Enhancing worker-centred digitalisation in industrial environments: A KPI evaluation methodology.

Recently, the European Commission announced Industry 5.0 as a strategic initiative toward a value-driven industrial transformation. This new paradigm coexists with previous Industry 4.0 revolution that has guided the efforts towards technology driven industrial digitalisation in the past ten years. As part of this Industry 4.0 strategies, numerous KPI-driven evaluation methods were proposed to cover the multiple pillars of smart industry assessment. However, they do not incorporate human workers and actors in a systematic way as drivers for digitalisation processes, as the new Industry 5.0 paradigm argues. This paper addresses this gap by proposing an evaluation methodology that incorporates multiple human actors in the digitalisation process. The final objective of this methodology is to evaluate the direct and indirect benefits of the technology-driven transformation process to achieve the goals of human workers and other human stakeholders. To this end, our methodology provides the basis for proposing assessment tools and instruments for technological and infrastructure integration, process optimisation, new functionalities and human factors benefits, and four core indicators that have been applied to a real case comparing the digitalisation processes of three different companies.

GATEKEEPER's Strategy for the Multinational Large-Scale Piloting of an eHealth Platform: Tutorial on How to Identify Relevant Settings and Use Cases.

BACKGROUND: The World Health Organization's strategy toward healthy aging fosters person-centered integrated care sustained by eHealth systems. However, there is a need for standardized frameworks or platforms accommodating and interconnecting multiple of these systems while ensuring secure, relevant, fair, trust-based data sharing and use. The H2020 project GATEKEEPER aims to implement and test an open-source, European, standard-based, interoperable, and secure framework serving broad populations of aging citizens with heterogeneous health needs. OBJECTIVE: We aim to describe the rationale for the selection of an optimal group of settings for the multinational large-scale piloting of the GATEKEEPER platform. METHODS: The selection of implementation sites and reference use cases (RUCs) was based on the adoption of a double stratification pyramid reflecting the overall health of target populations and the intensity of proposed interventions; the identification of a principles guiding implementation site selection; and the elaboration of guidelines for RUC selection, ensuring clinical relevance and scientific excellence while covering the whole spectrum of citizen complexities and intervention intensities. RESULTS: Seven European countries were selected, covering Europe's geographical and socioeconomic heterogeneity: Cyprus, Germany, Greece, Italy, Poland, Spain, and the United Kingdom. These were complemented by the following 3 Asian pilots: Hong Kong, Singapore, and Taiwan. Implementation sites consisted of local ecosystems, including health care organizations and partners from industry, civil society, academia, and government, prioritizing the highly rated European Innovation Partnership on Active and Healthy Aging reference sites. RUCs covered the whole spectrum of chronic diseases, citizen complexities, and intervention intensities while privileging clinical relevance and scientific rigor. These included lifestyle-related early detection and interventions, using artificial intelligence-based digital coaches to promote healthy lifestyle and delay the onset or worsening of chronic diseases in healthy citizens; chronic obstructive pulmonary disease and heart failure decompensations management, proposing integrated care management based on advanced wearable monitoring and machine learning (ML) to predict decompensations; management of glycemic status in diabetes mellitus, based on beat to beat monitoring and short-term ML-based prediction of glycemic dynamics; treatment decision support systems for Parkinson disease, continuously monitoring motor and nonmotor complications to trigger enhanced treatment strategies; primary and secondary stroke prevention, using a coaching app and educational simulations with virtual and augmented reality; management of multimorbid older patients or patients with cancer, exploring novel chronic care models based on digital coaching, and advanced monitoring and ML; high blood pressure management, with ML-based predictions based on different intensities of monitoring through self-managed apps; and COVID-19 management, with integrated management tools limiting physical contact among actors. CONCLUSIONS: This paper provides a methodology for selecting adequate settings for the large-scale piloting of eHealth frameworks and exemplifies with the decisions taken in GATEKEEPER the current views of the WHO and European Commission while moving forward toward a European Data Space.

Evaluating IoT-Based Services to Support Patient Empowerment in Digital Home Hospitalization Services.

Hospitals need to optimize patient care, as, among other factors, life expectancy has increased due to improvements in sanitation, nutrition, and medicines. Hospitalization-at-home (HaH) could increase admission efficiency, moderate costs, and reduce the demand for beds. This study aimed to provide data on the feasibility, acceptability, and effectiveness of the integration of IoT-based technology to support the remote monitoring and follow-up of patients admitted to HaH units, as well as the acceptability of IoT-based solutions in healthcare processes. The need for a reduction in the number of admission days, the percentage of admissions after discharge, and the actions of the emergency services during admission were the most relevant findings of this study. Furthermore, in terms of patient safety and trust perception, 98% of patients preferred this type of digitally-supported hospitalization model and up to 95% were very satisfied. On the professional side, the results showed a reduction in work overload and an increase in trust when the system was adopted.

A Secure and Scalable Smart Home Gateway to Bridge Technology Fragmentation.

Internet of Things (IoT) technologies are already playing an important role in our daily activities as we use them and rely on them to increase our abilities, connectivity, productivity and quality of life. However, there are still obstacles to achieving a unique interface able to transfer full control to users given the diversity of protocols, properties and specifications in the varied IoT ecosystem. Particularly for the case of home automation systems, there is a high degree of fragmentation that limits interoperability, increasing the complexity and costs of developments and holding back their real potential of positively impacting users. In this article, we propose implementing W3C's Web of Things Standard supported by home automation ontologies, such as SAREF and UniversAAL, to deploy the Living Lab Gateway that allows users to consume all IoT devices from a smart home, including those physically wired and using KNX® technology. This work, developed under the framework of the EC funded Plan4Act project, includes relevant features such as security, authentication and authorization provision, dynamic configuration and injection of devices, and devices abstraction and mapping into ontologies. Its deployment is explained in two scenarios to show the achieved technology's degree of integration, the code simplicity for developers and the system's scalability: one consisted of external hardware interfacing with the smart home, and the other of the injection of a new sensing device. A test was executed providing metrics that indicate that the Living Lab Gateway is competitive in terms of response performance.

Advancing Smart Home Awareness-A Conceptual Computational Modelling Framework for the Execution of Daily Activities of People with Alzheimer's Disease.

Utilizing context-aware tools in smart homes (SH) helps to incorporate higher quality interaction paradigms between the house and specific groups of users such as people with Alzheimer's disease (AD). One method of delivering these interaction paradigms acceptably and efficiently is through context processing the behavior of the residents within the SH. Predicting human behavior and uncertain events is crucial in the prevention of upcoming missteps and confusion when people with AD perform their daily activities. Modelling human behavior and mental states using cognitive architectures produces computational models capable of replicating real use case scenarios. In this way, SHs can reinforce the execution of daily activities effectively once they acquire adequate awareness about the missteps, interruptions, memory problems, and unpredictable events that can arise during the daily life of a person living with cognitive deterioration. This paper presents a conceptual computational framework for the modelling of daily living activities of people with AD and their progression through different stages of AD. Simulations and initial results demonstrate that it is feasible to effectively estimate and predict common errors and behaviors in the execution of daily activities under specific assessment tests.

Empowering Citizens through Perceptual Sensing of Urban Environmental and Health Data Following a Participative Citizen Science Approach.

The growth of the urban population together with a high concentration of air pollution have important health impacts on citizens who are exposed to them, causing serious risks of the development and evolution of different chronic diseases. This paper presents the design and development of a novel participatory citizen science-based application and data ecosystem model. These developments are imperative and scientifically designed to gather and process perceptual sensing of urban, environmental, and health data. This data acquisition approach allows citizens to gather and generate environment- and health-related data through mobile devices. The sum of all citizens' data will continuously enrich and increase the volumes of data coming from the city sensors and sources across geographical locations. These scientifically generated data, coupled with data from the city sensors and sources, will enable specialized predictive analytic solutions to empower citizens with urban, environmental, and health recommendations, while enabling new data-driven policies. Although it is difficult for citizens to relate their personal behaviour to large-scale problems such as climate change, pollution, or public health, the developed ecosystem provides the necessary tools to enable a greener and healthier lifestyle, improve quality of life, and contribute towards a more sustainable local environment.

Evaluation of the Create@School Game-Based Learning-Teaching Approach.

The constructivist approach is interested in creating knowledge through active engagement and encourages students to build their knowledge from their experiences in the world. Learning through digital game making is a constructivist approach that allows students to learn by developing their own games, enhancing problem-solving skills and fostering creativity. In this context two tools, Create@School App and the Project Management Dashboard (PMD), were developed to enable students from different countries to be able to adapt their learning material by programming and designing games for their academic subjects, therefore integrating the game mechanics, dynamics, and aesthetics into the academic curriculum. This paper focuses on presenting the validation context as well as the evaluation of these tools. The Hassenzahl model and AttrakDiff survey were used for measuring users' experience and satisfaction, and for understanding emotional responses, thus providing information that enables testing of the acceptability and usability of the developed apps. After two years of usage of code-making apps (i.e., Create@School and its pre-design version Pocket Code), the pupils processed knowledge from their academic subjects spontaneously as game-based embedded knowledge. The students demonstrated creativity, a practical approach, and enthusiasm regarding making games focused on academic content that led them to learning, using mobile devices, sensors, images, and contextual information. This approach was widely accepted by students and teachers as part of their everyday class routines.

Computerized neurocognitive interventions in the context of the brain training controversy.

This article presents, in the form of an analytic narrative review, a complete picture of the state-of-the-art, challenges, and perspectives in the field of information and communication technology (ICT)-based neurocognitive interventions for older adults. The narrative particularly focuses on applications aimed at mild cognitive impairment and similar age-related cognitive deficits, which are analyzed in the context of the brain training controversy. Clarifying considerations are provided about the nature and present extent of the brain training debate, regarding the possible influence it has on the support received by research and development initiatives dealing with innovative computerized neurocognitive interventions. It is recommended that, because of the preliminary nature of most data currently available in this area, further research initiatives must be supported in the quest for better effectiveness of computer-based interventions intended for age-related cognitive impairment. The conclusion suggests that advanced ICT-based tools, such as virtual and augmented reality technologies, are the most fitting platforms for applying nonpharmacological computerized neurocognitive interventions.

An m-Health system for education and motivation in cardiac rehabilitation: the experience of HeartCycle guided exercise.

Introduction Home-based programmes for cardiac rehabilitation play a key role in the recovery of patients with coronary artery disease. However, their necessary educational and motivational components have been rarely implemented with the help of modern mobile technologies. We developed a mobile health system designed for motivating patients to adhere to their rehabilitation programme by providing exercise monitoring, guidance, motivational feedback, and educational content. Methods Our multi-disciplinary approach is based on mapping "desired behaviours" into specific system's specifications, borrowing concepts from Fogg's Persuasive Systems Design principles. A randomised controlled trial was conducted to compare mobile-based rehabilitation (55 patients) versus standard care (63 patients). Results Some technical issues related to connectivity, usability and exercise sessions interrupted by safety algorithms affected the trial. For those who completed the rehabilitation (19 of 55), results show high levels of both user acceptance and perceived usefulness. Adherence in terms of started exercise sessions was high, but not in terms of total time of performed exercise or drop-outs. Educational level about heart-related health improved more in the intervention group than the control. Exercise habits at 6 months follow-up also improved, although without statistical significance. Discussion Results indicate that the adopted design methodology is promising for creating applications that help improve education and foster better exercise habits, but further studies would be needed to confirm these indications.

Parametric Cognitive Modeling of Information and Computer Technology Usage by People with Aging- and Disability-Derived Functional Impairments.

Despite the speedy evolution of Information and Computer Technology (ICT), and the growing recognition of the importance of the concept of universal design in all domains of daily living, mainstream ICT-based product designers and developers still work without any truly structured tools, guidance or support to effectively adapt their products and services to users' real needs. This paper presents the approach used to define and evaluate parametric cognitive models that describe interaction and usage of ICT by people with aging- and disability-derived functional impairments. A multisensorial training platform was used to train, based on real user measurements in real conditions, the virtual parameterized user models that act as subjects of the test-bed during all stages of simulated disabilities-friendly ICT-based products design. An analytical study was carried out to identify the relevant cognitive functions involved, together with their corresponding parameters as related to aging- and disability-derived functional impairments. Evaluation of the final cognitive virtual user models in a real application has confirmed that the use of these models produce concrete valuable benefits to the design and testing process of accessible ICT-based applications and services. Parameterization of cognitive virtual user models allows incorporating cognitive and perceptual aspects during the design process.

Corrigendum: A succinct overview of virtual reality technology use in Alzheimer's disease.

[This corrects the article on p. 80 in vol. 7, PMID: 26029101.].

A succinct overview of virtual reality technology use in Alzheimer's disease.

We provide a brief review and appraisal of recent and current virtual reality (VR) technology for Alzheimer's disease (AD) applications. We categorize them according to their intended purpose (e.g., diagnosis, patient cognitive training, caregivers' education, etc.), focus feature (e.g., spatial impairment, memory deficit, etc.), methodology employed (e.g., tasks, games, etc.), immersion level, and passive or active interaction. Critical assessment indicates that most of them do not yet take full advantage of virtual environments with high levels of immersion and interaction. Many still rely on conventional 2D graphic displays to create non-immersive or semi-immersive VR scenarios. Important improvements are needed to make VR a better and more versatile assessment and training tool for AD. The use of the latest display technologies available, such as emerging head-mounted displays and 3D smart TV technologies, together with realistic multi-sensorial interaction devices, and neuro-physiological feedback capacity, are some of the most beneficial improvements this mini-review suggests. Additionally, it would be desirable that such VR applications for AD be easily and affordably transferable to in-home and nursing home environments.

Experience in evaluating AAL solutions in living labs.

Ambient assisted living (AAL) is a complex field, where different technologies are integrated to offer solutions for the benefit of different stakeholders. Several evaluation techniques are commonly applied that tackle specific aspects of AAL; however, holistic evaluation approaches are lacking when addressing the needs of both developers and end-users. Living labs have been often used as real-life test and experimentation environments for co-designing AAL technologies and validating them with relevant stakeholders. During the last five years, we have been evaluating AAL systems and services in the framework of various research projects. This paper presents the lessons learned in this experience and proposes a set of harmonized guidelines to conduct evaluations in living labs.

Merging person-specific bio-markers for predicting oral cancer recurrence through an ontology.

One of the major problems related to cancer treatment is its recurrence. Without knowing in advance how likely the cancer will relapse, clinical practice usually recommends adjuvant treatments that have strong side effects. A way to optimize treatments is to predict the recurrence probability by analyzing a set of bio-markers. The NeoMark European project has identified a set of preliminary bio-markers for the case of oral cancer by collecting a large series of data from genomic, imaging, and clinical evidence. This heterogeneous set of data needs a proper representation in order to be stored, computed, and communicated efficiently. Ontologies are often considered the proper mean to integrate biomedical data, for their high level of formality and for the need of interoperable, universally accepted models. This paper presents the NeoMark system and how an ontology has been designed to integrate all its heterogeneous data. The system has been validated in a pilot in which data will populate the ontology and will be made public for further research.