In-silico techniques to inform and improve the personalized prescription of shoe insoles

Background: Corrective shoe insoles are prescribed for a range of foot deformities and are typically designed based on a subjective assessment limiting personalization and potentially leading to sub optimal treatment outcomes. The incorporation of in silico techniques in the design and customization of insoles may improve personalized correction and hence insole efficiency. Methods: We developed an in silico workflow for insole design and customization using a combination of measured motion capture, inverse musculoskeletal modelling as well as forward simulation approaches to predict the kinematic response to specific insole designs. The developed workflow was tested on twenty-seven participants containing a combination of healthy participants (7) and patients with flatfoot deformity (20). Results: Average error between measured and simulated kinematics were 4.7 ± 3.1, 4.5 ± 3.1, 2.3 ± 2.3, and 2.3 ± 2.7° for the chopart obliquity, chopart anterior-posterior axis, tarsometatarsal first ray, and tarsometatarsal fifth ray joints respectively. Discussion: The developed workflow offers distinct advantages to previous modeling workflows such as speed of use, use of more accessible data, use of only open-source software, and is highly automated. It provides a solid basis for future work on improving predictive accuracy by adapting the currently implemented insole model and incorporating additional data such as plantar pressure.

Digital Electronic System-on-Chip Design: Methodologies, Tools, Evolution, and Trends

This paper reviews the evolution of methodologies and tools for modeling, simulation, and design of digital electronic system-on-chip (SoC) implementations, with a focus on industrial electronics applications. Key technological, economic, and geopolitical trends are presented at the outset, before reviewing SoC design methodologies and tools. The fundamentals of SoC design flows are laid out. The paper then exposes the crucial role of the intellectual property (IP) industry in the relentless improvements in performance, power, area, and cost (PPAC) attributes of SoCs. High abstraction levels in design capture and increasingly automated design tools (e.g., for verification and validation, synthesis, place, and route) continue to push the boundaries. Aerospace and automotive domains are included as brief case studies. This paper also presents current and future trends in SoC design and implementation including the rising, evolution, and usage of machine learning (ML) and artificial intelligence (AI) algorithms, techniques, and tools, which promise even greater PPAC optimizations.

A process to foster pathology-related effects of design primes - how orthopedic patients might benefit from design features that influence health behaviour intention

A growing body of literature mainly in the context of consumer research indicates that the formal-aesthetic and conceptual design of objects can influence users' thoughts, emotions and even behavioural patterns. While there is strong evidence regarding these effects on actual purchasing decisions, evidence on the effect of aesthetic design features (e.g., haptics, colour) on health-related mental concepts and intentions for health behaviour change is scarce. Based on insights from material and conceptual priming, this article illustrates the research-driven and evidence-based design process of two design primes and comprises pre-tests and an experiment in two settings on the effect of design on health behaviour focusing i.a. on intention for health behaviour change. In an evidence-based and research-driven process, two lecterns were designed to work as primes, i.e., to have a positive vs. negative influence on several mental constructs (sense of control, sense of coherence, resiliency, self-efficacy) and health-related intention. The lecterns differed mainly in terms of aesthetic appearance (e.g., material, colour, proportion, steadiness). They were tested in (a.) a university setting with students (n = 83) and (b.) a clinical setting with orthopaedic rehabilitation patients (n = 38). Participants were asked to perform an unrelated task (evaluation of an unrelated product) while standing at and using the lecterns. Overall, t-tests and Mann-Whitney-U tests show no significant differences but differing tendencies in a mentioning task. When asked to name health-promoting activities, in the clinical setting, participants using the "positive" prime (i.e., the steady lectern, n = 13) mentioned more sport-related aspects on average and a higher portion of sport-related aspects of their answers than participants using the "negative" prime (n = 11). In the university setting (positive: n = 36; negative n = 38), no such differences emerged. This finding gives reason to believe that the prime might be specifically effective in the clinical setting as it relates to physical activity being the most relevant topic of the patients' pathology.

Optimization of Components with Topology Optimization for Direct Additive Manufacturing by DLMS

This paper presents a novel design methodology that validates and utilizes the results of topology optimization as the final product shape. The proposed methodology aims to streamline the design process by eliminating the need for remodeling and minimizing printing errors through process simulation. It also eliminates the repeated export and import of data between software tools. The study includes a case study involving the steering column housing of a racing car, where Siemens NX Topology Optimization was used for optimization, and verification analysis was conducted using the NX Nastran solver. The final solution was fabricated using AlSi10Mg via direct metal laser sintering on a 3D printer and successfully validated under real conditions. In conclusion, this paper introduces a comprehensive design methodology for the direct utilization of topology optimization, which was validated through a case study, yielding positive results.

A Systematic Literature Review on Healthcare Facility Evaluation Methods

To present a systematic literature review on predesign evaluation (PDE), postoccupancy evaluation (POE), and evidence-based design (EBD); to delimit the concepts and relationships of these terms and place them in the building life cycle framework to guide their application and indicate a common understanding and possible gaps. The preferred reporting items for systematic reviews and meta-analyses protocol was used. Inclusion criteria cover texts that present a concept, method, procedure, or tool and use the example in healthcare services or other environments. The reports were excluded if there was no evidence of a relationship between the terms, if cited rhetorically, duplicated, or if an instrument was not related to at least one other term. The identification used Scopus and Web of Science and considered reports until December 2021 (search period). When extracting the evidence, formal quality criteria were observed and sentences and other elements were collected as evidence and tabulated to segment topics of interest. The searches identified 799 reports with 494 duplicates. In the selection, 53 records were selected from 305 obtained in 14 searches. The classification extracted concepts, relationships, and frameworks. Results indicate a consistent understanding of POE and EBD and a diffuse understanding of PDE. A summary of the three concepts including two frameworks is proposed. Situations are contextualized where these frameworks are used in specific areas of research. One of these frameworks provides a basis for classifying building assessment methods, procedures, and tools but does not detail the classification criteria. Thus, more detailed adjustments should be considered in specific studies.

Diversity in Stakeholder Groups in Generative Co-design for Digital Health: Assembly Procedure and Preliminary Assessment

BACKGROUND

Diverse knowledge and ways of thinking are claimed to be important when involving stakeholders such as patients, care professionals, and care managers in a generative co-design (GCD) process. However, this claim is rather general and has not been operationalized; therefore, the influence of various stakeholders on the GCD process has not been empirically tested.

OBJECTIVE

In this study, we aimed to take the first step in assessing stakeholder diversity by formulating a procedure to assemble a group of diverse stakeholders and test its influence in a GCD process.

METHODS

To test the procedure and assess its influence on the GCD process, a case was selected involving a foundation that planned to develop a serious game to help people with cancer return to work. The procedure for assembling a stakeholder group involves snowball sampling and individual interviews, leading to the formation of 2 groups of stakeholders. Thirteen people were identified through snowball sampling, and they were briefly interviewed to assess their knowledge, inference experience, and communication skills. Two diverse stakeholder groups were formed, with one more potent than the other. The influence of both stakeholder groups on the GCD process was qualitatively assessed by comparing the knowledge output and related knowledge processing in 2 identical GCD workshops.

RESULTS

Our hypothesis on diverse stakeholders was confirmed, although it also appeared that merely assessing the professional background of stakeholders was not sufficient to reach the full potential of the GCD process. The more potently diverse group had a stronger influence on knowledge output and knowledge processing, resulting in a more comprehensive problem definition and more precisely described solutions. In the less potently diverse group, none of the stakeholders had experience with abduction-2 inferencing, and this did not emerge in the GCD process, suggesting that at least one stakeholder should have previous abduction-2 experience.

CONCLUSIONS

A procedure to assemble a stakeholder group with specific criteria to assess the diversity of knowledge, ways of thinking, and communication can improve the potential of the GCD process and the resulting digital health.

User-Centered Design Methodologies for the Prototype Development of a Smart Harness and Related System to Provide Haptic Cues to Persons with Parkinson's Disease

This paper describes the second part of the PASSO (Parkinson smart sensory cues for older users) project, which designs and tests an innovative haptic biofeedback system based on a wireless body sensor network using a smartphone and different smartwatches specifically designed to rehabilitate postural disturbances in persons with Parkinson's disease. According to the scientific literature on the use of smart devices to transmit sensory cues, vibrotactile feedback (particularly on the trunk) seems promising for improving people's gait and posture performance; they have been used in different environments and are well accepted by users. In the PASSO project, we designed and developed a wearable device and a related system to transmit vibrations to a person's body to improve posture and combat impairments like Pisa syndrome and camptocormia. Specifically, this paper describes the methodologies and strategies used to design, develop, and test wearable prototypes and the mHealth system. The results allowed a multidisciplinary comparison among the solutions, which led to prototypes with a high degree of usability, wearability, accessibility, and effectiveness. This mHealth system is now being used in pilot trials with subjects with Parkinson's disease to verify its feasibility among patients.

An Electrostatic MEMS Roll-Pitch Rotation Rate Sensor with In-Plane Drive Mode

In this paper, we presented a novel electrostatic Roll/Pitch MEMS gyroscope with in-plane drive mode and out-of-plane sense mode. The proposed structure is developed based on a tuning fork gyroscope with decoupled sense mass on each tine that control the sense out-of-plane frequency. A multi-height deep reactive ion etching (DRIE) fabrication process was utilized to achieve and enhance decoupling between the drive and sense modes. We presented our design methodology followed by an analytical and finite element (FEM) model. Our experimental results showed a good match between the analytical model and those obtained experimentally, from the drive and sense oscillation frequencies. Our characterization setup used a custom made application specific integrated circuit (ASIC) for characterization and was able to achieve ARW of 0.2 deg/rt-h, a bias instability 5.5 deg/h, and scale factor non-linearity (SFNL) 156 ppm FS.

Design methodology for sewage water treatment system comprised of Imhoff 's tank and a subsurface horizontal flow constructed wetland: a case study Dakhla Oasis, Egypt

In this study, in order to reuse the treated wastewater in irrigation in rural areas, a new sewage water treatment system comprised of primary treatment Imhoff's tank, Hama drying basins, inlet well, a subsurface horizontal flow constructed wetland (HSFW), water control device, and a groundwater tank is proposed and designed in Dakhla Oasis western desert of Egypt. The proposed system serves a population of 5000 capita with a designed discharge of 750 m³ d^-1. The kinetic parameters involved macrophyte organisms, media forms, water level, hydraulic retention time (HRT), and hydraulic loading rate (h_l) for the system were selected to achieve an efficient wastewater treatment system design. Imhoff's tank is sized as the primary sedimentation efficiency is 30%, and HSFW is sized based on the first-order kinetics (k-C∗) model, and total hydraulic design theory. The air temperatures were 29.7 °C and 13.8 °C in summer and winter respectively, influent pollutant concentrations after primary sedimentation for BOD, fecal coliforms (FC), total nitrogen (TN), and total phosphorus (TP) were 210 mg L^-1, 10⁸ CFU100 mL^-1, 30 and 7 mg L^-1, respectively. The expected designed effluent BOD and FC were 30 mg L^-1 and 1000 CFU100 mL^-1 respectively. The results show that FC removal controls the area of the HSFW (2.87 ha), 6 units of reed (Phragmites Australis and Papyrus) plants each one is 66 ×72.6 m with h_l of 2.6 cm d^-1 and HRT of 6.91 d. The expected overall removal efficiencies for BOD and FC were 85.7%, and 99.9% respectively.

How 3D Printing Is Reshaping Translational Research

"Translational Research" has traditionally been defined as taking basic scientific findings and developing new diagnostic tools, drugs, devices and treatment options for patients, that are translated into practice, reach the people and populations for whom they are intended and are implemented correctly. The implication is of a unidirectional flow from "the bench to bedside". The rapidly emergent field of additive manufacturing (3D printing) is contributing to a major shift in translational medical research. This includes the concept of bidirectional or reverse translation, early collaboration between clinicians, bio-engineers and basic scientists, and an increasingly entrepreneurial mindset. This coincides with, and is strongly complemented by, the rise of systems biology. The rapid pace at which this type of translational research can occur brings a variety of potential pitfalls and ethical concerns. Regulation surrounding implantable medical devices is struggling to keep up. 3D printing has opened the way for personalization which can make clinical outcomes hard to assess and risks putting the individual before the community. In some instances, novelty and hype has led to loss of transparency of outcomes with dire consequence. Collaboration with commercial partners has potential for conflict of interest. Nevertheless, 3D printing has dramatically changed the landscape of translational research. With early recognition and management of the potential risks, the benefits of reshaping the approach to translational research are enormous. This impact will extend into many other areas of biomedical research, re-establishing that science is more than a body of research. It is a way of thinking.

Design of Secure Microcontroller-Based Systems: Application to Mobile Robots for Perimeter Monitoring

This paper describes an original methodology for the design of microcontroller-based physical security systems and its application for the system of mobile robots. The novelty of the proposed methodology lies in combining various design algorithms on the basis of abstract and detailed system representations. The suggested design approach, which is based on the methodology, is modular and extensible, takes into account the security of the physical layer of the system, works with the abstract system representation and is looking for a trade-off between the security of the final solution and the resources expended on it. Moreover, unlike existing solutions, the methodology has a strong focus on security. It is aimed at ensuring the protection of the system against attacks at the design stage, considers security components as an integral part of the system and checks if the system can be designed in accordance with given requirements and limitations. An experimental evaluation of the methodology was conducted with help of its software implementation that consists of Python script, PostgreSQL database, Tkinter interface and available for download on our GitHub. As a use case, the system of mobile robots for perimeter monitoring was chosen. During the experimental evaluation, the design time was measured depending on the parameters of the attacker against which system security must be ensured. Moreover, the software implementation of the methodology was analyzed in compliance with requirements and compared with analogues. The advantages and disadvantages of the methodology as well as future work directions are indicated.

A Design Method to Induce Ductile Failure of Flexural Strengthened One-Way RC Slabs

Strengthening existing reinforced concrete (RC) slabs using externally bonded materials is increasingly popular due to its adaptability and versatility. Nevertheless, ductility reduction of the rehabilitated flexural members with these materials can lead to brittle shear failure. Therefore, a new approach for strengthening is necessary. This paper presents a methodology to induce ductile failure of flexural strengthened one-way RC slabs. Ultimate failure loads can be considered to develop the proposed design methodology. Different failure modes corresponding to ultimate failure loads for RC slabs are addressed. Flexural and shear failure regions of RC slabs can be established by considering the failure modes. The end span of the concrete slab is shown for a case study, and numerical examples are solved to prove the essentiality of this methodology.

An Anthropometrically Parameterized Assistive Lower Limb Exoskeleton

This paper presents an innovative design methodology for development of lower limb exoskeletons with the fabrication and experimental evaluation of prototype hardware. The proposed design approach is specifically conceived to be suitable for the pediatric population and uses additive manufacturing and a model parameterized in terms of subject anthropometrics to give a person-specific custom fit. The methodology is applied to create computer-aided design models using average anthropometrics of children 6-11 years old and using anthropometrics of an individual measured by the researchers. This demonstrates that the approach can scale to subject weight and height. A prototype exoskeleton is fabricated, which can actuate the hip and knee joints without restricting hip abduction-adduction motion. In order to test usability of the device and evaluate walking assistance, user effort is quantified in an assisted condition where the subject walks on a level treadmill with the exoskeleton powered. This is compared to an unassisted condition with the exoskeleton unpowered and a baseline condition with the subject not wearing the exoskeleton. Comparing assisted to baseline conditions, torque magnitudes increased at the hip and knee, mechanical energy generated increased at the hip but decreased at the knee, and muscle activations increased in the Vastus Lateralis but decreased in the Biceps Femoris. While the preliminary evidence for walking assistance is not entirely convincing for the tested conditions, the presented design methodology itself is promising as it has been successfully validated through the creation of computer-aided design models for children and fabrication of a serviceable exoskeleton prototype.

A User Centered Methodology for the Design of Smart Apparel for Older Users

Smart clothing plays a big role to foster innovation and to. boost health and well-being, improving the quality of the life of people, especially when addressed to niche users with particular needs related to their health. Designing smart apparel, in order to monitor physical and physiological functions in older users, is a crucial asset that user centered design is exploring, balancing needs expressed by the users with technological requirements related to the design process. In this paper, the authors describe a user centered methodology for the design of smart garments based on the evaluation of users' acceptance of smart clothing. This comparison method can be considered as similar to a simplified version of the quality function deployment tool, and is used to evaluate the general response of each garment typology to different categories of requirements, determining the propensity of the older user to the utilization of the developed product. The suggested methodology aims at introducing in the design process a tool to evaluate and compare developed solutions, reducing complexity in design processes by providing a tool for the comparison of significant solutions, correlating quantitative and qualitative factors.

Understanding the Methodological Issues and Solutions in the Research Design of Stroke Caregiving Technology

The rise in the number of cases of stroke has resulted in a significant burden on the healthcare system. As a result, the majority of care for the person living with stroke occurs within the community, resulting in caregivers being a central and challenged agent in care. To better support caregivers during the recovery trajectory poststroke, we investigated the role of health technologies to promote education and offer various kinds of support. However, the introduction of any new technology comes with challenges due to the growing need for more user-centric systems. The integration of user-centric systems in stroke caregiving has the potential to ensure long-term acceptance, success, and engagement with the technology, thereby ensuring better care for the person living with stroke. We first briefly characterize the affordances of available technologies for stroke caregiving. We then discuss key methodological issues related to the acceptance to such technologies. Finally, we suggest user-centered design strategies for mitigating such challenges.

Proof of Concept (PoC) 1.0-Implementing a Bioshading System Design Method

Nature provides a remarkable database of possible adaptation strategies that can be implemented in biomimetic design of shading systems. However, at this moment, successful design methods are conditioned to a limited knowledge and ability to emulate nature’s strategies to meet corresponding functional needs. The implementation of biomimetic processes has some major challenges: (1) the search and selection among several databases of appropriate strategies adopted by nature; (2) difficulties in reading, interpreting and translating at different scales; (3) connection problems between concepts and material premises. The selection of nature models is a very common situation among architectural projects. Proof of Concept (PoC) 1.0 was the first experience of application of the Bioshading System Design Method (BSDM). BSDM is a problem-based method that guides its users since the initial architectural challenge definition, improving users’ capabilities to interpret and translate nature strategies into architecture design, until its final state of creation, it’s physical condition. This experience enabled us to validate and evolve initial decisions, based on users experience and evaluation. At the end, PoC 1.0 revealed to be a fundamental step into the final version of BSDM.

Novel Data Mining Methodology for Healthcare Applied to a New Model to Diagnose Metabolic Syndrome without a Blood Test

Metabolic Syndrome (MetS) is a cluster of risk factors that increase the likelihood of heart disease and diabetes mellitus. It is crucial to get diagnosed with time to take preventive measures, especially for patients in locations without proper access to laboratories and medical consultations. This work presented a new methodology to diagnose diseases using data mining that documents all the phases thoroughly for further improvement of the resulting models. We used the methodology to create a new model to diagnose the syndrome without using biochemical variables. We compared similar classification models, using their reported variables and previously obtained data from a study in Colombia. We built a new model and compared it to previous models using the holdout, and random subsampling validation methods to get performance evaluation indicators between the models. Our resulting ANN model used three hidden layers and only Hip Circumference, dichotomous Waist Circumference, and dichotomous blood pressure variables. It gave an Area Under Curve (AUC) of 87.75% by the IDF and 85.12% by HMS MetS diagnosis criteria, higher than previous models. Thanks to our new methodology, diagnosis models can be thoroughly documented for appropriate future comparisons, thus benefiting the diagnosis of the studied diseases.

Automatic Off-Line Design of Robot Swarms: A Manifesto

Designing collective behaviors for robot swarms is a difficult endeavor due to their fully distributed, highly redundant, and ever-changing nature. To overcome the challenge, a few approaches have been proposed, which can be classified as manual, semi-automatic, or automatic design. This paper is intended to be the manifesto of the automatic off-line design for robot swarms. We define the off-line design problem and illustrate it via a possible practical realization, highlight the core research questions, raise a number of issues regarding the existing literature that is relevant to the automatic off-line design, and provide guidelines that we deem necessary for a healthy development of the domain and for ensuring its relevance to potential real-world applications.

Interdisciplinary User Groups and the Design of Healthcare Facilities

AIM

This Australian research explores how "user group" participants from diverse professional discipline backgrounds understand, define, perform their roles, and assess the outcomes of the healthcare design process.

BACKGROUND

Part of the design process in Australia and New Zealand, the purpose of interdisciplinary user group consultation is to design the best healthcare facilities possible within the parameters set by project clients and funding bodies.

METHOD

An online survey was used to explore how user group participants viewed the process, including how well informed they felt they were about their role/s in it, its success in achieving specific outcomes for their project, and how they felt their project client, owner, or funding body assessed these same issues. It included both closed and open-ended questions, and data were then analyzed using an interpretative methodology by an architect researcher based in practice.

RESULTS

Emergent issues identified include governance of the process, knowledge asymmetries between participants, missed opportunities for innovation, composition and workloads of user groups, and the quality of resources available to guide the process.

CONCLUSIONS

The interdisciplinary user group process could be improved, and future research will look at how drawing on participatory design methods used in sectors such as urban planning may support the development of new techniques for conducting user groups.

A System-Level Methodology for the Design of Reliable Low-Power Wireless Sensor Networks

Innovative Internet of Things (IoT) applications with strict performance and energy consumption requirements and where the agile collection of data is paramount are arising. Wireless sensor networks (WSNs) represent a promising solution as they can be easily deployed to sense, process, and forward data. The large number of Sensor Nodes (SNs) composing a WSN are expected to be autonomous, with a node’s lifetime dictated by the battery’s size. As the form factor of the SN is critical in various use cases, minimizing energy consumption while ensuring availability becomes a priority. Moreover, energy harvesting techniques are increasingly considered as a viable solution for building an entirely green SN and prolonging its lifetime. In the process of building a SN and in the absence of a clear and well-rounded methodology, the designer can easily make unfounded and suboptimal decisions about the right hardware components, their configuration, and reliable data communication techniques, such as automatic repeat request (ARQ) and forward error correction (FEC). In this paper, a methodology to design, configure, and deploy a reliable ultra-low power WSNs is proposed. A comprehensive energy model and a realistic path-loss (PL) model of the sensor node are also established. Through estimations and field measurements it is proven that, following the proposed methodology, the designer can thoroughly explore the design space and the make most favorable decisions when choosing commercial off-the-shelf (COTS) components, configuring the node, and deploying a reliable and energy-efficient WSN.

Assessing the Feasibility of Measuring Variation in Facility Design Among American Childbirth Facilities

OBJECTIVE

To assess the feasibility of quantifying variation in childbirth facility design and explore the implications for childbirth service delivery across the United States.

BACKGROUND

Design has been shown to impact quality of care in childbirth. However, most prior studies use qualitative data to examine associations between the design of patient rooms and patient experience. There has been limited exploration of measures of unit design and its impact on care provision.

METHOD

We recruited 12 childbirth facilities that were diverse with regard to facility type, location, delivery volume, cesarean delivery rate, and practice model. Each facility provided annotated floor plans and participated in a site visit or telephone interview to provide information on their design and clinical practices. These data were analyzed with self-reported primary cesarean delivery rates to assess associations between design and care delivery.

RESULTS

We observed wide variation in childbirth unit design. Deliveries per labor room per year ranged from 75 to 479. The ratio of operating rooms to labor rooms ranged from 1:1 to 1:9. The average distance between labor rooms and workstations ranged from 23 to 114 ft, and the maximum distance between labor rooms ranged from 9 to 242 ft. More deliveries per room, fewer labor rooms per operating room, and longer distances between spaces were all associated with higher primary cesarean delivery rates.

CONCLUSIONS

Clinically relevant differences in design can be feasibly measured across diverse childbirth facilities. The design of these facilities may not be optimally matched to service delivery needs.

Influence of Color in a Lactation Room on Users' Affective Impressions and Preferences

OBJECTIVE

The present study aims to examine the influence of environmental color hue in a lactation room at a health center on users' affective response and preference.

BACKGROUND

Hospital design plays an important role in the emotional experience of patients. In this regard, many studies have attempted to find relationships between design variables and healthcare facilities users' response. Color has been frequently examined because it is always present in the environment and can be easily changed. However, most of the studies dealing with color-emotion relationships acquire users' affective response by questionnaires developed by experts which could lead to inaccurate results since nonexperts may misunderstand concepts set by experts and use nonimmersive images to simulate the environments to assess.

METHODS

To overcome these limitations, a Kansei Engineering-based approach was proposed. In the first phase, users' specific affective factors for lactation rooms were determined using Semantic Differential. In the second phase, the influence of nine different color hues on users' affective factors was obtained. An immersive display system was used to visualize the room altering hues in an isolated and controlled way.

RESULTS

(1) Six user's affective factors connected to the lactation rooms were discovered: safety, elegance, coziness, spaciousness, simplicity, and luminosity, of which coziness has the most impact on the assessment of the room. (2) Warm colors like orange and yellow tend to score highly for coziness which puts them in leading positions when users' assess lactation rooms.

CONCLUSIONS

Results provide recommendations for designers and show the advantages of using semantic differential and immersive displays to analyze user's affective response to environments.

Quantifying Discretization Errors in Electrophoretically-Guided Micro Additive Manufacturing

This paper presents process models for a new micro additive manufacturing process termed Electrophoretically-guided Micro Additive Manufacturing (EPμAM). In EPμAM, a planar microelectrode array generates the electric potential distributions which cause colloidal particles to agglomerate and deposit in desired regions. The discrete microelectrode array nature and the used pulse width modulation (PWM) technique for microelectrode actuation create unavoidable process errors-space and time discretization errors-that distort particle trajectories. To combat this, we developed finite element method (FEM) models to study trajectory deviations due to these errors. Mean square displacement (MSD) analysis of the computed particle trajectories is used to compare these deviations for several electrode geometries. The two top-performing electrode geometries evaluated by MSD were additionally investigated through separate case studies via geometry variation and MSD recomputation. Furthermore, separate time-discretization error simulations are also studied where electrode actuating waveforms were simulated. The mechanical impulse of the electromechanical force, generated from these waveforms is used as the basis for comparison. The obtained results show a moderate MSDs variability and significant differences in the computed mechanical impulses for the actuating waveforms. The observed limitations of the developed process model and of the error comparison technique are briefly discussed and future steps are recommended.

A Comprehensive Comparative Study on Inductive and Ultrasonic Wireless Power Transmission to Biomedical Implants

This paper presents a comprehensive comparison between inductive coupling and ultrasound for wireless power transmission (WPT) to biomedical implants. Several sets of inductive and ultrasonic links for different powering distances (d 12) and receiver dimensions have been optimized, and their key parameters, including power transmission efficiency (PTE) and power delivered to the load (PDL) within safety constraints, have been compared to find out which method is optimal for any given condition. Two design procedures have been presented for maximizing the PTE of inductive and ultrasonic links by finding the optimal geometry for the transmitter (Tx) and receiver (Rx) coils and ultrasonic transducers as well as the optimal operation frequency (fp ). Our simulation and measurement results showed that the ultrasonic link transcends the inductive link in PTE and somewhat in PDL for a small Rx of 1.1 mm3 (diameter of 1.2 mm), particularly when the Rx was deeply implanted inside the tissue (d 12 ≥ 10 mm). However, for a larger 20 mm3 Rx (diameter of 5 mm), the inductive link achieved higher PTE and PDL, particularly at shorter distances (d 12 < 30 mm). The optimal loading condition is shown to be quite different in inductive and ultrasonic links. Despite higher performance for small Rx and large d 12, the ultrasonic link is more sensitive to Rx misalignments and orientations. This led us to propose a new design procedure based on the worst-case misalignment scenario. The simulation results have been validated by measurements. The inductive and ultrasonic links, operating at 30 MHz and 1.1 MHz, achieved measured PTEs of 0.05% and 0.65% for the 1.1 mm3 Rx located 30 mm inside tissue and oil environments with optimal load resistances of 295 Ω and 3.8 kΩ, respectively.

Octopus: A Design Methodology for Motion Capture Wearables

Human motion capture (MoCap) is widely recognised for its usefulness and application in different fields, such as health, sports, and leisure; therefore, its inclusion in current wearables (MoCap-wearables) is increasing, and it may be very useful in a context of intelligent objects interconnected with each other and to the cloud in the Internet of Things (IoT). However, capturing human movement adequately requires addressing difficult-to-satisfy requirements, which means that the applications that are possible with this technology are held back by a series of accessibility barriers, some technological and some regarding usability. To overcome these barriers and generate products with greater wearability that are more efficient and accessible, factors are compiled through a review of publications and market research. The result of this analysis is a design methodology called Octopus, which ranks these factors and schematises them. Octopus provides a tool that can help define design requirements for multidisciplinary teams, generating a common framework and offering a new method of communication between them.

Design for Additive Bio-Manufacturing: From Patient-Specific Medical Devices to Rationally Designed Meta-Biomaterials

Recent advances in additive manufacturing (AM) techniques in terms of accuracy, reliability, the range of processable materials, and commercial availability have made them promising candidates for production of functional parts including those used in the biomedical industry. The complexity-for-free feature offered by AM means that very complex designs become feasible to manufacture, while batch-size-indifference enables fabrication of fully patient-specific medical devices. Design for AM (DfAM) approaches aim to fully utilize those features for development of medical devices with substantially enhanced performance and biomaterials with unprecedented combinations of favorable properties that originate from complex geometrical designs at the micro-scale. This paper reviews the most important approaches in DfAM particularly those applicable to additive bio-manufacturing including image-based design pipelines, parametric and non-parametric designs, metamaterials, rational and computationally enabled design, topology optimization, and bio-inspired design. Areas with limited research have been identified and suggestions have been made for future research. The paper concludes with a brief discussion on the practical aspects of DfAM and the potential of combining AM with subtractive and formative manufacturing processes in so-called hybrid manufacturing processes.

Design Methodology for Magnetic Field-Based Soft Tri-Axis Tactile Sensors

Tactile sensors are essential if robots are to safely interact with the external world and to dexterously manipulate objects. Current tactile sensors have limitations restricting their use, notably being too fragile or having limited performance. Magnetic field-based soft tactile sensors offer a potential improvement, being durable, low cost, accurate and high bandwidth, but they are relatively undeveloped because of the complexities involved in design and calibration. This paper presents a general design methodology for magnetic field-based three-axis soft tactile sensors, enabling researchers to easily develop specific tactile sensors for a variety of applications. All aspects (design, fabrication, calibration and evaluation) of the development of tri-axis soft tactile sensors are presented and discussed. A moving least square approach is used to decouple and convert the magnetic field signal to force output to eliminate non-linearity and cross-talk effects. A case study of a tactile sensor prototype, MagOne, was developed. This achieved a resolution of 1.42 mN in normal force measurement (0.71 mN in shear force), good output repeatability and has a maximum hysteresis error of 3.4%. These results outperform comparable sensors reported previously, highlighting the efficacy of our methodology for sensor design.

Inductive Powering of Subcutaneous Stimulators: Key Parameters and Their Impact on the Design Methodology

Inductive powering of implantable medical devices involves numerous factors acting on the system efficiency and safety in adversarial ways. This paper lightens up their role and identifies a procedure enabling the system design. The latter enables the problem to be decoupled into four principal steps: the frequency choice, the magnetic link optimization, the secondary circuit and then finally the primary circuit designs. The methodology has been tested for the powering system of a device requirering a power of 300mW and implanted at a distance of 15 to 30mm from the outside power source. It allowed the identification of the most critical parameters. A satisfying efficiency of 34% was reached at 21mm and tend to validate the proposed design procedure.

Design Methodology of a Dual-Halbach Array Linear Actuator with Thermal-Electromagnetic Coupling

This paper proposes a design methodology for linear actuators, considering thermal and electromagnetic coupling with geometrical and temperature constraints, that maximizes force density and minimizes force ripple. The method allows defining an actuator for given specifications in a step-by-step way so that requirements are met and the temperature within the device is maintained under or equal to its maximum allowed for continuous operation. According to the proposed method, the electromagnetic and thermal models are built with quasi-static parametric finite element models. The methodology was successfully applied to the design of a linear cylindrical actuator with a dual quasi-Halbach array of permanent magnets and a moving-coil. The actuator can produce an axial force of 120 N and a stroke of 80 mm. The paper also presents a comparative analysis between results obtained considering only an electromagnetic model and the thermal-electromagnetic coupled model. This comparison shows that the final designs for both cases differ significantly, especially regarding its active volume and its electrical and magnetic loading. Although in this paper the methodology was employed to design a specific actuator, its structure can be used to design a wide range of linear devices if the parametric models are adjusted for each particular actuator.

Using of Group-Modeling in Predesign Phase of New Healthcare Environments: Stakeholders Experiences

BACKGROUND

Current research shows a relationship between healthcare architecture and patient-related outcomes. The planning and designing of new healthcare environments is a complex process. The needs of the various end users of the environment must be considered, including the patients, the patients' significant others, and the staff. The aim of this study was to explore the experiences of healthcare professionals participating in group modeling utilizing system dynamics in the predesign phase of new healthcare environments. We engaged healthcare professionals in a series of workshops using system dynamics to discuss the planning of healthcare environments in the beginning of a construction and then interviewed them about their experience.

METHODS

An explorative and qualitative design was used to describe participants' experiences of participating in the group-modeling projects. Participants (N = 20) were recruited from a larger intervention study using group modeling and system dynamics in planning and designing projects. The interviews were analyzed by qualitative content analysis.

RESULTS

Two themes were formed, representing the experiences in the group-modeling process: "Participation in the group modeling generated knowledge and was empowering" and "Participation in the group modeling differed from what was expected and required the dedication of time and skills."

CONCLUSIONS

The method can support participants in design teams to focus more on their healthcare organization, their care activities, and their aims rather than focusing on detailed layout solutions. This clarification is important when decisions about the design are discussed and prepared and will most likely lead to greater readiness for future building process.

Designing With Empathy: Humanizing Narratives for Inspired Healthcare Experiences

OBJECTIVE

Designers can and should play a critical role in shaping a holistic healthcare experience by creating empathetic design solutions that foster a culture of care for patients, families, and staff. Using narrative inquiry as a design tool, this case study shares strategies for promoting empathy.

BACKGROUND

Designing for patient-centered care infuses empathy into the creative process. Narrative inquiry offers a methodology to think about and create empathetic design that enhances awareness, responsiveness, and accountability.

METHODS

This article shares discoveries from a studio on empathetic design within an outpatient cancer care center. The studio engaged students in narrative techniques throughout the design process by incorporating aural, visual, and written storytelling. Benchmarking, observations, and interviews were merged with data drawn from scholarly evidence-based design literature reviews.

RESULTS

Using an empathy-focused design process not only motivated students to be more engaged in the project but facilitated the generation of fresh and original ideas. Design solutions were innovative and impactful in supporting the whole person. Similarities as well as differences defined empathetic cancer care across projects and embodied concepts of design empowerment, design for the whole person, and design for healing.

CONCLUSIONS

By becoming more conscious of empathy, those who create healthcare environments can better connect holistically to the user to take an experiential approach to design. Explicitly developing a mind-set that raises empathy to the forefront of the design process offers a breakthrough in design thinking that bridges the gap between what might be defined as "good design" and patient-centered care.

Usability and Feasibility of PIERS on the Move: An mHealth App for Pre-Eclampsia Triage

Background

Pre-eclampsia is one of the leading causes of maternal death and morbidity in low-resource countries due to delays in case identification and a shortage of health workers trained to manage the disorder. Pre-eclampsia Integrated Estimate of RiSk (PIERS) on the Move (PotM) is a low cost, easy-to-use, mobile health (mHealth) platform that has been created to aid health workers in making decisions around the management of hypertensive pregnant women. PotM combines two previously successful innovations into a mHealth app: the miniPIERS risk assessment model and the Phone Oximeter.

Objective

The aim of this study was to assess the usability of PotM (with mid-level health workers) for iteratively refining the system.

Methods

Development of the PotM user interface involved usability testing with target end-users in South Africa. Users were asked to complete clinical scenario tasks, speaking aloud to give feedback on the interface and then complete a questionnaire. The tool was then evaluated in a pilot clinical evaluation in Tygerberg Hospital, Cape Town.

Results

After ethical approval and informed consent, 37 nurses and midwives evaluated the tool. During Study 1, major issues in the functionality of the touch-screen keyboard and date scroll wheels were identified (total errors n=212); during Study 2 major improvements in navigation of the app were suggested (total errors n=144). Overall, users felt the app was usable using the Computer Systems Usability Questionnaire; median (range) values for Study 1 = 2 (1-6) and Study 2 = 1 (1-7). To demonstrate feasibility, PotM was used by one research nurse for the pilot clinical study. In total, more than 500 evaluations were performed on more than 200 patients. The median (interquartile range) time to complete an evaluation was 4 min 55 sec (3 min 25 sec to 6 min 56 sec).

Conclusions

By including target end-users in the design and evaluation of PotM, we have developed an app that can be easily integrated into health care settings in low- and middle-income countries. Usability problems were often related to mobile phone features (eg, scroll wheels, touch screen use). Larger scale evaluation of the clinical impact of this tool is underway.

Combining users' needs with health behavior models in designing an internet- and mobile-based intervention for physical activity in cardiac rehabilitation

Background

Internet-based physical activity interventions have great potential in supporting patients in cardiac rehabilitation. Health behavior change theories and user input are identified as important contributors in the effectiveness of the interventions, but they are rarely combined in a systematic way in the design of the interventions.

Objective

The aim of this study is to identify the appropriate theoretical framework, along with the needs of the users of a physical activity intervention for cardiac rehabilitation, and to combine them into an effective Internet- and mobile-based intervention.

Methods

We explain the theoretical framework of the intervention in a narrative overview of the existing health behavior change literature as it applies to physical activity. We also conducted a focus group with 11 participants of a cardiac rehabilitation program and used thematic analysis to identify and analyze patterns of meaning in the transcribed data.

Results

We chose stage-based approaches, specifically the transtheoretical model and the health action process approach as our main framework for tailoring, supplemented with other theoretical concepts such as regulatory focus within the appropriate stages. From the thematic analysis of the focus group data, we identified seven themes: (1) social, (2) motivation, (3) integration into everyday life, (4) information, (5) planning, (6) monitoring and feedback, and (7) concerns and potential problems. The final design of the intervention was based on both the theoretical review and the user input, and it is explained in detail.

Conclusions

We applied a combination of health behavioral theory and user input in designing our intervention. We think this is a promising design approach with the potential to combine the high efficacy of theory-based interventions with the higher perceived usefulness of interventions designed according to user input.

Trial Registration

Clinicaltrials.gov NCT01223170; http://clinicaltrials.gov/show/NCT01223170 (Archived by WebCite at http://www.webcitation.org/6M5FqT9Q2).