Search

Cardiovascular diseases (CVDs) are a global burden that requires attention. For the detection and diagnosis of CVDs, the 12-lead ECG is a key tool. With technological advancements, ECG devices are becoming smaller and available for home use. Most of these devices contain a limited number of leads and are aimed to detect atrial fibrillation (AF). To investigate whether a four-electrode arrangement could provide enough information to diagnose other CVDs, further research is necessary. At the University Medical Center Utrecht in a multidisciplinary team, we developed the miniECG, a four-electrode ECG handheld system for scientific research in clinical environments (TRL6). This paper describes the process followed during the development of the miniECG. From assembling a multidisciplinary team, which includes engineers, cardiologists, and clinical physicians to the contribution of team members in the design input, design, and testing for safety and functionality of the device. Finally, we detail how the development process was composed by iterative design steps based on user input and intended use evolution. The miniECG is a device compliant for scientific research with patients within Dutch Medical Centers. We believe that hospital-based development led to a streamlined process, which could be applied for the design and development of other technologies used for scientific research in clinical environments. [ABSTRACT FROM AUTHOR]

People with intellectual disabilities often show challenging behaviour, which can manifest itself in self-harm or aggression towards others. Real-time monitoring of stress in clients with challenging behaviour can help caregivers to promptly deploy interventions to prevent escalations, ultimately to improve the quality of life of client and caregiver. This study aimed to assess the impact of real-time stress monitoring with HUME, and the subsequent interventions deployed by the care team, on stress levels and quality of life. Real-time stress monitoring was used in 41 clients with intellectual disabilities in a long-term care setting over a period of six months. Stress levels were determined at the start and during the deployment of the stress monitoring system. The quality of life of the client and caregiver was measured with the Outcome Rating Scale at the start and at three months of use. The results showed that the HUME-based interventions resulted in a stress reduction. The perceived quality of life was higher after three months for both the clients and caregivers. Furthermore, interventions to provide proximity were found to be most effective in reducing stress and increasing the client's quality of life. The study demonstrates that real-time stress monitoring with the HUME and the following interventions were effective. There was less stress in clients with an intellectual disability and an increase in the perceived quality of life. Future larger and randomized controlled studies are needed to confirm these findings. Assistive technology such as real-time stress monitoring enables caregivers to timely intervene and contributes to the reduction of challenging behaviour. Real-time stress monitoring contributes to the quality of life of clients and caregivers in healthcare. There is a reduction in the levels of stress of people with an intellectual disability by using stress-monitoring technology. [ABSTRACT FROM AUTHOR]

Aim: The objective of the current study was to examine whether physical activity and sedentary behavior were associated with appetite among community‐dwelling older adults. Methods: Cross‐sectional analysis was performed on three cohort studies: the Longitudinal Aging Study Amsterdam (LASA); the Health, Aging and Body Composition Study (HABC Study) and the I'm Still Standing Study (ISS Study); (n = 1173, n = 162, n = 125; age range: 57–99, 85–95, 80–100 years; women: 51%, 56%, 61%, respectively). Physical activity and sedentary behavior were measured using hip‐worn (LASA and HABC) and wrist‐worn (ISS) accelerometers. Appetite was self‐reported. Logistic regression models were fitted by accelerometer placement to explore the association between good appetite and various physical activity metrics (total activity, sedentary behavior, and time spent in different intensities of physical activity). Results: Among cohorts using hip‐worn accelerometers, those having total activity within the highest tertile had more than double the odds of having good appetite compared with those within the lowest tertile (odds ratio [OR] 2.16 (1.15–4.06)). Each additional percent of daily sedentary behavior decreased the odds for having good appetite by 3% (OR 0.97 (0.95–0.996)), while each additional percent of daily light‐intensity physical activity increased the odds for having good appetite by 4% (OR 1.02 (1.01–1.06)). No association was found between either physical activity or sedentary behavior and appetite for measurements with the wrist‐worn accelerometers. Conclusions: Among community‐dwelling older adults, the associations between appetite, accelerometer‐assessed physical activity and sedentary behavior differ by accelerometer placement location. This study highlights the importance of careful interpretation of accelerometer data from different body locations and concurrent health outcomes. Geriatr Gerontol Int 2023; 23: 411–417. [ABSTRACT FROM AUTHOR]

Background: Rapid development and implementation of vaccines constituted a crucial step in containing the COVID-19 pandemic. A comprehensive understanding of physiological responses to these vaccines is important to build trust in medicine., Objective: This study aims to investigate temporal dynamics before and after COVID-19 vaccination in 4 physiological parameters as well as the duration of menstrual cycle phases., Methods: In a prospective trial, 17,825 adults in the Netherlands wore a medical device on their wrist for up to 9 months. The device recorded their physiological signals and synchronized with a complementary smartphone app. By means of multilevel quadratic regression, we examined changes in wearable-recorded breathing rate, wrist skin temperature, heart rate, heart rate variability, and objectively assessed the duration of menstrual cycle phases in menstruating participants to assess the effects of COVID-19 vaccination., Results: The recorded physiological signals demonstrated short-term increases in breathing rate and heart rate after COVID-19 vaccination followed by a prompt rebound to baseline levels likely reflecting biological mechanisms accompanying the immune response to vaccination. No sex differences were evident in the measured physiological responses. In menstruating participants, we found a 0.8% decrease in the duration of the menstrual phase following vaccination., Conclusions: The observed short-term changes suggest that COVID-19 vaccines are not associated with long-term biophysical issues. Taken together, our work provides valuable insights into continuous fluctuations of physiological responses to vaccination and highlights the importance of digital solutions in health care., International Registered Report Identifier (irrid): RR2-10.1186/s13063-021-05241-5., (©Andjela Markovic, Vladimir Kovacevic, Timo B Brakenhoff, Duco Veen, Paul Klaver, Marianna Mitratza, George S Downward, Diederick E Grobbee, Maureen Cronin, Brianna M Goodale, COVID-19 Remote Early Detection (COVID-RED) consortium. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 31.07.2024.)

Background: Out-of-hospital cardiac arrest (OHCA) is a leading cause of mortality in the developed world. Timely detection of cardiac arrest and prompt activation of emergency medical services (EMS) are essential, yet challenging. Automated cardiac arrest detection using sensor signals from smartwatches has the potential to shorten the interval between cardiac arrest and activation of EMS, thereby increasing the likelihood of survival., Objective: This cross-sectional survey study aims to investigate users' perspectives on aspects of continuous monitoring such as privacy and data protection, as well as other implications, and to collect insights into their attitudes toward the technology., Methods: We conducted a cross-sectional web-based survey in the Netherlands among 2 groups of potential users of automated cardiac arrest technology: consumers who already own a smartwatch and patients at risk of cardiac arrest. Surveys primarily consisted of closed-ended questions with some additional open-ended questions to provide supplementary insight. The quantitative data were analyzed descriptively, and a content analysis of the open-ended questions was conducted., Results: In the consumer group (n=1005), 90.2% (n=906; 95% CI 88.1%-91.9%) of participants expressed an interest in the technology, and 89% (n=1196; 95% CI 87.3%-90.7%) of the patient group (n=1344) showed interest. More than 75% (consumer group: n= 756; patient group: n=1004) of the participants in both groups indicated they were willing to use the technology. The main concerns raised by participants regarding the technology included privacy, data protection, reliability, and accessibility., Conclusions: The vast majority of potential users expressed a strong interest in and positive attitude toward automated cardiac arrest detection using smartwatch technology. However, a number of concerns were identified, which should be addressed in the development and implementation process to optimize acceptance and effectiveness of the technology., (© Wisse M F van den Beuken, Hans van Schuppen, Derya Demirtas, Vokko P van Halm, Patrick van der Geest, Stephan A Loer, Lothar A Schwarte, Patrick Schober. Originally published in JMIR Human Factors (https://humanfactors.jmir.org).)

Background: Continuous vital sign monitoring may potentially be improved through the use of wearable monitors linked wirelessly to hospital electronic patient records. By improving early detection of physiological deterioration this approach may save lives.Methods: We performed a single-centre before-and-after study including surgical and medical patients at a university hospital in The Netherlands. The study intervention was continuous vital sign monitoring using wearable monitors linked wirelessly to hospital systems. The co-primary outcomes were unplanned ICU admission and rapid response team calls. Secondary outcomes were length of hospital stay and in-patient death.Results: Our baseline cohort included 2466 admissions and our intervention cohort included 2303 admissions recruited from August 2017 to July 2019. Patients in the intervention cohort experienced fewer unplanned ICU admissions (84 [3.4%] vs 54 [2.3%]; P=0.03) and fewer rapid response team calls (107 [4.3%] vs 71 [3.1%]; P=0.02). The number of rapid response team calls that did not result in ICU admission also declined (70 [2.8%] vs 45 [2.0%]; P=0.05). The number of rapid response team calls that did result in ICU admission was not significantly different (52 [2.1%] vs 36 [1.6%]; P=0.16). There were no differences in hospital stay or in-patient deaths between the two study periods.Conclusions: Continuous monitoring of patient vital signs using wearable monitoring technology linked wirelessly to hospital systems was associated with a reduction in unplanned ICU admissions and rapid response team calls. Further research is necessary to confirm the impact of this approach on patient survival. [ABSTRACT FROM AUTHOR]

Fitness wearables and apps provide users with quantified information about their exercise behaviour. Users often access this information on online fitness communities (OFCs) such as RunKeeper or Strava. These OFCs do not only provide feedback on the user's performance but also offer social features. To date, little is known about the extent to which the different features in OFCs answer to users' motivations to exercise. This study addresses this question, by examining (1) whether there are differences in motivations for running between OFC users and non-users and (2) whether the use of particular features is driven by particular running motivations. A survey study was conducted among 717 runners, of which 57% used an OFC to support running activities. Results demonstrate that OFC users are more achievement-oriented than non-OFC users, especially regarding the attainment of personal goals. OFC users with physical motivations (e.g. weight loss) use self-regulatory features more frequently, while runners with social motivations more often use features that afford them to share activities on social media. Achievement-oriented runners appreciate features that allow them to track their progress and interact with other OFC users. No relation was found between the use of OFC features and psychological motivations for running. [ABSTRACT FROM AUTHOR]

Validation of precision dairy-monitoring technologies establishes technology behavioral-monitoring efficacy for research and commercial application. Technology metrics should be associated with behaviors of known physiological importance. The objective of this research project was to evaluate the Nedap SmartTag Neck (Nedap Livestock Management, Groenlo, the Netherlands) for dairy cow behavior measuring accuracy. The behaviors measured were eating, ruminating, and inactivity. Thirty-six lactating Holstein dairy cows were randomly selected from the University of Kentucky's Coldstream Dairy Research Herd and fitted with a Nedap SmartTag Neck. Cows were observed by a single observer for a total of 4 h per cow, including 2 h after the morning milking (0800 h) and 2 h after the evening milking (2000 h), from May to December 2017. The observer recorded the time behaviors occurred using a synchronized watch (CASIO, CASIO America, Inc., Dover, NJ, USA). The hour, minute, and second of the day each behavior occurred were compared with corresponding technology measurements. Pearson correlation coefficients (r; CORR procedure; SAS Institute Inc., Cary, NC, USA), concordance correlation coefficients (CCC; epiR package; R Foundation for Statistical Computing, Vienna, Austria), and Bland-Altman plots (epiR package; R Foundation for Statistical Computing) were used to determine association between visual observations and technology-recorded behaviors. Visually recorded eating, ruminating, and inactive time were moderately to strongly correlated with technology data (CCC ≥ 0.88) and Bland-Altman plots showed no bias, indicating a high level of agreement. In conclusion, the Nedap SmartTag Neck accurately monitored eating, ruminating, and inactivity behaviors and is expected to be effective in monitoring these behaviors in lactating dairy cattle in research or commercial farm settings., (Copyright © 2020. Published by Elsevier B.V.)