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Background: Arrhythmias and heart failure are common and invalidating sequelae in adult patients with congenital heart disease (CHD). Mobile health (m-Health) enables daily monitoring and a timely response that might prevent deterioration. We present an observational prospective registry to evaluate feasibility of an m‑Health telemonitoring program for managing arrhythmia, heart failure and blood pressure in symptomatic adults with CHD.Methods: Symptomatic adult patients with CHD are enrolled in an m‑Health telemonitoring program, which evaluates single-lead ECG, blood pressure and weight measurements. In case of symptoms extra measurements could be performed. Data are collected by mobile apps, matched with individualised thresholds. Patients are contacted if thresholds were exceeded or if arrhythmias were found, for treatment adjustments or reassurance. Data on emergency care utilisation, hospitalisation and patient-reported outcome measures are used to assess quality of life and self-management.Results: 129 symptomatic CHD patients were invited to participate, 55 participated. Reasons for refusing consent included too time consuming to participate in research (30) and to monitor vital signs (14). At baseline 22 patients were in New York Heart Association class ≥ II heart failure, 43 patients had palpitations or documented arrhythmias, and 8 had hypertension. Mean follow-up was 3.0 months, one patient dropped out, and adherence was 97%.Conclusion: The first results indicate that this program is feasible with high adherence. [ABSTRACT FROM AUTHOR]

We evaluated current experiences and future needs for the long-term engagement of patients in a hypertension hybrid care pathway (Maasstad Hospital, NL). Patients >18 y/o with ≥3 months care pathway participation were recruited by telephone and divided into three age/focus groups with distinct digital skills and attitudes toward lifestyle interventions (group 1:18-40 y/o, group 2:40-65 y/o, group 3:>65 y/o). We used deductive thematic content analysis to cluster the results to the different digital elements (remote monitoring, communication, digital lifestyle intervention) of the care pathway. Fifteen patients were interviewed in March 2023 (Group 1;2;3, 3;6;6 participants). The care pathway improved disease insight, engagement, and shared decision capabilities in all groups. For further improved adherence and engagement, all patients indicated the need to incorporate a more personalized approach and interaction with their healthcare provider. In addition, the oldest group preferred simplification of the telemonitoring application, while the other groups preferred enrichment with more complex information. To ensure optimal engagement, digital elements in hybrid care pathways should be personalized and tailored to individual as well as to age-specific needs., Competing Interests: Job van Steenkiste, MD: nothing to declare. Iris Verberk-Jonkers, MD, PhD: nothing to declare. Stephanie de Koning, CNS: nothing to declare. Joyce Voss-de Haan, CNS: nothing to declare. Bianca Verhagen, Msc: nothing to declare. Daan Dohmen, Prof, PhD: Prof. D. Dohmen is the CEO of Luscii, the involved HBPT platform used in the Maasstad hospital which was evaluated in this study. There was no financial support provided by Luscii to facilitate this study., (© The Author(s) 2024.)

Human language follows statistical regularities or linguistic laws. For instance, Zipf's law of brevity states that the more frequently a word is used, the shorter it tends to be. All human languages adhere to this word structure. However, it is unclear whether Zipf's law emerged de novo in humans or whether it also exists in the non-linguistic vocal systems of our primate ancestors. Using a vocal conditioning paradigm, we examined the capacity of marmoset monkeys to efficiently encode vocalizations. We observed that marmosets adopted vocal compression strategies at three levels: (i) increasing call rate, (ii) decreasing call duration and (iii) increasing the proportion of short calls. Our results demonstrate that marmosets, when able to freely choose what to vocalize, exhibit vocal statistical regularities consistent with Zipf's law of brevity that go beyond their context-specific natural vocal behaviour. This suggests that linguistic laws emerged in non-linguistic vocal systems in the primate lineage.

Background: Despite the fact that 95% of the global population has a mobile phone, the adoption of mHealth lags among people with a low socio-economic position (SEP). As they face health risks and many barriers in the traditional offline healthcare system, mHealth has an important role. Therefore, it is important to understand the factors that promote and impede mHealth adoption among people with a lower SEP., Objective: The current study aims to provide an overview of what is known about the facilitators and barriers to the adoption and use of autonomous mHealth applications among people with low SEP., Methods: A PRISMA scoping review in which the scientific databases PubMed, Web of Science, PsychInfo and SocINDEX were searched in the period of March 2017 to March 2022., Results: Of the 1827 indexed papers, 13 papers were included in the review. In these papers, 30 factors have been identified as promoting or hindering the adoption of autonomous mHealth applications among low SEP people., Conclusions: Thirty factors were found to facilitate or impede mHealth adoption among people with a low SEP, categorised into intrapersonal, interpersonal, community, ecological and app specific levels. Factors are assumed to be interrelated. The relationship between traditional (offline) care and digital care appeared to be of particular interest as the current study revealed that face-to-face contact is a prerequisite of mHealth adoption among people with low SEP. Therefore, a well-structured cosmopolitan system of stakeholders has been recommended., Trial Registration: This study was registered in OSF (https://doi.org/10.17605/OSF.IO/ATU9D)., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article., (© The Author(s) 2023.)

Background: During the COVID-19 pandemic, there was limited adoption of contact-tracing apps (CTAs). Adoption was particularly low among vulnerable people (eg, people with a low socioeconomic position or of older age), while this part of the population tends to have lesser access to information and communication technology and is more vulnerable to the COVID-19 virus., Objective: This study aims to understand the cause of this lagged adoption of CTAs in order to facilitate adoption and find indications to make public health apps more accessible and reduce health disparities., Methods: Because several psychosocial variables were found to be predictive of CTA adoption, data from the Dutch CTA CoronaMelder (CM) were analyzed using cluster analysis. We examined whether subgroups could be formed based on 6 psychosocial perceptions (ie, trust in the government, beliefs about personal data, social norms, perceived personal and societal benefits, risk perceptions, and self-efficacy) of (non)users concerning CM in order to examine how these clusters differ from each other and what factors are predictive of the intention to use a CTA and the adoption of a CTA. The intention to use and the adoption of CM were examined based on longitudinal data consisting of 2 time frames in October/November 2020 (N=1900) and December 2020 (N=1594). The clusters were described by demographics, intention, and adoption accordingly. Moreover, we examined whether the clusters and the variables that were found to influence the adoption of CTAs, such as health literacy, were predictive of the intention to use and the adoption of the CM app., Results: The final 5-cluster solution based on the data of wave 1 contained significantly different clusters. In wave 1, respondents in the clusters with positive perceptions (ie, beneficial psychosocial variables for adoption of a CTA) about the CM app were older (P<.001), had a higher education level (P<.001), and had higher intention (P<.001) and adoption (P<.001) rates than those in the clusters with negative perceptions. In wave 2, the intention to use and adoption were predicted by the clusters. The intention to use CM in wave 2 was also predicted using the adoption measured in wave 1 (P<.001, β=-2.904). Adoption in wave 2 was predicted by age (P=.022, exp(B)=1.171), the intention to use in wave 1 (P<.001, exp(B)=1.770), and adoption in wave 1 (P<.001, exp(B)=0.043)., Conclusions: The 5 clusters, as well as age and previous behavior, were predictive of the intention to use and the adoption of the CM app. Through the distinguishable clusters, insight was gained into the profiles of CM (non)intenders and (non)adopters., Trial Registration: OSF Registries osf.io/cq742; https://osf.io/cq742., (©Tessi M Hengst, Lilian Lechner, Laura Nynke van der Laan, Arjen Hommersom, Daan Dohmen, Lotty Hooft, Esther Metting, Wolfgang Ebbers, Catherine A W Bolman. Originally published in JMIR Formative Research (https://formative.jmir.org), 20.06.2023.)

Background: Reliable and objective assessment of psychomotor skills in physiotherapy students' education is essential for direct feedback and skill improvement. The aim of this study is to determine the interrater reliability in the assessment process of physiotherapy students and to analyse the assessment behaviour of the examiners., Methods: Physiotherapy teachers from two different schools assessed students from two different schools performing proprioceptive neuromuscular facilitation (PNF) patterns. An evaluation sheet with a 6-point rating scale and 20 evaluation criteria including an overall rating was used for assessment. The interrater reliability was determined calculating an intraclass-correlation coefficient (ICC) and Krippendorff's alpha. The assessment behaviour of the examiners was further analysed calculating the location parameters and showing the item response distribution over item in form of a Likert plot., Results: The ICC estimates were mostly below 0.4, indicating poor interrater reliability. This was confirmed by Krippendorff's alpha. The examiners showed a certain central tendency and intergroup bias., Discussion and Conclusion: The interrater reliability in this assessment format was rather low. No difference between the two physiotherapy schools concerning the interrater reliability could be identified. Despite certain limitations of this study, there is a definite need for improvement of the assessment process in physiotherapy education to provide the students with reliable and objective feedback and ensure a certain level of professional competence in the students., Trial Registration: The study was approved by the ethics committee of the Medical Faculty RWTH Aachen University (EK 340/16)., (© 2022. The Author(s).)

Marmosets have attracted significant interest in the life sciences. Similarities with human brain anatomy and physiology, such as the granular frontal cortex, as well as the development of transgenic lines and potential for transferring rodent neuroscientific techniques to small primates make them a promising neurodegenerative and neuropsychiatric model system. However, whether marmosets can exhibit complex motor tasks in highly controlled experimental designs-one of the prerequisites for investigating higher-order control mechanisms underlying cognitive motor behavior-has not been demonstrated. We show that marmosets can be trained to perform vocal behavior in response to arbitrary visual cues in controlled operant conditioning tasks. Our results emphasize the marmoset as a suitable model to study complex motor behavior and the evolution of cognitive control underlying speech.