Nevin Manimala

JMIR Mhealth Uhealth. 2025 Apr 4;13:e65782. doi: 10.2196/65782.

ABSTRACT

BACKGROUND: Cardiovascular diseases (CVDs) continue to be the leading cause of global morbidity and mortality. Aiming to reduce the risk of CVD development and better manage them, an increasing number of individuals are adopting mobile health (mHealth) apps and wearable devices (wearables). These technologies provide critical insights into heart health and fitness, supporting users to monitor their lifestyle behaviors and adhere to preventative medication.

OBJECTIVE: In this review, we aimed to investigate the current state of mHealth apps and wearables designed for cardiovascular health, with a specific focus on the DACH region (Germany, Austria, and Switzerland). We assessed the benefits these technologies provide to clinicians and patients, particularly in addressing unmet needs like sex-specific symptoms, while also examining their potential integration into the broader health care ecosystem.

METHODS: To identify heart health apps, a keyword search was performed on both the Swiss Apple App Store and Google Play Stores. A separate search was performed on Google to identify heart health wearables. The identified apps and wearables were evaluated using the foundational and contextual criteria of the sociotechnical framework for assessing patient-facing eHealth tools.

RESULTS: After filtering out apps and wearables that did not meet our inclusion criteria, 20 apps and 22 wearables were included in the review. While all the apps were available in the DACH region, only 30% (6/20) were specifically designed for these countries. Only 25% (5/20) of the apps included sex-specific information; 40% (8/20) provided information from evidence-based research, 35% (7/20) provided general health information without academic and clinical references, and 25% (5/20) did not include any evidence-based or general health information. While 20% (4/20) of the included apps had clinical integration features such as clinician dashboards, only 10% (2/20) had the potential to effectively enhance clinician workflows. Privacy policies were present in 95% (19/20) of the apps, with 75% (15/20) adhering to General Data Protection Regulation (GDPR) regulations; 1 app had no data protection policy. Only 20% (4/20) of the apps were medically certified. For wearables, only 9% (2/22) were tailored to the DACH region, and 40% (9/22) addressed women’s health. While around 60% (13/22) offered features to support clinical integration, only 9% (2/22) had the potential to improve clinical workflows. More than half (12/22) of the wearables were medically certified, and 77% (17/22) referenced scientific or peer-reviewed research. All wearables included a privacy policy.

CONCLUSIONS: While many mHealth tools for cardiovascular health are available, only a few provide meaningful value to both patients and clinicians or have the potential to integrate effectively into the health care system. Women’s sex-specific needs are often overlooked, and the benefits for clinicians are limited. In addition, mHealth apps largely lack robust evidence, whereas wearables showed comparatively stronger support through evidence-based and medical certification.

PMID:40184552 | DOI:10.2196/65782

Invest Radiol. 2025 Apr 7. doi: 10.1097/RLI.0000000000001186. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of the study was to compare the diagnostic quality of deep learning (DL) reconstructed balanced steady-state free precession (bSSFP) single-shot (SSH) cine images with standard, multishot (also: segmented) bSSFP cine (standard cine) in cardiac MRI.

METHODS AND MATERIALS: This prospective study was performed in a cohort of participants with clinical indication for cardiac MRI. SSH compressed-sensing bSSFP cine and standard multishot cine were acquired with breath-holding and electrocardiogram-gating in short-axis view at 1.5 Tesla. SSH cine images were reconstructed using an industry-developed DL super-resolution algorithm (DL-SSH cine). Two readers evaluated diagnostic quality (endocardial edge definition, blood pool to myocardium contrast and artifact burden) from 1 (nondiagnostic) to 5 (excellent). Functional left ventricular (LV) parameters were assessed in both sequences. Edge rise distance, apparent signal-to-noise ratio (aSNR) and contrast-to-noise ratio were calculated. Statistical analysis for the comparison of DL-SSH cine and standard cine included the Student’s t-test, Wilcoxon signed-rank test, Bland-Altman analysis, and Pearson correlation.

RESULTS: Forty-five participants (mean age: 50 years ±18; 30 men) were included. Mean total scan time was 65% lower for DL-SSH cine compared to standard cine (92 ± 8 s vs 265 ± 33 s; P < 0.0001). DL-SSH cine showed high ratings for subjective image quality (eg, contrast: 5 [interquartile range {IQR}, 5-5] vs 5 [IQR, 5-5], P = 0.01; artifacts: 4.5 [IQR, 4-5] vs 5 [IQR, 4-5], P = 0.26), with superior values for sharpness parameters (endocardial edge definition: 5 [IQR, 5-5] vs 5 [IQR, 4-5], P < 0.0001; edge rise distance: 1.9 [IQR, 1.8-2.3] vs 2.5 [IQR, 2.3-2.6], P < 0.0001) compared to standard cine. No significant differences were found in the comparison of objective metrics between DL-SSH and standard cine (eg, aSNR: 49 [IQR, 38.5-70] vs 52 [IQR, 38-66.5], P = 0.74). Strong correlation was found between DL-SSH cine and standard cine for the assessment of functional LV parameters (eg, ejection fraction: r = 0.95). Subgroup analysis of participants with arrhythmia or unreliable breath-holding (n = 14/45, 31%) showed better image quality ratings for DL-SSH cine compared to standard cine (eg, artifacts: 4 [IQR, 4-5] vs 4 [IQR, 3-5], P = 0.04).

CONCLUSIONS: DL reconstruction of SSH cine sequence in cardiac MRI enabled accelerated acquisition times and noninferior diagnostic quality compared to standard cine imaging, with even superior diagnostic quality in participants with arrhythmia or unreliable breath-holding.

PMID:40184545 | DOI:10.1097/RLI.0000000000001186

ACS Sens. 2025 Apr 4. doi: 10.1021/acssensors.4c03260. Online ahead of print.

ABSTRACT

Raman spectroscopy in biological applications faces challenges due to complex spectra, characterized by peaks of varying widths and significant biological background noise. Convolutional neural networks (CNNs) are widely used for spectrum classification due to their ability to capture local peak features. In this study, we introduce a multiscale CNN designed to detect weak biomolecule signals and differentiate spectra with features that cannot be statistically distinguished. The approach is further enhanced by a new visualization technique tailored for multiscale spectral analysis, providing clear insights into classification results. Using the classification of cholera toxin B subunit (CTB)-treated versus untreated cell membrane samples, whose spectra cannot be statistically differentiated, the optimized multiscale CNN achieved superior performance compared to traditional machine learning methods and existing multiscale CNNs, with accuracy (99.22%), sensitivity (99.27%), specificity (99.16%), and precision (99.20%). Our new visualization method, based on gradients of activation maps with respect to class scores, generates saliency scores that capture sample variations, with decision-making relying on consistently identified peak features. By visualizing the effects of different kernel sizes, Grad-AM highlights features at varying scales, aligning closely with spectral features and enhancing CNN interpretability in complex biomolecular analysis. These advancements demonstrate the potential of our method to improve spectral analysis and reveal previously hidden peaks in complex biological environments.

PMID:40184533 | DOI:10.1021/acssensors.4c03260

Adv Skin Wound Care. 2025 Apr 4. doi: 10.1097/ASW.0000000000000306. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effects of extra-virgin olive and almond oils on maintaining skin integrity in neonates admitted to the neonatal ICU.

METHODS: This was a semiexperimental study. The sample comprised 120 term (37-42 weeks) neonates treated in a state hospital in Istanbul, Turkey (May-August 2023), who met the sample criteria (olive oil: 60, almond oil: 60). The data were collected using a newborn identification form, the Neonatal Skin Condition Score, and the DMM Skin Moisture Meter.

RESULTS: The neonates’ sex, gestational age, postnatal age, birth weight, length, and head circumference measurements were similar, suggesting no significant differences between the groups (Ps > .05). A statistically significant difference was found between the mean skin hydration levels of neonates treated with almond oil and extra-virgin olive oil on the first, second, and third days of the application, where a higher skin hydration was determined in the extra-virgin olive oil group (P = .024, P = .004, P = .020). However, no statistically significant difference was found between the Neonatal Skin Condition Score scores of neonates treated with almond oil and extra-virgin olive oil before and on all days of the application (1-5 days, P > .05).

CONCLUSIONS: Both extra-virgin olive oil and almond oil increased the stratum corneum hydration in term neonates. The application of extra-virgin olive oil and almond oil did not result in any adverse effects on neonatal skin conditions of neonates admitted to the neonatal ICU.

PMID:40184517 | DOI:10.1097/ASW.0000000000000306

Adv Skin Wound Care. 2025 Apr 2. doi: 10.1097/ASW.0000000000000300. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the application of telemedicine in patients with an ostomy and assess the current research status.

DATA SOURCES: The authors searched PubMed, EMBASE, Web of Science, Ovid, CINAHL (Cumulative Index to Nursing and Allied Health Literature), China Biology Medicine, China National Knowledge Infrastructure, WanFang, and VIP (Chinese Scientific Journals Database) databases from the inception of each database to March 2024.

STUDY SELECTION: A total of 41 articles comparing telemedicine and standard care in ostomy patients were included.

DATA EXTRACTION: Information was extracted from full-text articles, including author(s), year, country, study design, ostomy type, sample characteristics, intervention type, duration, and outcomes.

DATA SYNTHESIS: In the 41 studies, telemedicine intervention tools encompass social and conference software, mobile healthcare apps, and remote devices. Intervention durations ranged from 4 weeks to 3 years. The intervention content can be categorized into seven key aspects: health guidance, health counseling, psychological care, peer support, medical appointment scheduling, information statistics, and remote visits. Evaluation of these interventions involves measuring outcomes in 10 areas, including quality of life, ostomy knowledge, self-efficacy, self-care ability, stoma complications, participant satisfaction, psychology, coping and adaptation, burden, and health condition.

CONCLUSIONS: The implementation of telemedicine for patients with an ostomy has had a profound impact. As internet technology evolves, optimization of platforms and longer interventions are needed. Healthcare professionals should enhance their training in online communication. In addition, researchers should design specific, specialized measurement scales based on the characteristics of patients with stomas.

PMID:40184509 | DOI:10.1097/ASW.0000000000000300

Eur J Endocrinol. 2025 Apr 4:lvaf060. doi: 10.1093/ejendo/lvaf060. Online ahead of print.

ABSTRACT

BACKGROUND: Congenital Adrenal Hyperplasia (CAH) due to 21-hydroxylase deficiency (21OHD) affects approximately 1 in 15,000 individuals. We leveraged the power of multicentre registry data to assess the trend and predictors of blood pressure (BP) within children and young persons with 21OHD to inform monitoring strategies.

METHOD: Data from the International CAH Registry in patients younger than 20 years was compared to normative values. Values of BP were modelled to create reference curves, multiple change point analysis applied to quantify the difference with normative data. Covariate adjustment was informed by a directed acyclic graph, prior to joint outcome regression modelling to accurately assess predictors of BP.

RESULTS: A total of 6436 visits within 554 patients (52.5% females) showed BP-Standard deviation scores (SDS) were higher at younger ages. Patients under five years had systolic BP-SDS of 1.6 (Q1:0.6-Q3:2.7) decreasing to 1.0 (Q1:0.2-Q3:1.8) over five years, equating to 31.0% over the 95th centile decreasing to 15.0%. Higher doses of fludrocortisone were associated with a small increase in systolic BP equivalent to 1.2mmHg with every 100 micrograms extra fludrocortisone. Renin of 100µU/ml was associated with 4.6mmHg lower systolic BP than a renin of 1µU/ml, higher 17OH-progesterone and androstenedione also predicted lower systolic and diastolic BP (p<0.05).

CONCLUSION: Higher BP in children with 21OHD is common and particularly pronounced at a younger age, but may not be attributable to excessive mineralocorticoid replacement. There is a need to improve our understanding of the determinants of this raised BP as well as its long-term effects.

PMID:40184493 | DOI:10.1093/ejendo/lvaf060

Gynecol Endocrinol. 2025 Dec;41(1):2487498. doi: 10.1080/09513590.2025.2487498. Epub 2025 Apr 4.

ABSTRACT

To date, there remains a paucity of prospective studies examining the association between premature ovarian insufficiency (POI) and cardiovascular diseases (CVD). The objective of this study was to investigate the potential association between POI and CVD utilizing the method of Mendelian randomization (MR). MR analyses utilized summary statistics from the most extensive genome-wide association studies (GWAS) on POI and CVD extracted from European ancestry cohorts and the FinnGen biobank. The inverse variance-weighted (IVW) method was the primary MR analysis technique. Supplementary analyses were performed using MR-Robust Adjusted Profile Score (MR-RAPS). Cochran’s Q statistic, MR-Egger, and weighted median MR models were employed to further assess heterogeneity and horizontal pleiotropy. Causal effects of POI on coronary heart disease (odds ratio [OR] = 1.048, 95% confidence interval [CI]: 1.006-1.091; p = 0.023)] and ischemic stroke (OR = 1.010, 95% CI: 1.000-1.020; p = 0.0498) were found. However, we did not observe a significant correlation between POI and hypertension (OR = 0.999, 95% CI: 0.994-1.004, p = 0.691), heart failure (OR = 1.009, 95% CI: 0.999-1.020, p = 0.0725), atrial fibrillation (OR = 0.995, 95% CI: 0.986-1.004, p = 0.3035), and myocardial infarction (OR = 1.002, 95% CI: 0.991-1.013, p = 0.7061). POI was causally associated with coronary heart disease and ischemic stroke, with no apparent impact on hypertension, heart failure, atrial fibrillation, or myocardial infarction. The causal relationship between POI and CVD underscores the imperative for proactive cardiovascular risk management in individuals with POI.

PMID:40184471 | DOI:10.1080/09513590.2025.2487498

PLoS One. 2025 Apr 4;20(4):e0321177. doi: 10.1371/journal.pone.0321177. eCollection 2025.

ABSTRACT

OBJECTIVE: The Chinese version of Dietary Sodium Restriction Questionnaire (DSRQ) was adapted to evaluate its reliability and validity for measuring adherence to a sodium-restricted diet in peritoneal dialysis (PD) patients.

METHODS: Specific items related to peritoneal dialysis were added to create a PD version of the DSRQ (PD-DSRQ), which was administered to 135 patients undergoing PD. Item analysis was performed using the critical ratio and homogeneity tests. The reliability of the questionnaire was determined by assessing the internal consistency. Content validity was evaluated using the expert evaluation method, and construct validity was assessed via exploratory and confirmatory factor analyses.

RESULTS: The item analysis revealed correlation coefficients (R-values) ranging from 0.311 to 0.745 for each item, with statistically significant differences between the high and low subgroups for all items. The Cronbach’s α coefficients for the overall PD-DSRQ and the attitude, subjective norm, and perceived behavioral control subscales were 0.805, 0.892, 0.794, and 0.889, respectively. The item-level content validity index ranged from 0.83 to 1.00, and the scale-level content validity index/universal agreement was 0.9894. Exploratory factor analysis identified a three-factor structure consistent with the original DSRQ, except for Question 18. The three factors had eigenvalues of 5.302, 4.179, and 1.290, which explained 64.32% of the variance. The average variance extracted for each dimension was 0.5777, 0.5654, and 0.5259, and the composite reliability values were 0.8864, 0.7956, and 0.8802, respectively, demonstrating good convergent and discriminant validity.

CONCLUSION: The PD-DSRQ encompasses general information and three dimensions: attitude, subjective norms, and perceived behavioral control. The questionnaire demonstrated strong reliability and validity, making it a reliable tool for assessing adherence to sodium-restricted diets in patients undergoing PD.

PMID:40184402 | DOI:10.1371/journal.pone.0321177

PLoS One. 2025 Apr 4;20(4):e0320795. doi: 10.1371/journal.pone.0320795. eCollection 2025.

ABSTRACT

Youth unemployment in the East Gojjam Zone is a critical issue. This study focuses on identifying the factors that influence unemployment duration and evaluating the impact of job creation programs on the well-being of youth in this region. We employed Cox regression to analyze the determinants of unemployment duration and used propensity score matching to assess the welfare effects of job creation initiatives. Our multistage cluster sampling revealed a youth unemployment rate of 33.3% (95% CI: 27.3-39.3). Over half of the unemployed youth transitioned to employment within four years, with 25% securing jobs within two years. Participation in job creation programs led to an average earnings increase of 1,069.716 birr, though retention in these programs was low at 49%. The findings reveal a connection between prolonged unemployment, skill mismatches, financial constraints, limited work experience, weak social networks, low income, and a preference for public-sector employment. To effectively address these challenges, interventions must focus on improving job accessibility, aligning vocational training with labor market needs, promoting financial inclusion, and enhancing social support systems.

PMID:40184397 | DOI:10.1371/journal.pone.0320795

PLoS One. 2025 Apr 4;20(4):e0321471. doi: 10.1371/journal.pone.0321471. eCollection 2025.

ABSTRACT

Respiratory health and chronic disease risks are prevalent concerns in agricultural communities in Northern Thailand, prompting an assessment of these issues among residents in Chiang Mai. A cross-sectional study involving 145 participants was conducted in San Pa Tong District from October to December 2023, utilizing structured questionnaires and spirometry tests to evaluate lung function and chronic health disease risk. The study found that education and income significantly impacted lung function, with better FVC% and FEV1/FVC% predicted values observed in those with primary education and lower income. Lower DM risk was associated with better lung function (P = 0.023). Logistic regression showed a significant increase in lung function impairment among participants with high to very high DM risk (aOR 9.06, p < 0.05). High CV and COPD risk levels also correlated with lung function impairment, though not all results were statistically significant. The results emphasize the intricate interplay between socioeconomic factors, chronic disease risks, and lung function, advocating for public health interventions that holistically address population respiratory and metabolic health.

PMID:40184396 | DOI:10.1371/journal.pone.0321471