Urine multi-index intelligent detection based on polymer/paper hybrid microfluidic biochip for hyperuricemia monitoring.

Hyperuricemia (HUA) has gradually become a public health burden as an independent risk factor for a variety of chronic diseases. Herein, a user-friendly point-of-care (POC) detection system (namely "Smart-HUA-Monitor") based on smartphone-assisted paper-based microfluidic is proposed for colorimetric quantification of HUA urinary markers, including uric acid (UA), creatinine (CR) and pH. The detection limits of UA and CR were 0.0178 and 0.5983 mM, respectively, and the sensitivity of pH were 0.1. The method was successfully validated in artificial urine samples and 100 clinical samples. Bland-Altman plots showed a high consistency between µPAD and the testing instruments (HITACHI 7600 Automatic Analyzer, URIT-500B Urine Analyzer and AU5800B automatic biochemical analyzer) in hospital. Smart-HUA-Monitor provides an accurate quantitative, rapid, low-cost and reliable tool for the monitoring and early diagnosis of HUA urine indicators.

Smartphone based wearable sweat glucose sensing device correlated with machine learning for real-time diabetes screening.

BACKGROUND: Diabetes is a significant health threat, with its prevalence and burden increasing worldwide indicating its challenge for global healthcare management. To decrease the disease severity, the diabetic patients are recommended to regularly check their blood glucose levels. The conventional finger-pricking test possesses some drawbacks, including painfulness and infection risk. Nowadays, smartphone has become a part of our lives offering an important benefit in self-health monitoring. Thus, non-invasive wearable sweat glucose sensor connected with a smartphone readout is of interest for real-time glucose detection. RESULTS: Wearable sweat glucose sensing device is fabricated for self-monitoring of diabetes. This device is designed as a body strap consisting of a sensing strip and a portable potentiostat connected with a smartphone readout via Bluetooth. The sensing strip is modified by carbon nanotubes (CNTs)-cellulose nanofibers (CNFs), followed by electrodeposition of Prussian blue. To preserve the activity of glucose oxidase (GOx) immobilized on the modified sensing strip, chitosan is coated on the top layer of the electrode strip. Herein, machine learning is implemented to correlate between the electrochemical results and the nanomaterial content along with deposition cycle of prussian blue, which provide the highest current response signal. The optimized regression models provide an insight, establishing a robust framework for design of high-performance glucose sensor. SIGNIFICANCE: This wearable glucose sensing device connected with a smartphone readout offers a user-friendly platform for real-time sweat glucose monitoring. This device provides a linear range of 0.1-1.5 mM with a detection limit of 0.1 mM that is sufficient enough for distinguishing between normal and diabetes patient with a cut-off level of 0.3 mM. This platform might be an alternative tool for improving health management for diabetes patients.

Concurrent Validity and Reliability of a New Smartphone Application for Measuring Cervical Range of Motion in Healthy Individuals.

BACKGROUND: Range of motion (ROM) measurement is an important part of physical therapy assessment and patient progress. Smartphones are user-friendly instruments and if proven to be reliable and valid, clinicians can use them for a variety of tasks including ROM measurement. OBJECTIVES: To determine concurrent validity and intra- and inter-rater reliability of the PhysioMaster application in measuring cervical ROM in both Android and iOS operating systems. METHODS: Forty-five healthy individuals (age 31.75 ± 11.94 yrs; 18 men, 27 women) completed this study. Two raters measured cervical ROM, three times each, using an Android phone for intra-rater and inter-rater reliability. With an interval time of 1-7 days after the first session, measurements were repeated by one of the raters once to measure intersession reliability. Validity was estimated by one of the raters using iPhone and Android phones one at a time while 3D motion analysis (3DMA) recorded cervical movements simultaneously. For reliability, intraclass correlation coefficient (ICC), and for validity, Pearson correlation coefficient and Bland-Altman plots were used. RESULTS: ICC values of ≥0.76 and ≥0.84 demonstrated excellent intra-rater and inter-rater reliability, respectively. For concurrent validity, correlation between each phone and 3DMA was nearly perfect for all movements (0.93 ≤ r ≤ 0.97). CONCLUSION: PhysioMaster appears to be a valid and reliable application for measuring cervical ROM in healthy individuals.

Comparing Human-Smartphone Interactions and Actigraphy Measurements for Circadian Rhythm Stability and Adiposity: Algorithm Development and Validation Study.

BACKGROUND: This study aimed to investigate the relationships between adiposity and circadian rhythm and compare the measurement of circadian rhythm using both actigraphy and a smartphone app that tracks human-smartphone interactions. OBJECTIVE: We hypothesized that the app-based measurement may provide more comprehensive information, including light-sensitive melatonin secretion and social rhythm, and have stronger correlations with adiposity indicators. METHODS: We enrolled a total of 78 participants (mean age 41.5, SD 9.9 years; 46/78, 59% women) from both an obesity outpatient clinic and a workplace health promotion program. All participants (n=29 with obesity, n=16 overweight, and n=33 controls) were required to wear a wrist actigraphy device and install the Rhythm app for a minimum of 4 weeks, contributing to a total of 2182 person-days of data collection. The Rhythm app estimates sleep and circadian rhythm indicators by tracking human-smartphone interactions, which correspond to actigraphy. We examined the correlations between adiposity indices and sleep and circadian rhythm indicators, including sleep time, chronotype, and regularity of circadian rhythm, while controlling for physical activity level, age, and gender. RESULTS: Sleep onset and wake time measurements did not differ significantly between the app and actigraphy; however, wake after sleep onset was longer (13.5, SD 19.5 minutes) with the app, resulting in a longer actigraphy-measured total sleep time (TST) of 20.2 (SD 66.7) minutes. The obesity group had a significantly longer TST with both methods. App-measured circadian rhythm indicators were significantly lower than their actigraphy-measured counterparts. The obesity group had significantly lower interdaily stability (IS) than the control group with both methods. The multivariable-adjusted model revealed a negative correlation between BMI and app-measured IS (P=.007). Body fat percentage (BF%) and visceral adipose tissue area (VAT) showed significant correlations with both app-measured IS and actigraphy-measured IS. The app-measured midpoint of sleep showed a positive correlation with both BF% and VAT. Actigraphy-measured TST exhibited a positive correlation with BMI, VAT, and BF%, while no significant correlation was found between app-measured TST and either BMI, VAT, or BF%. CONCLUSIONS: Our findings suggest that IS is strongly correlated with various adiposity indicators. Further exploration of the role of circadian rhythm, particularly measured through human-smartphone interactions, in obesity prevention could be warranted.

Factors Affecting Usage of a Digital Asthma Monitoring Application by Old-Age Asthmatics Living in Inner Central Portugal.

Purpose: To analyse factors affecting the ability to use the digital asthma monitoring application Mask-Air® in old-age individuals living in inland Portugal. Patients and Methods: In this observational study, patients with medically confirmed asthma who agreed to participate were interviewed and subdivided into Non-users Group: those who could not use the application and Users Group: those who could. Sociodemographic and psychological data, comorbidities, and asthma status were compared between groups. Assessment of reasons for refusal was based on a 6-item questionnaire. Results: Among the 72 sequentially recruited patients (mean age±SD 73.26±5.43 yrs; 61 women; 11 men), 44 (61.1%; mean age±SD 74.64±5.68 yrs; 38 women; 6 men)) were included in Non-users Group and 28 (38.9%; mean age±SD 71.11±4.26 yrs; 23 women; 5 men) in Users Group. Non-users Group patients were significantly older, had lower socioeconomic level, and more frequently had severe asthma (25% vs 3.6%; Odds ratio=0.08 (95% CI=0.01-0.81; p=0.033)) and diabetes (32.6% vs 7.4%; Odds ratio=0.17 (95% CI=0.03-0.80; p=0.025)) than Users Group. The main reasons for not using the App were "Lack of required hardware" (n=35) and "Digital illiteracy" (n=26), but lack of interest to use the App among those who had conditions to use it was uncommon. Conclusion: Most old-age asthmatics living in Beira Interior either lack a smartphone or digital skills, which are significant obstacles to implementing app-based monitoring studies.

This study was done to see whether it was possible to use a mobile phone application (App) to help old-age asthmatics living in inner Central Portugal better monitor and self-manage their disease. The researchers interviewed a group of 72 patients with proven asthma who agreed to participate in the study. This group was subdivided into two subgroups: Non-users Group (44 patients) included those who could not use the App because they did not have a smartphone; Users Group (28 patients) included those who had all the conditions to use the App. Patients were helped to download the App (called MASK-Air), were given a thorough explanation about it, and about how it should be used on a daily basis to monitor their asthma symptoms. The researchers found that patients in Non-users Group were significantly older, had worse socioeconomic conditions, and more often had severe asthma and diabetes. They also discovered that the main reasons for not using the App were lack of a smartphone and not knowing how to use a smartphone. These results show that lacking a smartphone and not knowing how to use digital tools are frequent situations in old-age asthmatics living in inner Central Portugal, and these may be obstacles for patients in monitoring their own asthma symptoms.

Effects of frequent assessments on the severity of suicidal thoughts: an ecological momentary assessment study.

Objective: In recent years, there has been a significant increase in research using ecological momentary assessment (EMA) to explore suicidal thoughts and behaviors (STBs). Meanwhile, concerns have been raised regarding the potential impacts of frequent and intense STBs assessments on the study participants. Methods: From November 2021 to June 2023, a total of 83 adolescent and young adult outpatients (Mage = 21.0, SDage = 6.3, 71.1% female), who were diagnosed with mood disorders, were recruited from three psychiatric clinics in China. Smartphone-based EMA was used to measure suicidal thoughts three times per day at randomly selected times. We examined the change of suicidal thoughts in each measurement and within 1 day to evaluate potential adverse effects using Bayesian multilevel models. Results: The 3,105 effective surveys were nested in 83 participants (median follow-up days: 14 days). The results of two-level models indicated that suicidal thoughts decreased during the monitoring period. However, this effect varied among different individuals in the two-level model. Conclusion: Our findings did not support the notion that repeated assessment of suicidal thoughts is iatrogenic, but future research should continue to investigate the impact of frequent assessment on suicidal thoughts, taking into account individual differences and utilizing larger sample sizes.

Do digital technologies reduce racially biased reporting? Evidence from NYPD administrative data.

Recent work has emphasized the disproportionate bias faced by minorities when interacting with law enforcement. However, research on the topic has been hampered by biased sampling in administrative data, namely that records of police interactions with citizens only reflect information on the civilians that police elect to investigate, and not civilians that police observe but do not investigate. In this work, we address a related bias in administrative police data which has received less empirical attention, namely reporting biases around investigations that have taken place. Further, we investigate whether digital monitoring tools help mitigate this reporting bias. To do so, we examine changes in reports of interactions between law enforcement and citizens in the wake of the New York City Police Department's replacement of analog memo books with mobile smartphones. Results from a staggered difference in differences estimation indicate a significant increase in reports of citizen stops once the new smartphones are deployed. Importantly, we observe that the rise is driven by increased reports of "unproductive" stops, stops involving non-White citizens, and stops occurring in areas characterized by a greater concentration of crime and non-White residents. These results reinforce the recent observation that prior work has likely underestimated the extent of racial bias in policing. Further, they highlight that the implementation of digital monitoring tools can mitigate the issue to some extent.

Tuberculosis Treatment Compliance Under Smartphone-Based Video-Observed Therapy Versus Community-Based Directly Observed Therapy: Cluster Randomized Controlled Trial.

BACKGROUND: There are no recent studies comparing the compliance rates of both patients and observers in tuberculosis treatment between the video-observed therapy (VOT) and directly observed therapy (DOT) programs. OBJECTIVE: This study aims to compare the average number of days that patients with pulmonary tuberculosis and their observers were compliant under VOT and DOT. In addition, this study aims to compare the sputum conversion rate of patients under VOT with that of patients under DOT. METHODS: Patient and observer compliance with tuberculosis treatment between the VOT and DOT programs were compared based on the average number of VOT and DOT compliance days and sputum conversion rates in a 60-day cluster randomized controlled trial with patients with pulmonary tuberculosis (VOT: n=63 and DOT: n=65) with positive sputum acid-fast bacilli smears and 38 observers equally randomized into the VOT and DOT groups (19 observers per group and n=1-5 patients per observer). The VOT group submitted videos to observers via smartphones; the DOT group followed standard procedures. An intention-to-treat analysis assessed the compliance of both the patients and the observers. RESULTS: The VOT group had higher average compliance than the DOT group (patients: mean difference 15.2 days, 95% CI 4.8-25.6; P=.005 and observers: mean difference 21.2 days, 95% CI 13.5-28.9; P<.001). The sputum conversion rates in the VOT and DOT groups were 73% and 61.5%, respectively (P=.17). CONCLUSIONS: Smartphone-based VOT significantly outperformed community-based DOT in ensuring compliance with tuberculosis treatment among observers. However, the study was underpowered to confirm improved compliance among patients with pulmonary tuberculosis and to detect differences in sputum conversion rates. TRIAL REGISTRATION: Thai Clinical Trials Registry (TCTR) TCTR20210624002; https://tinyurl.com/3bc2ycrh. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/38796.

Designing a Smartphone-Based Pulse Oximeter for Children in South Africa (Phefumla Project): Qualitative Analysis of Human-Centered Design Workshops With Health Care Workers.

Background: Pulse oximeters noninvasively measure blood oxygen levels, but these devices have rarely been designed for low-resource settings and are inconsistently available at outpatient clinics. Objective: The Phefumla project aims to develop and validate a pediatric smartphone-based pulse oximeter designed specifically for this context. We present the process of human-centered oximeter design with health care workers in South Africa. Methods: We purposively sampled 19 health care workers from 5 clinics in Khayelitsha, Cape Town. Using a human-centered design approach, we conducted participatory workshops with four activities with health care workers: (1) they received 3D-printed prototypes of potential oximeter designs to provide feedback; (2) we demonstrated on dolls how they would use the novel oximeter; (3) they used pile sorting to rank design features and suggest additional features they desired; and (4) they designed their preferred user interface using a whiteboard, marker, and magnetized features that could be repositioned. We audio recorded the workshops, photographed outputs, and took detailed field notes. Analysis involved iterative review of these data to describe preferences, identify key design updates, and provide modifications. Results: Participants expressed a positive sentiment toward the idea of a smartphone pulse oximeter and suggested that a pediatric device would address an important gap in outpatient care. Specifically, participants expressed a preference for the prototype that they felt enabled more diversity in the way it could be used. There was a strong tendency to prioritize pragmatic design features, such as robustness, which was largely dictated by health care worker context. They also added features that would allow the oximeter device to serve other clinical functions in addition to oxygen saturation measurement, such as temperature and respiratory rate measurements. Conclusions: Our end user-centered rapid participatory approach led to tangible design changes and prompted design discussions that the team had not previously considered. Overall, health care workers prioritized pragmatism for pediatric pulse oximeter device design.

Superior oxidase-mimetic activity of FeCo-NC dual-atom nanozyme for smartphone-based visually colorimetric assay of organophosphorus pesticides.

A colorimetric analysis platform has been successfully developed based on FeCo-NC dual-atom nanozyme (FeCo-NC DAzyme) for the detection of organophosphorus pesticides (OPPs). The FeCo-NC DAzyme exhibited exceptional oxidase-like activity (OXD), enabling the catalysis of colorless TMB to form blue oxidized TMB (oxTMB) without the need for H2O2 involvement. By combining acid phosphatase (ACP) hydrolase with FeCo-NC DAzyme, a "FeCo-NC DAzyme + TMB + ACP + SAP" colorimetric system was constructed, which facilitated the rapid detection of malathion. The chromogenic system was applied to detect malathion using a smartphone-based app and an auxiliary imaging interferogram device for colorimetric measurements, which have a linear range of 0.05-4.0 µM and a limit of detection (LOD) as low as 15 nM in real samples, comparable to UV-Vis and HPLC-DAD detection methods. Overall, these findings present a novel approach for convenient, rapid, and on-site monitoring of OPPs.

Effectiveness of the Green Heart Smartphone Application as a Self-Management Intervention for Hypertension and Dyslipidemia: A Randomized Clinical Trial.

BACKGROUND: Cardiovascular disease (CVD) is a major global health concern, the leading cause of death and disability. Thus, preventive interventions targeting modifiable risk factors are essential. Mobile-health technologies have emerged as promising tools for improving prevention by modifying risk factors. We created the "Green Heart" mobile app to help coronary artery disease (CAD) patients control their risk factors. The app has three modules: smoking cessation, dyslipidemia (DLP) control, and blood pressure (BP) management. This study evaluated the app's performance in monitoring hypertension (HTN) and DLP among known CAD cases. METHODS: A randomized controlled trial enrolled 1590 CAD subjects, including 1114 hypertensive patients and 1488 subjects with DLP, and assigned them randomly to paper-based education or application-based groups. RESULTS: Regarding HTN, after 6 months, we finally analyzed 545 and 546 hypertensive patients, assigned to the conventional and app groups, respectively. Patients in the app group were more likely to have their BP managed successfully (88.6% vs. 78.5%; P<0.001). The app group showed higher odds of successful BP management (odds ratio [OR]: 2.13; 95% CI: 1.51 - 3.03). Regarding DLP, we analyzed 728 patients in the conventional and 714 patients in the app group. A higher percentage of patients in the app group (24.8%) had low-density lipoprotein cholesterol (LDL-C) levels less than 70 mg/dL (16.1%; P<0.001). The app group showed higher odds of reducing LDL-C (OR: 1.72; 95% CI: 1.32-2.26). CONCLUSION: We found that using the Green Heart app in the self-monitoring setting significantly improved BP and DLP management across the study population.

Smartwatch-Based Interventions for People With Dementia: User-Centered Design Approach.

BACKGROUND: Assistive technologies can help people living with dementia maintain their everyday activities. Nevertheless, there is a gap between the potential and use of these materials. Involving future users may help close this gap, but the impact on people with dementia is unclear. OBJECTIVE: We aimed to determine if user-centered development of smartwatch-based interventions together with people with dementia is feasible. In addition, we evaluated the extent to which user feedback is plausible and therefore helpful for technological improvements. METHODS: We examined the interactions between smartwatches and people with dementia or people with mild cognitive impairment. All participants were prompted to complete 2 tasks (drinking water and a specific cognitive task). Prompts were triggered using a smartphone as a remote control and were repeated up to 3 times if participants failed to complete a task. Overall, 50% (20/40) of the participants received regular prompts, and 50% (20/40) received intensive audiovisual prompts to perform everyday tasks. Participants' reactions were observed remotely via cameras. User feedback was captured via questionnaires, which included topics like usability, design, usefulness, and concerns. The internal consistency of the subscales was calculated. Plausibility was also checked using qualitative approaches. RESULTS: Participants noted their preferences for particular functions and improvements. Patients struggled with rating using the Likert scale; therefore, we assisted them with completing the questionnaire. Usability (mean 78 out of 100, SD 15.22) and usefulness (mean 9 out of 12) were rated high. The smartwatch design was appealing to most participants (31/40, 76%). Only a few participants (6/40, 15%) were concerned about using the watch. Better usability was associated with better cognition. The observed success and self-rated task comprehension were in agreement for most participants (32/40, 80%). In different qualitative analyses, participants' responses were, in most cases, plausible. Only 8% (3/40) of the participants were completely unaware of their irregular task performance. CONCLUSIONS: People with dementia can have positive experiences with smartwatches. Most people with dementia provided valuable information. Developing assistive technologies together with people with dementia can help to prioritize the future development of functional and nonfunctional features.

Use of Mobile Technologies to Streamline Pretriage Patient Flow in the Emergency Department: Observational Usability Study.

BACKGROUND: In emergency departments (EDs), triage nurses are under tremendous daily pressure to rapidly assess the acuity level of patients and log the collected information into computers. With self-service technologies, patients could complete data entry on their own, allowing nurses to focus on higher-order tasks. Kiosks are a popular working example of such self-service technologies; however, placing a sufficient number of unwieldy and fixed machines demands a spatial change in the greeting area and affects pretriage flow. Mobile technologies could offer a solution to these issues. OBJECTIVE: The aim of this study was to investigate the use of mobile technologies to improve pretriage flow in EDs. METHODS: The proposed stack of mobile technologies includes patient-carried smartphones and QR technology. The web address of the self-registration app is encoded into a QR code, which was posted directly outside the walk-in entrance to be seen by every ambulatory arrival. Registration is initiated immediately after patients or their proxies scan the code using their smartphones. Patients could complete data entry at any site on the way to the triage area. Upon completion, the result is saved locally on smartphones. At the triage area, the result is automatically decoded by a portable code reader and then loaded into the triage computer. This system was implemented in three busy metropolitan EDs in Shanghai, China. Both kiosks and smartphones were evaluated randomly while being used to direct pretriage patient flow. Data were collected during a 20-day period in each center. Timeliness and usability of medical students simulating ED arrivals were assessed with the After-Scenario Questionnaire. Usability was assessed by triage nurses with the Net Promoter Score (NPS). Observations made during system implementation were subject to qualitative thematic analysis. RESULTS: Overall, 5928 of 8575 patients performed self-registration on kiosks, and 7330 of 8532 patients checked in on their smartphones. Referring effort was significantly reduced (43.7% vs 8.8%; P<.001) and mean pretriage waiting times were significantly reduced (4.4, SD 1.7 vs 2.9, SD 1.0 minutes; P<.001) with the use of smartphones compared to kiosks. There was a significant difference in mean usability scores for "ease of task completion" (4.4, SD 1.5 vs 6.7, SD 0.7; P<.001), "satisfaction with completion time" (4.5, SD 1.4 vs 6.8, SD 0.6; P<.001), and "satisfaction with support" (4.9, SD 1.9 vs 6.6, SD 1.2; P<.001). Triage nurses provided a higher NPS after implementation of mobile self-registration compared to the use of kiosks (13.3% vs 93.3%; P<.001). A modified queueing model was identified and qualitative findings were grouped by sequential steps. CONCLUSIONS: This study suggests patient-carried smartphones as a useful tool for ED self-registration. With increased usability and a tailored queueing model, the proposed system is expected to minimize pretriage waiting for patients in the ED.

Dropout rate in clinical trials of smartphone apps for diabetes management: A meta-analysis.

Applicability of smartphone-based digital health in diabetes management still face challenges due tolow user retention or engagement. Thus, this systematic and meta-analysis aimed to estimate the dropout rate from the clinical trials. Search of literature was performedon 4 September 2023 through various databases (PubMed, Scilit, Scopus, Embase, and Web of Science). Those reporting clinical trials of smartphone apps for diabetic controls (either type 1 or type 2 diabetes mellitus) were screened and selected in accordance with PRISMA guideline. Of 5,429 identified records, as many as 36 studies were found eligible with a total of 3,327 patients in the intervention group. The overall dropout rate was 29.6 % (95 %CI: 25 %-34.3 %) with high heterogeneity (p-Het < 0.001;I2 = 84.84 %). Sample size, intervention duration, patients' age and gender, and cultural adaptation on the app appeared to be non-significant moderators (p > 0.05). In sub-group levels, notably high dropout rates were observed in studies performing cultural adaptation (34.6 %) and conducted in high-income countries (31.9 %). Given the high dropout rate, the engagement level toward diabetic management apps in real-world setting is expected to be low. High heterogeneity in this study, however, requires careful interpretation of the foregoing results. PROSPERO: CRD42023460365 (14 September 2023).

Age-related behavioral resilience in smartphone touchscreen interaction dynamics.

We experience a life that is full of ups and downs. The ability to bounce back after adverse life events such as the loss of a loved one or serious illness declines with age, and such isolated events can even trigger accelerated aging. How humans respond to common day-to-day perturbations is less clear. Here, we infer the aging status from smartphone behavior by using a decision tree regression model trained to accurately estimate the chronological age based on the dynamics of touchscreen interactions. Individuals (N = 280, 21 to 87 y of age) expressed smartphone behavior that appeared younger on certain days and older on other days through the observation period that lasted up to ~4 y. We captured the essence of these fluctuations by leveraging the mathematical concept of critical transitions and tipping points in complex systems. In most individuals, we find one or more alternative stable aging states separated by tipping points. The older the individual, the lower the resilience to forces that push the behavior across the tipping point into an older state. Traditional accounts of aging based on sparse longitudinal data spanning decades suggest a gradual behavioral decline with age. Taken together with our current results, we propose that the gradual age-related changes are interleaved with more complex dynamics at shorter timescales where the same individual may navigate distinct behavioral aging states from one day to the next. Real-world behavioral data modeled as a complex system can transform how we view and study aging.

Gender differences in neck muscle activity during near-maximum forward head flexion while using smartphones with varied postures.

Women frequently express heightened neck discomfort even though they exhibit smaller neck flexion (NF) during smartphone use. Differences in natural posture while using smartphones may result in varying muscle activation patterns between genders. However, no study focused on this issue. This study investigated the influence of gender on neck muscle activity and NF when using smartphones, ranging from slight (20°) to nearly maximal forward head flexion, across different postures. We analyzed smartphone usage patterns in 16 men and 16 women and examined these behaviors across different scenarios: standing, supported sitting, and unsupported sitting, at 20°, 30°, 40°, and the maximum head angles. During data collection, muscle activity was measured, expressed as a percentage of the maximum voluntary contraction (%MVC), in the cervical erector spinae (CES) and upper trapezius (UTZ), along with NF. Results show significant influences of gender, head angle, and posture on all measures, with notable interactions among these variables. Women displayed higher muscle activities in CES and UTZ, yet exhibited lesser NF, while using smartphones in both standing (12.3%MVC, 10.7% MVC, and 69.0°, respectively) and unsupported sitting (10.8%MVC, 12.3%MVC, and 71.8°, respectively) compared to men (standing: 9.5%MVC, 8.8%MVC, and 76.1°; unsupported sitting: 9.7%MVC, 10.8%MVC, and 76.1°). This study provides a potential rationale for gender-related disparities in injury outcomes, emphasizing that women experience higher neck and shoulder discomfort level, despite their smaller NF during smartphone use, as found in previous research. Additionally, the cervical flexion-relaxation phenomenon may occur when the head angle exceeded 40°. The near-maximum head angle during smartphone use might induce the cervical flexion-relaxation phenomenon, potentially aggravating neck issues. We recommend limiting smartphone usage postures that exceed the near-maximum head angle, as they are commonly adopted by individuals in the daily smartphone activities.

Video livestreaming from medical emergency callers' smartphones to emergency medical dispatch centres: a scoping review of current uses, opportunities, and challenges.

BACKGROUND: Timely dispatch of appropriate emergency medical services (EMS) resources to the scene of medical incidents, and/or provision of treatment at the scene by bystanders and medical emergency lay callers (referred to as 'callers' in this review) can improve patient outcomes. Currently, in dispatch systems worldwide, prioritisation of dispatch relies mostly on verbal telephone information from callers, but advances in mobile phone technology provide means for sharing video footage. This scoping review aimed to map and identify current uses, opportunities, and challenges for using video livestreaming from callers' smartphones to emergency medical dispatch centres. METHODS: A scoping review of relevant published literature between 2007 and 2023 in the English language, searched within MEDLINE; CINAHL and PsycINFO, was descriptively synthesised, adhering to the PRISMA extension for scoping reviews. RESULTS: Twenty-four articles remained from the initial search of 1,565 articles. Most studies were simulation-based and focused on emergency medical dispatchers' (referred to as 'dispatcher/s' in this review) assisted video cardiopulmonary resuscitation (CPR), predominantly concerned with measuring how video impacts CPR performance. Nine studies were based on real-life practice. Few studies specifically explored experiences of dispatchers or callers. Only three articles explored the impact that using video had on the dispatch of resources. Opportunities offered by video livestreaming included it being: perceived to be useful; easy to use; reassuring for both dispatchers and callers; and informing dispatcher decision-making. Challenges included the potential emotional impact for dispatchers and callers. There were also concerns about potential misuse of video, although there was no evidence that this was occurring. Evidence suggests a need for appropriate training of dispatchers and video-specific dispatch protocols. CONCLUSION: Research is sparse in the context of video livestreaming. Few studies have focussed on the use of video livestreaming outside CPR provision, such as for trauma incidents, which are by their nature time-critical where visual information may offer significant benefit. Further investigation into acceptability and experience of the use of video livestreaming is warranted, to understand the potential psychological impact on dispatchers and callers.

[Wireless Pulse Wave Monitoring System Based on Reflective Flexible Probe and AFE4490].

Pulse rate and blood oxygen levels are crucial physiological parameters that reflect physiological and pathological information within the human body. The system designs a wireless pulse wave monitoring system utilizing a flexible reflective probe and the AFE4490, which is capable of monitoring pulse wave and blood oxygen levels on the human forehead. The system is predominantly based on a reflective flexible probe, the AFE4490, a power supply module, a control microcontroller unit (MCU), and a Wi-Fi module. Post-processing by a slave computer, the collected pulse wave data is wirelessly transmitted to a smartphone. The real-time pulse waveform, pulse rate, and blood oxygen levels are displayed on an application. Following relevant tests and verifications, the system can accurately detect pulse wave signals, meet the requirements for wearable technology, and possesses significant market application potential.

Multi-level prediction of substance use: Interaction of white matter integrity, resting-state connectivity and inhibitory control measured repeatedly in every-day life.

Substance use disorders are characterized by inhibition deficits related to disrupted connectivity in white matter pathways, leading via interaction to difficulties in resisting substance use. By combining neuroimaging with smartphone-based ecological momentary assessment (EMA), we questioned how biomarkers moderate inhibition deficits to predict use. Thus, we aimed to assess white matter integrity interaction with everyday inhibition deficits and related resting-state network connectivity to identify multi-dimensional predictors of substance use. Thirty-eight patients treated for alcohol, cannabis or tobacco use disorder completed 1 week of EMA to report substance use five times and complete Stroop inhibition testing twice daily. Before EMA tracking, participants underwent resting state functional MRI and diffusion tensor imaging (DTI) scanning. Regression analyses were conducted between mean Stroop performances and whole-brain fractional anisotropy (FA) in white matter. Moderation testing was conducted between mean FA within significant clusters as moderator and the link between momentary Stroop performance and use as outcome. Predictions between FA and resting-state connectivity strength in known inhibition-related networks were assessed using mixed modelling. Higher FA values in the anterior corpus callosum and bilateral anterior corona radiata predicted higher mean Stroop performance during the EMA week and stronger functional connectivity in occipital-frontal-cerebellar regions. Integrity in these regions moderated the link between inhibitory control and substance use, whereby stronger inhibition was predictive of the lowest probability of use for the highest FA values. In conclusion, compromised white matter structural integrity in anterior brain systems appears to underlie impairment in inhibitory control functional networks and compromised ability to refrain from substance use.

Cognitive Training with Older Adults Using Smartphone and Web-Based Applications: A Scoping Review.

INTRODUCTION: The present scoping review focused on: i) which apps were previously studied; ii) what is the most common frequency for implementing cognitive training; and iii) what cognitive functions the interventions most focus on. METHODS: PRISMA guidelines were followed, and the search was conducted on Web of Science, PsycInfo, Cochrane, and Pubmed. From 1733 studies found, 34 were included. RESULTS: it was highlighted the necessity for forthcoming investigations to tackle the methodical restrictions and disparities in the domain. DISCUSSION: great diversity in intervention protocols was found. Incorporating evaluations of physical fitness in conjunction with cognitive evaluations can offer a more all-encompassing comprehension of the impacts of combined interventions. Furthermore, exploring the efficacy of cognitive training applications requires additional scrutiny, considering individual variances and practical outcomes in real-life settings.