Effectiveness of a healthy lifestyle program based on a mobile serious game for childhood cancer survivors: A quasi-randomized trial.

PURPOSE: This study aimed to develop and evaluate the effectiveness of a healthy lifestyle program based on a mobile serious game (HLP-MSG) to enhance the lifestyles of childhood cancer survivors (CCSs). METHODS: This program proceeded in two stages: development and evaluation, using a non-synchronized design with a quasi-randomized trial. The participants were CCSs aged 6-13 years whose treatment was terminated at least 12 months prior. Data were collected at baseline, and post-intervention, with a follow-up after four weeks using the Child Healthy Lifestyle Profile (CHLP). The experimental (n = 26) and control groups (n = 25) were compared. Data were analyzed using descriptive statistics, chi-squared tests, t-tests, and repeated-measures ANOVA. RESULTS: The HLP-MSG promoted a healthy lifestyle by solving 26 quests, including seven sub-elements (nutrition, exercise, hygiene, interpersonal relationships, stress management, meaning of life, and health responsibility). This study revealed significant differences in the interaction between measurement time and group assignment in the CHLP (p = .006) and physical activity (p = .013), one of the seven sub-dimensions. CONCLUSIONS: A healthy lifestyle program based on a mobile serious game is a feasible health education modality to enhance the physical, psychological, social, and spiritual health of CCSs. IMPLICATIONS TO PRACTICE: The findings add to scientific evidence on a mobile serious game for health education among CCSs. The HLP-MSG provides an evolutionary educational modality that can be delivered non-face-to-face to promote CCSs' continuous healthy behavior maintenance. Moreover, the HLP-MSG is adolescent-friendly and can be utilized as a healthcare tool for parents and children to cooperate.

In-Car Environment Control Using an SSVEP-Based Brain-Computer Interface with Visual Stimuli Presented on Head-Up Display: Performance Comparison with a Button-Press Interface.

Controlling the in-car environment, including temperature and ventilation, is necessary for a comfortable driving experience. However, it often distracts the driver's attention, potentially causing critical car accidents. In the present study, we implemented an in-car environment control system utilizing a brain-computer interface (BCI) based on steady-state visual evoked potential (SSVEP). In the experiment, four visual stimuli were displayed on a laboratory-made head-up display (HUD). This allowed the participants to control the in-car environment by simply staring at a target visual stimulus, i.e., without pressing a button or averting their eyes from the front. The driving performances in two realistic driving tests-obstacle avoidance and car-following tests-were then compared between the manual control condition and SSVEP-BCI control condition using a driving simulator. In the obstacle avoidance driving test, where participants needed to stop the car when obstacles suddenly appeared, the participants showed significantly shorter response time (1.42 ± 0.26 s) in the SSVEP-BCI control condition than in the manual control condition (1.79 ± 0.27 s). No-response rate, defined as the ratio of obstacles that the participants did not react to, was also significantly lower in the SSVEP-BCI control condition (4.6 ± 14.7%) than in the manual control condition (20.5 ± 25.2%). In the car-following driving test, where the participants were instructed to follow a preceding car that runs at a sinusoidally changing speed, the participants showed significantly lower speed difference with the preceding car in the SSVEP-BCI control condition (15.65 ± 7.04 km/h) than in the manual control condition (19.54 ± 11.51 km/h). The in-car environment control system using SSVEP-based BCI showed a possibility that might contribute to safer driving by keeping the driver's focus on the front and thereby enhancing the overall driving performance.

Novel hybrid visual stimuli incorporating periodic motions into conventional flickering or pattern-reversal visual stimuli for steady-state visual evoked potential-based brain-computer interfaces.

In this study, we proposed a new type of hybrid visual stimuli for steady-state visual evoked potential (SSVEP)-based brain-computer interfaces (BCIs), which incorporate various periodic motions into conventional flickering stimuli (FS) or pattern reversal stimuli (PRS). Furthermore, we investigated optimal periodic motions for each FS and PRS to enhance the performance of SSVEP-based BCIs. Periodic motions were implemented by changing the size of the stimulus according to four different temporal functions denoted by none, square, triangular, and sine, yielding a total of eight hybrid visual stimuli. Additionally, we developed the extended version of filter bank canonical correlation analysis (FBCCA), which is a state-of-the-art training-free classification algorithm for SSVEP-based BCIs, to enhance the classification accuracy for PRS-based hybrid visual stimuli. Twenty healthy individuals participated in the SSVEP-based BCI experiment to discriminate four visual stimuli with different frequencies. An average classification accuracy and information transfer rate (ITR) were evaluated to compare the performances of SSVEP-based BCIs for different hybrid visual stimuli. Additionally, the user's visual fatigue for each of the hybrid visual stimuli was also evaluated. As the result, for FS, the highest performances were reported when the periodic motion of the sine waveform was incorporated for all window sizes except for 3 s. For PRS, the periodic motion of the square waveform showed the highest classification accuracies for all tested window sizes. A significant statistical difference in the performance between the two best stimuli was not observed. The averaged fatigue scores were reported to be 5.3 ± 2.05 and 4.05 ± 1.28 for FS with sine-wave periodic motion and PRS with square-wave periodic motion, respectively. Consequently, our results demonstrated that FS with sine-wave periodic motion and PRS with square-wave periodic motion could effectively improve the BCI performances compared to conventional FS and PRS. In addition, thanks to its low visual fatigue, PRS with square-wave periodic motion can be regarded as the most appropriate visual stimulus for the long-term use of SSVEP-based BCIs, particularly for window sizes equal to or larger than 2 s.