The new app, called Dermofit, has been designed to help train non-specialist doctors, nurses, and medical students to more accurately identify different skin lesions and growths along with their related diagnoses, using interactive, cognitive training techniques and an extensive image reference library. Launched earlier this month, Dermofit is already in use in a range of medical training settings around the world, helping healthcare professionals develop a greater knowledge of the variety of visual characteristics that different skin lesions have, and the way that these can be used to determine benign cases from more serious examples of skin cancer. Dermofit was first devised by Prof. Jonathan Rees, grant chair of dermatology at the University of Edinburgh, who came up with the idea to develop a digital tool to help medical professionals accurately identify malignant and benign skin lesion and skin growths at an early stage. The result of 4 years of research and development by the University of Edinburgh, Dermofit provides trainee doctors, nurses, and other non-specialist healthcare professionals with digital resources that allow them to hone their ability to correctly identify specific skin lesion types and, as a result, improve the accuracy with which they can determine skin cancer diagnoses. Algorithms group skin lesion photos based on color and texture In the case of suspected skin cancers - including malignant melanoma, squamous cell carcinoma, or basal cell carcinoma - the need for prompt referral to a specialist for assessment and treatment is essential. However, in many cases, these referrals are often unnecessary. "Thirty percent of doctors will automatically send a patient to a hospital if they have signs of a skin growth," says Prof. Rees. "But the evidence is that the vast majority of people who are seen and referred do not have skin cancer or anything serious at all." Resources that can equip non-specialist care practitioners with the skills necessary to more accurately identify these different types of skin growth and lesion can therefore be extremely valuable, in terms of improving the quality of care provided to patients and also reducing costs for care providers. Dermofit uses algorithms that automatically groups library photos of skin lesions based on their color and texture properties. Selecting from a library of more than 1,300 images, the Dermofit app will take the user to further sets of similar lesion types to illustrate the difference in lesions that may look similar but are from different skin lesion classes. Other modules allow users to further build and test their skills of identification and diagnosis. Bob Fisher, who specializes in computer vision and helped design the computer algorithms for the app, adds: "Dermofit contains a photo library of skin lesions to help inform practitioners to diagnosis more effectively." Practitioners can click on the image of a lesion of interest which then leads to further similar lesions. As lesions are selected, further sets of similar lesions are displayed. This gives familiarity with the different skin lesion types and allows users to differentiate between lesions that look similar, but that are from different skin lesion classes," he says. A rapidly growing area of medical training The use of cognitive teaching tools is a rapidly growing area of medical training, as it allows healthcare professionals to develop the necessary skills that are required to more accurately diagnose and treat patients within risk-free digital environments. Providing healthcare practitioners with training tools like Dermofit helps them acquire skills that would otherwise require years of practical experience. Simedics, a U.K.-based company specializing in digital products and publishing for the healthcare industry, is the commercial partner responsible for bringing Dermofit to market. They hope that the product will become instrumental in providing an effective way to train medical students and primary care practitioners in this area and, as a result, help improve skin cancer detection rates and patient care. The company is already working with teaching hospitals, universities, and organizations around the world to incorporate Dermofit into teaching regimens. More information on the Dermofit project is available at dermofit.org. Dermofit is available on iOS and can be downloaded from the App Store. Written by Matthew Driver, managing editor of The Journal of mHealth

The study forms the first part of a four-paper series published by The Lancet that provides an overview and update of worldwide trends of physical activity and the global impact of physical inactivity.

The first series observing physical activity was released in 2012 ahead of the Summer Olympic Games. The study authors caution that there has been little progress in tackling the global pandemic of physical activity since the 2012 Olympics, with a quarter of adults worldwide failing to meet physical activity recommendations.

In the analysis, the researchers posed the question: Does exercise reduce or eradicate the harmful effects - including increased risk of early death - that are associated with prolonged sitting?

Health risks that are linked to physical inactivity include an increased risk of heart disease, stroke, type 2 diabetes, and some cancers, with recent estimates suggesting that more than 5 million people die each year globally due to failing to meet daily activity levels.

Total worldwide cost of physical inactivity at least $67.5 billion

Findings from the second part of the series - a world-first study to estimate the economic burden of physical inactivity worldwide - shows that globally in healthcare expenditure and lost productivity, physical inactivity cost the world $67 billion in 2013.

"Physical inactivity is recognized as a global pandemic that not only leads to diseases and early deaths, but imposes a major burden to the economy," says Dr. Melody Ding, senior research fellow at The University of Sydney's School of Public Health, Australia.

Dr. Ding notes that if no action is taken to improve population levels of physical inactivity, the economic burden of physical inactivity is projected to increase globally, predominantly in low- and middle-income countries.

The World Health Organization (WHO) recommend that adults aged 18-64 should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week.

In the first paper of the series, the researchers analyzed 16 studies, which included data from over 1 million people.

The team formed four groups of individuals based on their level of moderate-intensity exercise, ranging from 5-75 minutes per day. Moderate-intensity exercise was defined as walking 3.5 miles per hour or cycling at 10 miles per hour.

1 hour of exercise daily can mitigate risks of early death

Results from the study show that people that spend 8 hours a day sitting but are physically active have a significantly lower risk of death than people who spend fewer hours sitting, but who are not physically active.

Moreover, the increased risk of death associated with spending 8 hours sitting was eliminated by 1 hour of physical activity per day.

People who had the greatest risk of death were those individuals who sat for prolonged periods and were mostly inactive. They were between 28-59 percent more likely to die early, compared with those in the most active group, which is a similar risk to that associated with smoking and obesity.

The study finds that only around 25 percent of participants did an hour or more exercise per day.

"There has been a lot of concern about the health risks associated with today's more sedentary lifestyles," says Prof. Ulf Ekelund, of the Norwegian School of Sports Sciences, Norway, and the Medical Research Council Epidemiology Unit at the University of Cambridge, United Kingdom.

"Our message is a positive one: it is possible to reduce - or even eliminate - these risks if we are active enough, even without having to take up sports or go to the gym."

Prof. Ulf Ekelund

"For many people who commute to work and have office-based jobs, there is no way to escape sitting for prolonged periods of time. For these people in particular, we cannot stress enough the importance of getting exercise, whether it's getting out for a walk at lunchtime, going for a run in the morning or cycling to work. An hour of physical activity per day is the ideal, but if this is unmanageable, then at least doing some exercise each day can help reduce the risk," he adds.

Watching TV for long durations raised death risk in most activity groups

Also observed in the study was time spent watching TV per day - a particular type of sedentary behavior - in a subgroup of approximately half a million people.

Watching TV for 3 hours per day was associated with an increased risk of death in all activity groups, except among the most active. The authors say that this association could be because long hours watching TV may be a marker of a more unhealthy lifestyle in general, including being less likely to take exercise.

In a third paper in the series looking at the progress and challenges in physical activity since the 2012 Olympics, Prof. Jim Sallis, of the University of California-San Diego, says: "The global pandemic of physical inactivity remains, and the global response has been far too slow."