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Introduction: Overuse musculoskeletal injuries (MSKI) remain a significant medical challenge in military personnel undergoing military training courses; further understanding of the biological process leading to overuse MSKI development and biological signatures for injury risk are warranted. The purpose of this study was to determine the association between overuse MSKI occurrence and physiological characteristics of allostatic load characterized as maladaptive biological responses to chronic stress measured by wearable devices in US Marine Corps officer candidates during a 10-wk training course. Methods: Devices recorded energy expenditure (EE), daytime heart rate (HR), sleeping HR, and sleep architecture (time and percentage of deep, light, rapid eye movement sleep, awake time, total sleep). Flux was calculated as the raw or absolute difference in the average value for that day or night and the day or night beforehand. Linear mixed-effect model analysis accounting for cardiorespiratory fitness assessed the association between overuse MSKI occurrence and device metrics (α = 0.05). Results: Sixty-nine participants (23 females) were included. Twenty-one participants (eight females) sustained overuse MSKI. Overuse MSKI occurrence in male participants was positively associated with daytime HR (β = 5.316, P = 0.008), sleeping HR (β = 2.708, P = 0.032), relative EE (β = 8.968, P = 0.001), absolute flux in relative EE (β = 2.994, P = 0.002), absolute EE (β = 626.830, P = 0.001), and absolute flux in absolute EE (β = 204.062, P = 0.004). Overuse MSKI occurrence in female participants was positively associated with relative EE (β = 5.955, P = 0.026), deep sleep time (β = 0.664, P < 0.001), and percent deep sleep (β = 12.564, P < 0.001) and negatively associated with absolute flux in sleeping HR (β = -0.660, P = 0.009). Conclusions: Overuse MSKI occurrences were associated with physiological characteristics of allostatic load, including chronically elevated HR and EE and greater time in restorative sleep stages, which may serve as biological signatures for overuse MSKI risk. [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]

The National Heart, Lung, and Blood Institute convened a virtual workshop in September 2022 to discuss "Optimal Instruments for Measurement of Diet, Physical Activity, and Sleep." This report summarizes the proceedings, identifying current research gaps and future directions for measuring different lifestyle behaviors in adult population-based studies. Key discussions centered on integrating report-based methods, like questionnaires, with device-based assessments, including wearables and physiological measures such as biomarkers and omics to enhance self-reported metrics and better understand the underlying biologic mechanisms of chronic diseases. Emphasis was placed on the need for data harmonization, including the adoption of standard terminology, reproducible metrics, and accessible raw data, to enhance the analysis through artificial intelligence and machine learning techniques. The workshop highlighted the importance of standardizing procedures for integrated behavioral phenotypes using time-series data. These efforts aim to refine data accuracy and comparability across studies and populations, thereby advancing our understanding of lifestyle behaviors and their impact on chronic disease outcomes over the life course.

Background: Physical activity (PA) was strongly associated with health status, with fewer related studies in adolescents (12-19 years). Most current studies using questionnaires to assess PA levels were not objective enough. So, this study used a wearable device to assess PA levels quantitatively and focused on the association between PA levels and self-reported 4 health status among adolescents., Methods: Data were obtained from adolescents (2241) with both PA and health status assessments from two cycles of NHANES, 2011-2014, using a wearable accelerometer-based device to assess PA levels quantitatively, MIMS-units as the metric, averaging over all valid days of wear (MIMS-units average). There were 4 health statuses, including (1) whether or not flu, pneumonia, or ear infection, (2) whether or not stomach or intestinal illness, (3) whether or not head cold or chest cold, and (4) general health condition, from the past 30 days self-reported. Weighted multiple logistic regression was used to analyze the association between the 4 health statuses and the MIMS-units average and MIMS-units average quartiles respectively. Subgroup analyses were also conducted on age, sex, BMI, and race., Results: After controlling confounding factors, there was no significant correlation between the MIMS-units average and the four physical health conditions in Table 3 model 3. While MIMS-units average quartiles results showed that compared to lower PA levels (Q1), higher PA levels (Q4) were linked to a lower incidence of "flu"(OR = 0.94, 95% CI [0.91, 0.99], P < 0.001). Furthermore, Q3 was linked to a decrease in the incidence of "head cold" (OR = 0.91, 95% CI [0.85, 0.96], P < 0.001), while Q2 showed a decrease in "stomach illness" (OR = 0.95, 95% CI [0.92, 0.99], P = 0.003) in Table 3 model 3. Subgroup analyses showed that higher PA levels significantly reduced "flu" risk among 12-15 year-olds, girls, obese, and Non-Hispanic White; decreased "head cold" risk among 16-19 year-olds, boys, obese, and Non-Hispanic White; significantly lower risk of "stomach illness" in girls., Conclusions: Enhancing PA levels can help prevent flu, head cold, and stomach or intestinal illness in US adolescents. Further studies are needed to determine whether adolescents in other regions have similar results, and high-quality cohort studies are needed to further validate the causal association., (© 2024. The Author(s).)

The majority of Black women with hypertension in the United States have smartphones or tablets and use social media, and many use wearable activity trackers and health or wellness apps, digital tools that can be used to support lifestyle changes and medication adherence., (©Jolaade Kalinowski, Sandesh Bhusal, Sherry L Pagoto, Robert Newton Jr, Molly E Waring. Originally published in JMIR Cardio (https://cardio.jmir.org), 09.09.2024.)

The COVID-19 crisis has helped facilitate and amplify a set of articulations between technology, public health, and culture. Among these connections is the idea that wearable technologies – with their attendant claims to know more and know better about the relationship between human bodies and daily life – are able to predict the onset of COVID-19 symptoms and, in doing so, to help mitigate its spread. This article considers this imaginary through a case study of the Oura 'smart ring' and Oura's partnership with medical researchers and the National Basketball Association. Through a close, critical reading of popular press reports, I examine how Oura is imagined as a productive articulation between technology and public health capable of compensating for the failure of the United States government to implement adequate COVID-19 testing. This analysis demonstrates one way cultural studies scholars might interrogate and map the politics of this unfolding conjuncture – that is, to understand how a series of public failings is offloaded to private companies in an effort to develop quick solutions that only further entrench existing crises. [ABSTRACT FROM AUTHOR]

Background: There has been an explosion in the use of wearable activity trackers (WATs), but we do not fully understand who wears them and why. This study's purpose was to describe the characteristics of WAT users and to compare current and former users.Materials and Methods: A variety of internet-based resources (eg, Craigslist, Facebook) were used to recruit current and former WAT users. Respondents completed a web-based survey, where they provided information on sociodemographic characteristics, health, physical activity behavior, and about their WAT use.Results: Of the 2826 respondents who gave informed consent, 70.8% (n = 2002) met inclusion criteria for this analysis. Respondents ranged from 18 to 81 years old (mean 32.9 ± 12.2 standard deviation) with 73.8% women. Most were current WAT users (68.7%), and the average length of WAT use overall was 9.3 ± 9.7 months. On average, current users wore the device for 3.7 months longer than former users. Compared to current users, former users had a lower body mass index (1.2 kg/m2 less), reported fewer medical conditions, shared data from their device less often, and received the device as a gift more frequently.Conclusions: Current and former users varied in their reasons for using a WAT and how they used their device. Differences identified between these groups support further exploration of associations between WAT users' profiles and their physical activity behavior. [ABSTRACT FROM AUTHOR]

Epilepsy is one of the most common neurological disorders affecting a significant portion of the world’s population and approximately 2.5 million people in the United States. Important biomedical research effort is focused on the development of energy efficient devices for the real-time detection of seizures. In this paper, we propose an Internet of Medical Things (IoMT)-based automated seizure detection system which will detect a seizure from electroencephalography (EEG) signals using a voltage level detector (VLD) and a signal rejection algorithm (SRA). The proposed system analyzes neural signals continuously and extracts the hyper-synchronous pulses for the detection of seizure onset. Within a time frame, if the number of pulses exceeds a predefined threshold value, a seizure is declared. The SRA reduces false detections, which in turn enhances the accuracy of the seizure detector. The design was validated using system-level simulations and consumer electronics proof of concept. The proposed seizure detector reports a sensitivity of 96.9% and specificity of 97.5%. The use of minimal circuitry can lead to reduction of power consumption compared to many contemporary approaches. The proposed approach can be generalized to other sensor modalities and the use of wearable or implantable solutions, or a combination of the two. [ABSTRACT FROM AUTHOR]

Background: With an increase in aging population and chronic medical conditions in the United States, the role of informal caregivers has become paramount as they engage in the care of their loved ones. Mounting evidence suggests that such responsibilities place substantial burden on informal caregivers and can negatively impact their health. New wearable health and activity trackers (wearables) are increasingly being used to facilitate and monitor healthy behaviors and to improve health outcomes. Although prior studies have examined the efficacy of wearables in improving health and well-being in the general population, little is known about their benefits among informal caregivers., Objective: This study aimed to examine the association between use of wearables and levels of physical activity (PA) among informal caregivers in the United States., Methods: We used data from the National Cancer Institute's Health Information National Trends Survey 5 (cycle 3, 2019 and cycle 4, 2020) for a nationally representative sample of 1273 community-dwelling informal caregivers-aged ≥18 years, 60% (757/1273) female, 75.7% (990/1273) had some college or more in education, and 67.3% (885/1273) had ≥1 chronic medical condition-in the United States. Using jackknife replicate weights, a multivariable logistic regression was fit to assess an independent association between the use of wearables and a binary outcome: meeting or not meeting the current World Health Organization's recommendation of PA for adults (≥150 minutes of at least moderate-intensity PA per week)., Results: More than one-third (466/1273, 37.8%) of the informal caregivers met the recommendations for adult PA. However, those who reported using wearables (390/1273, 31.7%) had slightly higher odds of meeting PA recommendations (adjusted odds ratios 1.1, 95% CI 1.04-1.77; P=.04) compared with those who did not use wearables., Conclusions: The results demonstrated a positive association between the use of wearables and levels of PA among informal caregivers in the United States. Therefore, efforts to incorporate wearable technology into the development of health-promoting programs or interventions for informal caregivers could potentially improve their health and well-being. However, any such effort should address the disparities in access to innovative digital technologies, including wearables, to promote health equity. Future longitudinal studies are required to further support the current findings of this study., (©Asos Mahmood, Hyunmin Kim, Satish Kedia, Patrick Dillon. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 24.11.2022.)

Background: Wearable devices that are used for observational research and clinical trials hold promise for collecting data from study participants in a convenient, scalable way that is more likely to reach a broad and diverse population than traditional research approaches. Amazon Mechanical Turk (MTurk) is a potential resource that researchers can use to recruit individuals into studies that use data from wearable devices.Objective: This study aimed to explore the characteristics of wearable device users on MTurk that are associated with a willingness to share wearable device data for research. We also aimed to determine whether compensation was a factor that influenced the willingness to share such data.Methods: This was a secondary analysis of a cross-sectional survey study of MTurk workers who use wearable devices for health monitoring. A 19-question web-based survey was administered from March 1 to April 5, 2018, to participants aged ≥18 years by using the MTurk platform. In order to identify characteristics that were associated with a willingness to share wearable device data, we performed logistic regression and decision tree analyses.Results: A total of 935 MTurk workers who use wearable devices completed the survey. The majority of respondents indicated a willingness to share their wearable device data (615/935, 65.8%), and the majority of these respondents were willing to share their data if they received compensation (518/615, 84.2%). The findings from our logistic regression analyses indicated that Indian nationality (odds ratio [OR] 2.74, 95% CI 1.48-4.01, P=.007), higher annual income (OR 2.46, 95% CI 1.26-3.67, P=.02), over 6 months of using a wearable device (OR 1.75, 95% CI 1.21-2.29, P=.006), and the use of heartbeat and pulse tracking monitoring devices (OR 1.60, 95% CI 0.14-2.07, P=.01) are significant parameters that influence the willingness to share data. The only factor associated with a willingness to share data if compensation is provided was Indian nationality (OR 0.47, 95% CI 0.24-0.9, P=.02). The findings from our decision tree analyses indicated that the three leading parameters associated with a willingness to share data were the duration of wearable device use, nationality, and income.Conclusions: Most wearable device users indicated a willingness to share their data for research use (with or without compensation; 615/935, 65.8%). The probability of having a willingness to share these data was higher among individuals who had used a wearable for more than 6 months, were of Indian nationality, or were of American (United States of America) nationality and had an annual income of more than US $20,000. Individuals of Indian nationality who were willing to share their data expected compensation significantly less often than individuals of American nationality (P=.02). [ABSTRACT FROM AUTHOR]

With one in five adults in the United States owning a smartwatch or fitness tracker, these devices are poised to impact all aspects of medicine by offering a more objective approach to replace self-reported data. Oncology has proved to be a prototypical example, and wearables offer immediate benefits to patients and oncologists with the ability to track symptoms and health metrics in real time. We aimed to review the recent literature on consumer-grade wearables and its current applications in cancer from the perspective of both the patient and the provider. The relevant studies suggested that these devices offer benefits, such as improved medication adherence and accuracy of symptom tracking over self-reported data, as well as insights that increase patient empowerment. Physical activity is consistently correlated with stronger patient outcomes, and a patient's real-time metrics were found to be capable of tracking medication side effects and toxicity. Studies have made associations between wearable data and telomere shortening, cardiovascular disease, alcohol consumption, sleep apnea, and other conditions. The objective data obtained by the wearable presents a more complete picture of an individual's health than the snapshot of a 15-minute office visit and a single set of vital signs. Real-time metrics can be translated into a digital phenotype that identifies risk factors specific to each patient, and shared risk factors across one's social network may uncover common environmental exposures detrimental to one's health. Wearable data and its upcoming integration with social media will be the foundation for the next generation of personalized medicine., (©Lakshan N Fonseka, Benjamin KP Woo. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 15.07.2021.)

• Updates on smartwatch watchfaces establish awareness of physical activity levels. • Users react to group related feedback on the watchface by engaging in physical activity. • Watchface updates can mediate group dynamics. • Users regularly glance at the watchface and notice wellness related indicators. Physical inactivity is a major cause of disease, both in the United States and globally. Physical activity interventions often use a multi-level and community-based approach combining individual and group-based behavioral strategies to promote physical activity and influence social norms. Such interventions can increase their impact by adopting technology-based solutions to facilitate the underlying behavioral strategies. Current technologies for persuading physical activity primarily focus on facilitating individual-level behavioral strategies and de-emphasizing interpersonal aspects. This article focuses on the design and evaluation of technology aimed at facilitating group dynamics-based strategies for promoting physical activity within small socially-connected teams. This work introduces a multi-component smartwatch-centered system called FitAware that uses sensors to automatically track physical activity and leverage the advantages of the watch form factor to facilitate both group and individual level behavioral strategies via non-interruptive, glanceable, and frequent updates. This article describes the design and evaluation of FitAware in the context of an 8-week statewide physical activity community-based intervention. [ABSTRACT FROM AUTHOR]

Study Objectives: Minimal focus has been placed on variations in health care delivery for obstructive sleep apnea (OSA). This study compared positive airway pressure usage in developing countries (Brazil and Mexico) vs. a developed country (United States) and investigated the impact of a patient engagement tool (myAir; ResMed, San Diego, CA) on adherence., Methods: Deidentified data from the AirView database (ResMed) for patients receiving positive airway pressure therapy with wirelessly connected Air10 (AirSense and AirCurve) devices in Brazil, Mexico, and the United States were analyzed. Adherence was defined using US Center for Medicare and Medicaid Services (CMS) criteria (usage ≥ 4 h/night on ≥ 70% of nights in the first 90 days)., Results: The analysis included 4,181,490 patients (Brazil: 31,672; Mexico 16,934; United States: 4,132,884). CMS adherence over 90 days was slightly lower in Latin America vs. the United States (Brazil: 71.7%; Mexico: 66.4%; United States: 74.0%). Significantly fewer patients were using the patient engagement tool in Brazil (8.1%) and Mexico (2.8%) vs. the United States (26%; both P < .001). Patients registered to use an engagement tool had a higher rate of CMS adherence and were twice as likely to achieve CMS adherence. Average daily usage and days with usage > 4 hours in the first week were the strongest predictors of CMS adherence. Across all countries, > 80% of patients meeting CMS criteria at 3 months were still using positive airway pressure therapy at 1 year, with 1-year adherences rates of > 75%., Conclusions: Short-term and long-term positive airway pressure adherence rates in Brazil and Mexico were similar to those achieved in the United States. Patients who registered to use an engagement tool consistently had better adherence than those who did not., (© 2021 American Academy of Sleep Medicine.)

This article provides a guideline for the design, manufacture, regulatory approval, and post-market surveillance (PMS) of wearable medical devices (WMDs). The integration of regulatory considerations can accelerate wearable device (WD) development from laboratory to market while mitigating device failure risks. The implementation of stringent clinical evaluations will transcend WDs beyond consumer products., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: There is increasing interest in using mobile technologies such as smartphones for improving the care of patients with schizophrenia. However, less is known about the current clinical evidence for the feasibility and effectiveness of smartphone apps in this population. Objective: To review the published literature of smartphone apps applied for the care of patients with schizophrenia and other psychotic disorders. Methods: An electronic database search of Ovid MEDLINE, the Cochrane Central Register of Controlled Trials, Health Technology Assessment Database, Allied and Complementary Medicine, Health and Psychosocial Instruments, PsycINFO, and Embase was conducted on May 24, 2015. All eligible studies were systematically reviewed, and proportional meta-analyses were applied to pooled data on recruitment, retention, and adherence to examine the overall feasibility of smartphone interventions for schizophrenia. Results: Our search produced 226 results from which 7 eligible articles were identified, reporting on 5 studies of smartphone apps for patients with schizophrenia. All examined feasibility, and one assessed the preliminary efficacy of a smartphone intervention for schizophrenia. Study lengths varied between 6 and 130 days. Overall retention was 92% (95% CI 82-98%). Participants consistently used the smartphone apps on more than 85% of days during the study period, averaging 3.95 interactions per person per day. Furthermore, participants responded to 71.9% of automated prompts (95% CI 65.7-77.8%). Participants reported a range of potential benefits from the various interventions, and user experience was largely positive. Conclusions: Although small, the current published literature demonstrates strong evidence for the feasibility of using smartphones to enhance the care of people with schizophrenia. High rates of engagement and satisfaction with a broad range of apps suggest the nascent potential of this mobile technology. However, there remains limited data on the efficacy of such interventions. [ABSTRACT FROM AUTHOR]