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1.
Indian J Ophthalmol ; 68(10): 2199-2201, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32971640

RESUMO

To describe a smartphone-based telemedicine tool for monitoring of corneal ulcer size during the corona pandemic, a simple "U"-shaped tool was constructed using three Schirmer's strips that were provided to the patients with small to medium-sized corneal ulcers. The patient and the attendant were trained to use this simple U-shaped tool at home and send digital images to the treating ophthalmologist, to monitor the course of the ulcer. The tool was used in five eyes of five patients with active microbial keratitis. Patients were followed up regularly with the use of telemedicine facility every 48 h for an average duration of 7.6 days (range 6-9 days). In all the five eyes, assessment of the serial images with U-shaped tool showed decrease in size of corneal ulcer, which corroborated with subjective improvement in symptoms. Hence, the novel "'U'-shaped tool" may provide an effective measure in following-up of corneal ulcer patients in times of the COVID-19 pandemic, obviating frequent hospital visits and risk of contracting COVID.


Assuntos
Betacoronavirus , Úlcera da Córnea/diagnóstico , Infecções por Coronavirus/epidemiologia , Técnicas de Diagnóstico Oftalmológico/instrumentação , Infecções Oculares Bacterianas/diagnóstico , Pneumonia Viral/epidemiologia , Smartphone/instrumentação , Telemedicina/métodos , Adulto , Idoso , Pré-Escolar , Úlcera da Córnea/microbiologia , Infecções Oculares Bacterianas/microbiologia , Feminino , Seguimentos , Humanos , Índia/epidemiologia , Masculino , Pandemias , Projetos Piloto , Microscopia com Lâmpada de Fenda
2.
PLoS One ; 15(7): e0234003, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32614842

RESUMO

Understanding which transportation modes people use is critical for smart cities and planners to better serve their citizens. We show that using information from pervasive Wi-Fi access points and Bluetooth devices can enhance GPS and geographic information to improve transportation detection on smartphones. Wi-Fi information also improves the identification of transportation mode and helps conserve battery since it is already collected by most mobile phones. Our approach uses a machine learning approach to determine the mode from pre-prepocessed data. This approach yields an overall accuracy of 89% and average F1 score of 83% for inferring the three grouped modes of self-powered, car-based, and public transportation. When broken out by individual modes, Wi-Fi features improve detection accuracy of bus trips, train travel, and driving compared to GPS features alone and can substitute for GIS features without decreasing performance. Our results suggest that Wi-Fi and Bluetooth can be useful in urban transportation research, for example by improving mobile travel surveys and urban sensing applications.


Assuntos
Acelerometria/instrumentação , Planejamento de Cidades , Smartphone , Aprendizado de Máquina Supervisionado , Transportes , Tecnologia sem Fio , Condução de Veículo , Dinamarca , Sistemas de Informação Geográfica , Humanos , Veículos Automotores , Ferrovias , Smartphone/instrumentação , População Urbana , Caminhada
3.
Middle East Afr J Ophthalmol ; 27(1): 14-21, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32549719

RESUMO

PURPOSE: The purpose of the study was to assess the feasibility of a mobile data collection app for use in trichiasis surgical audits in the Melfi and Mangalme districts of the Guera region of the Republic of Chad and to perform a cost analysis to determine if the auditing mechanism could be implemented nationally. MATERIALS AND METHODS: Patients who underwent trichiasis surgery 6 months prior and who had follow-up 7-14 days after surgery were included in the study. Each surgeon had a sample of 20% of operated eyelids; nine surgeons with data for ≥20 eyelids were included. A trichiasis recurrence rate of ≥25% suggested that the surgeon needed retraining. Smartphones captured data using the data collection app, which transmitted data to an online server. Direct costs and supervision costs were collated and summed. RESULTS: There were 916 eyelids operated on; 170 patients (269 eyelids, 29% follow-up rate) participated in the audit. Twenty participants (11.8%) had recurrence. The mean recurrence rate among surgeons was 8.3% (standard deviation: 0.07%; range: 0%-17.9%). None had a recurrence rate of ≥25%; thus, no retraining was necessary. The total cost of the audit was US$15,111.25 ($12,882.28 in direct costs and $2,228.97 in supervision costs). CONCLUSIONS: The simple, easy-to-use, and low-cost mobile auditing mechanism is a practical solution for conducting surgical audits in remote and resource-limited settings and is undergoing national scale-up by the Chadian trachoma elimination program.


Assuntos
Auditoria Médica/estatística & dados numéricos , Aplicativos Móveis/estatística & dados numéricos , Procedimentos Cirúrgicos Oftalmológicos/estatística & dados numéricos , Smartphone/instrumentação , Triquíase/diagnóstico , Triquíase/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Chade/epidemiologia , Criança , Pálpebras/cirurgia , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Recidiva , Tracoma/diagnóstico , Tracoma/epidemiologia , Tracoma/cirurgia , Triquíase/epidemiologia
4.
J Vis Exp ; (158)2020 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-32420998

RESUMO

This paper presents a study protocol to measure the task-switching cost of using a smartphone while walking. This method involves having participants walk on a treadmill under two experimental conditions: a control condition (i.e., simply walking) and a multitasking condition (i.e., texting while walking). During these conditions, the participants must switch between the tasks related to the experimental condition and a direction determining task. This direction task is done with a point-light walker figure, seemingly walking towards the left or the right of the participant. Performance on the direction task represents the participant's task-switching costs. There were two performance measures: 1) correct identification of the direction and 2) response time. EEG data are recorded in order to measure the alpha oscillations and cognitive engagement occurring during the task switch. This method is limited in its ecological validity: pedestrian environments have many stimuli occurring simultaneously and competing for attention. Nonetheless, this method is appropriate for pinpointing task-switching costs. The EEG data allow the study of the underlying mechanisms in the brain that are related to differing task-switching costs. This design allows the comparison between task switching when doing one task at a time, as compared to task switching when multitasking, prior to the stimulus presentation. This allows understanding and pinpointing both the behavioral and neurophysiological impact of these two different task-switching conditions. Furthermore, by correlating the task-switching costs with the brain activity, we can learn more about what causes these behavioral effects. This protocol is an appropriate base for studying the switching cost of different smartphone uses. Different tasks, questionnaires, and other measures can be added to it in order to understand the different factors involved in the task-switching cost of smartphone use while walking.


Assuntos
Atenção/fisiologia , Encéfalo/fisiologia , Exercício Físico , Desempenho Psicomotor/fisiologia , Tempo de Reação/fisiologia , Smartphone/estatística & dados numéricos , Caminhada/fisiologia , Eletroencefalografia/métodos , Humanos , Smartphone/instrumentação
5.
JAMA Netw Open ; 3(4): e202064, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-32242908

RESUMO

Importance: Atrial fibrillation (AF) affects more than 6 million people in the United States; however, much AF remains undiagnosed. Given that more than 265 million people in the United States own smartphones (>80% of the population), smartphone applications have been proposed for detecting AF, but the accuracy of these applications remains unclear. Objective: To determine the accuracy of smartphone camera applications that diagnose AF. Data Sources and Study Selection: MEDLINE and Embase were searched until January 2019 for studies that assessed the accuracy of any smartphone applications that use the smartphone's camera to measure the amplitude and frequency of the user's fingertip pulse to diagnose AF. Data Extraction and Synthesis: Bivariate random-effects meta-analyses were constructed to synthesize data. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) of Diagnostic Test Accuracy Studies reporting guideline. Main Outcomes and Measures: Sensitivity and specificity were measured with bivariate random-effects meta-analysis. To simulate the use of these applications as a screening tool, the positive predictive value (PPV) and negative predictive value (NPV) for different population groups (ie, age ≥65 years and age ≥65 years with hypertension) were modeled. Lastly, the association of methodological limitations with outcomes were analyzed with sensitivity analyses and metaregressions. Results: A total of 10 primary diagnostic accuracy studies, with 3852 participants and 4 applications, were included. The oldest studies were published in 2016 (2 studies [20.0%]), while most studies (4 [40.0%]) were published in 2018. The applications analyzed the pulsewave signal for a mean (range) of 2 (1-5) minutes. The meta-analyzed sensitivity and specificity for all applications combined were 94.2% (95% CI, 92.2%-95.7%) and 95.8% (95% CI, 92.4%-97.7%), respectively. The PPV for smartphone camera applications detecting AF in an asymptomatic population aged 65 years and older was between 19.3% (95% CI, 19.2%-19.4%) and 37.5% (95% CI, 37.4%-37.6%), and the NPV was between 99.8% (95% CI, 99.83%-99.84%) and 99.9% (95% CI, 99.94%-99.95%). The PPV and NPV increased for individuals aged 65 years and older with hypertension (PPV, 20.5% [95% CI, 20.4%-20.6%] to 39.2% [95% CI, 39.1%-39.3%]; NPV, 99.8% [95% CI, 99.8%-99.8%] to 99.9% [95% CI, 99.9%-99.9%]). There were methodological limitations in a number of studies that did not appear to be associated with diagnostic performance, but this could not be definitively excluded given the sparsity of the data. Conclusions and Relevance: In this study, all smartphone camera applications had relatively high sensitivity and specificity. The modeled NPV was high for all analyses, but the PPV was modest, suggesting that using these applications in an asymptomatic population may generate a higher number of false-positive than true-positive results. Future research should address the accuracy of these applications when screening other high-risk population groups, their ability to help monitor chronic AF, and, ultimately, their associations with patient-important outcomes.


Assuntos
Fibrilação Atrial/diagnóstico , Confiabilidade dos Dados , Determinação da Frequência Cardíaca/instrumentação , Smartphone/instrumentação , Adulto , Idoso , Idoso de 80 Anos ou mais , Fibrilação Atrial/epidemiologia , Coleta de Dados/métodos , Feminino , Dedos/fisiologia , Humanos , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Aplicativos Móveis/estatística & dados numéricos , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Estados Unidos/epidemiologia
6.
J Med Internet Res ; 22(5): e17572, 2020 05 29.
Artigo em Inglês | MEDLINE | ID: mdl-32348255

RESUMO

BACKGROUND: The public health impact of health and well-being digital interventions is dependent upon sufficient real-world uptake and engagement. Uptake is currently largely dependent on popularity indicators (eg, ranking and user ratings on app stores), which may not correspond with effectiveness, and rapid disengagement is common. Therefore, there is an urgent need to identify factors that influence uptake and engagement with health and well-being apps to inform new approaches that promote the effective use of such tools. OBJECTIVE: This review aimed to understand what is known about influences on the uptake of and engagement with health and well-being smartphone apps among adults. METHODS: We conducted a systematic review of quantitative, qualitative, and mixed methods studies. Studies conducted on adults were included if they focused on health and well-being smartphone apps reporting on uptake and engagement behavior. Studies identified through a systematic search in Medical Literature Analysis and Retrieval System Online, or MEDLARS Online (MEDLINE), EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO, Scopus, Cochrane library databases, DataBase systems and Logic Programming (DBLP), and Association for Computing Machinery (ACM) Digital library were screened, with a proportion screened independently by 2 authors. Data synthesis and interpretation were undertaken using a deductive iterative process. External validity checking was undertaken by an independent researcher. A narrative synthesis of the findings was structured around the components of the capability, opportunity, motivation, behavior change model and the theoretical domains framework (TDF). RESULTS: Of the 7640 identified studies, 41 were included in the review. Factors related to uptake (U), engagement (E), or both (B) were identified. Under capability, the main factors identified were app literacy skills (B), app awareness (U), available user guidance (B), health information (E), statistical information on progress (E), well-designed reminders (E), features to reduce cognitive load (E), and self-monitoring features (E). Availability at low cost (U), positive tone, and personalization (E) were identified as physical opportunity factors, whereas recommendations for health and well-being apps (U), embedded health professional support (E), and social networking (E) possibilities were social opportunity factors. Finally, the motivation factors included positive feedback (E), available rewards (E), goal setting (E), and the perceived utility of the app (E). CONCLUSIONS: Across a wide range of populations and behaviors, 26 factors relating to capability, opportunity, and motivation appear to influence the uptake of and engagement with health and well-being smartphone apps. Our recommendations may help app developers, health app portal developers, and policy makers in the optimization of health and well-being apps.


Assuntos
Comportamentos Relacionados com a Saúde/fisiologia , Aplicativos Móveis/normas , Smartphone/instrumentação , Adulto , Humanos
7.
J Med Internet Res ; 22(5): e16875, 2020 05 29.
Artigo em Inglês | MEDLINE | ID: mdl-32348284

RESUMO

BACKGROUND: Social anxiety disorder is a highly prevalent and burdensome condition. Persons with social anxiety frequently avoid seeking physician support and rarely receive treatment. Social anxiety symptoms are frequently underreported and underrecognized, creating a barrier to the accurate assessment of these symptoms. Consequently, more research is needed to identify passive biomarkers of social anxiety symptom severity. Digital phenotyping, the use of passive sensor data to inform health care decisions, offers a possible method of addressing this assessment barrier. OBJECTIVE: This study aims to determine whether passive sensor data acquired from smartphone data can accurately predict social anxiety symptom severity using a publicly available dataset. METHODS: In this study, participants (n=59) completed self-report assessments of their social anxiety symptom severity, depressive symptom severity, positive affect, and negative affect. Next, participants installed an app, which passively collected data about their movement (accelerometers) and social contact (incoming and outgoing calls and texts) over 2 weeks. Afterward, these passive sensor data were used to form digital biomarkers, which were paired with machine learning models to predict participants' social anxiety symptom severity. RESULTS: The results suggested that these passive sensor data could be utilized to accurately predict participants' social anxiety symptom severity (r=0.702 between predicted and observed symptom severity) and demonstrated discriminant validity between depression, negative affect, and positive affect. CONCLUSIONS: These results suggest that smartphone sensor data may be utilized to accurately detect social anxiety symptom severity and discriminate social anxiety symptom severity from depressive symptoms, negative affect, and positive affect.


Assuntos
Biomarcadores/metabolismo , Fobia Social/psicologia , Smartphone/instrumentação , Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
8.
J Med Internet Res ; 22(5): e16658, 2020 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-32347810

RESUMO

BACKGROUND: Diabetic retinopathy (DR), a common complication of diabetes mellitus, is the leading cause of impaired vision in adults worldwide. Smartphone ophthalmoscopy involves using a smartphone camera for digital retinal imaging. Utilizing smartphones to detect DR is potentially more affordable, accessible, and easier to use than conventional methods. OBJECTIVE: This study aimed to determine the diagnostic accuracy of various smartphone ophthalmoscopy approaches for detecting DR in diabetic patients. METHODS: We performed an electronic search on the Medical Literature Analysis and Retrieval System Online (MEDLINE), EMBASE, and Cochrane Library for literature published from January 2000 to November 2018. We included studies involving diabetic patients, which compared the diagnostic accuracy of smartphone ophthalmoscopy for detecting DR to an accurate or commonly employed reference standard, such as indirect ophthalmoscopy, slit-lamp biomicroscopy, and tabletop fundus photography. Two reviewers independently screened studies against the inclusion criteria, extracted data, and assessed the quality of included studies using the Quality Assessment of Diagnostic Accuracy Studies-2 tool, with disagreements resolved via consensus. Sensitivity and specificity were pooled using the random effects model. A summary receiver operating characteristic (SROC) curve was constructed. This review is reported in line with the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies guidelines. RESULTS: In all, nine studies involving 1430 participants were included. Most studies were of high quality, except one study with limited applicability because of its reference standard. The pooled sensitivity and specificity for detecting any DR was 87% (95% CI 74%-94%) and 94% (95% CI 81%-98%); mild nonproliferative DR (NPDR) was 39% (95% CI 10%-79%) and 95% (95% CI 91%-98%); moderate NPDR was 71% (95% CI 57%-81%) and 95% (95% CI 88%-98%); severe NPDR was 80% (95% CI 49%-94%) and 97% (95% CI 88%-99%); proliferative DR (PDR) was 92% (95% CI 79%-97%) and 99% (95% CI 96%-99%); diabetic macular edema was 79% (95% CI 63%-89%) and 93% (95% CI 82%-97%); and referral-warranted DR was 91% (95% CI 86%-94%) and 89% (95% CI 56%-98%). The area under SROC curve ranged from 0.879 to 0.979. The diagnostic odds ratio ranged from 11.3 to 1225. CONCLUSIONS: We found heterogeneous evidence showing that smartphone ophthalmoscopy performs well in detecting DR. The diagnostic accuracy for PDR was highest. Future studies should standardize reference criteria and classification criteria and evaluate other available forms of smartphone ophthalmoscopy in primary care settings.


Assuntos
Retinopatia Diabética/diagnóstico , Técnicas de Diagnóstico Oftalmológico/normas , Testes Diagnósticos de Rotina/métodos , Smartphone/instrumentação , Feminino , Humanos , Masculino
9.
PLoS One ; 15(3): e0229483, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32160205

RESUMO

Measuring blood pressure (BP) at home and remote monitoring can improve the patient's adherence to BP control and vascular outcomes. This study evaluated the feasibility of a trial regarding the effects of an intensive mobile BP management strategy versus usual care in acute ischemic stroke patients. A feasibility-testing, randomized, open-labeled controlled trial was conducted. Remote BP measurement, data transmission, storage, and centralized monitoring system were organized through a Bluetooth-equipped sphygmomanometer paired to the participants' smartphones. Participants were randomized equally into intensive management (behavioral intensification to measure BP at home by texting, direct telephone call, or breakthrough visit) and control (usual care) groups. The primary feasibility outcomes were: 1) recruitment time for the pre-specified number of participants, 2) retention of participants, 3) frequency of breakthrough visit calls, 4) response to breakthrough visit call, and 5) proportions satisfying BP measurement criteria. Sixty participants were randomly assigned to the intensive management (n = 31) and control (n = 29) groups, of which 57 participants were included in the primary analysis with comparable baseline characteristics. Recruitment time from the first to the last participant was 350 days, and 95% of randomized participants completed the final visit (intensive, 94%; control, 98%). Eight breakthrough visit calls were made to 7 participants (23%), with complete and immediate responses within 3 ± 4 days. The median of half-day blocks fulfilling the BP measurement criteria per patient were 91% in the intensive group and 83% in the control group (difference, 12.2; 95% confidence interval, 2.2-22.2). No adverse events related to the trial procedures were reported. The intensive monitoring, including remote BP measurement, data transfer, and centralized monitoring system, engaged with behavioral intensification was feasible if the patients complied with the intervention. However, the device utilized would need further improvement prior to a large trial.


Assuntos
Determinação da Pressão Arterial/métodos , Acidente Vascular Cerebral/prevenção & controle , Telemedicina/métodos , Idoso , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Smartphone/instrumentação
10.
PLoS One ; 15(3): e0230561, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32214340

RESUMO

Smartphones provide an ideal platform for colorimetric measurements due to their low cost, portability and image quality. As with any imaging-based colorimetry system, ambient light and device variations introduce error which must be dealt with. We propose a novel processing method consisting of a one-time calibration stage to account for inter-phone variations, and an innovative use of ambient light subtraction with image pairs to account for variation in ambient light. Data collection is kept very simple, making it particularly useful for use in the field, since nothing additional is required in the images. Ambient subtraction is first demonstrated for a range of colors and phones (Samsung S8 and LG Nexus 5X), and the Subtracted Signal to Noise Ratio (SSNR) is defined as a metric for assessing whether an image pair is appropriate at the time of image capture. The experimentally determined SSNR threshold below which to suggest retaking the images is 3.4. The classification accuracy for results using the proposed calibration pipeline is then compared to the simplest image metadata-based alternative and is found to be greatly superior. Finally, a custom colorcard is shown to improve the accuracy of device-independent results for known smaller ranges of colors over a standard colorcard, making this a possible application-specific modification to the overall processing pipeline.


Assuntos
Colorimetria/instrumentação , Smartphone/instrumentação , Algoritmos , Calibragem , Humanos , Razão Sinal-Ruído
11.
J Med Internet Res ; 22(3): e16987, 2020 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-32149711

RESUMO

BACKGROUND: In the past several years, gamified learning has been growing in popularity in various medical educational contexts including cardiopulmonary resuscitation (CPR) training. Furthermore, prior work in Basic Life Support (BLS) training has demonstrated the benefits of serious games as a method for pretraining among medical students. However, there is little evidence to support these benefits with regard to Advanced Life Support (ALS) training. OBJECTIVE: We compare the effects of a brief precourse ALS preparation using a serious smartphone game on student knowledge, skills, and perceptions in this area with those of conventional ALS training alone. METHODS: A serious game (Resus Days) was developed by a Thai physician based on global ALS clinical practice guidelines. Fifth-year medical students were enrolled and randomized to either the game group or the control group. Participants in both groups attended a traditional ALS lecture, but the game group was assigned to play Resus Days for 1 hour before attending the lecture and were allowed to play as much as they wished during the training course. All students underwent conventional ALS training, and their abilities were evaluated using multiple-choice questions and with hands-on practice on a mannequin. Subject attitudes and perceptions about the game were evaluated using a questionnaire. RESULTS: A total of 105 students participated in the study and were randomly assigned to either the game group (n=52) or the control group (n=53). Students in the game group performed better on the ALS algorithm knowledge posttest than those in the control group (17.22 [SD 1.93] vs 16.60 [SD 1.97], P=.01; adjusted mean difference [AMD] 0.93; 95% CI 0.21-1.66). The game group's pass rate on the skill test was also higher but not to a statistically significant extent (79% vs 66%, P=.09; adjusted odds ratio [AOR] 2.22; 95% CI 0.89-5.51). Students indicated high satisfaction with the game (9.02 [SD 1.11] out of 10). CONCLUSIONS: Engaging in game-based preparation prior to an ALS training course resulted in better algorithm knowledge scores for medical students than attending the course alone. TRIAL REGISTRATION: Thai Clinical Trials Registry HE611533; https://tinyurl.com/wmbp3q7.


Assuntos
Reanimação Cardiopulmonar/educação , Smartphone/instrumentação , Feminino , Humanos , Masculino , Estudos Prospectivos
12.
Am J Ophthalmol ; 213: 306-319, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32035831

RESUMO

PURPOSE: We sought to assess a smartphone-based, gold nanoparticle-based colorimetric lateral flow immunoassay paper sensor for quantifying urine 8-hydroxy-2'-deoxyguanosine (8-OHdG) as a biomarker for diabetic retinopathy (DR) screening. METHODS: Paper strips incorporate gold nanoparticle-8-OHdG antibody conjugates that produce color changes that are proportional to urine 8-OHdG and that are discernible on a smartphone camera photograph. Paper strip accuracy, precision, and stability studies were performed with 8-OHdG solutions of varying concentrations. Urine was collected from 97 patients with diabetes who were receiving DR screening examinations, including 7-field fundus photographs. DR was graded by standard methods as either low risk (no or mild DR) or high risk (moderate or severe DR). Paper sensor assays were performed on urine samples from patients and 8-OHdG values were correlated with DR grades. The differences in 8-OHdG values between the low- and high-risk groups were analyzed for outliers to identify the threshold 8-OHdG value that would minimize false-negative results. RESULTS: Lateral flow immunoassay paper strips quantitatively measure 8-OHdG and were found to be accurate, precise, and stable. Average urine 8-OHdG concentrations in study patients were 22 ± 10 ng/mg of creatinine in the low-risk group and 55 ± 11 ng/mg of creatinine in the high-risk group. Screening cutoff values of 8-OHdG >50 ng/mg of creatinine or urine creatinine >1.5 mg minimized screen failures, with 91% sensitivity and 81% specificity. CONCLUSIONS: Urinary 8-OHdG is a useful biomarker to screen DR. Quantitative 8-OHdG detection with the lateral flow immunoassay paper sensor and smartphone camera demonstrates its potential in DR screening. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.


Assuntos
8-Hidroxi-2'-Desoxiguanosina/urina , Biomarcadores/urina , Retinopatia Diabética/urina , Ouro/química , Imunoensaio/instrumentação , Monitorização Ambulatorial , Colorimetria , Creatinina/urina , Retinopatia Diabética/diagnóstico , Reações Falso-Positivas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nanopartículas/química , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Smartphone/instrumentação
13.
Phys Ther ; 100(3): 447-456, 2020 03 10.
Artigo em Inglês | MEDLINE | ID: mdl-32031221

RESUMO

BACKGROUND: Cancer-related fatigue is a symptom commonly reported in survivors of breast cancer and is the most variable symptom. Besides questionnaires like PIPER to assess cancer-related fatigue, there is a need to objectively measure fatigue. OBJECTIVE: The aim of this study was to assess the physiological dimension of fatigue based on acceleration during a 30-second maximal sit-to-stand test. DESIGN: This was a cross-sectional study. METHODS: Linear acceleration from a smartphone placed on the sternum was recorded in 70 survivors of breast cancer. Fourth-degree polynomial adjustment from the acceleration signal to the vertical and anterior-posterior axis was calculated. The fatigue temporal cut-off point was detected as a change in the curve slope of the first maximum point of acceleration. RESULTS: Women were aged 51.8 (8.9) years with a body mass index of 25.4 (5.1) Kg/m2. They performed 23.6 (6.57) number of repetitions. The mean fatigue cut-off point from the total sample was 10.2 (3.1) seconds. LIMITATIONS: Further research should employ time-prolonged tests to study acceleration behavior beyond 30 seconds as well as include a physiological criterion that justifies the nonlinear saturation of the acceleration-based criterion. CONCLUSIONS: This study assessed fatigue through a low-cost and easy-to-use methodology during a functional and widely used test such as 30-second maximal sit-to-stand. This would allow clinicians to assess fatigue in a short-effort exercise to individualize exercise prescription dose, measure changes during intervention, and track fatigue objectively throughout survivorship.


Assuntos
Aceleração , Neoplasias da Mama/fisiopatologia , Sobreviventes de Câncer , Teste de Esforço/instrumentação , Fadiga/diagnóstico , Smartphone/instrumentação , Adulto , Idoso , Neoplasias da Mama/terapia , Estudos Transversais , Teste de Esforço/métodos , Teste de Esforço/estatística & dados numéricos , Fadiga/fisiopatologia , Feminino , Humanos , Pessoa de Meia-Idade , Fenômenos Físicos , Postura Sentada , Posição Ortostática , Fatores de Tempo
14.
Acta Cytol ; 64(5): 399-405, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32074596

RESUMO

INTRODUCTION: Telecytology is the practice of cytology at a distance. The images captured by a camera are sent to the cytopathologist at a different location who views the images and reaches a diagnosis. Recently, smartphone-assisted telepathology has been evaluated for different subspecialities of pathology including cytology for second opinion. MATERIALS AND METHODS: For the purpose of the study, a total of 151 cases of fine needle aspiration and 10 cases of urine cytology reported by a single pathologist were retrieved from the records. The images of all the cases were captured by a trained pathologist using the primary camera of a smartphone from the ocular of a binocular microscope. The images were sent by WhatsApp to the same pathologist who had made the conventional microscopy diagnosis. The images were viewed on the smartphone screen by the pathologist who replied with the diagnosis after analysing all the images with or without digital zoom. RESULTS: A total of 154 cases out of 161 were correctly diagnosed on smartphone-assisted telepathology (overall intraobserver concordance of 95.6%). For head and neck swellings, the concordance was 65/70 (92.9%), for breast lesions, it was 23/24 (95.8%), and for miscellaneous swellings, it was 57/57 (100%). For urine cytology, the concordance rate was 9/10 (90%). CONCLUSION: Though the results of this study are encouraging, further improvement in the smartphone camera resolution and internet connectivity would enhance the utility of smartphone-assisted telecytopathology.


Assuntos
Neoplasias da Mama/patologia , Citodiagnóstico/métodos , Diagnóstico por Computador/métodos , Neoplasias de Cabeça e Pescoço/patologia , Smartphone/instrumentação , Smartphone/estatística & dados numéricos , Telepatologia/métodos , Biópsia por Agulha Fina , Feminino , Humanos , Metástase Neoplásica , Variações Dependentes do Observador
15.
J Glaucoma ; 29(5): e28-e30, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32097255

RESUMO

In this report, the authors highlight 2 effective and simple techniques of video documentation of the anterior chamber angle using the newer generation iPhone, iPhone 11 Pro Max. In these techniques, we also used a commercially available macro lens with the phone. The patient positions his/her chin on a slit-lamp biomicroscope as done during a routine slit-lamp examination. The first observer places the gonioscope over the patient's eye and projects a thin slit beam of light of the slit-lamp biomicroscope along the superior or inferior Gonio mirror. A second observer records the anterior chamber angle findings using the macro lens clipped smartphone after bringing it closer to the eye of the patient. In the phone, the video mode is selected after opening the phone's camera application. In the subcategory of video mode, 1× or the wide-angle mode is chosen. Under 1× mode, the magnification is further increased to 3× to document high-quality imaging findings of angle. Similarly, in the second technique, the slit (streak) light beam of the direct ophthalmoscope was used that completely circumvented the need for a slit lamp as a source of light.


Assuntos
Segmento Anterior do Olho/diagnóstico por imagem , Diagnóstico por Imagem/instrumentação , Técnicas de Diagnóstico Oftalmológico/instrumentação , Documentação/métodos , Glaucoma de Ângulo Fechado/diagnóstico por imagem , Glaucoma de Ângulo Aberto/diagnóstico por imagem , Smartphone/instrumentação , Feminino , Gonioscopia , Humanos , Masculino , Lâmpada de Fenda
16.
Mikrochim Acta ; 187(3): 173, 2020 02 18.
Artigo em Inglês | MEDLINE | ID: mdl-32072273

RESUMO

An optical colorimetric and smartphone-integrated paper device (SIPD) is demonstrated for determination of As (III) in water and soil samples using sucrose modified gold nanoparticles (AuNPs/Suc) as a nanoprobe. The mechanism for determination of As(III) is experimentally validated by performing UV-Vis, transmission electron microscope (TEM), Fourier transforms infra-red spectroscopy (FTIR) and dynamic light scattering (DLS) measurements. The density function theory (DFT) calculations using B3LYP with 6-311G (2d,2p) and LANL2DZ basis sets is used to theoretically prove the mechanism for determination of As(III). In addition, the paper fabricated with AuNPs/SuC was used as a nanoprobe for quantitative determination of As(III) using smartphone and ImageJ software. Calibration plot was linear over 10-800 µgL-1 for colorimetric determination of As(III) with limit of detection (LOD) of 4 µgL-1 acquired when the absorbance ratio obtained at 594 nm/515 nm. The linearity range of 50-3000 µgL-1 with LOD of 20 µgL-1 was determined using smartphone-integrated paper device. AuNPs/Suc is successfully employed for determination of As (III) from contaminated water and soil samples in colorimetry and SIPD. Graphical abstractColorimetric and Smartphone-integrated paper device used for selective detection of arsenic from contaminated water samples using sucrose modified gold nanoparticles (AuNPs/Suc) as a sensing probe.


Assuntos
Arsênico/química , Colorimetria/métodos , Ouro/química , Nanopartículas Metálicas/química , Smartphone/instrumentação , Sacarose/química , Colorimetria/instrumentação , Humanos , Papel
17.
PLoS One ; 15(1): e0227372, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31935231

RESUMO

Aortic valve disease is one of the leading forms of complications in the cardiovascular system. The failing native aortic valve is routinely surgically replaced with a bioprosthesis. However, insufficient durability of bioprosthetic heart valves often requires reintervention. Valve degradation can be assessed by an analysis of the blood flow characteristics downstream of the valve. This is cost and labor intensive using clinical methodologies and is performed infrequently. The integration of consumer smartphones and implantable blood flow sensors into the data acquisition chain facilitates remote management of patients that is not limited by access to clinical facilities. This article describes the characteristics of an implantable magnetic blood flow sensor which was optimized for small size and low power consumption to allow for batteryless operation. The data is wirelessly transmitted to the patient's smartphone for in-depth processing. Tests using three different experimental setups confirmed that wireless and batteryless blood flow recording using a magnetic flow meter technique is feasible and that the sensor system is capable of monitoring the characteristic flow downstream of the valve.


Assuntos
Estenose da Valva Aórtica/fisiopatologia , Valva Aórtica/fisiopatologia , Cardiopatias Congênitas/fisiopatologia , Doenças das Valvas Cardíacas/fisiopatologia , Próteses Valvulares Cardíacas , Hemodinâmica , Desenho de Prótese/instrumentação , Estenose da Valva Aórtica/cirurgia , Bioprótese , Humanos , Falha de Prótese , Smartphone/instrumentação
18.
Asia Pac J Ophthalmol (Phila) ; 9(1): 54-58, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31990747

RESUMO

PURPOSE: To determine whether use of a mobile device-based ophthalmic camera by ophthalmic technicians (OTs) in village screening camps in Nepal followed by remote image interpretation by an ophthalmologist can improve detection of ocular pathology and medical decision-making. DESIGN: Evaluation of mobile device-based ophthalmic camera through study of before and after clinical decision-making. METHODS: One hundred forty patients over 18 years of age presenting to remote screening camps with best-corrected visual acuity ≤20/60 in one or both eyes were enrolled. Participants were examined by an OT with direct ophthalmoscopy. The technician recorded a diagnosis for each eye and a disposition for each patient. Patients then had anterior segment and fundus photos and/or videos taken using a smartphone-based ophthalmic camera system. Photos and videos were uploaded to a secure, HIPAA-compliant, cloud-based server, and interpreted by masked ophthalmologists from XXX, who independently recorded diagnoses and a disposition for each patient. RESULTS: The diagnoses given by OTs and ophthalmologists differed in 42.4% of eyes. Diagnosis agreement was highest for cataract [k = 0.732, 95% confidence interval (CI) 0.65-0.81], but much lower for posterior segment (retina/optic nerve) pathology (k = 0.057, 95% CI -0.03-0.14). Ophthalmologists and OTs suggested different dispositions for 68.6% of patients. Agreement was highest for cataract extraction (k = 0.623, 95% CI 0.49-0.75), whereas agreement for referral to XXX was lower (k = 0.12, 95% CI 0.00-0.24). CONCLUSIONS: Remote ophthalmologist consultation utilizing a mobile device ophthalmic camera system is logistically feasible, easily scalable, and capable of capturing high-quality images in the setting of rural eye screening camps. Although OTs are well equipped to identify and triage anterior segment pathology, this technology may be helpful in the detection of and referral for posterior segment pathology.


Assuntos
Oftalmopatias/diagnóstico , Oftalmologia/métodos , Fotografação/métodos , Smartphone/instrumentação , Telemedicina/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Oftalmopatias/epidemiologia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Unidades Móveis de Saúde , Nepal/epidemiologia , Oftalmoscopia , Adulto Jovem
19.
Biosens Bioelectron ; 148: 111791, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31677526

RESUMO

A smartphone-integrated ratiometric fluorescent sensing system (DPA-Ce-GMP-Eu) for visual and point-of-care testing (POCT) of tetracycline with high sensitivity and accuracy was developed. The blue fluorescence of DPA-Ce-GMP was changed into red by doping with Eu3+ duo to the energy transfer from Ce3+ to Eu3+. Upon exposure to tetracycline, coordination between Eu3+ and tetracycline blocks energy transfer from Ce3+ to Eu3+, converting the fluorescent color from red to blue. The tetracycline detection can be realized within a wide concentration range from 0.01 µM to 45 µM. The limit of detection (LOD) reaches as low as 6.6 nM. To realize quantitative point-of-care detection in real samples, a portable device with smartphone as signal reader and analyzer is further designed to integrate with the DPA-Ce-GMP-Eu sensing platform. The Color Picker APP installed in the smartphone can convert the Red, Green and Blue (RGB) channels of the fluorescence images into digital values. With milk as real sample, tetracycline can be on-site detected with LOD of 10.8 nM. This developed platform presents a great promise for POCT in practical application with merits of low cost, easy carry, simple operation, and excellent selectivity and repeatability.


Assuntos
Antibacterianos/análise , Técnicas Biossensoriais/instrumentação , Contaminação de Alimentos/análise , Smartphone/instrumentação , Tetraciclina/análise , Animais , Cério/química , Desenho de Equipamento , Európio/química , Fluorescência , Corantes Fluorescentes/química , Análise de Alimentos/instrumentação , Limite de Detecção , Leite/química , Carne de Porco/análise , Espectrometria de Fluorescência/instrumentação
20.
Anal Bioanal Chem ; 412(4): 861-870, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31865416

RESUMO

In this paper, we report the use of a smartphone and B, N, and S co-doped carbon dots (BNS-CDs) as a promising peroxidase mimic to quantify hydrogen peroxide (H2O2). The synthesized BNS-CDs exhibited excellent peroxidase-like activity to catalyze the reaction of the chromogenic substrate 3,3',5,5'-tetramethylbenzidine (TMB) with H2O2 to generate a blue oxide product (ox-TMB) with maximum absorption at 652 nm. Steady-state kinetic analysis demonstrated that the BNS-CDs showed much higher affinity than natural horseradish peroxidase (HRP) for H2O2 due to their small size and larger specific surface area. A smartphone colorimetric readout device was employed to record the RGB (red green blue) value of the ox-TMB solution via the Android application Color Grab for quantitative detection. A good linear relationship (R2 = 0.9970) between the H2O2 concentration and |R-Rblank| value was obtained in the range of 3-30 µM with a limit of detection (LOD) of 0.8 µM. The current method was successfully applied to determine H2O2 in mouthwash and milk with recoveries of 92.70-108.30%. The developed assay is a promising portable detection platform for H2O2 with good sensitivity and selectivity, simple operation, fast response, and low cost. Graphical abstract.


Assuntos
Carbono/química , Colorimetria/instrumentação , Peróxido de Hidrogênio/análise , Leite/química , Antissépticos Bucais/análise , Animais , Benzidinas/química , Materiais Biomiméticos/química , Catálise , Desenho de Equipamento , Análise de Alimentos/instrumentação , Limite de Detecção , Peroxidase/química , Smartphone/instrumentação
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