Digital devices have gained popularity in the last 10 years as a tool for exercise prescription, the monitoring of daily physical activity, and nutrition for the management of a health-related parameter. Therefore, the aim of this study was to assess the effectiveness of the use of digital devices to monitor exercise data in sedentary persons with HIV who exercise following an individualized activity pacing (AP) protocol on cardiorespiratory fitness body composition, blood lipid profile, and psychological parameters. Twenty-four PLWH were enrolled in an 18-week randomized, open-label, pilot AP exercise protocol. All participants were monitored by a Health Band connected to a mobile app that transmitted the data to a server. At week 3, they were randomized either in an experimental group (EG), in which an open device configuration enabled them to receive training data feedback (n = 12), or continued with no data feedback (control group, n = 12). The primary endpoint was improvement from the baseline of 15% of steady-state oxygen consumption (V˙O2) during a 6-min walking test. Technical issues occurred when pairing the health band with the app, which prevented EG participants from regularly receiving data feedback, and with data transmission to the server, which enabled only 40% monitoring of the total training days. Consequently, the study outcomes could not be compared between the two groups, and participants also lost confidence in the study. However, 19 out of 24 participants completed the AP program. Overall, only 6 (32%) improved steady-state V˙O2, with no significant changes at W18 from the baseline. Significant reductions were observed of BMI (p = 0.040), hip circumference (p = 0.027), and total-(p = 0.049) and HDL-cholesterol (p = 0.045). The failure of digital device performance substantially affected study procedures, monitoring, and participants\' engagement, and likely limited the potential benefits of the AP exercise program.

In digital societies, the use of smart devices to solve childcare problems has become commonplace. Mothers are influenced both positively and negatively by smart devices used to resolve childcare concerns. Focusing on parental self-efficacy, this study identified the factors associated with relief and anxiety caused by the use of smart devices to eliminate parenting concerns among mothers with infants. A random sampling cross-sectional survey was administered to 257 Japanese mothers with infants aged 6-11 months. Structural equation modeling was used to explain the relief and anxiety caused by their use of smart devices in terms of maternal demographics, parental self-efficacy, smart-device dependence, and confidence in their ability to discriminate information. Mothers with high parental self-efficacy experienced increased relief and reduced anxiety by using smart devices to address concerns about child-rearing practices. Mothers who were highly dependent on smart devices felt more secure with their use of smart devices. Homemakers and highly educated mothers who used smart devices because of concerns regarding child health and development experienced more anxiety. Parenting professionals need to recognize the effectiveness of smart devices as a tool to relieve anxiety in parenting and provide additional support for parents to improve their parenting self-efficacy.

UNASSIGNED: Allergic rhinitis (AR) is a common allergic airway disorder that is often poorly managed. There is an urgent need to enhance medication adherence in order to improve treatment outcomes in patients with AR. The efficacy of wearable smart watches in improving medication adherence is currently unclear.
UNASSIGNED: This study aimed to evaluate the efficacy of a novel smart watch in improving medication adherence and symptom control in patients with AR. The reliability of self-reported medication use was also investigated.
UNASSIGNED: This randomized, open-label, parallel controlled, pilot study enrolled adult patients with AR caused by cypress pollen. Patients were randomized in a 1:2 ratio to an intervention group and control group. Smart watches were only distributed to patients in the intervention group. During the cypress pollen season, all patients were required to take oral antihistamines daily and use nasal corticosteroids and antihistamine eye drops as needed. Daily AR symptom scores and medication usage were recorded in both groups. The smart watch was able to identify medication-taking behaviors of patients via artificial intelligence (AI) and relay this information to physicians, who sent short message service reminders to patients who forgot to take oral antihistamines for more than 2 days.
UNASSIGNED: During the pollen season, the adherence rate to oral antihistamines in the intervention group (n = 17) was significantly higher than that in the control group (n = 38) (63.3% ± 28.5% versus 43.2% ± 30.2%, P = 0.02). The daily symptom score of the intervention group was lower than that of the control group (2.4 ± 1.1 versus 3.9 ± 1.0, P < 0.001). There was no significant difference in the on-demand medication score between the 2 groups (1.3 ± 0.4 versus 1.5 ± 0.5, P = 0.13). The consistency rate between self-reported nasal corticosteroid usage and the gold standard (ie, human observation of medication usage in the videos recorded by the smart watch) was 20.0% (0%, 53.7%), and the consistency rate between self-reported antihistamine eye drop usage and the gold standard was 24.3% (2.1%, 67.1%).
UNASSIGNED: This pilot study showed that the application of smart watches in patients with AR was associated with improved medication adherence and symptom control. Furthermore, the reliability of self-reported medication usage was limited.

UNASSIGNED: There are limited data on mobile health detection of prevalent atrial fibrillation (AF) and its related risk factors over time.
UNASSIGNED: This study aimed to report the trends on prevalent AF detection over time and risk factors, with a consumer-led photoplethysmography screening approach.
UNASSIGNED: 3,499,461 subjects aged over 18 years, who use smart devices (Huawei Technologies Co.) were enrolled between October 26, 2018, and December 1, 2021.
UNASSIGNED: Among 2,852,217 subjects for AF screening, 12,244 subjects (0.43%; 83.2% male, mean age 57 ± 15 years) detected AF episodes. When compared with 2018, the risk (adjusted HRs, 95% CI) for monitored prevalent AF increased significantly for subjects when monitoring started in 2020 (adjusted HR: 1.34; 95% CI: 1.27-1.40; P < .001) or in 2021 (adjusted HR: 1.67; 95% CI: 1.59-1.76; P < 0.001). Of the 961,931 subjects who screening for both AF and OSA, 18,032 (1.9%, 97.8% male, mean age 44 ±17 years) were identified as high risk for OSA, which resulted in a 1.5-fold increase (95% CI: 1.30-fold to 1.75-fold) in the prevalent AF. A total of 5,227 (53.3%, 5,227/9,797) subjects were effectively followed up, from which 4,903 (93.8%, 4,903/5,227) subjects were confirmed with the diagnosis of AF, by the mAFA Telecare Team health providers.
UNASSIGNED: Photoplethysmography-based smart devices can facilitate screening for AF with >93% confirmation of detected AF episodes even for the low-risk general population, highlighting the increased risk for detecting prevalent AF and the need for modification of OSA that increase AF susceptibility. (Mobile Health [mHealth] Technology for Improved Screening, Patient Involvement and Optimizing Integrated Care in Atrial Fibrillation [mAFA (mAF-App) II study]; ChiCTR-OOC-17014138).

During the past two decades, the era of digitalization in pharmaceutical device manufacturing has gained significant momentum for maintaining human health. From various available technologies, internet of things (IoT) sensors are being increasingly used as wearable devices (e.g., smart watches, wrist bands, mobile phones, tablets, implantable pumps, etc.) that enable real-time monitoring of data. Such devices are integrated with smart materials that typically monitor the real-time data (blood pressure, blood sugar, heart and pulse rate, cytokine levels, etc.) to advise patients and physicians. Hence, there has been a great demand for wearable devices as potential tools for remote clinical trial monitoring in cancers and other diseases and they are proving to be very cost-effective.

Introduction Online learning is the educational format adopted by schools and universities during the coronavirus disease 2019 (COVID-19) pandemic. It comprises Internet-based learning, computer-based learning, virtual classrooms, and digital collaborations. This study aims to assess digital eye strain (DES) among children attending online classes in the Qassim region, Saudi Arabia. Materials and methods This is a cross-sectional study conducted among children aged 3 to 18 years old in the Qassim region, Saudi Arabia. We sent out a self-administered questionnaire to parents of the targeted children by using social media, such as WhatsApp (Meta Platforms, Inc., Menlo Park, California, United States), Telegram (Telegram FZ LLC, Dubai), and Twitter (Twitter, Inc., San Francisco, California, United States). The questionnaire included questions on socio-demographic profile, smart devices being used, frequency of devices used per day before and during the lockdown, and DES.  Results  A total of 547 children were involved (50.3% males vs. 49.7% females). During online classes, the most commonly used device was tablets (51.2%). A significant increase was noticed in the use of devices during the COVID-19-related lockdown among children (p<0.001). The prevalence of DES-positive symptoms was 69.8%. The presence of DES symptoms was associated with age group (p=0.003), school level (p=0.040), device preferred for online classes (p=0.001), number of hours spent attending online classes (p=0.010), and number of hours spent using an electronic device during the lockdown (p<0.001). Conclusion Our study underlines a higher prevalence rate of DES among children during this time of the COVID-19 pandemic. Children who used a digital device for more than five hours during the lockdown had a greater risk of having DES than the rest.

BACKGROUND: The incidence of major surgery is on the rise globally, and more than 20% of patients are readmitted to hospital following discharge from hospital. During their hospital stay, patients are monitored for early detection of clinical deterioration, which includes regularly measuring physiological parameters such as blood pressure, heart rate, respiratory rate, temperature, and pulse oximetry. This monitoring ceases upon hospital discharge, as patients are deemed clinically stable. Monitoring after discharge is relevant to detect adverse events occurring in the home setting and can be made possible through the development of digital technologies and mobile networks. Smartwatches and other technological devices allow patients to self-measure physiological parameters in the home setting, and Bluetooth connectivity can facilitate the automatic collection and transfer of this data to a secure server with minimal input from the patient.
OBJECTIVE: This paper presents the protocol for the DREAMPath (Domiciliary Recovery After Medicalization Pathway) study, which aims to measure compliance with a multidevice remote monitoring kit after discharge from hospital following major surgery.
METHODS: DREAMPath is a single-center, prospective, observational, cohort study, comprising 30 patients undergoing major intracavity surgery. The primary outcome is to assess patient compliance with wearable and interactive smart technology in the first 30 days following discharge from hospital after major surgery. Secondary outcomes will explore the relation between unplanned health care events and physiological data collected in the study, as well as to explore a similar relationship with daily patient-reported outcome measures (Quality of Recovery-15 score). Secondary outcomes will be analyzed using appropriate regression methods. Cardiopulmonary exercise testing data will also be collected to assess correlations with wearable device data.
RESULTS: Recruitment was halted due to COVID-19 restrictions and will progress once research staff are back from redeployment. We expect that the study will be completed in the first quarter of 2022.
CONCLUSIONS: Digital health solutions have been recently made possible due to technological advances, but urgency in rollout has been expedited due to COVID-19. The DREAMPath study will inform readers about the feasibility of remote monitoring for a patient group that is at an increased risk of acute deterioration.
BACKGROUND: ISRCTN Registry ISRCTN62293620; https://www.isrctn.com/ISRCTN62293620.
UNASSIGNED: DERR1-10.2196/30638.

Voice-controlled intelligent personal assistants (VIPAs), such as Amazon Echo and Google Home, involve artificial intelligence-powered algorithms designed to simulate humans. Their hands-free interface and growing capabilities have a wide range of applications in health care, covering off-clinic education, health monitoring, and communication. However, conflicting factors, such as patient safety and privacy concerns, make it difficult to foresee the further development of VIPAs in health care.
This study aimed to develop a plausible scenario for the further development of VIPAs in health care to support decision making regarding the procurement of VIPAs in health care organizations.
We conducted a two-stage Delphi study with an internationally recruited panel consisting of voice assistant experts, medical professionals, and representatives of academia, governmental health authorities, and nonprofit health associations having expertise with voice technology. Twenty projections were formulated and evaluated by the panelists. Descriptive statistics were used to derive the desired scenario.
The panelists expect VIPAs to be able to provide solid medical advice based on patients\' personal health information and to have human-like conversations. However, in the short term, voice assistants might neither provide frustration-free user experience nor outperform or replace humans in health care. With a high level of consensus, the experts agreed with the potential of VIPAs to support elderly people and be widely used as anamnesis, informational, self-therapy, and communication tools by patients and health care professionals. Although users\' and governments\' privacy concerns are not expected to decrease in the near future, the panelists believe that strict regulations capable of preventing VIPAs from providing medical help services will not be imposed.
According to the surveyed experts, VIPAs will show notable technological development and gain more user trust in the near future, resulting in widespread application in health care. However, voice assistants are expected to solely support health care professionals in their daily operations and will not be able to outperform or replace medical staff.

Smart devices and mobile applications are now an integral part of all aspects of everyday life. They are particularly numerous in the field of health, contributing to the movement called ehealth. What is the potential role of these devices as prevention supports? The purpose of this article is to provide an exploratory analysis of the use, efficacy and contribution to conventional prevention strategies.
To address this issue, we conducted a scoping-review on the basis of 105 publications from the fields of medicine and human sciences.
Three dimensions of the use of smart devices in the field of health were identified: 1/a quantification tool allowing the users to measure their activities; 2/a tool of self-positioning in the community; 3/an interface between the medical world and the population, modifying the hierarchy of knowledge. However, few published studies have investigated the determinants of the efficacy of these devices and their impact on individual behaviours and professional health practices.
Based on the hypothesis of possible integration of these devices in prevention policies, it would be interesting to investigate two research issues: how and under what psycho-socio-environmental conditions can smart devices contribute to the adoption of positive health behaviours? To what degree does the use of smart devices modify the health care professional-patient relationship? Finding answers to these questions could help to define the real place of these devices in prevention strategies by determining their complementarity with respect to other prevention strategies, and the conditions of their efficacy on behaviours and inequalities.