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Background: Cardiovascular disease is the major cause of death worldwide. Although knowledge regarding diagnosing and treating cardiovascular disease has increased dramatically, secondary prevention remains insufficiently implemented due to failure among affected individuals to adhere to guideline recommendations. This has continued to lead to high morbidity and mortality rates. Involving patients in their healthcare and facilitating their active roles in their chronic disease management is an opportunity to meet the needs of the increasing number of cardio-vascular patients. However, simple recall of advice regarding a more preventive lifestyle does not affect sustainable behavioral lifestyle changes. We investigate the effect of plaque visualization combined with low-threshold daily lifestyle tasks using the smartphone app PreventiPlaque to evaluate change in cardiovascular risk profile. Methods: and study design: This randomized, controlled clinical trial includes 240 participants with ultrasound evidence of atherosclerotic plaque in one or both carotid arteries, defined as focal thickening of the vessel wall measuring 50% more than the regular vessel wall. A criterion for participation is access to a smartphone suitable for app usage. The participants are randomly assigned to an intervention or a control group. While both groups receive the standard of care, the intervention group has additional access to the PreventiPlaque app during the 12-month follow-up. The app includes daily tasks that promote a healthier lifestyle in the areas of smoking cessation, medication adherence, physical activity, and diet. The impact of plaque visualization and app use on the change in cardiovascular risk profile is assessed by SCORE2. Feasibility and effectiveness of the PreventiPlaque app are evaluated using standardized and validated measures for patient feedback.
Tap or swipe
(2023)
Open tracing tools
(2023)
Background: Coping with the rapid growing complexity in contemporary software architecture, tracing has become an increasingly critical practice and been adopted widely by software engineers. By adopting tracing tools, practitioners are able to monitor, debug, and optimize distributed software architectures easily. However, with excessive number of valid candidates, researchers and practitioners have a hard time finding and selecting the suitable tracing tools by systematically considering their features and advantages. Objective: To such a purpose, this paper aims to provide an overview of popular Open tracing tools via comparison. Methods: Herein, we first identified 30 tools in an objective, systematic, and reproducible manner adopting the Systematic Multivocal Literature Review protocol. Then, we characterized each tool looking at the 1) measured features, 2) popularity both in peer-reviewed literature and online media, and 3) benefits and issues. We used topic modeling and sentiment analysis to extract and summarize the benefits and issues. Specially, we adopted ChatGPT to support the topic interpretation. Results: As a result, this paper presents a systematic comparison amongst the selected tracing tools in terms of their features, popularity, benefits and issues. Conclusion: The result mainly shows that each tracing tool provides a unique combination of features with also different pros and cons. The contribution of this paper is to provide the practitioners better understanding of the tracing tools facilitating their adoption.
Coupling is one of the most frequently mentioned metric in software systems. However, to measure logical coupling between microservices, runtime information is needed or the availability of service-log files to analyze the calls between services is required. This work presents our emerging results, in which we propose a metric to statically calculate logical coupling between microservices based on commits to versioning systems. We performed an initial validation of the proposed metric with a dataset containing 145 open-source microservices projects. The results illustrate how logical coupling affects every system and increases overtime. However, we did not find a correlation between the number of commits or the number of developers and the introduction of logical coupling. In future, we investigate why, how, and when logical coupling is introduced in a system.
As the boundary between real and virtual life is becoming increasingly blurred, researchers and practitioners are looking for ways to integrate the two intending to improve human lives in a plethora of domains. A cutting-edge concept is the design of Digital Twins (DT), having a broad range of implications and applications, spanning from education, training, as well as safety and productivity in the workplace. An emergent approach for implementing DTs is the usage of mixed reality (MR) and augmented reality (AR), which are well aligned with merging real and virtual objects to enhance the human’s ability to interact with and manage DTs. Yet, this is still a novel area of research and, as such, a grounded understanding of the current state, challenges, and open questions is still lacking. Towards this, we conducted a PRISMA-based literature review of scientific articles and book chapters dealing with the use of MR and AR for digital twins. After a thorough screening phase and eligibility check, 25 papers were analyzed, sorted and compared by different categories like research topic (e.g., visualization, guidance), domain (e.g., manufacturing, education), paper type (e.g., design study, evaluation), evaluation type (user study, case study or none), used hardware (e.g., Microsoft HoloLens, mobile devices) as well as the different outcomes (result type and topic, problems, outlook). The major finding of this research survey is the predominant focus of the reviewed papers on the technology itself and the neglect of factors regarding the users. We, therefore, encourage researchers in this area to keep the importance of ease and joy of use in mind and include users in multiple stages of their work.
The increasing digitalisation of daily routines confronts people with frequent privacy decisions. However, obscure data processing often leads to tedious decision-making and results in unreflective choices that unduly compromise privacy. Serious Games could be applied to encourage teenagers and young adults to make more thoughtful privacy decisions. Creating a Serious Game (SG) that promotes privacy awareness while maintaining an engaging gameplay requires, however, a carefully balanced game concept. This study explores the benefits of an online role-playing boardgame as a co-designing activity for creating SGs about privacy. In a between-subjects trial, student groups and educator/researcher groups were taking the roles of player, teacher, researcher and designer to co-design a balanced privacy SG concept. Using predefined design proposal cards or creating their own, students and educators played the online boardgame during a video conference session to generate game ideas, resolve potential conflicts and balance the different SG aspects. The comparative results of the present study indicate that students and educators alike perceive support from role-playing when ideating and balancing SG concepts and are happy with their playfully co-designed game concepts. Implications for supporting SG design with role-playing in remote collaboration scenarios are conclusively synthesised.
When it comes to improving the health of the general population, mHealth technologies with self-monitoring and intervention components hold a lot of promise. We argue, however, that due to various factors such as access, targeting, personal resources or incentives, self-monitoring applications run the risk of increasing health inequalities, thereby creating a problem of social justice. We review empirical evidence for “intervention-generated” inequalities, present arguments that self-monitoring applications are still morally acceptable, and develop approaches to avoid the promotion of health inequalities through self-monitoring applications.
Background: Peripheral arterial disease (PAD) is a common and severe disease with a highly increased cardiovascular morbidity and mortality. Through the circulatory disorder and the linked undersupply of oxygen carriers in the lower limbs, the ongoing decrease of the pain-free walking distance occurs with a significant reduction in patients’ quality of life. Studies including activity monitoring for patients with PAD are rare and digital support to increase activity via mobile health technologies is mainly targeted at patients with cardiovascular disease in general. The special requirement of patients with PAD is the need to reach a certain pain level to improve the pain-free walking distance. Unfortunately, both poor adherence and availability of institutional resources are major problems in patient-centered care.
Objective: The objective of this trackPAD pilot study is to evaluate the feasibility of a mobile phone–based self tracking app to promote physical activity and supervised exercise therapy (SET) in particular. We also aim for a subsequent patient centered adjustment of the app prototype based on the results of the app evaluation and process evaluation.
Methods: This study was designed as a closed user group trial, with assessors blinded, and parallel group study with face-to-face components for assessment with a follow-up of 3 months. Patients with symptomatic PAD (Fontaine stage IIa or IIb) and possession of a mobile phone were eligible. Eligible participants were randomly assigned into study and control group, stratified by their distance covered in the 6-min walk test, using the software TENALEA. Participants randomized to the study group received usual care and the mobile intervention (trackPAD) for the follow-up period of 3 months, whereas participants randomized to the control group received only usual care. TrackPAD records the frequency and duration of training sessions and pain level using manual user input. Clinical outcome data were collected at the baseline and after 3 months via validated tools (6-min walk test, ankle-brachial index, and duplex ultrasound at the lower arteries) and self-reported quality of life. Usability and quality of the app was determined using the user version of the Mobile Application Rating Scale.
Results: The study enrolled 45 participants with symptomatic PAD (44% male). Of these participants, 21 (47%) were randomized to the study group and 24 (53%) were randomized to the control group. The distance walked in the 6-min walk test was comparable in both groups at baseline (study group: mean 368.1m [SD 77.6] vs control group: mean 394.6m [SD 100.6]).
Conclusions: This is the first trial to test a mobile intervention called trackPAD that was designed especially for patients with PAD. Its results will provide important insights in terms of feasibility, effectiveness, and patient preferences of an app-based mobile intervention supporting SET for the conservative treatment of PAD.
Background: The development of mobile interventions for noncommunicable diseases has increased in recent years. However, there is a dearth of apps for patients with peripheral arterial disease (PAD), who frequently have an impaired ability to walk.
Objective: Using a patient-centered approach for the development of mobile interventions, we aim to describe the needs and requirements of patients with PAD regarding the overall care situation and the use of mobile interventions to perform supervised exercise therapy (SET).
Methods: A questionnaire survey was conducted in addition to a clinical examination at the vascular outpatient clinic of the West-German Heart and Vascular Center of the University Clinic Essen in Germany. Patients with diagnosed PAD were asked to answer questions on sociodemographic characteristics, PAD-related need for support, satisfaction with their health care situation, smartphone and app use, and requirements for the design of mobile interventions to support SET.
Results: Overall, a need for better support of patients with diagnosed PAD was identified. In total, 59.2% (n=180) expressed their desire for more support for their disease. Patients (n=304) had a mean age of 67 years and half of them (n=157, 51.6%) were smartphone users. We noted an interest in smartphone-supported SET, even for people who did not currently use a smartphone. “Information,” “feedback,” “choosing goals,” and “interaction with physicians and therapists” were rated the most relevant components of a potential app.
Conclusions: A need for the support of patients with PAD was determined. This was particularly evident with regard to disease literacy and the performance of SET. Based on a detailed description of patient characteristics, proposals for the design of mobile interventions adapted to the needs and requirements of patients can be derived.
Background: Mobile health interventions are intended to support complex health care needs in chronic diseases digitally, but they are mainly targeted at general health improvement and neglect disease-specific requirements. Therefore, we designed TrackPAD, a smartphone app to support supervised exercise training in patients with peripheral arterial disease.
Objective: This pilot study aimed to evaluate changes in the 6-minute walking distance (meters) as a primary outcome measure. The secondary outcome measures included changes in physical activity and assessing the patients’ peripheral arterial disease–related quality of life.
Methods: This was a pilot two-arm, single-blinded, randomized controlled trial. Patients with symptomatic PAD (Fontaine stage IIa/b) and access to smartphones were eligible. Eligible participants were randomly assigned to the study, with the control group stratified by the distance covered in the 6-minute walking test using the TENALEA software. Participants randomized to the intervention group received usual care and the mobile intervention (TrackPAD) for the follow-up period of 3 months, whereas participants randomized to the control group received routine care only. TrackPAD records the frequency and duration of training sessions and pain levels using manual user input. Clinical outcome data were collected at the baseline and after 3 months via validated tools (the 6-minute walk test and self-reported quality of life). The usability and quality of the app were determined using the Mobile Application Rating Scale user version.
Results: The intervention group (n=19) increased their mean 6-minute walking distance (83 meters, SD 72.2), while the control group (n=20) decreased their mean distance after 3 months of follow-up (–38.8 meters, SD 53.7; P=.01). The peripheral arterial disease–related quality of life increased significantly in terms of “symptom perception” and “limitations in physical functioning.” Users’ feedback showed increased motivation and a changed attitude toward performing supervised exercise training.
Conclusions: Besides the rating providing a valuable support tool for the user group, the mobile intervention TrackPAD was linked to a change in prognosis-relevant outcome measures combined with enhanced coping with the disease. The influence of mobile interventions on long-term prognosis must be evaluated in the future.
Continuous monitoring of interactive exhibits in museums as part of a persuasive design approach
(2021)
One goal of the project described in this paper is to create learning algorithms for machines and robots that lack a precise virtual controller for correct simulations. Using a digital twin approach, the developed mixed reality application aims for an overlay of a virtual robot model with the real world counterpart using Microsoft HoloLens 2 smart glasses. The application should help users to have an inside look into the results of the learning algorithm and therefore supervise and improve those results. The main focus of this paper is the visual representation of the digital twin on the smart glasses. One of the challenges is the level of abstraction and specific use of shaders (program code defining material attributes) to help the user differentiating between virtual and real objects. Therefore different presentation methods are described and evaluated. Study results with 48 persons show that the most abstract representation (wireframe) scores lowest, whereas a half-transparent model works best.
During two studies the influence of technologies on sleep were analyzed. The first one is about the effect of light on the circadian rhythm and as a consequence on sleep quality of persons in a vegetative state. The second one, which is still running, surveys the influence of several technologies on the sleep of elderly people living in a nursing home.