De Wet Swanepoel: using digital technologies to improve access to hearing health.

De Wet Swanepoel talks to Gary Humphreys about leveraging the power of digital health technologies to improve access to hearing health care.

Digital technology in maize nutrient management research in northern Nigeria amid COVID-19 pandemic.

The COVID-19 pandemic has been a life threatening and spreads wildly with physical human contact. Physical distancing is recommended by health experts to prevent the spread; thus, agronomic research has to be designed in conformity to this preventive standard during the pandemic. Consequently, this study was designed to evaluate the reliability of using digital tools in nutrient management research amid the COVID-19 pandemic in northern Nigeria. Fifty extension agents (EAs) were selected across 15 LGAs of Kaduna and Kano states. The EAs were trained on how to generate fertilizer recommendation using an android mobile phone-based nutrient expert (NE), to measure farmers' field sizes using UTM Area measure mobile phone app, and open data kit to record, submit and aggregate data during the exercise. Each EA covered 50 farms, where two nutrient management practices-one determined by the farmers: farmer fertilizer practice (FFP), and the other generated using the NE were evaluated. Results show that around 90% of the farmers have an average field size of 1.13 ha. All selected farmers used improved maize varieties for planting, among which 21% been able to use the exact recommended or lower seed rate. Use of inorganic fertilizer was 33% higher than the average recommended NE rate, while average yield of the NE fields was 48% higher than for the FFP. The results of this study indicate that yield can be improved with site-specific nutrient management (SSNM) extension approach. The SSNM using digital tools as the NE seem promising and befits to agronomic research in northern Nigeria amid the COVID-19 pandemic.

Research on collaborative innovation optimization strategies for digitally enabled higher education ecosystems.

Digitally enabled higher education involves the in-depth use of new-generation digital technology, which has subverted and innovated the traditional teaching mode, driven the development of high-quality teaching and learning, and improved teachers' teaching experience, and increased efficiency. Based on ecosystem theory, this paper constructs a higher education ecosystem with the government, enterprises, and universities as the core participating subjects. It considers the participating subjects' effort level and the ecosystem's overall benefits under the three scenarios of noncooperative research and development (R&D), cost sharing, and cooperative R&D. The results show that (1) the service innovation effort level of the three parties increases with increasing human resource level and technology maturity, and the government's benefit decreases with increasing cost of fulfilling social responsibility. (2) The government's cost subsidies to universities and enterprises can enhance the service innovation level of both parties and increase the optimal returns of the three parties and the ecosystem as a whole. (3) In the cooperative R&D game scenario, the effort level of the three parties and the total ecosystem returns are greater than those in the noncollaborative R&D scenario, and after determining the subsidy coefficients of the government, Pareto optimality of the three parties and the ecosystem as a whole can be achieved. The conclusions of this study can aid in understanding the dynamic evolution mechanism of digitally enabled higher education and provide a realistic decision-making reference for higher education ecosystem managers.

Effect of the application of digital technology-assisted optimization in the process of adjusting jaw position.

OBJECTIVES: The aim of this study was to demonstrate a novel jaw position adjustment technique derived from digital twins and evaluate the application effect of digital technology-assisted optimization in the process of adjusting jaw position on patients with temporomandibular disorders (TMD). METHODS: A total of 74 patients with TMD who attended the Department of Temporomandibular Joint, West China Hospital of Stomatology, Si-chuan University, between June 2022 and May 2023 were selected. The patient's initial computed tomography (CT) and bilateral temporomandibular joint data obtained by magnetic resonance imaging (MRI) were collected. The 148 joints were divided into the normal disc-condyle relationship (N) group, disc displacement with reduction (DDWR) group, and disc displacement without reduction (DDWoR) group. Assisted by digital technology, the patient's CT data were reconstructed, and a personalized reference plane was established to adjust the jaw position. A three-point bite guiding splint was designed by the adjusted occlusal space and then fabricated by 3D printing technology. It was worn by the patients and then reviewed by MRI. Before and after the adjustment of jaw position, the amount and direction of condyle and disc displacement and the angle between condyle and disc were measured as the evaluation indexes of the effect of the adjustment. The correlation with condylar displacement was evaluated. RESULTS: In the N group, the disc moved backward and downward along the X and Z axes by (-0.60±0.62) and (0.51±0.71) mm, respectively. In the DDWR group, the disc moved backward and upward along the X and Z axes by (-1.33±1.38) and (-0.09±1.31) mm, respectively. In the DDWoR group, the disc moved forward and downward along the X and Z axes by (0.49±1.76) and (1.35±1.76) mm, respectively. The angle between the condyle and the disc decreased after adjustment of the jaw position in all three groups. All patients showed improvement in symptoms after adjustment. CONCLUSIONS: Digital technology-assisted jaw position adjustment can simplify the process, reduce the sensitivity of the technique, and improve patients' disc-condyle structure and symptoms. Therefore, its application in the treatment of patients with TMD is of great clinical significance.

Technology empowerment: Digital transformation and enterprise ESG performance-Evidence from China's manufacturing sector.

In light of the long-term constraints posed by the "dual carbon" objective, can digital technology emerge as a transformative solution for enterprises to embark on a sustainable development trajectory? The existing body of research has yet to reach a consensus. In order to shed further light on the intricate relationship between digital transformation and ESG performance of enterprises, this study empirically examines the mechanisms and boundaries through which digital transformation influences ESG performance, based on observational data from A-share manufacturing listed companies in Shanghai Stock Exchange and Shenzhen Stock Exchange spanning from 2011 to 2021. The findings demonstrate that digital transformation exerts a significant positive impact on the ESG performance of manufacturing enterprises. Mechanism analysis reveals that the enabling effect of digital transformation primarily enhances company transparency, thereby fostering continuous improvements in ESG performance among manufacturing enterprises. The performance expectation gap will give rise to the phenomenon of "stop-loss in time" and impede the promotional impact of digital transformation. Further investigation into industrial characteristics and industry competition intensity indicates that state-owned enterprises and those operating within highly competitive environments experience more pronounced effects of digital transformation on their ESG performance. This study expands the mechanism and boundary of digital transformation on ESG performance of manufacturing enterprises, and provides a new perspective for manufacturing enterprises to realize the collaborative transformation of digital and green.

Impact of digital inclusive finance on agricultural total factor productivity in Zhejiang Province from the perspective of integrated development of rural industries.

Improving agricultural total factor productivity is crucial for comprehensive rural revitalization and building a strong agricultural nation. Digital inclusive finance amalgamates the benefits of digital technology and inclusive finance, mitigating financial exclusion in agricultural production. It fosters rural revitalization and the modernization of agriculture by bolstering farmers' innovation, entrepreneurship, and agricultural technology advancements. Consequently, it significantly enhances overall agricultural total factor productivity. This study uses panel data from 2011 to 2020 to empirically investigate the impact and mechanism of digital inclusive finance on agricultural total factor productivity in Zhejiang Province, China. The research results show that digital inclusive finance significantly enhances agricultural total factor productivity in Zhejiang Province, which holds true even after a series of robustness tests. Analysis of the mechanism reveals that the integrated development of rural industries plays a crucial mediating role in empowering agricultural total factor productivity through digital inclusive finance. Furthermore, heterogeneity analysis indicates that the positive effect of digital inclusive finance on agricultural total factor productivity is more pronounced in the northeastern region of Zhejiang Province and in areas ranked in the second tier of agricultural development. Therefore, we recommend comprehensively enhancing the development of digital inclusive finance in rural areas, fostering a financial ecosystem that integrates rural industries, promoting the coordinated development of digital inclusive finance in different regions, and comprehensively improving agricultural total factor productivity.

Behavior Change Approaches in Digital Technology-Based Physical Rehabilitation Interventions Following Stroke: Scoping Review.

BACKGROUND: Digital health technologies (DHTs) are increasingly used in physical stroke rehabilitation to support individuals in successfully engaging with the frequent, intensive, and lengthy activities required to optimize recovery. Despite this, little is known about behavior change within these interventions. OBJECTIVE: This scoping review aimed to identify if and how behavior change approaches (ie, theories, models, frameworks, and techniques to influence behavior) are incorporated within physical stroke rehabilitation interventions that include a DHT. METHODS: Databases (Embase, MEDLINE, PsycINFO, CINAHL, Cochrane Library, and AMED) were searched using keywords relating to behavior change, DHT, physical rehabilitation, and stroke. The results were independently screened by 2 reviewers. Sources were included if they reported a completed primary research study in which a behavior change approach could be identified within a physical stroke rehabilitation intervention that included a DHT. Data, including the study design, DHT used, and behavior change approaches, were charted. Specific behavior change techniques were coded to the behavior change technique taxonomy version 1 (BCTTv1). RESULTS: From a total of 1973 identified sources, 103 (5%) studies were included for data charting. The most common reason for exclusion at full-text screening was the absence of an explicit approach to behavior change (165/245, 67%). Almost half (45/103, 44%) of the included studies were described as pilot or feasibility studies. Virtual reality was the most frequently identified DHT type (58/103, 56%), and almost two-thirds (65/103, 63%) of studies focused on upper limb rehabilitation. Only a limited number of studies (18/103, 17%) included a theory, model, or framework for behavior change. The most frequently used BCTTv1 clusters were feedback and monitoring (88/103, 85%), reward and threat (56/103, 54%), goals and planning (33/103, 32%), and shaping knowledge (33/103, 32%). Relationships between feedback and monitoring and reward and threat were identified using a relationship map, with prominent use of both of these clusters in interventions that included virtual reality. CONCLUSIONS: Despite an assumption that DHTs can promote engagement in rehabilitation, this scoping review demonstrates that very few studies of physical stroke rehabilitation that include a DHT overtly used any form of behavior change approach. From those studies that did consider behavior change, most did not report a robust underpinning theory. Future development and research need to explicitly articulate how including DHTs within an intervention may support the behavior change required for optimal engagement in physical rehabilitation following stroke, as well as establish their effectiveness. This understanding is likely to support the realization of the transformative potential of DHTs in stroke rehabilitation.

Digital inclusive finance, industrial structure, and economic growth: An empirical analysis of Beijing-Tianjin-Hebei region in China.

As a product of combining digital technology and traditional finance, digital inclusive finance plays a vital role in economic growth. This paper deeply analyzes the impact of digital inclusive finance on economic growth and the specific transmission path. This research selects the municipal panel data of Beijing-Tianjin-Hebei from 2011 to 2020 and empirically studies the impact of digital inclusive finance on economic growth. From the perspectives of industrial structure transformation speed, industrial structure upgrading, and industrial structure rationalization, this study analyzes the role of industrial structure in the impact of digital inclusive finance on economic growth and tests the heterogeneity of the impact of digital inclusive finance on economic growth. The results show that digital inclusive finance has a significant role in promoting economic growth. The depth of use of digital inclusive finance has the most significant impact, followed by the breadth of coverage, and the degree of digitization is the smallest. The industrial structure transformation speed and the industrial structure rationalization play a significant intermediary role in the economic growth effect of digital inclusive finance, and the industrial structure upgrading has no significant impact on the economic growth effect of digital inclusive finance; the promotion effect of digital inclusive finance on economic growth is bigger in the economically developed group, the higher digital inclusive finance group and the technologically developed group, and the promotion effect is smaller in the economically underdeveloped group, the lower digital inclusive finance group and the technologically underdeveloped group. The results provide a strong reference for policy formulation to promote the development of digital inclusive finance and economic growth.

Top 10 research priorities for digital technology for adolescents and young persons with inflammatory bowel disease: Results of a James Lind Alliance Priority Setting Partnership.

OBJECTIVES: Priority Setting Partnerships (PSP's) using the James Lind Alliance (JLA) methodology, bring together health professionals, patients and parents/carers to identify and prioritise unanswered questions that can be addressed by future research projects. To identify and prioritise the top 10 unanswered research priorities in digital technology for adolescents and young people (AYP) with inflammatory bowel disease (IBD). METHODS: A steering group (SG) consisting of AYP with IBD, their parents/carers, representatives from two charities (Crohn's & Colitis UK, Crohn's in Childhood Research Association), patient information forum and paediatric and adult and primary care healthcare professionals was established in 2021. The SG agreed the protocol, and scope of the PSP and oversaw all aspects. SG meetings were chaired by a JLA advisor and followed the established JLA methodology. RESULTS: The initial survey generated 414 in-scope questions from 156 respondents, thematically categorised into 10 themes and consolidated into 92 summary questions by the SG. A comprehensive literature review followed by SG deliberation narrowed the unanswered summary questions to 45, for the interim prioritising survey. One hundred and two respondents ranked their top 10 research questions. Outputs generated top 18 research priorities presented at a final virtual prioritisation workshop, facilitated by JLA advisors and attended by key stakeholders, ranked into top 10 research priorities. DISCUSSION: The top 10 research priorities will encourage researchers to undertake research that addresses these areas of unmet need for AYP living with IBD, their parents/carers and their healthcare professionals, thereby facilitating improved patient care.

Understanding the role of digital immersive technology in educating the students of english language: does it promote critical thinking and self-directed learning for achieving sustainability in education with the help of teamwork?

PURPOSE: Universities are constantly searching for best practices to promote sustainability when it comes to educating students of the English language. Although this area of study has recently gained the attention of scholars around the world there is still a need to explore it from various perspectives. OBJECTIVE: This study aims to comprehensively investigate the impact of digital immersive technology on the education of English language students, specifically focusing on its potential to promote critical thinking and self-directed learning for achieving sustainability in education through teamwork. The research will assess the influence of digital immersive experiences on enhancing learning outcomes, examining their role in fostering critical thinking skills and encouraging self-directed learning practices. Additionally, the study explores the collaborative aspects of digital immersive technology, evaluating its contribution to teamwork among students. METHODOLOGY: The objective was achieved by using a survey questionnaire to collect data from 304 registered students in various universities in Beijing. Data analysis was conducted by applying Mplus 7.0 software. FINDINGS: The findings revealed that the use of digital immersive technology was pivotal for achieving sustainable education both directly and indirectly to an extent. In addition, team working moderated all the respective paths except the path involving the use of digital immersive technology and critical thinking. IMPLICATIONS: These results generated implications for teachers and policymakers to promote and facilitate the use of digital technology for teaching the English language to students, encouraging them to develop critical skills and self-directed learning strategies. The study also offered guidance and deeper understanding for researchers to address the concerns linked to the use of digital technology and sustainable education particularly in their future endeavors.

New evidence on the real role of digital economy in influencing public health efficiency.

In recent years, the rapid advancement of digital technology has supported the growth of the digital economy. The transformation towards digitization in the public health sector serves as a key indicator of this economic shift. Understanding how the digital economy continuously improves the efficiency of public health services and its various pathways of influence has become increasingly important. It is essential to clarify the impact mechanism of the digital economy on public health services to optimize health expenditures and advance digital economic construction. This study investigates the impact of digital economic development on the efficiency of public health services from a novel perspective, considering social media usage and urban-rural healthcare disparities while constructing a comprehensive index of digital economic development. The findings indicate that the digital economy reduces the efficiency of public health services primarily through two transmission mechanisms: the promotion of social media usage and the widening urban-rural healthcare gap. Moreover, these impacts and transmission pathways exhibit spatial heterogeneity. This study unveils the intrinsic connection and mechanisms of interaction between digital economic development and the efficiency of public health services, providing a theoretical basis and reference for government policy formulation. However, it also prompts further considerations on achieving synergy and interaction between the digital economy and public health services.

The Acceptance and Use of Digital Technologies for Self-Reporting Medication Safety Events After Care Transitions to Home in Patients With Cancer: Survey Study.

BACKGROUND: Actively engaging patients with cancer and their families in monitoring and reporting medication safety events during care transitions is indispensable for achieving optimal patient safety outcomes. However, existing patient self-reporting systems often cannot address patients' various experiences and concerns regarding medication safety over time. In addition, these systems are usually not designed for patients' just-in-time reporting. There is a significant knowledge gap in understanding the nature, scope, and causes of medication safety events after patients' transition back home because of a lack of patient engagement in self-monitoring and reporting of safety events. The challenges for patients with cancer in adopting digital technologies and engaging in self-reporting medication safety events during transitions of care have not been fully understood. OBJECTIVE: We aim to assess oncology patients' perceptions of medication and communication safety during care transitions and their willingness to use digital technologies for self-reporting medication safety events and to identify factors associated with their technology acceptance. METHODS: A cross-sectional survey study was conducted with adult patients with breast, prostate, lung, or colorectal cancer (N=204) who had experienced care transitions from hospitals or clinics to home in the past 1 year. Surveys were conducted via phone, the internet, or email between December 2021 and August 2022. Participants' perceptions of medication and communication safety and perceived usefulness, ease of use, attitude toward use, and intention to use a technology system to report their medication safety events from home were assessed as outcomes. Potential personal, clinical, and psychosocial factors were analyzed for their associations with participants' technology acceptance through bivariate correlation analyses and multiple logistic regressions. RESULTS: Participants reported strong perceptions of medication and communication safety, positively correlated with medication self-management ability and patient activation. Although most participants perceived a medication safety self-reporting system as useful (158/204, 77.5%) and easy to use (157/204, 77%), had a positive attitude toward use (162/204, 79.4%), and were willing to use such a system (129/204, 63.2%), their technology acceptance was associated with their activation levels (odds ratio [OR] 1.83, 95% CI 1.12-2.98), their perceptions of communication safety (OR 1.64, 95% CI 1.08-2.47), and whether they could receive feedback after self-reporting (OR 3.27, 95% CI 1.37-7.78). CONCLUSIONS: In general, oncology patients were willing to use digital technologies to report their medication events after care transitions back home because of their high concerns regarding medication safety. As informed and activated patients are more likely to have the knowledge and capability to initiate and engage in self-reporting, developing a patient-centered reporting system to empower patients and their families and facilitate safety health communications will help oncology patients in addressing their medication safety concerns, meeting their care needs, and holding promise to improve the quality of cancer care.

Digital Neuropsychology beyond Computerized Cognitive Assessment: Applications of Novel Digital Technologies.

Compared with other health disciplines, there is a stagnation in technological innovation in the field of clinical neuropsychology. Traditional paper-and-pencil tests have a number of shortcomings, such as low-frequency data collection and limitations in ecological validity. While computerized cognitive assessment may help overcome some of these issues, current computerized paradigms do not address the majority of these limitations. In this paper, we review recent literature on the applications of novel digital health approaches, including ecological momentary assessment, smartphone-based assessment and sensors, wearable devices, passive driving sensors, smart homes, voice biomarkers, and electronic health record mining, in neurological populations. We describe how each digital tool may be applied to neurologic care and overcome limitations of traditional neuropsychological assessment. Ethical considerations, limitations of current research, as well as our proposed future of neuropsychological practice are also discussed.

The Political Economy of Digital Health Equity: Structural Analysis.

Digital technologies have produced many innovations in care delivery and enabled continuity of care for many people when in-person care was impossible. However, a growing body of research suggests that digital health can also exacerbate health inequities for those excluded from its benefits for reasons of cost, digital literacy, and structural discrimination related to characteristics such as age, race, ethnicity, and socioeconomic status. In this paper, we draw on a political economy perspective to examine structural barriers to progress in advancing digital health equity at the policy level. Considering the incentive structures and investments of powerful actors in the field, we outline how characteristics of neoliberal capitalism in Western contexts produce and sustain digital health inequities by describing 6 structural challenges to the effort to promote health equity through digital health, as follows: (1) the revenue-first incentives of technology corporations, (2) the influence of venture capital, (3) inequitable access to the internet and digital devices, (4) underinvestment in digital health literacy, (5) uncertainty about future reimbursement of digital health, and (6) justified mistrust of digital health. Building on these important challenges, we propose future immediate and long-term directions for work to support meaningful change for digital health equity.

Performance of digital technologies in assessing fall risks among older adults with cognitive impairment: a systematic review.

Older adults with cognitive impairment (CI) are twice as likely to fall compared to the general older adult population. Traditional fall risk assessments may not be suitable for older adults with CI due to their reliance on attention and recall. Hence, there is an interest in using objective technology-based fall risk assessment tools to assess falls within this population. This systematic review aims to evaluate the features and performance of technology-based fall risk assessment tools for older adults with CI. A systematic search was conducted across several databases such as PubMed and IEEE Xplore, resulting in the inclusion of 22 studies. Most studies focused on participants with dementia. The technologies included sensors, mobile applications, motion capture, and virtual reality. Fall risk assessments were conducted in the community, laboratory, and institutional settings; with studies incorporating continuous monitoring of older adults in everyday environments. Studies used a combination of technology-based inputs of gait parameters, socio-demographic indicators, and clinical assessments. However, many missed the opportunity to include cognitive performance inputs as predictors to fall risk. The findings of this review support the use of technology-based fall risk assessment tools for older adults with CI. Further advancements incorporating cognitive measures and additional longitudinal studies are needed to improve the effectiveness and clinical applications of these assessment tools. Additional work is also required to compare the performance of existing methods for fall risk assessment, technology-based fall risk assessments, and the combination of these approaches.

Chatbots and COVID-19: Taking Stock of the Lessons Learned.

While digital innovation in health was already rapidly evolving, the COVID-19 pandemic has accelerated the generation of digital technology tools, such as chatbots, to help increase access to crucial health information and services to those who were cut off or had limited contact with health services. This theme issue titled "Chatbots and COVID-19" presents articles from researchers and practitioners across the globe, describing the development, implementation, and evaluation of chatbots designed to address a wide range of health concerns and services. In this editorial, we present some of the key challenges and lessons learned arising from the content of this theme issue. Most notably, we note that a stronger evidence base is needed to ensure that chatbots and other digital tools are developed to best serve the needs of population health.