Análise de aplicativos móveis voltados para controle parental: revisão narrativa / Analysis of mobile applications aimed at parental control: narrative review / Análisis de aplicaciones móviles orientadas al control parental: revisión narrativa

Crianças e adolescentes usam a tecnologia móvel para diversas finalidades, como lazer, entretenimento, estudos e comunicação. No entanto, faz-se necessário o controle e mediação parental pois o uso inadequado pode gerar danos à saúde. Existem aplicativos voltados para esta tarefa e com funcionalidades e características variadas. Diante disso, este estudo teve como objetivo analisar as aplicações móveis disponíveis para download na plataforma Google Play Store por meio de uma revisão narrativa e com auxílio do software IRAMUTEQ para revisão dos dados, analisar os comentários deixados pelos usuários. Foram investigadas as informações de 138 aplicativos, boa parte deles realizam funções essenciais, como controlar o tempo de acesso, bloquear sites e apps indesejados, porém, há muitas críticas relacionadas a problemas técnicos, aplicabilidade e prejuízos gerados pelo excessivo controle dos pais. A investigação mostrou que cinco softwares para o controle parental apresentavam as principais funções de acordo com a aplicabilidade (limite de tempo, filtros, localizador GPS, monitoramento de chamadas e mensagens), nota acima de 3,0 e ano de atualização em 2021. A análise dos comentários feita pelo software IRAMUTEQ, destacou as palavras "App" (referente à aplicativo), "filho", "celular", "bloquear", "funcionar", "criança", "instalar" e "desinstalar" como as mais importantes pelos usuários.

Children and teenagers use mobile technology for different purposes, such as leisure, entertainment, studies and communication. However, parental control and mediation is necessary, as inappropriate use can cause health damage. There are applications aimed at this task and with varied functionalities and characteristics. Therefore, this study aimed to analyze the mobile applications available for download on the Google Play Store platform through a narrative review and with the help of the IRAMUTEQ software to review the data, analyze the comments left by users. Information from 138 applications was investigated, most of which perform essential functions, such as controlling access time, blocking unwanted websites and apps, however, there are many criticisms related to technical problems, applicability and damage caused by excessive parental control. The investigation showed that five parental control software had the main functions according to applicability (time limit, filters, GPS locator, call and message monitoring), grade above 3.0 and year of update in 2021. The analysis of the comments made by the IRAMUTEQ software, highlighted the words "App" (referring to the application), "son", "cell phone", "block", "work", "child", "install" and "uninstall" as the most important for users.

Los niños y adolescentes utilizan la tecnología móvil para diferentes fines, como el ocio, el entretenimiento, los estudios y la comunicación. Sin embargo, es necesario el control y la mediación parental, ya que un uso inadecuado puede causar daños a la salud. Existen aplicaciones destinadas a esta tarea y con funcionalidades y características variadas. Por lo tanto, este estudio tuvo como objetivo analizar las aplicaciones móviles disponibles para su descarga en la plataforma Google Play Store a través de una revisión narrativa y con la ayuda del software IRAMUTEQ para revisar los datos, analizar los comentarios dejados por los usuarios. Se investigó la información de 138 aplicaciones, la mayoría de las cuales cumplen funciones esenciales, como controlar el tiempo de acceso, bloquear sitios web y apps no deseadas, sin embargo, existen muchas críticas relacionadas con problemas técnicos, de aplicabilidad y daños causados por el excesivo control parental. La investigación mostró que cinco programas de control parental tenían las funciones principales según aplicabilidad (límite de tiempo, filtros, localizador GPS, monitorización de llamadas y mensajes), grado superior a 3.0 y año de actualización en 2021. El análisis de los comentarios realizados por el software IRAMUTEQ, destacó las palabras "App" (refiriéndose a la aplicación), "hijo", "móvil", "bloquear", "trabajar", "niño", "instalar" y "desinstalar" como las más importantes para los usuarios.

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.

Android malware classification based on random vector functional link and artificial Jellyfish Search optimizer.

Smartphone usage is nearly ubiquitous worldwide, and Android provides the leading open-source operating system, retaining the most significant market share and active user population of all open-source operating systems. Hence, malicious actors target the Android operating system to capitalize on this consumer reliance and vulnerabilities present in the system. Hackers often use confidential user data to exploit users for advertising, extortion, and theft. Notably, most Android malware detection tools depend on conventional machine-learning algorithms; hence, they lose the benefits of metaheuristic optimization. Here, we introduce a novel detection system based on optimizing the random vector functional link (RVFL) using the artificial Jellyfish Search (JS) optimizer following dimensional reduction of Android application features. JS is used to determine the optimal configurations of RVFL to improve classification performance. RVFL+JS minimizes the runtime of the execution of the optimized models with the best performance metrics, based on a dataset consisting of 11,598 multi-class applications and 471 static and dynamic features.

Rationale and validation of a novel mobile application probing motor inhibition: Proof of concept of CALM-IT.

Identification of behavioral mechanisms underlying psychopathology is essential for the development of novel targeted therapeutics. However, this work relies on rigorous, time-intensive, clinic-based laboratory research, making it difficult to translate research paradigms into tools that can be used by clinicians in the community. The broad adoption of smartphone technology provides a promising opportunity to bridge the gap between the mechanisms identified in the laboratory and the clinical interventions targeting them in the community. The goal of the current study is to develop a developmentally appropriate, engaging, novel mobile application called CALM-IT that probes a narrow biologically informed process, inhibitory control. We aim to leverage the rigorous and robust methods traditionally used in laboratory settings to validate this novel mechanism-driven but easily disseminatable tool that can be used by clinicians to probe inhibitory control in the community. The development of CALM-IT has significant implications for the ability to screen for inhibitory control deficits in the community by both clinicians and researchers. By facilitating assessment of inhibitory control outside of the laboratory setting, researchers could have access to larger and more diverse samples. Additionally, in the clinical setting, CALM-IT represents a novel clinical screening measure that could be used to determine personalized courses of treatment based on the presence of inhibitory control deficits.

A Novel Virtual Wet Lab-Using a Smartphone Camera Adapter and a Video Conference Platform to Provide Real-Time Surgical Instruction.

PURPOSE: Proctored surgical instruction has traditionally been taught through in-person interactions in either the operating room or an improvised wet lab. Because of the COVID-19 pandemic, live in-person instruction was not feasible owing to social distancing protocols, so a virtual wet lab (VWL) was proposed and implemented. The purpose of this article is to describe our experience with a VWL as a Descemet membrane endothelial keratoplasty (DMEK) skills-transfer course. This is the first time that a VWL environment has been described for the instruction of ophthalmic surgery. METHODS: Thirteen participant surgeons took part in VWLs designed for DMEK skills transfer in September and October 2020. A smartphone camera adapter and a video conference software platform were the unique media for the VWL. After a didactic session, participants were divided into breakout rooms where their surgical scope view was broadcast live, allowing instructors to virtually proctor their participants in real time. Participants were surveyed to assess their satisfaction with the course. RESULTS: All (100%) participants successfully injected and unfolded their DMEK grafts. Ten of the 13 participants completed the survey. Respondents rated the experience highly favorably. CONCLUSIONS: With the use of readily available technology, VWLs can be successfully implemented in lieu of in-person skills-transfer courses. Further development catering to the needs of the participant might allow VWLs to serve as a viable option of surgical education, currently limited by geographical and social distancing boundaries.

Effects of a six-week mobile app versus paper book intervention on quality of life, symptoms, and self-care in patients with fibromyalgia: a randomized parallel trial.

BACKGROUND: The ProFibro application (app) was developed as a Mobile Health resource to promote self-care in fibromyalgia management. OBJECTIVE: This study aimed to assess the effects of the use of the ProFibro app for six weeks compared to the use of a traditional paper book of similar content to improve health-related quality of life, symptoms, and self-care agency in individuals with fibromyalgia. METHODS: Forty individuals with fibromyalgia were included in this randomized, single-blind, parallel trial. One group received intervention content using the ProFibro app on a smartphone while the other received similar information using a paper book. Participants were assessed at baseline and after six weeks. The primary outcome was the Revised Fibromyalgia Impact Questionnaire. Secondary outcomes were Widespread Pain Index, Pain Visual Analog Scale, Symptom Severity Scale, and Appraisal of Self-Care Agency Scale - Revised. RESULTS: No differences in changes were found between groups at the end of the treatment for any outcome. Both groups showed improvements in symptom severity. CONCLUSIONS: The use of the ProFibro app for six weeks was not more effective than the use of a traditional paper book with similar content for health-related quality of life, symptoms, or self-care agency in individuals with fibromyalgia. Both groups showed improvements from baseline on severity of symptoms, suggesting that the self-care program using a mobile app or a paper book may be beneficial for individuals with fibromyalgia.

Aplicativos móveis sobre o HIV/aids: uma prospecção tecnológica / Mobile applications on hiv/aids: a technological prospection / Aplicaciones móviles sobre VIH/sida: una prospección tecnológica

Objetivo: identificar aplicativos, disponíveis para a cultura brasileira, que promovam conhecimentos ou informações acercas do HIV/Aids. Método: prospecção tecnológica realizada através de pesquisa documental com abordagem qualitativa. Foi realizada a busca por aplicativos através de acesso as lojas virtuais Apple Store e Google Play em janeiro de 2019. Na estratégia de busca utilizou-se os termos: HIV e aids. A organização dos dados foi realizada a partir de uma listagem com os aplicativos e suas características. Resultados: foram identificados 19 aplicativos na loja virtual Apple Store e 13 na Google Play. Em ambas as lojas virtuais foram identificados aplicativos voltados a população usuária dos sistemas de saúde, profissionais da saúde e população em geral, que promovem o acesso as informações relacionadas ao tema HIV/Aids. Conclusão: os aplicativos apresentam potencial para contribuir no controle no HIV/aids no país através da abordagem a prevenção combinada

Objective: to identify applications, available for brazilian culture, that promote knowledge or information about HIV/AIDS. Method:technological prospecting study carried out through documentary research with a qualitative approach. The search for applications was carried out through access to the Apple Store and Google Play virtual stores in January 2019. The search strategy used the terms: HIV and AIDS. The organization of the data was carried out from a list with the applications and their characteristics. Results: 19 applications were identified in the Apple Store and 13 in Google Play. In both virtual stores, applications were identified aimed at the population using health systems, health professionals and the general population, which promote access to information related to the HIV / AIDS theme. Conclusion: the applications have the potential to contribute to the control of HIV / AIDS in the country through the combined prevention approach

Objetivo: identificar aplicaciones, disponibles para la cultura brasileña, que promuevan el conocimiento o la información sobre el VIH / SIDA. Método:estudio de prospección tecnológica realizado mediante investigación documental con enfoque cualitativo. La búsqueda de aplicaciones se realizó a través del acceso a las tiendas virtuales Apple Store y Google Play en enero de 2019. La estrategia de búsqueda utilizó los términos: VIH y SIDA. La organización de los datos se realizó a partir de una lista con las aplicaciones y sus características. Resultados: se identificaron 19 aplicaciones en Apple Store y 13 en Google Play. En ambas tiendas virtuales, se identificaron aplicaciones dirigidas a la población utilizando sistemas de salud, profesionales de la salud y la población en general, que promueven el acceso a la información relacionada con el tema del VIH / SIDA. Conclusão: las aplicaciones tienen el potencial de contribuir al control del VIH / SIDA en el país a través del enfoque de prevención combinada

Effectiveness of WeChat for Improving Exclusive Breastfeeding in Huzhu County China: Randomized Controlled Trial.

BACKGROUND: The benefits of breastfeeding for both infants and mothers have been well recognized. However, the exclusive breastfeeding rate in China is low and decreasing. Mobile technologies have rapidly developed; communication apps such as WeChat (one of the largest social networking platforms in China) are widely used and have the potential to conveniently improve health behaviors. OBJECTIVE: This study aimed to assess the effectiveness of using WeChat to improve breastfeeding practices. METHODS: This 2-arm randomized controlled trial was conducted among pregnant women from May 2019 to April 2020 in Huzhu County, Qinghai Province, China. Pregnant women were eligible to participate if they were aged 18 years or older, were 11 to 37 weeks pregnant with a singleton fetus, had no known illness that could limit breastfeeding after childbirth, used WeChat through their smartphone, and had access to the internet. A total of 344 pregnant women were recruited at baseline, with 170 in the intervention group and 174 in the control group. Women in the intervention group received breastfeeding knowledge and promotion information weekly through a WeChat official account from their third month of pregnancy to 6 months postpartum. The primary outcome of exclusive and predominant breastfeeding rate was measured 0-1 month, 2-3 months, and 4-5 months postpartum. RESULTS: At 0-1 month postpartum, the exclusive breastfeeding rate was significantly higher in the intervention group than that in the control group (81.1% vs 63.3%; odds ratio [OR] 2.75, 95% CI 1.58-4.78; P<.001). Similarly, mothers in the intervention group were more likely to provide predominantly breast milk (OR 2.77, 95% CI 1.55-4.96; P<.001) and less likely to give dairy products to their children (OR 0.40, 95% CI 0.21-0.75; P=.005). There was no statistically significant difference for exclusive breastfeeding rate 2-3 months (P=.09) and 4-5 months postpartum (P=.27), though more children in the intervention group were exclusively breastfed than those in the control group 2-3 months postpartum (intervention: 111/152, 73.0%; control: 96/152, 63.2%) and 4-5 months postpartum(intervention: 50/108, 46.3%; control: 46/109, 42.2%). CONCLUSIONS: This study is the first effort to promote exclusive breastfeeding through WeChat in China, which proved to be an effective method of promoting exclusive breastfeeding in early life. WeChat health education can be used in addition to local breastfeeding promotion programs. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1800017364; http://www.chictr.org.cn/showproj.aspx?proj=29325. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12889-019-7676-2.

Evaluation of stallion sperm motility with ImageJ using a cell phone camera and a light microscope / [Avaliação da motilidade espermática de garanhões com ImageJ usando-se câmera de celular e microscópio óptico]

This study aimed to determine the accuracy of assessing stallion sperm motility using a light microscope, a cell phone camera, and a free computer-assisted semen analysis (FCASA) package for ImageJ. The total motility of frozen (n=22) and cooled (n=48) equine semen was determined by FCASA and compared to the results of subjective visual analysis (SVA) by two technicians. Frozen samples were also evaluated by a commercial computer-assisted semen analysis (CCASA) system. The Friedman test revealed no significant differences (P>0.05) between cooled samples analyzed by FCASA (38.0) and SVA (technician 1, 40.0; technician 2, 40.0), nor between frozen samples analyzed by FCASA (23.36 ± 15.9), SVA (25.5 ± 18.8 and 25.8 ± 18.5), and CCASA (25.2 ± 18.3). However, mean FCASA results were underestimated by 7.2% compared with CCASA. The correlation between FCASA and CCASA was significant and strong (P<0.0001, r=0.95). Chi-squared tests indicated that FCASA provided similar results (P=0.14) to the reference method (CCASA), but SVA had lower accuracy (P=0.04). ImageJ analysis of cell phone videos captured under a light microscope can be used for estimation of stallion sperm motility with comparable accuracy to commercial systems.(AU)

O objetivo deste estudo foi testar as configurações necessárias para avaliar a motilidade espermática total de garanhões, mediante o uso de ImageJ, microscópio óptico e câmera de celular. Os valores de motilidade total das amostras de sêmen equino congeladas (22) e refrigeradas (48) foram comparados por análise visual (SVA) e pelo plugin do ImageJ (CASAF). Amostras congeladas também foram comparadas por um CASA comercial (CCASA). O teste de Friedman não resultou em diferença estatística (P>0,05) entre as 48 amostras analisadas com CASAF (38,0) e SVA de dois avaliadores (40,0 e 40,0). A comparação das 22 amostras congeladas entre CASAF (23,36±15,9), SVA (25,5±18,8 e 25,8±18,5) e CCASA (25,2±18,3) também não resultou em diferença estatística, sendo que a média dos resultados obtidos com CASAF subestimou a obtida com o CCASA em 7,2%. A correlação entre CASAF e CCASA foi significativamente elevada (r=0,95, P<0,0001). O teste de qui-quadrado resultou em proporção de acertos semelhantes entre o CASAF e o CCASA (P=0,14), enquanto SVA resultou em proporção diferente (P=0,04), indicando menor acurácia. O uso de microscópio óptico e câmera de celular foi útil para obter vídeos de sêmen de garanhões a serem analisados com ImageJ, proporcionando resultados de motilidade total equiparáveis a sistemas comerciais.(AU)

Wireless, battery-free and wearable device for electrically controlled drug delivery: sodium salicylate released from bilayer polypyrrole by near-field communication on smartphone.

Compared with traditional drug delivery methods, transdermal drug delivery has many advantages in avoiding the side effects in gastrointestinal tract, reducing the fluctuations in drug concentration, and improving patients' compliance. Among them, electrically controlled drug delivery is a promising solution. This work presents a wireless, battery-free and wearable device with electrically controlled drug delivery capability. The electronic component of the device is a flexible circuit board with a temperature sensor and a near-field communication module. With the help of smartphone, the device could wirelessly obtain energy and implement data transmission. The drug delivery component is a paper-based electrode modified with polypyrrole, in which non-steroidal anti-inflammatory drug sodium salicylate was encapsulated. The applied potential for electrically controlled drug delivery was more negative than -0.6 V. The drug release dose and release rates could be controlled by applying potentials with different amplitudes and durations through this device. It provided a minimalized wearable transdermal drug delivery platform for monitoring diseases such as gout. This wearable device shows promising potential in develop closed-loop drug delivery and monitoring systems for the treatment of various diseases.

A New Smartphone Application to Predict Hematologic Acute Radiation Syndrome Based on Blood Cell Count Changes-The H-module App.

Treatment regimens for acute radiation syndrome have been improved over the past years. The application of appropriate therapy relies on rapid and high-throughput tests ideally conducted in the first 3 d after a radiation exposure event. We have examined the utility of blood cell counts (BCCs) 3 d post irradiation to predict clinical outcome for hematologic acute radiation syndrome (HARS). The BCCs and HARS severity information originated from data available in the System-for-Evaluation-and-Archiving-of-Radiation Accidents-based-on-Case-Histories (SEARCH). We found an almost complete discrimination of unexposed (HARS score H0) vs. irradiated individuals during model development and validation (negative predictive value > 94%) when using BCC data for all 3 d. We also found that BCC data increased the correct prediction of exposed individuals from day 1 to day 3. We developed spreadsheets to calculate the likelihood of correct diagnoses of the worried-well, requirement of hospitalization (HARS 2-4), or development of severe hematopoietic syndrome (HARS 3-4). In two table-top exercises, we found the spreadsheets were confusing and cumbersome, so we converted the spreadsheets into a smartphone application, named the H-module App, designed for ease of use, wider dissemination, and accommodation of co-morbidities in the HARS severity prediction algorithm.

Stratification of Individual Symptoms of Contact Lens-Associated Dry Eye Using the iPhone App DryEyeRhythm: Crowdsourced Cross-Sectional Study.

BACKGROUND: Discontinuation of contact lens use is mainly caused by contact lens-associated dry eye. It is crucial to delineate contact lens-associated dry eye's multifaceted nature to tailor treatment to each patient's individual needs for future personalized medicine. OBJECTIVE: This paper aims to quantify and stratify individual subjective symptoms of contact lens-associated dry eye and clarify its risk factors for future personalized medicine using the smartphone app DryEyeRhythm (Juntendo University). METHODS: This cross-sectional study included iPhone (Apple Inc) users in Japan who downloaded DryEyeRhythm. DryEyeRhythm was used to collect medical big data related to contact lens-associated dry eye between November 2016 and January 2018. The main outcome measure was the incidence of contact lens-associated dry eye. Univariate and multivariate adjusted odds ratios of risk factors for contact lens-associated dry eye were determined by logistic regression analyses. The t-distributed Stochastic Neighbor Embedding algorithm was used to depict the stratification of subjective symptoms of contact lens-associated dry eye. RESULTS: The records of 4454 individuals (median age 27.9 years, SD 12.6), including 2972 female participants (66.73%), who completed all surveys were included in this study. Among the included participants, 1844 (41.40%) were using contact lenses, and among those who used contact lenses, 1447 (78.47%) had contact lens-associated dry eye. Multivariate adjusted odds ratios of risk factors for contact lens-associated dry eye were as follows: younger age, 0.98 (95% CI 0.96-0.99); female sex, 1.53 (95% CI 1.05-2.24); hay fever, 1.38 (95% CI 1.10-1.74); mental illness other than depression or schizophrenia, 2.51 (95% CI 1.13-5.57); past diagnosis of dry eye, 2.21 (95% CI 1.63-2.99); extended screen exposure time >8 hours, 1.61 (95% CI 1.13-2.28); and smoking, 2.07 (95% CI 1.49-2.88). The t-distributed Stochastic Neighbor Embedding analysis visualized and stratified 14 groups based on the subjective symptoms of contact lens-associated dry eye. CONCLUSIONS: This study identified and stratified individuals with contact lens-associated dry eye and its risk factors. Data on subjective symptoms of contact lens-associated dry eye could be used for prospective prevention of contact lens-associated dry eye progression.

Pilot Audit of Trichiasis Surgery Outcomes Using a Mobile App in the Republic of Chad.

PURPOSE: The purpose of the study was to assess the feasibility of a mobile data collection app for use in trichiasis surgical audits in the Melfi and Mangalme districts of the Guera region of the Republic of Chad and to perform a cost analysis to determine if the auditing mechanism could be implemented nationally. MATERIALS AND METHODS: Patients who underwent trichiasis surgery 6 months prior and who had follow-up 7-14 days after surgery were included in the study. Each surgeon had a sample of 20% of operated eyelids; nine surgeons with data for ≥20 eyelids were included. A trichiasis recurrence rate of ≥25% suggested that the surgeon needed retraining. Smartphones captured data using the data collection app, which transmitted data to an online server. Direct costs and supervision costs were collated and summed. RESULTS: There were 916 eyelids operated on; 170 patients (269 eyelids, 29% follow-up rate) participated in the audit. Twenty participants (11.8%) had recurrence. The mean recurrence rate among surgeons was 8.3% (standard deviation: 0.07%; range: 0%-17.9%). None had a recurrence rate of ≥25%; thus, no retraining was necessary. The total cost of the audit was US$15,111.25 ($12,882.28 in direct costs and $2,228.97 in supervision costs). CONCLUSIONS: The simple, easy-to-use, and low-cost mobile auditing mechanism is a practical solution for conducting surgical audits in remote and resource-limited settings and is undergoing national scale-up by the Chadian trachoma elimination program.

Accuracy of Smartphone Camera Applications for Detecting Atrial Fibrillation: A Systematic Review and Meta-analysis.

Importance: Atrial fibrillation (AF) affects more than 6 million people in the United States; however, much AF remains undiagnosed. Given that more than 265 million people in the United States own smartphones (>80% of the population), smartphone applications have been proposed for detecting AF, but the accuracy of these applications remains unclear. Objective: To determine the accuracy of smartphone camera applications that diagnose AF. Data Sources and Study Selection: MEDLINE and Embase were searched until January 2019 for studies that assessed the accuracy of any smartphone applications that use the smartphone's camera to measure the amplitude and frequency of the user's fingertip pulse to diagnose AF. Data Extraction and Synthesis: Bivariate random-effects meta-analyses were constructed to synthesize data. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) of Diagnostic Test Accuracy Studies reporting guideline. Main Outcomes and Measures: Sensitivity and specificity were measured with bivariate random-effects meta-analysis. To simulate the use of these applications as a screening tool, the positive predictive value (PPV) and negative predictive value (NPV) for different population groups (ie, age ≥65 years and age ≥65 years with hypertension) were modeled. Lastly, the association of methodological limitations with outcomes were analyzed with sensitivity analyses and metaregressions. Results: A total of 10 primary diagnostic accuracy studies, with 3852 participants and 4 applications, were included. The oldest studies were published in 2016 (2 studies [20.0%]), while most studies (4 [40.0%]) were published in 2018. The applications analyzed the pulsewave signal for a mean (range) of 2 (1-5) minutes. The meta-analyzed sensitivity and specificity for all applications combined were 94.2% (95% CI, 92.2%-95.7%) and 95.8% (95% CI, 92.4%-97.7%), respectively. The PPV for smartphone camera applications detecting AF in an asymptomatic population aged 65 years and older was between 19.3% (95% CI, 19.2%-19.4%) and 37.5% (95% CI, 37.4%-37.6%), and the NPV was between 99.8% (95% CI, 99.83%-99.84%) and 99.9% (95% CI, 99.94%-99.95%). The PPV and NPV increased for individuals aged 65 years and older with hypertension (PPV, 20.5% [95% CI, 20.4%-20.6%] to 39.2% [95% CI, 39.1%-39.3%]; NPV, 99.8% [95% CI, 99.8%-99.8%] to 99.9% [95% CI, 99.9%-99.9%]). There were methodological limitations in a number of studies that did not appear to be associated with diagnostic performance, but this could not be definitively excluded given the sparsity of the data. Conclusions and Relevance: In this study, all smartphone camera applications had relatively high sensitivity and specificity. The modeled NPV was high for all analyses, but the PPV was modest, suggesting that using these applications in an asymptomatic population may generate a higher number of false-positive than true-positive results. Future research should address the accuracy of these applications when screening other high-risk population groups, their ability to help monitor chronic AF, and, ultimately, their associations with patient-important outcomes.

Inertial Sensors Embedded in Smartphones as a Tool for Fatigue Assessment Based on Acceleration in Survivors of Breast Cancer.

BACKGROUND: Cancer-related fatigue is a symptom commonly reported in survivors of breast cancer and is the most variable symptom. Besides questionnaires like PIPER to assess cancer-related fatigue, there is a need to objectively measure fatigue. OBJECTIVE: The aim of this study was to assess the physiological dimension of fatigue based on acceleration during a 30-second maximal sit-to-stand test. DESIGN: This was a cross-sectional study. METHODS: Linear acceleration from a smartphone placed on the sternum was recorded in 70 survivors of breast cancer. Fourth-degree polynomial adjustment from the acceleration signal to the vertical and anterior-posterior axis was calculated. The fatigue temporal cut-off point was detected as a change in the curve slope of the first maximum point of acceleration. RESULTS: Women were aged 51.8 (8.9) years with a body mass index of 25.4 (5.1) Kg/m2. They performed 23.6 (6.57) number of repetitions. The mean fatigue cut-off point from the total sample was 10.2 (3.1) seconds. LIMITATIONS: Further research should employ time-prolonged tests to study acceleration behavior beyond 30 seconds as well as include a physiological criterion that justifies the nonlinear saturation of the acceleration-based criterion. CONCLUSIONS: This study assessed fatigue through a low-cost and easy-to-use methodology during a functional and widely used test such as 30-second maximal sit-to-stand. This would allow clinicians to assess fatigue in a short-effort exercise to individualize exercise prescription dose, measure changes during intervention, and track fatigue objectively throughout survivorship.

Smartphone-Assisted Telecytopathology: An Intraobserver Concordance Study.

INTRODUCTION: Telecytology is the practice of cytology at a distance. The images captured by a camera are sent to the cytopathologist at a different location who views the images and reaches a diagnosis. Recently, smartphone-assisted telepathology has been evaluated for different subspecialities of pathology including cytology for second opinion. MATERIALS AND METHODS: For the purpose of the study, a total of 151 cases of fine needle aspiration and 10 cases of urine cytology reported by a single pathologist were retrieved from the records. The images of all the cases were captured by a trained pathologist using the primary camera of a smartphone from the ocular of a binocular microscope. The images were sent by WhatsApp to the same pathologist who had made the conventional microscopy diagnosis. The images were viewed on the smartphone screen by the pathologist who replied with the diagnosis after analysing all the images with or without digital zoom. RESULTS: A total of 154 cases out of 161 were correctly diagnosed on smartphone-assisted telepathology (overall intraobserver concordance of 95.6%). For head and neck swellings, the concordance was 65/70 (92.9%), for breast lesions, it was 23/24 (95.8%), and for miscellaneous swellings, it was 57/57 (100%). For urine cytology, the concordance rate was 9/10 (90%). CONCLUSION: Though the results of this study are encouraging, further improvement in the smartphone camera resolution and internet connectivity would enhance the utility of smartphone-assisted telecytopathology.

Utility and Feasibility of Teleophthalmology Using a Smartphone-Based Ophthalmic Camera in Screening Camps in Nepal.

PURPOSE: To determine whether use of a mobile device-based ophthalmic camera by ophthalmic technicians (OTs) in village screening camps in Nepal followed by remote image interpretation by an ophthalmologist can improve detection of ocular pathology and medical decision-making. DESIGN: Evaluation of mobile device-based ophthalmic camera through study of before and after clinical decision-making. METHODS: One hundred forty patients over 18 years of age presenting to remote screening camps with best-corrected visual acuity ≤20/60 in one or both eyes were enrolled. Participants were examined by an OT with direct ophthalmoscopy. The technician recorded a diagnosis for each eye and a disposition for each patient. Patients then had anterior segment and fundus photos and/or videos taken using a smartphone-based ophthalmic camera system. Photos and videos were uploaded to a secure, HIPAA-compliant, cloud-based server, and interpreted by masked ophthalmologists from XXX, who independently recorded diagnoses and a disposition for each patient. RESULTS: The diagnoses given by OTs and ophthalmologists differed in 42.4% of eyes. Diagnosis agreement was highest for cataract [k = 0.732, 95% confidence interval (CI) 0.65-0.81], but much lower for posterior segment (retina/optic nerve) pathology (k = 0.057, 95% CI -0.03-0.14). Ophthalmologists and OTs suggested different dispositions for 68.6% of patients. Agreement was highest for cataract extraction (k = 0.623, 95% CI 0.49-0.75), whereas agreement for referral to XXX was lower (k = 0.12, 95% CI 0.00-0.24). CONCLUSIONS: Remote ophthalmologist consultation utilizing a mobile device ophthalmic camera system is logistically feasible, easily scalable, and capable of capturing high-quality images in the setting of rural eye screening camps. Although OTs are well equipped to identify and triage anterior segment pathology, this technology may be helpful in the detection of and referral for posterior segment pathology.

Nano-lantern on paper for smartphone-based ATP detection.

ATP-driven bioluminescence relying on the D-luciferin-luciferase reaction is widely employed for several biosensing applications where bacterial ATP detection allows to verify microbial contamination for hygiene monitoring in hospitals, food processing and in general for cell viability studies. Several ATP kit assays are already commercially available but an user-friendly ATP biosensor characterized by low-cost, portability, and adequate sensitivity would be highly valuable for rapid and facile on site screening. Thanks to an innovative freeze-drying procedure, we developed a user-friendly, ready-to-use and stable ATP sensing paper biosensor that can be combined with smartphone detection. The ATP sensing paper includes a lyophilized "nano-lantern" with reaction components being rapidly reconstituted by 10 µL sample addition, enabling detection of 10-14 mol of ATP within 10 min. We analysed urinary microbial ATP as a biomarker of urinary tract infection (UTI), confirming the capability of the ATP sensing paper to detect the threshold for positivity corresponding to 105 colony-forming units of bacteria per mL of urine.