BACKGROUND: Knee arthritis is a destructive disorder that affects the knee joints and causes pain and reduced mobility. Drug treatments, weight loss, and exercise control the symptoms of the disease, but these methods only delay the disease process and eventually, knee joint replacement surgery will be needed. After surgery, with the help of a proper physiotherapy program, full recovery takes an average of 6-12 months. However, currently, there is no similar tool to facilitate this process in Iran.
OBJECTIVE: The purpose of this research is to design and develop the prototype of a rehabilitation system for patients after knee replacement surgery, which provides patients with information and appropriate physiotherapy programs.
METHODS: This study was development-applied and was done in three stages. In the first stage, the needs and content of education and therapeutic exercises were prepared in the form of a checklist, and then the necessity of each item was checked in the evaluation sessions. In the second stage, the prototype of the system was developed using Adobe XD software and based on the requirements approved from the previous stage. In the third stage, the usability of the program was analyzed from the point of view of experts using the exploratory evaluation method with Nielsen\'s 13 principles of usability.
RESULTS: At first, the system requirements were extracted and prepared in two checklists of content (51 exercises) and capabilities (60 items). Then after a survey of experts based on the Delphi technique, content information (43 exercises) and functional and non-functional requirements (53 items) were obtained. A survey of experts helped to finalize the information elements, categorize them, and prepare the final version of the checklists. Based on this, the system requirements were classified into 11 categories, and the training content was classified into 3 training periods. Finally, the design and development of the system was done. This system has admin, physician, and patient user interfaces. The result of usability showed that this system is efficient and there are only a few problems in the feature of helping users to detect and recover from errors.
CONCLUSIONS: It seems necessary to develop a system based on the principles of usability by therapists and rehabilitation specialists to train and monitor the remote rehabilitation process of patients after knee joint replacement at home. And the importance of involving stakeholders in the design and development of remote rehabilitation systems is not hidden from anyone. Kara system has all of the above.

BACKGROUND: Blood glucose management around exercise is challenging for youth with type 1 diabetes (T1D). Previous research has indicated interventions including decision-support aids to better support youth to effectively contextualize blood glucose results and take appropriate action to optimize glucose levels during and after exercise. Mobile health (mHealth) apps help deliver health behavior interventions to youth with T1D, given the use of technology for glucose monitoring, insulin dosing, and carbohydrate counting.
OBJECTIVE: We aimed to develop a novel prototype mHealth app to support exercise management among youth with T1D, detail the application of a co-design process and design thinking principles to inform app design and development, and identify app content and functionality that youth with T1D need to meet their physical activity goals.
METHODS: A co-design approach with a user-centered design thinking framework was used to develop a prototype mHealth app \"acT1ve\" during the 18-month design process (March 2018 to September 2019). To better understand and respond to the challenges among youth with diabetes when physically active, 10 focus groups were conducted with youth aged 13-25 years with T1D and parents of youth with T1D. Thereafter, we conducted participatory design workshops with youth to identify key app features that would support individual needs when physically active. These features were incorporated into a wireframe, which was critically reviewed by participants. A beta version of \"acT1ve\" was built in iOS and android operating systems, which underwent critical review by end users, clinicians, researchers, experts in exercise and T1D, and app designers.
RESULTS: Sixty youth with T1D, 14 parents, 6 researchers, and 10 clinicians were engaged in the development of \"acT1ve.\" acT1ve included key features identified by youth, which would support their individual needs when physically active. It provided advice on carbohydrates and insulin during exercise, information on hypoglycemia treatment, pre- and postexercise advice, and an educational food guide regarding exercise management. \"acT1ve\" contained an exercise advisor algorithm comprising 240 pathways developed by experts in diabetes and exercise research. Based on participant input during exercise, acT1ve provided personalized insulin and carbohydrate advice for exercise lasting up to 60 minutes. It also contains other features including an activity log, which displays a complete record of the end users\' activities and associated exercise advice provided by the app\'s algorithm for later reference, and regular reminder notifications for end users to check or monitor their glucose levels.
CONCLUSIONS: The co-design approach and the practical application of the user-centered design thinking framework were successfully applied in developing \"acT1ve.\" The design thinking processes allowed youth with T1D to identify app features that would support them to be physically active, and particularly enabled the delivery of individualized advice. Furthermore, app development has been described in detail to help guide others embarking on a similar project.
BACKGROUND: Australian New Zealand Clinical Trials Registry ACTRN12619001414101; https://tinyurl.com/mu9jvn2d.

In clinical settings, due largely to the cost, size and calibration complexity of existing indirect calorimetry systems, there is seldom instrumentation available to provide reliable, continuous tracking of a mechanically ventilated patient\'s metabolic output in support of proper nutrition. The atypical metabolisms associated with critically ill patients are difficult to predict and both underfeeding and overfeeding lead to negative impacts on both mortality and the recovery and healing processes. With these issues in mind, a novel ventilator-agnostic indirect calorimetry sensor design, prototype development, and validation were undertaken with the goal of enabling 24/7 metabolic monitoring of mechanically ventilated patients by means of a passive, rate-proportional side-stream sampling scheme and miniature mixing chamber. The miniature mixing chamber enables the use of small, low-cost gas concentration and flow sensing components to ensure the affordability of commercial design-for-manufacture implementations of the prototype sensor. In addition to continuous measurement of patient metabolism, the prototype sensor also enables autonomous monitoring and detection of calibration drift in the gas measurement sensors without disrupting the patient ventilation.

BACKGROUND: Multiple studies have examined the impact of deferral on the motivation of prospective blood donors, proposing various policies and strategies to support individuals who undergo this experience. However, existing information and communications technology systems focused on blood donation have not yet integrated these ideas or provided options to assist with the deferral experience.
OBJECTIVE: This study aims to propose an initial gamified design aimed at mitigating the impact of the deferral experience by addressing the drivers of awareness and knowledge, interaction and validation, and motivation. Additionally, the study explores the feasibility of implementing such a system for potential users.
METHODS: We conducted a literature review focusing on the dynamics of motivation and intention related to blood donation, as well as the deferral situation and its impact on citizens. Through this review, we identified weak donor identity, lack of knowledge, and reduced motivation as key factors requiring support from appropriate interventions. These factors were then defined as our key drivers. Taking these into account, we proposed a gamification approach that incorporates concepts from the MDA framework. The aim is to stimulate the aforementioned drivers and expand the concept of contribution and identity in blood donation. For a preliminary evaluation, we designed a prototype to collect feedback on usability, usefulness, and interest regarding a potential implementation of our proposed gamification approach.
RESULTS: Among the participants, a total of 11 citizens interacted with the app and provided feedback through our survey. They indicated that interacting with the app was relatively easy, with an average score of 4.13 out of 5 when considering the 11 tasks of interaction. The SUS results yielded a final average score of 70.91 from the participants\' answers. Positive responses were received when participants were asked about liking the concept of the app (3.82), being likely to download it (3.55), and being likely to recommend it to others (3.64). Participants expressed positivity about the implementation of the design but also highlighted current shortcomings and suggested possible improvements in both functionality and usability.
CONCLUSIONS: Although deferral is a common issue in blood donation, there is a missed opportunity in existing ICT services regarding how to effectively handle such experiences. Our proposed design and implementation seem to have captured the interest of prospective users due to its perceived positive usefulness and potential. However, further confirmation is needed. Improving the design of activities that currently rely heavily on extrinsic motivation elements and integrating more social components to create an enhanced activity loop for intrinsic motivation could further increase the value of the proposed project. Future research could involve conducting a more specialized and longitudinal design evaluation with a larger sample size.

BACKGROUND: Cyclic vomiting syndrome (CVS) is an enigmatic and debilitating disorder of gut-brain interaction that is characterized by recurrent episodes of severe vomiting and nausea. It significantly impairs patients\' quality of life and can lead to frequent medical visits and substantial health care costs. The diagnosis for CVS is often protracted and complex, primarily due to its exclusionary diagnosis nature and the lack of specific biomarkers. This typically leads to a considerable delay in accurate diagnosis, contributing to increased patient morbidity. Additionally, the absence of approved therapies for CVS worsens patient hardship and reflects the urgent need for innovative, patient-centric solutions to improve CVS management.
OBJECTIVE: We aim to develop a digital patient assistant (DPA) for patients with CVS to address their unique needs, and iteratively enhance the technical features and user experience on the initial DPA versions.
METHODS: The development of the DPA for CVS used a design thinking approach, prioritizing user needs. A literature review and Patient Advisory Board shaped the initial prototype, focusing on diagnostic support and symptom tracking. Iterative development, informed by the design thinking approach and feedback from patients with CVS and caregivers through interviews and smartphone testing, led to significant enhancements in user interaction and artificial intelligence integration. The final DPA\'s effectiveness was validated using the System Usability Scale and feedback questions, ensuring it met the specific needs of the CVS community.
RESULTS: The DPA developed for CVS integrates an introductory bot, daily and weekly check-in bots, and a knowledge hub, all accessible via a patient dashboard. This multicomponent solution effectively addresses key unmet needs in CVS management: efficient symptom and impacts tracking, access to comprehensive disease information, and a digital health platform for disease management. Significant improvements, based on user feedback, include the implementation of artificial intelligence features like intent recognition and data syncing, enhancing the bot interaction and reducing the burden on patients. The inclusion of the knowledge hub provides educational resources, contributing to better disease understanding and management. The DPA achieved a System Usability Scale score of 80 out of 100, indicating high ease of use and relevance. Patient feedback highlighted the DPA\'s potential in disease management and suggested further applications, such as integration into health care provider recommendations for patients with suspected or confirmed CVS. This positive response underscores the DPA\'s role in enhancing patient engagement and disease management through a patient-centered digital solution.
CONCLUSIONS: The development of this DPA for patients with CVS, via an iterative design thinking approach, offers a patient-centric solution for disease management. The DPA development framework may also serve to guide future patient digital support and research scenarios.

The process of seedling transplantation has significant importance within the realm of mechanical vegetable production in contemporary agriculture. A prototype of a two-row tractor-mounted semi-automatic vegetable seedling transplanter (SVT) was conceptualized and developed for small agricultural holdings. The functional behaviour of the prototype was examined with computer-aided design tools, and the various units of the prototype have been finalized. To develop the prototype, the feeding, metering, transplanting, drive train, and soil compacting/covering unit of the machine were developed and constructed using materials readily accessible locally. The machine has a set row-to-row spacing of 600 mm, and it may alter the plant-to-plant spacing when the machine\'s forward speed changes. The pace was customized to achieve the required 450 mm plant-to-plant spacing. A 12:1 speed reduction gearbox was used for the proper metering of seedlings. The effect of independent factors, namely tray cell type, feeding mechanism, soil covering/compacting wheel angle, and age of seedling, on the machine\'s actual field capacity (AFC) was examined. The prototype underwent preliminary field testing to assess the functional viability, and the functioning was satisfactory. The main effect of the feeding mechanism and soil covering/compacting wheel angle on AFC was statistically significant at 5 % for tomato and brinjal whereas their first-order interaction was found statistically significant on AFC for tomatoes. The findings demonstrate that this study\'s prototype can be marketed or used to further vegetable production studies.

UNASSIGNED: 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.
UNASSIGNED: This study aimed to assess the feasibility of the prototype of a serious game called \"Silver.\"
UNASSIGNED: 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.
UNASSIGNED: 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%).
UNASSIGNED: 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.

In response to the challenges of low automation and a lack of a continuous processing system for Taiping Houkui tea, this study proposed a design scheme for a continuous processing line and built a continuous processing prototype for testing by combining the production requirements of Taiping Houkui tea, the characteristics of withered leaves, and the existing relevant production equipment. First, the physical properties of Taiping Houkui tea were determined. A simulation was performed using the Hertz-Mindlin model, and the motion states of the tea leaves were obtained under different conditions to define the parameter design range of the experimental platform and verify its structural rationality. Then, the response surface methodology was used to optimize the working parameter ranges and obtain the best working parameters for the feeding and kneading mechanisms. Finally, a continuous production prototype was constructed for further production verification. The experimental results show that the success rate of continuous production on this platform was 70.68%, with an average output of approximately 0.4 kg/h for Taiping Houkui dry tea on a single slide track, and the produced tea was similar to manually made tea. This demonstrates that the continuous production technique has high feasibility and provides a reference for continuous production of Taiping Houkui tea.

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

UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.