A New Perspective on Supporting Vulnerable Road Users' Safety, Security and Comfort through Personalized Route Planning.

Due to an increase in population, urban centers are currently seeing an increase in traffic, resulting in negative consequences such as pollution and congestion. Efforts have been made to promote a modal shift towards the use of more sustainable means of transport, such as walking and cycling, but several deterrents influence the citizens' perceptions of safety, security and comfort, discouraging their choice of active modes of transport. This study focuses on the importance of providing meaningful information to vulnerable road users (VRUs) to support their perceptions and objectives while moving within urban spaces through a novel concept of route planning. A broad survey of the needs and concerns of VRUs through interviews, focus groups and questionnaires, applied to the Portuguese population of the Metropolitan Area of Porto, led to the development of a new concept of route planners that show personalized routes according to the individual perceptions of each user. This concept is materialized in a route planner prototype that has been extensively tested by potential users. Subjective evaluation and feedback showed the usefulness of the concept and added value to a familiar product, leading to a satisfying experience for participants. This study shows that there is an opportunity to improve these tools to provide a higher degree of power and customization to users on route planning, which includes addressing mobility restrictions and personal perceptions of safety, security and comfort. The ultimate goal of this new approach is to persuade citizens to switch to more sustainable means of transport.

A Multipurpose Platform for Ambient Assisted Living (ActiveAdvice): Usability Study.

BACKGROUND: Aging of the global population is slowly paving the way for new markets for care products and services. The desire of older people to maintain their independence while remaining at home is boosting the development of ambient assisted living (AAL) solutions. Lack of user awareness of AAL solutions paired with an insufficient use of user-centered and participatory design approaches in the development of these products has hindered the uptake of these solutions by end users. OBJECTIVE: This study aims to describe the usability and users' experiences within a novel platform, ActiveAdvice, aimed at offering advice and a holistic market overview of AAL products and services. METHODS: Usability tests were performed on the developed platform among identified prospective end users, with 32 older adults and informal carers from 4 European countries being part of the user tests. The usability and appeal of the web interface design, information flow, and information architecture were analyzed by collecting both objective and subjective measures. These would include pretest and posttest surveys, along with a series of think-aloud tasks to be performed within the platform. RESULTS: The outcomes suggest that the ActiveAdvice platform's objectives and functionalities are mostly aligned with the needs and expectations of end users, who demonstrated interest in using it, stressing its purpose along with its simple and intuitive interaction. Task completion rates were high, and participants had good satisfaction rates when navigating the platform. However, the tests still advocate for an improved design at some points and better disclosure of information. CONCLUSIONS: Our findings shed light on a few peculiarities of interface design, information architecture, user needs, and preferred functionalities, which should be applied to future developments of similar platforms with related services. The AAL field could benefit from tools supporting the dissemination of available AAL solutions and how they can improve one's quality of life. These tools may benefit not only older adults but also caregivers, business owners, and governmental employees.

A multicenter prospective study of the real-time use of narrow-band imaging in the diagnosis of premalignant gastric conditions and lesions.

BACKGROUND AND AIM: Some studies suggest that narrow-band imaging (NBI) can be more accurate at diagnosing gastric intestinal metaplasia and dysplasia than white-light endoscopy (WLE) alone. We aimed to assess the real-time diagnostic validity of high resolution endoscopy with and without NBI in the diagnosis of gastric premalignant conditions and to derive a classification for endoscopic grading of gastric intestinal metaplasia (EGGIM). METHODS: A multicenter prospective study (five centers: Portugal, Italy, Romania, UK, USA) was performed involving the systematic use of high resolution gastroscopes with image registry with and without NBI in a centralized informatics platform (available online). All users used the same NBI classification. Histologic result was considered the diagnostic gold standard. RESULTS: A total of 238 patients and 1123 endoscopic biopsies were included. NBI globally increased diagnostic accuracy by 11 percentage points (NBI 94 % vs. WLE 83 %; P < 0.001) with no difference in the identification of Helicobacter pylori gastritis (73 % vs. 74 %). NBI increased sensitivity for the diagnosis of intestinal metaplasia significantly (87 % vs. 53 %; P < 0.001) and for the diagnosis of dysplasia (92 % vs. 74 %). The added benefit of NBI in terms of diagnostic accuracy was greater in OLGIM III/IV than in OLGIM I/II (25 percentage points vs. 15 percentage points, respectively; P < 0.001). The area under the curve (AUC) of the receiver operating characteristic (ROC) curve for EGGIM in the identification of extensive metaplasia was 0.98. CONCLUSIONS: In a real-time scenario, NBI demonstrates a high concordance with gastric histology, superior to WLE. Diagnostic accuracy higher than 90 % suggests that routine use of NBI allows targeted instead of random biopsy samples. EGGIM also permits immediate grading of intestinal metaplasia without biopsies and merits further investigation.

Identifying technology interaction opportunities within a gastroenterology exam room.

Gastric cancer is a serious disease that most people usually do not know they have until they start to get symptoms. Gastroenterology imaging is an essential tool for this battle, since an early diagnosis typically leads to a good prognosis. However, this is a rapidly evolving technological area with novel imaging devices such as capsule, narrow-band imaging or high-definition endoscopy. Adapting to these technologies has a high time-price cost, even for experienced clinicians, motivating the appearance of interactive environments that can accelerate these training processes. The GEMINI (Gastroenterology Made Interactive) project aims to create an interactive clinical decision support system (CDSS) that can be used to help with the diagnosis within a gastroenterology room during real endoscopic examinations. We used human computer interaction (HCI) support methodologies in order to identify interaction opportunities. As a final conclusion, the most promising avenue for interactions with CDSS is probably using mobile devices such as tablets, controlled by a nurse at the physician's request. As future work, we will prototype and evaluate such a system in a real hospital environment.

Evaluating purifying selection in the mitochondrial DNA of various mammalian species.

Mitochondrial DNA (mtDNA), the circular DNA molecule inside the mitochondria of all eukaryotic cells, has been shown to be under the effect of purifying selection in several species. Traditional testing of purifying selection has been based simply on ratios of nonsynonymous to synonymous mutations, without considering the relative age of each mutation, which can be determined by phylogenetic analysis of this non-recombining molecule. The incorporation of a mutation time-ordering from phylogeny and of predicted pathogenicity scores for nonsynonymous mutations allow a quantitative evaluation of the effects of purifying selection in human mtDNA. Here, by using this additional information, we show that purifying selection undoubtedly acts upon the mtDNA of other mammalian species/genera, namely Bos sp., Canis lupus, Mus musculus, Orcinus orca, Pan sp. and Sus scrofa. The effects of purifying selection were comparable in all species, leading to a significant major proportion of nonsynonymous variants with higher pathogenicity scores in the younger branches of the tree. We also derive recalibrated mutation rates for age estimates of ancestors of these various species and proposed a correction curve in order to take into account the effects of selection. Understanding this selection is fundamental to evolutionary studies and to the identification of deleterious mutations.