The Ubiquitin-specific Protease USP36 Associates with the Microprocessor Complex and Regulates miRNA Biogenesis by SUMOylating DGCR8.

miRNA biogenesis is a cellular process that produces mature miRNAs from their primary transcripts, pri-miRNAs, via two RNAse III enzyme complexes: the Drosha-DGCR8 microprocessor complex in the nucleus and the Dicer-TRBP complex in the cytoplasm. Emerging evidence suggests that miRNA biogenesis is tightly regulated by posttranscriptional and posttranslational modifications and aberrant miRNA biogenesis is associated with various human diseases including cancer. DGCR8 has been shown to be modified by SUMOylation. Yet, the SUMO ligase mediating DGCR8 SUMOylation is currently unknown. Here, we report that USP36, a nucleolar ubiquitin-specific protease essential for ribosome biogenesis, is a novel regulator of DGCR8. USP36 interacts with the microprocessor complex and promotes DGCR8 SUMOylation, specifically modified by SUMO2. USP36-mediated SUMOylation does not affect the levels of DGCR8 and the formation of the Drosha-DGCR8 complex, but promotes the binding of DGCR8 to pri-miRNAs. Consistently, abolishing DGCR8 SUMOylation significantly attenuates its binding to pri-miRNAs and knockdown of USP36 attenuates pri-miRNA processing, resulting in marked reduction of tested mature miRNAs. Induced expression of a SUMOylation-defective mutant of DGCR8 inhibits cell proliferation. Together, these results suggest that USP36 plays an important role in regulating miRNA biogenesis by SUMOylating DGCR8. Significance: This study identifies that USP36 mediates DGCR8 SUMOylation by SUMO2 and is critical for miRNA biogenesis. As USP36 is frequently overexpressed in various human cancers, our study suggests that deregulated USP36-miRNA biogenesis pathway may contribute to tumorigenesis.

Trastornos en la salud visual causados por el síndrome del computador en el siglo xxi / Disorders of the eyesight health caused by the computer vision syndrome in the XXI century

En el siglo xxi, la mayoría de los ciudadanos del mundo utiliza herramientas tecnológicas con pantalla electrónica sin considerar el trastorno a la salud producido por su uso indiscriminado, al que se le denomina síndrome de visión por computador. Con el objetivo de concientizar a la sociedad acerca del daño a la salud visual que causa la exposición excesiva a las pantallas de los dispositivos electrónicos se realizó una revisión bibliográfica en las bases de datos electrónicas de Literatura Latinoamericana y del Caribe en Ciencias de la Salud y Literatura Internacional en Ciencias de la Salud, en los portales ScienceDirect y U.S. National Library of Medicine. De los 50 artículos encontrados, fueron seleccionados 29 por su utilidad y se consultaron 108 personas. Se concluyó que el síndrome del computador afecta a millones de personas dedicadas a trabajar frente a las pantallas de los aparatos electrónicos y se recomienda una debida preparación para atender y prever sus efectos perjudiciales en la población(AU)

In the XXI century, most of the world's citizens use technological tools with electronic screens without taking into account the health disorders those produce due to their indiscriminate use, which are denominated as computer vision syndrome. With the objective of creating awareness in the society in relation with the damage to the visual health caused by the excessive exposure to the screens of electronic devices, I was carried out a bibliographic review in the databases of Latin American and Caribbean Literature on Health Sciences, and International Literature on Health Sciences; and in the websites of Science Direct and U.S. National Library of Medicine. Of the 50 articles found, 29 were selected for their usefulness and a survey of 108 people was conducted. It was concluded that the syndrome of computer affects to millions of people who work in front of the screens of electronic devices, and it is recommended a proper preparation to address and prevent the harmful effects they have in the population(AU)

High-Resolution Imaging of Human Cancer Proteins Using Microprocessor Materials.

Mutations in tumor suppressor genes, such as Tumor Protein 53 (TP53), are heavily implicated in aggressive cancers giving rise to gain- and loss-of-function phenotypes. While individual domains of the p53 protein have been studied extensively, structural information for full-length p53 remains incomplete. Functionalized microprocessor chips (microchips) with properties amenable to electron microscopy permitted us to visualize complete p53 assemblies for the first time. The new structures revealed p53 in an inactive dimeric state independent of DNA binding. Residues located at the protein-protein interface corresponded with modification sites in cancer-related hot spots. Changes in these regions may amplify the toxic effects of clinical mutations. Taken together, these results contribute advances in technology and imaging approaches to decode native protein models in different states of activation.

Radiotherapy for patient with cardiac implantable electronic device, consensus from French radiation oncology society.

Radiotherapy in patients with cardiac implantable electronic device such as pacemakers or defibrillators, is a clinical situation that is becoming increasingly common. There is a risk of interaction between the magnetic field induced by accelerators and the cardiac implantable electronic device, but also a risk of device dysfunction due to direct and/or indirect irradiation if the cardiac implantable electronic device is in the field of treatment. The risk can be dose-dependent, but it is most often independent of the total dose and occurs randomly in case of neutron production (stochastic effect). The presence of this type of device is therefore described as a contraindication for radiotherapy by the French national agency for the safety of medicines and health products (Agence nationale de sécurité du médicament et des produits de santé, ANSM). Nevertheless, since radiotherapy is often possible, it is advisable to respect the recommendations of good practice, in particular the eligibility criteria, the monitoring modalities before, during and after irradiation according to the type of treatment, the dose and the characteristics of the cardiac implantable electronic device. It is sometimes necessary to discuss repositioning the device and/or modifying the treatment plan to minimize the risk of cardiac implantable electronic device dysfunction. We present the update of the recommendations of the French society of oncological radiotherapy on in patients with cardiac implantable electronic device.

Computer Vision Syndrome: Will the Pandemic Lead to Eye Problems for Dentists?

ABSTRACT Over the past year and a half dental education has been conducted primarily online due to the SARS-CoV-2 pandemic. During the pandemic, we have spent many hours a day on our computers, mobile phones, and tablets to gather information and participate in online seminars and classrooms. Health consequences resulting from the overuse of these devices include carpal tunnel syndrome as well as computer vision syndrome (CVS). Computer vision syndrome, also known as digital eye strain, has several associated features such as eye burning, strained vision, dry eye, blurred vision, and associated neck and shoulder pain. Several predisposing factors have been linked with CVS, but often this problem gets ignored. The management of this syndrome is aimed at educating dentists on computer use, position, and the surrounding environment. Considering all this, we must ensure that we spend some time away from these devices every day to avoid any significant vision problems. The objective of preparing this manuscript was to provide a brief overview of the increased prevalence of computer vision syndrome and its associated features.

netgsa: Fast computation and interactive visualization for topology-based pathway enrichment analysis.

Existing software tools for topology-based pathway enrichment analysis are either computationally inefficient, have undesirable statistical power, or require expert knowledge to leverage the methods' capabilities. To address these limitations, we have overhauled NetGSA, an existing topology-based method, to provide a computationally-efficient user-friendly tool that offers interactive visualization. Pathway enrichment analysis for thousands of genes can be performed in minutes on a personal computer without sacrificing statistical power. The new software also removes the need for expert knowledge by directly curating gene-gene interaction information from multiple external databases. Lastly, by utilizing the capabilities of Cytoscape, the new software also offers interactive and intuitive network visualization.

Abdominal Laser Lipolysis Using a Microprocessor-Controlled Robotic Arm With Noncontact Heating and Cooling.

BACKGROUND: A novel FDA-cleared device uses a 1064-nm laser to noninvasively induce apoptosis for lipolysis of subcutaneous abdominal fat while maintaining comfortable skin temperatures with a proprietary jet cooling system (eon; Dominion Aesthetic Technologies, Inc., San Antonio, TX). A programmable articulated robotic arm moves the treatment head without any subject contact, maintaining an appropriate 3-dimensional treatment path, compensating for patient movement. OBJECTIVES: The goal of this prospective, single center, open-label study was to demonstrate the safety and effectiveness of this device for reducing subcutaneous abdominal fat when operated with an updated power delivery curve. METHODS: Male and female subjects with Fitzpatrick skin types I to VI (N = 26) were treated. Four abdominal zones up to 150 cm2 each, customized in size and location for body habitus, were treated. Each zone underwent a single 20-minute treatment session. Follow-up visits occurred after 6 and 12 weeks. A standardized protocol was used to obtain ultrasound measurement of subcutaneous abdominal fat thickness, abdominal circumference, reported patient satisfaction and digital images. RESULTS: The mean treatment area was 378.5 cm2. At Week 12, there was a 21.6% or 6.3 mm mean reduction in abdominal subcutaneous fat thickness and a 4.1-cm (1.6-inch) mean reduction in abdominal circumference. Most subjects (84.6%) were satisfied or very satisfied with their results. The mean pain score was 2.5 on an 11-point ordinal scale. There were no nonresponders. Only 2 adverse events were noted: mild transient erythema (n = 1, 3.8%) and localized subcutaneous firmness (n = 1, 3.8%) which resolved without intervention within 12 weeks. CONCLUSIONS: This contact-free device is safe and effective for reducing subcutaneous abdominal fat and represents an improvement on the prior treatment protocol.

[Design of Gas Detection System Based on STM32 Infusion Set].

Aiming at the low efficiency and low quality detection level of the manual infusion set, a gas detection system for infusion set based on STM32 single-chip microcomputer was designed. The detection system includes hardware system design and software system design. The hardware system is based on the STM32F103 single-chip microcomputer. It mainly designs the gas pressure sensor acquisition circuit and the multi-way solenoid valve control circuit. The software system uses a C ++ real-time operating system to ensure system monitoring's real-time performance and validity. Test data is transmitted to the upper computer and displayed via USB serial communication. The experiment proves that the infusion set gas detection system can perform gas detection on the infusion set. The system has the characteristics of stability and high accuracy. The relative error of the experimental measurement is within ±5%, and the detection efficiency is better than manual detection.

Primary headache and factors associated in university students: a cross sectional study / Cefaleia primária e fatores associados em estudantes universitários: um estudo transversal

INTRODUCTION: Primary headaches, defined as disorders in themselves caused by independent pathomechanisms and not by other disorders, are prevalent in university students and considered one important health problems in the world. OBJECTIVE: To investigate the prevalence of primary headaches and analyze associations with sociodemographic characteristics and the use of electronic devices by university students. METHODS: A cross-sectional observational study analysis was carried out with a sample of 1,143 students of both genders who responded to the questionnaire on demographic, socioeconomic aspects, use of electronic devices, and on the primary headaches. Descriptive analysis, bivariate analysis, and Poisson regression were performed. RESULTS: The overall prevalence of primary headache of 60.7%, being that, in relation to the type, 33.2% presented tension-type headache, 54.3% migraine, and 12.3% other types of headache. Regression analysis showed that female gender and income of up to two minimum wages were associated with primary headache and migraine type. The primary headache was associated with subjects of the white race; watching television and playing video games for more than 3 hours per day, for example. The sitting posture, semi-lying down, and distance from the eyes to the mobile phone and tablet longer than 20 cm were associated with primary headache and the three types of headaches. CONCLUSION: The results allow us to conclude that there is a high prevalence of primary headaches in college students and that socioeconomic factors related to the use of electronic devices are associated with the presence of primary headaches.

INTRODUÇÃO: As dores de cabeça primárias, definidas como perturbações em si mesmas, causadas por patomecanismos independentes e não por outras perturbações, são prevalentes em universitários e considerada um importante problema de saúde mundial. OBJETIVO: Investigar a prevalência de cefaleia primária e analisar associações com características sociodemográficas e uso de dispositivos eletrônicos em estudantes universitários. MÉTODOS: Foi realizado um estudo observacional transversal com uma amostra de 1143 estudantes de ambos os sexos, que responderam ao questionário sobre aspectos demográficos, socioeconômicos, uso de dispositivos eletrônicos e cefaleia primária. Foram realizadas análises descritivas, análises bivariadas e regressão de Poisson. RESULTADOS: A prevalência geral de cefaleia primária de 60,7%, sendo que, em relação ao tipo, 33,2% apresentavam cefaleia tensional, 54,3% enxaqueca e 12,3% outros tipos de cefaleia. A análise de regressão mostrou que o sexo feminino e a renda de até dois salários-mínimos estavam associados à cefaleia primária e a enxaqueca; a cefaleia primária está associada a indivíduos da raça branca; assistir televisão e jogar videogame por mais de 3 horas por dia foi associado ao tipo tensional, a enxaqueca e cefaleia primária; a postura sentada, semideitada e distância dos olhos ao telefone celular e tablet com mais de 20 cm com a cefaleia primária e aos três tipos específicos. CONCLUSÃO: Os resultados permitem concluir que existe alta prevalência de cefaleia primária em estudantes universitários e que fatores socioeconômicos e relacionados ao uso de dispositivos eletrônicos estão associados à presença de cefaleia primária.

Using Mobile Technologies Among Undergraduate Nursing Students for Academic Purposes in Tertiary Education: A Quantitative Survey.

Mobile devices are increasingly part of daily life, with the benefits of using the technology in nursing education widely recognized. This study explored the use of mobile devices among undergraduate nursing students for academic purposes in South Africa, using a quantitative survey. The majority of participants owned smartphones (87.6%), followed by laptops (76%) and tablets (47.1%). Mobile devices were used to perform academic tasks and communicate and collaborate with peers and teachers, as well as search and access electronic resources. Few of the first year nursing students owned laptops and tablets and used them less frequently than the students from other levels of the study. Equipping nursing students with mobile devices, such as laptops and tablets, particularly first year students, and ensuring that they have adequate skills to use them, is essential to training future nurses who are expected to work in a technology-mediated health environment.

[Design of Remote Multi-part Personal Radiation Dose System Based on Bluetooth Communication Module].

OBJECTIVE: A remote multi-part personal radiation dose detection system is designed with ATmega32A single chip microcomputer as the control core. METHODS: First of all, the geiger counter tube module collects the radiation signal of the surrouding environment. Secondly, using ATmega32A Microprocessor of Slave computer to calculate the collected signal. Finally, it is sent to the host receiving device or mobile APP through Bluetooth module,so as to realize real-time detection of radiation data, remote transmission and security alarm. RESULTS: The system is measured in the same environment as the RG1100 radiometer, with a maximum difference of 0.03 µSv/h.This shows that it can stably realize the functions of radiation measurement, monitoring, alarm, remote connection and multimodal display. CONCLUSIONS: The system has the advantages of good portability (easy to carry), low power consumption, accurate measurement and so on. It has certain reference value and practicability.

QPMASS: A parallel peak alignment and quantification software for the analysis of large-scale gas chromatography-mass spectrometry (GC-MS)-based metabolomics datasets.

Gas chromatography-mass spectrometry (GC-MS) is a robust analytical platform for analysis of small molecules. Recently, it is widely used for large-scale metabolomics studies, in which hundreds or even thousands of samples are analyzed simultaneously, producing a very large and complex GC-MS datasets. A number of software are currently available for processing GC-MS data, but it is too compute-intensive for them to efficiently and accurately align chromatographic peaks from thousands of samples. Here, we report a newly developed software, QPMASS, for analysis of large-scale GC-MS data. The parallel computing with an advanced dynamic programming approach is implemented in QPMASS to align peaks from multiple samples based on retention time and mass spectra, enabling fast processing large-scale datasets. Furthermore, the missing value filtering and backfilling are introduced into the program, greatly reducing false positive and false negative errors to be less than 5%. We demonstrated that it took only 8 h to align and quantify a GC-TOF-MS dataset from 300 rice leaves samples, and 17 h to process a GC-qMS dataset from 1000 rice seed samples by using a personal computer (3.70 GHz CPU, 16 GB of memory and > 100 GB hard disk). QPMASS is written in C++ programming language, and is able to run under Windows operation system with a user-friendly interface.

Accuracy and Reliability of the Recommendation for IV Thrombolysis in Acute Ischemic Stroke Based on Interpretation of Head CT on a Smartphone or a Laptop.

OBJECTIVE. The objective of this study was to assess the accuracy and reliability of IV thrombolysis recommendations made after interpretation of head CT images of patients with symptoms of acute stroke displayed on smartphone or laptop reading systems compared with those made after interpretation of images displayed on a medical workstation monitor. MATERIALS AND METHODS. This retrospective study was institutional review board-approved, and the requirement for informed consent was waived. We used a factorial design including 2256 interpretations (188 patients, four neuroradiologists, and three reading systems). To evaluate the reliability, we calculated the intraobserver and interobserver agreements using the intraclass correlation coefficient (ICC) and the following interpretation variables: hemorrhagic lesions, intraaxial neoplasm, stroke dating (acute, subacute, and chronic), hyperdense arteries, and infarct size assessment. Accuracy equivalence tests were performed for the IV thrombolysis recommendation; for this variable, sensitivity, specificity, and ROC curves were evaluated. RESULTS. Good or very good interobserver and intraobserver agreements were obtained after interpretation of each variable. The IV thrombolysis recommendation showed very good interobserver agreements (ICC ≥ 0.85) and very good intraobserver agreements (ICC ≥ 0.81). For the IV thrombolysis recommendation, the AUC values (0.83-0.84) and sensitivities (0.94-0.95) were equivalent among all the reading systems at a 5% equivalent threshold. CONCLUSION. Our study found that mobile devices are reliable and accurate to help stroke teams to decide whether to administer IV thrombolysis in patients with acute stroke.

Cost-effectiveness and budget impact of the microprocessor-controlled knee C-Leg in transfemoral amputees with and without diabetes mellitus.

BACKGROUND: The safe use of a prosthesis in activities of daily living is key for transfemoral amputees. However, the number of falls varies significantly between different prosthetic device types. This study aims to compare medical and economic consequences of falls in transfemoral amputees who use the microprocessor-controlled knee joint C-Leg with patients who use non-microprocessor-controlled (mechanical) knee joints (NMPK). The main objectives of the analysis are to investigate the cost-effectiveness and budget impact of C-Legs in transfemoral amputees with diabetes mellitus (DM) and without DM in Germany. METHODS: A decision-analytic model was developed that took into account the effects of prosthesis type on the risk of falling and fall-related medical events. Cost-effectiveness and budget impact analyses were performed separately for transfemoral amputees with and without DM. The study took the perspective of the statutory health insurance (SHI). Input parameters were derived from the published literature. Univariate and probabilistic sensitivity analyses (PSA) were performed to investigate the impact of changes in individual input parameter values on model outcomes and to explore parameter uncertainty. RESULTS: C-Legs reduced the rate of fall-related hospitalizations from 134 to 20 per 1000 person years (PY) in amputees without DM and from 146 to 23 per 1000 PY in amputees with DM. In addition, the C-Leg prevented 15 or 14 fall-related death per 1000 PY. Over a time horizon of 25 years, the incremental cost-effectiveness ratio (ICER) was 16,123 Euro per quality-adjusted life years gained (QALY) for amputees without DM and 20,332 Euro per QALY gained for amputees with DM. For the period of 2020-2024, the model predicted an increase in SHI expenditures of 98 Mio Euro (53 Mio Euro in prosthesis users without DM and 45 Mio Euro in prosthesis users with DM) when all new prosthesis users received C-Legs instead of NMPKs and 50% of NMPK user whose prosthesis wore out switched to C-Legs. Results of the PSA showed moderate uncertainty and a probability of 97-99% that C-Legs are cost-effective at an ICER threshold of 40,000 Euro (≈ German GDP per capita in 2018) per QALY gained. CONCLUSION: Results of the study suggest that the C-Leg provides substantial additional health benefits compared with NMPKs and is likely to be cost-effective in transfemoral amputees with DM as well as in amputees without DM at an ICER threshold of 40,000 Euro per QALY gained.

Telehealth spirometry for children with cystic fibrosis.

AIM: We assessed the feasibility of telehealth spirometry assessments for children with cystic fibrosis (CF) living in a regional setting. METHOD: Patients with acceptable computer hardware at home were provided with a SpiroUSB (Vyaire) spirometer. Spirometry was performed during 'home admissions' or for ongoing home monitoring in children living outside metropolitan Melbourne. At the end of the session, the family forwarded the data to the Royal Children's Hospital, Melbourne. RESULTS: Twenty-two patients aged 7 to 17 years participated, with spirometry successful in 55 of 59 (93%) attempted sessions according to American Thoracic Society/European Respiratory Society criteria. The median distance between the subject's home and the hospital was 238 km (range 62-537 km) which equated to a travel time saving of 5 hours and 34 min per hospital visit. CONCLUSION: Home-based telehealth spirometry is feasible in children with CF and can support the CF team during home-based admissions and for ongoing outpatient monitoring.

Speech polar plots for different directionality settings of SONNET cochlear implant processor.

Objectives: The newest CI processor from MED-EL company, the SONNET, has two new directional microphone settings. Besides the Omnidirectional microphone mode, it has the possibility to switch to Natural or Adaptive directionality. Both new modes favour perception of sound coming from a front-facing direction compared to sounds from sources at alternate azimuths. Natural directionality mimics the pinna effect of the normal external ear. Design: We undertook to verify the effect of these options in vivo by means of clinical audiological tests. Speech reception thresholds were successively measured for a variety of speech presentation azimuths while keeping the noise azimuths constant. Complete 'Speech Reception Threshold (SRT)-Polar-Plots' were obtained from these data for the Omnidirectional and Natural directionality modes of the SONNET. In addition, one 'SRT-point' was also measured in the 'Adaptive' mode for speech coming from 45° azimuth. Study sample: A group of 13 adult CI recipients participated. Only one of these subjects had previous experience with the SONNET processor. Results: Complete 'SRT-Polar-Plots' could be measured in Natural and Omnidirectional modes in CI recipients within an acceptable timeframe. The pinna-following directionality for Natural mode could be confirmed. Median SRT in noise for speech coming from the 45° azimuth speaker was -5.6 dB SNR for Omnidirectional, -9.1 dB SNR for Natural and -12.8 dB SNR for Adaptive microphone. Natural and Adaptive significantly improved performance compared to Omnidirectional mode at this optimal azimuth of 45° with a median improvement in SRT of 3.5 and 7.2 dB respectively. Conclusions: A novel audiological method, 'SRT-Polar-Plot', was developed and described. Significant directionality benefits for Natural and Adaptive mode were confirmed in vivo using this technique.

Use of electrosurgical units in the endoscopic resection of gastrointestinal tumors.

Electrosurgical units (ESUs) are indispensable devices in our endoscopy units. However, many endoscopists are not well-trained on their use and their physical bases are usually not properly studied or understood. In addition, comparative data concerning the settings that may be applied in different circumstances are scarce in the medical literature. Given that it is important to be aware of their strengths and risks, we conducted a review of the available information and research on this topic.

Outcomes and Device Usage for Fully Automated Internet Interventions Designed for a Smartphone or Personal Computer: The MobileQuit Smoking Cessation Randomized Controlled Trial.

BACKGROUND: Many best practice smoking cessation programs use fully automated internet interventions designed for nonmobile personal computers (desktop computers, laptops, and tablets). A relatively small number of smoking cessation interventions have been designed specifically for mobile devices such as smartphones. OBJECTIVE: This study examined the efficacy and usage patterns of two internet-based best practices smoking cessation interventions. METHODS: Overall, 1271 smokers who wanted to quit were randomly assigned to (1) MobileQuit (designed for-and constrained its use to-mobile devices, included text messaging, and embodied tunnel information architecture) or (2) QuitOnline (designed for nonmobile desktop or tablet computers, did not include text messages, and used a flexible hybrid matrix-hierarchical information architecture). Primary outcomes included self-reported 7-day point-prevalence smoking abstinence at 3- and 6-month follow-up assessments. Program visits were unobtrusively assessed (frequency, duration, and device used for access). RESULTS: Significantly more MobileQuit participants than QuitOnline participants reported quitting smoking. Abstinence rates using intention-to-treat analysis were 20.7% (131/633) vs 11.4% (73/638) at 3 months, 24.6% (156/633) vs 19.3% (123/638) at 6 months, and 15.8% (100/633) vs 8.8% (56/638) for both 3 and 6 months. Using Complete Cases, MobileQuit's advantage was significant at 3 months (45.6% [131/287] vs 28.4% [73/257]) and the combined 3 and 6 months (40.5% [100/247] vs 25.9% [56/216]) but not at 6 months (43.5% [156/359] vs 34.4% [123/329]). Participants in both conditions reported their program was usable and helpful. MobileQuit participants visited their program 5 times more frequently than did QuitOnline participants. Consistent with the MobileQuit's built-in constraint, 89.46% (8820/9859) of its visits were made on an intended mobile device, whereas 47.72% (691/1448) of visits to QuitOnline used an intended nonmobile device. Among MobileQuit participants, 76.0% (459/604) used only an intended mobile device, 23.0% (139/604) used both mobile and nonmobile devices, and 0.1% (6/604) used only a nonmobile device. Among QuitOnline participants, 31.3% (137/438) used only the intended nonmobile devices, 16.7% (73/438) used both mobile and nonmobile devices, and 52.1% (228/438) used only mobile devices (primarily smartphones). CONCLUSIONS: This study provides evidence for optimizing intervention design for smartphones over a usual care internet approach in which interventions are designed primarily for use on nonmobile devices such as desktop computers, laptops. or tablets. We propose that future internet interventions should be designed for use on all of the devices (multiple screens) that users prefer. We forecast that the approach of designing internet interventions for mobile vs nonmobile devices will be replaced by internet interventions that use a single Web app designed to be responsive (adapt to different screen sizes and operating systems), share user data across devices, embody a pervasive information architecture, and complemented by text message notifications. TRIAL REGISTRATION: ClinicalTrials.gov NCT01952236; https://clinicaltrials.gov/ct2/show/NCT01952236 (Archived by WebCite at http://www.webcitation.org/6zdSxqbf8).