Smartphone-Based Screening for Cardiovascular Diseases: A Trend?

Abstract Cardiovascular diseases are the leading cause of death in the world. People living in vulnerable and poor places such as slums, rural areas and remote locations have difficulty in accessing medical care and diagnostic tests. In addition, given the COVID-19 pandemic, we are witnessing an increase in the use of telemedicine and non-invasive tools for monitoring vital signs. These questions motivate us to write this point of view and to describe some of the main innovations used for non-invasive screening of heart diseases. Smartphones are widely used by the population and are perfect tools for screening cardiovascular diseases. They are equipped with camera, flashlight, microphone, processor, and internet connection, which allow optical, electrical, and acoustic analysis of cardiovascular phenomena. Thus, when using signal processing and artificial intelligence approaches, smartphones may have predictive power for cardiovascular diseases. Here we present different smartphone approaches to analyze signals obtained from various methods including photoplethysmography, phonocardiograph, and electrocardiography to estimate heart rate, blood pressure, oxygen saturation (SpO2), heart murmurs and electrical conduction. Our objective is to present innovations in non-invasive diagnostics using the smartphone and to reflect on these trending approaches. These could help to improve health access and the screening of cardiovascular diseases for millions of people, particularly those living in needy areas.

O uso de smartphones como ferramenta de aprendizado por estudantes de Odontologia / The use of smartphones as a learning tool by dental students

As tecnologias podem ser potentes facilitadoras do processo de aprendizagem dos alunos, principalmente nas gerações atuais. Os smartphonessão ferramentas rotineiramente utilizadas a qualquer momento e em qualquer lugar na busca de variadas informações. Assim, a aquisição de conhecimento por meiodeste dispositivo móvel, alinhada com as perspectivas de ensino e resultados esperados para o aprendizado, parece fazer cada vez mais sentido. Neste contexto, este estudo foi proposto com o objetivo de conhecer o perfil do uso de smartphones como ferramenta de aprendizagem ativa e móvel por estudantes de Odontologia. Trata-se de um estudo transversal, realizado por meiode um questionário eletrônico, composto por perguntas objetivas e abertas, as quais avaliaram características sociodemográficas, tipo de aparelho e conexão, usogerale para aprendizado odontológico, bem como aatitude dos alunos em relação ao uso. Do total de estudantes elegíveis ao estudo, 169 alunos responderam ao questionário (taxa de resposta de 49,1%). A maioria dos participantes eram mulheres, com faixa etária de 19 a 21 anos. Todos os estudantes afirmaram ter smartphone, com conexão à internet. Os principais usos descritos foram relacionados à comunicação, gerenciamento de tempo e educação. As vantagens relatadas foram praticidade, flexibilidade de uso, acesso a diferentes conteúdos, capacidade de pesquisar informações e de se comunicar rapidamente. Os desafios identificados incluíram distração e excesso de uso. Os resultados permitiram concluir que os estudantes utilizam os smartphonescomo ferramenta de aprendizagem ativa, principalmente, para acessar e-books, artigos científicos, escutar podcasts,assistir livese visualizar publicações de conteúdos teóricos e práticos no Instagram (AU).

Technologies can be powerful and helpful tools for students' learning process, especially for the current generations. Smartphones are routinely used to search for a wide rangeof information, at anytime and anywhere. Thus, knowledge acquisition through this mobile device, for teaching and learning outcomes, seems to increasingly make more and more sense. Therefore, the aim of thisstudy was to understand the profile of the use of smartphones as an active learning tool by dental students. The data of this cross-sectional study was collected by an electronic questionnaire, with open and closed questions regarding the socio-demographic characteristics, type of device and connection, general use for dentallearning, as well as the students' attitudes towards the use of smartphone for learning. Out of the total number of students eligible for the study, 169 students responded to the questionnaire (response rate of 49.1%). Most participants were women, aged between 19 and 21 years. All students declaredtohave a smartphone, with internet connection. The main uses described were related to communication, time management,and education. The advantages pointed out by the participants were convenience, flexibility of use, access to different contents in different ways, ability to search for information,and rapid communication. The main challenges included distraction and overuse. The results of this study demonstrate that students use smartphones as an active learning tool, mainly to access e-books, scientific articles, to listen to podcasts, watch lives,and view publications of theoretical and practical content on Instagram (AU).

Efecto de una Intervención Educativa vía WhatsApp en la Higiene Oral de Pacientes con Ortodoncia / Effect of an Educational Intervention via WhatsApp on the Oral Hygiene of Orthodontic Patients

RESUMEN: La higiene oral en pacientes con ortodoncia fija se encuentra comprometida y las nuevas tecnologías de información podrían convertirse en una herramienta valiosa de educación en salud oral. El objetivo fue determinar el efecto de una intervención educativa vía whatsapp en la higiene oral de pacientes con aparatología de ortodoncia fija. La muestra del estudio estuvo conformada por 46 pacientes (18.65 ± 3.21 años de edad) que iniciaron tratamiento de ortodoncia fija. Se realizó el índice de placa de O´Leary y se aplicó un cuestionario para medir el nivel de conocimiento en higiene oral. Los participantes se dividieron en un grupo experimental y control, mediante asignación aleatoria. Al grupo experimental se le envió una intervención educativa elaborada mediante la herramienta Play Ground Versión 2.0, vía la aplicación para mensajería instantánea WhatsApp Messenger Versión 2.19.153 y al grupo control se brindó las instrucciones de rutina sobre higiene oral. Después de 6 semanas, se evaluó el índice y cuestionario. Para el análisis de datos se utilizó el Coeficiente de Correlación de Concordancia, la prueba de Shapiro Wilk y la prueba T de Student para muestras relacionadas e independientes. Los pacientes del grupo experimental tuvieron diferencias estadísticamente significativas en el control de placa (p = 0.001) y nivel de conocimiento después de la intervención educativa (p = 0.016), a comparación del grupo control. La intervención educativa vía WhatsApp tuvo un efecto positivo en la higiene oral, con respecto al control de placa y al nivel de conocimientos de pacientes con ortodoncia fija.

ABSTRACT: Oral hygiene in patients with fixed orthodontics is compromised and new information technologies could become a valuable tool for oral health education. The objective of the study was to determine the effect of an educational intervention via WhatsApp on the oral hygiene of patients with fixed orthodontic appliances. The study sample consisted of 46 patients (18.65 ± 3.21 years old) who started fixed orthodontic treatment. The O'Leary plaque index was performed and a questionnaire was applied to measure the level of knowledge in oral hygiene. Participants were divided into an experimental and control group, by randomization. The experimental group was sent an educational intervention prepared using the Play Ground Version 2.0 tool, via the WhatsApp Messenger versión 2.19.153 instant messaging application, and the control group was given routine instructions on oral hygiene. After 6 weeks, the index and questionnaire were evaluated. For data analysis, the concordance correlation coefficient, the Shapiro Wilk test and the Student's T test for related and independent samples were used. The patients in the experimental group had statistically significant differences in plaque control (p = 0.001) and level of knowledge after the educational intervention (p = 0.016), compared to the control group. The educational intervention via WhatsApp had a positive effect on oral hygiene, with respect to plaque control and the level of knowledge of patients with fixed orthodontics.

Prevalence and sociodemographic factors associated with sedentary behavior in adolescents from Rio Claro-SP, Brazil / Prevalência e fatores sociodemográficos associados ao comportamento sedentário em adolescentes de Rio Claro-SP - Brazil

ABSTRACT The objective of this study was to analyze the prevalence of and sociodemographic factors associated with sedentary behavior (SB) situations among adolescents from Rio Claro, São Paulo, Brazil, namely: (1) obligations; 2) computer/tablet and video game; 3) smartphone; 4) television; 5) total SB. It included 482 teenagers (14.4 ± 2.1 years old) from 3 public and 2 private schools. They were assessed through an identification, clinical history and socioeconomic level questionnaire; Sedentary Behavior Questionnaire, with additional questions related to SB and use of smartphones and video games; Habitual Physical Activity Questionnaire for Adolescents; and weight and height measurement for Body Mass Index (BMI) calculation (kg/m²). Descriptive analysis was performed, Student's t test was run to compare SB situations and level of physical activity between boys and girls, and logistic regression was carried out to verify the association of the situations with total SB (p <0.05). Results revealed that 47.5% of the adolescents spend more than 14 hours/day on SB (mean of 13.7 ± 3.4 hours/day). The situations associated with total SB were: smartphone (OR=6.23; p<0.001); computer/tablet and video game (OR=2.5; p=0.012); obligations (OR=2.43; p=0.009) and TV (OR=2.35; p=0.009). High SB prevalence was found, but there was no sociodemographic factor associated with this behavior. Additionally, smartphone use presented a greater association with high amount of time for total SB.

RESUMO O objetivo do estudo foi analisar a prevalência, os fatores sociodemográficos e o comportamento sedentário (CS) associados as situações do CS (1) obrigações; 2) computador/tablet e videogame; 3) smartphone; 4) televisão; 5) CS total) de adolescentes de Rio Claro-SP. Participaram do estudo 482 adolescentes (14,4±2,1 anos) de 3 escolas públicas e 2 particulares, avaliados por um questionário de identificação, anamnese clínica e nível socioeconômico; Questionário de Comportamento Sedentário, com questões adicionais relacionadas ao CS e o uso de smartphones e videogames; Questionário de Atividade Física Habitual para Adolescentes; e mensuração do peso e estatura para o cálculo de Índice de Massa Corporal (IMC) (kg/m²). Realizou-se análise descritiva, teste t de Student para comparar as situações de CS e nível de atividade física entre meninos e meninas e regressão logística para verificar a associação das situações com o CS total (p<0,05). Identificou-se que 47,5% dos adolescentes permanecem mais de 14 horas/dia em CS (média de 13,7±3,4 horas/dia). As situações associados ao CS total foram: smartphone (RO=6,23; p<0,001); computador/tablet e videogame (RO=2,5; p=0,012); obrigações (RO=2,43; p=0,009) e televisão (RO=2,35; p=0,009). Relatou-se alta prevalência de CS, porém não houve nenhum fator sociodemográfico associado com esse comportamento. Adicionalmente, o uso do smartphone apresentou maior associação com o alto tempo de CS total.

Development of an App to look up the anesthetic implications of genetic syndromes and rare diseases in patients / Creación de una aplicación electrónica para consultar las implicaciones anestésicas de los síndromes genéticos y enfermedades raras en los pacientes

Abstract Introduction: Orphan diseases are a heterogeneous group of conditions involving the structure and functioning of several organs and systems; this represents a significant challenge for the anesthesiologist and the surgical team. Specific knowledge of each disease reduces the risk of any adverse events secondary to perioperative management errors in these patients. Objective: Developing a strategy to quickly and effectively look up for the perioperative risks of patients with rare diseases. Methods: An academic literature review was conducted and the information available in databases was selected. A group of engineers and designers summarized the information and developed a software application for mobile devices, to look up at a list of rare diseases, their description, any surgical implications, and the most relevant anesthetic considerations. Results: The CARAN App (CARAN is the Spanish acronym for Rare Cases in Anesthesia) was developed, which may be downloaded into any iOS (Apple) and Android mobile device at no cost. The App makes available information on the major anesthetic implications, with a view to improving patient care safety. This article discusses the first part of the project which comprises the development and design of the App and the review of 60 diseases. Additional diseases are expected to be included in the second phase of the project. Conclusion: We are introducing the first App available in Spanish to quickly and effectively look up for the most relevant anesthetic implications in 60 rare diseases.

Resumen Introducción: Las enfermedades huérfanas son un grupo heterogéneo de patologías que comprometen la estructura y el funcionamiento de varios órganos y sistemas, lo que representa un enorme reto para el anestesiólogo y el equipo quirúrgico. El conocimiento específico de cada enfermedad disminuye el riesgo de eventos adversos secundario a errores en el manejo perioperatorio de estos pacientes. Objetivo: Desarrollar una estrategia que permita consultar de manera rápida y efectiva los riesgos perioperatorios de pacientes con enfermedades raras. Métodos: Se hizo una revisión académica de la literatura y se seleccionó la información disponible en las bases de datos. Un grupo de ingenieros y diseñadores sintetizaron la información y desarrollaron la aplicación para dispositivos móviles, donde se puede consultar una lista de enfermedades raras, su descripción, las implicaciones quirúrgicas y las consideraciones anestésicas más relevantes. Resultados: Se creó la aplicación CARAN = Casos raros en anestesia, la cual se puede descargar gratis en dispositivos móviles con sistemas operativos iOS (Apple) y Android; esta aplicación nos brinda información sobre las principales implicaciones anestésicas, con el propósito de mejorar la seguridad en la atención del paciente. Se presenta aquí la primera parte del proyecto, que consiste en la creación y el diseño de la aplicación, y la revisión de 60 enfermedades. Se espera que en una segunda fase se incluyan más enfermedades. Conclusión: Presentamos la primera aplicación disponible en español para consultar de forma rápida y efectiva las principales implicaciones anestésicas de 60 enfermedades raras.