Platform For Disease Management Research Articles

Development of a Digital Patient Assistant for the Management of Cyclic Vomiting Syndrome: Patient-Centric Design Study.

Cyclic vomiting syndrome (CVS) is an enigmatic and debilitating disorder of gut-brain interaction that is characterized by recurrent episodes of severe vomiting and nausea. It significantly impairs patients' quality of life and can lead to frequent medical visits and substantial health care costs. The diagnosis for CVS is often protracted and complex, primarily due to its exclusionary diagnosis nature and the lack of specific biomarkers. This typically leads to a considerable delay in accurate diagnosis, contributing to increased patient morbidity. Additionally, the absence of approved therapies for CVS worsens patient hardship and reflects the urgent need for innovative, patient-centric solutions to improve CVS management. We aim to develop a digital patient assistant (DPA) for patients with CVS to address their unique needs, and iteratively enhance the technical features and user experience on the initial DPA versions. The development of the DPA for CVS used a design thinking approach, prioritizing user needs. A literature review and Patient Advisory Board shaped the initial prototype, focusing on diagnostic support and symptom tracking. Iterative development, informed by the design thinking approach and feedback from patients with CVS and caregivers through interviews and smartphone testing, led to significant enhancements in user interaction and artificial intelligence integration. The final DPA's effectiveness was validated using the System Usability Scale and feedback questions, ensuring it met the specific needs of the CVS community. The DPA developed for CVS integrates an introductory bot, daily and weekly check-in bots, and a knowledge hub, all accessible via a patient dashboard. This multicomponent solution effectively addresses key unmet needs in CVS management: efficient symptom and impacts tracking, access to comprehensive disease information, and a digital health platform for disease management. Significant improvements, based on user feedback, include the implementation of artificial intelligence features like intent recognition and data syncing, enhancing the bot interaction and reducing the burden on patients. The inclusion of the knowledge hub provides educational resources, contributing to better disease understanding and management. The DPA achieved a System Usability Scale score of 80 out of 100, indicating high ease of use and relevance. Patient feedback highlighted the DPA's potential in disease management and suggested further applications, such as integration into health care provider recommendations for patients with suspected or confirmed CVS. This positive response underscores the DPA's role in enhancing patient engagement and disease management through a patient-centered digital solution. The development of this DPA for patients with CVS, via an iterative design thinking approach, offers a patient-centric solution for disease management. The DPA development framework may also serve to guide future patient digital support and research scenarios.

Application and Effect of Patient Portal System in the Remote Management of Chronic Diseases for Older Adults With Coronary Heart Disease

To investigate the application of personal health record (PHR) and chronic disease management platform established on the basis of patient portal system (PPS) in managing older adults with coronary heart disease and to examine the effect on patients' self-care ability, coping mode, and quality of life. A total of 532 elderly patients with coronary heart disease were included in the study. All the participants enrolled were admitted to a tertiary-care hospital between January 2019 and June 2021. They were randomly assigned to the study group (269 cases) and the control group (263 cases). Patients in the control group were discharged with the routine discharge procedures and received the routine follow-up care. On the other hand, patients in the study group were discharged and followed up through the PHR and chronic disease management platform established on the basis of PPS. After 6 months, 12 months, and 18 months of patient management, the Exercise of Self-Care Agency (ESCA) Scale, Medical Coping Modes Questionnaire (MCMQ) and Seattle Angina Questionnaire (SAQ) were used to evaluate the patients' self-care ability, coping mode, and quality of life, respectively. The patient management effects of the two groups were analyzed. Before the management programs started, there was no statistically significant difference in the scores for the scales between the two groups of patients. After 6 months, 12 months, and 18 months of patient management, the ESCA scores of both groups were higher than those before patient management started (P<0.05). Facing scores in the MCMQ of both groups were higher than those before patient management started (P<0.05), while the scores for avoidance and yielding were lower than those before patient management started (P<0.05). The SAQ scores of both groups were higher than those before patient management started (P<0.05). After 6 months, 12 months and 18 months of patient management, the ESCA scores of the study group were always higher compared with those of the control group (P<0.05). The facing score of the study group was higher, while the scores for avoidance and yielding were lower compared with those of the control group (P<0.05). The SAQ scores of the study group were higher compared with those of the control group (P<0.05). The medication compliance rate in the study group (83.27%) was higher than that in the control group (69.96%) (P<0.05). The incidence of adverse cardiovascular events in the study group (4.09%) was lower than that in the control group (10.27%) (P<0.05). The average times of emergency treatment and readmission in the study group were lower compared with those of the control group (P<0.05). The patient satisfaction score of the study group was higher compared with that of the control group (P<0.05). The PHR and chronic disease management platform established on the basis of PPS can increase the convenient access to medical care among elderly patients with coronary heart disease, which is conducive to improving their self-care ability, coping mode, and quality of life. In addition, the patient management effect is good.

A Nationwide Chronic Disease Management Solution via Clinical Decision Support Services: Software Development and Real-Life Implementation Report.

The increasing population of older adults has led to a rise in the demand for health care services, with chronic diseases being a major burden. Person-centered integrated care is required to address these challenges; hence, the Turkish Ministry of Health has initiated strategies to implement an integrated health care model for chronic disease management. We aim to present the design, development, nationwide implementation, and initial performance results of the national Disease Management Platform (DMP). This paper's objective is to present the design decisions taken and technical solutions provided to ensure successful nationwide implementation by addressing several challenges, including interoperability with existing IT systems, integration with clinical workflow, enabling transition of care, ease of use by health care professionals, scalability, high performance, and adaptability. The DMP is implemented as an integrated care solution that heavily uses clinical decision support services to coordinate effective screening and management of chronic diseases in adherence to evidence-based clinical guidelines and, hence, to increase the quality of health care delivery. The DMP is designed and implemented to be easily integrated with the existing regional and national health IT systems via conformance to international health IT standards, such as Health Level Seven Fast Healthcare Interoperability Resources. A repeatable cocreation strategy has been used to design and develop new disease modules to ensure extensibility while ensuring ease of use and seamless integration into the regular clinical workflow during patient encounters. The DMP is horizontally scalable in case of high load to ensure high performance. As of September 2023, the DMP has been used by 25,568 health professionals to perform 73,715,269 encounters for 16,058,904 unique citizens. It has been used to screen and monitor chronic diseases such as obesity, cardiovascular risk, diabetes, and hypertension, resulting in the diagnosis of 3,545,573 patients with obesity, 534,423 patients with high cardiovascular risk, 490,346 patients with diabetes, and 144,768 patients with hypertension. It has been demonstrated that the platform can scale horizontally and efficiently provides services to thousands of family medicine practitioners without performance problems. The system seamlessly interoperates with existing health IT solutions and runs as a part of the clinical workflow of physicians at the point of care. By automatically accessing and processing patient data from various sources to provide personalized care plan guidance, it maximizes the effect of evidence-based decision support services by seamless integration with point-of-care electronic health record systems. As the system is built on international code systems and standards, adaptation and deployment to additional regional and national settings become easily possible. The nationwide DMP as an integrated care solution has been operational since January 2020, coordinating effective screening and management of chronic diseases in adherence to evidence-based clinical guidelines.

Abstract 13475: Implementation of a Digital Disease Management Platform for Heart Failure: AMAZE

Background: Optimal heart failure (HF) management after hospitalization requires ongoing care coordination. Digital approaches with a unified disease management platform (DMP) experience may improve patient care. Objective: A single-arm single-institution pilot study to assess feasibility of implementation and engagement with a DMP among HF patients for 60 days post-hospitalization. Methods: The DMP included a clinician electronic medical record-integrated dashboard and patient-facing smartphone app that provided patient-reported data entry, educational materials, and secure messaging. Eligible patients admitted to a cardiology service were onboarded with a smartphone DMP app at discharge. Clinical outcomes were compared between the intervention group and propensity-matched historical controls at the same institution and matched contemporary and historical controls at a nearby institution. Results: 70 of 167 eligible patients (41.9%) enrolled over the 6-month recruitment period and 51 (71.4%) completed the study. Mean age of completed participants was 65.8 (SD 12.9) years; 36 (70.6%) were male and 22 (43.1%) had HF with reduced ejection fraction. Daily DMP engagement (patient-reported data entry or in-app messaging) ranged from 35%-78% and participants engaged a median 44 (IQR 14-53) days during the 60-day study period. There was no correlation between age, sex, or clinical comorbidities and daily engagement. Compared to matched historical controls at the same institution, the study cohort had significantly fewer all-cause readmissions (HR 0.39, 95% CI 0.19 - 0.80, p=0.009). Matched contemporary and historical controls over the same time period on a cardiology service at a nearby institution had no reduction in readmission rates. Conclusions: Implementation of a post-hospitalization HF-specific DMP is feasible and may yield improvements in readmission rates, supporting the role for future randomized controlled trials (NCT04782973).

Chronic Disease Management in Primary Care: A Cross-Sectional Study in Türkiye

Objective: The aim of our study was to evaluate the chronic disease management of family physicians and family health workers and to examine their views on the Disease Management Platform (DMP) and the usability of this platform. &#x0D; Material and Methods: This study is a descriptive cross-sectional type of study. The universe of the study consisted of family physicians and family health workers working in family health centers (FHC) in our country. Sociodemographic data, chronic disease management practices, questions about DMP, System Usability Scale (SUS) were asked. &#x0D; Results: Of the participants 19.0% can make using the DMP system a part of their routine work. The percentage of those who thought that the biggest obstacle to the use of the DMP was the waste of time was 79.4%. The SUS scores of the participants who knew the number of obese, diabetic and hypertensive patients registered in their unit were also significantly higher (p

Evaluation of the Use of the Disease Management Platform by Family Physicians and Family Health Workers

Evaluation of the Use of the Disease Management Platform by Family Physicians and Family Health Workers

User experience research in the development of digital health products: Research letter

BackgroundDigital health solutions are facing an increasing impact on healthcare. The current scientific focus is mainly set on clinical studies providing efficacy for different indications. In contrast to pharmaceutical therapy, user experience plays a major role in digital health. However, fundamental scientific knowledge about patient engagement, adoption and qualitative user experience of digital health solutions is missing. ObjectiveTo perform user experience design research for the development of a disease management platform for fibromyalgia-like post-COVID19 syndrome. To discuss relevant user experience and its current status in digital health products development. MethodsA literature review on PubMed and interviews with digital health stakeholders were performed. German registered digital health applications (DiGAs) for musculoskeletal indications were reviewed in terms of front-end design and navigation. An online user experience design survey about Patient Reported Outcomes (PROs) collection was sent to patients from a Swiss post-COVID19 patient association. ResultsThe literature documenting patient experience aspects in digital health is poor despite all stakeholders agreed on its importance, potentially also influencing efficacy of the therapies. Currently available DiGAs have a heterogeneous front-end design without clear user interface design or navigation strategy, respectively. Patient online surveys have shown to be easily feasible and effective tools for qualitative user experience research. Basic user experience research provided helpful guidelines for choices in design features for the purpose of the development of a digital health product. ConclusionsUser experience research as a tool in the patient-centric development of a digital health product provides valuable data. This data has the potential to help increase adoption and efficacy of the product. Further research studies are needed to clarify the role of user experience in digital therapies.

Aile Hekimliği Yaşlı Hasta İzlemi Kapsamında Polifarmasinin Değerlendirilmesi

Çalışmamızın amacı Sağlık Bakanlığı Hastane Medulla Sistemi kullanılarak polifarmasiye maruz kalan 65 yaş ve üstü hastalarda, ilaç-ilaç etkileşimlerinin belirlenip, ciddi etkileşimleri olan hastalarda klinik önlem alınması için farkındalık yaratmaktır. Çalışmamız Gebze 1 nolu Aile Sağlığı Merkezi’nden hizmet almakta olan 65 yaş üstü, Hasta Yönetim Platformu veri tabanında yer alan 188 hasta üzerinde yapılmıştır. Lexicomb® ilaç etkileşimi modülü ile hastaların kronik olarak kullandıkları ilaçlar listelenerek etkileşim düzeyleri değerlendirilmiştir. Bununla birlikte yaşlılarda uygunsuz ilaç kullanımı değerlendirilmesinde kullanılan kriterler üzerinde de durulmuştur. Çalışma sonuçlarımıza göre, 167 hastada toplamda 529 potansiyel ilaç-ilaç etkileşimi görüldü. Bu etkileşimlerin 52’sinde (%9,8) bilinen bir etkileşim saptanmadı ve risk kategorisi A olarak tespit edildi. B, C, D ve X risk kategorilerinde ilaç-ilaç etkileşimi sayıları sırasıyla, 74 (%13,9), 363(%68,6), 33 (%6,2) ve 7 (%1,3) idi. Çalışmadaki hastaların %54’ünde esansiyel hipertansiyon tanısı mevcuttu. En çok kullanılan ilaç ise asetilsalisilik asit (%26)’di. C kategorisinde ilaç-ilaç etkileşim potansiyelinin verilerimize göre anlamlı oranda yüksek çıkması, hastaların tedavisinin daha düzenli ve etkili bir şekilde monitorize edilmesinin gerekliliğini vurgulamaktadır. D ve X kategorisinde saptanan ilaç-ilaç etkileşimleri en fazla nonsteroidal antiinflamatuar ilaçlar, antihipertansif ilaçlar, antipelet ilaçlar ve santral sinir sistemi ilaçlar arasında meydana gelmiştir. Bu ilaçların takibine özellikle dikkat edilmelidir.

Endophytic Diaporthe Associated with Morinda officinalis in China.

Diaporthe species are endophytes, pathogens, and saprobes with a wide host range worldwide. However, little is known about endophytic Diaporthe species associated with Morinda officinalis. In the present study, 48 endophytic Diaporthe isolates were obtained from cultivated M. officinalis in Deqing, Guangdong Province, China. The nuclear ribosomal internal transcribed spacer (ITS), partial sequences of translation elongation factor 1-α (tef1-α), partial calmodulin (cal), histone H3 (his), and Beta-tubulin (β-tubulin) gene regions were sequenced and employed to construct phylogenetic trees. Based on morphology and combined multigene phylogeny, 12 Diaporthe species were identified, including five new species of Diaporthe longiconidialis, D. megabiguttulata, D. morindendophytica, D. morindae, and D. zhaoqingensis. This is the first report of Diaporthe chongqingensis, D. guangxiensis, D. heliconiae, D. siamensis, D. unshiuensis, and D. xishuangbanica on M. officinalis. This study provides the first intensive study of endophytic Diaporthe species on M. officinalis in China. These results will improve the current knowledge of Diaporthe species associated with this traditional medicinal plant. Furthermore, results from this study will help to understand the potential pathogens and biocontrol agents from M. officinalis and to develop a disease management platform.

Nomogram to predict rapid kidney function decline in population at risk of cardiovascular disease

BackgroundTo develop a reliable model to predict rapid kidney function decline (RKFD) among population at risk of cardiovascular disease.MethodsIn this retrospective study, key monitoring residents including the elderly, and patients with hypertension or diabetes of China National Basic Public Health Service who underwent community annual physical examinations from January 2015 to December 2020 were included. Healthy records were extracted from regional chronic disease management platform. RKFD was defined as the reduction of estimated glomerular filtration rate (eGFR) ≥ 40% during follow-up period. The entire cohort were randomly assigned to a development cohort and a validation cohort in a 2:1 ratio. Cox regression analysis was used to identify the independent predictors. A nomogram was established based on the development cohort. The concordance index (C-index) and calibration plots were calculated. Decision curve analysis was applied to evaluate the clinical utility.ResultsA total of 8455 subjects were included. During the median follow-up period of 3.72 years, the incidence of RKFD was 11.96% (n = 1011), 11.98% (n = 676) and 11.92% (n = 335) in the entire cohort, development cohort and validation cohort, respectively. Age, eGFR, hemoglobin, systolic blood pressure, and diabetes were identified as predictors for RKFD. Good discriminating performance was observed in both the development (C-index, 0.73) and the validation (C-index, 0.71) cohorts, and the AUCs for predicting 5-years RKFD was 0.763 and 0.740 in the development and the validation cohort, respectively. Decision curve analysis further confirmed the clinical utility of the nomogram.ConclusionsOur nomogram based on five readily accessible variables (age, eGFR, hemoglobin, systolic blood pressure, and diabetes) is a useful tool to identify high risk patients for RKFD among population at risk of cardiovascular disease in primary care. Whereas, further external validations are needed before clinical generalization.

Clinical therapeutic effect on bronchial asthma by the observation of skin reaction after acupoint application based on chronic disease management platform of asthma

To compare the therapeutic effect on bronchial asthma between presence of skin reaction and the absence of skin reaction after acupoint application. Sixty-one patients with bronchial asthma were treated with acupoint application during the hottest periods of summer ("dog days"). The acupoints included Dingchuan (EX-B 1), Feishu (BL 13), Xinshu (BL 15), Pishu (BL 20) and Shenshu (BL 23). The treatment was given once every 7 days, with the herbal plaster remained for 6 h each time, and 4 treatments were required totally. According to the local skin reaction after acupoint application, a skin reaction group (30 cases, 2 cases dropped off) and a non-skin reaction group (31 cases) were divided. Separately, before treatment and 1 year after treatment, using chronic disease management platform of asthma, the number of asthma attacks, the score of asthma control test (ACT) and the score of asthma quality of life questionnaire (AQLQ) were recorded online. Besides, the therapeutic effect was observed in the two groups 1 year after treatment. One year after treatment, the number of asthma attacks was reduced as compared with that before treatment in the patients of either group (P<0.001), the score of ACT and each domain in AQLQ, i.e. activity limitation, asthma symptoms, psychological state, reactions to stimuli and self-health care as well as the total scores of AQLQ were all increased as compared with those before treatment (P<0.001). The number of asthma attacks in the skin reaction group was less than the non-skin reaction group (P<0.05), the score of ACT and each domain of AQLQ and the total scores of AQLQ were all higher than the non-skin reaction group successively (P<0.05, P<0.01). The total effective rate was 82.1% (23/28) in the skin reaction group, better than 67.7% (21/31) in the non-skin reaction group (P<0.05). In treatment of acupoint application for bronchial asthma, the clinical therapeutic effect is better in the patients with local skin reaction after acupoint application. The chronic disease management platform of asthma is convenient for online evaluation.

HeartMan DSS: A decision support system for self-management of congestive heart failure

Congestive heart failure is a chronic medical condition that affects about 2% of the adult population. Even though it cannot be cured, it can be relieved by a proper, long-term, complex and personalized disease management. In this paper we present the HeartMan Decision Support System (DSS), aimed at supporting individual patients in their uptake of well-established clinical guidelines (i.e., both medication and behaviour based) for disease management. The HeartMan DSS is a central component of the wider HeartMan mobile-health platform that employs mobile phones, wristband sensors and a web application for communication with patients, their physicians and caregivers. The DSS itself provides recommendations for (1) managing patient’s physical health in terms of exercise, nutrition, medications and self-monitoring, (2) psychological support, and (3) managing environmental parameters. The DSS employs a variety of methods: rule-based decision models and adaptable workflows developed using literature and in collaboration with medical experts, classification models developed by machine learning from data, and optimization algorithms. Taken together, they provide a comprehensive, personalized and user-friendly disease management platform. The system was evaluated in a clinical proof-or-concept trial, involving 56 patients in four hospitals. The results confirmed that the system was successful in improving self-care behaviour, decreased patients' levels of depression and anxiety, and improved the overall predicted 1-year mortality risk.

Why the incidence in dialysis in the Lisbon and Tagus Valley Region (LVTR) is two to three times higher than in other regions of the country

The analysis of data from the Ministry of Health’s Integrated Chronic Kidney Disease Management Platform (PI -GID), reveals the existence of a striking regional difference in the incidence in dialysis. This difference is characterized by high levels of incidence in all regions, except the Alentejo, and extremely high levels in the Lisbon and Tagus Valley region. In this region, the incidence values are two to three times higher than in the others. The difference between regions is the result of a different number of patients starting hemodialysis, since the incidence in peritoneal dialysis is low and similar in all of them. It is difficult to find justification for such a discrepancy since the prevalence of factors usually responsible for the higher or lower level of incidence in dialysis does not differ significantly between them. A probable explanation may lie in the difference found in the concentration of public hemodialysis centers, a fact that may determine a difference in the criteria used for the entry of patients undergoing substitutive treatment of renal function. In fact, we found a close correlation between the number of public hemodialysis centers per million inhabitants and the level of incidence in dialysis. A more comprehensive analysis of the data from the Ministry of Health’s Integrated Chronic Kidney Disease Management Platform (PI -GID), if allowed, would be of enormous interest, not only to explain this discrepancy in the incidence of dialysis between regions, but because it could probably allow an explanation for Portugal having (one of) the highest levels of dialysis incidence in Europe

Smartphone-Flashlight-Mediated Remote Control of Rapid Insulin Secretion Restores Glucose Homeostasis in Experimental Type-1 Diabetes.

Emerging digital assessment of biomarkers by linking health-related data obtained from wearable electronic devices and embedded health and fitness sensors in smartphones is opening up the possibility of creating a continuous remote-monitoring platform for disease management. It is considered that the built-in flashlight of smartphones may be utilized to remotely program genetically engineered designer cells for on-demand delivery of protein-based therapeutics. Here, the authors present smartphone-induced insulin release in β-cell line (iβ-cell) technology for traceless light-triggered rapid insulin secretion, employing the light-activatable receptor melanopsin to induce calcium influx and membrane depolarization upon illumination. This iβ-cell-based system enables repeated, reversible secretion of insulin within 15min in response to light stimulation, with a high induction fold both in vitro and in vivo. It is shown that programmable percutaneous remote control of implanted microencapsulated iβ-cells with a smartphone's flashlight rapidly reverses hyperglycemia in a mouse model of type-1 diabetes.

Patient engagement with digital disease management and readmission rates: The case of congestive heart failure.

Congestive heart failure (CHF) is one of the most common diagnoses in the elderly United States Medicare (⩾ age 65) population. This patient population has a particularly high readmission rate, with one estimate of the 6-month readmission rate topping 40%. The rapid rise of mobile health (mHealth) presents a promising new pathway for reducing hospital readmissions of CHF, and, more generally, the management of chronic conditions. Using a randomized research design and a multivariate regression model, we evaluated the effectiveness of a hybrid mHealth model-the integration of remote patient monitoring with an applied health technology and digital disease management platform-on 45-day hospital readmissions for patients diagnosed with CHF. We find a 78% decrease in the likelihood of CHF hospital readmission for patients who were assigned to the digital disease management platform as compared to patients assigned to control.

Role of Digital Engagement in Diabetes Care Beyond Measurement: Retrospective Cohort Study

BackgroundThe use of remote data capture for monitoring blood glucose and supporting digital apps is becoming the norm in diabetes care. One common goal of such apps is to increase user awareness and engagement with their day-to-day health-related behaviors (digital engagement) in order to improve diabetes outcomes. However, we lack a deep understanding of the complicated association between digital engagement and diabetes outcomes.ObjectiveThis study investigated the association between digital engagement (operationalized as tagging of behaviors alongside glucose measurements) and the monthly average blood glucose level in persons with type 2 diabetes during the first year of managing their diabetes with a digital chronic disease management platform. We hypothesize that during the first 6 months, blood glucose levels will drop faster and further in patients with increased digital engagement and that difference in outcomes will persist for the remainder of the year. Finally, we hypothesize that disaggregated between- and within-person variabilities in digital engagement will predict individual-level changes in blood glucose levels.MethodsThis retrospective real-world analysis followed 998 people with type 2 diabetes who regularly tracked their blood glucose levels with the Dario digital therapeutics platform for chronic diseases. Subjects included “nontaggers” (users who rarely or never used app features to notice and track mealtime, food, exercise, mood, and location, n=585) and “taggers” (users who used these features, n=413) representing increased digital engagement. Within- and between-person variabilities in tagging behavior were disaggregated to reveal the association between tagging behavior and blood glucose levels. The associations between an individual’s tagging behavior in a given month and the monthly average blood glucose level in the following month were analyzed for quasicausal effects. A generalized mixed piecewise statistical framework was applied throughout.ResultsAnalysis revealed significant improvement in the monthly average blood glucose level during the first 6 months (t=−10.01, P<.001), which was maintained during the following 6 months (t=−1.54, P=.12). Moreover, taggers demonstrated a significantly steeper improvement in the initial period relative to nontaggers (t=2.15, P=.03). Additional findings included a within-user quasicausal nonlinear link between tagging behavior and glucose control improvement with a 1-month lag. More specifically, increased tagging behavior in any given month resulted in a 43% improvement in glucose levels in the next month up to a person-specific average in tagging intensity (t=−11.02, P<.001). Above that within-person mean level of digital engagement, glucose levels remained stable but did not show additional improvement with increased tagging (t=0.82, P=.41). When assessed alongside within-person effects, between-person changes in tagging behavior were not associated with changes in monthly average glucose levels (t=1.30, P=.20).ConclusionsThis study sheds light on the source of the association between user engagement with a diabetes tracking app and the clinical condition, highlighting the importance of within-person changes versus between-person differences. Our findings underscore the need for and provide a basis for a personalized approach to digital health.

Data Analysis for Thermal Disease Wearable Devices

This study was conducted as a planning stage for development of wearable devices capable of managing the thermal diseases by applying the ICT(Information Communication Technology) in an endeavor to meet the urgent needs for countermeasures amid rapid increase in the number of patients with the thermal diseases caused as a result of global warming. The purpose of this study was to provide the basic data for development of wearable devices allowing the patients to be transported expeditiously to hospitals based on synchronization with medical institutions or enabling the prevention of diseases through the response system for each stage according to the reference values based on the data reflecting physical characteristics of individuals by applying the ICT, so that the thermal diseases can be managed effectively. For that, basic study will be conducted on expanding the role of the devices capable of protecting human lives from various thermal diseases caused by the scorching heat waves, which are affecting countries worldwide and expected to persist in the period ahead, by setting the goals of each stage for the thermal disease management platform and collecting necessary information. Based on the accumulated data, the functions of precise diagnosis and treatment can be expected through more accurate evidences pertaining to the thermal diseases.

Fast, Precise, and Reliable Multiplex Detection of Potato Viruses by Loop-Mediated Isothermal Amplification

Potato is an important staple food crop in both developed and developing countries. However, potato plants are susceptible to several economically important viruses that reduce yields by up to 50% and affect tuber quality. One of the major threats is corky ringspot, which is a tuber necrosis caused by tobacco rattle virus (TRV). The appearance of corky ringspot symptoms on tubers prior to commercialization results in ≈ 45% of the tubers being downgraded in quality and value, while ≈ 55% are declared unsaleable. To improve current disease management practices, we have developed simple diagnostic methods for the reliable detection of TRV without RNA purification, involving minimalized sample handling (mini), subsequent improved colorimetric loop-mediated isothermal amplification (LAMP), and final verification by lateral-flow dipstick (LFD) analysis. Having optimized the mini-LAMP-LFD approach for the sensitive and specific detection of TRV, we confirmed the reliability and robustness of this approach by the simultaneous detection of TRV and other harmful viruses in duplex LAMP reactions. Therefore, our new approach offers breeders, producers, and farmers an inexpensive and efficient new platform for disease management in potato breeding and cultivation.

The application in patients with chronic heart failure based on the "Internet plus" three entities double track interactive continuity nursing

Objective To explore the application effect of Interactive continuing nursing intervention model with three subjects and two tracks, which is based on internet and applied to chronic heart failure patients. Methods During January 1 to December 30, 2017, 110 chronic heart failure patients, who were going to discharge from the Second People′s Hospital of Guangdong Province, were selected for this research. Participants were equally divided into control group and observation group with random number table with 55 cases each. Participants were adopted conventional medication and traditional care, while patients in control group were given extra interactive continuing nursing intervention with three subjects and two tracks, which was relied on internet-based cardiovascular disease management platform. Comparing patients′ scores of life quality, self-care ability, anxiety and depression degree before intervention and that in 6 months after intervention with Minnesota Living with Heart Failure Questionnaire (MLHFQ), Self Care of Heart Failure Index (SCHFI), Self-rating Anxiety Scale(SAS) and Hamilton Depression Scale (HAMD) respectively. Moreover, 6 minute walk test was conducted, simultaneously, the incidence of cardiovascular events was calculated respectively before intervention, 3 months after intervention and 6 months after intervention. Results It showed that total scores of MLHFQ, SCHFI, SAS and HAMD for patients in observation group before intervention were (49.05 ± 4.39), (101.57 ± 21.04), (58.3 ± 5.2) and (40.1 ± 3.5) points respectively while that for patients in observation group after 6 months intervention were (43.03 ± 6.85), (123.17 ± 18.23), (42.3 ± 4.2) and (24.4 ± 4.3) points respectively. The difference was statistically significant (t=5.49-20.60, all P <0.01). In comparison, intervention effect of observation group was better than that of control group, although, the SAS scores of the control group were statistically significant. Furthermore, after intervention, the difference of MLHFQ, SCHFI, SAS and HAMD scores were statistically significant(t=3.48-17.79, all P <0.01). Moreover, 6 months after intervention, 6 minute walk test evaluation showed that there was statistical significance between observation group and control group (χ2=8.11, P <0.05). Besides, The death rate in observation group was lower than that in control group after 6 months intervention (χ2= 6.30, P <0.05). Meanwhile, readmission rate after 3 months and 6 months indicates that there was statistical significance between observation group and control group(χ2=5.25, 6.30, P <0.05). Conclusions Interactive nursing intervention model with three subjects and two tracks which based on internet is able to enhance chronic heart failure patients′ self-care ability and life quality, decrease the incidence of cardiovascular events and negative emotion of patients. Key words: Internet; Interactive nursing intervention model with three subjects and two tracks; Cardiac failure; Quality of life; Self-care ability; Depression

CKD Express © - A New IT-Software Proposed for a Paradigm Change in CKD Care

CKD Express © - A New IT-Software Proposed for a Paradigm Change in CKD Care