1. Review and comparative evaluation of mobile apps for cardiovascular risk estimation: usability evaluation using mHealth app usability questionnaireAdrijana Svenšek, Lucija Gosak, Mateja Lorber, Gregor Štiglic, Nino Fijačko, 2025, original scientific article Abstract: Background: Cardiovascular diseases (CVD) are the leading cause of death and disability worldwide, and their prevention is a major public health priority. Detecting health issues early and assessing risk levels can significantly improve the chances of reducing mortality. Mobile apps can help estimate and manage CVD risks by providing users with personalized feedback, education, and motivation. Incorporating visual analysis into apps is an effective method for educating society. However, the usability evaluation and inclusion of visualization of these apps are often unclear and variable. Objective: The primary objective of this study is to review and compare the usability of existing apps designed to estimate CVD risk using the mHealth App Usability Questionnaire (MAUQ). This is not a traditional usability study involving user interaction design, but rather an assessment of how effectively these applications meet usability standards as defined by the MAUQ. Methods: First, we used predefined criteria to review 16 out of 2238 apps to estimate CVD risk in the Google Play Store and the Apple App Store. Based on the apps' characteristics (ie, developed for health care professionals or patient use) and their functions (single or multiple CVD risk calculators), we conducted a descriptive analysis. Then we also compared the usability of existing apps using the MAUQ and calculated the agreement among 3 expert raters. Results: Most apps used the Framingham Risk Score (8/16, 50%) and Atherosclerotic Cardiovascular Disease Risk (7/16, 44%) prognostic models to estimate CVD risk. The app with the highest overall MAUQ score was the MDCalc Medical Calculator (mean 6.76, SD 0.25), and the lowest overall MAUQ score was obtained for the CardioRisk Calculator (mean 3.96, SD 0.21). The app with the highest overall MAUQ score in the "ease-of-use" domain was the MDCalc Medical Calculator (mean 7, SD 0); in the domain "interface and satisfaction," it was the MDCalc Medical Calculator (mean 6.67, SD 0.33); and in the domain "usefulness," it was the ASCVD Risk Estimator Plus (mean 6.80, SD 0.32). Conclusions: We found that the Framingham Risk Score is the most widely used prognostic model in apps for estimating CVD risk. The "ease-of-use" domain received the highest ratings. While more than half of the apps were suitable for both health care professionals and patients, only a few offered sophisticated visualizations for assessing CVD risk. Less than a quarter of the apps included visualizations, and those that did were single calculators. Our analysis of apps showed that they are an appropriate tool for estimating CVD risk.
Keywords: cardiovascular diseases, MAUQ, prognostic models, mobile applications, visualization, PRISMA
Published in DKUM: 21.05.2025; Views: 0; Downloads: 1
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2. Monitoring of honey bee colony losses : A special issueAleš Gregorc, 2020, other scientific articles Abstract: In recent decades, independent national and international research programs have revealed possible reasons for the death of managed honey bee colonies worldwide. Such losses are not due to a single factor, but instead are due to highly complex interactions between various internal and external influences, including pests, pathogens, honey bee stock diversity, and environmental change. Reduced honey bee vitality and nutrition, exposure to agrochemicals, and quality of colony management contribute to reduced colony survival in beekeeping operations. Our Special Issue (SI) on ‘’Monitoring of Honey Bee Colony Losses’’ aims to address specific challenges facing honey bee researchers and beekeepers. This SI includes four reviews, with one being a meta-analysis that identifies gaps in the current and future directions for research into honey bee colonies mortalities. Other review articles include studies regarding the impact of numerous factors on honey bee mortality, including external abiotic factors (e.g., winter conditions and colony management) as well as biotic factors such as attacks by Vespa velutina and Varroa destructor.
Keywords: honey bee diseases, stressors, pathology, honey bee mortalities, colonies management
Published in DKUM: 23.01.2025; Views: 0; Downloads: 8
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3. Academic general practice/family medicine in times of COVID-19 - Perspective of WONCA EuropeAdam Windak, Thomas Frese, Eva Hummers-Pradier, Zalika Klemenc-Ketiš, Sonia Tsukagoshi, Josep Vilaseca, Shlomo Vinker, Mehmet Ungan, 2020, original scientific article Abstract: COVID-19 outbreak has significantly changed all aspects of general practice in Europe. This art-icle focuses on the academic challenges for the discipline, mainly in the field of education,research, and quality assurance. The efforts of the European Region of the World Organisationof National Colleges, Academies, and Academic Associations of General Practitioners/FamilyPhysicians (WONCA Europe) to support academic sustainability of the discipline in the time ofpandemic are presented. Medical education was affected by the pandemic, threatening both itsproductivity and quality. Emerging new educational methods might be promising, but theresults of their rapid implementation remain uncertain. A relatively small number of publicationsrelated to COVID-19 and general practice is available in the medical literature. There is a short-age of original data from general practice settings. This contrasts with the crucial role of GPs infighting a pandemic. COVID-19 outbreak has opened widely new research areas, which shouldbe explored by GPs. Maintaining the quality of care and safety of all patients during the COVID-19 pandemic is the utmost priority. Many of them suffer from poor access or inadequate man-agement of their problems. Rapid implementation of telemedicine brought both threats andopportunities. The COVID-19 pandemic also challenged doctors' safety and well-being. Theseaspects will require discussion and remedy to prevent deterioration of the quality of primarycare. WONCA Europe is making a multi-faceted effort to support GPs in difficult times of thepandemic. It is ready to support future efforts to uphold the integrity of family medicine as anacademic discipline.
Keywords: infectious diseases, quality of care, public health, community medicine, health care organisation, management, medical education
Published in DKUM: 07.01.2025; Views: 0; Downloads: 4
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4. Single-cell transcriptomic and targeted genomic profiling adjusted for inflammation and therapy bias reveal CRTAM and PLCB1 as novel hub genes for anti-tumor necrosis factor alpha therapy response in Crohn’s diseaseMario Gorenjak, Boris Gole, Larisa Goričan, Gregor Jezernik, Uršula Prosenc Zmrzljak, Cvetka Pernat Drobež, Pavel Skok, Uroš Potočnik, 2024, original scientific article Abstract: The lack of reliable biomarkers in response to anti-TNFα biologicals hinders
personalized therapy for Crohn’s disease (CD) patients. The motivation behind our study is to shift
the paradigm of anti-TNFα biomarker discovery toward specific immune cell sub-populations using
single-cell RNA sequencing and an innovative approach designed to uncover PBMCs gene expression
signals, which may be masked due to the treatment or ongoing inflammation; Methods: The singlecell
RNA sequencing was performed on PBMC samples from CD patients either naïve to biological
therapy, in remission while on adalimumab, or while on ustekinumab but previously non-responsive
to adalimumab. Sieves for stringent downstream gene selection consisted of gene ontology and
independent cohort genomic profiling. Replication and meta-analyses were performed using publicly
available raw RNA sequencing files of sorted immune cells and an association analysis summary.
Machine learning, Mendelian randomization, and oligogenic risk score methods were deployed to
validate DEGs highly relevant to anti-TNFα therapy response; Results: This study found PLCB1 in
CD4+ T cells and CRTAM in double-negative T cells, which met the stringent statistical thresholds
throughout the analyses. An additional assessment proved causal inference of both genes in response
to anti-TNFα therapy; Conclusions: This study, jointly with an innovative design, uncovered
novel candidate genes in the anti-TNFα response landscape of CD, potentially obscured by therapy
or inflammation.
Keywords: inflammatory bowel diseases, Crohn’s disease, tumor necrosis factor alpha, adalimumab, single-cell gene expression analysis
Published in DKUM: 10.12.2024; Views: 0; Downloads: 8
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5. Scaling-up an integrated care for patients with non-communicable diseases : an analysis of healthcare barriers and facilitators in Slovenia and BelgiumČrt Zavrnik, Katrien Danhieux, Miriam Hurtado Monarres, Nataša Stojnić, Majda Mori-Lukančič, Monika Martens, Zalika Klemenc-Ketiš, Edwin Wouters, Josefien Van Olmen, Tonka Poplas-Susič, 2021, original scientific article Abstract: Introduction: Although the concept of integrated care for non-communicable diseases was introduced at the primary level to move from disease-centered to patient-centered care, it has only been partially implemented in European countries. The aim of this study was to identify and compare identified facilitators and barriers to scale-up this concept between Slovenia and Belgium.
Methods: This was a qualitative study. Fifteen focus groups and fifty-one semi-structured interviews were conducted with stakeholders at the micro, meso and macro levels. In addition, data from two previously published studies were used for the analysis. Data collection and analysis was initially conducted at country level. Finally, the data was evaluated by a cross-country team to assess similarities and differences between countries.
Results: Four topics were identified in the study: patient-centered care, teamwork, coordination of care and task delegation. Despite the different contexts, true teamwork and patient-centered care are limited in both countries by hierarchies and a very heavily skewed medical approach. The organization of primary healthcare in Slovenia probably facilitates the coordination of care, which is not the case in Belgium. The financing and organization of primary practices in Belgium was identified as a barrier to the implementation of task delegation between health professionals.
Conclusions: This study allowed formulating some important concepts for future healthcare for non-communicable diseases at the level of primary healthcare. The results could provide useful insights for other countries with similar health systems.
Keywords: scale-up, noncommunicable diseases, patientcentered care, primary healthcare, integrated healthcare
Published in DKUM: 22.10.2024; Views: 0; Downloads: 7
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6. Multilingual framework for risk assessment and symptom tracking (MRAST)Valentino Šafran, Simon Lin, Jama Nateqi, Alistair G. Martin, Urška Smrke, Umut Arioz, Nejc Plohl, Matej Rojc, Dina Běma, Marcela Chavez, Matej Horvat, Izidor Mlakar, 2024, original scientific article Abstract: The importance and value of real-world data in healthcare cannot be overstated because it offers a valuable source of insights into patient experiences. Traditional patient-reported experience and outcomes measures (PREMs/PROMs) often fall short in addressing the complexities of these experiences due to subjectivity and their inability to precisely target the questions asked. In contrast, diary recordings offer a promising solution. They can provide a comprehensive picture of psychological well-being, encompassing both psychological and physiological symptoms. This study explores how using advanced digital technologies, i.e., automatic speech recognition and natural language processing, can efficiently capture patient insights in oncology settings. We introduce the MRAST framework, a simplified way to collect, structure, and understand patient data using questionnaires and diary recordings. The framework was validated in a prospective study with 81 colorectal and 85 breast cancer survivors, of whom 37 were male and 129 were female. Overall, the patients evaluated the solution as well made; they found it easy to use and integrate into their daily routine. The majority (75.3%) of the cancer survivors participating in the study were willing to engage in health monitoring activities using digital wearable devices daily for an extended period. Throughout the study, there was a noticeable increase in the number of participants who perceived the system as having excellent usability. Despite some negative feedback, 44.44% of patients still rated the app’s usability as above satisfactory (i.e., 7.9 on 1–10 scale) and the experience with diary recording as above satisfactory (i.e., 7.0 on 1–10 scale). Overall, these findings also underscore the significance of user testing and continuous improvement in enhancing the usability and user acceptance of solutions like the MRAST framework. Overall, the automated extraction of information from diaries represents a pivotal step toward a more patient-centered approach, where healthcare decisions are based on real-world experiences and tailored to individual needs. The potential usefulness of such data is enormous, as it enables better measurement of everyday experiences and opens new avenues for patient-centered care.
Keywords: multilingual framework, risk assessment, symptom tracking, chronic diseases, patient-centered care, real-world data
Published in DKUM: 12.08.2024; Views: 74; Downloads: 18
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7. Lipoprotein(a) as a risk factor in a cohort of hospitalised cardiovascular patients : A retrospective clinical routine data analysisDavid Šuran, Tadej Završnik, Peter Kokol, Marko Kokol, Andreja Sinkovič, Franjo Naji, Jernej Završnik, Helena Blažun Vošner, Vojko Kanič, 2023, original scientific article Abstract: Lipoprotein(a) (Lp(a)) is a well-recognised risk factor for ischemic heart disease (IHD) and calcific aortic valve stenosis (AVS). Methods: A retrospective observational study of Lp(a) levels (mg/dL) in patients hospitalised for cardiovascular diseases (CVD) in our clinical routine was performed. The Lp(a)-associated risk of hospitalisation for IHD, AVS, and concomitant IHD/AVS versus other non-ischemic CVDs (oCVD group) was assessed by means of logistic regression. Results: In total of 11,767 adult patients, the association with Lp(a) was strongest in the IHD/AVS group (eβ = 1.010, p < 0.001), followed by the IHD (eβ = 1.008, p < 0.001) and AVS group (eβ = 1.004, p < 0.001). With increasing Lp(a) levels, the risk of IHD hospitalisation was higher compared with oCVD in women across all ages and in men aged ≤75 years. The risk of AVS hospitalisation was higher only in women aged ≤75 years (eβ = 1.010 in age < 60 years, eβ = 1.005 in age 60–75 years, p < 0.05). Conclusions: The Lp(a)-associated risk was highest for concomitant IHD/AVS hospitalisations. The differential impact of sex and age was most pronounced in the AVS group with an increased risk only in women aged ≤75 years.
Keywords: acute myocardial infarction, aortic valve stenosis, atherosclerosis, cardiovascular diseases, cardiovascular risk, ischemic heart disease, lipoprotein(a), postmenopausal women
Published in DKUM: 12.06.2024; Views: 137; Downloads: 11
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8. Digital tools in behavior change support education in health and other students : a systematic reviewLucija Gosak, Gregor Štiglic, Leona Cilar Budler, Isa B. Félix, Katja Braam, Nino Fijačko, Mara Pereira Guerreiro, Mateja Lorber, 2022, review article Abstract: Due to the increased prevalence of chronic diseases, behavior changes are integral to self-management. Healthcare and other professionals are expected to support these behavior changes, and therefore, undergraduate students should receive up-to-date and evidence-based training in this respect. Our work aims to review the outcomes of digital tools in behavior change support education. A secondary aim was to examine existing instruments to assess the effectiveness of these tools. A PIO (population/problem, intervention, outcome) research question led our literature search. The population was limited to students in nursing, sports sciences, and pharmacy; the interventions were limited to digital teaching tools; and the outcomes consisted of knowledge, motivation, and competencies. A systematic literature review was performed in the PubMed, CINAHL, MEDLINE, Web of Science, SAGE, Scopus, and Cochrane Library databases and by backward citation searching. We used PRISMA guidelines 2020 to depict the search process for relevant literature. Two authors evaluated included studies using the Mixed Methods Appraisal Tool (MMAT) independently. Using inclusion and exclusion criteria, we included 15 studies in the final analysis: six quantitative descriptive studies, two randomized studies, six mixed methods studies, and one qualitative study. According to the MMAT, all studies were suitable for further analysis in terms of quality. The studies resorted to various digital tools to improve students’ knowledge of behavior change techniques in individuals with chronic disease, leading to greater self-confidence, better cooperation, and practical experience and skills. The most common limitations that have been perceived for using these tools are time and space constraints.
Keywords: digital tools, didactics, noncommunicable diseases, chronic diseases, behavior change support education, health science
Published in DKUM: 28.09.2023; Views: 361; Downloads: 79
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9. Protective role of mitochondrial uncoupling proteins against age-related oxidative stress in type 2 diabetes mellitusMaša Čater, Lidija Križančić Bombek, 2022, review article Abstract: The accumulation of oxidative damage to DNA and other biomolecules plays an important role in the etiology of aging and age-related diseases such as type 2 diabetes mellitus (T2D), atherosclerosis, and neurodegenerative disorders. Mitochondrial DNA (mtDNA) is especially sensitive to oxidative stress. Mitochondrial dysfunction resulting from the accumulation of mtDNA damage impairs normal cellular function and leads to a bioenergetic crisis that accelerates aging and associated diseases. Age-related mitochondrial dysfunction decreases ATP production, which directly affects insulin secretion by pancreatic beta cells and triggers the gradual development of the chronic metabolic dysfunction that characterizes T2D. At the same time, decreased glucose oxidation in skeletal muscle due to mitochondrial damage leads to prolonged postprandial blood glucose rise, which further worsens glucose homeostasis. ROS are not only highly reactive by-products of mitochondrial respiration capable of oxidizing DNA, proteins, and lipids but can also function as signaling and effector molecules in cell membranes mediating signal transduction and inflammation. Mitochondrial uncoupling proteins (UCPs) located in the inner mitochondrial membrane of various tissues can be activated by ROS to protect cells from mitochondrial damage. Mitochondrial UCPs facilitate the reflux of protons from the mitochondrial intermembrane space into the matrix, thereby dissipating the proton gradient required for oxidative phosphorylation. There are five known isoforms (UCP1-UCP5) of mitochondrial UCPs. UCP1 can indirectly reduce ROS formation by increasing glutathione levels, thermogenesis, and energy expenditure. In contrast, UCP2 and UCP3 regulate fatty acid metabolism and insulin secretion by beta cells and modulate insulin sensitivity. Understanding the functions of UCPs may play a critical role in developing pharmacological strategies to combat T2D. This review summarizes the current knowledge on the protective role of various UCP homologs against age-related oxidative stress in T2D.
Keywords: uncoupling proteins, reactive oxygen species, aging, age-related diseases, diabetes
Published in DKUM: 23.08.2023; Views: 467; Downloads: 46
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