Notes

Outcomes of screening process regarding geriatric problems along with move forward attention preparing in the Medicare Once-a-year Wellbeing Go to.
© The Author(s) 2020.In April 2019, a select group of medical, academic, and private-sector leaders in bioelectronic medicine convened in Geneva to discuss the potential for building a cross-disciplinary movement that would advance the field with key stakeholders - both those who are already active in research and commercialization as well as those who will influence the pace of development and uptake of innovative technologies and treatments. Hosted by BioSig Technologies and physicians from the Mayo Clinic, the roundtable was unique in its focus on what it will take to advance awareness of bioelectronic medicine, including a shared definition, unified narrative, and set of tailored messages to win over key audiences. The attendees developed a consensus on these issues and agreed to form a working group beyond the roundtable, which has since evolved into the Alliance for Advancing Bioelectronic Medicine. This meeting report summarizes the key insights from the roundtable, including a call to action aimed at accelerating growth and collaboration across the field. © The Author(s) 2020.Pulmonary arterial hypertension (PAH) is a rare disease of unknown etiology that progresses to right ventricular failure. It has a complex pathophysiology, which involves an imbalance between vasoconstrictive and vasodilative processes in the pulmonary circulation, pulmonary vasoconstriction, vascular and right ventricular remodeling, systemic inflammation, and autonomic imbalance, with a reduced parasympathetic and increased sympathetic tone. Current pharmacological treatments for PAH include several classes of drugs that target signaling pathways in vascular biology and cardiovascular physiology, but they can have severe unwanted effects and they do not typically stop the progression of the disease. Pulmonary artery denervation has been tested clinically as a method to suppress sympathetic overactivation, however it is a nonspecific and irreversible intervention. Bioelectronic medicine, in particular vagus nerve stimulation (VNS), has been used in cardiovascular disorders like arrhythmias, heart failure and arterial hypertension and could, in principle, be tested as a treatment in PAH. VNS can produce pulmonary vasodilation and renormalize right ventricular function, via activation of pulmonary and cardiac vagal fibers. It can suppress systemic inflammation, via activation of fibers that innervate the spleen. Finally, VNS can gradually restore the balance between parasympathetic and sympathetic tone by regulating autonomic reflexes. Preclinical studies support the feasibility of using VNS in PAH. However, there are challenges with such an approach, arising from the need to affect a relatively small number of relevant vagal fibers, and the potential for unwanted cardiac and noncardiac effects of VNS in this sensitive patient population. © The Author(s) 2019.Background Transcutaneous neuromuscular electrical stimulation is routinely used in physical rehabilitation and more recently in brain-computer interface applications for restoring movement in paralyzed limbs. Due to variable muscle responses to repeated or sustained stimulation, grasp force levels can change significantly over time. Here we develop and assess closed-loop methods to regulate individual finger forces to facilitate functional movement. We combined this approach with custom textile-based electrodes to form a light-weight, wearable device and evaluated in paralyzed study participants. Methods A textile-based electrode sleeve was developed by the study team and Myant, Corp. (Toronto, ON, Canada) and evaluated in a study involving three able-body participants and two participants with quadriplegia. A feedforward-feedback control structure was designed and implemented to accurately maintain finger force levels in a quadriplegic study participant. Results Individual finger flexion and extension movements, along with functional grasping, were evoked during neuromuscular electrical stimulation. Closed-loop control methods allowed accurate steady state performance ( less then  15% error) with a settling time of 0.67 s (SD = 0.42 s) for individual finger contact force in a participant with quadriplegia. Conclusions Textile-based electrodes were identified to be a feasible alternative to conventional electrodes and facilitated individual finger movement and functional grasping. Furthermore, closed-loop methods demonstrated accurate control of individual finger flexion force. This approach may be a viable solution for enabling grasp force regulation in quadriplegia. Trial registration NCT, NCT03385005. Registered Dec. 28, 2017. © The Author(s) 2019.Background Inflammation and swelling of the sinus and nasal mucosa are commonly caused by viral infection, bacterial infection, or exposure to allergens and irritants. Sinonasal inflammation can cause symptoms of nasal congestion, facial pressure, and rhinogenic facial pain or "sinus pain". A previous randomized controlled study demonstrated that acute treatment with non-invasive periorbital microcurrent stimulation resulted in a rapid and clinically meaningful reduction in self-report of sinus pain that significantly outperformed sham control treatment. Here, we assessed the acute durability of microcurrent pain relief and longitudinal effects of 4 weeks of daily microcurrent treatment in patients presenting with sinus pain. Galunisertib cell line Methods Thirty subjects with moderate facial pain (numeric rating scale ≥5) attributed to self-reported sinonasal disease were enrolled in a single-arm, prospective interventional study. At enrollment, subjects were given a microcurrent treatment device and written instructions and self- weeks (p  less then  0.0001). For subjects who enrolled with moderate or worse congestion, mean congestion scores (CQ7) were reduced by - 4.2 (- 22.0%) after 1 week (p  less then  0.0001), - 5.8 (- 33.0%) after 2 weeks (p  less then  0.0001), - 7.2 (- 37.4%) after 3 weeks (p  less then  0.0001) and - 8.6 (- 44.3%) after 4 weeks (p  less then  0.0001) of microcurrent treatment. Conclusion Self-administered periorbital microcurrent treatment given at home was efficacious in significantly reducing moderate sinus pain for up to 6 hrs and significantly reducing moderate pain and congestion over 4 weeks of daily use. Microcurrent therapy was found to be safe with only minor side effects that resolved without intervention. Trial registration ClinicalTrials.gov, NCT03888274. Registered 25 March 2019. Retroactively registered, https//clinicaltrials.gov/ct2/show/NCT03888274. © The Author(s) 2019.
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