Avatar-based app helps recognise heart attack symptoms

Agencies
June 11, 2018

Melbourne, Jun 11: Scientists have developed an app that uses a simulated digital nurse to teach patients how to recognise symptoms of heart attack and call emergency. Patients using the SAVE app are more likely to call an ambulance when they had symptoms and had fewer hospital admissions, researchers said.

“Most deaths from heart attacks occur within the first few hours of symptom onset,” said Jintana Tongpeth, a PhD student at Flinders University in Australia. “The death rate can be halved by getting patients to a hospital more quickly. Delays occur mainly because patients don’t recognise symptoms or know to call an ambulance,” said Tongpeth.

An avatar is a simulated digital character that interacts by talking and using facial expressions and body language. The SAVE app uses an avatar, a nurse named Cora, to teach heart attack warning signs and symptoms, and what to do when they occur. The app has four sections heart attack warning sign quiz; heart attack signs and symptoms, showing which symptoms are more common in men versus women; what to do when having a heart attack; heart attack warning signs test.

During the initial development phase, a pilot study in ten heart attack survivors found that using the app improved symptom recognition and knowledge about what to do. These results became the preliminary data for a larger, statistically powered randomised controlled trial.

On Monday, researchers present results of this first randomised controlled trial testing the impact of using the app on knowledge and response to heart attack symptoms. The trial randomly allocated 70 heart attack survivors to the app plus routine discharge information or routine discharge information alone (usual care group). App users received a tablet computer, with the app installed, to use at home for six months.

Knowledge of symptoms and appropriate responses was assessed in both groups at the start of the study and at six months. Ambulance use and hospitalisations during the six month period were recorded. When symptoms occurred, app users were significantly more likely to call an ambulance (89 per cent) compared to the usual care group (43 per cent).

During the six months, app users spent less time in a hospital for heart problems than patients in the usual care group (3.6 days versus 6.4 days on average, respectively). At the start of the study, patients in both groups had similar knowledge of heart attack symptoms and how to react. At six months, app users had significantly better knowledge of symptoms and how to react than those who received routine discharge information alone. Some 85 per cent of app users said Cora had increased their confidence in recognising heart attack symptoms and knowing how to react.

“Our study shows that patients using an avatar-based app are more likely to call emergency if they have heart attack symptoms and spend less time in hospital. A larger trial is needed to see if this translates into quicker treatment and increased survival,” said Tongpeth. “Nurses have limited time to provide discharge education and often encounter literacy and language barriers. This avatar app will be an essential tool to help overcome these difficulties. The pictures do not require patients to read, and we are translating the content so that Cora speaks 144 languages,” said Robyn Clark, a professor at Flinders University.

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Agencies
June 21,2020

Lower neighbourhood socioeconomic status and greater household crowding increase the risk of becoming infected with SARS-CoV-2, the virus that causes COVID-19, warn researchers.

"Our study shows that neighbourhood socioeconomic status and household crowding are strongly associated with risk of infection," said study lead author Alexander Melamed from Columbia University in the US.

"This may explain why Black and Hispanic people living in these neighbourhoods are disproportionately at risk for contracting the virus," Melamed added.

For the findings, published in the journal JAMA, the researchers examined the relationships between COVID-19 infection and neighbourhood characteristics in 396 women who gave birth during the peak of the Covid-19 outbreak in New York City. Since March 22, all women admitted to the hospitals for delivery have been tested for the virus, which gave the researchers the opportunity to detect all infections -- including infections with no symptoms -- in a defined population

The strongest predictor of COVID-19 infection among these women was residence in a neighbourhood where households with many people are common.The findings showed that women who lived in a neighbourhood with high household membership were three times more likely to be infected with the virus. Neighbourhood poverty also appeared to be a factor, the researchers said.Women were twice as likely to get COVID-19 if they lived in neighbourhoods with a high poverty rate, although that relationship was not statistically significant due to the small sample size.

The study revealed that there was no association between infection and population density.

"New York City has the highest population density of any city in the US, but our study found that the risks are related more to density in people's domestic environments rather than density in the city or within neighbourhoods," says co-author Cynthia Gyamfi-Bannerman."

The knowledge that SARS-CoV-2 infection rates are higher in disadvantaged neighbourhoods and among people who live in crowded households could help public health officials target preventive measures," the authors wrote.

Recently, another study published in the Journal of the American Planning Association, showed that dense areas were associated with lower COVID-19 death rates.

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Agencies
June 27,2020

After admitting that the world may have a COVID-19 vaccine within one year or even a few months earlier, the World Health Organisation (WHO) on Friday said that UK-based AstraZeneca is leading the vaccine race while US-based pharmaceutical major Moderna is not far behind.

WHO Chief Scientist Soumya Swaminathan stated that the AstraZeneca's coronavirus vaccine candidate is the most advanced vaccine currently in terms of development.

"I think AstraZeneca certainly has a more global scope at the moment in terms of where they are doing and planning their vaccine trials," she told the media.

AstraZeneca's Covid-19 vaccine candidate developed by researchers from the Oxford University will likely provide protection against the disease for one year, the British drug maker's CEO told Belgian radio station Bel RTL this month.

The Oxford University last month announced the start of a Phase II/III UK trial of the vaccine, named AZD1222 (formerly known as ChAdOx1 nCoV-19), in about 10,000 adult volunteers. Other late-stage trials are due to begin in a number of countries.

Last week, Swaminathan had said that nearly 2 billion doses of the COVID-19 vaccine would be ready by the end of next year.

Addressing the media from Geneva, she said that "at the moment, we do not have a proven vaccine but if we are lucky, there will be one or two successful candidates before the end of this year" and 2 billion doses by the end of next year.

Scientists predict that the world may have a COVID-19 vaccine within one year or even a few months earlier, said the Director-General of the World Health Organization even as he underlined the importance of global cooperation to develop, manufacture and distribute the vaccines.

However, making the vaccine available and distributing it to all will be a challenge and will require political will, WHO chief Tedros Adhanom Ghebreyesus said on Thursday during a meeting with the European Parliament's Committee for Environment, Public Health and Food Safety.

One option would be to give the vaccine only to those who are most vulnerable to the virus.

There are currently over 100 COVID-19 vaccine candidates in various stages of development.

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Agencies
July 4,2020

The Union health ministry on Friday revised the dosage of anti-viral drug remdesivir to be administered to coronavirus patients in the moderate stage of illness from the earlier six days to five days as it issued an updated 'Clinical Management Protocols for COVID-19'.

The drug, administered in the form of injection, should be given at a dose of 200 mg on day one followed by 100 mg daily for four days (total five days), the new treatment protocols stated.

The Health Ministry on June 13 had allowed the use of remdesivir for restricted emergency use in moderate cases under "investigational therapies".

"Under emergency use authorisation, remdesivir may be considered for patients in moderate stage requiring oxygen support," the document stated.

It is not recommended for those with severe renal impairment and high level of liver enzymes, pregnant and lactating women, and those below 12 years, it said.

The ministry also okayed off-label application of tocilizumab, a drug that modifies the immune system or its functioning, and convalescent plasma for treating COVID-19 patients in the moderate stage of illness as "investigational therapies".

It also recommended hydroxychloroquine for patients during the early course of the disease and not for critically-ill patients.

On June 27, the ministry had included an inexpensive, widely used steroid dexamethasone in treatment protocols for COVID-19 patients in the moderate to severe stages of their illness among other therapeutic measures.

The ministry advised use of dexamethasone, which is already used in a wide range of conditions for its anti-inflammatory and immunosuppressant effects, as an alternative choice to methylprednisolone for managing moderate to severe cases of coronavirus infection.

India's COVID-19 cases soared by over 20,000 in a day for the first time taking the country's total tally to 6,25,544 on Friday while the death toll climbed to 18,213 with 379 new fatalities, according to the Union Health Ministry data updated at 8 am.

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