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
May 25,2020

Singapore, May 25: COVID-19 patients are no longer infectious after 11 days of getting sick even though some may still test positive, according to a new study by infectious disease experts in Singapore.

A positive test "does not equate to infectiousness or viable virus," a joint research paper by Singapore's National Centre for Infectious Diseases and the Academy of Medicine, Singapore said. The virus "could not be isolated or cultured after day 11 of illness."

The paper was based on a study of 73 patents in the city-state.

The latest findings may have implications on the country's patient discharge policy. The discharge criteria is currently based on negative test results rather than infectiousness.

Singapore's strategy on managing COVID-19 patients is guided by the latest local and international clinical scientific evidence, and the Ministry of Health will evaluate if the latest evidence can be incorporated into its patient clinical management plan, according to a report by the Straits Times.

So far, 13,882, or about 45% of the total 31,068 Covid-19 patients in Singapore have been discharged from hospitals and community facilities. Singapore reported 642 new Covid-19 cases as of noon on Saturday.

The government has been actively screening pre-school staff as it prepares to reopen pre-schools from June 2. On Friday, two pre-school employees tested positive for the novel coronavirus, bringing the total number of confirmed cases among pre-school staff to seven, according to the Ministry of Health.

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Agencies
July 14,2020

UN, Jul 14: There will be no return to the "old normal" for the foreseeable future as a result of the ongoing COVID-19 pandemic, and too many countries were still headed in the wrong direction, the chief of the World Health Organization (WHO) warned.

"The virus remains public enemy number one, but the actions of many governments and people do not reflect this," Xinhua news agency quoted WHO Director-General Tedros Adhanom Ghebreyesus at as saying a regular briefing on Monday.

He noted that mixed messages from leaders are undermining trust, which is the most critical ingredient of any response, while the only aim of the virus is to find people to infect.

Things are going to "get worse and worse and worse", he warned, unless governments communicate clearly with their citizens and roll out a comprehensive strategy focused on suppressing transmission and saving lives, while populations follow the basic public health principles of physical distancing, hand washing, wearing masks, coughing etiquette and staying home when sick.

COVID-19 has been gaining its momentum lately.

According to Tedros, Sunday saw a record of 230,000 cases reported to WHO, of which almost 80% were from just 10 countries and about half from just two countries.

"But it does not have to be this way," he said, asking every single leader, government and individual "to do their bit to break the chains of COVID-19 transmission and end the collective suffering".

To control the disease and get on with people's lives, Tedros said, three things are required. The first is to focus on reducing mortality and suppressing transmission; the second is to focus on an empowered, engaged community that takes individual behaviour measures in the interest of each other.

And the third is a strong government leadership and coordination of comprehensive strategies that are communicated clearly and consistently.

"We weren't prepared collectively, but we must use all the tools we have to bring this pandemic under control. And we need to do it right now," he added.

At the WHO briefing on Monday, health experts also said there was evidence to suggest that children under the age of 10 were only very mildly affected by Covid-19, while those over 10 seemed to suffer similar mild symptoms to young adults.

To what extent children can transmit the virus, while it appears to be low, remains unknown.

On Tuesday, the number of global coronavirus cases cross the 13 million mark, according to the Johns Hopkins University.

The total number of cases currently stood at 13,070,097, while the fatalities rose to 572,411, the University's Center for Systems Science and Engineering (CSSE) revealed in its latest update.

The US accounted for the world's highest number of infections and fatalities at 3,363,056 and 135,605, respectively, according to the CSSE.

Brazil came in the second place with 1,884,967 infections and 72,833 deaths.

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Agencies
April 4,2020

Washington D.C., Apr 4: While consuming a high-diet salt can result in high blood pressure, a recent study has revealed a link between salt-rich diet and weaker immune system.

The study was conducted under the leadership of the University Hospital Bonn, and the results were published in the journal Science Translational Medicine.

The research was conducted on mice that were fed a high-salt diet. Later, they were found to suffer from much more severe bacterial infections.

Human volunteers who consumed an additional six grams of salt per day also showed pronounced immune deficiencies.

The World Health Organization (WHO) has recommended a maximum amount of five grams of salt a day.

It corresponds approximately to one level teaspoon. In reality, however, many Germans exceed this limit considerably. 

Figures from the Robert Koch Institute suggest that on average men consume ten, and women more than eight grams a day.

This means that we reach for the salt shaker much more than is good for us. After all, sodium chloride, which is its chemical name, raises blood pressure and thereby increases the risk of heart attack or stroke.

"We have now been able to prove for the first time that excessive salt intake also significantly weakens an important arm of the immune system," said Prof. Dr. Christian Kurts from the Institute of Experimental Immunology at the University of Bonn.

This finding is unexpected, as some studies point in the opposite direction. For example, infections with certain skin parasites in laboratory animals heal significantly faster if these consume a high-salt diet.

The study also sheds light on the fact that the skin serves as a salt reservoir.

"Our results show that this generalization is not accurate," emphasized Katarzyna Jobin, lead author of the study.

The body keeps the salt concentration in the blood and in the various organs largely constant. Otherwise important biological processes would be impaired. The only major exception is the skin which functions as a salt reservoir of the body. This is why the additional intake of sodium chloride works so well for some skin diseases.

However, other parts of the body are not exposed to the additional salt consumed with food. Instead, it is filtered out by the kidneys and excreted in the urine.

"We examined volunteers who consumed six grams of salt in addition to their daily intake," said Prof. Kurts. This is roughly the amount contained in two fast-food meals, i.e. two burgers and two portions of French fries.

After one week, from the results, it showed that the immune cells coped much worse with bacteria after the test subjects had started to eat a high-salt diet.

In human volunteers, excessive salt intake also resulted in increased glucocorticoid levels.

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