SmartPDT®: Smartphone enabled real-time dosimetry via satellite observation for daylight photodynamic therapy

Application of mobile health to support the elderly during the COVID-19 outbreak: A systematic review

Background

: The COVID-19 outbreak has affected the elderly's physical and mental health. The application of information and communication technology, such as mobile health (m-health), can help control this pandemic by changing the behavior and lifestyle of the elderly during this time of crisis.

Objective

: This review aimed to synthesize the capabilities of m-health in providing health services to the elderly during the COVID-19 pandemic, and to identify the factors contributing to the success of these tools.

Methods

: To find the relevant studies, a search was conducted in PubMed, Web of Science, Scopus, ProQuest, and Google Scholar. The inclusion criteria were: studies in English that used m-health intervention in all aspects of elderly healthcare during the COVID-19 outbreak, were published in peer-reviewed journals from 31 December 2019, and had any research design and methodology. Two authors independently took all the steps of this review, and finally performed narrative synthesis to report the findings.

Results

: Our initial search identified 421 studies, of which 10 met the inclusion criteria. The data analysis showed that all the m-health interventions had positive effects on the health of the elderly. The m-health services for the elderly during the current pandemic were used for therapy, information provision, self-help, monitoring, and mental health consultation purposes. The results also indicated that various factors affected the elderly's use of m-health tools.

Conclusion

: The application of m-health keeps the elderly and healthcare providers safe, accelerates health service provision, reduces the costs of service provision, and decreases the risk of morbidity and mortality during the COVID-19 outbreak. The successful use of m-health tools for the elderly in health programs during the current crisis greatly depends on supporting the elderly and overcoming the barriers.

Theoretical design of an absorption hologram-based sensor for dose quantification in daylight photodynamic therapy

Daylight photodynamic therapy (D-PDT) is an effective and almost painless treatment for many skin conditions, where successful treatment relies on daylight activation of a topical photosensitizer. Optimization of D-PDT requires accurate assessment of light dose received. There is a requirement for a small-area sensor that can be placed adjacent to the treatment site to facilitate accurate dose quantification. Here, a novel, to the best of our knowledge, configuration for a D-PDT dose sensor, consisting of a holographic absorption grating fabricated in a photosensitive film, is presented. Theoretical modeling of the sensor's response (i.e., change in grating diffraction efficiency due to change in grating absorption modulation, α₁, on exposure to daylight) was conducted using Kogelnik's coupled-wave theory. The influence of the different grating parameters (initial film absorption, thickness, spatial frequency, and reconstruction wavelength) on the sensor response was examined and revealed that the initial absorption and grating thickness values have a large impact on both the magnitude and rate of the D-PDT sensor response. The optimum design for an absorption grating-based D-PDT sensor is described.

Global verification of a model for determining daylight photodynamic therapy dose

Daylight photodynamic therapy is an effective treatment for actinic keratoses and relies on a minimum PpIX-effective light exposure dose being delivered during treatment. As such, daylight dosimetry is an important aspect of this treatment. Relatively simple measurements of illuminance may be converted to PpIX-effective irradiance, and subsequently exposure dose, via a conversion model (the O'Mahoney model). This model has been verified against spectral irradiance data from the UK, however the accuracy of the model has not been determined outside the UK. In this work, we test the O'Mahoney model against spectral irradiance measurements from several global locations to within bounds of a median deviation of ±10 %. The median percentage deviations are shown to be independent of location latitude and longitude. The model can be used confidently to determine PpIX-effective irradiance from illuminance measurements irrespective of location and can be widely implemented as an effective and low-cost means of accurately measuring effective light exposure for this important treatment.

Impact of High Solar UV Radiant Exposures in Spring 2020 on SARS-CoV-2 Viral Inactivation in the UK†

Potential for SARS-CoV-2 viral inactivation by solar UV radiation in outdoor spaces in the UK has been assessed. Average erythema effective and UV-A daily radiant exposures per month were higher (statistically significant, P < 0.05) in spring 2020 in comparison with spring 2015-2019 across most of the UK, while irradiance generally appeared to be in the normal expected range of 2015-2019. It was found that these higher radiant exposures may have increased the potential for SARS-CoV-2 viral inactivation outdoors in April and May 2020. Assessment of the 6-year period 2015-2020 in the UK found that for 50-60% of the year, that is most of October to March, solar UV is unlikely to have a significant (at least 90% inactivation) impact on viral inactivation outdoors. Minimum times to reach 90% and 99% inactivation in the UK are of the order of tens of minutes and of the order of hours, respectively. However, these times are best case scenarios and should be treated with caution.

Telehealth Use in Geriatrics Care during the COVID-19 Pandemic-A Scoping Review and Evidence Synthesis

Introduction: Globally, the COVID-19 pandemic has affected older people disproportionately. Prior to the pandemic, some studies reported that telehealth was an efficient and effective form of health care delivery, particularly for older people. There has been increased use of telehealth and publication of new literature on this topic during the pandemic, so we conducted a scoping review and evidence synthesis for telehealth use in geriatric care to summarize learning from these new data. Methods: We searched PubMed, Embase, and the World Health Organization's COVID-19 global research database for articles published between 1 January and 20 August 2020. We included 79 articles that met our inclusion criteria. The information collected has been synthesized and presented as descriptive statistics. Strengths, weaknesses, opportunities, and threats (SWOT) have also been discussed. Results: The articles included in our review provide some evidence of effective provision of preventive, curative, and rehabilitative telehealth services for older people, but they highlight a greater focus on curative services and are mostly concentrated in high-income countries. We identified convenience and affordability as the strengths of telehealth use in geriatric care. Weaknesses identified include the inability of telehealth to cater to the needs of older people with specific physical and cognitive limitations. While the threats of increasing inequity and the lack of standardization in the provision of age-friendly telehealth services remain, we identified opportunities for technologic advancements driven by simplicity and user-friendliness for older people. Conclusion: Telehealth offers futuristic promise for the provision of essential health care services for older people worldwide. However, the extent of these services via telehealth appears to be currently limited in low and low-middle income countries. Optimizing telehealth services that can be accessed by older people requires greater government investments and active engagement by broader participation of older people, their caregivers, physicians and other health care providers, technology experts, and health managers.