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BackgroundPeer support is an emerging form of person-driven active health care. Chronic conditions such as Ménière’s disease (a disorder of the inner ear) need continuing rehabilitation and support that is beyond the scope of routine clinical medical practice. Hence, peer-support programs can be helpful in supplementing some of the rehabilitation aspects. ObjectiveThe aim of this study was to design a computerized data collection system for the peer support of Menière’s disease that is capable in profiling the subject for diagnosis and in assisting with problem solving. MethodsThe expert program comprises several data entries focusing on symptoms, activity limitations, participation restrictions, quality of life, attitude and personality trait, and an evaluation of disease-specific impact. Data was collected from 740 members of the Finnish Ménière’s Federation and utilized in the construction and evaluation of the program. ResultsThe program verifies the diagnosis of a person by using an expert system, and the inference engine selects 50 cases with matched symptom severity by using a nearest neighbor algorithm. These cases are then used as a reference group to compare with the person’s attitude, sense of coherence, and anxiety. The program provides feedback for the person and uses this information to guide the person through the problem-solving process. ConclusionsThis computer-based peer-support program is the first example of an advanced computer-oriented approach using artificial intelligence, both in the profiling of the disease and in profiling the person’s complaints for hearing loss, tinnitus, and vertigo.

The purpose of this study was to determine the factors explaining changes in the generic quality of life among patients with Meniere's disorder (MD) and to evaluate the EuroQol 5D (EQ-5D) quality-of-life measures. A questionnaire focusing on symptoms and disabilities caused by MD was collected from 726 individuals. General health-related quality of life (EQ-5D) was evaluated using the time trade-off (TTO) and visual-analogue scale (VAS). Personal traits were measured with the sense of coherence. The TTO-VAS score difference was modeled with activity limitations, participation restrictions, attitudes, and symptoms. For TTO as the outcome measure, one symptom-based, three attitude-based, one activity limitation, and one participation restriction item explained 43% of the variability. For VAS, six attitude-based, one symptom-based, three activity limitations, and one participation restriction item explained 43% of the variability of the data. The correlation between TTO and VAS (r=0.515, P less than 0.001) explained only 27% of the variance. The difference between TTO and VAS was reflected in attitudes towards the illness. The model explained 10% of the variability in the VAS and TTO difference. There was a disease duration effect in the TTO-VAS difference. In conclusion, a symptom-based model combined with disabilities provided a good description of general quality of life in MD. The TTO-based and VAS-based evaluation explained somewhat different aspects of MD. The difference between TTO and VAS could be described as an attitude toward the ailment. Evaluation of disabilities and the difference in TTO and VAS can be used to guide the rehabilitation to promote attitude change. (Contains 2 figures and 2 tables.)

Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disease, which affects the structure of heart muscle tissue. The clinical symptoms include arrhythmias, progressive heart failure, and even sudden cardiac death but the mutation carrier can also be totally asymptomatic. To date, over 1400 mutations have been linked to HCM, mostly in genes encoding for sarcomeric proteins. However, the pathophysiological mechanisms of the disease are still largely unknown. Two founder mutations for HCM in Finland are located in myosin-binding protein C (MYBPC3-Gln1061X) and α-tropomyosin (TPM1-Asp175Asn) genes. We studied the properties of HCM cardiomyocytes (CMs) derived from patient-specific human induced pluripotent stem cells (hiPSCs) carrying either MYBPC3-Gln1061X or TPM1-Asp175Asn mutation. Both types of HCM-CMs displayed pathological phenotype of HCM but, more importantly, we found differences between CMs carrying either MYBPC3-Gln1061X or TPM1-Asp175Asn gene mutation in their cellular size, Ca2+ handling, and electrophysiological properties, as well as their gene expression profiles. These findings suggest that even though the clinical phenotypes of the patients carrying either MYBPC3-Gln1061X or TPM1-Asp175Asn gene mutation are similar, the genetic background as well as the functional properties on the cellular level might be different, indicating that the pathophysiological mechanisms behind the two mutations would be divergent as well. [ABSTRACT FROM AUTHOR]

Objective: To explore the impact, reactions and coping methods of the significant others (SOs) of people with Ménière's disease (MD). Design: SOs of people with MD were asked to answer open-ended questions reporting the ' life effects' and ' positive experiences' they have had as a result of the partner's condition. The replies to the ' life effects' question was categorized using the WHO-ICF framework. The responses of ' life effects' from this study and the ' positive experiences' reported in a recent study (Manchaiah et al, 2013) were evaluated with K-means clustering analysis. Study sample: Eighty-eight SOs (42 male, 42 female, and four did not state gender). Results: While the SOs mainly listed their own problems, a significant number of responses related to the problems of their partner. Personal perspectives tended to focus on the consequences of their partner's condition, whereas in perspectives of their partner they focussed on his/her symptoms. Further, replies from 81 SOs were used in evaluation of responses and were classified into four categories: constrained life attitude; disease burden attitude; care and support attitude; and social isolation attitude. Conclusions: The results of this study support the importance of including the SO of people with MD in the rehabilitation process. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate whether rehabilitation of muscle force or balance improves postural stability and quality of life (QoL), and whether self-administered training is comparable with guided training among older adults residing in an institutional setting. Patients and methods: A randomized, prospective intervention study was undertaken among 55 elderly patients. Three intervention groups were evaluated: a muscle force training group; a balance and muscle force training group; and a self-administered training group. Each group underwent 1-hour-long training sessions, twice a week, for 3 months. Postural stability was measured at onset, after 3 months, and after 6 months. Time-domain-dependent body sway variables were calculated. The fall rate was evaluated for 3 years. General health related quality of life (HRQoL) was measured with a 15D instrument. Postural stability was used as a primary outcome, with QoL and falls used as secondary outcomes. Results: Muscle force trainees were able to undertake training, progressing towards more strenuous exercises. In posturography, the number of spiky oscillations was reduced after training, and stationary fields of torque moments of the ankle increased, providing better postural stability in all groups; in particular, the zero crossing rate of weight signal and the number of low variability episodes in the stabilogram were improved after training. While no difference was found between different training groups in posturography outcomes, a reduction of fall rate was significant in only the guided training groups. A significant part of the variability of the QoL could be explained by the posturography outcome (46%). However, the outcome of training was associated with a reduced QoL. Conclusion: Even moderate or severely demented residents could do exercises in five-person groups under the supervision of a physiotherapist. An improvement in postural stability was observed in all training groups, indicating that even self-administered training could be beneficial. Posturography outcome indicated that training alters the postural strategy by reducing the oscillatory fluctuations of body sway signal. However, only guided training tended to reduce falls. Short training intervention programs may decrease QoL by changing the elderly's daily routine and making it more active and exhausting. [ABSTRACT FROM AUTHOR]

The human postural control system is complex and it combines information from different sources. The most important information comes from vestibular, visual and proprioceptive senses. We studied the effects of removing the visual and proprioceptive information simultaneously. The force feedback from the ground was removed with vibrators attached on the musculus soleus of both calves. By using features of force platform signals, when the vibrators were on, the lengths of the swaying paths were four times the lengths when the vibrators were off. Our results show that it is possible to separate the effects of the visual and proprioceptive senses from that of vestibular sense, which is very useful for investigations of balance problems in otoneurology. This supports our future aim to classify between healthy subjects and different otoneurological patients with signal analysis and pattern recognition methods to be used for force platform signals. [ABSTRACT FROM AUTHOR]

Induced pluripotent stem cells (iPSC) can be derived from fully differentiated cells of adult individuals and used to obtain any other cell type of the human body. This implies numerous prospective applications of iPSCs in regenerative medicine and drug development. In order to obtain valid cell culture, a quality control process must be applied to identify and discard abnormal iPSC colonies. Computer vision systems that analyze visual characteristics of iPSC colony health can be especially useful in automating and improving the quality control process. In this paper, we present an ongoing research that aims at the development of local spatially-enhanced descriptors for classification of iPSC colony images. For this, local oriented edges and local binary patterns are extracted from the detected colony regions and used to represent structural and textural properties of the colonies, respectively. We preliminary tested the proposed descriptors in classifying iPSCs colonies according to the degree of colony abnormality. The tests showed promising results for both, detection of iPSC colony borders and colony classification.

Induced pluripotent stem cell (iPSC) lines derived from skin fibroblasts of patients suffering from cardiac disorders were differentiated to cardiomyocytes and used to generate a data set of Ca(2+) transients of 136 recordings. The objective was to separate normal signals for later medical research from abnormal signals. We constructed a signal analysis procedure to detect peaks representing calcium cycling in signals and another procedure to classify them into either normal or abnormal peaks. Using machine learning methods we classified signals into normal or abnormal signals on the basis of peak findings in them. We compared classification results obtained to those made visually by an expert biotechnologist who assessed the signals independent of the computer method. Classification accuracies of around 85% indicated high congruence between two modes denoting the high capability and usefulness of computer based processing for the present data.

The human postural control system is complex and it combines information from different sources. The most important information comes from vestibular, visual and proprioceptive senses. We studied the effects of removing the visual and proprioceptive information simultaneously. The force feedback from the ground was removed with vibrators attached on the musculus soleus of both calves. By using features of force platform signals, when the vibrators were on, the lengths of the swaying paths were four times the lengths when the vibrators were off. Our results show that it is possible to separate the effects of the visual and proprioceptive senses from that of vestibular sense, which is very useful for investigations of balance problems in otoneurology. This supports our future aim to classify between healthy subjects and different otoneurological patients with signal analysis and pattern recognition methods to be used for force platform signals.