A blockchain-based healthcare data marketplace: prototype and demonstration

Objectives

This study aimed to develop healthcare data marketplace using blockchain-based B2C model that ensures the transaction of healthcare data among individuals, companies, and marketplaces.

Materials and methods

We designed an architecture for the healthcare data marketplace using blockchain. A healthcare data marketplace was developed using Panacea, MySQL 8.0, JavaScript library, and Node.js. We evaluated the performance of the data marketplace system in 3 scenarios.

Results

We developed mobile and web applications for healthcare data marketplace. The transaction data queries were executed fully within about 1-2 s, and approximately 9.5 healthcare data queries were processed per minute in each demonstration scenario.

Discussion

Blockchain-based healthcare data marketplaces have shown compliance performance in the process of data collection and will provide a meaningful role in analyzing healthcare data.

Conclusion

The healthcare data marketplace developed in this project can iron out time and place limitations and create a framework for gathering and analyzing fragmented healthcare data.

Effects of a Serious Game for Adolescent Mental Health on Cognitive Vulnerability: Pilot Usability Study

Background

Adolescent mental health is of utmost importance. E-mental health interventions, and serious games in particular, are appealing to adolescents and can have beneficial effects on their mental health. A serious game aimed at improving cognitive vulnerability (ie, beliefs or attitudes), which can predispose an individual to mental health problems, can contribute to the prevention of these problems in adolescents.

Objective

This study aimed to assess the feasibility of the prototype of a serious game called "Silver."

Methods

The prototype of the serious game was developed using a user-centered participatory design. The prototype of Silver focused on 1 aspect of a serious game for improving cognitive vulnerability in adolescents, that is, the recognition and identification of cognitive distortions. Through the game, players were required to identify and classify the character's thoughts as helpful or unhelpful. Upon successful advancement to the next level, the task becomes more challenging, as players must also identify specific types of cognitive distortions. A pre- and posttest uncontrolled design was used to evaluate the game, with a 1-week intervention phase in which participants were asked to play the game. Participants aged 12-16 years were recruited in schools. The outcomes of interest were the recognition of cognitive distortions and presence of participants' cognitive distortions. The game was also evaluated on its effects, content, and usefulness.

Results

A total of 630 adolescents played Silver and completed the assessments. Adolescents were significantly better at recognizing cognitive distortions at the pretest (mean 13.09, SD 4.08) compared to the posttest (mean 13.82, SD 5.09; t629=-4.00, P<.001). Furthermore, their cognitive distortions decreased significantly at the posttest (mean 38.73, SD 12.79) compared to the pretest (mean 41.43, SD 10.90; t629=7.98, P<.001). Participants also indicated that the game helped them recognize cognitive distortions. Many participants considered the game appealing (294/610, 48.2%) but boring (317/610, 52%) and preferred a more comprehensive game (299/610, 49%).

Conclusions

Findings from this study suggest that a serious game may be an effective tool for improving cognitive vulnerability in adolescents. The development of such a serious game, based on the prototype, is recommended. It may be an important and innovative tool for the universal prevention of mental health problems in adolescents. Future research on the effects of the game is warranted.

Operational criteria application does not change clinicians' opinion on the diagnosis of mental disorder: a pre- and post-intervention validity study

Objective

Our objective was to check if the ICD-10 operational criteria application changes non-operational, prototype-based diagnoses obtained in a real-life scenario.

Methods

Psychiatry residents applied the diagnostic criteria of the ICD-10 as a "diagnostic test" to five outpatient patients they were already following who had a prototype-based diagnosis. Tests were used to ascertain whether changes in opinion were significant and if any of the diagnostic groups were more prone to change than others. The present paper is part of the study with UTN U1111-1260-1212.

Results

Seventeen residents reviewed their last five case files, retrieving 85 diagnostic pairs of non-operational-based vs. operational-based diagnoses. The Stuart-Maxwell test did not indicate a significant opinion change (χ2 = 5.25, p = 0.39; power = 0.94) besides 30% of diagnostic changes. Despite not being statistically significant, 20.2% of all evaluations resulted in a change that would affect treatment choices. Using ICD-10 operational criteria slightly increased the number of observed diagnoses, but probably without clinical relevance. None of the non-operational diagnoses have a higher tendency to change with operational criteria application (χ2 = 11.6, p = 0.07). The female gender was associated with a higher diagnostic change tendency.

Conclusion

Applying ICD-10 operational criteria as a diagnostic test does not induce a statistically significant diagnostic opinion change in residents and no diagnostic group seems more sensible to diagnostic change. Gender-related differences in diagnostic opinion changes might be evidence of sunk cost bias. Although not statistically significant, using operational criteria after diagnostic elaboration might help to deal with subjects without adequate treatment response.

Promoting a Patient-Centered Understanding of Safety in Acute Mental Health Wards: A User-Centered Design Approach to Develop a Real-Time Digital Monitoring Tool

BACKGROUND

Acute mental health services report high levels of safety incidents that involve both patients and staff. The potential for patients to be involved in interventions to improve safety within a mental health setting is acknowledged, and there is a need for interventions that proactively seek the patient perspective of safety. Digital technologies may offer opportunities to address this need.

OBJECTIVE

This research sought to design and develop a digital real-time monitoring tool (WardSonar) to collect and collate daily information from patients in acute mental health wards about their perceptions of safety. We present the design and development process and underpinning logic model and programme theory.

METHODS

The first stage involved a synthesis of the findings from a systematic review and evidence scan, interviews with patients (n=8) and health professionals (n=17), and stakeholder engagement. Cycles of design activities and discussion followed with patients, staff, and stakeholder groups, to design and develop the prototype tool.

RESULTS

We drew on patient safety theory and the concepts of contagion and milieu. The data synthesis, design, and development process resulted in three prototype components of the digital monitoring tool (WardSonar): (1) a patient recording interface that asks patients to input their perceptions into a tablet computer, to assess how the ward feels and whether the direction is changing, that is, "getting worse" or "getting better"; (2) a staff dashboard and functionality to interrogate the data at different levels; and (3) a public-facing ward interface. The technology is available as open-source code.

CONCLUSIONS

Recent patient safety policy and research priorities encourage innovative approaches to measuring and monitoring safety. We developed a digital real-time monitoring tool to collect information from patients in acute mental health wards about perceived safety, to support staff to respond and intervene to changes in the clinical environment more proactively.

Development of a psychotherapy process prototype for the Real Relationship

OBJECTIVE

The Real Relationship (RR) describes the aspect of the psychotherapy relationship that is based on a genuine connection and a realistic view between patient and therapist. In the current study, we aimed to develop a Psychotherapy Process Q-set (PQS) prototype of the RR to facilitate post-hoc assessment of the RR in psychotherapy session recordings. We also aimed to measure the association between the RR-PQS and current PQS measures of theoretical treatment principles and the working alliance.

METHOD

We developed an RR-PQS prototype based on ratings of an ideal RR session by eight RR experts. We assessed the associations between the RR-PQS and existing cognitive behavioral and psychodynamic process prototypes, and seven PQS items known to predict the working alliance.

RESULTS

RR experts agreed on the ideal RR session ratings to a high degree (ICC = 0.89). The RR-PQS was moderately related to both cognitive behavioral (r = 0.66, p < 0.01), and psychodynamic prototypes (r = 0.56, p < 0.01). PQS items predictive of the working alliance were characteristic of the RR-PQS.

CONCLUSION

The RR-PQS prototype appears to behave in theoretically predicted ways and may be a valid measure of the RR.

A Risk Assessment and Planning Tool to Prevent Sudden Unexpected Death in Infancy: Development and Evaluation of The Baby Sleep Planner

BACKGROUND

Successful national safer sleep campaigns in the United Kingdom have lowered the death rates from sudden unexpected death in infancy (SUDI) over the past 3 decades, but deaths persist in socioeconomically deprived families. The circumstances of current deaths suggest that improvements in support for some families to follow safer sleep advice more consistently could save lives.

OBJECTIVE

This study aimed to develop and evaluate a risk assessment and planning tool designed to improve the uptake of safer sleep advice in families with infants at increased risk of SUDI.

METHODS

A co-design approach was used to develop the prototype interface of a web-based tool with 2 parts: an individual SUDI risk assessment at birth and a downloadable plan for safety during times of disruption. The advice contained within the tool is concordant with national guidance from the Lullaby Trust, the United Nations International Children's Emergency Fund (UNICEF), and the National Institute for Health and Care Excellence. User testing of the prototype tool was conducted by inviting health visitors, midwives, and family nurses to use it with families eligible for additional support. Qualitative interviews with health professionals and families allowed for iterative changes to the tool and for insights into its function and influence on parental behavior.

RESULTS

A total of 22 health professionals were enrolled in the study, of whom 20 (91%) were interviewed. They reported appreciating the functionality of the tool, which allowed them to identify at-risk families for further support. They felt that the tool improved how they communicated about risks with families. They suggested expanding its use to include relevance in the antenatal period and having versions available in languages other than English. They reported using the tool with 58 families; 20 parents gave consent to be interviewed by the research team about their experiences with the tool. Families were positive about the tool, appreciated the trustworthy information, and felt that it was useful and appropriate and that the plans for specific infant sleeps would be of benefit to them and other family members.

CONCLUSIONS

Our tool combines risk assessment and safety planning, both of which have the potential to improve the uptake of lifesaving advice. Refinements to the tool based on these findings have ensured that the tool is ready for further evaluation in a larger study before being rolled out to families with infants at increased risk.

Data Representation Structure to Support Clinical Decision-Making in the Pediatric Intensive Care Unit: Interview Study and Preliminary Decision Support Interface Design

BACKGROUND

Clinical decision-making is a complex cognitive process that relies on the interpretation of a large variety of data from different sources and involves the use of knowledge bases and scientific recommendations. The representation of clinical data plays a key role in the speed and efficiency of its interpretation. In addition, the increasing use of clinical decision support systems (CDSSs) provides assistance to clinicians in their practice, allowing them to improve patient outcomes. In the pediatric intensive care unit (PICU), clinicians must process high volumes of data and deal with ever-growing workloads. As they use multiple systems daily to assess patients' status and to adjust the health care plan, including electronic health records (EHR), clinical systems (eg, laboratory, imaging and pharmacy), and connected devices (eg, bedside monitors, mechanical ventilators, intravenous pumps, and syringes), clinicians rely mostly on their judgment and ability to trace relevant data for decision-making. In these circumstances, the lack of optimal data structure and adapted visual representation hinder clinician's cognitive processes and clinical decision-making skills.

OBJECTIVE

In this study, we designed a prototype to optimize the representation of clinical data collected from existing sources (eg, EHR, clinical systems, and devices) via a structure that supports the integration of a home-developed CDSS in the PICU. This study was based on analyzing end user needs and their clinical workflow.

METHODS

First, we observed clinical activities in a PICU to secure a better understanding of the workflow in terms of staff tasks and their use of EHR on a typical work shift. Second, we conducted interviews with 11 clinicians from different staff categories (eg, intensivists, fellows, nurses, and nurse practitioners) to compile their needs for decision support. Third, we structured the data to design a prototype that illustrates the proposed representation. We used a brain injury care scenario to validate the relevance of integrated data and the utility of main functionalities in a clinical context. Fourth, we held design meetings with 5 clinicians to present, revise, and adapt the prototype to meet their needs.

RESULTS

We created a structure with 3 levels of abstraction-unit level, patient level, and system level-to optimize clinical data representation and display for efficient patient assessment and to provide a flexible platform to host the internally developed CDSS. Subsequently, we designed a preliminary prototype based on this structure.

CONCLUSIONS

The data representation structure allows prioritizing patients via criticality indicators, assessing their conditions using a personalized dashboard, and monitoring their courses based on the evolution of clinical values. Further research is required to define and model the concepts of criticality, problem recognition, and evolution. Furthermore, feasibility tests will be conducted to ensure user satisfaction.

Cone-beam x-ray luminescence computed tomography (CB-XLCT) prototype development and performance evaluation

This study developed a prototype for a rotational cone-beam x-ray luminescence computed tomography (CB-XLCT) system, considering its potential application in pre-clinical theranostic imaging. A geometric calibration method applicable to both imaging chains (XL and CT) was also developed to enhance image quality. The results of systematic performance evaluations were presented to assess the feasibility of commercializing XLCT technology. Monte Carlo GATE simulation was performed to determine the optimal imaging conditions for nanophosphor particles (NPs) irradiated by 70 kV x-rays. We acquired a low-dose transmission x-ray tube and designed a prone positioning platform and a rotating gantry, using mice as targets from commercial small animalμ-CT systems. We then employed the image cross-correlation (ICC) automatic geometric calibration method to calibrate XL and CT images. The performance of the system was evaluated through a series of phantom experiments with a linearity of 0.99, and the contrast-to-noise ratio (CNR) between hydroxyl-apatite (HA) and based epoxy resin is 19.5. The XL images of the CB-XLCT prototype achieved a Dice similarity coefficient (DICE) of 0.149 for a distance of 1 mm between the two light sources. Finally, the final XLCT imaging results were demonstrated using the Letter phantoms with NPs. In summary, the CB-XLCT prototype developed in this study showed the potential to achieve high-quality imaging with acceptable radiation doses for small animals. The performance of CT images was comparable to current commercial machines, while the XL images exhibited promising results in phantom imaging, but further efforts are needed for biomedical applications.

Molecular Epidemiology of Foot-and-Mouth Disease Viruses in the Emirate of Abu Dhabi, United Arab Emirates

Foot-and-mouth disease (FMD) is an endemic disease in the United Arab Emirates (UAE) in both wild and domestic animals. Despite this, no systematic FMD outbreak investigation accompanied by molecular characterisation of FMD viruses (FMDVs) in small ruminants or cattle has been performed, and only a single report that describes sequences for FMDVs in wildlife from the Emirate has been published. In this study, FMD outbreaks that occurred in 2021 in five animal farms and one animal market in the Emirate of Abu Dhabi were investigated. Cases involved sheep, goats, and cattle, as well as Arabian oryx (Oryx leucoryx). Twelve samples were positive for FMDV via RT-qPCR, and four samples (Arabian oryx n = 1, goat n = 2, and sheep n = 1) were successfully genotyped using VP1 nucleotide sequencing. These sequences shared 88~98% identity and were classified within the serotype O, Middle East-South Asia topotype (O/ME-SA). Phylogenetic analysis revealed that the Arabian oryx isolate (UAE/2/2021) belonged to the PanAsia-2 lineage, the ANT-10 sublineage, and was closely related to the FMDVs recently detected in neighbouring countries. The FMDV isolates from goats (UAE/10/2021 and UAE/11/2021) and from sheep (UAE/14/2021) formed a monophyletic cluster within the SA-2018 lineage that contained viruses from Bangladesh, India, and Sri Lanka. This is the first study describing the circulation of the FMDV O/ME-SA/SA-2018 sublineage in the UAE. These data shed light on the epidemiology of FMD in the UAE and motivate further systematic epidemiological studies and genomic sequencing to enhance the ongoing national animal health FMD control plan.

Predicting Waist Circumference From a Single Computed Tomography Image Using a Mobile App (Measure It): Development and Evaluation Study

Background

Despite the existing evidence that waist circumference (WC) provides independent and additive information to BMI when predicting morbidity and mortality, this measurement is not routinely obtained in clinical practice. Using computed tomography (CT) scan images, mobile health (mHealth) has the potential to make this abdominal obesity parameter easily available even in retrospective studies.

Objective

This study aimed to develop a mobile app as a tool for facilitating the measurement of WC based on a cross-sectional CT image.

Methods

The development process included three stages: determination of the principles of WC measurement from CT images, app prototype design, and validation. We performed a preliminary validity study in which we compared WC measurements obtained both by the conventional method using a tape measurement in a standing position and by the mobile app using the last abdominal CT slice not showing the iliac bone. Pearson correlation, student t tests, and Q-Q and Bland-Altman plots were used for statistical analysis. Moreover, to perform a diagnostic test evaluation, we also analyzed the accuracy of the app in detecting abdominal obesity.

Results

We developed a prototype of the app Measure It, which is capable of estimating WC from a single cross-sectional CT image. We used an estimation based on an ellipse formula adjusted to the gender of the patient. The validity study included 20 patients (10 men and 10 women). There was a good correlation between both measurements (Pearson R=0.906). The student t test showed no significant differences between the two measurements (P=.98). Both the Q-Q dispersion plot and Bland-Altman analysis graphs showed good overlap with some dispersion of extreme values. The diagnostic test evaluation showed an accuracy of 83% when using the mobile app to detect abdominal obesity.

Conclusions

This app is a simple and accessible mHealth tool to routinely measure WC as a valuable obesity indicator in clinical and research practice. A usability and validity evaluation among medical teams will be the next step before its use in clinical trials and multicentric studies.

Eye State Detection Using Frequency Features from 1 or 2-Channel EEG

Brain-computer interfaces (BCIs) establish a direct communication channel between the human brain and external devices. Among various methods, electroencephalography (EEG) stands out as the most popular choice for BCI design due to its non-invasiveness, ease of use, and cost-effectiveness. This paper aims to present and compare the accuracy and robustness of an EEG system employing one or two channels. We present both hardware and algorithms for the detection of open and closed eyes. Firstly, we utilize a low-cost hardware device to capture EEG activity from one or two channels. Next, we apply the discrete Fourier transform to analyze the signals in the frequency domain, extracting features from each channel. For classification, we test various well-known techniques, including Linear Discriminant Analysis (LDA), Support Vector Machine (SVM), Decision Tree (DT), or Logistic Regression (LR). To evaluate the system, we conduct experiments, acquiring signals associated with open and closed eyes, and compare the performance between one and two channels. The results demonstrate that employing a system with two channels and using SVM, DT, or LR classifiers enhances robustness compared to a single-channel setup and allows us to achieve an accuracy percentage greater than 95% for both eye states.

An Individualized Postoperative Pain Risk Communication Tool for Use in Pediatric Surgery: Co-Design and Usability Evaluation

BACKGROUND

Risk identification and communication tools have the potential to improve health care by supporting clinician-patient or family discussion of treatment risks and benefits and helping patients make more informed decisions; however, they have yet to be tailored to pediatric surgery. User-centered design principles can help to ensure the successful development and uptake of health care tools.

OBJECTIVE

We aimed to develop and evaluate the usability of an easy-to-use tool to communicate a child's risk of postoperative pain to improve informed and collaborative preoperative decision-making between clinicians and families.

METHODS

With research ethics board approval, we conducted web-based co-design sessions with clinicians and family participants (people with lived surgical experience and parents of children who had recently undergone a surgical or medical procedure) at a tertiary pediatric hospital. Qualitative data from these sessions were analyzed thematically using NVivo (Lumivero) to identify design requirements to inform the iterative redesign of an existing prototype. We then evaluated the usability of our final prototype in one-to-one sessions with a new group of participants, in which we measured mental workload with the National Aeronautics and Space Administration (NASA) Task Load Index (TLX) and user satisfaction with the Post-Study System Usability Questionnaire (PSSUQ).

RESULTS

A total of 12 participants (8 clinicians and 4 family participants) attended 5 co-design sessions. The 5 requirements were identified: (A) present risk severity descriptively and visually; (B) ensure appearance and navigation are user-friendly; (C) frame risk identification and mitigation strategies in positive terms; (D) categorize and describe risks clearly; and (E) emphasize collaboration and effective communication. A total of 12 new participants (7 clinicians and 5 family participants) completed a usability evaluation. Tasks were completed quickly (range 5-17 s) and accurately (range 11/12, 92% to 12/12, 100%), needing only 2 requests for assistance. The median (IQR) NASA TLX performance score of 78 (66-89) indicated that participants felt able to perform the required tasks, and an overall PSSUQ score of 2.1 (IQR 1.5-2.7) suggested acceptable user satisfaction with the tool.

CONCLUSIONS

The key design requirements were identified, and that guided the prototype redesign, which was positively evaluated during usability testing. Implementing a personalized risk communication tool into pediatric surgery can enhance the care process and improve informed and collaborative presurgical preparation and decision-making between clinicians and families of pediatric patients.

3D printed meat and the fundamental aspects affecting printability

Three-dimensional (3D) printing, one of the forms of additive manufacturing, has become a popular trend worldwide with a wide range of applications including food. The technology is adaptable and meets foods nutritional and sensory needs allowing meat processing to reach a sustainable level, technology addressing the food requirement of the ever-increasing population and the fast-paced lifestyle by reducing food preparation time. By minimizing food waste and the strain on animal resources, technology can help to create a more sustainable economy and environment. This review article discusses the 3D printing process and various 3D printing techniques used for food printing, such as laser powder bed fusion, inkjet food printing, and binder jetting, a suitable 3D technique used for meat printing, such as extrusion-based bioprinting. Moreover, we discuss properties that affect the printability of meat and its products with their applications in the meat industry, 3D printing market potential challenges, and future trends.

A new short version of the Facial expressions of emotion: Stimuli and tests (FEEST) including prototype and morphed emotional stimuli

The ability to recognize emotions from facial expressions plays an important role in social interaction. This study aimed to develop a short version of the FEEST as a brief instrument to measure emotion recognition ability by applying prototype and morphed emotional stimuli. Morphed emotional stimuli include mixed emotions. Overall, 68 prototypes and 32 morphed emotional expressions were presented to 138 participants for 1 s. A retest with 76 participants was conducted after 6 months. The results showed sufficient variance for the measurement of individual differences in emotion recognition ability. Accuracy varied between emotions and was highest for anger and happiness. Cronbach's α was, on average, 0.70 for prototypes and 0.67 for morphed stimuli. Test-retest reliability was 0.60 for prototypes and 0.62 for morphed stimuli. The new short version of the FEEST is a reliable test to measure emotion recognition.

Self-help application for obsessive-compulsive disorder based on exposure and response prevention technique with prototype design and usability evaluation: A cross-sectional study

Background and Aims

Obsessive-compulsive disorder (OCD) is a relatively common disorder that, due to its debilitating nature, significantly affects personal abilities, job performance, social adjustment, and interpersonal relationships. There are significant barriers to accessing evidence-based cognitive-behavioral therapy as a first-line treatment for obsessive-compulsive disorder. Mobile health applications (Apps) offer a promising way to improve access to evidence-based therapies while overcoming these barriers. The present study was to design and evaluate a prototype of a self-help application for people with OCD (the most common pattern of OCD) based on the exposure and response prevention (ERP) technique.

Methods

This work was developed in four different phases. (1) Needs assessment: a thorough literature review, reviewing existing related programs and apps, and interviewing patients and psychiatrists; (2) Creating a paper prototype: considering the functional features identified in the previous phase using wireframe sketcher software. (3) Creating a digital prototype: developing an actual prototype using Axure RP software based on the information obtained from an expert panel's evaluation of the paper prototype. (4) Prototype usability evaluation: through a heuristic evaluation with experts and usability testing with patients using the SUS questionnaire.

Results

After requirement analysis, requirements were defined in the areas of information and educational elements, and functional capabilities. Prototypes designed based on identified requirements include capabilities such as in-app online self-help groups, assessing the severity of the symptoms of the disorder, psychological training, supportive treatment strategies, setting personalized treatment plans, tracking treatment progress through weekly reports provided, anxiety assessment, and setting reminders.

Conclusion

The results of the heuristic evaluation with experts made it possible to identify how to provide information and implement the capabilities in a way that is more appropriate and easier for the user.

Prototyping Apps for the Management of Sleep, Fatigue, and Behavioral Health in Austere Far-Forward Environments: Development Study

BACKGROUND

Military service inherently includes frequent periods of high-stress training, operational tempo, and sustained deployments to austere far-forward environments. These occupational requirements can contribute to acute and chronic sleep disruption, fatigue, and behavioral health challenges related to acute and chronic stress and disruption of team dynamics. To date, there is no centralized mobile health platform that supports self- and supervised detection, monitoring, and management of sleep and behavioral health issues in garrison and during and after deployments.

OBJECTIVE

The objective of this study was to adapt a clinical decision support platform for use outside clinical settings, in garrison, and during field exercises by medics and soldiers to monitor and manage sleep and behavioral health in operational settings.

METHODS

To adapt an existing clinical decision support digital health platform, we first gathered system, content, and context-related requirements for a sleep and behavioral health management system from experts. Sleep and behavioral health assessments were then adapted for prospective digital data capture. Evidence-based and operationally relevant educational and interventional modules were formatted for digital delivery. These modules addressed the management and mitigation of sleep, circadian challenges, fatigue, stress responses, and team communication. Connectivity protocols were adapted to accommodate the absence of cellular or Wi-Fi access in deployed settings. The resulting apps were then tested in garrison and during 2 separate field exercises.

RESULTS

Based on identified requirements, 2 Android smartphone apps were adapted for self-monitoring and management for soldiers (Soldier app) and team supervision and intervention by medics (Medic app). A total of 246 soldiers, including 28 medics, received training on how to use the apps. Both apps function as expected under conditions of limited connectivity during field exercises. Areas for future technology enhancement were also identified.

CONCLUSIONS

We demonstrated the feasibility of adapting a clinical decision support platform into Android smartphone-based apps to collect, save, and synthesize sleep and behavioral health data, as well as share data using adaptive data transfer protocols when Wi-Fi or cellular data are unavailable. The AIRE (Autonomous Connectivity Independent System for Remote Environments) prototype offers a novel self-management and supervised tool to augment capabilities for prospective monitoring, detection, and intervention for emerging sleep, fatigue, and behavioral health issues that are common in military and nonmilitary high-tempo occupations (eg, submarines, long-haul flights, space stations, and oil rigs) where medical expertise is limited.

Prototype of an Innovative Vacuum Dryer with an Ejector System: Comparative Drying Analysis with a Vacuum Dryer with a Vacuum Pump on Selected Fruits

The following article describes new research about the design, construction and installation of the new prototype of a vacuum dryer with an ejector system. Moreover, the testing of this new prototype involved comparing the qualities of fruit dried in a vacuum drier with an ejector system to fruit dried in a convectional vacuum drier. The data obtained were then analyzed and presented. Due to their economic relevance and highly valuable nutritional value and sensory properties, sour cherries and apricots have been chosen to be the subjects for the testing. The most appropriate quality indicators for analyzing were moisture content, aw value, share and penetration force, total phenol, flavonoid and anthocyanin content and antioxidant activity (FRAP, DPPH and ABTS test). The main results of this study were achieved by designing, constructing, installing and testing the usage of the innovative prototype of a vacuum dryer with an ejector system in the laboratory of the Technology of fruit and vegetable products of the Faculty of Technology Novi Sad, University of Novi Sad. Based on our analyses of the obtained data, it was concluded that vacuum dryer with an ejector system are similar to vacuum dryer with a vacuum pump in terms of all tested physical, chemical and biological properties of dried samples. We observed similarities in some of the most important parameters, including product safety and quality, such as the aw value and the total phenol content, respectively. For example, in dried sour cherry, the aw values ranged from 0.250 to 0.521 with the vacuum pump and from 0.232 to 0.417 with the ejector system; the total phenol content ranged from 2322 to 2765 mg GAE/100 g DW with the vacuum pump and from 2327 to 2617 mg GAE/100 g DW with the ejector system. In dried apricot, the aw ranged from 0.176 to 0.405 with the vacuum pump and from 0.166 to 0.313 with the ejector system; total phenol content ranged from 392 to 439 mg GAE/100 g DW with the vacuum pump and from 378 to 428 mg GAE/100 g DW with the ejector system.

A Tailored mHealth App for Improving Health and Well-Being Behavioral Transformation in UK Police Workers: Usability Testing via a Mixed Methods Study

BACKGROUND

When considering the policing environment of 2022, many roles previously in the domain of warranted officers (police officer) are now performed by nonwarranted police staff equivalents. These police staff roles have expanded rapidly into other areas such as investigations, custody, and contact management, which were traditionally seen as police officer functions and put staff under some of the same stresses as police officers. A UK police force requested help in investigating technologies that could be used to improve health and well-being for both officers and staff.

OBJECTIVE

The aim of this study was to create a health and well-being app for police officers and staff, which considered the unique requirements of the users throughout the designing, building, prototyping, and testing stages.

METHODS

This study involved quantitative approaches (demographic web-based survey questions and the System Usability Scale) and qualitative approaches (open web-based survey questions and semistructured interviews). Unsupervised usability testing of a prototype app was undertaken by members (N=48) of the commissioning client using their smartphones. After completing a preregistration application for screening purposes, participants downloaded a trial version of the app. Then, they completed a web-based questionnaire after testing the app for 10 days. A subsample of participants (9/48, 19%) was interviewed. Deductive thematic analysis was undertaken to identify key themes and subthemes.

RESULTS

Data collected during usability testing concerned the 6 domains of the app-food and diet, activity, fluid intake, sleep, good mental health, and financial well-being-and informed the creation of improved design during prototyping. Some usability and design issues and suggestions for improvements were also addressed and implemented-including shift management and catch-up cards-during this cycle of development.

CONCLUSIONS

This study highlights the importance of coparticipation with officers and staff across the entire development cycle, to coproduce a human-centered design methodology to enable the development of a considered and user-centered solution. It demonstrates the need for producing a multifunctional tool rather than focusing purely on an individual element for this user group. It also highlights how linking and being able to track optional, personalized elements of health data against one another, cross-referenced to individual shift patterns, might help to inform and provide users with a chance for reflection and therefore influence behavior change.

Who Were We? Exploring French Past Group Prototypes

Groups have cognitive existence through the prototype of the group (Haslam et al., 1995; https://doi.org/10.1002/ejsp.2420250504). Past group prototypes then refer to the most representative characteristics that define the group in these previous states. We suppose, as collective events might have different versions associated with different valences (Zaromb et al., 2014; https://doi.org/10.3758/s13421-013-0369-7), this might also be the case for prototypes also held in the collective memory (Halbwachs, 1950; http://dx.doi.org/doi:10.1522/cla.ham.mem1). After highlighting different facets of the past (Study 1) or not (Study 2), we used the "free association method" (Lo Monaco et al., 2017; https://doi.org/10.1111/jtsb.12124; Vergès, [1992], L'évocation de l'argent. Bulletin de Psychologie, 45(4-7), 203-209). Yet, this research explored the content of past prototypes associated with different elements of French collective memory: the French during the Second World War (Study 1, N = 301), and French people in 18th century (Study 2, N = 354). Results suggest the existence for each of these periods of a "two-sided" prototype, i.e., a positive vs. negative-valence prototype. The implications of the existence of these "two-sided" prototypes, the implication of collective continuity perceived for each of them and avenues for future research will be discussed.

Using a Design Thinking Approach to Develop a Social Media-Based Parenting Program for Parents of Children With Attention-Deficit/Hyperactivity Disorder: Mixed Methods Study

Background: Parenting programs have proven effective in improving the behavior of children with attention-deficit/hyperactivity disorder (ADHD). However, barriers such as job and transportation constraints hinder parents from attending face-to-face therapy appointments. The COVID-19 pandemic has further exacerbated these challenges. Objective: This study aimed to develop and test the feasibility of a social media-based parenting program for parents of children with ADHD, considering both the pre-existing challenges faced by parents and the additional barriers imposed by the COVID-19 pandemic. Methods: This study used a 5-stage design thinking process, encompassing empathizing with parents, defining their needs, ideating innovative solutions, prototyping the program, and testing the program with parents. Qualitative interviews were conducted with 18 parents of children with ADHD to understand their unique needs and values. Brainstorming techniques were used to generate creative ideas, leading to the creation of a prototype that was tested with 32 parents. Participants' engagement with the program was measured, and posttraining feedback was collected to assess the program's effectiveness. Results: Parents of children with ADHD encounter specific challenges, including managing impulsive behavior and difficulties in emotion regulation. The social media-based parenting program was delivered through the LINE app (Line Corporation) and consisted of 7 modules addressing topics related to ADHD management and effective parenting strategies. The program exhibited a high completion rate, with 84% (27/32) of participants successfully finishing it. Program provider-participant interaction peaked during the first week and gradually decreased over time. Qualitative feedback indicated that the program was feasible, accessible, and well received by participants. The LINE app was found to be convenient and helpful, and participants preferred content delivery once or twice per week, expressing acceptance for various content formats. Conclusions: This study emphasizes the significance of adopting a human-centered design thinking approach to develop parenting programs that cater to the unique needs and values of parents. By leveraging social media platforms, such as LINE, a parenting program can overcome the challenges posed by the COVID-19 pandemic and other constraints faced by parents. LINE offers a viable and feasible option for supporting parents of children with ADHD, with the potential for customization and widespread dissemination beyond the pandemic context.

A Practice-Proven Adaptive Case Management Approach for Innovative Health Care Services (Health Circuit): Cluster Randomized Clinical Pilot and Descriptive Observational Study

BACKGROUND

Digital health tools may facilitate the continuity of care. Enhancement of digital aid is imperative to prevent information gaps or redundancies, as well as to facilitate support of flexible care plans.

OBJECTIVE

The study presents Health Circuit, an adaptive case management approach that empowers health care professionals and patients to implement personalized evidence-based interventions, thanks to dynamic communication channels and patient-centered service workflows; analyze the health care impact; and determine its usability and acceptability among health care professionals and patients.

METHODS

From September 2019 to March 2020, the health impact, usability (measured with the system usability scale; SUS), and acceptability (measured with the net promoter score; NPS) of an initial prototype of Health Circuit were tested in a cluster randomized clinical pilot (n=100) in patients with high risk for hospitalization (study 1). From July 2020 to July 2021, a premarket pilot study of usability (with the SUS) and acceptability (with the NPS) was conducted among 104 high-risk patients undergoing prehabilitation before major surgery (study 2).

RESULTS

In study 1, Health Circuit resulted in a reduction of emergency room visits (4/7, 13% vs 7/16, 44%), enhanced patients' empowerment (P<.001) and showed good acceptability and usability scores (NPS: 31; SUS: 54/100). In study 2, the NPS was 40 and the SUS was 85/100. The acceptance rate was also high (mean score of 8.4/10).

CONCLUSIONS

Health Circuit showed potential for health care value generation and good acceptability and usability despite being a prototype system, prompting the need for testing a completed system in real-world scenarios.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04056663; https://clinicaltrials.gov/ct2/show/NCT04056663.

Promoting Engagement With Smartphone Apps for Suicidal Ideation in Young People: Development of an Adjunctive Strategy Using a Lived Experience Participatory Design Approach

BACKGROUND

Suicide among young people is a worrying public health concern. Despite this, there is a lack of suitable interventions aligned with the needs of this priority population. Emerging evidence supports the effectiveness of digital interventions in alleviating the severity of suicidal thoughts. However, their efficacy may be undermined by poor engagement. Technology-supported strategies (eg, electronic prompts and reminders) have been deployed alongside digital interventions to increase engagement with the latter. However, evidence of their efficacy is inconclusive. User-centered design approaches may be key to developing feasible and effective engagement strategies. Currently, no study has been published on how such an approach might be expressly applied toward developing strategies for promoting engagement with digital interventions.

OBJECTIVE

This study aimed to detail the processes and activities involved in developing an adjunctive strategy for promoting engagement with LifeBuoy-a smartphone app that helps young people manage suicidal thoughts.

METHODS

Development of the engagement strategy took place in 2 phases. The discovery phase aimed to create an initial prototype by synthesizing earlier findings-from 2 systematic reviews and a cross-sectional survey of the broader mental health app user population-with qualitative insights from LifeBuoy users. A total of 16 web-based interviews were conducted with young people who participated in the LifeBuoy trial. Following the discovery phase, 3 interviewees were invited by the research team to take part in the workshops in the design phase, which sought to create a final prototype by making iterative improvements to the initial prototype. These improvements were conducted over 2 workshops. Thematic analysis was used to analyze the qualitative data obtained from the interviews and workshops.

RESULTS

Main themes from the interviews centered around the characteristics of the strategy, timing of notifications, and suitability of social media platforms. Subsequently, themes that emerged from the design workshops emphasized having a wider variety of content, greater visual consistency with LifeBuoy, and a component with more detailed information to cater to users with greater informational needs. Thus, refinements to the prototype were focused on (1) improving the succinctness, variety, and practical value of Instagram content, (2) creating a blog containing articles contributed by mental health professionals and young people with lived experience of suicide, and (3) standardizing the use of marine-themed color palettes across the Instagram and blog components.

CONCLUSIONS

This is the first study to describe the development of a technology-supported adjunctive strategy for promoting engagement with a digital intervention. It was developed by integrating perspectives from end users with lived experience of suicide with evidence from the existing literature. The development process documented in this study may be useful for guiding similar projects aimed at supporting the use of digital interventions for suicide prevention or mental health.

Feasibility, Usability, and Safety of ParaGym, an Intelligent Mobile Exercise App for Individuals With Paraplegia: Protocol for a Pilot Block-Randomized Controlled Trial

BACKGROUND

Exercise is crucial for individuals with paraplegia to reduce the risk of secondary diseases and improve independence and quality of life. However, numerous barriers such as inadequate accessibility restrict their participation in exercise programs. Digital exercise apps can help overcome these barriers. Personalization is considered a crucial feature of mobile exercise apps, as people with paraplegia have individual requirements regarding exercise programs depending on their level of impairment. Despite the increasing popularity of mobile exercise apps, there are none available that target the individual needs of this cohort. The ParaGym mobile exercise app prototype was designed to automatically tailor exercise sessions to the individual needs of users with paraplegia.

OBJECTIVE

This study aims to evaluate the feasibility, usability, safety, and preliminary effectiveness of the ParaGym mobile exercise app prototype.

METHODS

This pilot block-randomized controlled feasibility trial will include 45 adult participants with paraplegia. Eligible participants will be block randomized to either the intervention or waitlist control group. The intervention group will perform a 6-week exercise program using the ParaGym mobile exercise app, comprising three 35-minute exercise sessions per week. The waitlist control group will continue their usual care and receive access to the app after study completion. Participants will record all exercise sessions conducted with the app as well as additional exercise sessions conducted during the study period using exercise diaries. The primary outcomes include feasibility, usability, and safety. Feasibility will be assessed through semistructured interviews, study adherence, and retention rates. Usability will be measured using the System Usability Scale. Safety will be determined by the occurrence of adverse events. Secondary outcomes include the effects of the intervention on peak exercise capacity (VO₂ peak); handgrip strength; independence, which will be measured using the Spinal Cord Independence Measure III (SCIM III); and health-related quality of life, which will be measured using the Short Form-36 Health Survey (SF-36).

RESULTS

Recruitment commenced in November 2022. Overall, 12 participants were enrolled at the time of submission. Data collection commenced in January 2023, with completion expected in April 2023.

CONCLUSIONS

To the best of our knowledge, this is the first study to assess the feasibility, usability, and safety of an intelligent mobile exercise app for individuals with paraplegia. Thereafter, the app should be adapted according to the findings of this trial. Future trials with an updated version of the app should aim for a larger sample size, longer intervention duration, and more diverse target group. In the long term, a fully marketable version of the ParaGym app should be implemented. This would increase the access to personalized, independent, and evidence-based exercise training for this cohort and, in the future, other people who use wheelchairs.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00030370; https://drks.de/search/de/trial/DRKS00030370.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/45652.

Fine-tuning Strategies for Classifying Community-Engaged Research Studies Using Transformer-Based Models: Algorithm Development and Improvement Study

BACKGROUND

Community-engaged research (CEnR) involves institutions of higher education collaborating with organizations in their communities to exchange resources and knowledge to benefit a community's well-being. While community engagement is a critical aspect of a university's mission, tracking and reporting CEnR metrics can be challenging, particularly in terms of external community relations and federally funded research programs. In this study, we aimed to develop a method for classifying CEnR studies that have been submitted to our university's institutional review board (IRB) to capture the level of community involvement in research studies. Tracking studies in which communities are "highly engaged" enables institutions to obtain a more comprehensive understanding of the prevalence of CEnR.

OBJECTIVE

We aimed to develop an updated experiment to classify CEnR and capture the distinct levels of involvement that a community partner has in the direction of a research study. To achieve this goal, we used a deep learning-based approach and evaluated the effectiveness of fine-tuning strategies on transformer-based models.

METHODS

In this study, we used fine-tuning techniques such as discriminative learning rates and freezing layers to train and test 135 slightly modified classification models based on 3 transformer-based architectures: BERT (Bidirectional Encoder Representations from Transformers), Bio+ClinicalBERT, and XLM-RoBERTa. For the discriminative learning rate technique, we applied different learning rates to different layers of the model, with the aim of providing higher learning rates to layers that are more specialized to the task at hand. For the freezing layers technique, we compared models with different levels of layer freezing, starting with all layers frozen and gradually unfreezing different layer groups. We evaluated the performance of the trained models using a holdout data set to assess their generalizability.

RESULTS

Of the models evaluated, Bio+ClinicalBERT performed particularly well, achieving an accuracy of 73.08% and an F₁-score of 62.94% on the holdout data set. All the models trained in this study outperformed our previous models by 10%-23% in terms of both F₁-score and accuracy.

CONCLUSIONS

Our findings suggest that transfer learning is a viable method for tracking CEnR studies and provide evidence that the use of fine-tuning strategies significantly improves transformer-based models. Our study also presents a tool for categorizing the type and volume of community engagement in research, which may be useful in addressing the challenges associated with reporting CEnR metrics.

Using Decision Trees as an Expert System for Clinical Decision Support for COVID-19

COVID-19 has impacted billions of people and health care systems globally. However, there is currently no publicly available chatbot for patients and care providers to determine the potential severity of a COVID-19 infection or the possible biological system responses and comorbidities that can contribute to the development of severe cases of COVID-19. This preliminary investigation assesses this lack of a COVID-19 case-by-case chatbot into consideration when building a decision tree with binary classification that was stratified by age and body system, viral infection, comorbidities, and any manifestations. After reviewing the relevant literature, a decision tree was constructed using a suite of tools to build a stratified framework for a chatbot application and interaction with users. A total of 212 nodes were established that were stratified from lung to heart conditions along body systems, medical conditions, comorbidities, and relevant manifestations described in the literature. This resulted in a possible 63,360 scenarios, offering a method toward understanding the data needed to validate the decision tree and highlighting the complicated nature of severe cases of COVID-19. The decision tree confirms that stratification of the viral infection with the body system while incorporating comorbidities and manifestations strengthens the framework. Despite limitations of a viable clinical decision tree for COVID-19 cases, this prototype application provides insight into the type of data required for effective decision support.

Adding Mobile Elements to Online Physical Activity Interventions for Adults Aged Over 50 Years: Prototype Development Study

BACKGROUND

Only a minority of adults aged over 50 years meet physical activity (PA) guidelines of the World Health Organization (WHO). eHealth interventions are proven effective tools to help this population increase its PA levels in the short term, among which the Active Plus and I Move interventions have been developed by our own research group. To achieve long-term effects, increase intervention use, and decrease dropout rates, 3 emergent but different mobile elements (an activity tracker, an ecological momentary intervention [EMI] program, and a chatbot) were added separately to Active Plus and I Move. In this study, the prototype development and pilot-testing of these interventions is described.

OBJECTIVE

This study aims to enhance 2 existing PA-stimulating computer-based interventions with 3 mobile elements (an activity tracker, an EMI program, or a chatbot) and test the prototypes on usability and appreciation within a target population of adults aged over 50 years.

METHODS

A systematic design protocol consisting of development, evaluation, and adaptation procedures was followed with involvement of the target population. Literature searches separated per mobile element and interviews with the target population (N=11) led to 6 prototypes: Active Plus or I Move including (1) an activity tracker, (2) EMI, or (3) a chatbot. These prototypes were tested on usability and appreciation during pilot tests (N=47) and subsequently fine-tuned based on the results.

RESULTS

The literature searches and interviews provided important recommendations on the preferences of the target population, which enabled us to develop prototypes. The subsequent pilot tests showed that the mobile elements scored moderate to good on usability, with average System Usability Scale (SUS) scores of 52.2-82.2, and moderate to good on enjoyment and satisfaction, with average scores ranging from 5.1 to 8.1 on a scale of 1-10. The activity tracker received the best scores, followed by EMI, followed by the chatbot. Based on the findings, the activity tracker interventions were fine-tuned and technical difficulties regarding EMI and the chatbot were solved, which is expected to further improve usability and appreciation.

CONCLUSIONS

During this study, 6 prototypes of online PA interventions with added mobile elements were developed and tested for usability and appreciation. Although all prototypes scored moderate to high on usability, enjoyment, and satisfaction, it can be concluded that the integration of an activity tracker with a computer-based PA intervention is the most promising option among the 3 mobile elements tested during this study. The prototype development steps of the systematic design protocol followed can be considered useful and successful for the purposes of this study. The interventions can now be evaluated on a larger scale through a randomized controlled trial.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/31677.

Designing for patient decision-making: Design challenges generated by patients with atrial fibrillation during evaluation of a decision aid prototype

Shared decision-making (SDM) empowers patients and care teams to determine the best treatment plan in alignment with the patient's preferences and goals. Decision aids are proven tools to support high quality SDM. Patients with atrial fibrillation (AF), the most common cardiac arrhythmia, struggle to identify optimal rhythm and symptom management strategies and could benefit from a decision aid. In this Brief Research Report, we describe the development and preliminary evaluation of an interactive decision-making aid for patients with AF. We employed an iterative, user-centered design method to develop prototypes of the decision aid. Here, we describe multiple iterations of the decision aid, informed by the literature, expert feedback, and mixed-methods design sessions with AF patients. Results highlight unique design requirements for this population, but overall indicate that an interactive decision aid with visualizations has the potential to assist patients in making AF treatment decisions. Future work can build upon these design requirements to create and evaluate a decision aid for AF rhythm and symptom management.

A non-interventive monitoring system prototype for chronic patients with hypertension and asthma

BACKGROUND

Monitoring the vital signs of chronic patients with hypertension, asthma, and chronic obstructive pulmonary disease (COPD) aids in disease prevention.

OBJECTIVE

This study enhances the patient quality of life while adding to the corpus of information about electronic medical devices.

METHOD

The requirements for both the functional and non-functional system architecture were determined and designs were made. Diagrams were used to describe the system's parts, behaviour, and connections before implementation.

RESULTS

Although the project's development produced a remote monitoring system prototype with outcomes comparable to those of patented and regarded as reliable devices, CCFHAC is not yet prepared to be considered a fully finished good that can be used to define a person's health status with absolute certainty.

CONCLUSION

This endeavour marks a step in investigating how the Internet of Things might improve the quality of life for Jordanian patients.

Optimization of 3D Printing Technology for Fabrication of Dental Crown Prototype Using Plastic Powder and Zirconia Materials

This research was aimed at developing a dental prototype from 3D printing technology using a synthetic filament of polylactic acid (PLA) and zirconium dioxide (ZrO₂) with glycerol and silane coupling agent as a binder. A face-centered central composite design was used to study the effects of the filament extrusion parameters and the 3D printing parameters. Tensile and compressive testing was conducted to determine the stress-strain relationship of the filaments. The yield strength, elongation percentage and Young's modulus were also calculated. Results showed the melting temperature of 193 °C, ZrO₂ ratio of 17 wt.% and 25 rpm screw speed contributed to the highest ultimate tensile strength of the synthetic filament. A Nozzle temperature of 210 °C and an infill density of 100% had the most effect on the ultimate compressive strength whilst the printing speed had no significant effects. Differential scanning calorimetry (DSC) was used to study the thermal properties and percentage of crystallinity of PLA filaments. The addition of glycerol and a silane coupling agent increased the tensile strength and filament size. The ZrO₂ particles induced the crystallization of the PLA matrix. A higher crystallization was also obtained from the annealing treatment resulting in the greater thermal resistance performance of the dental crown prototype.

Identification of Requirements for a Postoperative Pediatric Pain Risk Communication Tool: Focus Group Study With Clinicians and Family Members

BACKGROUND

Pediatric surgery is associated with a risk of postoperative pain that can impact the family's quality of life. Although some risk factors for postoperative pain are known, these are often not consistently communicated to families. In addition, although tools for risk communication exist in other domains, none are tailored to pediatric surgery.

OBJECTIVE

As part of a larger project to develop pain risk prediction tools, we aimed to design an easy-to-use tool to effectively communicate a child's risk of postoperative pain to both clinicians and family members.

METHODS

With research ethics board approval, we conducted virtual focus groups (~1 hour each) comprising clinicians and family members (people with lived surgical experience and parents of children who had recently undergone surgery/medical procedures) at a tertiary pediatric hospital to understand and evaluate potential design approaches and strategies for effectively communicating and visualizing postoperative pain risk. Data were analyzed thematically to generate design requirements and to inform iterative prototype development.

RESULTS

In total, 19 participants (clinicians: n=10, 53%; family members: n=9, 47%) attended 6 focus group sessions. Participants indicated that risk was typically communicated verbally by clinicians to patients and their families, with severity indicated using a descriptive or a numerical representation or both, which would only occasionally be contextualized. Participants indicated that risk communication tools were seldom used but that families would benefit from risk information, time to reflect on the information, and follow-up with questions. In addition, 9 key design requirements and feature considerations for effective risk communication were identified: (1) present risk information clearly and with contextualization, (2) quantify the risk and contextualize it, (3) include checklists for preoperative family preparation, (4) provide risk information digitally to facilitate recall and sharing, (5) query the family's understanding to ensure comprehension of risk, (6) present the risk score using multimodal formats, (7) use color coding that is nonthreatening and avoids limitations with color blindness, (8) present the most significant factors contributing to the risk prediction, and (9) provide risk mitigation strategies to potentially decrease the patient's level of risk.

CONCLUSIONS

Key design requirements for a pediatric postoperative pain risk visualization tool were established and guided the development of an initial prototype. Implementing a risk communication tool into clinical practice has the potential to bridge existing gaps in the accessibility, utilization, and comprehension of personalized risk information between health care professionals and family members. Future iterative codesign and clinical evaluation of this risk communication tool are needed to confirm its utility in practice.

A Clinical Decision Support System for Assessing the Risk of Cervical Cancer: Development and Evaluation Study

Background

Cervical cancer has been recognized as a preventable type of cancer. As the assessment of all the risk factors of a disease is challenging for physicians, information technology and risk assessment models have been used to estimate the degree of risk.

Objective

The aim of this study was to develop a clinical decision support system to assess the risk of cervical cancer.

Methods

This study was conducted in 2 phases in 2021. In the first phase of the study, 20 gynecologists completed a questionnaire to determine the essential parameters for assessing the risk of cervical cancer, and the data were analyzed using descriptive statistics. In the second phase of the study, the prototype of the clinical decision support system was developed and evaluated.

Results

The findings revealed that the most important parameters for assessing the risk of cervical cancer consisted of general and specific parameters. In total, the 8 parameters that had the greatest impact on the risk of cervical cancer were selected. After developing the clinical decision support system, it was evaluated and the mean values of sensitivity, specificity, and accuracy were 85.81%, 93.82%, and 91.39%, respectively.

Conclusions

The clinical decision support system developed in this study can facilitate the process of identifying people who are at risk of developing cervical cancer. In addition, it can help to increase the quality of health care and reduce the costs associated with the treatment of cervical cancer.

Investigating the Potential for Clinical Decision Support in Sub-Saharan Africa With AFYA (Artificial Intelligence-Based Assessment of Health Symptoms in Tanzania): Protocol for a Prospective, Observational Pilot Study

BACKGROUND

Low- and middle-income countries face difficulties in providing adequate health care. One of the reasons is a shortage of qualified health workers. Diagnostic decision support systems are designed to aid clinicians in their work and have the potential to mitigate pressure on health care systems.

OBJECTIVE

The Artificial Intelligence-Based Assessment of Health Symptoms in Tanzania (AFYA) study will evaluate the potential of an English-language artificial intelligence-based prototype diagnostic decision support system for mid-level health care practitioners in a low- or middle-income setting.

METHODS

This is an observational, prospective clinical study conducted in a busy Tanzanian district hospital. In addition to usual care visits, study participants will consult a mid-level health care practitioner, who will use a prototype diagnostic decision support system, and a study physician. The accuracy and comprehensiveness of the differential diagnosis provided by the diagnostic decision support system will be evaluated against a gold-standard differential diagnosis provided by an expert panel.

RESULTS

Patient recruitment started in October 2021. Participants were recruited directly in the waiting room of the outpatient clinic at the hospital. Data collection will conclude in May 2022. Data analysis is planned to be finished by the end of June 2022. The results will be published in a peer-reviewed journal.

CONCLUSIONS

Most diagnostic decision support systems have been developed and evaluated in high-income countries, but there is great potential for these systems to improve the delivery of health care in low- and middle-income countries. The findings of this real-patient study will provide insights based on the performance and usability of a prototype diagnostic decision support system in low- or middle-income countries.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04958577; http://clinicaltrials.gov/ct2/show/NCT04958577.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/34298.

Software Architecture for Automated Assessment of Prescription Writing

Prescribing skills are a crucial competency in medical practice considering the increasing numbers of medications available and the increasingly complex patients with multiple diseases faced in clinical practice. Medical students need to become proficient in these skills during training, as required by medical licensing colleges. Not only is teaching the fundamentals of safe and cost-effective prescribing to medical students challenging but evaluating their prescribing skills by faculty members is difficult and time consuming. The COVID-19 pandemic has accelerated the interest in clinically relevant online exams, including automated assessment of short answer style questions. The goal of this project was to design a software to automate the assessment of learners' prescriptions written during low stakes formative assessments. After establishing the components of a legal prescription with multiple medications, and identifying the sources of errors in prescribing and prescribing assessment, we designed and validated an architecture and developed a prototype for automated parsing of learner prescriptions.

Refinement of a Parent-Child Shared Asthma Management Mobile Health App: Human-Centered Design Study

BACKGROUND

The school-age years, approximately ages 7 through 11, represent a natural transition when children begin assuming some responsibility for their asthma management. Previously, we designed a theoretically derived, tailored parent-child shared asthma management mobile health app prototype, Improving Asthma Care Together (IMPACT).

OBJECTIVE

The purpose of this study was to use human-centered design (HCD) to iteratively refine IMPACT to optimize user experience and incorporate evidence-based longitudinal engagement strategies.

METHODS

This study used a mixed methods design from December 2019 to April 2021. Our app refinement used the HCD process of research, ideation, design, evaluation, and implementation, including 6 cycles of design and evaluation. The design and evaluation cycles focused on core app functionality, child engagement, and overall refinement. Evaluation with parent-child dyads entailed in-person and remote concept testing and usability testing sessions, after which rapid cycle thematic analyses identified key insights that informed future design refinement.

RESULTS

Twelve parent-child dyads enrolled in at least one round of this study. Eight of the 12 child participants were male with a mean age of 9.9 (SD 1.6) years and all parent participants were female. Throughout evaluation cycles, dyads selected preferred app layouts, gamification concepts, and overall features with a final design prototype emerging for full-scale development and implementation.

CONCLUSIONS

A theoretically derived, evidence-based shared asthma management app was co-designed with end users to address real-world pain points and priorities. An 8-week pilot study testing app feasibility, acceptability, and preliminary efficacy is forthcoming.

Project and Prototype of Mobile Application for Monitoring the Global COVID-19 Epidemiological Situation

The purpose of this research is to analyze currently available solutions that help to monitor the global epidemiological situation, including travel restrictions, as well as proposing a new solution dedicated to users who want to keep updated with the current restrictions and COVID-19-related statistics. The analysis of existing tools is prepared from the perspective of practical usability for the end user. This paper consists of an overview of the tools and techniques of data visualization and demonstrates how to integrate them with practical business usage in a mobile application.

Intra-rater Kappa Accuracy of Prototype and ICD-10 Operational Criteria-Based Diagnoses for Mental Disorders: A Brief Report of a Cross-Sectional Study in an Outpatient Setting

BACKGROUND AND OBJECTIVES

The use of "operational criteria" is a solution for low reliability, contrasting with a prototypical classification that is used in clinics. We aim to measure the reliability of prototypical and ICD-10 diagnoses.

METHODS

This is a retrospective study, with a convenience sample of subjects treated in a university clinic. Residents reviewed their diagnosis using ICD-10 criteria, and Cohen's kappa statistic was performed on operational and prototype diagnoses.

RESULTS

Three out of 30 residents participated, reviewing 146 subjects under their care. Diagnoses were grouped in eight classes: organic (diagnoses from F00 to F09), substance disorders (F10-F19), schizophrenia spectrum disorders (F20-F29), bipolar affective disorder (F30, F31, F34.0, F38.1), depression (F32, F33), anxiety-related disorders (F40-F49), personality disorders (F60-F69), and neurodevelopmental disorders (F70-F99). Overall, agreement was high [K = 0.77, 95% confidence interval (CI) = 0.69-0.85], with a lower agreement related to personality disorders (K = 0.58, 95% CI = 0.38-0.76) and higher with schizophrenia spectrum disorders (K = 0.91, 95% CI = 0.82-0.99).

DISCUSSION

Use of ICD-10 criteria did not significantly increase the number of diagnoses. It changed few diagnoses, implying that operational criteria were irrelevant to clinical opinion. This suggests that reliability among interviewers is more related to information gathering than diagnostic definitions. Also, it suggests an incorporation of diagnostic criteria according to training, which then became part of the clinician's prototypes. Residents should be trained in the use of diagnostic categories, but presence/absence checking is not needed to achieve operational compatible diagnoses.

Design and Development of Isolating Pods to Prevent the Spread of Coronavirus or Other Viruses for Hospital and Domestic Purposes

OBJECTIVES

This project investigated into the design and construction of an isolation pod to keep infected people in quarantine, thus avoiding the spread of viruses such as the COVID-19. This product was made to be used in hospitals and at homes.

BACKGROUND

Mauritius is among the few countries, which has not had any cases of COVID-19 since for since May 2020 for a period of 150 days. It has opened its borders since October 2020, and since Mauritius being a small country, the spread of any type of virus can be imminent if not controlled properly. In case there is another spread of the COVID-19 in Mauritius, then the isolation pod could be used to keep infected people in quarantine. The aims of the study were to develop a prototype of an isolation cubicle that is collapsible and can be easily erected at homes or in hospitals, whenever the need arises.

METHODS

A prototype of the pod was made with metal bars welded together and tarpaulin materials were sewn together. A HEPA Fan Extractor was fitted inside the pod to allow the air to circulate.

RESULTS

the tests carried out the pod could easily be assembled, transported and stored for further usage. From the volunteers' feedback, it was found that the pod was comfortable, spacious, and practical. The air monitoring tests carried on the carbon dioxide, temperature, and relative humidity were within the acceptable ranges.

Combined Application of Prototype Ultrasound and BSA-Loaded PLGA Particles for Protein Delivery

PURPOSE

To develop an in vitro culture system for tissue engineering to mimic the in vivo environment and evaluate the applicability of ultrasound and PLGA particle system.

METHODS

For tissue engineering, large molecules such as growth factors for cell differentiation should be supplied in a controlled manner into the culture system, and the in vivo microenvironment need to be reproduced in the system for the regulation of cellular function. In this study, portable prototype ultrasound with low intensity was devised and tested for protein release from bovine serum albumin (BSA)-loaded poly(lactic-co-glycolic acid) (PLGA) particles.

RESULTS

BSA-loaded PLGA particles were prepared using various types of PLGA reagents and their physicochemical properties were characterized including particle size, shape, or aqueous wetting profiles. The BSA-loaded formulation showed nano-ranged size distribution with optimal physical stability during storage period, and protein release behaviors in a controlled manner. Notably, the application of prototype ultrasound with low intensity influenced protein release patterns in the culture system containing the BSA-loaded PLGA formulation. The results revealed that the portable ultrasound set controlled by the computer could contribute for the protein delivery in the culture medium.

CONCLUSIONS

This study suggests that combined application with ultrasound and protein-loaded PLGA encapsulation system could be utilized to improve culture system for tissue engineering or cell regeneration therapy.

Pharmaceutical Perspective in Wearable Drug Delivery Systems

Humans have been dealing with health problems for millions of years. Normal health services need well-trained personnel and high-cost diagnostic tests, which forces patients to go to hospitals if medical treatment is required. To address this, prototype testing has been carried out into the wearable drug delivery health care perspectives. Researchers have devised a wide variety of formulations for the treatment of various diseases at home by performing real-time monitoring of different routes of drug administration such as ocular, transdermal, intraoral, intracochlear, and several more. A comprehensive review of the different types of wearable drug delivery systems with respect to their manufacturing, mechanism of action and specifications has been done. In the pharmaceutical context, these devices are technologically well-equipped interfaces for diverse physicochemical signals. Above mentioned information with a broader perspective has also been discussed in this article. Several wearable drug delivery systems have been introduced in the market in recent years. But a lot of testing needs to be conducted to address the numerous obstacles before the wearable devices are successfully launched in the market.

T cell epitopes of SARS-CoV-2 spike protein and conserved surface protein of Plasmodium malariae share sequence homology

Since its emergence in late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been spreading remarkably fast worldwide. Effective countermeasures require the rapid development of data and tools to monitor its spread and better understand immunogenic profile. However, limited information is available about the tools and target of the immune responses to SARS-CoV-2. In this study, we excogitated a new approach for analyzing phylogenetic relationships by using the whole prototype proteome sequences. Phylogenetic analysis on the whole prototype proteome sequences showed that SARS-CoV-2 was a direct descendant of Bat-CoV and was closely related to Pangolin-CoV, Bat-SL-CoV, and SARS-CoV. The pairwise comparison of SARS-CoV-2 with Bat-CoV showed an unusual replacement of the motif consisting of seven amino acids (NNLDSKV) within the spike protein of SARS-CoV-2. The replaced motif in the spike protein of SARS-CoV-2 was found in 12 other species, including a conserved surface protein of a malaria-causing pathogen, Plasmodium malariae. We further identified the T and B cell epitope sequence homology of SARS-CoV-2 spike protein with conserved surface protein of P. malariae using the Immune Epitope Database and Analysis Resource (IEDB). The shared immunodominant epitopes may provide immunity against SARS-CoV-2 infection to those previously infected with P. malariae.

A radical change in our autism research strategy is needed: Back to prototypes

The evolution of autism diagnosis, from its discovery to its current delineation using standardized instruments, has been paralleled by a steady increase in its prevalence and heterogeneity. In clinical settings, the diagnosis of autism is now too vague to specify the type of support required by the concerned individuals. In research, the inclusion of individuals categorically defined by over-inclusive, polythetic criteria in autism cohorts results in a population whose heterogeneity runs contrary to the advancement of scientific progress. Investigating individuals sharing only a trivial resemblance produces a large-scale type-2 error (not finding differences between autistic and dominant population) rather than detecting mechanistic differences to explain their phenotypic divergences. The dimensional approach of autism proposed to cure the disease of its categorical diagnosis is plagued by the arbitrariness of the dimensions under study. Here, we argue that an emphasis on the reliability rather than specificity of diagnostic criteria and the misuse of diagnostic instruments, which ignore the recognition of a prototype, leads to confound autism with the entire range of neurodevelopmental conditions and personality variants. We propose centering research on cohorts in which individuals are selected based on their expert judged prototypicality to advance the theoretical and practical pervasive issues pertaining to autism diagnostic thresholds. Reversing the current research strategy by giving more weight to specificity than reliability should increase our ability to discover the mechanisms of autism. LAY SUMMARY: Scientific research into the causes of autism and its mechanisms is carried out on large cohorts of people who are less and less different from the general population. This historical trend may explain the poor harvest of results obtained. Services and intervention are provided according to a diagnosis that now encompasses extremely different individuals. Last, we accept as a biological reality the constant increase over the years in the proportion of autistic people among the general population. These drifts are made possible by the attribution of a diagnosis of autism to people who meet vague criteria, rather than to people who experienced clinicians recognize as autistic. We propose to change our research strategy by focusing on the study of the latter, fewer in number, but more representative of the "prototype" of autism. To do this, it is necessary to clearly distinguish the population on which the research is carried out from that to which we provide support. People must receive services according to their needs, and not according to the clarity of their diagnosis.

Design and development of a biological implant for long term intravaginal retention in cattle

OBJECTIVE

Design, develop and trial an intravaginal device able to remain within the bovine vagina for up to 6 months, accommodating various technologies, while not adversely affecting the cow, or pregnancy.

METHODS

Device scoping required minimal interference with vaginal drainage, no constant pressure on any single point of the vaginal mucosa and minimal footprint on the vaginal floor. A polycarbonate prototype was developed consisting of a central cargo space to house sensors and battery, with a separate retention module. Mathematical modelling informed the required length and flexibility of the arms on the retention module to reduce pressure necrosis and inflammation within the vagina. The prototype was initially trialled, with a loaded cargo pod, for 4 weeks in five non-pregnant cows. Cows were monitored for signs of systemic infection and inflammation by collecting blood samples for haematology and acute phase inflammatory proteins. Cows were also assessed for general demeanour, signs of discomfort and positioning of the device. Later, the device was inserted into 20 early pregnant cows, with 20 contemporary, untreated controls. Cows were monitored, as in the initial trial, every 4 weeks for the next 5 to 6 months until calving.

RESULTS

In Trial 1, there was 100% retention with no adverse effects. In Trial 2, device retention was 75% until calving with no adverse effects on cow health or pregnancy.

CONCLUSIONS

We describe the longest successful deployment of an intravaginal device in pregnant and non-pregnant cattle, with long-term retention, no adverse effects and 28 cm³ of cargo space.

The Implementation Science for Genomic Health Translation (INSIGHT) Study in Epilepsy: Protocol for a Learning Health Care System

BACKGROUND

Genomic medicine is poised to improve care for common complex diseases such as epilepsy, but additional clinical informatics and implementation science research is needed for it to become a part of the standard of care. Epilepsy is an exemplary complex neurological disorder for which DNA diagnostics have shown to be advantageous for patient care.

OBJECTIVE

We designed the Implementation Science for Genomic Health Translation (INSIGHT) study to leverage the fact that both the clinic and testing laboratory control the development and customization of their respective electronic health records and clinical reporting platforms. Through INSIGHT, we can rapidly prototype and benchmark novel approaches to incorporating clinical genomics into patient care. Of particular interest are clinical decision support tools that take advantage of domain knowledge from clinical genomics and can be rapidly adjusted based on feedback from clinicians.

METHODS

Building on previously developed evidence and infrastructure components, our model includes the following: establishment of an intervention-ready genomic knowledge base for patient care, creation of a health informatics platform and linking it to a clinical genomics reporting system, and scaling and evaluation of INSIGHT following established implementation science principles.

RESULTS

INSIGHT was approved by the Institutional Review Board at the University of Texas Health Science Center at Houston on May 15, 2020, and is designed as a 2-year proof-of-concept study beginning in December 2021. By design, 120 patients from the Texas Comprehensive Epilepsy Program are to be enrolled to test the INSIGHT workflow. Initial results are expected in the first half of 2023.

CONCLUSIONS

INSIGHT's domain-specific, practical but generalizable approach may help catalyze a pathway to accelerate translation of genomic knowledge into impactful interventions in patient care.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/25576.

Do Only White or Asian Males Belong in Genius Organizations? How Academic Organizations' Fixed Theories of Excellence Help or Hinder Different Student Groups' Sense of Belonging

High-profile organizations often emphasize fixed giftedness rather than malleable effort-based criteria as critical for excellent achievements. With giftedness being primarily associated with White or Asian males, such organizational implicit theories of excellence may shape individuals' sense of belonging depending on the extent to which they match the gifted White/Asian male prototype, i.e., the prototypical gifted person which is typically imagined to be a White or Asian male. Previous research has reported fixed excellence theories emphasizing giftedness (vs. malleable theories emphasizing effort) to impair the sense of belonging of females and negatively stereotyped ethnic minorities. We investigate the combined effects of gender and ethnicity. We predicted that, while individuals whose gender and ethnicity do not match the gifted prototype show a reduced sense of belonging in fixed organizations, White/Asian males who match the gifted prototype show the opposite effect, experiencing a higher sense of belonging in fixed (vs. malleable) organizations. In an experimental study (N = 663 students), we manipulated advertising material used by a highly selective academic institution in Germany and tested effects on students' belonging. Whereas the original material emphasized giftedness as essential for excelling (fixed excellence version), our manipulated version stressed effort (malleable version). As expected, females from stereotyped ethnic minority groups felt less belonging in the fixed (vs. malleable) organization, while White/Asian males anticipated stronger belonging in the fixed (vs. malleable) organization. Fixed views of excellence impair negatively stereotyped individuals' belonging but may even strengthen the belonging of prototypical academic elites.

Taking Serious Games Forward in Curriculum and Assessment: Starting Infusions Right Every Time

Technology-driven educational modalities are increasingly utilized today in a variety of forms. Different combinations of the spectrum of simulation-based learning, the use of virtual reality, augmented reality, mixed reality, and serious gaming continue to gain traction on various educational platforms. In this paper, we share the formation of our project team to plan and execute a serious game on starting infusions and the use of infusion pump for nursing and health-care staff. The incorporation of element of assessment is also discussed. The various phases we went through included: Learning needs assessment and conceptualizationAssembly of project teamTransfer of medical conceptsStoryboard and content productionLearners' experiential mappingTesting of the prototypeBeta testing and release of the final product The collaborative work and coordination between the subject-matter experts together with the technical production team is critical. Issues such as assessment and debriefing in serious gaming were also addressed, not forgetting the need to ensure that, above all, learning must take place.

Development and Consumer Perception of a Snack Machine Producing Customized Spoonable and Drinkable Products Enriched in Dietary Fiber and Protein

The aim of the study was to evaluate consumer perceptions toward customized snacks produced with a Healthy Snack Machine (HSM) prototype, at-site of the purchase and consumption. The present study had a multi-disciplinary approach including both snack product and HSM development (hardware and user interface). Snack development included both instrumental (viscosity, colloidal stability) and sensory characterization (by trained sensory (N = 10) and consumer (N = 55) panels) of spoonable and drinkable, oat- and dairy-based snack products, fortified with protein and/or dietary fiber. The protein and fiber addition reduced viscosity in spoonable products but did not affect the consistency of drinkable samples. Oat-based samples differed from dairy-based in multiple attributes in sensory profiling. In consumer sample testing, sample odor and taste were the most and least preferred aspects, respectively. In the snack machine testing, a qualitative consumer study (N = 33) showed that the HSM was easy to use, the user interface was clear, the ordering process was quick, and the participants were interested in using the HSM in the future. The snack choices (spoonable/drinkable and dairy/oat base) made by the consumers were distributed equally, but the berry-flavor was preferred over cocoa and vanilla. The most common HSM usage scenarios were “between work/school and hobbies” and “in transit from one place to another”.

Development of a Social Network for People Without a Diagnosis (RarePairs): Evaluation Study

Background

Diagnostic delay in rare disease (RD) is common, occasionally lasting up to more than 20 years. In attempting to reduce it, diagnostic support tools have been studied extensively. However, social platforms have not yet been used for systematic diagnostic support. This paper illustrates the development and prototypic application of a social network using scientifically developed questions to match individuals without a diagnosis.

Objective

The study aimed to outline, create, and evaluate a prototype tool (a social network platform named RarePairs), helping patients with undiagnosed RDs to find individuals with similar symptoms. The prototype includes a matching algorithm, bringing together individuals with similar disease burden in the lead-up to diagnosis.

Methods

We divided our project into 4 phases. In phase 1, we used known data and findings in the literature to understand and specify the context of use. In phase 2, we specified the user requirements. In phase 3, we designed a prototype based on the results of phases 1 and 2, as well as incorporating a state-of-the-art questionnaire with 53 items for recognizing an RD. Lastly, we evaluated this prototype with a data set of 973 questionnaires from individuals suffering from different RDs using 24 distance calculating methods.

Results

Based on a step-by-step construction process, the digital patient platform prototype, RarePairs, was developed. In order to match individuals with similar experiences, it uses answer patterns generated by a specifically designed questionnaire (Q53). A total of 973 questionnaires answered by patients with RDs were used to construct and test an artificial intelligence (AI) algorithm like the k-nearest neighbor search. With this, we found matches for every single one of the 973 records. The cross-validation of those matches showed that the algorithm outperforms random matching significantly. Statistically, for every data set the algorithm found at least one other record (match) with the same diagnosis.

Conclusions

Diagnostic delay is torturous for patients without a diagnosis. Shortening the delay is important for both doctors and patients. Diagnostic support using AI can be promoted differently. The prototype of the social media platform RarePairs might be a low-threshold patient platform, and proved suitable to match and connect different individuals with comparable symptoms. This exchange promoted through RarePairs might be used to speed up the diagnostic process. Further studies include its evaluation in a prospective setting and implementation of RarePairs as a mobile phone app.

A Path Towards Inclusion: Transdisciplinary Experience for the Inclusion of Self-Perceived Gender in an Information System

In Argentina, since 2012 the Gender Identity Law guarantees that people who identify as transgender must be called by their chosen name, among other things. Transgender patients are usually not represented in information systems, whether electronic or not. This can place them in situations of vulnerability and discrimination. With that in mind, an interdisciplinary team was formed to take address the problems of this population regarding to the information systems of Hospital Italiano de Buenos Aires. The aim of this study is to spread the experience of the transdisciplinary team on the Electronic Health Record's modification and other associated applications to achieve include the self-perceived gender identity and the chosen name of those people who modified their gender.

Heated Air Delivery by Micro-Sauna: An Experimental Treatment Prototype Concept for Coronavirus Disease 2019

Coronavirus disease 2019 (COVID-19) has gained international attention as it poses a significant threat to global health. Currently, medical researchers are working to exhaust all strategies that may prove beneficial in combating this disease. Heat has been shown to destabilize other coronavirus strains in testing environments, and it has been hypothesized that heated air may destabilize viral pathogens in vivo as well. The present report describes the engineering of a micro-sauna prototype for the delivery of heated air. Concept formulation, process highlights, and the final prototype are all discussed. The prototype can deliver air heated to 80-90 degrees Celsius in a safe and tolerable manner. The goal of this technical report is to further encourage the study of heated air as a potential COVID-19 treatment.

A Prototype of EEG System for IoT

In this work, we develop open source hardware and software for eye state classification and integrate it with a protocol for the Internet of Things (IoT). We design and build the hardware using a reduced number of components and with a very low-cost. Moreover, we propose a method for the detection of open eyes (oE) and closed eyes (cE) states based on computing a power ratio between different frequency bands of the acquired signal. We compare several real- and complex-valued transformations combined with two decision strategies: a threshold-based method and a linear discriminant analysis. Simulation results show both classifier accuracies and their corresponding system delays.