Search Results (876)

Background: Dry eye disease (DED) impairs quality of life. Artificial tears are the first-line treatment, but compliance is generally poor. Patients forget to instil drops or underestimate the importance of regular use. Mobile health (mHealth) applications improve adherence in other chronic conditions, but their role in DED remains unclear. This study evaluated the effectiveness of a smartphone reminder application in improving compliance to a four-times-daily artificial tear regimen and the associated symptom relief among patients with DED. Methods: A masked randomised crossover trial was conducted in 29 women with DED (mean ± SD age 21.2 ± 3.0 years). Participants completed two 14-day study phases: one with app-based reminders and one without, separated by a 7-day washout period. The primary outcome was mean daily drop frequency. Secondary outcomes were self-reported symptom frequency and severity assessed using the Symptom Assessment iN Dry Eye (SANDE). Results: The mean daily drop frequency was higher during the app phase compared with the non-app phase (F = 22.906, p < 0.001) but declined in both phases over time (F = 3.023, p < 0.001). Symptom frequency did not differ between phases but decreased over time (F = 1.993, p = 0.021). Symptom severity remained unchanged with no significant effects by phase or time. Baseline clinical measures did not predict drop use frequency or app-related improvement (p > 0.05). Conclusions: The reminder application increased short-term compliance to artificial tear use, but there was no corresponding reduction in symptoms or signs over two weeks’ usage. Compliance waned over time despite active reminders, suggesting that prompts alone are insufficient for sustaining behaviour change. Future digital interventions for DED should incorporate strategies to enhance motivation, support long-term engagement, and provide personalised education. Full article

This article describes a new hardware/software alert system designed to assist elderly people and prevent falls due to bed-exit events at night. To assist the elderly during the night, it is important to implement automatic lighting activation in the bedroom. This helps reduce the risk of falls when they need to, for example, go to the bathroom. The caregiver can be alerted immediately via Wi-Fi, during the night, providing immediate assistance to the elderly person. The developed HW/SW system combines a passive infrared motion sensing device, a light sensor, and dedicated hardware based on the ESP32-C6 RISC-V microcontroller that communicates via Wi-Fi with a developed Android dedicated App, which the caregiver can access using a tablet or smartphone. Nighttime falls remain one of the most serious health problems for older people. The main innovative contribution of this work is the development of a low-cost preventive battery-free assistive system that does not require an internet access contract, preserves the elderly person’s privacy, and promptly alerts the caregiver whenever the elderly person gets out of bed during the night. The system is directly integrated with automated lighting, preventing the elderly person from walking in the dark and without appropriate aid. The system also supports the caregiver by generating alerts through an open-source mobile App. Full article

Context: Different studies on football players with fifth metatarsal stress fractures have found that hip internal rotation (HIR)range of motion is significantly reduced, while lateral forefoot pressure is significantly increased; therefore, the purpose of this study was to determine whether HIR range of motion is related to lateral plantar pressure. Methods: The study included 120 college students (60 males and 60 females). HIR was measured using a smartphone inclinometer app in the prone position and a compass app in the supine position. Plantar pressure was assessed using the Gaitview AFA-50 system during standing and walking. Correlation analysis was performed using SPSS 27.0. Results: Among all subjects, HIR activity in the prone position was significantly negatively correlated with standing second through fourth metatarsophalangeal joints(MTPJ2-4), fifth metatarsophalangeal joint (MTPJ5), and midfoot (FM)pressures and significantly positively correlated with standing first toe (T1)pressure. During walking, there is a significant negative correlation between HIR in the prone position and MTPJ2-4, MTPJ5, FM, and lateral heel (LH). Similarly, in the supine position, HIR is significantly negatively correlated with MTPJ2-4, MTPJ5, FM, medial heel (MH), and LH. Conclusion: There is a significant negative correlation between HIR and lateral plantar pressure, indicating that reduced HIR is associated with increased lateral plantar pressure. Improving HIR through targeted rehabilitation may reduce lateral plantar pressure, offering new approaches for non-surgical treatment of little toe capsulitis and reducing the risk of fifth metatarsal stress fractures. Full article

Objective: The long-term management of cardiovascular diseases (CVDs) requires comprehensive rehabilitation strategies aimed at optimizing functional recovery and promoting behavioral changes. These interventions may include digital technologies that emerged as promising approaches to facilitate lifestyle changes, such as dietary behavior and physical activity (PA). Aim: This review aimed to synthesize the current evidence for the potential impact of remotely delivered nutrition interventions with or without a combination of PA interventions on biochemical biomarkers, cardiovascular indexes, anthropometric parameters, levels of PA, exercise and functional capacity, adherence to the Mediterranean Diet (MD), diet quality and quality of life, rehospitalization, urgent visits, death and acute events in adults (≥18 years) with CVDs. Secondary outcomes were accessibility, safety, usability, and adherence. Methods: The PubMed, Web of Science, and Scopus databases were comprehensively searched up to 2026 for Randomized Controlled Trials (RCTs) published in English, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The methodological quality was assessed using the revised Cochrane Risk of bias tool for RCTs (RoB2). Results: 11 RCTs met the inclusion criteria. Sample sizes ranged from 66 to 879 participants. The duration of the interventions varied from 4 weeks to 12 months. The interventions were delivered remotely using a range of digital health technologies, including web-based programs, mobile phones, wearable devices, smartphone applications, and mini-apps. Favorable changes were observed in diet quality and in adherence to MD and PA levels, with no intervention-related adverse events reported. The RoB2 assessment indicated that the majority of included studies (6 out of 11) were classified as having some concerns regarding risk of bias. Conclusions: Remotely combined nutrition and PA interventions are a feasible and effective approach for improving mainly patient-reported outcomes in adults with CVDs. These findings support integrating remote multimodal rehabilitation into routine cardiovascular care and highlight the potential of telehealth-based models to enhance patients’ access to rehabilitation services. Full article

Background: Objective breast assessment is relevant in aesthetic, reconstructive, and oncoplastic breast surgery. Smartphones and tablets are widely available devices that may offer an accessible means for three-dimensional (3D) breast surface imaging, with potential relevance for preoperative assessment, surgical planning, and outcome evaluation. However, the available evidence is heterogeneous, and the validity of different devices, applications, and workflows remains unclear. This narrative review aimed to summarize the evidence on smartphone-based 3D surface imaging. Methods: A structured literature search was conducted in PubMed, Embase, Web of Science, and EBSCOhost. Only original studies that used smartphone- or tablet-based breast assessment were included. Data extraction included devices, software, population/material, outcomes, comparators, validation metrics, and limitations. Reporting completeness was assessed using an adapted GRRAS-based appraisal. Results: A total of 9 studies representing approximately 7 independent datasets were included. Only two studies assessed volumetry as one of the primary aims. The evidence base was small and heterogeneous. Most studies were patient-based, while the remaining studies used phantom or model-based designs. Feasibility was demonstrated for selected device–application–workflow combinations, predominantly involving iPhones and the 3D Scanner App, but these findings were not generalizable to smartphone-based 3D breast imaging as a whole. Evidence was more favorable for selected linear anthropometric measurements than for volumetry. Key limitations included breast ptosis, inframammary fold (IMF) geometry, posterior boundary definition, software, and operator dependence. Three of the included reports had potentially overlapping cohorts. Due to substantial heterogeneity in devices, applications, comparators, outcomes, and validation metrics, meta-analysis was not performed. Conclusions: Current evidence is limited to a small number of heterogeneous, predominantly single-center datasets and supports only workflow-specific feasibility for selected anthropometric and surface-based measurements. These findings should not be generalized across smartphone devices, applications, or reconstruction workflows. Breast volumetry remains insufficiently validated and is supported by only two non-comparable studies. Future studies should provide more detailed reporting that focuses on objective characteristics of the workflow and outcomes, including predefined analyses of agreement and measurement error. Full article

Background/Objectives: Sensor-based movement assessment is increasingly used to quantify movement execution quality and support feedback-guided rehabilitation exercise, particularly in home-based and remote rehabilitation contexts. However, exercise adherence, movement execution quality, and rehabilitation progress remain difficult to monitor continuously and objectively outside direct therapist supervision. This scoping review aimed to map the current applications of sensor-based biofeedback and movement-quality assessment systems for rehabilitation exercise and to identify evidence gaps. Methods: This review followed established scoping review methodology and PRISMA-ScR guidance. PubMed/MEDLINE, Web of Science Core Collection, and IEEE Xplore were searched, and Google Scholar was used for supplementary searching. English-language studies published from January 2014 to May 2026 were eligible if they involved rehabilitation-related populations, sensor-based movement assessment, biofeedback, or training guidance. Data were charted and narratively synthesized according to rehabilitation context, sensor technology, movement-quality metrics, computational approaches, feedback strategies, real-time or remote functions, and reported outcomes. Results: Fifty-five studies published between 2015 and 2026 were included. The evidence covered neurological, musculoskeletal and orthopedic, balance and vestibular, fall-prevention, home-based, and telerehabilitation applications. Technologies included inertial sensors, smartphones, vision/depth cameras, surface electromyography, pressure/force sensors, and multisensor systems. Movement-quality metrics included range of motion, postural stability, gait characteristics, loading, muscle activation, movement correctness, repetition count, and task completion quality. Feedback was visual, auditory, vibrotactile, app-based, avatar-based, therapist-facing, or remote-platform-based. Most evidence came from feasibility, technical validation, algorithmic validation, and small-sample clinical studies. Conclusions: Sensor-based systems may help translate rehabilitation exercise performance into quantifiable and feedback-enabled information. Future research should strengthen real-world validation, standardize task-specific movement-quality metrics, and clarify how feedback mechanisms can support individualized rehabilitation progression. Full article

This article examines the legal implications of civilian intelligence applications used during armed conflict, focusing on smartphone-based reporting systems deployed in the Russian–Ukrainian war. Applications such as Ukraine’s e-Enemy feature integrated into the Diia platform and the standalone ePPO application have enabled civilians to provide real-time geolocated information concerning troop movements, missile trajectories, and military activities. While these technologies provide substantial operational advantages, they simultaneously challenge foundational principles of International Humanitarian Law (IHL), particularly the distinction between civilians and combatants. The article critically evaluates whether civilians using such applications engage in direct participation in hostilities (DPH) under Article 51(3) of Additional Protocol I, analysing the criteria of threshold of harm, direct causation, and belligerent nexus. It argues that although certain forms of real-time operational reporting may satisfy the DPH threshold in limited circumstances, existing doctrine remains insufficient to address the broader systemic implications of state-organised digital civilian mobilisation. The article further contends that embedding military intelligence functions within civilian digital infrastructure transforms such platforms into potential dual-use objects, thereby engaging state obligations under Articles 48, 52, 57, and 58 of Additional Protocol I, as well as Common Article 1 of the Geneva Conventions. Through doctrinal analysis and the Ukrainian case study, the article proposes the development of a “duty of digital separation” requiring states to maintain clearer distinctions between civilian services and military intelligence systems. It additionally advocates enhanced precautionary duties, informed consent mechanisms, risk disclosure obligations, and governance frameworks for civilian intelligence applications. Ultimately, the article demonstrates that while IHL remains technologically adaptable in principle, interpretative refinement is necessary to preserve civilian protection in the context of digitally mobilised warfare. Full article

Background/Objectives: SPINEHealthie is a smartphone-based application enabling remote patient monitoring, care delivery and standardized collection of patient-reported outcome measures (PROMs). This registry-based analysis evaluates patient satisfaction with the platform across a large, heterogeneous spine surgery cohort. Methods: A total of 1729 thoracolumbar spine surgery cases were eligible for analysis. Among these, 881 (50.9%) completed the in-app feedback survey and constituted the primary feedback cohort. The global app experience was categorized as “Very Good” or “Poor”. Clinical outcomes, i.e., the Visual Analogue Scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI) were assessed at baseline and in the postoperative period; Δ denotes the change from baseline to two weeks postoperation. Results: Among feedback responders, 800 patients (90.8%) rated their app experience as “Very Good”, while 80.8% of 639 patients with surgical outcome data reported that the surgery met their expectations. However, app experience and surgical outcome expectations were assessed using different items at different postoperative time points. Among patients whose surgery did not meet expectations, 84.6% rated their app experience as “Very Good”. Patients with a “Very Good” app-experience rating demonstrated significantly greater improvement in back pain (ΔVAS Back pain 2.94 vs. 2.13, p = 0.027), leg pain (ΔVAS Leg pain 3.16 vs. 2.14, p = 0.019) and disability (ΔODI 11.00 vs. 2.41, p < 0.001). In the primary model, older age, shorter follow-up duration and smaller ODI improvement were associated with an unfavorable app experience; only the association with age remained consistent across sensitivity analyses. Conclusions: Among feedback responders, SPINEHealthie was associated with a high proportion of favorable global app-experience ratings. Favorable app-experience ratings remained high, even among patients with unmet surgical expectations or failure to achieve the exploratory two-week ODI-improvement threshold, suggesting that perceived platform value is not solely explained by surgical outcome. Older patients and those with limited functional recovery were identified as subgroups that may benefit from targeted onboarding and engagement strategies. Full article

Modern smartphones keep background apps to reduce latency during frequent app switching. Under memory pressure, Android terminates cached processes and reclaims pages, yet neither path represents when each resident app is likely to return. This paper presents RankProp, which learns an eviction order over the current resident app set and propagates through Android’s memory management. Unlike its predecessor, which scores apps independently, RankProp uses machine learning to train a neural network ranking model that produces an eviction order over all resident apps at each launch event. Android projects the order onto a cached process to reclaim priority and derives a hint for page reclaim. Across 279 user app usage traces, RankProp enhances the aggregate hit ratio from 0.9172 for the calibrated predecessor to 0.9252 across logical app cache capacities from 5 to 15. In an Android emulator with synthetic apps and sustained memory pressure, propagation to both reclaim paths reduced mean launch time by 4.71 percent relative to Android’s stock recency policy. Within this scope, mobile operating systems’ reclaim paths can consume priorities derived from the app eviction ranking without replacing their native decision units. Full article

Motorcycle noise along leisure routes constitutes a distinct environmental health burden poorly captured by standard road traffic noise indicators. This study derives source-specific exposure–response functions and examines non-acoustic predictors of residential motorcycle noise annoyance. A mixed-methods socio-acoustic design was applied in five study areas in Baden-Wuerttemberg, Germany. A community survey (N = 493) assessed long-term annoyance (12-month recall); a smartphone-based experience-sampling study (MotoApp; N = 213; ten days in summer 2022) collected hourly ratings. Acoustic measurements provided vehicle-specific L_Aeq,1h, L_AFmax,1h, and N₆₀; exposure–response functions were estimated using logistic regression and generalised estimating equations. In the long-term survey, 46.5% were highly annoyed by motorcycle noise, compared with 18.4% for passenger cars. Motorcycle exposure–response curves were markedly shifted; the 25–highly-annoyed threshold was reached approximately 16 dB lower in L_Aeq,1h than for passenger cars on weekends. Negative attitudes towards motorcycle riders, low coping capacity, and noise sensitivity were significant independent predictors. Source-specific assessment is necessary for motorcycle leisure routes. The 25–highly-annoyed criterion maps to approximately 52 dB L_Aeq,1h and 78 dB L_AFmax,1h on weekends, and to 25 N₆₀ events per hour—substantially below current road traffic guideline values—providing actionable thresholds for noise action planning. Full article

Background: Radiation therapy with or without systemic treatment for lung cancer can cause adverse reactions, e.g., fatigue. Affected patients may experience a decrease in physical activity and, as a consequence, be unable to receive the complete assigned treatment. Physical exercise may be helpful. A benefit of exercise regarding completion of systemic treatment and quality of life was previously suggested. Irradiated patients may benefit as well. A smartphone-based app reminding patients to make a minimum number of steps might positively influence physical activity. The prototype of an app called “Step Reminder” was recently finalized. The randomized APPAREL trial (NCT07627022) evaluates whether this app can improve physical activity during irradiation for lung cancer. Methods: The primary endpoint of this phase 2 trial focuses on the within-patient change regarding the mean number of daily steps (week 5 minus week 1). Secondary objectives include satisfaction with the application and its impact on the perception of digital health technology. Patients are randomized 1:1 to be treated with a standard approach (conventionally fractionated irradiation with or without systemic treatment) supported by the “Step Reminder” app (Arm A) or standard treatment without the app (Arm B). The app provides reminders several times per day to walk a pre-defined number of steps. To make sure that the required 28 patients are included in the primary analysis population (full analysis set), 32 patients have to be randomized. Results: At this stage, results are not available. Conclusions: It is expected that the app will have a positive effect on the patients’ physical activity (number of steps). Full article

Preserving non-renewable geological assets for future generations requires balancing physical geoconservation with engaging public outreach. Digital twins provide an excellent method for protecting delicate geological specimens. Unfortunately, traditional on-site interactive displays rely on expensive, high-maintenance proprietary hardware that small museums can rarely afford. This study introduces GYRO3DSCOPE, a free, multi-tenant Bring Your Own Device (BYOD) platform built to widen public access to digital collections. Scanning a dynamic QR code lets visitors use their own smartphones as remote spatial controllers. This allows them to rotate and manipulate high-fidelity 3D models in real time without downloading or installing local apps. The system is an open-access aggregator, enabling curators to stream site-specific content directly from existing repositories like Sketchfab or 3DBigDataSpace. The platform was evaluated at the Geology Museum of the “Alexandru Ioan Cuza” University of Iași (Romania) during the May 2026 Night of Museums public exhibition. The installation featured a collection of 149 digital twins of rocks, minerals, and fossils. Automated tracking across 276 unique visitor sessions showed excellent engagement, recording an average dwell time of 91.3 s and a user satisfaction score of 4.9 out of 5.0. This approach gives underfunded venues an affordable, scalable tool to encourage public engagement with geosciences and complement the sustainable management of ex situ geoheritage collections without adding maintenance liabilities. Full article

Background: Convergence insufficiency (CI) is a common binocular vision disorder that causes eye strain, headaches, and blurriness. Although pencil push-ups (PPU) are widely used to treat CI, their real-world effectiveness may be limited by inconsistent performance and poor adherence. MobileS (the App) is an AI-based smartphone application that tracks eye movements through the front camera, enabling guided “digital push-ups” with instant visual feedback and automatic performance monitoring. This follow-up study evaluated the feasibility, recorded adherence, and preliminary clinical signals of MobileS as a home-based therapy for CI compared with conventional PPU. Methods: Twenty-five participants with CI were randomly assigned to either the App group (n = 12) or the PPU group (n = 13) for 8 weeks of home-based training. Both groups performed convergence push-ups—using the app or a pencil. NPC was measured using a RAF ruler at baseline, mid-point, and endpoint. Symptom severity was assessed using the Convergence Insufficiency Symptom Survey (CISS), and adherence was recorded automatically by the app or manually by participants. Results: All 25 randomized participants completed all three NPC assessment points. The App group showed a statistically significant improvement in NPC from baseline to study completion (mean improvement = 2.81 cm, p = 0.007), whereas the PPU group showed no significant change. Recorded adherence was higher in the App group compared with the PPU group (90.1% vs. 75.4%, p = 0.0069). The App group showed a significant reduction in symptom severity (p = 0.049). Between-group differences in symptom change were not statistically significant. Conclusions: MobileS appears feasible as a home-based CI management tool, and was associated with higher recorded adherence and preliminary NPC improvement signals. Larger, adequately powered studies are needed to confirm efficacy, particularly for symptoms, and guide teleophthalmology implementation. Full article

Agapé is a light–touch relationship enhancement smartphone app. This study used data from a longitudinal study of couples using the Agapé app to explore change within an array of behavioral processes to uncover patterns of interconnected change, thereby providing some of the first quantitative insights into how various relationship processes might be linked as relationships change over time. A sample of 405 couples in long-term relationships (810 partners, 50% women, 75% white, together M = 4.5 yrs, 50% living together, 33% currently dissatisfied) completed assessments across their first month of using Agapé. Men and women significantly improved on 15 of the 16 relationship processes assessed. As the study lacked a randomized control condition, it remains unclear if those improvements were due to using the Agapé app or to factors like expectancy effects, regression to the mean, self-selection, demand characteristics, or general participation effects. Network analyses explored correlational linkages among the self-reported pre–post changes observed. Results highlighted increases in three processes (quality time spent together, perceived partner responsiveness, and gratitude toward partner) as the processes most proximally linked to increases in relationship quality. The network findings also uncovered a number of patterns of interconnected change to be explored in future studies (e.g., increases in couples talking about their relationships to increases in mindful awareness within those relationships to increases in gratitude and quality time to increases in relationship quality). Thus, the results offer some of the first comprehensive multivariate (albeit correlational) insights toward understanding how relationship processes might work in concert with one another within a broader multivariate pattern of self-reported relationship change. Full article

Commercial age-friendly modes are increasingly embedded in smartphone applications, yet their task-performance implications for older adults remain uncertain. This two-stage study used a cognitively informed ecological-to-controlled strategy linking evaluation of commercial age-friendly versions with controlled testing of specified interface components while modeling older adults’ task-relevant cognitive ability. In Experiment 1 (n = 22), older adults completed ten tasks in standard and age-friendly versions of WeChat and Pinduoduo. The age-friendly versions showed no overall advantage in clicks, completion time, or erroneous clicks (all ps ≥ 0.548). Activity Theory-informed video coding identified recurrent task-to-interface mismatches, including insufficiently salient feedback. The exploratory Task 8 product-search observations, together with these coded interaction problems, indicated that product search was a relevant context in which menu configuration, action confirmation, and cognitive demands could be examined together. Because the commercial app versions differed across content and interface features, Experiment 2 (n = 30) used a custom Android product-search task to manipulate menu configuration and vibration feedback while modeling delayed recall continuously as an indicator of task-relevant cognitive ability. Relative to the flat configuration, the two-level menu was associated with 56.7% fewer clicks and 30.7% shorter completion time, whereas vibration feedback was associated with 20.2% fewer ineffective clicks. Delayed recall was associated with completion time in the primary model, but this association was attenuated after adjustment for age and sex. Together, the findings show that a commercial age-friendly label should not be treated as evidence of performance benefit. By separating ecological diagnosis from controlled component testing, the study provides an evidence pathway for translating real-world human–computer interaction problems into testable, task-specific interface components and supports a cognitively informed, information-structure-prioritized, and multisensory approach to smartphone-based product-search design for older adults. Full article