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The CeHRes Roadmap 2.0:Update of a Holistic Framework for Development, Implementation, and Evaluation of eHealth Technologies
Get PDFTo ensure that an eHealth technology fits with its intended users, other stakeholders, and the context within which it will be used, thorough development, implementation, and evaluation processes are necessary. The CeHRes (Centre for eHealth and Wellbeing Research) Roadmap is a framework that can help shape these processes. While it has been successfully used in research and practice, new developments and insights have arisen since the Roadmap’s first publication in 2011, not only within the domain of eHealth but also within the different disciplines in which the Roadmap is grounded. Because of these new developments and insights, a revision of the Roadmap was imperative. This paper aims to present the updated pillars and phases of the CeHRes Roadmap 2.0. The Roadmap was updated based on four types of sources: (1) experiences with its application in research; (2) literature reviews on eHealth development, implementation, and evaluation; (3) discussions with eHealth researchers; and (4) new insights and updates from relevant frameworks and theories. The updated pillars state that eHealth development, implementation, and evaluation (1) are ongoing and intertwined processes; (2) have a holistic approach in which context, people, and technology are intertwined; (3) consist of continuous evaluation cycles; (4) require active stakeholder involvement from the start; and (5) are based on interdisciplinary collaboration. The CeHRes Roadmap 2.0 consists of 5 interrelated phases, of which the first is the contextual inquiry, in which an overview of the involved stakeholders, the current situation, and points of improvement is created. The findings from the contextual inquiry are specified in the value specification, in which the foundation for the to-be-developed eHealth technology is created by formulating values and requirements, preliminarily selecting behavior change techniques and persuasive features, and initiating a business model. In the Design phase, the requirements are translated into several lo-fi and hi-fi prototypes that are iteratively tested with end users and other stakeholders. A version of the technology is rolled out in the Operationalization phase, using the business model and an implementation plan. In the Summative Evaluation phase, the impact, uptake, and working mechanisms are evaluated using a multimethod approach. All phases are interrelated by continuous formative evaluation cycles that ensure coherence between outcomes of phases and alignment with stakeholder needs. While the CeHRes Roadmap 2.0 consists of the same phases as the first version, the objectives and pillars have been updated and adapted, reflecting the increased emphasis on behavior change, implementation, and evaluation as a process. There is a need for more empirical studies that apply and reflect on the CeHRes Roadmap 2.0 to provide points of improvement because just as with any eHealth technology, the Roadmap has to be constantly improved based on the input of its users.</p
From Single to Multi‐Material 3D Printing of Glass‐Ceramics for Micro‐Optics
Get PDFFeynman's statement, “There is plenty of room at the bottom”, underscores vast potential at the atomic scale, envisioning microscopic machines. Today, this vision extends into 3D space, where thousands of atoms and molecules are volumetrically patterned to create light‐driven technologies. To fully harness their potential, 3D designs must incorporate high‐refractive‐index elements with exceptional mechanical and chemical resilience. The frontier, however, lies in creating spatially patterned micro‐optical architectures in glass and ceramic materials of dissimilar compositions. This multi‐material capability enables novel ways of shaping light, leveraging the interaction between diverse interfaced chemical compositions to push optical boundaries. Specifically, it encompasses both multi‐material integration within the same architectures and the use of different materials for distinct architectural features in an optical system. Integrating fluid handling systems with two‐photon lithography (TPL) provides a promising approach for rapidly prototyping such complex components. This review examines single and multi‐material TPL processes, discussing photoresin customization, essential physico‐chemical conditions, and the need for cross‐scale characterization to assess optical quality. It reflects on challenges in characterizing multi‐scale architectures and outlines advancements in TPL for both single and spatially patterned multi‐material structures. The roadmap provides a bridge between research and industry, emphasizing collaboration and contributions to advancing micro‐optics
Examining the nonlinear effects of traffic and built environment factors on the traffic safety of cyclist from different age groups
Get PDFIn the Netherlands and all over the world, traffic safety problem has been growing particularly for cyclists over the last decades with more people shifting to cycling as a healthy and sustainable mode of transport. Literature shows that age is an important factor in crash involvement and consequences; however, few studies identify the risk factors for cyclists from across different age groups. Therefore, this study aims to identify and understand the effects of traffic, infrastructure, and land use factors on vehicle-to-bike injury and fatal crashes involving cyclists from different age groups. For this purpose, we adopted an approach consisting of resampling and machine learning (XGBoost-Tweedie) techniques to analyse police-reported crashes between the years 2015 and 2019 in the Netherlands. The analysis shows that effects of external variables on crashes widely vary among different age groups and the analysis of total crash rates may not disclose the nature of crashes of cyclist from different age groups. The analysis also shed light on the nonlinear effects of traffic and built environment factors on cyclist crashes, which are usually disregarded in the traffic safety literature. The proposed approach and findings provide a profound understanding of the nature of cyclist crashes and the complex relationships between factors, which can contribute to developing effective crash prevention strategies tailored to different age groups.</p
A Preliminary Study of the Pulse Oximetry for Early Breast Cancer Detection
Get PDFBreast cancer is a critical health issue globally, with a high incidence rate especially in the Netherlands, where around one of eight women develop the disease during the lifetime. Early detection could enhance the survival rate. However, current methodologies like the mammography have the problems of low accessibility, high cost, and less reliability. This study proposed a novel screening method using an array of pulse oximeters, a potentially low-cost but highly accessible strategy, to detect the early signs of breast cancer through the hypoxia measurement. This approach used the phenomenon that the early-stage breast cancer cells consume increased amounts of oxygen for growth, thereby changing the oxygen levels in the blood. In this study, a simple setup including six pulse oximetry sensors was developed. It was compared with a commercial finger pulse oximeter on the wrist for basic operational verification. Next, a phantom model was created to simulate breast tissues. This was used to test whether the pulse oximetry sensors could detect the low oxygen levels caused by breast cancer. The experimental design tested various sensor configurations and performed comparative analyses to establish a baseline of the accuracy and reliability for the sensors under different oxygen-level conditions. The results showed that the pulse oximetry setup could detect variations of oxygen saturation, which might correlate with the hypoxic conditions from the breast tumours. However, effectively using it for breast screening is still challenging due to the deep location and specific nature of low oxygen levels of breast cancer, which differ from the surface-level measurements typically using this technology. Future research will adapt the proposed design to directly measure the oxygen level from the breast tissues. In addition, the next step will also focus on enhancing sensor sensitivity and specificity for the breast tissue hypoxia and validating in a clinical setting. This study explored an innovative use of pulse oximetry for early breast cancer detection. It paved the way for developing more accessible and less invasive breast cancer screening methods, potentially increasing the early detection rates and survival rates
Evaluating environmental indicators for eco-labeling within the European railway sector: towards adaptive and sustainable transportation systems
No full textEnvironmental indicators are key to eco-labeling schemes, helping assess and improve sustainability performance in the railway sector. Under the European Green Deal, this study evaluates the role of these indicators in creating adaptive, human-centric, and sustainable transportation systems. Through analysis of fifteen European railway companies, we categorize indicators into energy, circularity, noise, and environmental impact. These indicators support real-time monitoring, regulatory compliance, and data-driven decision-making, promoting sustainability goals. Additionally, we examine the role of life-cycle assessment (LCA) methodologies, and their implications on classification within eco-labeling schemes. By connecting eco-labeling schemes with Type I, II, and III labels, this research highlights pathways to enhance sustainability in adaptive transportation networks
Towards Resilient Construction Logistics with Digital Twins
Get PDFEfficient logistics management is key for maintaining project timelines, controlling budgets, and enhancing productivity and promoting sustainability within the construction industry. However, challenges such as delays in material delivery, equipment malfunctions, and labor shortages require effective management strategies to prevent significant disruptions. This research explores the application of digital twin (DT) technology to optimize construction planning and execution through real-time monitoring, simulation, and analysis. By leveraging advanced sensing and communication technologies, this study aims to develop and validate DT models specifically tailored for construction logistics. The anticipated outcomes include improved decision-making, enhanced collaboration, and increased efficiency, which are expected to result in reduced costs and shortened timelines. The findings have the potential to strengthen the competitiveness and operational efficiency of the construction industry
Transforming Healthcare with Lean:Hospital-wide Change, Dynamic Capabilities, and Relational Coordination
Get PDFHospitals face growing challenges, including increasing patient demand, financial constraints, and workforce shortages. To address these, Lean management has emerged as a promising approach. However, its implementation in healthcare remains fragmented, often limited to isolated improvement initiatives rather than a hospital-wide system. My PhD research investigates how Lean can be implemented as a comprehensive management system in academic hospitals to foster continuous improvement and learning, ultimately enhancing performance.The research consists of three interrelated studies:1. Lean Implementation Strategies: The first study examines top-down and bottom-up Lean implementation approaches. It proposes a hybrid implementation model that balances centralized planning with participatory learning processes, ensuring alignment across all hospital levels.2. Developing Continuous Improvement as a Dynamic Capability: The second study conceptualizes continuous improvement as a dynamic capability, showing how Lean routines evolve into hospital-wide learning and adaptation mechanisms. A structured framework demonstrates how organizations can build sustainable improvement systems.3. Lean and Relational Coordination: The third study explores how different Lean learning stages influence relational coordination (RC) and, in turn, hospital performance. Findings highlight the necessity of a shared Lean infrastructure—daily stand-ups, Gemba walks, Kaizen events—to bridge organizational silos and enhance coordination.This research underscores that Lean is not merely a set of process optimization tools but a holistic system integrating technical and relational elements. By embedding Lean as a learning system, hospitals can systematically improve quality, collaboration, and adaptability, ensuring sustainable healthcare transformation.<br/
Selectivity Versus Noise Trade-Offs in Resistively Driven Passive Switched-Capacitor Infinite Impulse Response Low-Pass Filters
Get PDFIn this article, we derive a practical limit on the maximum achievable selectivity of three commonly used Passive Switched-Capacitor (PSC) Infinite-Impulse Response (IIR) low-pass filter (LPF) topologies driven from a resistive source. We show that filter topology selection and component dimensioning aimed to improve the selectivity of these filters will necessarily degrade the Noise Figure (NF), revealing a selectivity versus NF trade-off. We subsequently capture this in selectivity versus NF graphs. These graphs quantify the limitations on achievable selectivity and NF for each topology given the number of filter poles, and graphically provide guidance in navigating the trade-off between them. The three considered topologies mainly differ in how the sampling capacitor resets, inverts, or holds its voltage between clock periods. We capture the handling of the sampling capacitor as a new design parameter. We derive a singular model to encompass the entire design space consisting of the three topologies, filter order (number of history/integration capacitors), clock frequency, and component dimensions. The model comprises an adjoint network with a state-space description and is used to analyze the filter transfer function (to quantify selectivity), input-and output-referred noise, and NF.</p
A school-based program to prevent depressive symptoms and strengthen well-being among pre-vocational students (Happy Lessons):Results of a randomized controlled trial
Get PDFBackground: Many adolescents experience depressive symptoms, with even higher prevalences among lower-educated Dutch students. Effective prevention programs for these students are scarce but needed. This randomized controlled trial (RCT) investigates the effectiveness of school-based prevention program Happy Lessons (HL) among Dutch pre-vocational students. Methods: Classes within schools were randomized to intervention (n = 124) or waitlist control group (n = 143). Students (n = 267, aged 11 to 15) completed questionnaires at baseline, 3- and 6-month follow-up. The primary outcome was depressive symptoms. Secondary outcomes were well-being and life satisfaction. Linear mixed models were executed, based on the intention-to-treat principle. Explorative analysis of the effect of HL on potential mechanisms such as class and school environmental variables was conducted. Trial registration: Dutch Trial Register NL9732. Results: This study found no statistically significant differences in favor of the intervention group on depressive symptoms (T1: Cohen's d [95 % CI] = -0.21[-0.49;0.07], T2: -0.20 [-0.48;0.08]), well-being (T1: 0.24 [-0.04;0.52], T2: 0.18 [-0.10;0.47]), life satisfaction (T1: 0.03 [-0.25;0.31], T2: 0.10 [-0.18;0.39]), classmate support (T1: -0.20 [-0.48;0.08], T2: -0.14 [-0.43;0.14]), school connectedness (T1: -0.08 [-0.36;0.20], T2: 0.20 [-0.08;0.49]), bullying others (T1: OR[CI] = 0.95 [0.68;1.32], T2: 0.92 [0.66;1.29]) and bullying victimization (T1: OR[CI] = 1.93 [0.73;5.15], T2: 1.61 [0.62;4.20]). Significant moderate effects were found on teacher support in favor of the intervention group at T1 (d[CI] = -0.37 [-0.65;-0.08]) and control group at T2 (d[CI] = 0.35 [0.07;0.64]). Conclusions: Further research should focus on the working mechanisms of school-based depression prevention programs and how to successfully implement these programs in the school context.</p
Frequency-Domain Decoding of Cascaded Dual-Polarity Waves for Ultrafast Ultrasound Imaging
Get PDFUltrafast plane-wave (PW) ultrasound imaging is a versatile tool that has become increasingly relevant for blood flow imaging using speckle tracking but suffers from a low signal-to-noise ratio (SNR). Cascaded dual-polarity wave (CDW) imaging can improve the SNR by transmitting pulse trains, which are subsequently decoded to recover the imaging resolution. However, the current decoding method (in the time domain) requires a set of two acquisitions, which introduces motion artifacts that result in incorrect speckle tracking at high flow velocities. Here, we evaluate an inverse filtering approach that uses frequency-domain decoding to decode acquisitions independently. Experiments using a disk phantom show that frequency-domain decoding of a four-pulse train achieves an SNR gain of up to 4.2 dB, versus 5.9 dB for conventional decoding. The benefit of frequency-domain decoding for flow quantification is assessed through experiments performed with a rotating disk phantom and a parabolic flow, and through matching linear simulations. Both CDW methods improve the tracking accuracy compared to single PW imaging. Time-domain decoding outperforms frequency-domain decoding in low SNR conditions and low velocities (≤ 0.25 m/s), as a result of the higher SNR gain. In contrast, frequency-domain decoding outperforms time-domain decoding for high peak velocities in imaging of the rotating disk (1 m/s) and of the parabolic flow (2 m/s), when significant scatterer motion between acquisitions causes imperfect time-domain decoding. Its ability to decode individual acquisitions makes the used frequency-domain decoding of CDW (F-CDW) a promising approach to improve the SNR and thereby the accuracy of flow quantification at high velocities.</p