Toward an mHealth Intervention for Smoking Cessation

The prevalence of tobacco dependence in the United States (US) remains alarming. Invariably, smoke-related health problems are the leading preventable causes of death in the US. Research has shown that a culturally tailored cessation counseling program can help reduce smoking and other tobacco usage. In this paper, we present a mobile health (mHealth) solution that leverages the Short Message Service (SMS) or text messaging feature of mobile devices to motivate behavior change among tobacco users. Our approach implements the Theory of Planned Behavior (TPB) and a phase-based framework. We make contributions to improving previous mHealth intervention approaches by delivering personalized and evidence-based motivational SMS messages to participants. Our proposed solution implements machine learning algorithms that take the participant\u27s demographic profile and previous smoking behavior into account. We discuss our preliminary evaluation of the system against a couple of pseudo-scenarios and our observation of the system\u27s performance

Building a Tailored Text Messaging System for Smoking Cessation in Native American Populations

When starting new and healthy habits or encouraging vigilance against returning to poor habits, a simple text message can be beneficial. Text messages also have the advantage of being easily accessible for lower-income populations spread over a rural area, who may not be able to afford smartphones with apps or data plans. Users benefit the most from text messages that are customized for them, but personalization requires time and effort on part of the user and the counselor. However, personalization that focuses on the cultural background of a pool of recipients, in addition to general personal preferences, can be a low-cost method of ensuring the best experience for patients interested in taking up new habits. In this paper, we discuss the development of a system for motivating users to quit smoking designed for Native American users in South Dakota, using text messaging as a daily intervention method for patients. Our results show that focusing on modular message customization options and messages with a conversational tone best helps our goal of providing users with customization options that help motivate them to live happy and healthy lifestyles

Reality Versus Grant Application Research “Plans”

This article describes the implementation of the American Indian mHealth Smoking Dependence Study focusing on the differences between what was written in the grant application compared to what happened in reality. The study was designed to evaluate a multicomponent intervention involving 256 participants randomly assigned to one of 15 groups. Participants received either a minimal or an intense level of four intervention components: (1) nicotine replacement therapy, (2) precessation counseling, (3) cessation counseling, and (4) mHealth text messaging. The project team met via biweekly webinars as well as one to two in-person meetings per year throughout the study. The project team openly shared progress and challenges and collaborated to find proactive solutions to address challenges as compared to what was planned in the original grant application. The project team used multiple strategies to overcome unanticipated intervention issues: (1) cell phone challenges, (2) making difficult staffing decisions, (3) survey lessons, (4) nicotine replacement therapy, (5) mHealth text messages, (6) motivational interviewing counseling sessions, and (7) use of e-cigarettes. Smoking cessation studies should be designed based on the grant plans. However, on the ground reality issues needed to be addressed to assure the scientific rigor and innovativeness of this study

A Culturally Tailored Intervention System for Cancer Survivors to Motivate Physical Activity

It is necessary for a cancer survivor to have good health behavior. Essential exercise and proper diet are helpful to decrease the risk of recurrence of the disease and the development of a new cancer type. People from low socioeconomic status are more likely to participate in risky health behaviors and have a higher chance of recurrence of cancer. It is important to have a motivational system for cancer survivors that motivates them to perform regular physical activities. In this article, we discuss the development of an mHealth system, which aims to increase physical activity in Native American populations with culturally appropriate motivational text and video messages. The system also includes an e-journal to monitor and maintain proper healthcare. We will also analyze the pilot data to evaluate the usability and the effectiveness of the system

Portable Apparatus for Electrochemical Sensing of Ethylene

A small, lightweight, portable apparatus based on an electrochemical sensing principle has been developed for monitoring low concentrations of ethylene in air. Ethylene has long been known to be produced by plants and to stimulate the growth and other aspects of the development of plants (including, notably, ripening of fruits and vegetables), even at concentrations as low as tens of parts per billion (ppb). The effects are magnified in plant-growth and -storage chambers wherein ethylene can accumulate. There is increasing recognition in agriculture and related industries that it is desirable to monitor and control ethylene concentrations in order to optimize the growth, storage, and ripening of plant products. Hence, there are numerous potential uses for the present apparatus in conjunction with equipment for controlling ethylene concentrations. The ethylene sensor is of a thick-film type with a design optimized for a low detection limit. The sensor includes a noble metal sensing electrode on a chip and a hydrated solid-electrolyte membrane that is held in contact with the chip. Also located on the sensor chip are a counter electrode and a reference electrode. The sensing electrode is held at a fixed potential versus the reference electrode. Detection takes place at active-triple-point areas where the sensing electrode, electrolyte, and sample gas meet. These areas are formed by cutting openings in the electrolyte membrane. The electrode current generated from electrochemical oxidation of ethylene at the active triple points is proportional to the concentration of ethylene. An additional film of the solid-electrolyte membrane material is deposited on the sensing electrode to increase the effective triple-point areas and thereby enhance the detection signal. The sensor chip is placed in a holder that is part of a polycarbonate housing. When fully assembled, the housing holds the solid-electrolyte membrane in contact with the chip (see figure). The housing includes a water reservoir for keeping the solid-electrolyte membrane hydrated. The housing also includes flow channels for circulating a sample stream of air over the chip: ethylene is brought to the sensing surface predominately by convection in this sample stream. The sample stream is generated by a built-in sampling pump. The forced circulation of sample air contributes to the attainment of a low detection limit

Robotic arm rehabilitation in chronic stroke patients with aphasia may promote speech and language recovery (but effect is not enhanced by supplementary tDCS)

Objective: This study aimed to determine the extent to which robotic arm rehabilitation for chronic stroke may promote recovery of speech and language function in individuals with aphasia. Methods: We prospectively enrolled 17 individuals from a hemiparesis rehabilitation study pairing intensive robot assisted therapy with sham or active tDCS and evaluated their speech (N = 17) and language (N = 9) performance before and after a 12-week (36 session) treatment regimen. Performance changes were evaluated with paired t-tests comparing pre- and post-test measures. There was no speech therapy included in the treatment protocol. Results: Overall, the individuals significantly improved on measures of motor speech production from pre-test to post-test. Of the subset who performed language testing (N = 9), overall aphasia severity on a standardized aphasia battery improved from pre-test baseline to post-test. Active tDCS was not associated with greater gains than sham tDCS. Conclusions: This work indicates the importance of considering approaches to stroke rehabilitation across different domains of impairment, and warrants additional exploration of the possibility that robotic arm motor treatment may enhance rehabilitation for speech and language outcomes. Further investigation into the role of tDCS in the relationship of limb and speech/language rehabilitation is required, as active tDCS did not increase improvements over sham tDCS

Mitotic activity patterns and cytoskeletal changes throughout the progression of diapause developmental program in Daphnia

Abstract Background Diapause is a form of dormancy that is genetically predetermined to allow animals to overcome harsh environmental conditions. It is induced by predictive environmental cues bringing cellular activity levels into a state of suspended animation. Entering diapause requires organismal, molecular and cellular adaptation to severely reduced energy flows. Cells must therefore have evolved strategies that prepare them for periods with limited metabolic resources. However, changes that occur on the (sub-)cellular level have not been thoroughly described. Results We investigated mitotic activity and we monitored cytoskeletal network changes in successive stages of diapausing and non-diapausing Daphnia magna embryos using (immuno-)fluorescent labeling. We find that embryos destined to diapause show a delayed and 2.5x slower mitotic activity in comparison to continuously developing embryos. Development is halted when D. magna embryos reach ~ 3500 cells, whereupon mitotic activity is absent and cytoskeletal components are severely reduced, rendering diapause cells compact and condensed. Conclusion In the initiation phase of diapause, the slower cell division rate points to prolonged interphase duration, preparing the cells for diapause maintenance. During diapause, cytoskeletal depletion and cellular condensation may be a means to save energy resources. Our data provide insights into the sub-cellular change of diapause in Daphnia

Newborn-Care Training and Perinatal Mortality in Developing Countries

Background: Of the 3.7 million neonatal deaths and 3.3 million stillbirths each year, 98% occur in developing countries. An evaluation of community-based interventions designed to reduce the number of these deaths is needed. Methods: With the use of a train-the-trainer model, local instructors trained birth attendants from rural communities in six countries (Argentina, Democratic Republic of Congo, Guatemala, India, Pakistan, and Zambia) in the World Health Organization Essential Newborn Care course (which focuses on routine neonatal care, resuscitation, thermoregulation, breast-feeding, kangaroo [skin-to-skin] care, care of the small baby, and common illnesses) and ( except in Argentina) in a modified version of the American Academy of Pediatrics Neonatal Resuscitation Program (which teaches basic resuscitation in depth). The Essential Newborn Care intervention was assessed among 57,643 infants with the use of a before-and-after design. The Neonatal Resuscitation Program intervention was assessed as a cluster-randomized, controlled trial involving 62,366 infants. The primary outcome was neonatal death in the first 7 days after birth. Results: The 7-day follow-up rate was 99.2%. After birth attendants were trained in the Essential Newborn Care course, there was no significant reduction from baseline in the rate of neonatal death from all causes in the 7 days after birth ( relative risk with training, 0.99, 95% confidence interval [CI], 0.81 to 1.22) or in the rate of perinatal death, there was a significant reduction in the rate of stillbirth ( relative risk with training, 0.69, 95% CI, 0.54 to 0.88, P = 0.003). In clusters of births in which attendants had been randomly assigned to receive training in the Neonatal Resuscitation Program, as compared with control clusters, there was no reduction in the rates of neonatal death in the 7 days after birth, stillbirth, or perinatal death. Conclusions: The rate of neonatal death in the 7 days after birth did not decrease after the introduction of Essential Newborn Care training of community-based birth attendants, although the rate of stillbirths was reduced. Subsequent training in the Neonatal Resuscitation Program did not significantly reduce the mortality rates

Controversial Aspects of Diagnostics and Therapy of Arthritis of the Temporomandibular Joint in Rheumatoid and Juvenile Idiopathic Arthritis: An Analysis of Evidence- and Consensus-Based Recommendations Based on an Interdisciplinary Guideline Project

Introduction: Due to potentially severe sequelae (impaired growth, condylar resorption, and ankylosis) early diagnosis of chronic rheumatic arthritis of the temporomandibular joint (TMJ) and timely onset of therapy are essential. Aim: Owing to very limited evidence the aim of the study was to identify and discuss controversial topics in the guideline development to promote further focused research. Methods: Through a systematic literature search, 394 out of 3771 publications were included in a German interdisciplinary guideline draft. Two workgroups (1: oral and maxillofacial surgery, 2: interdisciplinary) voted on 77 recommendations/statements, in 2 independent anonymized and blinded consensus phases (Delphi process). Results: The voting results were relatively homogenous, except for a greater proportion of abstentions amongst the interdisciplinary group (p < 0.001). Eighty four percent of recommendations/statements were approved in the first round, 89% with strong consensus. Fourteen recommendations/statements (18.2%) required a prolonged consensus phase and further discussion. Discussion: Contrast-enhanced MRI was confirmed as the method of choice for the diagnosis of TMJ arthritis. Intraarticular corticosteroid injection is to be limited to therapy refractory cases and single injection only. In adults, alloplastic joint replacement is preferable to autologous replacement. In children/adolescents, autologous reconstruction may be performed lacking viable alternatives. Alloplastic options are currently still considered experimental