Clinical decision support system for point of care use: ontology driven design and software implementation

OBJECTIVES: The objective of this research was to design a clinical decision support system (CDSS) that supports heterogeneous clinical decision problems and runs on multiple computing platforms. Meeting this objective required a novel design to create an extendable and easy to maintain clinical CDSS for point of care support. The proposed solution was evaluated in a proof of concept implementation. METHODS: Based on our earlier research with the design of a mobile CDSS for emergency triage we used ontology-driven design to represent essential components of a CDSS. Models of clinical decision problems were derived from the ontology and they were processed into executable applications during runtime. This allowed scaling applications' functionality to the capabilities of computing platforms. A prototype of the system was implemented using the extended client-server architecture and Web services to distribute the functions of the system and to make it operational in limited connectivity conditions. RESULTS: The proposed design provided a common framework that facilitated development of diversified clinical applications running seamlessly on a variety of computing platforms. It was prototyped for two clinical decision problems and settings (triage of acute pain in the emergency department and postoperative management of radical prostatectomy on the hospital ward) and implemented on two computing platforms-desktop and handheld computers. CONCLUSIONS: The requirement of the CDSS heterogeneity was satisfied with ontology-driven design. Processing of application models described with the help of ontological models allowed having a complex system running on multiple computing platforms with different capabilities. Finally, separation of models and runtime components contributed to improved extensibility and maintainability of the system.

Towards a web-based progressive handwriting recognition environment for mathematical problem solving

The emergence of pen-based mobile devices such as PDAs and tablet PCs provides a new way to input mathematical expressions to computer by using handwriting which is much more natural and efficient for entering mathematics. This paper proposes a web-based handwriting mathematics system, called WebMath, for supporting mathematical problem solving. The proposed WebMath system is based on client-server architecture. It comprises four major components: a standard web server, handwriting mathematical expression editor, computation engine and web browser with Ajax-based communicator. The handwriting mathematical expression editor adopts a progressive recognition approach for dynamic recognition of handwritten mathematical expressions. The computation engine supports mathematical functions such as algebraic simplification and factorization, and integration and differentiation. The web browser provides a user-friendly interface for accessing the system using advanced Ajax-based communication. In this paper, we describe the different components of the WebMath system and its performance analysis.

Mobile bluetooth-based multi-player game development in ubiquitous computing

This paper describes the use of Bluetooth and Java-Based technologies in developing a multi-player mobile game in ubiquitous computing, which strongly depends on automatic contextual reconfiguration and context-triggered actions. Our investigation focuses on an extended form of ubiquitous computing which game software developers utilize to develop games for players. We have developed an experimental ubiquitous computing application that provides context-aware services to game server and game players in a mobile distributed computing system. Obviously, contextual services provide useful information in a context-aware system. However, designing a context-aware game is still a daunting task and much theoretical and practical research remains to be done to reach the ubiquitous computing era. In this paper, we present the overall architecture and discuss, in detail, the implementation steps taken to create a Bluetooth and Java based context-aware game. We develop a multi-player game server and prepare the client and server codes in ubiquitous computing, providing adaptive routines to handle connection information requests, logging and context formatting and delivery for automatic contextual reconfiguration and context-triggered actions. © 2010 Binary Information Press.

Mobile app reading speed test

Aim: To validate the accuracy and repeatability of a mobile app reading speed test compared with the traditional paper version. Method: Twenty-one subjects wearing their full refractive correction glasses read 14 sentences of decreasing print size between 1.0 and -0.1 logMAR, each consisting of 14 words (Radner reading speed test) at 40 cm with a paper-based chart and twice on iPad charts. Time duration was recorded with a stop watch for the paper chart and on the App itself for the mobile chart allowing critical print size (CPS) and optimal reading speed (ORS) to be derived objectively. Results: The ORS was higher for the mobile app charts (194±29 wpm; 195±25 wpm) compared with the paper chart (166±20 wpm; F=57.000, p<0.001). The CPS was lower for the mobile app charts (0.17±0.20 logMAR; 0.18±0.17 logMAR) compared with the paper chart (0.25±0.17 logMAR; F=5.406, p=0.009). The mobile app test had a mean difference repeatability of 0.30±22.5 wpm, r=0.917 for ORS, and a CPS of 0.0±0.2 logMAR, r=0.769. Conclusions: Repeatability of the app reading speed test is as good (ORS) or better (CPS) than previous studies on the paper test. While the results are not interchangeable with paper-based charts, mobile app tablet-based tests of reading speed are reliable and rapid to perform, with the potential to capture functional visual ability in research studies and clinical practice.

Mobile app Aston contrast sensitivity test

BACKGROUND: Contrast detection is an important aspect of the assessment of visual function; however, clinical tests evaluate limited spatial frequencies and contrasts. This study validates the accuracy and inter-test repeatability of a swept-frequency near and distance mobile app Aston contrast sensitivity test, which overcomes this limitation compared to traditional charts. METHOD: Twenty subjects wearing their full refractive correction underwent contrast sensitivity testing on the new near application (near app), distance app, CSV-1000 and Pelli-Robson charts with full correction and with vision degraded by 0.8 and 0.2 Bangerter degradation foils. In addition repeated measures using the 0.8 occluding foil were taken. RESULTS: The mobile apps (near more than distance, p = 0.005) recorded a higher contrast sensitivity than printed tests (p < 0.001); however, all charts showed a reduction in measured contrast sensitivity with degradation (p < 0.001) and a similar decrease with increasing spatial frequency (interaction > 0.05). Although the coefficient of repeatability was lowest for the Pelli-Robson charts (0.14 log units), the mobile app charts measured more spatial frequencies, took less time and were more repeatable (near: 0.26 to 0.37 log units; distance: 0.34 to 0.39 log units) than the CSV-1000 (0.30 to 0.93 log units). The duration to complete the CSV-1000 was 124 ± 37 seconds, Pelli-Robson 78 ± 27 seconds, near app 53 ± 15 seconds and distance app 107 ± 36 seconds. CONCLUSIONS: While there were differences between charts in contrast levels measured, the new Aston near and distance apps are valid, repeatable and time-efficient method of assessing contrast sensitivity at multiple spatial frequencies.

Creative thinking experimentations for entrepreneurship with a disruptive, personalised and mobile game-based learning ecosystem

Based on an unprecedented need of stimulating creative capacities towards entrepreneurship to university students and young researchers, this paper introduces and analyses a smart learning ecosystem for encouraging teaching and learning on creative thinking as a distinct feature to be taught and learnt in universities. The paper introduces a mashed-up authoring architecture for designing lesson-plans and games with visual learning mechanics for creativity learning. The design process is facilitated by creativity pathways discerned across components. Participatory learning, networking and capacity building is a key aspect of the architecture, extending the learning experience and context from the classroom to outdoor (co-authoring of creative pathways by students, teachers and real-world entrepreneurs) and personal spaces. We anticipate that the smart learning ecosystem will be empirically evaluated and validated in future iterations for exploring the benefits of using games for enhancing creative mindsets, unlocking the imagination that lies within, practiced and transferred to multiple academic tribes and territories.

iServe:a serious game for servitization

Servitization concerns the process of manufacturers shifting from a focus on producing and selling tangible goods to service-based business models. Factors that drive adoption of servitization are financial, strategic (competitive advantage) and marketing. However, uptake is slow and active efforts are being made to transfer knowledge about servitization to the manufacturing sector. This paper presents early results from the first test of a serious computer game which has the goal of educating managers about what advanced services are and how they fit in supply chains. Results suggest the role-play scenario tested is appropriate for an audience of largely non-expert gamers, and that the approach has the potential to instruct users about the role of services in the supply chain.

A quiz-based game for addressing growing population issues:linking learning mechanics to the GROWTH serious game

This paper discusses the integration of quiz mechanism into digital game-based learning platform addressing environmental and social issues caused by population growth. 50 participants' learning outcomes were compared before and after the session. Semi-structured interview was used to gather participants' viewpoints regarding of issues presented in the game. Phenomenography was used as a methodology for data collection and analysis. Preliminary outcomes have shown that the current game implementation and quiz mechanism can be used to: (1) promote learning and awareness on environmental and social issues and (2) sustain players' attention and engagements.

Emerging perspectives on the design, use, and evaluation of mobile and handheld devices

Human-computer interaction is a growing field of study in which researchers and professionals aim to understand and evaluate the impact of new technologies on human behavior. With the integration of smart phones, tablets, and other portable devices into everyday life, there is a greater need to understand the influence of such technology on the human experience. Emerging Perspectives on the Design, Use, and Evaluation of Mobile and Handheld Devices is an authoritative reference source consisting of the latest scholarly research and theories from international experts and professionals on the topic of human-computer interaction with mobile devices. Featuring a comprehensive collection of chapters on critical topics in this dynamic field, this publication is an essential reference source for researchers, educators, students, and practitioners interested in the use of mobile and handheld devices and their impact on individuals and society as a whole. This publication features timely, research-based chapters pertaining to topics in the design and evaluation of smart devices including, but not limited to, app stores, category-based interfaces, gamified mobility applications, mobile interaction, mobile learning, pervasive multimodal applications, smartphone interaction, and social media use.

Participatory research with older adults with AMD:co-designing a SMART diet diary app

The global population of people aged 60 years and older is growing rapidly. In the UK, there are currently around 10 million people aged 65 and over, and the number is projected to rise by 50% in the next 20 years (RNIB, 2013). While ongoing advances in information technology (IT) are undoubtedly increasing the scope for IT to enhance and support older adults' daily living, the digital divide between older and younger adults - 43% of people below the age of 55 own and use a smartphone, compared to only 3% of people aged 65 and over (AgeUK, 2013) - raises concerns about the suitability of technological solutions for older adults, especially for older adults with impairments. Evidence suggests that sympathetic design of mobile technology does render it useful and acceptable to older adults: the key issue is, however, how best to achieve such sympathetic design when working with impaired older adults. We report here on a case study in order to outline the practicalities and highlight the benefits of participatory research for the design of sympathetic technology for (and importantly with) older adults with impairments.

A longitudinal evaluation of the acceptability and impact of a diet diary app for older adults with age-related macular degeneration

Ongoing advances in technology are increasing the scope for enhancing and supporting older adults’ daily living. The digital divide between older and younger adults raises concerns, however, about the suitability of technological solutions for older adults, especially for those with impairments. Taking older adults with Age-Related Macular Degeneration (AMD) as a case study, we used user-centred and participatory design approaches to develop an assistive mobile app for self-monitoring their intake of food [12,13]. In this paper we report on findings of a longitudinal field evaluation of our app that was conducted to investigate how it was received and adopted by older adults with AMD and its impact on their lives. Demonstrating the benefit of applying inclusive design methods for technology for older adults, our findings reveal how the use of the app raises participants’ awareness and facilitates self-monitoring of diet, encourages positive (diet) behaviour change, and encourages learning.

Green@CU:an environmental game for residential accommodation

The importance of using games for supporting behavioural and attitudinal change has been explored in the literature, most recently the games for change movement has promulgated the use of games for supporting altruistic changes that have a positive impact upon the environment. This paper presents a Serious Game designed for University students and its main aim is to educate them about environmental issues. In particular, the focus lies in the importance of saving energy. A user study with 42 participants assessed the feeling of presence of the whole virtual learning experience.

Client QoE-oriented segment selection for DASH

A segment selection method controlled by Quality of Experience (QoE) factors for Dynamic Adaptive Streaming over HTTP (DASH) is presented in this paper. Current rate adaption algorithms aim to eliminate buffer underrun events by significantly reducing the code rate when experiencing pauses in replay. In reality, however, viewers may choose to accept a level of buffer underrun in order to achieve an improved level of picture fidelity or to accept the degradation in picture fidelity in order to maintain the service continuity. The proposed rate adaption scheme in our work can maximize the user QoE in terms of both continuity and fidelity (picture quality) in DASH applications. It is shown that using this scheme a high level of quality for streaming services, especially at low packet loss rates, can be achieved. Our scheme can also maintain a best trade-off between continuity-based quality and fidelity-based quality, by determining proper threshold values for the level of quality intended by clients with different quality requirements. In addition, the integration of the rate adaptation mechanism with the scheduling process is investigated in the context of a mobile communication network and related performances are analyzed.