Functionality Of System Research Articles

Thermal Optimalization with CFD Analysis and Real-Time Performance Identification in Briquette Ovens Using Modbus-Based Communication

Briquette ovens that utilize biomass energy frequently face obstacles in achieving consistent heat distribution, resulting in ineffective energy usage and varying product quality. This study tackles these challenges by merging Computational Fluid Dynamics (CFD) analysis, performed with Cradle software, alongside a Modbus-based temperature data acquisition system to significantly boost energy efficiency and temperature regulation. A total of 32 K-type thermocouples were meticulously positioned within the oven to gather real-time temperature data, which was processed through LabVIEW. CFD simulations revealed irregular heat distribution patterns, especially at the rear of the oven. The temperature data obtained via Modbus corroborated these observations, allowing for strategic modifications to enhance heat distribution and minimize energy loss. The system achieved an impressive accuracy rate of 98.89%, with a mere error margin of 1.11%, substantially elevating the oven’s energy efficiency and briquette drying capabilities. This research clearly illustrates that the integration of CFD modeling with real-time data acquisition constitutes a powerful method for optimizing the functionality of industrial heating systems.

Metformin in Antiviral Therapy: Evidence and Perspectives

Metformin, a widely used antidiabetic medication, has emerged as a promising broad-spectrum antiviral agent due to its ability to modulate cellular pathways essential for viral replication. By activating AMPK, metformin depletes cellular energy reserves that viruses rely on, effectively limiting the replication of pathogens such as influenza, HIV, SARS-CoV-2, HBV, and HCV. Its role in inhibiting the mTOR pathway, crucial for viral protein synthesis and reactivation, is particularly significant in managing infections caused by HIV, CMV, and EBV. Furthermore, metformin reduces oxidative stress and reactive oxygen species (ROS), which are critical for replicating arboviruses such as Zika and dengue. The drug also regulates immune responses, cellular differentiation, and inflammation, disrupting the life cycle of HPV and potentially other viruses. These diverse mechanisms suppress viral replication, enhance immune system functionality, and contribute to better clinical outcomes. This multifaceted approach highlights metformin’s potential as an adjunctive therapy in treating a wide range of viral infections.

Application of precast reinforced concrete fuse units as energy dissipation units in various self-centering precast bridge pier systems

This study proposes the implementation of scaled modular reinforced concrete (RC) units as replaceable energy dissipation (ED) elements in various RC self-centering (SC) precast bridge pier (PBP) systems. Regarding the resistance mechanism of RC ED units, two types can be integrated with the main SC system: modular RC units that dissipate energy through the well-known plastic hinge mechanism, and hybrid modular precast SC units that dissipate energy through the yielding of mild steel reinforcement. Using commercial finite element (FE) software, three-dimensional (3D) FE models for different PBP systems (single-column, double-column, and wall PBP systems) were developed and examined under lateral cyclic loading. Various potentially influential design parameters were carefully studied. The studied cases successfully demonstrated that the proposed system introduces a novel, cost-effective damage-control system, which provides customizable ED capabilities, offers additional designable lateral resistance, and ensures rapid repair without compromising the functionality of the main SC structural system. Furthermore, in accordance with the design codes/guidelines for concrete structures exposed to earthquakes, the components defined as ED units can achieve the predefined seismic response without compromising the seismic performance or SC capacity of the main system.

Quantitative Measurement of Cyber Resilience: Modeling and Experimentation

Abstract Cyber resilience is the ability of a system to resist and recover from a cyber attack, thereby restoring the system's functionality. Effective design and development of a cyber resilient system requires experimental methods and tools for quantitative measuring of cyber resilience. This paper describes an experimental method and test bed for obtaining resilience-relevant data as a system (in our case – a truck) traverses its route, in repeatable, systematic experiments. We model a truck equipped with an autonomous cyber-defense system and which also includes inherent physical resilience features. When attacked by malware, this ensemble of cyber-physical features (i.e., “bonware”) strives to resist and recover from the performance degradation caused by the malware's attack. We propose parsimonious mathematical models to aid in quantifying systems’ resilience to cyber attacks. Using the models, we identify quantitative characteristics obtainable from experimental data, and show that these characteristics can serve as useful quantitative measures of cyber resilience.

Incentivizing Rural Work Preferences Among Specialist Physicians: Protocol for a Discrete Choice Experiment.

Retaining specialist physicians in rural parts of India poses a fundamental challenge, which affects the health care system's functionality and provision of standard health care services. There has been an acute shortfall of specialist physicians in the fields of medicine, pediatrics, obstetrics and gynecology, and surgery at rural community health centers. This necessitates urgent policy focus to address the shortages and design effective rural retention strategies. In this study, which uses a discrete choice experiment (DCE), individuals choose from multiple-choice preferences that resemble hypothetical job descriptions. DCEs are a quantitative approach to assessing several aspects of job selection. This study aims to develop a detailed plan of a DCE method used to determine specialist physicians' job choices. This protocol outlines the DCE method, which uses an exploratory sequential mixed methods research design to understand specialist physicians' preferences and design reward packages that would effectively motivate them to work in underserved regions. The qualitative phase of the study involved identifying job attributes and their corresponding levels for the DCE. We followed a meticulous process, which included reviewing relevant literature, performing qualitative pilot work, conducting in-depth individual interviews, and consulting with medical and health experts.The quantitative phase involved generating a D-efficient orthogonal fractional factorial design using Ngene software to create choice scenarios using the identified job factors and their corresponding levels. The generated choice scenarios were blocked into 6 versions in 6 blocks. The DCE wasundertaken among final-year postgraduate medical residents and specialist physicians from several health care facilities in Rajasthan. Various statistical models will be applied to explore the response variability and quantify the trade-offs that participants are willing to make for nonmonetary features as a substitute for adjustments in the monetary attribute. After the ethics committee's approval of the study, the qualitative data collection phase occurred from September to December 2021, while the quantitative phase took place from May to August 2022. Six attributes and 14 levels were identified and established through qualitative surveys. The experimental design resulted in 36 choice situations, which were grouped into 6 blocks. The preliminary investigation demonstrated that the instrument was valid and reliable. Statistical data analysis has been initiated, and the principal findings are expected to be disseminated in January 2025. The protocol provides a systematic framework to assess specialist physicians' preferences regarding working in rural health care centers. This research has the potential to substantially influence the future of rural health care by laying the foundation for understanding specialist physicians' choices, which will help design future incentive schemes, policy interventions, and research. DERR1-10.2196/59621.

Genetic Diversity and Phylogenetic Analysis of the Endangered Transylvanian Pinzgau Cattle: A Key Resource for Biodiversity Conservation and the Sustainability of Livestock Production

Animal biodiversity is essential for maintaining the functionality of local food systems and ensuring sustainable livelihoods. Starting in 2000, the Food and Agriculture Organization of the United Nations (F.A.O.) has drawn attention to the decline in cattle populations, including the Transylvanian Pinzgau breed from Romania. Renowned for its hardiness, adaptability, and enhanced resistance to diseases and climate change, the Transylvanian Pinzgau is regarded as an important genetic asset for advancing livestock production. As a result, tracking genetic diversity has become a key focus in breeding programs, particularly for small, endangered local populations that play a vital role in regional agro-ecological systems. This research paper sought to assess the genetic diversity of a group of 24 head of cattle from the Transylvania region by analyzing two mtDNA markers, cytochrome b and D-loop sequences, both widely recognized for their relevance and importance in the analysis of genetic diversity of cattle and phylogenetic studies. The findings, derived through statistical analysis of nucleotide sequences using specialized software, indicated that the analyzed cattle are part of the ancestral T haplogroup, with a direct lineage tracing back to Bos taurus. This information can aid in developing crossbreeding programs focused on conserving essential genetic resources, improving other cattle breeds, and protecting biodiversity.

Waterways and Roads in the Pre-colonial Bengal Delta: A Historical Perspective

The paper reviews the general conditions of the transport networks in the pre-colonial Bengal Delta. This region has a rich history of political dynamics, a thriving economy, and active commercial ventures. In the pre-colonial period, two primary transport systems operated in the Bengal Delta: waterways, due to the riverine and coastal landscape, served as the main mode of communication, while road transport was utilised in the areas where water transport was minimal. Variations in nature, capacity, shape, and functionality of these transport systems were influenced by the distinct geo-environmental features of the region. This paper serves as an in-depth exploration of pre-colonial transport systems, providing a foundation for understanding the evolution of modern transportation in Bengal.

Application of Single Chip Microcomputer in Smart Home Products

This article explores the application of Single Chip Microcomputers (SCMs) in smart home products. SCMs, compact computing devices integrating a processor, memory, and I/O peripherals, are ideal for IoT-enabled smart homes due to their real-time processing, energy efficiency, and affordability. Their core characteristics include low power consumption, real-time processing, compact size, affordability, versatility in communication, making them indispensable in smart home ecosystems. SCMs are widely used in smart lighting systems, thermostats, home security systems, smart appliances, and voice-controlled systems, enhancing user convenience, energy efficiency, and security. Technological enablers like IoT connectivity and sensor integration facilitate the integration of SCM-based smart devices. However, security concerns remain critical. Future trends include the integration of AI and Machine Learning and the adoption of 5G technology, enhancing the functionality and sophistication of smart home systems.

Decoding the molecular, cellular, and functional heterogeneity of zebrafish intracardiac nervous system

The proper functioning of the heart relies on the intricate interplay between the central nervous system and the local neuronal networks within the heart itself. While the central innervation of the heart has been extensively studied, the organization and functionality of the intracardiac nervous system (IcNS) remain largely unexplored. Here, we present a comprehensive taxonomy of the IcNS, utilizing single-cell RNA sequencing, anatomical studies, and electrophysiological techniques. Our findings reveal a diverse array of neuronal types within the IcNS, exceeding previous expectations. We identify a subset of neurons exhibiting characteristics akin to pacemaker/rhythmogenic neurons similar to those found in Central Pattern Generator networks of the central nervous system. Our results underscore the heterogeneity within the IcNS and its key role in regulating the heart’s rhythmic functionality. The classification and characterization of the IcNS presented here serve as a valuable resource for further exploration into the mechanisms underlying heart functionality and the pathophysiology of associated cardiac disorders.

Public Room Door Locking System Using Wireless Technology and Internet of Things

Enhancing the efficiency and security of public spaces has become increasingly important, leading to the development of an automatic door lock system utilizing wireless technology and the Internet of Things (IoT). This study aims to design and implement a smart door lock system that provides automated control and improves convenience in managing public room access. The research methodology involves programming the ESP32 microcontroller, integrating IoT applications, and conducting various testing methods. These include manual control through physical switches, automated control via the Sinric Pro platform, and Wi-Fi hotspot-based control using the ESP32 module. Comprehensive hardware and software testing was carried out to ensure system reliability and functionality. The results indicate that the proposed system enables seamless control of public room doors through multiple methods, including an Android-based application and Wi-Fi connectivity. By leveraging IoT technology, the system offers a user-friendly, efficient, and secure solution for managing public space access, addressing modern requirements for convenience and safety.

Prospective Evaluation of Autonomic Function and Intestinal Blood Flow in Health and Irritable Bowel Syndrome Shows Differences Limited to Patients With Constipation Predominance.

Autonomic dysfunction may contribute to symptom generation in irritable bowel syndrome (IBS), possibly driven by psychological morbidity and activation of the hypothalamic-pituitary-adrenal axis. Previous data are conflicting, perhaps due to lack of accounting for differential bowel patterns in IBS (constipation vs. diarrhea) or by diverse methodologies used to measure autonomic function. Our aim was to determine if autonomic response differed between IBS subtypes and healthy controls. Forty female volunteers (20 IBS and 20 healthy) underwent comprehensive autonomic testing, fasting and postprandially, and in response to cold pressor and deep breathing challenges. Pulse transit time (PTT) and ultrasound measurements of intestinal blood flow were used as measures of systemic and local autonomic function, respectively. Outcomes were adjusted for baseline psychological comorbidities and gastric emptying (measured concurrently with scintigraphy). Findings, confined to IBS patients with predominant constipation (IBS-C), included (1) lower fasting and a trend to larger postprandial increase in superior mesenteric artery end-diastolic velocity; (2) lower fasting PTT, suggesting higher sympathetic tone, but no difference in postprandial PTT change; and (3) attenuated increase in postprandial aortic peak systolic velocity. Response to systemic autonomic challenges did not differ between IBS and health. Some psychological factors mediated differences between groups in the fasting, but not postprandial, state. IBS-C patients display systemic and local autonomic imbalance providing some support for recent therapies aimed at modulating autonomic state specifically in this patient group (e.g., acustimulation).

Evidence-Based Clinical Utility of Heart Rate Variability Across Populations, Including Long COVID

Purpose: Heart rate variability (HRV) has been used for decades as a tool for measuring systemic health through the autonomic nervous system (ANS). The purpose of this paper was to examine the literature on HRV and to investigate its use in the long COVID (LC) population. Summary of Key Points: Measurement devices vary significantly in their validity and reliability when compared with the gold standard of electrocardiogram (ECG). Wrist and hand devices typically demonstrate diminished validity for capturing HRV signal, while chest strap devices often exhibit high reliability and validity. Lack of transparency in third-party software used to clean and analyze HRV data makes assessment for accuracy problematic. This is of particular concern when single beat miscalculations can result in significantly dissimilar output. The conditions under which HRV data are collected, such as natural or paced breathing, activity intensity, and patient position, can dramatically affect HRV readings. While some individual HRV metrics have consistently been shown to reflect certain components of the ANS, such as high-frequency power as a measure of parasympathetic function, the meaning of other metrics is less clear. Recommendations for Clinical Practice: Heart rate variability can be an extraordinarily valuable tool to measure systemic function. However, it is recommended that clinicians be judicious in the interpretation of HRV, considering inconsistencies in presentation. This is particularly true in LC, where individual HRV varies greatly. In all populations, clinicians should consider using valid devices to assess trends in HRV values over time, along with consideration of unique physical conditions.

Definitive Evidence for the Identification and Function of Renin-Expressing Cholinergic Neurons in the Nucleus Ambiguus

BACKGROUND: The importance of the brain renin-angiotensin system in cardiovascular function is well accepted. However, not knowing the precise source of renin in the brain has been a limitation toward a complete understanding of how the brain renin-angiotensin system operates. METHODS: Highly sensitive in situ hybridization techniques and conditional knockout mice were used to address the location and function of renin in the brainstem. RESULTS: We identified novel renin-expressing cholinergic neurons in the nucleus ambiguus (NuAm), a major vagal cardioinhibitory center in the brainstem. The expression of renin-angiotensin system genes was relatively abundant in the NuAm, implying that angiotensin II might mediate an important regulatory role in this nucleus and other regions with neural connectivity to the NuAm. Then, we generated conditional knockout mice lacking the classical renin isoform (Ren-a ChAT-KO ), specifically in cholinergic neurons. Ablation of Ren-a in cholinergic neurons abrogated renin expression in the NuAm. Moreover, studies using radiotelemetry, heart rate variability analyses, and pharmacological approaches revealed that the parasympathetic nervous system is depressed in Ren-a ChAT-KO males while augmented in the Ren-a ChAT-KO females. Subsequently, transcriptomic approaches were used to infer putative genes and signaling pathways regulated by renin within the NuAm. CONCLUSIONS: This study revealed that renin in cholinergic neurons plays a fundamental role in preserving autonomic balance and cardiovascular homeostasis in a sex-dependent manner. These findings define the NuAm as an endogenous, local source of renin with biological function and serve as conclusive evidence for the presence and functionality of the brain renin-angiotensin system.

Experimental study on performance of 100kW low temperature superconducting steady-state magnetoplasmadynamic thruster

Abstract Applied field magnetoplasmadynamic thrusters (AF-MPDTs), with their high specific impulse and considerable thrust, are increasingly favored for large-scale space missions. This paper presents the composition, functionality, and testing methods of a high-power electric propulsion performance testing system, along with the vacuum ignition test results of a 100 kW superconducting MPD thruster. The relationships between thruster effciency, magnetic field strength, current, and mass flow rate are analyzed. For each combination of current and flow rate in an AF-MPDT, there is an optimal magnetic field strength where the thruster effciency reaches its peak. Under conditions of 320 A current and 60 mg/s flow rate, the optimal magnetic field strength is 0.5 T, yielding the highest thruster effciency of 71%.

Relationship between glymphatic system dysfunction and cognitive impairment in patients with mild-to-moderate chronic traumatic brain injury: an analysis of the analysis along the perivascular space (ALPS) index.

Cognitive impairment associated with mild-to-moderate chronic traumatic brain injury (TBI) presents substantial challenges for which the functionality of the brain glymphatic system is a key area of interest. This study aimed to explore the functionality of the brain glymphatic system in patients with chronic cognitive impairment following mild-to-moderate TBI using diffusion tensor image analysis along the perivascular space (DTI-ALPS). This was a prospective cross-sectional study. A total of 56 patients with mild-to-moderate chronic TBI at the Radiology Outpatient Clinic of the First Affiliated Hospital of Hainan Medical University were enrolled in the study between January 2021 and July 2022. Additionally, 20 healthy control (HC) subjects were recruited from the Health Screening Center during the same period as the HC group. Relevant clinical data for all the participants were collected, and cognitive assessments were conducted using cognitive scales. The TBI patients were categorized into the traumatic brain injury cognitive impairment (TBI-CI) and traumatic brain injury cognitively normal (TBI-CN) groups based on their of the Chinese Version of the Montreal Cognitive Assessment-Basic (MoCA-BC) scores. Each group comprised 20 subjects. All three groups of participants underwent diffusion tensor imaging (DTI). The DTI data were processed and analyzed using the MRIcron and FMRIB Software Library (FSL) toolboxes, and the analysis along the perivascular space (ALPS) index was calculated. Differences in the ALPS index among the three groups were examined by an analysis of covariance, adjusted for age and gender. A corrected receiver operating characteristic (ROC) curve analysis was employed to evaluate the diagnostic performance of the ALPS index in identifying patients with traumatic chronic cognitive impairment. Compared with the HC group, both the mild-to-moderate TBI patients with and without cognitive impairment had a decreased ALPS index (HC vs. TBI-CI: 1.629 vs. 1.302, P<0.001; HC vs. TBI-CN: 1.629 vs. 1.523, P=0.003). Moreover, the decrease in the ALPS index was more significant in the mild-to-moderate TBI patients with cognitive impairment (TBI-CN vs. TBI-CI: 1.523 vs. 1.302, P<0.001). The adjusted ROC curve analysis revealed that the area under the curve (AUC) of the ALPS index for diagnosing traumatic chronic cognitive impairment was 0.983 [95% confidence interval (CI): 0.953-1, P<0.001], with a sensitivity of 90% and specificity of 95%. Cognitive impairment in patients with mild-to-moderate chronic TBI may be associated with impairment of the glymphatic system. Additionally, the ALPS index may serve as a potential predictor of the disease. Our findings provide some novel insights into the pathophysiological mechanisms underlying cognitive impairment in mild-to-moderate chronic TBI.

Pembuatan Sistem Pencatatan Pinjaman Kelompok Wanita Tani Berbasis Web Menggunakan Metode V-Model

This research focuses on designing a web-based loan recording system for the Jati Mekar Women Farmers Group (KWT) in Sindanglaut Village. KWT Jati Mekar is an organization consisting of women farmers in Sindanglaut Village who have joined together to improve their welfare and productivity through various agricultural and economic activities.The main objective of the research is to develop a system that can increase efficiency and accuracy in recording group members' loans. The methodology used is the V-Model, which allows for structured and systematic system development through stages of requirements analysis, design, implementation, testing, and maintenance.This system is designed to facilitate the process of recording, monitoring, and reporting loans, as well as increasing transparency in the group's financial management. During the development process, blackbox testing was conducted to evaluate the system's functionality without examining the internal code structure. This testing focuses on the system's inputs and outputs, ensuring that each feature functions according to expected specifications.The research results show that the implementation of this web-based system can address problems that often occur in manual recording, such as inaccurate data and difficulties in tracking loan status. Blackbox testing verifies that the system can handle various usage scenarios correctly, including member data management, loan recording, and report generation.

A poly (vinyl alcohol) coated core-shell nanoparticle with a tunable surface for pH and glutathione dual-responsive drug delivery

The surface characteristics of nanoparticles play a pivotal role in modulating the efficiency and functionality of drug delivery systems, particularly when addressing the complex challenges of targeted therapeutics. This study presents the development of a core-shell nanoparticle system (PMAA@DOX-PVA), incorporating poly(vinyl alcohol) (PVA) as a dynamic shell component to establish dual responsiveness to pH and glutathione levels. The hydrophilic PVA shell is covalently conjugated to the poly (methylacrylic acid) (PMAA) core via a boronic ester bond, establishing a robust platform for controlled release with tunable surface properties. Notably, our findings demonstrate a remarkable enhancement in drug loading efficiency from a modest 8% (PMAA@DOX) to an impressive 18% (PMAA@DOX-PVA-0.2). Furthermore, under physiological conditions (pH 7.4), the drug leakage after 62hours is significantly reduced, dropping from 37% (PMAA@DOX) to 21% (PMAA@DOX-PVA-0.2). This suggests a potential improvement in stability during blood circulation. Intriguingly, the PVA ratio was found to influence drug release profiles under different environments distinctly. The possible mechanism was proposed offering insight into this tunable behavior. In vitro cytotoxicity assays on A549 cancer cells reveal that the blank carriers exhibit excellent biocompatibility, while the PVA-coated nanoparticles significantly boost anti-tumor efficacy. Collectively, these results present a promising strategy for designing core-shell nanoparticles with customizable surface properties, paving the way for next-generation, multifunctional drug delivery systems in diverse biomedical applications.

Design of an effective multiple objects tracking framework for dynamic video scenes

Nowadays, the applications corresponding to video surveillance systems are getting popular due to their wide range of deployment in various places such as schools, roads, and airports. Despite the continuous evolution and increasing deployment of object-tracking features in video surveillance applications, the loopholes still need to be solved due to the limited functionalities of video-tracking systems. The existing video surveillance systems pose high processing overhead due to the larger size of video files. However, the traditional literature report quite sophisticated schemes which might successfully retain higher object detection accuracy from the video scenes but needs more effectiveness regarding computational complexity under limited computing resources. The study thereby identifies the scope of enhancement in traditional object-tracking functions. Further, it introduces a novel, cost-effective tracking model based on Gaussian mixture model (GMM) and Kalman filter (KF) that can accurately identify numerous mobile objects from a dynamic video scene and ensures computing efficiency. The study's outcome shows that the proposed strategic modelling offers better tracking performance for dynamic objects with cost-effective computation compared to the popular baseline approaches.

Image quality safety model for the safety of the intended functionality in highly automated agricultural machines

Achieving safe and reliable environmental perception is crucial for the success of highly automated or even autonomous agricultural machinery. However, developing such a system is challenging due to the inherent limitations of perception sensors. In certain conditions, these sensors may fail to capture accurate data, leading to erroneous perceptions of the environment and potentially compromising safety. Monitoring the functional insufficiencies of the measurement data is crucial for ensuring the safety and reliability of perception systems.This article introduces ISO standards, which provide guidelines for ensuring functional safety in highly automated mobile machines and vehicles. It also proposes an Image Quality Safety Model (IQSM) for monitoring the safety of the intended functionality in perception systems. The IQSM estimates the confidence level with which a camera can safely perform a specific object detection task. If the confidence level falls below a predefined threshold, the IQSM can trigger actions, alert operators, and prevent potential safety hazards. The IQSM exhibits remarkable performance, achieving a validation accuracy of about 90%, demonstrating its ability to effectively distinguish the safety of the intended functionality under a variety of image quality conditions.

Co-design of an electronic patient-reported outcome symptom monitoring system for immunotherapy toxicities.

Utilising electronic patient-reported outcomes (ePRO) to monitor symptoms can improve patient outcomes. However, ePRO systems are typically not co-designed with end-users which may limit their utility and long-term sustainability. We aimed to co-design a real-time ePRO symptom monitoring system for immune checkpoint inhibitor (ICI) toxicities. We conducted three co-design workshops at an Australian quaternary cancer centre. Participants were patients who had received/were receiving ICI or their caregivers, managing clinicians, administration staff, and electronic medical record (EMR) analysts. Workshop 1 identified preferences for an ideal ePRO system, informing the development of a prototype and generic workflow. Workshop 2 sought feedback on the prototype and workflow. Workshop 3 reviewed the updated prototype and adapted the generic workflow to create a site-specific workflow. Workshop transcripts were analysed thematically. Twenty-seven participants were included. Themes relating to system content and functionality included the need for customisation according to anticipated ICI toxicities; maximising patient accessibility, comprehension, and usability; providing ICI-specific self-management advice; and maximising clinician interpretability and usability. Themes relating to the model of care included the importance of maintaining the "human element" within the ePRO system, providing 24-hour support, alignment with existing clinical workflows, and automation of symptom monitoring processes using the EMR. Early, broad stakeholder engagement through co-design may improve the relevance, uptake, and sustainability of ePRO systems. Future work will involve usability and acceptance testing of the prototype, followed by implementation into routine care.