450 Cellular Energy Monitoring for Diagnosis and Management of Therapy for Sleep Disordered Breathing

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A178-A178
Author(s):  
Guy Hatch
Keyword(s):  
Unmet Need ◽  
Test Site ◽  
Hypoxic Stress ◽  
Cellular Energy ◽  
Primary Snoring ◽  
Home Recording ◽  
Cellular Hypoxia ◽  
Normal Sleep ◽  
Physiologic Responses ◽  
At Home

Abstract Introduction Polysomnogram (PSG) monitoring, including pulse oximetry, is the current diagnostic standard in sleep medicine. However, potentially confounding aspects of PSG testing include: test site other than the subject’s normal bed, distracting sensors and wires, subjective interpretation of complex recorded signals, and limited sensitivity to relevant phenomena. There is currently an unmet need for a sleep test that is more clinically effective than PSG, and that can be administered in the subject’s normal sleeping environment. Additionally, confirmation that home therapy has been optimized cannot be achieved by PSG titration. Methods A recent proof of concept (POC) study of the armband-wearable Reveal Cellular Energy Monitor (CE monitor) directly compared its data product, Cellular Energy Index (CEi), with PSG data. Scoring methods were adapted from AASM guidance for interpretation of PSG data. At-home recording with the CE monitor was also performed prior to and following PSG studies. At-home incremental adjustment of APAP settings and mask selection was documented with CE monitoring and compared with the information recorded by the home APAP machine. Results The comparison of the POC data consistently found the CE monitor to be more sensitive and responsive to hypoxic stress than the PSG pulse oximeter during primary snoring. Obstructive and central apnea events were detected by both, but the CE monitor provided finer resolution of the breath-by-breath effort of breathing compared with PSG RIP and nasal sensors. At-home CE monitor optimization of therapy was documented to often differ from the settings and mask selection determined by PSG titration, and resulted in ‘normal’ sleep breathing data. Conclusion All diagnostically-relevant physiologic responses detected by PSG were also detected by the CE monitor. Evidence of cellular hypoxia in the skin, by CE monitor, was consistently recorded during prolonged periods of ‘primary snoring;’ i.e., SpO2 is less sensitive to hypoxic stress during sleep than CEi. Breath-by-breath effort is detected by the CE monitor. Support (if any) The POC study costs at UCSF were paid by Reveal Biosensors, Inc.

scholarly journals Telehealth Use in a Home-Based Dementia Care-Coordination Program

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 195-196
Author(s):  
Deirdre Johnston ◽  
Melissa Reuland ◽  
Kelly Marshall ◽  
Inga Antonsdottir ◽  
Morgan Bunting ◽  
...  
Keyword(s):  
Clinical Supervision ◽  
Unmet Need ◽  
Dementia Care ◽  
Care Plan ◽  
Home Setting ◽  
Home Team ◽  
Individualized Care ◽  
Home Based ◽  
Increased Risk ◽  
At Home

Abstract In the coming decades, greater numbers of people will either have Alzheimer’s Disease or a related dementia or will take care of a family member with dementia. The dementia syndromes are associated with increased risk of medical, social, and behavioral complications in both the person with dementia (PWD) and the caregiver (CG), many of which are preventable. These complications, and the dementia itself, can impede access to care and ultimately hasten residential care placement, which can be both undesirable and costly. A nearly universal unmet need in PWD/CG dyads is dementia-specific education. Therefore, it is vital we find ways to support and provide education to CG/PWD dyads to manage dementia in the community and home setting. MIND at Home is a dementia-care model developed and tested at Johns Hopkins University School of Medicine to minimize dementia complications and delay institutionalization by training non-clinical Memory Care Coordinators (MCCs) working under clinical supervision to support and guide PWD/CG dyads in the community. MCCs collaborate with CGs and PWDs in the community using an individualized care plan structured around the dyads’ specific dementia-related needs. This presentation will describe how the MIND at Home team used handheld tablets to connect MCCs to clinicians from participants’ homes, and will report on challenges encountered, strategies to address them, and participant and caregiver satisfaction with the telehealth experience.

A Novel Myofunctional Therapy Water Bottle to Reduce Snoring and Obstructive Sleep Apnea

2020 ◽  
Author(s):  
Anders Olmanson ◽  
Tyler Nordmann ◽  
Bjorn Olmanson ◽  
Evan Molitor ◽  
Gunnar Hodnefield
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Unmet Need ◽  
Water Bottle ◽  
Usability Study ◽  
Myofunctional Therapy ◽  
Primary Snoring ◽  
Obstructive Sleep ◽  
Device Use ◽  
The One

Abstract There is a clear unmet need to provide alternative, first-line solutions for both obstructive sleep apnea and primary snoring. A novel myofunctional therapy nozzle that delivers therapy through drinking water provides a low risk, low burden, and affordable solution that can easily be administered to primary snorers and obstructive sleep apnea patients to reduce the overall harm from these conditions. A prototype myofunctional therapy nozzle and water bottle were developed and used to conduct a product usability study over the summer of 2020 to assess likeability, one-month adherence, and snoring improvement. 37 participants participated in the study and completed one month of device use. 27 participants were included in the snoring analysis and 35 participants in the tiredness analysis. The one-month assessment has shown 88% adherence, the overall satisfaction of the product was 80% measured by CSAT, 93% have reported subjective improvements in reducing snoring intensity, occurrence, and/or impact, and 34% of participants reported improvements in tiredness. Bedpartner reported median snoring intensity decreased from somewhat loud to soft or quiet, overall snoring occurrence decreased, and median snoring impact reduced from moderately to a little bit after one month of device use. Preliminary results are promising and warrant further investigation.

Wearable at-home recording system for sleep apnea

2015 ◽  
Author(s):  
Stephen J. Bethel ◽  
Chris T. Joslin ◽  
Brian S. Shepherd ◽  
Joseph M. Martel ◽  
Douglas E. Dow
Keyword(s):  
Sleep Apnea ◽  
Recording System ◽  
Home Recording ◽  
At Home

Track 1

2018 ◽  
Author(s):  
Adam Patrick Bell
Keyword(s):  
Digital Age ◽  
Learning Approach ◽  
Learning Approaches ◽  
Digital Immigrants ◽  
Music Making ◽  
Home Recording ◽  
At Home

Fifty-three-year-old guitarist Michael is the figurative flag-bearer of learning anew in the digital age. Despite decades of experience making multitrack recordings at home and professionally, Michael found himself in unfamiliar territory when first encountering the DAW Ableton Live. Leaning on skeuomorphic design cues and refusing to be bound by the learning approaches that characterize “digital immigrants,” Michael clicked his way through frustration to discover the din of his dreams. Without the aid of a teacher in any sense of the word, Michael matter-of-factly summarized his learning approach: “I didn’t have anybody tutoring me and I didn’t have any help files, so I just had to figure it out for myself.” His music-making processes exemplify how the quest for a specific sound (timbre) is foundational in DIY home recording.

scholarly journals Elderly Parents, Adult Children and the Romanian Transnational Family: An Intergenerational Solidarity Approach

2016 ◽  
Vol 61 (1) ◽  
pp. 77-108 ◽  
Author(s):  
Ionuţ Földes
Keyword(s):  
Adult Children ◽  
Unmet Need ◽  
Nationwide Survey ◽  
Low Fertility ◽  
Spatial Proximity ◽  
Elderly Persons ◽  
Intergenerational Support ◽  
Intergenerational Solidarity ◽  
The Impact ◽  
At Home

Abstract Recent demographic changes such as ageing, low-fertility, and large out-migration from Eastern European countries, brought into discussion the vivid question of the future of intergenerational solidarity within families. In the context of increasing geographical mobility of young people in search for better paid jobs, the unmet need for personal assistance among the elderly, the underdeveloped system of care services, Romania knows new dynamics of intergenerational support. Contrary to perspectives that consider spatial proximity between adult children and their elder parents the indisputable enabling factor for intergenerational support transfers (Rossi and Rossi, 1990), emerging literature on transnational families highlights that such tight kinship relations continue to exist even across borders (Baldassar et al., 2007). Using recent data from the nationwide survey “The Impact of Migration on Older Parents Left Behind in Romania” (2011), this paper examines the complex dynamics of intergenerational solidarity involving adult children as transnational migrants and their elder parents who remain at home. The statistical models used indicate the migrants’ role as providers of remittances, but also the ways in which other forms of support are distributed among the dyads. Despite a possible presupposition that parents who were left at home might only be beneficiaries of support, the data show the opposite: elderly persons, depending on their age, were active providers of help as well.

scholarly journals COVID-19 Diagnostic Testing For All - Using Non-Dilutive Saliva Sample Collection, Stabilization and Ambient Transport Devices

2021 ◽  
Author(s):  
Yuan Carrington ◽  
Justin Orlino ◽  
Alejandro Romero ◽  
Jessica Gustin ◽  
Mahssa Rezaei ◽  
...  
Keyword(s):  
Ambient Temperature ◽  
Saliva Sample ◽  
Rna Stability ◽  
Test Site ◽  
Viral Rna ◽  
Sample Collection ◽  
Saliva Collection ◽  
Asymptomatic Individuals ◽  
Rna Stabilization ◽  
At Home

AbstractCOVID-19 testing is not accessible for millions during this pandemic despite our best efforts. Without greatly expanded testing of asymptomatic individuals, contact tracing and subsequent isolation of spreaders remains as a means for control. In an effort to increase RT-PCR assay testing for the presence of the novel beta-coronavirus SARS-CoV-2 as well as improve sample collection safety, GenTegra LLC has introduced two products for saliva collection and viral RNA stabilization: GTR-STM™ (GenTegra Saliva Transport Medium) and GTR-STMdk™ (GenTegra Saliva Transport Medium Direct to PCR). Both products contain a proprietary formulation based on GenTegra’s novel “Active Chemical Protection™” (ACP) technology that gives non-dilutive, error-free saliva sample collection using RNA stabilization chemicals already dried in the collection tube.GTR-STM can be used for safer saliva-based sample collection at home (or at a test site). Following saliva collection, the sample-containing GTR-STM can be kept at ambient temperature during shipment to an authorized CLIA lab for analysis. SARS-CoV-2 viral RNA in GTR-STM is stable for over a month at ambient temperature, easily surviving the longest transit times from home to lab. GTR-STM enhances patient comfort, convenience, compliance and reduces infectious virus exposure to essential medical and lab professionals.Alternatively, the GTR-STMdk direct-into-PCR product can be used to improve lab throughput and reduce reagent costs for saliva sample collection and testing at any lab site with access to refrigeration. GTR-STMdk reduces lab process time by 25% and reagent costs by 30% compared to other approaches. Since GTR-STMdk retains SARS-CoV-2 viral RNA stability for three days at ambient temperature, it is optimized for lab test site rather than at home saliva collection. SARS-COV-2 viral RNA levels as low as 0.4 genome equivalents/uL are detected in saliva samples using GTR-STMdk. The increased sensitivity of SARS-CoV-2 detection can expand COVID-19 testing to include asymptomatic individuals using pooled saliva.One Sentence SummaryGTR-STM and Direct-into-PCR GTR-STMdk offer substantive improvements in SARS-CoV-2 viral RNA stability, safety, and RT-PCR process efficiency for COVID-19 testing by using a non-dilutive saliva sample collection system for individuals at home or onsite respectively.

scholarly journals Capturing hand use of individuals with spinal cord injury at home using egocentric video: A feasibility study

2020 ◽  
Author(s):  
Jirapat Likitlersuang ◽  
Ryan J Visee ◽  
Sukhvinder Kalsi-Ryan ◽  
Jose Zariffa
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Feasibility Study ◽  
Hand Function ◽  
Unmet Need ◽  
Living Environment ◽  
Self Report ◽  
Interaction Detection ◽  
Cord Injury ◽  
At Home

Background: Measuring arm and hand function in the community is a critical unmet need of rehabilitation after cervical spinal cord injury (SCI). This information could provide clinicians and researchers with insight into an individual's independence and reliance on care. Current techniques for monitoring upper limb function at home, including self-report and accelerometry, lack the necessary resolution to capture the performance of the hand in activities of daily living (ADLs). On the other hand, a wearable (egocentric) camera provides detailed video information about the hand and its interactions with the environment. Egocentric recordings at home have the potential to provide unbiased information captured directly in the user's own living environment. Purpose: To explore the feasibility of capturing egocentric video recordings in the home of individuals with SCI for hand function evaluation. Study Design: Feasibility study Methods: Three participants with SCI recorded ADLs at home without the presence of a researcher. Information regarding recording characteristics and compliance was obtained as well as structured and semi-structured interviews involving privacy, usefulness and usability. A video processing algorithm capable of detecting interactions between the hand and objects was applied to the home recordings. Results: 98.58 ± 1.05 % of the obtained footage was usable and included 4 to 8 unique activities over a span of 3 to 7 days. The interaction detection algorithm yielded an F1-score of 0.75 ± 0.15. Conclusion: Capturing ADLs using an egocentric camera in the home environment after SCI is feasible. Considerations regarding privacy, ease of use of the devices and scheduling of recordings are provided.

scholarly journals SkinSpecs: A Mobile Solution that Addresses an Unmet Need for Tracking Chronic Skin Diseases in the Office and at Home

2019 ◽  
Vol 3 (5) ◽  
pp. 309-320
Author(s):  
Olga K Afanasiev ◽  
Mika Tabata ◽  
Akhila Narla ◽  
Gregory Scott ◽  
Justin M Ko
Keyword(s):  
3D Reconstruction ◽  
Skin Disease ◽  
Visual Information ◽  
Clinical Decision Making ◽  
Skin Diseases ◽  
Unmet Need ◽  
Chronic Skin ◽  
Skin Conditions ◽  
Chronic Skin Diseases ◽  
At Home

Introduction: Currently there are no portable solutions to robustly document and longitudinally monitor dynamically changing chronic skin conditions. This study set out to engineer and test a mobile-based 3D imaging solution for chronic skin diseases to enhance clinical workflow and patient care.Methods: SkinSpecs uses smartphone-captured videos of patients’ skin disease and renders 3D true-to-life models that were evaluated by Stanford Health Care dermatologists.Results: We utilized video input to accurately reconstruct interactive 3D models of 16 different skin conditions from 31 patients. Assessment of SkinSpecs 3D reconstruction is faster (p<0.05) compared to descriptive exam, standard photographs or original videos. Dermatologists maintained highest accuracy, confidence and satisfaction with 3D reconstruction.  Dermatologist preferred SkinSpecs for documentation over other capture modalities. SkinSpecs was favorably used by dermatologists, with high satisfaction with resolution, breadth of visual information, time and ability to pick up incidental findings.Conclusion: We identified a proof-of-concept solution to objectively and robustly capture skin disease, with an office and home workflow that is acceptable to providers and patients. This fast, scalable method is deployable on smartphones and could be utilized to augment clinical decision making in the clinic and to empower patients at home.

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