (ML) enhance drug design and development by improving our understanding of disease heterogeneity, identifying dysregulated molecular pathways and therapeutic targets, designing and optimizing drug candidates, as well as evaluating in silico clinical efficacy. By providing an unprecedented level of knowledge on both patient specificities and drug candidate properties, AI is fostering the emergence of a computational precision medicine allowing the design of therapies or preventive measures tailored to the singularities of individual patients in terms of their physiology, disease features, and exposure to environmental risks.

Learning objectives: an epiphany.

A new Bachelor-Master curriculum in Biomedical Sciences was created at the University of Geneva in 2017. As we organized the new curriculum, we discovered the usefulness of learning objectives. This goal-oriented approach of teaching proved essential to determine the overall structure of the teaching program, as well as the content of specific courses, and the nature of the examinations. It led us to include innovative elements in the program, preparing students for real-life situations. Finally, it convinced us to change our role as teachers, in order to engage students in a more active learning relationship.

Adoption of health technologies for effective health information system: Need of the hour for Pakistan.

Health information technology systems have the capacity to improve health outcomes for the patients thus ensuring quality and efficient services. Health information systems (HIS) are important tools in guidance towards patient safety and better outcomes. However, still, morbidity and mortality attributed to medical errors remain an important issue that needs to be addressed. The objective of the present study was to assess the health information system in terms of technological, environmental, organizational and human factors affecting the adoption as well as the perceptions of stakeholders along with barriers and constraints related to successful implementation. A descriptive cross-sectional study design was used. Prospective data was collected from primary sources by self-administering the pre-validated questionnaires as well as by physical verification of the availability of equipment. After data collection, data was analyzed to assess the health information management systems. The results of the present study showed that the health information system in Pakistan is not up to the mark. The equipment was mostly unavailable at the primary healthcare facilities. The staff was also unsatisfied with the available services. Administrative, financial and human constraints were identified as the major barriers towards successful implementation and management of HIS. The present study concluded that the health information system of Pakistan needs to be revamped. Health information management system partially existed at district and sub-district offices, while was completely absent at tertiary, secondary and primary healthcare levels. The poor adoption of health information technology systems at healthcare facilities might largely be attributed to insufficient human resources with limited resources and budget allocation for health in Pakistan. Effective and timely strategies involving all important stakeholders and healthcare professionals must be designed and implemented at the National level to restructure an affordable, resilient and quality healthcare system.

Exosomes Engineering and Their Roles as Therapy Delivery Tools, Therapeutic Targets, and Biomarkers.

Exosomes are becoming increasingly important therapeutic biomaterials for use in a variety of therapeutic applications due to their unique characteristics, especially due to the ineffectiveness and cytotoxicity of some existing therapies and synthetic therapeutic nanocarriers. They are highly promising as carriers of drugs, genes, and other therapeutic agents that can be incorporated into their interior or onto their surface through various modification techniques to improve their targeting abilities. In addition, they are biocompatible, safe, and stable. The review focuses on different types of exosomes and methods of their preparation, including the incorporation of different kinds of cargo, especially for drug delivery purposes. In particular, their importance and effectiveness as delivery vehicles of various therapeutic agents for a variety of therapeutic applications, including different diseases and disorders such as cancer treatment, cardiovascular and neurodegenerative diseases, are emphasized. Administration routes of exosomes into the body are also included. A novelty in the article is the emphasis on global companies that are already successfully developing and testing such therapeutic biomaterials, with a focus on the most influential ones. Moreover, a comparison of the advantages and disadvantages of the various methods of exosome production is summarized for the first time.

Neurodegeneration & imperfect ageing: Technological limitations and challenges?

Cellular homeostasis is regulated by the protein quality control (PQC) machinery, comprising multiple chaperones and enzymes. Studies suggest that the loss of the PQC mechanisms in neurons may lead to the formation of abnormal inclusions that may lead to neurological disorders and defective aging. The questions could be raised how protein aggregate formation precisely engenders multifactorial molecular pathomechanism in neuronal cells and affects different brain regions? Such questions await thorough investigation that may help us understand how aberrant proteinaceous bodies lead to neurodegeneration and imperfect aging. However, these studies face multiple technological challenges in utilizing available tools for detailed characterizations of the protein aggregates or amyloids and developing new techniques to understand the biology and pathology of proteopathies. The lack of detection and analysis methods has decelerated the pace of the research in amyloid biology. Here, we address the significance of aggregation and inclusion formation, followed by exploring the evolutionary contribution of these structures. We also provide a detailed overview of current state-of-the-art techniques and advances in studying amyloids in the diseased brain. A comprehensive understanding of the structural, pathological, and clinical characteristics of different types of aggregates (inclusions, fibrils, plaques, etc.) will aid in developing future therapies.

Volume Balance in Chronic Kidney Disease: Evaluation Methodologies and Innovation Opportunities.

BACKGROUND: Patients affected by chronic kidney disease are at a risk of cardiovascular morbidity and mortality. Body fluids unbalance is one of the main characteristics of this condition, as fluid overload is highly prevalent in patients affected by the cardiorenal syndrome. SUMMARY: We describe the state of the art and new insights into body volume evaluation. The mechanisms behind fluid balance are often complex, mainly because of the interplay of multiple regulatory systems. Consequently, its management may be challenging in clinical practice and even more so out-of-hospital. Availability of novel technologies offer new opportunities to improve the quality of care and patients' outcome. Development and validation of new technologies could provide new tools to reduce costs for the healthcare system, promote personalized medicine, and boost home care. Due to the current COVID-19 pandemic, a proper monitoring of chronic patients suffering from fluid unbalances is extremely relevant. Key Message: We discuss the main mechanisms responsible for fluid overload in different clinical contexts, including hemodialysis, peritoneal dialysis, and heart failure, emphasizing the potential impact provided by the implementation of the new technologies.

Technological Advances in Charged-Particle Therapy.

Charted-particle therapy (CPT) benefits cancer patients by localizing doses in the tumor volume while minimizing the doses delivered to normal tissue through its unique physical and biological characteristics. The world's first CPT applied on humans was proton beam therapy (PBT), which was performed in the mid-1950s. Among heavy ions, carbon ions showed the most favorable biological characteristics for the treatment of cancer patients. Carbon ions show coincidence between the Bragg peak and maximum value of relative biological effectiveness. In addition, they show low oxygen enhancement ratios. Therefore, carbon-ion radiotherapy (CIRT) has become mainstream in the treatment of cancer patients using heavy ions. CIRT was first performed in 1977 at the Lawrence Berkeley Laboratory. The CPT technology has advanced in the intervening decades, enabling the use of rotating gantry, beam delivery with fast pencil-beam scanning, image-guided particle therapy, and intensity-modulated particle therapy. As a result, as of 2019, a total of 222,425 and 34,138 patients with cancer had been treated globally with PBT and CIRT, respectively. For more effective and efficient CPT, many groups are currently conducting further studies worldwide. This review summarizes recent technological advances that facilitate clinical use of CPT.

Nanomaterials for Biomedical Applications: Production, Characterisations, Recent Trends and Difficulties.

Designing of nanomaterials has now become a top-priority research goal with a view to developing specific applications in the biomedical fields. In fact, the recent trends in the literature show that there is a lack of in-depth reviews that specifically highlight the current knowledge based on the design and production of nanomaterials. Considerations of size, shape, surface charge and microstructures are important factors in this regard as they affect the performance of nanoparticles (NPs). These parameters are also found to be dependent on their synthesis methods. The characterisation techniques that have been used for the investigation of these nanomaterials are relatively different in their concepts, sample preparation methods and obtained results. Consequently, this review article aims to carry out an in-depth discussion on the recent trends on nanomaterials for biomedical engineering, with a particular emphasis on the choices of the nanomaterials, preparation methods/instruments and characterisations techniques used for designing of nanomaterials. Key applications of these nanomaterials, such as tissue regeneration, medication delivery and wound healing, are also discussed briefly. Covering this knowledge gap will result in a better understanding of the role of nanomaterial design and subsequent larger-scale applications in terms of both its potential and difficulties.

Home Monitoring for Glaucoma: Current Applications and Future Directions.

Technological advances provide a number of options for glaucoma monitoring outside the office setting, including home-based tonometry and perimetry. This has the potential to revolutionize management of this chronic disease, improve access to care, and enhance patient engagement. Here, we provide an overview of existing technologies for home-based glaucoma monitoring. We also discuss areas for future research and the potential applications of these technologies to telemedicine, which has been brought to the forefront during the ongoing COVID-19 pandemic.

Research and application of hydrostatic high pressure in tumor vaccines (Review).

It is well known that hydrostatic pressure (HP) is a physical parameter that is now regarded as an important variable for life. High hydrostatic pressure (HHP) technology has influenced biological systems for more than 100 years. Food and bioscience researchers have shown great interest in HHP technology over the past few decades. The development of knowledge related to this area can better facilitate the application of HHP in the life sciences. Furthermore, new applications for HHP may come from these current studies, particularly in tumor vaccines. Currently, cancer recurrence and metastasis continue to pose a serious threat to human health. The limited efficacy of conventional treatments has led to the need for breakthroughs in immunotherapy and other related areas. Research into tumor vaccines is providing new insights for cancer treatment. The purpose of this review is to present the main findings reported thus far in the relevant scientific literature, focusing on knowledge related to HHP technology and tumor vaccines, and to demonstrate the potential of applying HHP technology to tumor vaccine development.