Iterative Design Process Research Articles

Comparing Virtual and Real-Life Rapid Prototyping Methods for User Testing Smart City Interfaces: A Case Study

In the development of complex embedded interactive systems, a tension arises between, on the one hand, ever shorter and highly iterative design processes, and, on the other hand, the need for user testing with early prototypes to validate systems from a user-centred design perspective. This study focuses on the integration of Virtual Reality (VR) into prototyping embedded interactive systems, examining its potential to bridge the gap between rapid prototyping and user-centered design validation. Adopting a comparative research approach, we analyze a case study: the development of a cultural smart city experience. It juxtaposes in situ, low-fidelity prototype testing with VR-based testing, evaluating their realism, interactivity, functionality, presence and task difficulty. This mixed-method research design incorporates both qualitative and quantitative methodologies, engaging 27 design students in a comparative study, conducting participatory research and 8 expert interviews. These findings reveal divergent roles in field testing and VR in the new product development process, highlighting VR’s strengths in visualizing procedures and facilitating discussion. This study identifies the limitations of VR in mimicking realistic interactions and incorporating social context yet underscores its superiority over paper prototypes in its realism and interactivity. Where field testing can hold broader contextual insights, the VR prototype gives more concrete and applied insights. The main advantage of VR testing is its visualisation of procedures and its final materialisation according to the participants interviewed. According to the experts interviewed, VR can be used as a useful tool within the development process especially for visualisation and testing user flows of complex interfaces.

Development of Worksheets for Immunomodulator Shared Decision-Making to Facilitate Patient-Clinician Communication: A Quality Improvement Project Employing Design Thinking Principles.

Shared decision-making (SDM) is a principle of humanistic, patient-centered health care within the field of rheumatology. However, clear communication between patients and their clinicians regarding the benefits and risks of immunomodulators may be challenging in a clinical setting. The design-thinking process is a human-centered approach to quality improvement that can help to identify insights to uphold high-quality communication. The development process adhered to the Stanford design thinking process framework, encompassing 5 stages: (1) empathize, (2) define, (3) ideate, (4) prototype, and (5) test. During the empathy stage, quality improvement members spent 4 hours immersed in the clinical setting observing how patients and clinicians engage in SDM conversations. These observations were augmented by unstructured debriefing sessions to better understand the needs and drivers of high-quality SDM. Following this, a rapid ideation workshop was convened to generate creative solutions. These led to rapid prototyping and testing, yielding a final product. The iterative design process identified 4 critical needs: (1) ensuring comprehensibility of materials, (2) upholding accuracy of information, (3) balancing standardization with individualization, and (4) promoting retention of knowledge. During the rapid ideation workshop, the concept of a Worksheet for Immunomodulator Shared Decision-Making (WISDM) was introduced and selected for further elaboration. This led to the creation of 5 prototypes for methotrexate, which were subsequently tested. These were reconciled and modified to make a final product. The WISDM template contains 7 elements that support SDM. Forty-five WISDMs were created for 23 immunomodulators. Further investigation will focus on how WISDMs exactly impact SDM.

Development of the iManage SCD mobile health application for transition

ObjectiveThis paper outlines the design and implementation of iManage SCD, a self-management mobile health application for adolescents and young adults (AYA) with sickle cell disease (SCD) during transition from pediatric to adult health care. MethodsThe Integrate, Design, Assess, Share (IDEAS) framework, emphasizing user insights, iterative design, rigorous assessment, and knowledge sharing, guided the development process. The design team consisted of researchers, psychologists, physicians, social workers, AYA with SCD, and parents of AYA with SCD (n = 16) across three states. Qualitative focus groups and interviews were conducted and analyzed using thematic analysis across the integrate and design phases. Point of use feedback from AYA with SCD was used to assess feasibility and acceptability. ResultsThe development process was centered around tenants of the Social-ecological Model of Adolescent and Young Adult Readiness to Transition. Development integrated multidisciplinary perspectives, fostering a person-centered approach. The iterative design process involved collaboration with a digital health firm, Agency39A. Health equity and implementation considerations were addressed at individual, community, and healthcare system levels. Themes that emerged from focus groups with AYA, clinicians, and researchers in the integrate and design phases of development included recommendations for content and user experience features. ConclusionsiManage SCD emerges as a comprehensive, user-friendly mobile health application, incorporating theoretical principles and direct user input. The development process demonstrated feasibility and acceptability, and the paper discusses dissemination strategies for the Community Health Workers and Mobile Health Programs to Help Young Adults with SCD Transition to Using Adult Healthcare Services (COMETS) study.

Audio-Vibratory You-Are-Here Mobile Maps for People with Visual Impairments

Self-localization and wayfinding are challenging tasks for people with visual impairments (PVIs), severely impacting independent mobility. Visual “You-are-here” (YAH) maps are useful for assisting local wayfinding of sighted users. They are used to self-localize and display points of interest, landmarks and routes in the surroundings. However, these maps are not always available and rarely accessible to PVIs. Relying on an iterative participatory design process with eight end-users with visual impairments, we created a proof of concept of a mobile audio-vibratory YAH map. Our design is based on either a tablet or a smartphone to ensure a small and portable solution. A user study with ten PVIs showed that the audio-vibratory YAH map that we designed provides the user with a good understanding of the surroundings and wayfinding cues. Surprisingly, the results show that the audio-vibratory YAH map prototype was as usable as the control condition (audio-tactile YAH map with a tactile overlay), with similar user satisfaction and cognitive load. A follow-up field study with two participants showed the effectiveness of the prototype for assisting in crossroad understanding. To conclude, our innovative design of a mobile audio-vibratory YAH map can overcome the portability and printing issues associated with tactile overlays and can be an appropriate solution for assisting the pedestrian navigation of PVIs.

Decoding roughness perception in distributed haptic devices

Abstract The ability to render realistic texture perception using haptic devices has been consistently challenging. A key component of texture perception is roughness. When we touch surfaces, mechanoreceptors present under the skin are activated and the information is processed by the nervous system, enabling perception of roughness/smoothness. Several distributed haptic devices capable of producing localized skin stretch have been developed with the aim of rendering realistic roughness perception; however, current state-of-the-art devices rely on device fabrication and psychophysical experimentation to determine whether a device configuration will perform as desired. Predictive models can elucidate physical mechanisms, providing insight and a more effective design iteration process. Since existing models (1, 2) are derived from responses to normal stimuli only, they cannot predict the performance of laterally actuated devices which rely on frictional shear forces to produce localized skin stretch. They are also unable to predict the augmentation of roughness perception when the actuators are spatially dispersed across the contact patch or actuated with a relative phase difference (3). In this study, we have developed a model that can predict the perceived roughness for arbitrary external stimuli and validated it against psychophysical experimental results from different haptic devices reported in literature. The model elucidates two key mechanisms: 1) The variation in the change of strain across the contact patch can predict roughness perception with strong correlation 2) The inclusion of lateral shear forces is essential to correctly predict roughness perception. Using the model can accelerate device optimization by obviating the reliance on trial-and-error approaches.

Developing a Motion Sensor-Based Game to Support Frozen Shoulder Rehabilitation in Older Adults through a Participatory Design Approach.

Objective: Although some serious games have been developed for physical therapy, little work has been conducted through a participatory design approach. Therefore, a game prototype was developed, which involved related stakeholders in the design process. Materials and Methods: The iterative participatory design process was adopted with the input of 18 patients with frozen shoulder symptoms, 4 health professionals, 2 game designers, and 5 researchers in an iterative process to design, test, and evaluate the game prototype. In total, 17 patients participated in the interviews to explore their needs and desires for a serious game. The health professionals participated in the interviews to understand the medical requirement and experience pertaining to frozen shoulder and were included in the workshop to give feedback on the game prototype. At the conclusion of the iterative design process, a Kinect-based prototype game with three levels was used for a case study with one patient who was diagnosed with frozen shoulder and has been receiving medical treatment in the hospital. Results: Based on the outcomes derived from data collected among diverse stakeholders, the prototype game underwent iterative development by the team and was assessed by a participant with frozen shoulder symptoms. Findings revealed that the participant demonstrated enhanced shoulder mobility and a reduction in pain intensity, despite the lack of significant improvement for health-related quality of life. Nevertheless, the participant reported a positive experience with the prototype game. Conclusion: This study underscores the importance of involving diverse stakeholders in the development process to create more effective and user-centric serious games for rehabilitation. The participatory approach, exemplified by the prototype game, demonstrates potential improvements in both user experience and overall effectiveness during the rehabilitation process.

The user-centered design and development of a childhood and adolescent obesity Electronic Health Record tool, a mixed-methods study.

Childhood and adolescent obesity are persistent public health issues in the United States. Childhood obesity Electronic Health Record (EHR) tools strengthen provider-patient relationships and improve outcomes, but there are currently limited EHR tools that are linked to adolescent mHealth apps. This study is part of a larger study entitled, CommitFit, which features both an adolescent-targeted mobile health application (mHealth app) and an ambulatory EHR tool. The CommitFit mHealth app was designed to be paired with the CommitFit EHR tool for integration into clinical spaces for shared decision-making with patients and clinicians. The objective of this sub-study was to identify the functional and design needs and preferences of healthcare clinicians and professionals for the development of the CommitFit EHR tool, specifically as it relates to childhood and adolescent obesity management. We utilized a user-centered design process with a mixed-method approach. Focus groups were used to assess current in-clinic practices, deficits, and general beliefs and preferences regarding the management of childhood and adolescent obesity. A pre- and post-focus group survey helped assess the perception of the design and functionality of the CommitFit EHR tool and other obesity clinic needs. Iterative design development of the CommitFit EHR tool occurred throughout the process. A total of 12 healthcare providers participated throughout the three focus group sessions. Two themes emerged regarding EHR design: (1) Functional Needs, including Enhancing Clinical Practices and Workflow, and (2) Visualization, including Colors and Graphs. Responses from the surveys (n = 52) further reflect the need for Functionality and User-Interface Design by clinicians. Clinicians want the CommitFit EHR tool to enhance in-clinic adolescent lifestyle counseling, be easy to use, and presentable to adolescent patients and their caregivers. Additionally, we found that clinicians preferred colors and graphs that improved readability and usability. During each step of feedback from focus group sessions and the survey, the design of the CommitFit EHR tool was updated and co-developed by clinicians in an iterative user-centered design process. More research is needed to explore clinician actual user analytics for the CommitFit EHR tool to evaluate real-time workflow, design, and function needs. The effectiveness of the CommitFit mHealth and EHR tool as a weight management intervention needs to be evaluated in the future.

Implementing strong sustainability in a design process

The emergence of a post-growth era is expected that implies rethinking the production and consumption patterns with novel design models this forces higher educational institutions to reconsider their traditional ways of teaching sustainability in their curricula. Companies also need to overcome strategies that compartmentalize environment, society and economy in their industrial strategy in order to evolve in their support for the transition. The aim of this paper is to present a design process anchored in the Strong Sustainability paradigm to overcome the gap of how Strong Sustainability could be operationalised. Design Research Methodology (DRM) has been chosen as the supporting framework for the development of this project. The Design for Strong Sustainability (DfSoSy) methodology proposed, is built on three aspects of Strong Sustainability (Milieu, Regeneration, Safe and just operating space) successively applied in a sequenced iterative design process. The latter enable the integration of thought patterns associated with integrative, systemic and fractal or multi-scale thinking respectively. Moreover, the principle of sub-optimality is highlighted as a decision principle in SoSy. Results obtain has been validated as well on the pedagogical objectives as in the usefulness of the DfSoSy. The practical contribution of this study is the DfSoSy toolkit©.

Towards end-to-end structure determination from x-ray diffraction data using deep learning

Powder crystallography is the experimental science of determining the structure of molecules provided in crystalline-powder form, by analyzing their x-ray diffraction (XRD) patterns. Since many materials are readily available as crystalline powder, powder crystallography is of growing usefulness to many fields. However, powder crystallography does not have an analytically known solution, and therefore the structural inference typically involves a laborious process of iterative design, structural refinement, and domain knowledge of skilled experts. A key obstacle to fully automating the inference process computationally has been formulating the problem in an end-to-end quantitative form that is suitable for machine learning, while capturing the ambiguities around molecule orientation, symmetries, and reconstruction resolution. Here we present an ML approach for structure determination from powder diffraction data. It works by estimating the electron density in a unit cell using a variational coordinate-based deep neural network. We demonstrate the approach on computed powder x-ray diffraction (PXRD), along with partial chemical composition information, as input. When evaluated on theoretically simulated data for the cubic and trigonal crystal systems, the system achieves up to 93.4% average similarity (as measured by structural similarity index) with the ground truth on unseen materials, both with known and partially-known chemical composition information, showing great promise for successful structure solution even from degraded and incomplete input data. The approach does not presuppose a crystalline structure and the approach are readily extended to other situations such as nanomaterials and textured samples, paving the way to reconstruction of yet unresolved nanostructures.

Surgical instrument tray optimization process at a university hospital: A comprehensive overview

ObjectiveThis study presents the results of a surgical instrument tray optimization process implemented across all surgical specialties within the largest university hospital in Denmark. MethodsData was extracted from a comprehensive instrument optimization process including all Operating Rooms at Aarhus University Hospital. Adopting a holistic perspective, the optimization process, involved aligning instrument trays across various surgical specialties. This included: a) Reduction in number of instruments, b) Consolidation or separation of trays, c) Modularization - introducing modular trays for specific purposes, and d) Standardization - standardizing commonly used instruments across specialties. Instruments per tray, total number of instruments, and changes in the number of trays were compared against existing tray contents to identify discipline-specific changes. ResultsSome specialties made substantial alterations to tray structures, while others primarily reduced number of instruments in existing trays. Across all specialties, optimization resulted in 17 % decrease in number of tray types (p = 0.01, 95%CI:1.0–6.8), 1 % increase in total number of trays (p = 0.36, 95%CI:-11.9–4.8), 18 % decrease in number of instruments per tray (p = 0.0002, 95%CI: 3.2–7.6) and 16 % reduction in total number of instruments for all specialties (p < 0.0001, 95%CI:404–758). ConclusionThis study underscores complexity of instrument tray design. The approach employed at Aarhus University Hospital, involving interdisciplinary experts in an iterative design process, demonstrated the feasibility of redesigning instrument trays with significant reduction in content. Additionally, data suggests that reducing the number of instruments could lead to a decrease in workload within the Central Sterile Supply Specialty. This presents opportunity to minimize wasted resources and streamlining cleaning processes for unused instruments.

Design and Application of an Evaluation Tool to Assess World Organization for Animal Health Competencies for Graduating (Day 1) Veterinarians

Graduating competent veterinarians with the appropriate knowledge and skills to support and strengthen their country's National Veterinary Services is a key priority for veterinary institutions globally. The World Organisation for Animal Health (WOAH) developed a set of Day 1 Competencies that should be expected of every veterinary graduate. Veterinary schools need to be able to assess the coverage of these competencies in their curriculum and determine the level of proficiency of their graduates. This article describes the iterative design and development process used to create a semi-quantitative, competency-based assessment survey. The Evaluation Tool for WOAH Day 1 Graduating Veterinarian Competencies is used as part of a stepwise process to systematically assess a veterinary curriculum regarding these competencies. This tool was developed and tested at the University of Gondar College of Veterinary Medicine and Animal Sciences in Ethiopia. The Evaluation Tool was successful in systematically collecting, measuring, and analyzing the perceptions of faculty, senior veterinary students, recent graduates, and external stakeholders about the level of proficiency of graduates in all 19 WOAH Day 1 Competencies. It was specifically designed to be used in conjunction with curriculum mapping to provide a full picture of how effectively these competencies were taught and identify gaps that needed to be addressed. This tool, the supporting resources, and the methodology are now globally accessible to all veterinary institutions, enabling them to revise and update their curricula and, ultimately, improve the training of the future veterinary workforce to support veterinary services in their respective countries.

EmPATHs - A serious board game to raise awareness and empathy towards vulnerable-to-exclusion groups in mobility

IntroductionSocial inequalities are a day-to-day problem experienced by the most vulnerable populations. In mobility, a basic human need, these inequalities can translate into lower accessibility to basic needs and social exclusion. The mobility barriers and needs of vulnerable-to-exclusion (v2e) groups have been documented in the literature, however, issues on accessibility, empathy and awareness strategies and people's attitudes remain. Serious games —fun teaching tools— have been successfully applied in urban/transport planning and have also been used to increase empathy and prosocial behavior. Despite the application of serious games in multiple fields pertinent to this study, the pressing mobility and accessibility issues faced by vulnerable populations have not been addressed in any serious game to date. This study focuses on creating and evaluating a serious board game (EmPATHs) to raise awareness and empathy towards v2e groups among various stakeholders while being fun at the same time. MethodIn this case, the goal of the game is to reach as many destinations as possible by playing different v2e personas. The winner of the game is the player who has reached the most destinations at the end with different v2e personas. EmPATHs targets university students from mobility-related programs, the general public, practitioners and decision makers from related fields. The game was created following a four-step iterative design process involving four categories of participants' groups, namely, frequent board game players (gamers) and experts on accessibility, mobility justice, and serious games. The game's evaluation was based on the answers of 26 players and focused on characteristics of serious games and the main goal of the game. The evaluation methodology included close-ended questions to assign a score from 1 to 5 to the established criteria and open-ended questions to complement with the quantitative results. Results & conclusionsThe participants considered EmPATHs to be a fun (4.4/5 score) and engaging (4.5/5 score) game, with a medium difficulty level (2.5/5 score) and which does not evoke frustrating feelings (2.0/5 score). The participants acknowledged learning more in-depth about barriers of v2e people (4.5/5 score) and recognized the game's capacity to raise awareness (4.5/5 score). They also felt more likely to empathize with v2e groups after the game (4.5/5 score). Future applications of the game can be expected to be in teaching contexts, public mobility-related events, and workshops with stakeholders from the planning and designing field.

DESIGNING VISUAL SYMBOLS IN DIGITAL CULTURE

Designing visual symbols is crucial in the ever-changing world of digital culture for communication, identity building, and cultural expression. With an eye toward the aesthetic, functional, and semiotic aspects, this article delves into the methods and principles of making effective visual symbols in digital settings. The study delves into a wide array of digital symbols, including emojis, logos, icons for user interfaces, and digital art, to uncover how these visual components communicate meaning, impact user behavior, and aid in forming online identities and communities. Recognizing digital spaces' multicultural and global character, the research highlights the significance of cultural sensitivity and contextual knowledge throughout the design phase. Additionally, it delves into how technological innovations, including augmented reality and vector graphics, have influenced the development of visual symbols. The adaptability of symbols in response to user interactions and cultural trends may be shown in case studies from various digital platforms and social media networks. The results stress the importance of designers balancing originality and clarity in creating visually appealing and universally understandable symbols. At the end of the paper, we suggest ways to make symbols that may change with digital culture and appeal to different audiences by using iterative design processes and user feedback.

Success in Asynchronous Courses Through Increasing Student’s Social Presence

Online education has fundamentally altered the educational landscape, enhancing accessibility and flexibility for learners. However, a notable limitation of asynchronous learning modalities is the diminished interpersonal engagement inherent in traditional face-to-face pedagogical contexts. This empirical inquiry investigates the impact of deliberately integrating highly interactive instructional activities within online asynchronous developmental mathematics courses. Three principal thematic categories emerged through the iterative design process of these activities. Each category is delineated and exemplified, followed by exploring course policies conducive to student achievement in interactive learning contexts. Following a grounded theory approach, this study scrutinizes course outcomes alongside student and instructor evaluations at the semester’s end. Findings suggest incorporating social interactive activities yields positive effects on course outcomes.

Effectiveness of a suction device for containment of pathogenic aerosols and droplets.

As the global community begins recovering from the COVID-19 pandemic, the challenges due to its aftermath remain. This health crisis has highlighted challenges associated with airborne pathogens and their capacity for rapid transmission. While many solutions have emerged to tackle this challenge, very few devices exist that are inexpensive, easy to manufacture, and versatile enough for various settings. This paper presents a novel suction device designed to counteract the spread of aerosols and droplets and be cost-effective and adaptable to diverse environments. We also conducted an experimental study to evaluate the device's effectiveness using an artificial cough generator, a particle counter, and a mannequin in an isolated system. We measured droplet removal rates with simulated single and repeated cough incidents. Also, measurements were taken at four distinct areas to compare its effectiveness on direct plume versus indirect particle removal. The device reduced airborne disease transmission risk, as evidenced by its capacity to decrease the half-life of aerosol volume from 23.6 minutes to 15.6 minutes, effectively capturing aerosol-sized droplets known for their extended airborne persistence. The suction device lessened the peak total droplet volume from peak counts. At 22 minutes post peak droplet count, the count had dropped 24% without the suction device and 43% with the suction device. The experiment's findings confirm the suction device's capability to effectively remove droplets from the environment, making it a vital tool in enhancing indoor air quality. Given the sustained performance of the suction device irrespective of single or multiple cough events, this demonstrates its potential utility in reducing the risk of airborne disease transmission. 3D printing for fabrication opens the possibility of a rapid iterative design process, flexibility for different configurations, and rapid global deployment for future pandemics.

An integrative approach to protein sequence design through multiobjective optimization.

With recent methodological advances in the field of computational protein design, in particular those based on deep learning, there is an increasing need for frameworks that allow for coherent, direct integration of different models and objective functions into the generative design process. Here we demonstrate how evolutionary multiobjective optimization techniques can be adapted to provide such an approach. With the established Non-dominated Sorting Genetic Algorithm II (NSGA-II) as the optimization framework, we use AlphaFold2 and ProteinMPNN confidence metrics to define the objective space, and a mutation operator composed of ESM-1v and ProteinMPNN to rank and then redesign the least favorable positions. Using the two-state design problem of the foldswitching protein RfaH as an in-depth case study, and PapD and calmodulin as examples of higher-dimensional design problems, we show that the evolutionary multiobjective optimization approach leads to significant reduction in the bias and variance in RfaH native sequence recovery, compared to a direct application of ProteinMPNN. We suggest that this improvement is due to three factors: (i) the use of an informative mutation operator that accelerates the sequence space exploration, (ii) the parallel, iterative design process inherent to the genetic algorithm that improves upon the ProteinMPNN autoregressive sequence decoding scheme, and (iii) the explicit approximation of the Pareto front that leads to optimal design candidates representing diverse tradeoff conditions. We anticipate this approach to be readily adaptable to different models and broadly relevant for protein design tasks with complex specifications.

Usability and Preliminary Efficacy of an Adaptive Supportive Care System for Patients With Cancer: Pilot Randomized Controlled Trial.

Using an iterative user-centered design process, our team developed a patient-centered adaptive supportive care system, PatientCareAnywhere, that provides comprehensive biopsychosocial screening and supportive cancer care to patients across the continuum of care adaptively. The overarching goal of PatientCareAnywhere is to improve health-related quality of life (HRQOL) and self-efficacy of patients with cancer by empowering them with self-management skills and bringing cancer care support directly to them at home. Such support is adaptive to the patient's needs and health status and coordinated across multiple sources in the forms of referrals, education, engagement of community resources, and secure social communication. This study aims to assess the usability of the new web-based PatientCareAnywhere system and examine the preliminary efficacy of PatientCareAnywhere to improve patient-reported outcomes compared with usual care. For phase 1, usability testing participants included patients with cancer (n=4) and caregivers (n=7) who evaluated the software prototype and provided qualitative (eg, interviews) and quantitative (eg, System Usability Scale) feedback. For phase 2, participants in the 3-month pilot randomized controlled trial were randomized to receive the PatientCareAnywhere intervention (n=36) or usual care control condition (n=36). HRQOL and cancer-relevant self-efficacy were assessed at baseline (preintervention assessment) and 12 weeks from baseline (postintervention assessment); mean differences between pre- and postintervention scores were compared between the 2 groups. Participants were highly satisfied with the prototype and reported above-average acceptable usability, with a mean System Usability Scale score of 84.09 (SD 10.02). Qualitative data supported the overall usability and perceived usefulness of the intervention, with a few design features (eg, "help request" function) added based on participant feedback. With regard to the randomized controlled trial, patients in the intervention group reported significant improvements in HRQOL from pre- to postintervention scores (mean difference 6.08, SD 15.26) compared with the control group (mean difference -2.95, SD 10.63; P=.01). In contrast, there was no significant between-group difference in self-efficacy (P=.09). Overall, PatientCareAnywhere represents a user-friendly, functional, and acceptable supportive care intervention with preliminary efficacy to improve HRQOL among patients diagnosed with cancer. Future studies are needed to further establish the efficacy of PatientCareAnywhere as well as explore strategies to enhance user engagement and investigate the optimal intensity, frequency, and use of the intervention to improve patient outcomes. ClinicalTrials.gov NCT02408406; https://clinicaltrials.gov/study/NCT02408406.

Community-engaged Systems for Population Health Improvement: A Novel Approach to Improve Diabetes Outcomes in Rural Communities

BackgroundApproaches to prevent and manage diabetes at a community population level are hindered because current strategies are not aligned with the structure and function of a community system. We describe a community-driven process based on local data and rapid prototyping as an alternative approach to create diabetes prevention and care management solutions appropriate for each community. We report on the process and provide baseline data for a 3-year case study initiative to improve diabetes outcomes in two rural Nebraska communities.MethodsWe developed an iterative design process based on the assumption that decentralized decision-making using local data feedback and monitoring will lead to the innovation of local sustainable solutions. Coalitions act as community innovation hubs and meet monthly to work through a facilitated design process. Six core diabetes measures will be tracked over the course of the project using the electronic health record from community clinics as a proxy for the entire community.ResultsBaseline data indicate two-thirds of the population in both communities are at risk for prediabetes based on age and body mass index. However, only a fraction (35% and 12%) of those at risk have been screened. This information led both coalitions to focus on improving screening rates in their communities.DiscussionIn order to move a complex system towards an optimal state (e.g., improved diabetes outcomes), stakeholders must have access to continuous feedback of accurate, pertinent information in order to make informed decisions. Conventional approaches of implementing evidence-based interventions do not facilitate this process.

Design and Analysis of a Dual-Band Microstrip Patch Antenna for Sub-6 GHz Applications

This paper explores the design, simulation, and analysis of a dual-band Microstrip patch antenna designed to operate efficiently at frequency ranges of 3.32 GHz - 3.62 GHz and 4.72 GHz - 6.83 GHz, utilizing Ansys High-Frequency Structure Simulator (HFSS) software. The primary objective is to enhance performance metrics such as bandwidth, gain, and radiation efficiency to meet the requirements of applications necessitating concurrent operation at both frequency bands. The study involves a comprehensive design, iterative simulation, and detailed analysis using Ansys HFSS, with customized design considerations aimed at optimizing performance for modern wireless communication systems. The research was conducted in a simulated environment over a period that included iterative design processes, multiple simulation runs, and thorough analysis phases. Methodologically, the study focused on iterative design refinement to improve key performance parameters such as reflection coefficient, gain, radiation efficiency, Voltage Standing Wave Ratio (VSWR), and relative permittivity at the specified frequency bands. Results indicate that at 3.32 GHz - 3.62 GHz, the antenna achieves a reflection coefficient of -5 dB, a gain of 2.77 dB, a radiation efficiency of 0.7429, and a VSWR of 1.9299. At the higher frequency range of 4.72 GHz - 6.83 GHz, the antenna exhibits a reflection coefficient of -20.5213 dB, a gain of 3.34 dB, a radiation efficiency of 0.7, and a VSWR of 1.2203. These findings underscore the antenna's capability to deliver improved performance metrics across both frequency bands. In conclusion, the dual-band Microstrip patch antenna designed and analyzed through Ansys HFSS demonstrates significant potential for use in contemporary wireless communication systems, offering enhanced bandwidth, gain, and radiation efficiency suitable for multi-frequency applications.

Empirical and Computational Evaluation of Hemolysis in a Microfluidic Extracorporeal Membrane Oxygenator Prototype.

Microfluidic devices promise to overcome the limitations of conventional hemodialysis and oxygenation technologies by incorporating novel membranes with ultra-high permeability into portable devices with low blood volume. However, the characteristically small dimensions of these devices contribute to both non-physiologic shear that could damage blood components and laminar flow that inhibits transport. While many studies have been performed to empirically and computationally study hemolysis in medical devices, such as valves and blood pumps, little is known about blood damage in microfluidic devices. In this study, four variants of a representative microfluidic membrane-based oxygenator and two controls (positive and negative) are introduced, and computational models are used to predict hemolysis. The simulations were performed in ANSYS Fluent for nine shear stress-based parameter sets for the power law hemolysis model. We found that three of the nine tested parameters overpredict (5 to 10×) hemolysis compared to empirical experiments. However, three parameter sets demonstrated higher predictive accuracy for hemolysis values in devices characterized by low shear conditions, while another three parameter sets exhibited better performance for devices operating under higher shear conditions. Empirical testing of the devices in a recirculating loop revealed levels of hemolysis significantly lower (<2 ppm) than the hemolysis ranges observed in conventional oxygenators (>10 ppm). Evaluating the model's ability to predict hemolysis across diverse shearing conditions, both through empirical experiments and computational validation, will provide valuable insights for future micro ECMO device development by directly relating geometric and shear stress with hemolysis levels. We propose that, with an informed selection of hemolysis parameters based on the shear ranges of the test device, computational modeling can complement empirical testing in the development of novel high-flow blood-contacting microfluidic devices, allowing for a more efficient iterative design process. Furthermore, the low device-induced hemolysis measured in our study at physiologically relevant flow rates is promising for the future development of microfluidic oxygenators and dialyzers.