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Pulse interval is a biomarker of psychological and physiological health. Pulse interval can now be assessed using mobile phone apps, which expands researchers' ability to assess pulse interval in the real world. Prior to implementation, measurement accuracy should be established. This investigation evaluated the validity of the Light Heart mobile app to measure pulse interval and pulse rate variability in healthy young adults. Validity was assessed by comparing the pulse interval and SD of normal pulse intervals obtained by Light Heart to the gold standard, electrocardiogram (ECG), in 14 young healthy individuals (mean age 24, SD 5 years; n=9, 64% female) in a seated posture. Mean pulse interval (Light Heart: 859, SD 113 ms; ECG: 857, SD 112 ms) demonstrated a strong positive linear correlation (r=0.99; P<.001) and strong agreement (intraclass correlation coefficient=1.00, 95% CI 0.99-1.00) between techniques. The Bland-Altman plot demonstrated good agreement for the mean pulse interval measured with Light Heart and ECG with evidence of fixed bias (-1.56, SD 1.86; 95% CI -5.2 to 2.1 ms), suggesting that Light Heart overestimates pulse interval by a small margin. When Bland-Altman plots were constructed for each participant's beat-by-beat pulse interval data, all participants demonstrated strong agreement between Light Heart and ECG with no evidence of fixed bias between measures. Heart rate variability, assessed by SD of normal pulse intervals, demonstrated strong agreement between techniques (Light Heart: mean 73, SD 23 ms; ECG: mean 73, SD 22 ms; r=0.99; P<.001; intraclass correlation coefficient=0.99, 95% CI 0.97-1.00). This study provides evidence to suggest that the Light Heart mobile app provides valid measures of pulse interval and heart rate variability in healthy young adults.

Competitive mobile apps depend strongly on the development team’s ability to deliver successful releases, consistently and often. Although continuous integration took a more mainstream priority among the development industry, companies are starting to realize the importance of continuity beyond integration and testing. This book starts off with a brief introduction to fastlane—a robust command-line tool that enables iOS and Android developers to automate their releasing workflow. The book then explores and guides you through all of its features and utilities; it provides the reader a comprehensive understanding of the tool and how to implement them. Themes include setting up and managing your certificates and provisioning and push notification profiles; automating the creation of apps and managing the app metadata on iTunes Connect and the Apple Developer Portal; and building, distributing and publishing your apps to the App Store. You will also learn how to automate the generation of localized screenshots and mesh your continuous delivery workflow into a continuous integration workflow for a more robust setup. By the end of the book, you will gain substantial knowledge on delivering bug free, developer-independent, and stable application release cycle.

Learn how to solve blocking user experience and build event based reactive applications with Swift. Key Features Build fast and scalable apps with RxSwift Apply reactive programming to solve complex problems and build efficient programs with reactive user interfaces Take expressiveness, scalability, and maintainability of your Swift code to the next level with this practical guide Book Description RxSwift belongs to a large family of Rx implementations in different programming languages that share almost identical syntax and semantics. Reactive approach will help you to write clean, cohesive, resilient, scalable, and maintainable code with highly configurable behavior. This book will introduce you to the world of reactive programming, primarily focusing on mobile platforms. It will tell how you can benefit from using RxSwift in your projects, existing or new. Further on, the book will demonstrate the unbelievable ease of configuring asynchronous behavior and other aspects of the app that are traditionally considered to be hard to implement and maintain. It will explain what Rx is made of, and how to switch to reactive way of thinking to get the most out of it. Also, test production code using RxTest and the red/ green approach. Finally, the book will dive into real-world recipes and show you how to build a real-world app by applying the reactive paradigm. By the end of the book, you’ll be able to build a reactive swift application by leveraging all the concepts this book takes you through. What you will learn Understand the practical benefits of Rx on a mobile platform Explore the building blocks of Rx, and Rx data flows with marble diagrams Learn how to convert an existing code base into RxSwift code base Learn how to debug and test your Rx Code Work with Playgrounds to transform sequences by filtering them using map, flatmap and other operators Learn how to combine different operators to work with Events in a more controlled manner. Discover RxCocoa and convert your simple UI elements to Reactive components Build a complete RxSwift app using MVVM as design pattern Who this book is for This book is for the developers who are familiar with Swift and iOS application development and are looking out to reduce the complexity of their apps. Prior experience of reactive programming is not necessary.

Cardiac rehabilitation is central in reducing mortality and morbidity after myocardial infarction. However, the fulfillment of guideline-recommended cardiac rehabilitation targets is unsatisfactory. eHealth offers new possibilities to improve clinical care. This study aims to assess the effect of a web-based application designed to support adherence to lifestyle advice and self-control of risk factors (intervention) in addition to center-based cardiac rehabilitation, compared with cardiac rehabilitation only (usual care). All 150 patients participated in cardiac rehabilitation. Patients randomized to the intervention group (n=101) received access to the application for 25 weeks where information about lifestyle (eg, diet and physical activity), risk factors (eg, weight and blood pressure [BP]), and symptoms could be registered. The software provided feedback and lifestyle advice. The primary outcome was a change in submaximal exercise capacity (Watts [W]) between follow-up visits. Secondary outcomes included changes in modifiable risk factors between baseline and follow-up visits and uptake and adherence to the application. Regression analysis was used, adjusting for relevant baseline variables. There was a nonsignificant trend toward a larger change in exercise capacity in the intervention group (n=66) compared with the usual care group (n=40; +14.4, SD 19.0 W, vs +10.3, SD 16.1 W; P=.22). Patients in the intervention group achieved significantly larger BP reduction compared with usual care patients at 2 weeks (systolic -27.7 vs -16.4 mm Hg; P=.006) and at 6 to 10 weeks (systolic -25.3 vs -16.4 mm Hg; P=.02, and diastolic -13.4 vs -9.1 mm Hg; P=.05). A healthy diet index score improved significantly more between baseline and the 2-week follow-up in the intervention group (+2.3 vs +1.4 points; P=.05), mostly owing to an increase in the consumption of fish and fruit. At 6 to 10 weeks, 64% (14/22) versus 46% (5/11) of smokers in the intervention versus usual care groups had quit smoking, and at 12 to 14 months, the respective percentages were 55% (12/22) versus 36% (4/11). However, the number of smokers in the study was low (33/149, 21.9%), and the differences were nonsignificant. Attendance in cardiac rehabilitation was high, with 96% (96/100) of patients in the intervention group and 98% (48/49) of patients receiving usual care only attending 12- to 14-month follow-up. Uptake (logging data in the application at least once) was 86.1% (87/101). Adherence (logging data at least twice weekly) was 91% (79/87) in week 1 and 56% (49/87) in week 25. Complementing cardiac rehabilitation with a web-based application improved BP and dietary habits during the first months after myocardial infarction. A nonsignificant tendency toward better exercise capacity and higher smoking cessation rates was observed. Although the study group was small, these positive trends support further development of eHealth in cardiac rehabilitation. ClinicalTrials.gov NCT03260582; https://clinicaltrials.gov/ct2/show/NCT03260582. RR2-10.1186/s13063-018-3118-1.

Objective Trust and accessibility are vital to adoption of health and wellness apps. This research scoped three elements of cognitive accessibility of health app privacy policies: availability, ease of navigation, and readability. Methods For this cross-sectional study, quantitative data collected in the Netherlands, Sweden, and the United Kingdom included: whether privacy information was in a country's official language (availability); number of distracting visual elements (ease of navigation); word count and Common European Framework of Reference (CEFR) reading level (readability). Health app privacy policies were compared to policies from a purposively selected sample of websites, and to benchmarks, including CEFR reading level B1. Results Health app privacy policies were less often available in countries’ official languages compared to sampled websites (Chi-Square [1, 180]  =  57.470, p < 0.001) but contained fewer distracting visual elements. More UK privacy policies were in the country's official language, whereas Swedish privacy policies contained fewest words and fewest potentially distracting design elements. Only one privacy policy met the CEFR reading level benchmark. Conclusions Lack of privacy information in non-Anglophone app-users’ native languages and high reading levels may be major barriers to cognitive accessibility. Web and app developers should consider recommendations arising from this study, to stimulate trust in and adoption of health and wellness apps.

A decline in physical functioning can result in a loss of independence, particularly in older adults. Information and communications technologies supporting physical activity, such as fitness apps, are perceived as promising tools to increase activity levels. However, only little is known about fitness apps' impact on older people's abilities and skills to accomplish activities of daily living. In this study, we aimed to investigate whether a newly developed app-based physical activity program improves self-perceived physical functioning or at least prevents a functional decline in older adults. We targeted older adults in their early years of retirement and conducted a randomized waitlist-controlled trial in Austria. The app-based program was received by the intervention group (IG) for a period of 14 weeks first; afterwards, the IG handed over the devices to the control group (CG). Both groups had 3 appointments with a fitness coach. The app comprised 3 functions, a multicomponent fitness exercise program, recommendations for outdoor activities, and e-learning courses. Self-perceived physical functioning was measured by 4 common daily life activities rated on 6-point scales. Data were collected through online surveys at 3 time points, 8 weeks before intervention start (t-1), at intervention start (t0), and 14 weeks later at the end of the intervention (t1). We estimated generalized linear mixed models and derived average marginal effects. The effects are presented as differences in percentage points resulting from differences in estimated probabilities between groups before and after the intervention. A total of 219 participants between 60 and 72 years, 96 in the IG and 123 in the CG, were analyzed. The intervention significantly increased the self-perceived abilities of \"climb up stairs and carry something\" (odds ratio [OR] 2.67, 95% CI 1.37-5.18; P=.004) and of \"lift and carry groceries\" (OR 1.99, 95% CI 1.02-3.89; P=.04). On the contrary, no significant impact on the ability to \"walk 1 km\" (OR 1.91, 95% CI 0.85-4.30; P=.12) and \"stretch to the toes\" (OR 1.31, 95% CI 0.62-2.76; P=.48) was found. The probability of rating \"climb up stairs and carry something\" as \"very easy\" increased by 8.8 percentage points (95% CI 2.6-14.9; P=.005) and \"lift and carry groceries\" by 7.9 percentage points (95% CI 0.5-15.3; P=.04). Predicted probabilities showed that outcomes improved in the IG and remained unchanged in the CG. Although the fitness app was designed as a multicomponent program, it supported only selected capabilities relevant for independent living. The app-based physical activity program increased self-perceived physical functioning related to strength, endurance, and balance, but not to flexibility. This highlights a clear need for future apps and research to focus on all relevant areas, including flexibility and mobility, which are crucial for fully maintaining independence in older adults.

Dementia is on the rise globally due to increasing life expectancies and population growth. Digital technologies may help detect early signs, enabling timely interventions to slow or reverse cognitive decline. However, to support the successful implementation of these digital technologies into health care settings, they must be acceptable to target users. Older adults and those with mild cognitive impairment (MCI) are at risk of developing dementia in later life and need to be able to use these technologies in order for this intervention to be approved and implemented in clinical practice. This study explored the perspectives of older adults and those living with a clinical diagnosis of MCI on the acceptability of using various digital technologies that have the potential to support early dementia detection. Participants were recruited from Boston University's Alzheimer's Disease Research Center. Participants selected at least 2 technologies from 9 different wearables and software to use for 2 weeks, at 3-month intervals, over a total duration of 2 years. A subgroup of self-selecting participants was interviewed after the first 2 weeks of use to gather initial perspectives regarding the acceptability of using the digital technologies. An inductive framework thematic analysis approach was used, assisted by NVivo (version 14.23.2; QSR International). In total, 13 individuals living with a clinical diagnosis of MCI and 11 adults aged 65 years and older were interviewed. Our analysis identified five key themes: (1) gamification, (2) wearability, (3) user guidance, (4) burden of use, and (5) usefulness. Gamified apps were generally liked, although users with little experience of digital games needed time to adjust. Wearables resembling everyday accessories (eg, watches) were preferred, but complaints about tight or uncomfortable straps were frequently reported. Clear instructions were critical to support correct use, but many participants would have liked more troubleshooting support when technical issues arose. The use of 5 or more devices led to a high burden, especially when devices had practicality issues such as not being waterproof. Devices offering personal feedback were perceived as useful to satisfy personal interests, though some questioned their usefulness within health care. Participants raised concerns about losing valued personal interactions with health care professionals and questioned how their existing health conditions and treatment for such conditions may affect the validity of the data collected by the devices. These findings can guide researchers in choosing appropriate devices and minimizing burden. Future work should explore the views of those experiencing digital exclusion to ensure equitable access to dementia-detection technologies.

The Android team has announced first-class support for Kotlin 1.1. This acts as an added boost to the language and more and more developers are now looking at Kotlin for their application development. This recipe-based book will be your guide to learning the Kotlin programming language. The recipes in this book build from simple language concepts to more complex applications of the language. After the fundamentals of the language, you will learn how to apply the object-oriented programming features of Kotlin 1.1. Programming with Lambdas will show you how to use the functional power of Kotlin. This book has recipes that will get you started with Android programming with Kotlin 1.1, providing quick solutions to common problems encountered during Android app development. You will also be taken through recipes that will teach you microservice and concurrent programming with Kotlin. Going forward, you will learn to test and secure your applications with Kotlin. Finally, this book supplies recipes that will help you migrate your Java code to Kotlin and will help ensure that it's interoperable with Java.

Pulmonary hypertension (PH) is a chronic and complex condition, requiring consistent management and education. The widespread use of smartphones has opened possibilities for mobile health apps to support both patients and health care professionals in monitoring and managing PH more effectively. This study aimed to identify and assess the quality of free smartphone apps for PH targeted at either patients or health care professionals. A systematic search was conducted on freely available apps for patients with PH and health care professionals, accessed from a Spanish IP address, on Android (Google Play) and iOS (App Store) platforms. Searches were performed in October 2022 and 2023. Apps were independently analyzed by two reviewers, focusing on general characteristics. Quality assessment was based on the Mobile Application Rating Scale (MARS) framework, and Mann-Whitney U tests compared mean MARS scores against specific variables. In the overall study, 21 apps were identified. In the 2022 search, 19 apps were listed (9 iOS, 7 Android, 3 available on both platforms). In the subsequent 2023 search, 16 apps were identified (6 Android, 7 iOS, 3 available on both platforms). Of those identified in 2022, 14 remained available in 2023, with only 7 updated since 2022. In addition, 12 apps targeted patients or the general population, while 9 targeted health care professionals; none involved patients in the development or design. Conversely, 13 apps involving health care professionals were identified. There were 10 apps that received pharmaceutical industry funding. The primary goal for 81% (17/21) of the apps was to disseminate general information about PH. The overall mean MARS quality was acceptable in 2022 and 2023, with mean ratings of 3.1 (SD 0.6) and 3.3 (SD 0.5), respectively. The functionality category achieved the highest scores in both years, indicating ease of use and intuitive navigation. In contrast, the subjective quality domain consistently received the lowest ratings in the MARS assessment across both years. None of the apps underwent clinical testing themselves; however, 2 incorporated tools or algorithms derived from trials. The overall quality of iOS apps statistically outperformed that of Android apps in both years (P<.05). Furthermore, the involvement of health care professionals in app development was associated with enhanced quality, a trend observed in both years (P=.003 for both years). This review of mobile health apps for PH reveals their emergent development stage, with generally acceptable quality but lacking refinement. It highlights the critical role of health care professionals in app development, as they contribute significantly to quality and reliability. Despite this, a notable stagnation in app quality and functionality improvement over 2 years points to a need for continuous innovation and clinical validation for effective clinical integration. This research advocates for future app developers to actively engage with health care professionals, integrate patient insights, and mandate rigorous clinical validation for PH management.

The effects of smartphone use on mental health and brain activity in adolescents have received much attention; however, the effects on older adults have received little attention. As more and more older adults begin to use smartphones, exploring the effects of nonaddictive smartphone use on mental health, cognitive function, and brain activity in older adults is imperative. This study aimed to examine differences in cognitive performance, emotional symptoms (depression, anxiety, and insomnia), and brain functional activity between older adults who use smartphones and those who do not. A total of 1014 community-dwelling older adults aged 60 years and above were surveyed in a rural area of China. Participants were categorized into 2 groups based on their smartphone use status. The Patient Health Questionnaire, Generalized Anxiety Disorder Scale, Insomnia Severity Index, and Montreal Cognitive Assessment-Basic were used to evaluate the symptoms of depression, anxiety, insomnia, and cognitive function of the participants by trained medical staff. To explore neural mechanisms, a subsample of 130 participants (89 smartphone users and 41 nonusers) was selected using stratified random sampling for resting-state functional magnetic resonance imaging scanning. Participants with contraindications for magnetic resonance imaging (eg, metal implants or claustrophobia) or who refused to participate were excluded. Functional brain activity was analyzed and compared between groups. Among all 1015 older adults, 641 reported using smartphones, while 373 reported never using smartphones. Older adults who use smartphones exhibited better cognitive function compared with those who never use smartphones (z=3.806, P<.001), especially in the domains of fluency (z=3.025, P=.002) and abstraction (z=5.311, P<.001). However, there were no significant differences in levels of depression (z=0.689, P=.49), anxiety (z=0.934, P=.35), and insomnia (z=0.340, P=.73). In terms of the magnetic resonance imaging findings, a total of 130 participants completed functional magnetic resonance imaging scanning, including 89 who use smartphones and 41 who never use smartphones, and results showed that older adults who were smartphone users exhibited higher degree centrality values in the left parahippocampal gyrus. These findings suggest that smartphone use among older adults is associated with better cognitive performance and fewer emotional symptoms, potentially linked to enhanced brain activity in key cognitive regions. Promoting digital engagement may offer cognitive and emotional benefits for aging populations. Longitudinal studies are warranted to examine causal relationships.