ASTHMAXcel PRO patient satisfaction and usability field testing.

Background: ASTHMAXcel PRO, an enhanced version of the ASTHMAXcel mobile application, has been developed to deliver comprehensive, guideline-based asthma education while also facilitating the collection of patient-reported outcomes (PROs) and enhancing user experience.Objective: To perform field testing and conduct formative and summative evaluation of the ASTHMAXcel PRO application to assess its impact on patient satisfaction, usability, and usage.Methods: Twenty-eight adult patients completed a baseline visit during which ASTHMAXcel PRO was introduced, health literacy was assessed, and demographic data were collected. They were instructed to use the app for 4 weeks. The Questionnaire for User Interface Satisfaction (QUIS) and the Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire were administered at baseline and 4 weeks to assess user satisfaction and technology acceptance, respectively. Semi-structured interviews were conducted to gather feedback regarding the application from patients.Results: The baseline total scores were high for both UTAUT and QUIS (mean (SD): 64.2 (10.1), 6.8 (2.2) respectively) indicating that user satisfaction and acceptance began at high levels. UTAUT total score, as well as all domain scores, improved significantly from baseline to 4 weeks (p < 0.02). QUIS total score along with several domain scores (screen, system capabilities, usability) also increased from baseline to 4-weeks (p = 0.03, 0.01, 0.03, 0.01, respectively). These improvements remained significant when adjusting for age, gender, education, and health literacy. Patients reported that the application was helpful, informative, and easy to understand and use.Conclusion: The significant increases in satisfaction and technology adoption observed among ASTHMAXcel PRO users demonstrate that the application is viable and has the potential to improve upon usability challenges faced by existing mobile health applications.

Understanding the Benefits and Challenges of Using Large Language Model-based Conversational Agents for Mental Well-being Support.

Conversational agents powered by large language models (LLM) have increasingly been utilized in the realm of mental well-being support. However, the implications and outcomes associated with their usage in such a critical field remain somewhat ambiguous and unexplored. We conducted a qualitative analysis of 120 posts, encompassing 2917 user comments, drawn from the most popular subreddit focused on mental health support applications powered by large language models (u/Replika). This exploration aimed to shed light on the advantages and potential pitfalls associated with the integration of these sophisticated models in conversational agents intended for mental health support. We found the app (Replika) beneficial in offering on-demand, non-judgmental support, boosting user confidence, and aiding self-discovery. Yet, it faced challenges in filtering harmful content, sustaining consistent communication, remembering new information, and mitigating users' overdependence. The stigma attached further risked isolating users socially. We strongly assert that future researchers and designers must thoroughly evaluate the appropriateness of employing LLMs for mental well-being support, ensuring their responsible and effective application.

Mobile Apps for Children's Health and Wellbeing: Design Features and Future Opportunities.

Mobile health apps hold great potential for promoting children's health and wellbeing. However, there is limited understanding of how these technologies are currently designed to support children with their health concerns or wellness goals. To gain insight into the current landscape of mobile apps designed for children's health, we retrieved and reviewed 43 apps from IOS and Google Play store that are specifically marketed for children. Our qualitative analysis identified the dominant health focuses and goals of children's mobile health apps. We analyzed the primary users and their expectations as well as the methods of engagement and involvement adopted. Based on our findings, we discussed the opportunities to support children with chronic illnesses through mobile apps, design for dual use, and design for age appropriateness and digital health safety. This study provides insights and recommendations for app designers, health researchers, and policymakers on strategies for engaging children and parents while also promoting children's health and wellbeing through mobile technology.

The Role of Conversational Agents for Substance Use Disorder in Social Distancing Contexts.

The COVID-19 pandemic and its related policies, such as social distancing orders, are affecting the ability for people with substance use disorders (SUD) to seek prevention and treatment. In this commentary, we introduce conversational agents, a type of social technology. We discuss the role of conversational agents in the prevention and treatment of SUD in social distancing contexts and the potential benefits and limitations of designing and implementing such technology in the prevention and care for patients with SUD.

A scoping review of qualitative research in JAMIA: past contributions and opportunities for future work.

OBJECTIVE: Qualitative methods are particularly well-suited to studying the complexities and contingencies that emerge in the development, preparation, and implementation of technological interventions in real-world clinical practice, and much remains to be done to use these methods to their full advantage. We aimed to analyze how qualitative methods have been used in health informatics research, focusing on objectives, populations studied, data collection, analysis methods, and fields of analytical origin. METHODS: We conducted a scoping review of original, qualitative empirical research in JAMIA from its inception in 1994 to 2019. We queried PubMed to identify relevant articles, ultimately including and extracting data from 158 articles. RESULTS: The proportion of qualitative studies increased over time, constituting 4.2% of articles published in JAMIA overall. Studies overwhelmingly used interviews, observations, grounded theory, and thematic analysis. These articles used qualitative methods to analyze health informatics systems before, after, and separate from deployment. Providers have typically been the main focus of studies, but there has been an upward trend of articles focusing on healthcare consumers. DISCUSSION: While there has been a rich tradition of qualitative inquiry in JAMIA, its scope has been limited when compared with the range of qualitative methods used in other technology-oriented fields, such as human-computer interaction, computer-supported cooperative work, and science and technology studies. CONCLUSION: We recommend increased public funding for and adoption of a broader variety of qualitative methods by scholars, practitioners, and policy makers and an expansion of the variety of participants studied. This should lead to systems that are more responsive to practical needs, improving usability, safety, and outcomes.

Analyzing Description, User Understanding and Expectations of AI in Mobile Health Applications.

Previous research has studied medical professionals' perception of artificial intelligence (AI). However, there has been a limited understanding of how healthcare consumers perceive and use AI-powered technologies such as mobile health apps. We collected 40 popular mobile health apps that claim to have adopted AI, to study how AI is explained in these apps' descriptions, and how users react to it through app reviews. We found that four AI features (Recommendation, Conversational Agent, Recognition, and Prediction) are frequently used across seven health domains, including Fitness, Mental Health, Meditation and Sleep, Nutrition and Diet, etc. Our results show that (1) users have unique expectations toward each AI features, such as including feedback for recommendations, humanlike experience for conversational agents, and accuracy for recognition and prediction; (2) when AI is not adequately described, users make their own attempts to understand AI and to find out how (well) it works.

[Effects of electroacupuncture at "Changqiang" (GV 1) on expression of nerve growth factor and brain derived neurotrophic factor in rats after acute spinal cord injury].

OBJECTIVE: To observe the effects of electroacupuncture (EA) at"Changqiang"(GV 1) on expression of nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) in rats after acute spinal cord injury (ASCI), and to explore the mechanism of EA at"Changqiang"(GV 1) on ASCI. METHODS: Twenty-four adult female SD rats were randomly divided into an EA group, a model group and a sham operation group, 8 rats in each one. The rats in the sham operation group were treated with laminectomy to expose the spinal cord without any strike. The rats in the model group and EA group were treated with modified Allen's method to establish ASCI model. After model was established, the rats in the EA group were treated with EA at"Changqiang"(GV 1), once a day for continuous 7 days. The rats in the sham operation group and model group were treated with immobilization, once a day, without any other interventions. The basso beattie bresnahan (BBB) was evaluated 1, 3, 5, 7 days after operation. 7 days after operation, the rats were sacrificed with perfusion and the spinal cord was embedded with paraffin. The morphological changes of spinal cord and neuron were observed by Nissl's staining method; the expressions of NGF and BDNF were detected by immune fluorescence method. RESULTS: 3 days, 5 days and 7 days after operation, the BBB scores in the EA group were higher than those in the model group (P<0.05, P<0.01). The Nissl's staining indicated the gray matter of spinal cord was butterfly-shaped with complete structure and clear boundaries between the gray and white matter; the tabby-shaped Nissl bodies were observed in cytoplasm. There were incomplete gray nucleus, big and saturate local stasis plaque. Compared with the model group, the smallerarea of blood stasis, less severity of neuron edema, better morphology of neuron and no vacuole change were observed in the EA group. The immune fluorescence results indicated the expressions of NGF and BDNF in the model group and EA group were higher than those in the sham operation group (all P<0.01); the expressions of NGF and BDNF in the EA group were higher than those in the model group (both P<0.01). CONCLUSION: EA at"Changqiang"(GV 1) could improve the expression of NGF and BDNF and increase the score of BBB in rats with ASCI, which is beneficial to the repair of ASCI.

[Effects of pricking and cupping combined with rehabilitation training on elbow flexion spasticity of upper limb after stroke and its IEMG value].

OBJECTIVE: Based on rehabilitation training, to observe the clinical effect difference between pricking combined with cupping and western medication for elbow flexion spasticity of upper limb of stroke patients. METHODS: Sixty patients were randomly assigned by SPSS software random number generator into a comprehension group and a western medication group, 30 cases in each one. Rehabilitation was used in the two groups. Pricking and cupping were applied at the affected abdominal center of biceps brachii muscle on Tuesday and Friday continuously for 4 weeks in the comprehensive group. Baclofen was prescribed orally continuously for 4 weeks, once 10 mg and 3 times a day in the western medication group. The indexes were observed before and after 4-week treatment as well as at immediate treatment, immediately after the first treatment in the comprehension group and 24 h after treatment in the western medication group, including the affected elbow joint activity, modified Ashworth scale (MAS), simple Fugl-Meyer assessment (FMA), integrated electromyogram (IEMG) of the affected biceps brachii and triceps brachii. The clinical effects were evaluated. RESULTS: After treatment, the elbow joint activity in the two groups was improved compared with that before treatment (both P ＜0.05), with better result in the comprehension group (P ＜0.05). There was no statistical significance for MAS and FMA scores at immediate treatment between the two groups (both P ＞0.05). After treatment, the MAS score decreased and the FMA score increased in the two groups (both P＜0.05), with better results in the comprehension group (both P ＜0.05). At immediate treatment and after treatment, biceps brachii IEMG decreased in the two groups (all P ＜0.05). The biceps brachii IEMG in the comprehension group at the immediate treatment was higher and that after treatment was lower compared with those in the western medication group (both P ＜0.05). The triceps brachii IEMG at immediate treatment was not statistically different from that before treatment in the comprehension group (P ＞0.05) and that in the western medication group decreased (P＜0.05). After treatment, the triceps brachii IEMG increased in the two groups (both P ＜0.05), with higher IEMG in the comprehension group (P ＜0.05). The total effective rate was 83.3% (25/30) in the comprehensive group, which was higher than 60.0% (18/30) in the western medication group (P ＜0.05). . CONCLUSION: Pricking and cupping combined with rehabilitation training can reduce the IEMG of the biceps brachii muscle in patients with stroke, and improve the spasticity and motor function.