Bringing a scalable adaptive hybrid modeling framework closer to industrial use: Application on a multiscale fungal fermentation.

Digitalization has paved the way for new paradigms such as digital shadows and digital twins for fermentation processes, opening the door for real-time process monitoring, control, and optimization. With a digital shadow, real-time model adaptation to accommodate complex metabolic phenomena such as metabolic shifts of a process can be monitored. Despite the many benefits of digitalization, the potential has not been fully reached in the industry. This study investigates the development of a digital shadow for a very complex fungal fermentation process in terms of microbial physiology and fermentation operation on pilot-scale at Novonesis and the challenges thereof. The process has historically been difficult to optimize and control due to a lack of offline measurements and an absence of biomass measurements. Pilot-scale and lab-scale fermentations were conducted for model development and validation. With all available pilot-scale data, a data-driven soft sensor was developed to estimate the main substrate concentration (glucose) with a normalized root mean squared error (N-RMSE) of 2%. This robust data-driven soft sensor was able to estimate accurately in lab-scale (volume < 20× pilot) with a N-RMSE of 7.8%. A hybrid soft sensor was developed by combining the data-driven soft sensor with a mass balance to estimate the glycerol and biomass concentrations on pilot-scale data with N-RMSEs of 11% and 21%, respectively. A digital shadow modeling framework was developed by coupling a mechanistic model (MM) with the hybrid soft sensor. The digital shadow modeling framework significantly improved the predictability compared with the MM. The contribution of this study brings the application of digital shadows closer to industrial implementation. It demonstrates the high potential of using this type of modeling framework for scale-up and leads the way to a new generation of in silico-based process development.

Natural history of rare diseases using natural language processing of narrative unstructured electronic health records: The example of Dravet syndrome.

OBJECTIVE: The increasing implementation of electronic health records allows the use of advanced text-mining methods for establishing new patient phenotypes and stratification, and for revealing outcome correlations. In this study, we aimed to explore the electronic narrative clinical reports of a cohort of patients with Dravet syndrome (DS) longitudinally followed at our center, to identify the capacity of this methodology to retrace natural history of DS during the early years. METHODS: We used a document-based clinical data warehouse employing natural language processing to recognize the phenotype concepts in the narrative medical reports. We included patients with DS who have a medical report produced before the age of 2 years and a follow-up after the age of 3 years ("DS cohort," 56 individuals). We selected two control populations, a "general control cohort" (275 individuals) and a "neurological control cohort" (281 individuals), with similar characteristics in terms of gender, number of reports, and age at last report. To find concepts specifically associated with DS, we performed a phenome-wide association study using Cox regression, comparing the reports of the three cohorts. We then performed a qualitative analysis of the surviving concepts based on their median age at first appearance. RESULTS: A total of 76 concepts were prevalent in the reports of children with DS. Concepts appearing during the first 2 years were mostly related with the epilepsy features at the onset of DS (convulsive and prolonged seizures triggered by fever, often requiring in-hospital care). Subsequently, concepts related to new types of seizures and to drug resistance appeared. A series of non-seizure-related concepts emerged after the age of 2-3 years, referring to the nonseizure comorbidities classically associated with DS. SIGNIFICANCE: The extraction of clinical terms by narrative reports of children with DS allows outlining the known natural history of this rare disease in early childhood. This original model of "longitudinal phenotyping" could be applied to other rare and very rare conditions with poor natural history description.

Validation of the Sleepiz One + as a radar-based sensor for contactless diagnosis of sleep apnea.

PURPOSE: The cardiorespiratory polysomnography (PSG) is an expensive and limited resource. The Sleepiz One + is a novel radar-based contactless monitoring device that can be used e.g. for longitudinal detection of nocturnal respiratory events. The present study aimed to compare the performance of the Sleepiz One + device to the PSG regarding the accuracy of apnea-hypopnea index (AHI). METHODS: From January to December 2021, a total of 141 adult volunteers who were either suspected of having sleep apnea or who were healthy sleepers took part in a sleep study. This examination served to validate the Sleepiz One + device in the presence and absence of additional SpO2 information. The AHI determined by the Sleepiz One + monitor was estimated automatically and compared with the AHI derived from manual PSG scoring. RESULTS: The correlation between the Sleepiz-AHI and the PSG-AHI with and without additional SpO2 measurement was rp = 0.94 and rp = 0,87, respectively. In general, the Bland-Altman plots showed good agreement between the two methods of AHI measurement, though their deviations became larger with increasing sleep-disordered breathing. Sensitivity and specificity for recordings without additional SpO2 was 85% and 88%, respectively. Adding a SpO2 sensor increased the sensitivity to 88% and the specificity to 98%. CONCLUSION: The Sleepiz One + device is a valid diagnostic tool for patients with moderate to severe OSA. It can also be easily used in the home environment and is therefore beneficial for e.g. immobile and infectious patients. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION FOR PROSPECTIVELY REGISTERED TRIALS: This study was registered on clinicaltrials.gov (NCT04670848) on 2020-12-09.

Effectiveness of gamified digital interventions in mental health prevention and health promotion among adults: a scoping review.

BACKGROUND: Though still a young field of research, gamified digital interventions have demonstrated potential in exerting a favourable impact on health and overall well-being. With the increasing use of the internet and digital devices, the integration of game elements presents novel opportunities for preventing mental disorders and enhancing mental health. Hence, this review aims to assess the effectiveness of gamified interventions focusing on preventing mental disorders or promoting mental health among adults. METHODS: Based on a scoping review across four databases (MEDLINE, Embase, PsycInfo and Web of Science), 7,953 studies were initially identified. After removing duplicates and screening titles, abstracts and full texts, 16 studies were identified as suitable for inclusion in a narrative synthesis of findings. We included interventional studies encompassing an intervention and a control group aiming to investigate the effectiveness of the use of gamified digital mental health interventions and the use of gamified digital elements. RESULTS: Overall, positive effects of gamified interventions on mental health-related outcomes were identified. In particular, beneficial consequences for psychological well-being and depressive symptoms were observed in all studies. However, further outcomes, such as resilience, anxiety, stress or satisfaction with life, showed heterogenous findings. Most game elements used were reward, sensation and progress, whilst the quantity of elements was not consistent and, therefore, no substantiated conclusion regarding the (optimal) quantity or composition of game elements can be drawn. Further, the outcomes, measurements and analyses differed greatly between the 16 included studies making comparisons difficult. CONCLUSION: In summary, this review demonstrates the potential of integrating digital game elements on mental health and well-being with still a great gap of research. A taxonomy is needed to adequately address relevant game elements in the field of mental health promotion and prevention of mental disorders. Therefore, future studies should explicitly focus on the mechanisms of effect and apply rigorous study designs.

Association between constant connectivity to work during leisure time and insomnia: does work engagement matter?

PURPOSE: The influx of communication media to contemporary workplaces has exposed workers to be always connected to their work. Constant connectivity to work (CCW) refers to the condition in which workers are always connected to work, even during their non-work hours, and are not detached from the work situation. We investigated the association between CCW and insomnia and the moderating effect of work engagement. METHODS: A total of 29,512 nationally representative samples of workers in Korea were used. Insomnia was assessed by the Minimal Insomnia Symptom Scale. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). The additive interaction between CCW and low work engagement was estimated by calculating Relative Excess Risk due to Interaction (RERI). RESULTS: Exposure to CCW was related to insomnia (OR [95% CI] 1.33 [1.22-1.46]). Additionally, a significant negative interaction between CCW and work engagement was observed. The effects of CCW were mitigated in those with high work engagement. The OR of the combined effect of CCW exposure and low work engagement was 2.52 (95% CI 2.22-2.87). RERI between exposure to CCW and low work engagement was 0.69 (95% CI 0.38-0.99), indicating that there is a supra-additive interaction. CONCLUSION: Our study found that CCW is related to an increased risk of insomnia and that high work engagement can mitigate the effect of CCW. Our study suggests that improving work engagement and disconnecting from work outside of work hours can help protect employees' sleep quality.

[Healthcare 4.0-Medicine in transition]. / Healthcare 4.0 ­ Medizin im Wandel.

Healthcare 4.0 describes the future transformation of the healthcare sector driven by the combination of digital technologies, such as artificial intelligence (AI), big data and the Internet of Medical Things, enabling the advancement of precision medicine. This overview article addresses various areas such as large language models (LLM), diagnostics and robotics, shedding light on the positive aspects of Healthcare 4.0 and showcasing exciting methods and application examples in cardiology. It delves into the broad knowledge base and enormous potential of LLMs, highlighting their immediate benefits as digital assistants or for administrative tasks. In diagnostics, the increasing usefulness of wearables is emphasized and an AI for predicting heart filling pressures based on cardiac magnetic resonance imaging (MRI) is introduced. Additionally, it discusses the revolutionary methodology of a digital simulation of the physical heart (digital twin). Finally, it addresses both regulatory frameworks and a brief vision of data-driven healthcare delivery, explaining the need for investments in technical personnel and infrastructure to achieve a more effective medicine.

Old by obsolescence: The paradox of aging in the digital era.

Geroscience and philosophy of aging have tended to focus their analyses on the biological and chronological dimensions of aging. Namely, one ages with the passage of time and by experiencing the cellular-molecular deterioration that accompanies this process. However, our concept of aging depends decisively on the social valuations held about it. In this article, we will argue that, if we study social aging in the contemporary world, a novel phenomenon can be identified: the paradox of aging in the digital era. If the social understanding of aging today is linked to unproductivity and obsolescence; then there is a possibility that, given the pace of change of digital technologies, we become obsolete at an early chronological and biological age, and therefore, feel old at a younger age. First, we will present the social dimension of aging based on Rowe and Kahn's model of successful aging. We will also show that their notion of social aging hardly considers structural aspects and weakens their approach. Second, departing from social aging in its structural sense, we will develop the paradox of aging in the digital era. On the one hand, we will explain how the institutionalization of aging has occurred in modern societies and how it is anchored in the concepts of obsolescence and productivity. On the other hand, we will state the kind of obsolescence that digitalization produces and argue that it can make cohorts of biologically and chronologically young individuals obsolete, and thus they would be personally and socially perceived as old.

Christian anthropology-based contributions to the ethics of socially assistive robots in care for older adults.

Our society, in general, and health care, in particular, faces notable challenges due to the emergence of innovative digital technologies. The use of socially assistive robots in aged care is a particular digital application that provokes ethical reflection. The answers we give to the ethical questions associated with socially assistive robots are framed by ontological and anthropological considerations of what constitutes human beings and how the meaning of being human relates to how these robots are conceived. Religious beliefs and secular worldviews, each of which may participate fully in pluralist societies, have an important responsibility in this foundational debate, as anthropological theories can be inspired by religious and secular viewpoints. This article identifies seven anthropological considerations grounded in the synthesis of biblical scriptures, Roman Catholic documents, and recent research literature. We highlight the inspirational quality of these anthropological considerations when dealing with ethical issues regarding the development and use of socially assistive robots in aged care. With this contribution, we aim to foster a global and inclusive dialogue on digitalization in aged care that deeply challenges our basic understanding of what constitutes a human being and how this notion relates to machine artefacts.

Greenway of Digital Health Technology During COVID-19 Crisis: Bibliometric Analysis, Challenges, and Future Perspective.

Digital health has transformed the healthcare landscape by leveraging technology to improve patient outcomes and access to medical services. The COVID-19 pandemic has highlighted the urgent need for digital healthcare solutions that can mitigate the impact of the outbreak while ensuring patient safety. In this chapter, we delve into how digital health technologies such as telemedicine, mobile apps, and wearable devices can provide personalized care, reduce healthcare provider burden, and lower healthcare costs. We also explore the creation of a greenway of digital healthcare that safeguards patient confidentiality, enables efficient communication, and ensures cost-effective payment systems. This chapter showcases the potential of digital health to revolutionize healthcare delivery while ensuring patient well-being and medical staff satisfaction.

Designing and Implementation of a Digitalized Intersectoral Discharge Management System and Its Effect on Readmissions: Mixed Methods Approach.

BACKGROUND: Digital transformation offers new opportunities to improve the exchange of information between different health care providers, including inpatient, outpatient and care facilities. As information is especially at risk of being lost when a patient is discharged from a hospital, digital transformation offers great opportunities to improve intersectoral discharge management. However, most strategies for improvement have focused on structures within the hospital. OBJECTIVE: This study aims to evaluate the implementation of a digitalized discharge management system, the project "Optimizing instersectoral discharge management" (SEKMA, derived from the German Sektorübergreifende Optimierung des Entlassmanagements), and its impact on the readmission rate. METHODS: A mixed methods design was used to evaluate the implementation of a digitalized discharge management system and its impact on the readmission rate. After the implementation, the congruence between the planned (logic model) and the actual intervention was evaluated using a fidelity analysis. Finally, bivariate and multivariate analyses were used to evaluate the effectiveness of the implementation on the readmission rate. For this purpose, a difference-in-difference approach was adopted based on routine data of hospital admissions between April 2019 and August 2019 and between April 2022 and August 2022. The department of vascular surgery served as the intervention group, in which the optimized discharge management was implemented in April 2022. The departments of internal medicine and cardiology formed the control group. RESULTS: Overall, 26 interviews were conducted, and we explored 21 determinants, which can be categorized into 3 groups: "optimization potential," "barriers," and "enablers." On the basis of these results, 19 strategies were developed to address the determinants, including a lack of networking among health care providers, digital information transmission, and user-unfriendliness. On the basis of these strategies, which were prioritized by 11 hospital physicians, a logic model was formulated. Of the 19 strategies, 7 (37%; eg, electronic discharge letter, providing mobile devices to the hospital's social service, and generating individual medication plans in the format of the national medication plan) have been implemented in SEKMA. A survey on the fidelity of the application of the implemented strategies showed that 3 of these strategies were not yet widely applied. No significant effect of SEKMA on readmissions was observed in the routine data of 14,854 hospital admissions (P=.20). CONCLUSIONS: This study demonstrates the potential of optimizing intersectoral collaboration for patient care. Although a significant effect of SEKMA on readmissions has not yet been observed, creating a digital ecosystem that connects different health care providers seems to be a promising approach to ensure secure and fast networking of the sectors. The described intersectoral optimization of discharge management provides a structured template for the implementation of a similar local digital care networking infrastructure in other care regions in Germany and other countries with a similarly fragmented health care system.

Attitudes Toward and Use of eHealth Technologies Among German Dermatologists: Repeated Cross-Sectional Survey in 2019 and 2021.

BACKGROUND: In recent years, legal and infrastructural conditions have been set to improve the adoption of digital applications in health care in Germany. The impact of these actions was amplified by the COVID-19 pandemic. So far, no studies have confirmed this progress in dermatology. OBJECTIVE: The aim of this study was to measure changes in knowledge, interest, expectation, and use of digital applications in health care among dermatologists in Germany in 2019 and 2021. METHODS: We administered a repeated cross-sectional survey among dermatologists in medical practices and clinics in Germany at 2 time points: t1 (2019; before the COVID-19 pandemic) and t2 (2021; during the COVID-19 pandemic). We used a standardized questionnaire, including items on respondents' knowledge, interest, expectation, and use of digital applications, as well as their demographics. The survey was distributed by post and email. The data were analyzed descriptively as well as with multiple logistic regressions. RESULTS: At t1, 585 (272/571, 47.6% female; mean age 52.4, SD 8.9 years) dermatologists and at t2, 792 (360/736, 48.9% female; mean age 54.3, SD 8.6 years) dermatologists participated in this survey. Interest in digital medicine was higher at t1 than at t2 (381/585, 65.1% vs 458/792, 57.8%; P≤.001). Nevertheless, 38.6% (306/792) had used digital applications more often since the beginning of the pandemic. For example, real-time telemedicine with patients (12/585, 2.1% vs 160/792, 7.6%; P≤.001) and other specialists did increase (33/385, 5.7% vs 181/792, 22.8%; P≤.001). Almost one-third expressed great concerns about digitalization (272/792, 34.3% vs 294/792, 37.1%; P=.21). Spatial analysis revealed higher interest in, more positive expectations toward, and higher use of digital applications in urban areas in comparison to rural areas. For instance, dermatologists from urban areas assessed future applications as having less risk (adjusted odds ratio [aOR] 0.51, 95% CI 0.35-0.76) than did dermatologists from rural areas. The situation was similar with the age groups, as, for example, dermatologists aged <50 years also expected lower risks (aOR 0.51, 95% CI 0.34-0.77) than those aged ≥50 years. There were no differences between sexes in use, but there were differences in knowledge and expectation; for example, male participants assessed their confidence in using digital applications as higher (aOR 1.44, 95% CI 1.01-2.04) than did female participants. CONCLUSIONS: During the pandemic, the use of digital applications in dermatology increased but still remained at a moderate level. The regional and age-related disparities identified indicate the need for further action to ensure equal access to digital care.

Planned behavior, social networks, and perceived risks: Understanding farmers' behavior toward precision dairy technologies.

Precision dairy tools (PDT) can provide timely information on individual cow's physiological and behavioral parameters, which can lead to more efficient management of the dairy farm. Although the economic rationale behind the adoption of PDT has been extensively discussed in the literature, the socio-psychological aspects related to the adoption of these technologies have received far less attention. Therefore, this paper proposes a socio-psychological model that builds upon the theory of planned behavior and develops hypotheses regarding cognitive constructs, their interaction with the farmers' perceived risks and social networks, and their overall influence on adoption. These hypotheses are tested using a generalized structural equation model for (a) the adoption of automatic milking systems (AMS) on the farms and (b) the PDT that are usually adopted with the AMS. Results show that adoption of these technologies is affected directly by intention, and the effects of subjective norms, perceived control, and attitudes on adoption are mediated through intention. A unit increase in perceived control score is associated with an increase in marginal probability of adoption of AMS and PDT by 0.05 and 0.19, respectively. Subjective norms are associated with an increase in marginal probability of adoption of AMS and PDT by 0.009 and 0.05, respectively. These results suggest that perceived control exerts a stronger influence on adoption of AMS and PDT, particularly compared with their subjective norms. Technology-related social networks are associated with an increase in marginal probability of adoption of AMS and PDT by 0.026 and 0.10, respectively. Perceived risks related to AMS and PDT negatively affect probability of adoption by 0.042 and 0.16, respectively, by having negative effects on attitudes, perceived self-confidence, and intentions. These results imply that integrating farmers within knowledge-sharing networks, minimizing perceived risks associated with these technologies, and enhancing farmers' confidence in their ability to use these technologies can significantly enhance uptake.

Patients' Experiences With Digitalization in the Health Care System: Qualitative Interview Study.

BACKGROUND: The digitalization of public and health sectors worldwide is fundamentally changing health systems. With the implementation of digital health services in health institutions, a focus on digital health literacy and the use of digital health services have become more evident. In Denmark, public institutions use digital tools for different purposes, aiming to create a universal public digital sector for everyone. However, this digitalization risks reducing equity in health and further marginalizing citizens who are disadvantaged. Therefore, more knowledge is needed regarding patients' digital practices and experiences with digital health services. OBJECTIVE: This study aims to examine digital practices and experiences with public digital health services and digital tools from the perspective of patients in the neurology field and address the following research questions: (1) How do patients use digital services and digital tools? (2) How do they experience them? METHODS: We used a qualitative design with a hermeneutic approach. We conducted 31 semistructured interviews with patients who were hospitalized or formerly hospitalized at the department of neurology in a hospital in Denmark. The interviews were audio recorded and subsequently transcribed. The text from each transcribed interview was analyzed using manifest content analysis. RESULTS: The analysis provided insights into 4 different categories regarding digital practices and experiences of using digital tools and services in health care systems: social resources as a digital lifeline, possessing the necessary capabilities, big feelings as facilitators or barriers, and life without digital tools. Our findings show that digital tools were experienced differently, and specific conditions were important for the possibility of engaging in digital practices, including having access to social resources; possessing physical, cognitive, and communicative capabilities; and feeling motivated, secure, and comfortable. These prerequisites were necessary for participants to have positive experiences using digital tools in the health care system. Those who did not have these prerequisites experienced challenges and, in some cases, felt left out. CONCLUSIONS: Experiences with digital practices and digital health services are complex and multifaceted. Engagement in digital practices for the examined population requires access to continuous assistance from their social network. If patients do not meet requirements, digital health services can be experienced as exclusionary and a source of concern. Physical, cognitive, and communicative difficulties might make it impossible to use digital tools or create more challenges. To ensure that digitalization does not create inequities in health, it is necessary for developers and institutions to be aware of the differences in digital health literacy, focus on simplifying communication with patients and next of kin, and find flexible solutions for citizens who are disadvantaged.

Viable Escherichia coli enumeration on a polydimethylsiloxane (PDMS) chip with vertical channel-well configuration.

The culture-based methods for viable Escherichia coli (E. coli) detection suffer from long detection time and laborious procedures, whereas the molecule tests and immune recognition technologies lack live/dead E. coli differentiation. Rapid, easy-to-use, and accessible viable E. coli detection is of benefit to bacterial infection diagnosis and risk warning of E. coli contamination of water and food, safeguarding human health. Herein, we propose a microwell chip-based solution to realize simple and rapid determination of viable E. coli. The vertical channel-well configuration is applied to develop the microwell array chip for increasing the microwell density (6200 wells/cm2), yielding a broad dynamic range from 103 to 107 CFU/mL. We incorporate an inducible enzyme assay with the developed chip and achieve the differentiation of live/dead E. coli within 4 h, significantly shortening the detection time from over 24 h in the standard method. By encapsulating single E. coli into microwells, the concentration of viable cells can be determined simultaneously through counting positive microwells. In addition, the air soluble PDMS that can store negative pressure for independent sample digitalization endows the developed chip with simple operation and less reliance on external equipment. With further developments for increasing the number of microwell and integrating more sample panels, the developed chip can become a useful tool for rapid viable E. coli enumeration with user-friendly operation, simple procedures, and accessibility in decentralized settings, thereby deploying this device for water and food safety monitoring, as well as clinical bacterial infection diagnosis.

E-learning platforms in ideological and political education at universities: students' motivation and learning performance.

BACKGROUND: The study aimed to examine the impact of using the MOODLE e-learning platform in ideological and political education on Chinese students' motivation and academic performance. METHODS: The study involved 447 students from China-based universities (the experimental group - 232 students who studied using electronic educational platforms, and the control group - 215 students who used no digital technologies in their learning). The following methods were used: Measuring the need to achieve success among students; T. I. Ilyina's method for studying motivation to study at university; Method for studying student success motivation; Method for studying the motives of students' educational activities; Method for determining the main motives for choosing a profession (E. M. Pavlyutenkov); Motivation of learning activities: Levels and types (I. S. Dombrovskaya). Students' academic performance was assessed by testing in the studied disciplines at the beginning and end of the study. RESULTS: As a result, the significance of the motivational component in achieving the success of ideological and political education and the impact on students' motivation to use e-learning platforms is theoretically substantiated. CONCLUSIONS: It has been confirmed that using e-learning platforms in ideological and political education helps increase student motivation and academic performance.

Development of Self-Sensing Asphalt Pavements: Review and Perspectives.

The digitalization of the road transport sector necessitates the exploration of new sensing technologies that are cost-effective, high-performing, and durable. Traditional sensing systems suffer from limitations, including incompatibility with asphalt mixtures and low durability. To address these challenges, the development of self-sensing asphalt pavements has emerged as a promising solution. These pavements are composed of stimuli-responsive materials capable of exhibiting changes in their electrical properties in response to external stimuli such as strain, damage, temperature, and humidity. Self-sensing asphalt pavements have numerous applications, including in relation to structural health monitoring (SHM), traffic monitoring, Digital Twins (DT), and Vehicle-to-Infrastructure Communication (V2I) tools. This paper serves as a foundation for the advancement of self-sensing asphalt pavements by providing a comprehensive review of the underlying principles, the composition of asphalt-based self-sensing materials, laboratory assessment techniques, and the full-scale implementation of this innovative technology.

Design and Implementation of an Ontology for Measurement Terminology in Digital Calibration Certificates.

Digital Calibration Certificates (DCCs) are a key focus in metrology digitalization, necessitating that they satisfy the criteria for machine readability and understandability. Current DCCs are machine-readable, but they are still missing the essential semantic information required for machine understandability. This shortfall is particularly notable in the lack of a dedicated semantic ontology for measurement terminologies. This paper proposes a domain ontology for measurement terminologies named the OMT (Ontology for Measurement Terminology), using a foundation of metrological terms from standards like the International Vocabulary of Metrology (VIM), the Guide to the Expression of Uncertainty in Measurement (GUM), and JJF1001. It also incorporates insights from models such as the SI Reference Point, the Simple Knowledge Organization System (SKOS), and the DCC Schema. The methodology was guided by Stanford's Seven-Step Method, ensuring a systematic development process tailored to the needs of metrological semantics. Through semantic expression capability verification and SPARQL query validations, the OMT has been confirmed to possess essential machine readability and understandability features. It has been successfully integrated into version 3.2.1 of DCCs across ten representative domains. This integration demonstrates an effective method for ensuring that DCCs are machine-readable and capable of interoperating within digital environments, thereby advancing the research in metrology digitization.

Telemedicine Beyond Borders: A Mixed-Methods Approach to Understanding Cross-National Usage Intention.

Introduction: Drawing on the Unified Theory of Acceptance and Use of Technology 2 and the Diffusion of Innovation Theory, this article investigates the adoption of telemedicine services from a patient perspective in Germany, Spain, and the United States using a mixed-methods approach. Digital health technologies have the potential to improve access to care and to alleviate the burden on traditional health care systems and are becoming more integrated into everyday medicine. Therefore, understanding the factors that impact patients' intentions to use telemedicine is crucial to ensure successful development. Methods: Based on 1,200 surveys collected in Germany, Spain, and the United States, structural equation modeling (IBM SPSS Amos 24) is employed to test the hypotheses. The article also explores how age and gender moderate the proposed relationships. Results: Seven out of the 10 hypotheses (performance expectancy, hedonic motivation, habit, relative advantage, and perceived security) are found to be positive, direct, and statistically significant. Furthermore, findings suggest stronger effects for telemedicine usage intention for younger female users than their male counterparts. Discussion: With digital health technologies becoming more prevalent, the outcomes of this study can endorse the development of effective strategies to promote the adoption of telemedicine, ultimately improving access to care and contributing to the advancement of and modern health care.

Accuracy of Smartphone-Based Three-Dimensional Facial Scanning System: A Systematic Review.

BACKGROUND: Recently, the integration of 3D face scanning into smartphones has raised vast interest in plastic surgery. With the release of smartphones featuring 3D face scanning technology, users now can capture detailed 3D models of their faces using their smartphones. However, trueness and precision of this system is less well established. METHODS: PubMed, Cochrane Library, Embase, ScienceDirect, Scopus, and Web of Science databases were searched for studies evaluating 3D scanning of smartphone devices and conventional 3D imaging systems from January 1, 2017, to June 1, 2023. A qualitative systematic review was conducted by two review authors after independently selecting studies, extracting data, and assessing the risk of bias of included studies. RESULTS: A total of 11 studies were included, all focusing on the accuracy of smartphone 3D facial scanning. The results show that although smartphones perform poorly on deep and irregular surfaces, they are accurate enough for clinical applications and have the advantage of being economical and portable. CONCLUSIONS: Smartphone-based 3D facial scanning has been basically validated for clinical application, showing broad clinical application prospects in plastic surgery. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .

The digitalization of outdoor recreation: Global perspectives on the opportunities and challenges for protected area management.

The increasing popularity of digital media among protected area visitors poses challenges to protected area management. It alters the way visitors move and behave in the area, potentially increasing disturbance of nature, and it might also affect their expectation prior to the visit and their reflection on it. Simultaneously, digital media allow protected area managers to develop and implement new methods of digital visitor management (DVM). This may help to avoid conflicts and ensure compliance with rules and regulations and may have much further reaching positive consequences. Based on an online survey across 131 parks in 46 countries covering all continents, this study examined for the first time how protected areas view DVM. The results showed that the majority of park managers see digitalization as an opportunity, with 91% agreeing that it enables them to reach larger numbers of visitors and to provide real-time information. The advantage of integrating digital media into visitor monitoring was recognized. However, some park managers perceived digitalization as problematic, with 42% agreeing that it increases visitor load in sensitive areas and 40% agreeing that it leads to more off-trail activity. A clear majority of the respondents (61-91%) saw the proposed methods of DVM as effective or very effective. Accordingly, 70% of them envisioned using DVM in the future. Our findings suggest that the effects of digitalization in outdoor recreation are largely similar across the globe, with no significant influence of economic status or region. They offer insights into the potential of DVM for protected area management, but also its main obstacles. Adoption will be facilitated by increasing staff and funding for DVM. Additionally, knowledge exchange between protected areas can ease the successful implementation of new digital tools.