Children centered care status after implementation: What happens when the spotlight and hype are turned off?

Mid-air gestures in Extended Reality (XR) often lead to fatigue, discomfort and imprecision, limiting their suitability for extended use. Surface-based interactions offer a compelling alternative, providing improved accuracy, speed, and comfort. However, current egocentric vision-based methods struggle with reliable surface inputs due to challenges in hand tracking and surface plane estimation from oblique and occluded viewing angles. To this extent, we introduce SurfaceXR, a novel sensor fusion approach that combines headset based hand tracking with micro-vibration data sampled from commodity smartwatch IMUs to enable precise and robust inputs on everyday surfaces. Our system is designed with flexibility in mind - it can function using only hand tracking, only IMU sensing, or optimally with both modalities combined, and remains robust even without explicit surface calibration. Our key insight is that these modalities are complementary - hand tracking provides 3D positional data of hand joints, whereas IMUs supply high-frequency wrist/hand motion data. Our user study across 21 participants validates SurfaceXR's effectiveness in augmenting surface touch tracking and 8 class hand-surface gesture recognition, demonstrating significant improvements over single-modality approaches. Enabled by SurfaceXR, we demonstrate a series of interactive apps for both AR and VR, ranging from on-surface sketching, text entry and gesture-based navigation.

This study integrates digital technologies to design and develop a Reminiscence Therapy (RT) application. Based on user feedback, two main findings emerged: (1) three-dimensional (3D) visual presentations effectively reduce cognitive load, as depth perception and enhanced visual cues improve user comprehension; and (2) continuous navigation is more effective than layered navigation in reducing working memory demands for older adults with dementia. Furthermore, considering the clinical features of dementia, electroencephalogram (EEG) technology was employed to collect physiological data. Results indicated that 70% of participants entered a more relaxed or focused state during the intervention, evidenced by increased α-wave activity. Additionally, β-wave analysis demonstrated that 45% of participants experienced improved attention, suggesting that the RT content effectively enhances cognitive engagement. Overall, the developed 3D-RT interactive app shows significant potential for interaction design and emotional stimulation, while the use of EEG signals provides a more objective assessment tool compared to conventional self-report measures.

This study aimed to co-design, with key stakeholders, a digital dementia risk reduction application (app) for Chinese older migrant adults and carers residing in Australia, and to address the challenges of this proposed intervention. A four-stage co-design process was conducted, followed by one usability testing session. Each workshop focussed on core domains of healthy ageing and included guided discussions, interactive app testing and structured feedback activities. Thematic analysis was used to identify key themes. The app prototype was refined between sessions and changes were guided by participant feedback. A total of 20 end-users and 18 usability testers participated in this study (mean age = 74.8 years, SD = 8.2, range = 61-89). Participants expressed strong preferences for culturally tailored, interactive and visually clear app features. Eight themes emerged: health prioritisation in later life, designing for simplicity, functional needs in brain health testing, goal setting and motivation, brain training preferences, dietary preferences, preventive health monitoringand trusted medical information, and iterative design feedback. Older adults demonstrated high receptivity to health tracking and goal setting features when framed as personally relevant and adjustable. Feedbackinformed design features such as icon clarity, font size, navigation simplicity, motivational rewards and culturally specific content. This study highlighted the importance of co-design in developing effective digital tools for older adults. The active involvement of Chinese older adults in shaping the app supported cultural sensitivity, usability and individual motivational alignment. The final prototype reflected both sociotechnical responsiveness and real-world relevance and offers a potential, scalable model for culturally-tailored digital health interventions.

Personalised interventions which optimise the balance of physical activity (PA), sleep and sedentary behaviour (i.e., time use) in the 24-h day may be more effective than one-size-fits-all approaches. We present an interactive app to personalise 24-h time use based on individuals' health and sociodemographic characteristics. Analyses used cross-sectional data from 53,057 UK Biobank participants. Average daily time use was measured using 7-day accelerometry data and expressed as a 24-h composition using isometric log-ratio transformation. Five cognitive composites were derived from web-based tests. Regularized linear regression examined the relationship between 24-h time-use composition and cognition, with sociodemographic and health characteristics as additional predictors. Model estimates were used to estimate optimized cognition based on the interaction of 24-h time-use composition and personal characteristics. Our 'ideal day' app delivers personalised 24-h time-use recommendations tailored to individual characteristics. We demonstrate that personalisation of time-use interventions can be achieved in real time using open-source software.

Purpose Children undergoing Magnetic Resonance Imaging (MRI) often experience anticipatory anxiety, which can lead to distress, rescheduled scans or sedation. This study evaluated the acceptability and impact of Xploro, a digital interactive app designed to improve children's understanding of MRI procedures and reduce anxiety. Design/methodology/approach The GLOWING STARS study used a before-and-after design. Children aged 4–11 attending diagnostic MRI scans in secondary care paediatric NHS Trusts accessed Xploro one-to-one on the day of their appointment. Children and parents/caregivers completed paper proformas assessing perceived knowledge and emotional responses before and after using the app. Qualitative data were analysed thematically, and quantitative data summarised descriptively. Findings The study indicated that Xploro was highly acceptable and effective in enhancing procedural understanding, improving preparation and increasing emotional security before MRI scans, especially for children aged 7 to 11. This study is the first to involve children aged 4–6 years using the Xploro digital interactive intervention for MRI preparation, and the first to deliver Xploro on-site at the ANONYMISED hospital NHS Trust. This study provides valuable evidence guiding recommendations for the development of digital interventions for children under 7 years old (∼3–6). Research limitations/implications Due to the very small sample size of the data, caution should be taken when interpreting results about app-based strategies alongside relational support. Further research with a larger sample and with more balanced representation across diagnostic categories is needed to clarify the child-digital technology relationship and explore the role of adult facilitation in digital health app engagement among children (7–11 years old). Although the subgroup sizes were too small to draw reliable conclusions about children with physical disabilities and neurodevelopmental conditions, the qualitative data from the 4 children with conditions suggest a potential disparity in the perceived effectiveness of the app for children with physical disabilities and neurodiverse developmental needs. Originality/value This study is the first to involve children aged 4–6 years using the Xploro digital interactive intervention for MRI preparation, and the first to deliver Xploro on-site at the ANONYMISED hospital NHS Trust. This study provides valuable evidence guiding recommendations for the development of digital interventions for children under 7 years old (∼3–6).

Generalist models in medical image segmentation: A survey and performance comparison with task-specific approaches

Nurses' duties have come to include new technological solutions when supporting patients in cancer care. Patient-reported outcomes through digital self-monitoring in routine clinical care are highly recommended when supporting patients in cancer care. Learning about nurses' perceptions when providing digital support would enhance understanding of this new way of working and is necessary for future development and implementation. We performed a focus group interview with nurses who had been working with an interactive app (Interaktor) for digital support in daily practice when caring for patients undergoing radiotherapy for prostate cancer. The interview revealed that the nurses had retrieved useful information through the app about patients' symptoms and concerns that had promoted contact with the patients. Furthermore, they acknowledged that the app supported patients in communicating emotions such as worry. Monitoring and managing patients' symptoms were not seen as difficult or overly burdensome, although the organization at the clinic had difficulty putting it into practice. Overall, the nurses had a positive attitude and gained more knowledge about the patients than in standard care. This study contributes to the growing research on digital technology in health care delivery and its potential for supporting patients in cancer care.

Exploration of large-scale biological datasets remains a central challenge in computational biology. While many tools are available, they are often developed in isolation, leading to fragmented workflows, duplicated efforts, and limited reproducibility. There is a pressing need for flexible, standardized solutions that unify exploratory data analysis and biomarker discovery across diverse platforms. We present HDAnalyzeR, a user-friendly and extensible R package for the streamlined analysis of high-dimensional biological data. HDAnalyzeR provides modular, reproducible workflows that support a range of analyses, from quality control and dimensionality reduction to differential expression and enrichment analysis. The package features built-in visualization, metadata-aware modeling, and seamless integration with interactive apps and learning resources. We also present two case studies, where HDAnalyzeR dramatically reduced analysis time and code complexity while providing biologically meaningful insights, such as classification of blood cancer types with AUC = 1.0 and identification of thousands of solid tumor-associated genes. HDAnalyzeR is designed to support both beginner users and experienced bioinformaticians, promoting transparency, reproducibility, and publication-quality output. HDAnalyzeR is freely available both as an open-source R package at https://github.com/kantonopoulos/HDAnalyzeR and a web application at https://hdanalyzer.serve.scilifelab.se.

Breast cancer is the most commonly diagnosed cancer among women and a leading cause of cancer-related death. The increasing use of oral anticancer medications (OAMs) shifts responsibility for medication management to patients, often without adequate support. This study aimed to co-design an early-stage prototype intervention to support patients with breast cancer in managing OAMs, using a patient-centered, participatory design approach. We conducted three rounds of participatory design (PD) sessions with five patients receiving OAMs at a federally qualified health center's outpatient breast cancer clinic, in central Indiana. Eligible participants were 18 years old or older, diagnosedwith breast cancer, and currently taking OAMs. The PD process involved three stages: (1) Inspiration-patients identified key challenges in OAM management; (2) Ideation-patients co-developed potential solutions; and (3) Convergence-patients evaluated and selected preferred design concepts. Participants (median age: 66; range: 38-75) identified key challenges, including side-effect management, difficulty navigating resources, and lack of clear information. Ten solution ideas were generated and grouped into three categories: resource booklet, care navigation/support, and transportation assistance. Two priority prototypes emerged: (1) a physical breast cancer handbook, and (2) an interactive treatment navigation app. Participants favored the ease of use from the handbook while appreciated the mobile app's potential for bidirectional communication and peer support features. This study highlights the value of engaging patients as co-designers in the early stages of intervention development. Both the physical handbook and interactive app show potential to support OAM adherence and management. While the two design concepts require further refinement before implementation and pilot testing, the findings offer valuable insight for potential interventions in the context of oral anticancer medications used for treating breast cancer.

The study investigates how digital interpretation tools impact visitor experiences at cultural heritage sites in Serbia, focusing on satisfaction, emotional and cognitive engagement, educational outcomes, and ease of use. In response to evolving visitor expectations and the growing integration of digital technologies in tourism, this research addresses gaps related to demographic variations and lesser-known heritage sites in Southeast Europe. A mixed-methods approach was employed, combining a quantitative survey (N=150) with qualitative interviews (30 participants) across three culturally significant sites— Belgrade Fortress, Felix Romuliana, and Mokra Gora. These sites were selected for their cultural prominence and differing levels of technological integration, allowing for a nuanced exploration of visitor interactions with digital tools. Results reveal that digital tools, such as augmented reality, virtual reconstructions, and interactive apps, enhance learning, foster emotional connection, and increase visitor satisfaction, particularly among younger and first-time visitors. However, older adults and those with limited digital literacy reported usability challenges, highlighting the need for inclusive design and multilingual options. Regression analysis confirmed that emotional engagement and immersive storytelling strongly predict satisfaction. The study also demonstrates that digital tools facilitate experiential learning, enabling visitors to internalize historical narratives more deeply than through traditional methods. Qualitative findings emphasize the role of personal, narrative-driven content in shaping memorable and meaningful site experiences. By providing a holistic, multi-dimensional evaluation, this research advances the discourse on digital heritage tourism, emphasizing the importance of adaptive, demographically sensitive, and culturally contextualized digital strategies. The study offers practical recommendations for site managers and designers, advocating for inclusive, emotionally engaging, and locally grounded digital experiences that cater to diverse visitor profiles.

Chronic stress is a risk factor for neuropsychiatric disorders, making the ability to adapt to repeated stress a crucial determinant of mental health. It remains unclear whether repeated stress exposure leads to habituation or new adaptive responses. Here, we investigated how the transcriptomic response to acute restraint stress changes - in the mouse ventralhippocampus - with repeated exposure. Using bulk RNA-seq across multiple timepoints, we observed widespread transcriptional habituation: stress-induced gene expression was blunted without the emergence of new response profiles or changes in baseline gene expression. Temporally resolved single-nucleus multi-omic profiling (RNA and chromatin accessibility) confirmed that the transcriptional habituation occurs across cell types, revealing cell type-specific patterns. We identify gene clusters whose expression habituates with repeated exposure, which appear primarily related to two distinct mechanisms: an early blunting of cAMP-associated genes chiefly linked to a reduced number of activated cells, and a shortened transcriptional response of corticosterone-associated genes, independent of the number of activated cells. Our study provides a comprehensive resource, accessible as an interactive app, that characterizes the dynamic transcriptomic response to stress in the mouse hippocampus and how it habituates with repeated exposure to stress.

In recent years, the integration of technology into early childhood education has significantly transformed language learning, particularly in non-native English-speaking contexts like Malaysia. This study investigates the impact of interactive mobile applications on English vocabulary development among preschool children and evaluates the benefits of incorporating such digital tools into early language education. Interactive applications offer multimedia-rich and highly engaging learning experiences, utilizing features such as animations, gamified tasks, sound effects, and speech recognition. These elements are designed to capture young learners’ attention and facilitate deeper learning through play-based strategies. Recognizing the essential role that both educators and parents play in early childhood education, this study centers on their perspectives to understand how interactive apps are perceived, implemented, and evaluated in real-world preschool settings. A mixed-methods research design was employed, involving the collection of quantitative and qualitative data through structured questionnaires, focus group discussions with educators and parents, and analysis of user reviews from app platforms. The study aims to generate a comprehensive understanding of the educational value of such applications, highlighting their strengths and limitations. Findings from this research are expected to inform best practices in integrating interactive digital tools into the preschool English language curriculum and pedagogical decisions in early education.

The consumption of fast food has increased significantly and is associated with obesity and other chronic diseases. Digital nutrition education has been proposed as a solution to promote healthy eating behaviors. This randomized controlled trial was conducted in Jakarta and Bandung, Indonesia, in 2024 and involved 200 participants aged 18–50 years old. The experimental group (n=100) received digital nutrition education through a mobile application, whereas the control group (n=100) received no intervention. Data on fast-food consumption frequency, nutritional knowledge, and attitudes were collected using validated questionnaires before and after the 6-week intervention. Fast food consumption in the experimental group decreased significantly by 53% (from 6.5 to 3 times/week) compared with a 12% reduction in the control group. Nutritional knowledge improved from 40% to 75%, and 80% of the participants reported improved eating habits. Higher engagement with interactive app features led to a 30% increase in healthy food consumption. Digital nutrition education interventions effectively reduce fast food consumption and improve nutritional knowledge and attitudes. These findings support the integration of digital tools into public health strategies.

Soft materials represent an interdisciplinary frontier in modern science, combining theoretical and experimental knowledge from diverse fields in both fundamental research and cutting‐edge technological applications. Hydrogels have garnered significant interest due to their unique properties. Nevertheless, practitioners often lack sufficient information on how to synthesize hydrogels, and the final composition is traditionally determined through trial and error. This study introduces a novel methodology to identify the optimal composition prior to experimentation. An ordinal regression model for mixture experiments to simulate the synthesis process, an adaptation of the Particle Swarm Optimization algorithm to tackle the complex optimization problem, and an open‐access interactive app to facilitate the calculations are proposed. This work represents a milestone in the hydrogel synthesis field: first, because of the savings in human, economic, and material resources it entails, the latter being consistent with the commitment to environmental sustainability; second, because it aligns with the principles of open science, providing an accessible and reproducible tool for the entire scientific community; and finally, because it seeks to overcome the barrier of expert knowledge to generalize the use of hydrogels. It represents the first step toward the development of an AI system specialized in the design of novel smart materials.

This qualitative study explores the integration of digital tools in early childhood education (ECE) in Lahore, Pakistan, through semi-structured interviews with 25 educators and 25 parents of children aged 4–6 years. Employing thematic analysis, the study identifies seven themes: Educational Enhancement, Access and Equity Challenges, Developmental Concerns, Teacher Preparedness, Screen Time Regulation Strategies, Cultural and Contextual Relevance, and Parental Involvement. Findings reveal that digital tools, such as interactive apps, enhance engagement, literacy, numeracy, and motivation. Still, benefits are limited by unequal access to devices and the internet, particularly in public schools and low-income households. Excessive screen time and unsuitable content raise concerns about developmental impacts, while educators’ limited training hinders effective technology use. Parents and educators employ strategies like time limits and guided interaction to balance digital engagement, emphasizing the need for culturally relevant tools reflecting local values. Parental collaboration with educators strengthens learning outcomes, though technological unfamiliarity poses challenges. Grounded in Piaget’s constructivist theory, Vygotsky’s sociocultural theory, and the Technology Acceptance Model, the study advocates for equitable access, teacher training, localized content, and parent-educator partnerships to ensure digital tools support holistic development in ECE, aligning with developmentally appropriate practices.

This research describes the digital storytelling in ELT in engaging learners through multimedia narratives. This research is library research. The analysis shows that storytelling is a traditional method of conveying experiences, ideas, and emotions through words, images, and sound. It involves narrating stories that share personal experiences and facilitate emotional connections between individuals. In education, storytelling enriches learning by presenting vivid narratives that convey values, morals, and knowledge effectively. In ELT specifically, storytelling aids in understanding language structures, improving speaking skills, and deepening comprehension of target language cultures. Digital storytelling in ELT encompasses various applications that enhance language learning through multimedia narratives. Students engage in personal narrative projects, book reviews in video format, and historical or cultural storytelling to develop English proficiency and critical thinking. They use digital storyboards to structure narratives, interactive apps for creative storytelling, and collaborate on digital projects to foster teamwork. Competitions and augmented reality (AR) applications further motivate students, promoting language skills, cultural awareness, and digital literacy in dynamic educational settings. Digital storytelling in ELT relies on various platforms, tools, and resources for creating and engaging with multimedia narratives. It integrates images, videos, and audio to deepen reflection and articulate personal or academic content creatively. Educators access curated materials from sources like the British Council's Teaching English and TESOL International, while educational apps and YouTube offer templates and examples for language learners. Besides, professional journals, webinars, and teacher networks provide further support, promoting effective implementation of digital storytelling to enhance learning and collaboration in ELT classrooms.

Participatory engagements with digital tools and urban data have become a defining trend in smart city and digital twin projects. However, many platforms, interactive apps, and immersive media fall short compared to analog participation formats regarding open‐ended collaborations and the inclusion of situated perspectives. In this article, we explore the potential of geogames to address these contextual and contingent aspects of urban participation. Drawing on Suchman’s concept of “situated actions,” we argue that gameplay and game making enable “reconfigurations” between structured game systems and open‐ended play. We further propose that these “playful reconfigurations” bear the potential to attune digital media to contextual perspectives on urban planning issues and specific places. We illustrate this approach through three engagements with geogames conducted within the New European Bauhaus project Creating NEBourhoods Together, focusing on the co‐creation of several mobility hubs. First, we introduce core geogame principles developed in three co‐creation workshops with citizens in Neuperlach. These formats highlight the corporeal and performative dimensions invoked by digital media. Based on these insights, we discuss the making of participatory geogames as a reciprocal reframing of game systems and the urban issues at stake. Finally, we reflect on the resulting geogames by playing them on‐site and observing how they co‐constitute participatory engagements with the topic of mobility. In conclusion, we propose these “reconfigurations” as a resource to play with—a means of mediating between digital technologies and urban worlds, data and situated perspectives, presumed problems and contingent controversies.

BackgroundBullying is a significant public health issue, with approximately 25% of middle school students reporting being a target of bullying in the past year. Students who are targets of bullying or witness bullying are at high risk for negative mental health outcomes, including depression and anxiety. STAC is an evidence-based bullying bystander intervention for middle school students, with program outcomes that include reductions in bullying perpetration and victimization, as well as associated mental health risks. We developed a technology-based version of STAC (STAC-T) to reduce implementation barriers associated with in-person bullying prevention programs. STAC-T is an interactive app that includes a 40-minute training and a 15-minute booster session.ObjectiveThis study aimed to evaluate the acceptability and relevance of the STAC-T program. We were also interested in how program acceptability and relevance are related to the use of specific bystander intervention skills (eg, STAC strategies) students learn in the program.MethodsThis study was part of a larger study in which students recruited from 6 middle schools in rural, low-income communities in the United States were randomized to either the STAC-T intervention or a control condition. Participants in this study were 229 students in the intervention group who completed the 30-day follow-up survey, including the acceptability and relevance questionnaire. The survey assessed program acceptability and relevance, whether or not students witnessed bullying posttraining, and the use of the STAC strategies to intervene in bullying situations. Descriptive statistics were used to assess acceptability, relevance, and the use of STAC strategies. Linear regression analysis was used to assess the relationship of program acceptability and relevance to STAC strategy use.ResultsOf the 229 student participants, the majority reported the program was acceptable (188, 82.1%, to 206, 90.0%) and relevant (180, 78.6%, to 190, 83.0%) for students at their school. Of the 54.6% (125/229) of students who witnessed bullying posttraining, 88.8% (111/125) reported the use of at least one STAC strategy to intervene when witnessing bullying. Students were most likely to use the STAC bystander intervention strategies Turning it Over and Accompanying Others, relative to Stealing the Show and Coaching Compassion. Regression analyses revealed that program relevance was a significant predictor of posttraining use of STAC strategies (P=.016). In contrast, program acceptability was not a significant predictor of posttraining STAC strategy use (P=.660).ConclusionsThis study provides support for the acceptability and relevance of STAC-T and its effectiveness in promoting the use of the STAC strategies to intervene in bullying situations. Furthermore, program relevance was related to STAC strategy use, highlighting the importance of assessing program relevance for specific student populations.

Ranked data is commonly used in research across many fields of study including medicine, biology, psychology, and economics. One common statistic used for analyzing ranked data is Kendall’s τ coefficient, a nonparametric measure of rank correlation which describes the strength of the association between two monotonic continuous or ordinal variables. While the mathematics involved in calculating Kendall’s τ is well-established, there are relatively few graphing methods available to visualize the results. Here, we describe several alternative and complementary visualization methods and provide an interactive app for graphing Kendall’s τ . The resulting graphs provide a visualization of rank correlation which helps display the proportion of concordant and discordant pairs. Moreover, these methods highlight other key features of the data which are not represented by Kendall’s τ alone but may nevertheless be meaningful, such as longer monotonic chains and the relationship between discrete pairs of observations. We demonstrate the utility of these approaches through several examples and compare our results to other visualization methods.