Touch-screen automatisms in the digital age.

OBJECTIVE: To describe a novel set of gestural automatisms related to the use of digital screens on smartphones and tablets in patients with epilepsy. METHODS: Representative patients were selected from among those admitted to the Epilepsy Monitoring Unit at the Toronto Western Hospital between April 2016 and January 2020, and included if they exhibited automatisms clearly related to or mimicking digital device use. RESULTS: In total 5 patients were included, 4 female. All had temporal lobe epilepsy: 2 had left mesial temporal sclerosis and 3 had normal imaging. Nearly equal numbers of seizures began with right (5/9) and left (4/9) temporal onsets, with most automatisms occurring after seizure propagation to bilateral temporal involvement (6/9). Left-handed automatisms were most common (8/9). The majority of the automatisms (7/9) were perseverative on device usage prior to the seizure. CONCLUSION: Gestural automatisms appear related to the contemporary lived experience, culture, and habitual behaviour of patients with epilepsy. In the modern era, the use of smartphones and tablets are both common and habitual for many, and this case series shows that touch-screen automatisms may be added to the semiological panoply of temporal lobe seizures.

Web-Based Warfarin Management (Alfalfa App) Versus Traditional Warfarin Management: Multicenter Prospective Cohort Study.

BACKGROUND: Poor anticoagulation management of warfarin may lead to patient admission, prolonged hospital stays, and even death due to anticoagulation-related adverse events. Traditional non-web-based outpatient clinics struggle to provide ideal anticoagulation management services for patients, and there is a need to explore a safer, more effective, and more convenient mode of warfarin management. OBJECTIVE: This study aimed to compare differences in the quality of anticoagulation management and clinical adverse events between a web-based management model (via a smartphone app) and the conventional non-web-based outpatient management model. METHODS: This study is a prospective cohort research that includes multiple national centers. Patients meeting the nadir criteria were split into a web-based management group using the Alfalfa app or a non-web-based management group with traditional outpatient management, and they were then monitored for a 6-month follow-up period to collect coagulation test results and clinical events. The effectiveness and safety of the 2 management models were assessed by the following indicators: time in therapeutic range (TTR), bleeding events, thromboembolic events, all-cause mortality events, cumulative event rates, and the distribution of the international normalized ratio (INR). RESULTS: This national multicenter cohort study enrolled 522 patients between June 2019 and May 2021, with 519 (99%) patients reaching the follow-up end point, including 260 (50%) in the non-web-based management group and 259 (50%) in the web-based management group. There were no observable differences in baseline characteristics between the 2 patient groups. The web-based management group had a significantly higher TTR than the non-web-based management group (82.4% vs 71.6%, P<.001), and a higher proportion of patients received effective anticoagulation management (81.2% vs 63.5%, P<.001). The incidence of minor bleeding events in the non-web-based management group was significantly higher than that in the web-based management group (12.1% vs 6.6%, P=.048). Between the 2 groups, there was no statistically significant difference in the incidence of severe bleeding and thromboembolic and all-cause death events. In addition, compared with the non-web-based management group, the web-based management group had a lower proportion of INR in the extreme subtreatment range (17.6% vs 21.3%) and severe supertreatment range (0% vs 0.8%) and a higher proportion in the treatment range (50.4% vs 43.1%), with statistical significance. CONCLUSIONS: Compared with traditional non-web-based outpatient management, web-based management via the Alfalfa app may be more beneficial because it can enhance patient anticoagulation management quality, lower the frequency of small bleeding events, and improve INR distribution.

Mobile applications in radiation oncology-current choices and future potentials.

PURPOSE: To review existing scientific literature on mobile applications (apps) in the field of radiation oncology and to evaluate characteristics of commercially available apps across different platforms. METHODS: A systematic review of the literature for publications presenting apps in the field of radiation oncology was carried out using the PubMed database, Cochrane library, Google Scholar, and annual meetings of major radiation oncology societies. Additionally, the two major marketplaces for apps, App Store and Play Store, were searched for available radiation oncology apps for patients and health care professionals (HCP). RESULTS: A total of 38 original publications which met the inclusion criteria were identified. Within those publications, 32 apps were developed for patients and 6 for HCP. The vast majority of patient apps focused on documenting electronic patient-reported outcomes (ePROs). In the two major marketplaces, 26 apps were found, mainly supporting HCP with dose calculations. CONCLUSION: Apps used in (and for) scientific research in radiation oncology are rarely available for patients and HCP in common marketplaces.

Is the Implementation of an Interprofessional Communication Smart Phone Application Associated With Improved Survival Among Critically Ill Surgical Patients?

INTRODUCTION: Patients admitted to intensive care units (ICUs) have high rates of mortality and morbidity. Improved communication between providers within ICUs may reduce morbidity. The goal of this study is to leverage a natural experiment of the temporally staggered implementation of a smart phone application for interprofessional communication to quantify the association with postoperative mortality and morbidity among critically ill surgical patients. METHODS: We conducted an observational case-control study and utilized a difference-in-difference model to determine the impact of temporally staggered implementation of an interprofessional communication smart phone application on mortality, postoperative hyperglycemia, malnutrition, venous thromboembolism (VTE), and surgical site infections. Our study included patients who underwent surgical procedures and were admitted to the ICU at one of three hospitals (one academic medical center, hospital A, and two community hospitals, hospitals B and C) in a single health system between March 2018 and April 2021. RESULTS: Our cohort consisted of 1457 patients, of which 1174 were hospitalized at hospital A and 283 at hospitals B and C. In the full cohort, 80 (5.6%) patients died during ICU admission. Difference-in-difference analysis demonstrated a relative difference in mortality of 4.8% [1.1%-8.5%] (P = 0.04) at hospitals B and C compared to hospital A after the implementation of the application. Our model demonstrated a 2.5% difference in VTEs [1.1%-3.8%], P = 0.03. There were no significant reductions in hyperglycemia, malnutrition, or surgical site infection. CONCLUSIONS: The implementation of an interprofessional communication smart phone application is associated with reduced mortality and VTE incidence among critically ill surgical patients across three diverse hospitals.

Comparative effectiveness of verbal instruction versus video-based education (VIVid) among family caregivers for improving the quality of life in advanced head and neck cancer patients receiving palliative care in Eastern India: a randomized controlled trial.

PURPOSE: To determine if video-based educational intervention compared to the standard verbal guidelines, provided to caregivers on home-based palliative care could enhance the quality of life (QoL) in advanced head and neck cancer (HNC) patients. METHODS: The study employed a prospective, two-arm parallel-group, randomized controlled trial design. Investigators prepared a real-world demonstrational video of ten minutes duration regarding home-based care for family caregivers, with voice-over in Odia language (Eastern India). The contents of the video addressed the management of common problems in palliative care among HNC patients. This study included 180 participants, 90 patient & caregiver dyads randomized to interventional (video-based education) or control (verbal instruction) groups. Patients' QoL was measured at baseline and 3 weeks follow-up using EORTC QLQ C30. Data were analyzed descriptively, and the Chi-square, Mann-Whitney U, T-test, spearman correlation, and multiple hierarchical regression analyses were employed for statistical analysis, with a significance level of p < 0.05. RESULTS: Seventy participant dyads completed the planned two assessments: baseline and at the end of 3rd week (Intervention = 37; Control = 33). The intervention group showed a significant improvement in the patient's health-related QoL, physical, emotional, and social functioning. Symptom burden reduction was observed for pain, nausea, and fatigue. A significant increase in the change in QoL with the video-based education group (VBE) compared to the verbal instruction (VI) group after adjusting for age, gender, physical functioning, and pain symptomology (adjusted R2 = 0.402) was noted. CONCLUSION: VBE intervention using smart-phone may offer caregivers a viable means of enhancing self-management while improving patients' QoL within the socio-cultural challenges for home-based palliative care in India. Further research on training caregivers using digital interventions and home-based visits is recommended. TRIAL REGISTRATION NUMBER: CTRI/2021/06/034473 [Registered on: 30/06/2021].

Smart phone addiction and its mental health risks among university students in Jordan: a cross-sectional study.

BACKGROUND: Addiction to smart phones is classified clinically as behavioral addiction resulted from an excessive problematic usage of smart phones that effect the daily life of the users. Therefore, this study aims to explore the prevalence of smart phone addiction, its associated psychological distress risk, and its associated predictors among university students in Jordan. METHODS: Between November 2022 and January 2023, a cross-sectional online survey study was conducted in Jordan. In this study, we used previously developed questionnaire instruments, the psychological Distress scale of Kessler and the Smartphone Addiction Scale. A score of 30 was used to identify the dummy variable in the binary logistic regression analysis to identify predictors of severe psychological distress, and smartphone addiction score of 38.7 was used to to identify predictors of smartphone addiction. RESULTS: A total of 2337 university students participated in this study. The mean psychological distress score for the study participants was 30.0 (SD: 8.9). More than half of the study participants (59.1%) had a psychological distress score of 30 and above, which indicates a severe mental disorder state. More than half of the study participants (56.7%) had a smartphone addiction score of 30 and above, which reflects a smartphone addiction state. Females, divorced, those who feel that their mental abilities have been negatively affected by the use of smart phones, those who feel that using smartphones has affected their sleep and made it harder to fall asleep, and those feel that everything requires effort and fatigue, and they do not want to do any activity that requires effort were more likely to have severe psychological distress compared to others (p < 0.05). Females, those who feel that using smartphones has affected their sleep and made it harder to fall asleep, and those feel that everything requires effort and fatigue, and they do not want to do any activity that requires effort were more likely to be smartphone addicted compared to others (p < 0.05). CONCLUSION: Mental diseases are a major public health concern in Jordan, especially among university students. Females, those who thought smartphone usage hurt their mental capacities, and those who had trouble sleeping and fatigue were more likely to develop serious psychological discomfort and smartphone addiction. Smartphones are indispensable, but excessive use can lead to addiction and harm university students' mental health.

Design of illumination system using characterized illuminances for smartphone-based fundus camera.

Recently, smartphone-based fundus camera (SBFC) research has been actively conducted in response to the need to expand medical infrastructure in underdeveloped countries and the increased telemedicine since the COVID-19 pandemic. Compared to the conventional table-top system, SBFCs have technical challenges that make it difficult to guarantee uniform illumination and avoid back-reflection because of the design constraints of minimizing the form factor and cost. This paper proposes a novel illumination design methodology using characterized illuminance to obtain high-quality fundus images for SBFCs. Key performance indicators (KPIs), such as retinal uniformity, back-reflection suppression, and optical efficiency, were defined to evaluate the performance of the illumination system. Each KPI was calculated using optical simulation software based on Monte-Carlo ray tracing and mapped into a normalized three-dimensional coordinate, the retinal illumination performance space (RIPS). In RIPS, the KPIs are combined into a single parameter ΔRIPS, which is the quantitative difference evaluated as the Euclidean distance between the ideal and actual design point. A compact SBFC illumination system with five design variables was presented to verify the proposed methodology. The final design values at the minimum ΔRIPS were determined using the Taguchi method and response surface methodology. Finally, a working prototype was built, and fundus images were acquired by clinical testing under institutional review board approval. The fundus image had sufficient brightness and resolution to diagnose the lesion with a viewing angle of approximately 50° in one shot.

Self-supporting wound care mobile applications for nurses: A scoping review protocol.

AIM: Mobile health (mHealth) is playing an increasingly important role in the computerization of wound care on an international scale with an aim to improve care. The aim of this scoping review protocol is to present a transparent process for how we plan to search and review the existing evidence related to self-supporting mobile wound care applications used by nurses. MATERIALS AND METHODS: The scoping review will follow the Joanna Briggs Institute (JBI) methodology. An exploratory search was performed using MEDLINE (Ovid), Embase, CINAHL (Ebsco), to identify concepts, keywords, MeSH terms, and headings to identify study types looking for mobile applications in wound care. The findings of this search will determine the final search strategy. Data sources will include MEDLINE, Embase, CINAHL, Web of Science, LiSSa, Cochrane Wounds (Cochrane Library) and Erudit. The titles and abstracts of the identified articles will be screened independently by two authors for relevance. Full texts will also be screened by two independent reviewers and data extraction will be performed in accordance with a pre-designed extraction form. All types of studies and literature linked to self-supporting mobile wound care application used by nurses will be included (quantitative, qualitative, mixed methods and grey literature). CONCLUSION: The results of the scoping review will give an overview of the existing self-supporting mobile applications in wound care used by nurses. These will also help to identify the existing applications, and describe knowledge in nursing about their utilisation, development, and evaluation, as well as synthesize the available literature on their impacts.

Adaptiveness of RGB-image derived algorithms in the measurement of fractional vegetation coverage.

BACKGROUND: Fractional vegetation coverage (FVC) is a crucial parameter in determining vegetation structure. Automatic measurement of FVC using digital images captured by mobile smart devices is a potential direction for future research on field survey methods in plant ecology, and this algorithm is crucial for accurate FVC measurement. However, there is a lack of insight into the influence of illumination on the accuracy of FVC measurements. Therefore, the main objective of this research is to assess the adaptiveness and performance of different algorithms under varying light conditions for FVC measurements and to deepen our understanding of the influence of illumination on FVC measurement. METHODS AND RESULTS: Based on a literature survey, we selected four algorithms that have been reported to have high accuracy in automatic FVC measurements. The first algorithm (Fun01) identifies green plants based on the combination of [Formula: see text], [Formula: see text], and [Formula: see text] ([Formula: see text], [Formula: see text], and [Formula: see text] are the actual pixel digital numbers from the images based on each RGB channel, [Formula: see text] is the abbreviation of the Excess Green index), the second algorithm (Fun02) is a decision tree that uses color properties to discriminate plants from the background, the third algorithm (Fun03) uses [Formula: see text] ([Formula: see text] is the abbreviation of the Excess Red index) to recognize plants in the image, and the fourth algorithm (Fun04) uses [Formula: see text] and [Formula: see text] to separate the plants from the background. [Formula: see text] is an algorithm used to determine a threshold to transform the image into a binary image for the vegetation and background. We measured the FVC of several surveyed quadrats using these four algorithms under three scenarios, namely overcast sky, solar forenoon, and solar noon. FVC values obtained using the Photoshop-assisted manual identification method were used as a reference to assess the accuracy of the four algorithms selected. Results indicate that under the overcast sky scenario, Fun01 was more accurate than the other algorithms and the MAPE (mean absolute percentage error), BIAS, relBIAS (relative BIAS), RMSE (root mean square error), and relRMSE (relative RMSE) are 8.68%, 1.3, 3.97, 3.13, and 12.33%, respectively. Under the scenario of the solar forenoon, Fun02 (decision tree) was more accurate than other algorithms, and the MAPE, BIAS, relBIAS, RMSE, and relRMSE are 22.70%, - 2.86, - 7.70, 5.00, and 41.23%. Under the solar noon scenario, Fun02 was also more accurate than the other algorithms, and the MAPE, BIAS, relBIAS, RMSE, and relRMSE are 20.60%, - 6.39, - 20.67, 7.30, and 24.49%, respectively. CONCLUSIONS: Given that each algorithm has its own optimal application scenario, among the four algorithms selected, Fun01 (the combination of [Formula: see text], [Formula: see text], and [Formula: see text]) can be recommended for measuring FVC on cloudy days. Fun02 (decision tree) is more suitable for measuring the FVC on sunny days. However, it considerably underestimates the FVC in most cases. We expect the findings of this study to serve as a useful reference for automatic vegetation cover measurements.

Sociodemographic Correlates of Contemporary Screen Time Use among 9- and 10-Year-Old Children.

OBJECTIVE: To determine sociodemographic correlates of contemporary screen time use among a diverse population-based sample of 9- and 10-year-old children. STUDY DESIGN: In 2021, we analyzed cross-sectional baseline (2016-2018) data from the Adolescent Brain Cognitive Development study (n = 10 755). Multiple linear regression analyses were conducted to estimate associations between sociodemographic factors (sex, race/ethnicity, country of birth, household income, parental education) and 6 contemporary forms of screen time (television, videos [eg, YouTube], video games, social networking, texting, and video chat). RESULTS: On average, children reported 3.99 hours of screen time per day across 6 modalities, with the most time spent watching/streaming television shows/movies (1.31 hours), playing video games (1.06 hours), and watching/streaming videos (1.05 hours). On average, Black children reported 1.58 more hours of screen time per day and Asian children reported 0.35 less hours of screen time per day compared with White children (mean 3.46 hours per day), and these trends persisted across most modalities. Boys reported higher overall screen time (0.75 hours more) than girls, which was primarily attributed to video games and videos. Girls reported more time texting, social networking, and video chatting than boys. Higher income was associated with lower screen time usage across all modalities except video chat. However, in high-income households, Latinx children reported 0.65 more hours of screen time per day than White children. CONCLUSIONS: Given the sociodemographic differences in child screen use, guideline implementation strategies can focus on key populations, encourage targeted counseling by pediatricians, and adapt Family Media Use Plans for diverse backgrounds.

Using a smartphone on the move: do visual constraints explain why we slow walking speed?

Viewing one's smartphone whilst walking commonly leads to a slowing of walking. Slowing walking speed may occur because of the visual constraints related to reading the hand-held phone whilst in motion. We determine how walking-induced phone motion affects the ability to read on-screen information. Phone-reading performance (PRP) was assessed whilst participants walked on a treadmill at various speeds (Slow, Customary, Fast). The fastest speed was repeated, wearing an elbow brace (Braced) or with the phone mounted stationary (Fixed). An audible cue ('text-alert') indicated participants had 2 s to lift/view the phone and read aloud a series of digits. PRP was the number of digits read correctly. Each condition was repeated 5 times. 3D-motion analyses determined phone motion relative to the head, from which the variability in acceleration in viewing distance, and in the point of gaze in space in the up-down and right-left directions were assessed. A main effect of condition indicated PRP decreased with walking speed; particularly so for the Braced and Fixed conditions (p = 0.022). Walking condition also affected the phone's relative motion (p < 0.001); post-hoc analysis indicated that acceleration variability for the Fast, Fixed and Braced conditions were increased compared to that for Slow and Customary speed walking (p ≤ 0.05). There was an inverse association between phone acceleration variability and PRP (p = 0.02). These findings may explain why walking speed slows when viewing a hand-held phone: at slower speeds, head motion is smoother/more regular, enabling the motion of the phone to be coupled with head motion, thus making fewer demands on the oculomotor system. Good coupling ensures that the retinal image is stable enough to allow legibility of the information presented on the screen.

Impact of walking states, self-reported daily walking amount and age on the gait of older adults measured with a smart-phone app: a pilot study.

BACKGROUND: Smartphones provide a cost-effective avenue for gait assessment among older adults in the community. The purpose of this study is to explore the impact of walking state, self-reported daily walking amount, and age on gait quality, using a smartphone application. METHODS: One hundred older adult individuals from North China, aged 73.0 ± 7.7 years, voluntarily participated in this study. They performed three walking tests: normal walking, fast walking, and visually impaired walking. Three-dimensional acceleration data for gait were obtained using the smartphone app Pocket Gait. This study used multivariate analysis of variance (MANOVA) to explore the effects of the walking state, self-reported daily walking amount, and age on the step frequency, root mean square (RMS) acceleration, step time variability, regularity, and symmetry. RESULTS: The walking state, self-reported daily walking amount, and age had statistically significant effects on gait quality. Compared with normal walking, the step frequency, RMS acceleration, variability, and regularity were greater in the fast-walking state, and simulated visually impaired walking did not significantly affect gait quality. Relatively older individuals had a significant decline in gait quality compared to (relatively) younger older adult individuals. Compared with older adults who walked less than 1 km a day, older adults who walked more had better gait quality. CONCLUSIONS: The walking state, self-reported daily walking amount, and age have a significant effect on the gait quality of older adults. Walking with pigmented sunglasses can be used as a training intervention to improve gait performance. Older adult people who walk less than 1 km/day have worse gait quality compared with their counterparts.

Validity of OSCE Evaluation Using the FLEX Model of Blended Learning.

BACKGROUND: For OSCE (Objective Structured Clinical Examination) scoring, medical schools must bring together many clinical experts at the same place, which is very risky in the context of the coronavirus pandemic. However, if the FLEX model with the properties of self-directed learning and offline feedback is applied to OSCE, it is possible to provide a safe and effective evaluation environment for both universities and students through experts' evaluation of self-video clips of medical students. The present study investigated validity of the FLEX model to evaluate OSCE in a small group of medical students. METHODS: Sixteen 3rd grade medical students who failed on OSCE were required to take a make-up examination by videotaping the failed items and submitting them online. The scores between original examination and make-up examination were compared using Paired Wilcoxon Signed Rank Test, and a post-hoc questionnaire was conducted. RESULTS: The score for make-up examination was significantly higher than those for original examination. The significance was maintained even when the score was compared by individual domains of skills and proficiency. In terms of preference, students were largely in favor of self-videotaped examination primarily due to the availability of self-practice. CONCLUSION: The FLEX model can be effectively applied to medical education, especially for evaluation of OSCE.

Use of a Smart-Phone Mobile Application is Associated With Improved Compliance and Reduced Length of Stay in Patients Undergoing Primary Total Joint Arthroplasty of the Hip and Knee.

BACKGROUND: Patient compliance with perioperative protocols is paramount to improving outcomes and reducing adverse events in total joint arthroplasty (TJA) of the hip and knee. Given the widespread use of smartphones, mobile applications (MAs) may present an opportunity to improve outcomes in TJA. We aim to determine whether the use of a mobile application platform improves compliance with standardized pre-operative protocols and outcomes in TJA. METHODS: A non-randomized, prospective cohort study was conducted in adult patients undergoing primary elective TJA to determine whether the use of an MA with timed reminders starting 5 days pre-operatively, to perform a chlorhexidine gluconate (CHG) shower and oral hydration protocol improves compliance with these protocols. OUTCOME MEASURES: compliance, length of stay (LOS), surgical site infection (SSI), 90-day readmission. RESULTS: App-users had increased adherence to the hydration protocol (odds ratio [OR] = 3.17 [95% confidence interval {CI} = 1.42, 7.09: P = .003]). App-use was associated with shorter LOS (Median Interquartile ranges [IQR] 2.0 days [1.0, 2.0 days]) for App-users vs 2.0 days ([1.0, 3.0] for non-App users, P = .031), younger age, (63.3 vs 67.9 years, P = .0001), Caucasian race (OR = 3.32 [95% CI = 1.59, 6.94 P = .0009]) and male gender (48.2% vs 35.0%, P = .02). There was no difference in adherence to chlorhexidine gluconate (CHG), readmission, or surgical site infection (SSI) (2.2% App-users vs 2.9% non-App users; P = .74). CONCLUSION: Use of a mobile application was associated with increased compliance with a hydration protocol and reduced LOS. App-users were more likely to be younger, male and Caucasian. These disparities may reflect inequity of access to the requisite technology and warrant further study.

Development, dissemination and evaluation of a smartphone-based app for pressure ulcer/injury prevention and treatment for use at the bedside.

OBJECTIVE: After launching the 2019 International Pressure Ulcer/Injury Guideline, the National Pressure Injury Advisory Panel (NPIAP), the European Pressure Ulcer Advisory Panel (EPUAP) and the Pan Pacific Pressure Injury Alliance (PPPIA) collaborated with Sensorydata Corp., US, to develop a guideline app (InterPIP App). The app was designed to: present evidence-based guideline recommendations; incorporate search capacities and functionality to facilitate easy access to clinical guidance; provide accessibility in multiple languages; and to be available worldwide at a reasonable price, including opportunities for free access in low-resource countries. This paper describes the development, dissemination and formative evaluation of a mobile app providing evidence-based recommendations for pressure injury prevention, assessment/classification, and treatment at the point of care. METHOD: An evaluation tool was designed based on a framework developed by Nouri et al. and made available to all app subscribers. RESULTS: The InterPIP App is currently available in 11 languages and had been downloaded 3616 times by February 2022 in 78 countries. A total of 62 individuals responded to the survey of end-users. In this formal evaluation of user experiences, the app was rated positively on criteria of: information/content; usability; design; functionality; ethics; and security/privacy (median=4 on a 1-5 Likert scale). Overall perceived value was ranked lower with a median of three. Users provided suggestions for ongoing app enhancement. CONCLUSION: The InterPIP App offers a unique opportunity to bring evidence-based guidance to the point of care. Formal evaluation of end-user experiences identified opportunities for quality improvement, and informed plans for future development and evaluation.

Comparison of peak electromagnetic exposures from mobile phones operational in either data mode or voice mode.

The aim of this study is to compare the typical peak ElectroMagnetic (EM) exposures from smart phones during data transmission and voice calls, respectively, in the typical Western-European city of Leuven, Belgium. Since transmission powers towards the outdoor network in an indoor environment are expected to be higher than in an outdoor environment, measurements were executed indoors. The influence of factors like network generation [2G, 3G, and 4G] and choice of mobile operator was also investigated. The most important conclusion of the study is that there is a huge difference between peak exposures generated by the 3 network generations currently active in Leuven. To the average, in many cases the peak exposure for 3G is more than a factor 20 lower than for 2G, and about a factor 5-10 lower than for 4G. These numbers are much higher than expected. There are also systematic differences between peak exposures for data mode and voice mode.

Contemporary screen time modalities among children 9-10 years old and binge-eating disorder at one-year follow-up: A prospective cohort study.

OBJECTIVE: To determine the prospective associations between contemporary screen time modalities in a nationally representative cohort of 9-10-year-old children and binge-eating disorder at one-year follow-up. METHOD: We analyzed prospective cohort data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 11,025). Logistic regression analyses were conducted to estimate associations between baseline child-reported screen time (exposure) and parent-reported binge-eating disorder based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5, outcome) at one-year follow-up, adjusting for race/ethnicity, sex, household income, parent education, BMI percentile, site, and baseline binge-eating disorder. RESULTS: Each additional hour of total screen time per day was prospectively associated with 1.11 higher odds of binge-eating disorder at 1-year follow-up (95% CI 1.05-1.18) after adjusting for covariates. In particular, each additional hour of social networking (aOR 1.62, 95% CI 1.18-2.22), texting (aOR 1.40, 95% CI 1.08-1.82), and watching/streaming television shows/movies (aOR 1.39, 95% CI 1.14-1.69) was significantly associated with binge-eating disorder. DISCUSSION: Clinicians should assess screen time usage and binge eating in children and adolescents and advise parents about the potential risks associated with excessive screen time.

A longitudinal study of changes in smart phone addiction and depressive symptoms and potential risk factors among Chinese college students.

BACKGROUND: The current study aims to track the changes in the levels of smart phone addiction (SPA) and depressive symptoms between pre and during COVID-19 and potential risk factors of among Chinese college students in a four-wave longitudinal study. METHODS: The participants were recruited from a Chinese university (n = 195; 58.5% females). The first three-wave surveys were conducted before COVID-19 (during December of Year 1, June of Year 1, and December of Year 2 of their college study; Time 1, Time 2, Time 3), while the fourth survey (Time 4; during June of Year 2 of their college study) was conducted in June 2020 during COVID-19. COVID-19-related factors, including quarantine, lockdown, boredom, emotional loneliness, and social loneliness, were investigated. RESULTS: The results showed a significant increase in the levels of depressive symptoms and prevalence of probable depression during COVID-19 (69.2%) compared to those 18 months, 12 months and 6 months before COVID-19 (41.5, 45.6, 48.2%) but non-significant changes in SPA. Boredom and emotional loneliness were positively associated with both SPA and depressive symptoms during COVID-19. Social loneliness was also positively associated with depressive symptoms during COVID-19. Quarantine and lockdown were not significantly associated with SPA or depressive symptoms. DISCUSSION AND CONCLUSIONS: The results highlight that the study population may be a high risk group of probable depression. Future studies should continue to track these mental and behavioral status with the progression of the epidemic. The identified emotional factors could be used to reduce depressive symptoms during COVID-19 and prevent the potential risk of SPA.

Assessment of Grain Harvest Moisture Content Using Machine Learning on Smartphone Images for Optimal Harvest Timing.

Grain moisture content (GMC) is a key indicator of the appropriate harvest period of rice. Conventional testing is time-consuming and laborious, thus not to be implemented over vast areas and to enable the estimation of future changes for revealing optimal harvesting. Images of single panicles were shot with smartphones and corrected using a spectral-geometric correction board. In total, 86 panicle samples were obtained each time and then dried at 80 °C for 7 days to acquire the wet-basis GMC. In total, 517 valid samples were obtained, in which 80% was randomly used for training and 20% was used for testing to construct the image-based GMC assessment model. In total, 17 GMC surveys from a total of 201 samples were also performed from an area of 1 m2 representing on-site GMC, which enabled a multi-day GMC prediction. Eight color indices were selected using principal component analysis for building four machine learning models, including random forest, multilayer perceptron, support vector regression (SVR), and multivariate linear regression. The SVR model with a MAE of 1.23% was the most suitable for GMC of less than 40%. This study provides a real-time and cost-effective non-destructive GMC measurement using smartphones that enables on-farm prediction of harvest dates and facilitates the harvesting scheduling of agricultural machinery.

Evaluating the performance of a low-cost mobile phone attachable microscope in cervical cytology.

BACKGROUND: Cervical cancer remains a global health problem especially in remote areas of developing countries which have limited resources for cervical cancer screening. In this study, we evaluated the performance of a low-cost, smartphone attachable paper-based microscope when used for classifying images of cervical cytology. METHODS: Cervical cytology samples included: 10 Normal, 10 Low-grade squamous intraepithelial lesion (LSIL), 10 High-grade squamous intraepithelial lesion (HSIL), and 10 Malignant Pap Smears. The agreement between conventional microscopy vs. Foldscope imaging was calculated using a weighted kappa coefficient. A confusion matrix was created with three classes: Normal, LSIL, and HSIL/malignant, to evaluate the performance of the Foldscope by calculating the accuracy, sensitivity, and specificity. RESULTS: We observed a kappa statistic of 0.68 for the agreement. This translates into a substantial agreement between the cytological classifications by the Foldscope vs. conventional microscopy. The accuracy of the Foldscope was 80%, with a sensitivity and specificity of 85 and 90% for the HSIL/Mal category, 80 and 83.3%, for LSIL, and 70 and 96.7% for Normal. CONCLUSIONS: This study highlights the usefulness of the Foldscope in cervical cytology, demonstrating it has substantial agreement with conventional microscopy. Its use could improve cytologic interpretations in underserved areas and, thus, improve the quality of cervical cancer screening. Improvements in existing limitations of the device, such as ability to focus, could potentially increase its accuracy.