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BackgroundTelemonitoring studies in chronic heart failure are characterized by mixed mortality and hospitalization outcomes, which have deterred the uptake of telemonitoring in clinical practice. These mixed outcomes may reflect the diverse range of patient management strategies incorporated in telemonitoring. To address this, we compared the effects of different telemonitoring strategies on clinical outcomes. ObjectiveThe aim of this systematic review and subgroup meta-analysis was to identify noninvasive telemonitoring strategies attributing to improvements in all-cause mortality or hospitalization outcomes for patients with chronic heart failure. MethodsWe reviewed and analyzed telemonitoring strategies from randomized controlled trials (RCTs) comparing telemonitoring intervention with usual care. For each strategy, we examined whether RCTs that applied the strategy in the telemonitoring intervention (subgroup 1) resulted in a significantly lower risk ratio (RR) of all-cause mortality or incidence rate ratio (IRR) of all-cause hospitalization compared with RCTs that did not apply this strategy (subgroup 2). ResultsWe included 26 RCTs (N=11,450) incorporating 18 different telemonitoring strategies. RCTs that provided medication support were found to be associated with a significantly lower IRR value than RCTs that did not provide this type of support (P=.01; subgroup 1 IRR=0.83, 95% CI 0.72-0.95 vs subgroup 2 IRR=1.02, 95% CI 0.93-1.12). RCTs that applied mobile health were associated with a significantly lower IRR (P=.03; IRR=0.79, 95% CI 0.64-0.96 vs IRR=1.00, 95% CI 0.94-1.06) and RR (P=.01; RR=0.67, 95% CI 0.53-0.85 vs RR=0.95, 95% CI 0.84-1.07). ConclusionsTelemonitoring strategies involving medication support and mobile health were associated with improvements in all-cause mortality or hospitalization outcomes. These strategies should be prioritized in telemonitoring interventions for the management of patients with chronic heart failure.

BackgroundTelemonitoring enables care providers to remotely support outpatients in self-managing chronic heart failure (CHF), but the objective assessment of patient compliance with self-management recommendations has seldom been studied. ObjectiveThis study aimed to evaluate patient compliance with self-management recommendations of an innovative telemonitoring enhanced care program for CHF (ITEC-CHF). MethodsWe conducted a multicenter randomized controlled trial with a 6-month follow-up. The ITEC-CHF program comprised the provision of Bluetooth-enabled scales linked to a call center and nurse care services to assist participants with weight monitoring compliance. Compliance was defined a priori as weighing at least 4 days per week, analyzed objectively from weight recordings on the scales. The intention-to-treat principle was used to perform the analysis. ResultsA total of 184 participants (141/184, 76.6% male), with a mean age of 70.1 (SD 12.3) years, were randomized to receive either ITEC-CHF (n=91) or usual care (control; n=93), of which 67 ITEC-CHF and 81 control participants completed the intervention. For the compliance criterion of weighing at least 4 days per week, the proportion of compliant participants in the ITEC-CHF group was not significantly higher than that in the control group (ITEC-CHF: 67/91, 74% vs control: 56/91, 60%; P=.06). However, the proportion of ITEC-CHF participants achieving the stricter compliance standard of at least 6 days a week was significantly higher than that in the control group (ITEC-CHF: 41/91, 45% vs control: 23/93, 25%; P=.005). ConclusionsITEC-CHF improved participant compliance with weight monitoring, although the withdrawal rate was high. Telemonitoring is a promising method for supporting both patients and clinicians in the management of CHF. However, further refinements are required to optimize this model of care. Trial RegistrationAustralian New Zealand Clinical Trial Registry ACTRN12614000916640; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366691

BackgroundAn ongoing challenge for smart homes research for aging-in-place is how to make sense of the large amounts of data from in-home sensors to facilitate real-time monitoring and develop reliable alerts. ObjectiveThe objective of our study was to explore the usefulness of a routine-based approach for making sense of smart home data for the elderly. MethodsMaximum variation sampling was used to select three cases for an in-depth mixed methods exploration of the daily routines of three elderly participants in a smart home trial using 180 days of power use and motion sensor data and longitudinal interview data. ResultsSensor data accurately matched self-reported routines. By comparing daily movement data with personal routines, it was possible to identify changes in routine that signaled illness, recovery from bereavement, and gradual deterioration of sleep quality and daily movement. Interview and sensor data also identified changes in routine with variations in temperature and daylight hours. ConclusionsThe findings demonstrated that a routine-based approach makes interpreting sensor data easy, intuitive, and transparent. They highlighted the importance of understanding and accounting for individual differences in preferences for routinization and the influence of the cyclical nature of daily routines, social or cultural rhythms, and seasonal changes in temperature and daylight hours when interpreting information based on sensor data. This research has demonstrated the usefulness of a routine-based approach for making sense of smart home data, which has furthered the understanding of the challenges that need to be addressed in order to make real-time monitoring and effective alerts a reality.

BackgroundThe high number of adult males engaging in low levels of physical activity and poor dietary practices, and the health risks posed by these behaviors, necessitate broad-reaching intervention strategies. Information technology (IT)-based (Web and mobile phone) interventions can be accessed by large numbers of people, yet there are few reported IT-based interventions targeting males’ physical activity and dietary practices. ObjectiveThis study examines the effectiveness of a 9-month IT-based intervention (ManUp) to improve the physical activity, dietary behaviors, and health literacy in middle-aged males compared to a print-based intervention. MethodsParticipants, recruited offline (eg, newspaper ads), were randomized into either an IT-based or print-based intervention arm on a 2:1 basis in favor of the fully automated IT-based arm. Participants were adult males aged 35-54 years living in 2 regional cities in Queensland, Australia, who could access the Internet, owned a mobile phone, and were able to increase their activity level. The intervention, ManUp, was based on social cognitive and self-regulation theories and specifically designed to target males. Educational materials were provided and self-monitoring of physical activity and nutrition behaviors was promoted. Intervention content was the same in both intervention arms; only the delivery mode differed. Content could be accessed throughout the 9-month study period. Participants’ physical activity, dietary behaviors, and health literacy were measured using online surveys at baseline, 3 months, and 9 months. ResultsA total of 301 participants completed baseline assessments, 205 in the IT-based arm and 96 in the print-based arm. A total of 124 participants completed all 3 assessments. There were no significant between-group differences in physical activity and dietary behaviors (P≥.05). Participants reported an increased number of minutes and sessions of physical activity at 3 months (exp(β)=1.45, 95% CI 1.09-1.95; exp(β)=1.61, 95% CI 1.17-2.22) and 9 months (exp(β)=1.55, 95% CI 1.14-2.10; exp(β)=1.51, 95% CI 1.15-2.00). Overall dietary behaviors improved at 3 months (exp(β)=1.07, 95% CI 1.03-1.11) and 9 months (exp(β)=1.10, 95% CI 1.05-1.13). The proportion of participants in both groups eating higher-fiber bread and low-fat milk increased at 3 months (exp(β)=2.25, 95% CI 1.29-3.92; exp(β)=1.65, 95% CI 1.07-2.55). Participants in the IT-based arm were less likely to report that 30 minutes of physical activity per day improves health (exp(β)=0.48, 95% CI 0.26-0.90) and more likely to report that vigorous intensity physical activity 3 times per week is essential (exp(β)=1.70, 95% CI 1.02-2.82). The average number of log-ins to the IT platform at 3 and 9 months was 6.99 (SE 0.86) and 9.22 (SE 1.47), respectively. The average number of self-monitoring entries at 3 and 9 months was 16.69 (SE 2.38) and 22.51 (SE 3.79), respectively. ConclusionsThe ManUp intervention was effective in improving physical activity and dietary behaviors in middle-aged males with no significant differences between IT- and print-based delivery modes. Trial RegistrationAustralian New Zealand Clinical Trials Registry: ACTRN12611000081910; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611000081910 (Archived by WebCite at http://www.webcitation.org/6QHIWad63).

BackgroundLifespace is a multidimensional construct that describes the geographic area in which a person lives and conducts their activities, and reflects mobility, health, and well-being. Traditionally, it has been measured by asking older people to self-report the length and frequency of trips taken and assistance required. Global Positioning System (GPS) sensors on smartphones have been used to measure Lifespace of older people, but not with people with Parkinson’s disease (PD). ObjectiveThe objective of this study was to investigate whether GPS data collected via smartphones could be used to indicate the Lifespace of people with PD. MethodsThe dataset was supplied via the Michael J Fox Foundation Data Challenge and included 9 people with PD and 7 approximately matched controls. Participants carried smartphones with GPS sensors over two months. Data analysis compared the PD group and the control group. The impact of symptom severity on Lifespace was also investigated. ResultsVisualization methods for comparing Lifespace were developed including scatterplots and heatmaps. Lifespace metrics for comparison included average daily distance, percentage of time spent at home, and number of trips into the community. There were no significant differences between the PD and the control groups on Lifespace metrics. Visual representations of Lifespace were organized based on the self-reported severity of symptoms, suggesting a trend of decreasing Lifespace with increasing PD symptoms. ConclusionsLifespace measured by GPS-enabled smartphones may be a useful concept to measure the progression of PD and the impact of various therapies and rehabilitation programs. Directions for future use of GPS-based Lifespace are provided.

Abstract Campus basketball culture is gradually affecting students’ sports spirit and sports accomplishment. As for the evaluation of basketball teaching achievements, the method of specified items is generally used for testing, which is highly subjective. It’s completely teacher-led, and teachers make relevant evaluations of students’ basketball behavior. Teachers can’t be absolutely fair and just in the evaluation, because teacher evaluation can be affected by many factors, such as teachers’ mood on that day, teachers’ affection for students, and so on, the traditional way of teacher basketball evaluation is easy to cause negative emotional impact on some students, so that students have negative emotions on basketball activities, and even affect their sports quality, and finally affect their health. Based on the evaluation method of basketball teaching, this paper introduced a reliability intelligent evaluation model based on swarm intelligence and edge computing and used this model to evaluate students’ performance in basketball teaching classes. Moreover, this paper designed a related experiment, the experimental results showed that boys and girls in basketball level gap was more obvious. As far as dribbling skills were concerned, the highest score of boy A was 91 points, while the lowest score of girl C was 54 points. The gap was quite large. At the same time, the introduction results of the reliability intelligent evaluation model were studied by using the questionnaire survey method. As can be seen from the results of the questionnaire, the number of people who are very interested in basketball teaching activities is obviously high, and the number of people who are still not interested in the six activities is no more than 2. Through the change data of students’ interests and attitudes, it was proved that the reliability intelligent evaluation model could improve the students’ enthusiasm for learning basketball courses, thus improving their sports quality. This study provided a reference value for the application of swarm intelligence and edge computing in the intelligent evaluation model of basketball teaching reliability, and provided a direction for the future development of basketball teaching.

BackgroundIgG4-related disease (IgG4-RD) is a rare fibro-inflammatory disease, which is prone to missed diagnosis or misdiagnosis due to nonspecific clinical manifestations.ObjectiveTo analyze the clinical characteristics of IgG4-related disease (IgG4-RD) .MethodsA retrospective design was adopted. Participants were 106 IgG4-RD patients recruited from the First Affiliated Hospital of Zhengzhou University from January 2015 to September 2019. Their clinical data were collected, including demographics, results of serological examinations, imaging examinations, histopathological examinations and treatment status. Data of follow-up conducted by telephone or checking medical history data as of January 1, 2020 were also collected.ResultsOf the 106 cases, 69 were male and 37 were female, with a mean age of onset of (54.6±13.1) years. The most common organs involved were lymph nodes (67.0%) , salivary glands (37.7%) , and pancreas (35.8%) . Single organ involvementoccurred in 17 patients (16.0%) . The median number of involved organs was 3 (2, 4) . Women had higher incidence of salivary gland involvement, lacrimal gland involvement as well as lower incidence of pancreatic involvement than men did (P