TY - JOUR AU - Sakazaki, Hiroyuki AU - Noda, Masao AU - Dobashi, Yumi AU - Kuroda, Tatsuaki AU - Tsunoda, Reiko AU - Fushiki, Hiroaki PY - 2025/2/27 TI - Monitoring Nystagmus in a Patient With Vertigo Using a Commercial Mini-Infrared Camera and 3D Printer: Cost-Effectiveness Evaluation and Case Report JO - JMIR Form Res SP - e70015 VL - 9 KW - dizziness KW - vertigo KW - smartphone KW - BPPV KW - telemedicine KW - 3D-printer N2 - Background: Observing eye movements during episodic vertigo attacks is crucial for accurately diagnosing vestibular disorders. In clinical practice, many cases lack observable symptoms or clear findings during outpatient examinations, leading to diagnostic challenges. An accurate diagnosis is essential for timely treatment, as conditions such as benign paroxysmal positional vertigo (BPPV), Ménière?s disease, and vestibular migraine require different therapeutic approaches. Objective: This study aimed to develop and evaluate a cost-effective diagnostic tool that integrates a mini-infrared camera with 3D-printed goggles, enabling at-home recording of nystagmus during vertigo attacks. Methods: A commercially available mini-infrared camera (US $25) was combined with 3D-printed goggles (US $13) to create a system for recording eye movements in dark conditions. A case study was conducted on a male patient in his 40s who experienced recurrent episodic vertigo. Results: Initial outpatient evaluations, including oculomotor and vestibular tests using infrared Frenzel glasses, revealed no spontaneous or positional nystagmus. However, with the proposed system, the patient successfully recorded geotropic direction-changing positional nystagmus during a vertigo attack at home. The nystagmus was beating distinctly stronger on the left side down with 2.0 beats/second than the right side down with 1.2 beats/second. Based on the recorded videos, a diagnosis of lateral semicircular canal-type BPPV was made. Treatment with the Gufoni maneuver effectively alleviated the patient?s symptoms, confirming the diagnosis. The affordability and practicality of the device make it particularly suitable for telemedicine and emergency care applications, enabling patients in remote or underserved areas to receive accurate diagnoses. Conclusions: The proposed system demonstrates the feasibility and utility of using affordable, accessible technology for diagnosing vestibular disorders outside of clinical settings. By addressing key challenges, such as the absence of symptoms during clinical visits and the high costs associated with traditional diagnostic tools, this device offers a practical solution for real-time monitoring and accurate diagnosis. Its potential applications extend to telemedicine, emergency settings, and resource-limited environments. Future iterations that incorporate higher-resolution imaging and automated analysis could further enhance its diagnostic capabilities and usability across diverse patient populations. UR - https://formative.jmir.org/2025/1/e70015 UR - http://dx.doi.org/10.2196/70015 ID - info:doi/10.2196/70015 ER - TY - JOUR AU - Vander Zwalmen, Yannick AU - Hoorelbeke, Kristof AU - Demeester, David AU - Koster, W. Ernst H. PY - 2024/11/29 TI - High-Frequency Cognitive Control Training for Depression: Case Report JO - JMIR Form Res SP - e56598 VL - 8 KW - cognitive control training KW - CCT KW - cognitive function KW - depression KW - recurrence KW - relapse KW - prevention KW - case report KW - working memory KW - memory training KW - task performance KW - digital health N2 - Background: Cognitive control training (CCT) has gained attention in recent years as a preventative intervention in the context of major depressive disorder. To date, uncertainty exists around the working mechanisms of CCT and how its effects unfold overtime. Objective: This study aimed to examine cognitive and affective transfer effects following an unusually high number of training sessions. Methods: This case report presents data of a participant completing a large amount of training sessions (n=55) over the course of 1 year in 2 training phases: 10 initial sessions, followed by 45 additional sessions. Reliable change indices were calculated for several self-report questionnaires, measuring cognitive and affective functioning. Results: Cognitive task performance suggests improved cognitive functioning after training (accuracy scores increased from 43/181, 24% at baseline to 110/181, 61% shortly after training), which was maintained at follow-up (accuracy scores around 50%). Reliable change indices suggest a decrease in depressive symptoms (Beck Depression Inventory-II score decreased from 23 at baseline to 3 following initial training). Similarly, burnout symptoms following CCT showed a similar decrease. Maladaptive emotion regulation strategies displayed high variability, decreasing after periods of training but increasing when no training was performed. However, no changes in repetitive negative thinking were observed. Thematic analysis from an in-depth interview focusing on CCT adherence and user experience pointed to the importance of independency and accessibility of CCT in perceived agency, as well as the need for clear feedback mechanisms following training. Conclusions: Training task performance indicates further increases in performance beyond typical amounts of training sessions (10-20 sessions), hinting that more sessions could be beneficial for continued improvement in cognitive functioning. In line with previous research, CCT decreased depressive symptomatology. However, its effects on emotion regulation remain unclear. Further mechanistic studies into the temporal unfolding of CCT effects are necessary to investigate potential working mechanisms. Trial Registration: ClinicalTrials.gov NCT05166798; https://clinicaltrials.gov/study/NCT05166798 UR - https://formative.jmir.org/2024/1/e56598 UR - http://dx.doi.org/10.2196/56598 UR - http://www.ncbi.nlm.nih.gov/pubmed/39612206 ID - info:doi/10.2196/56598 ER - TY - JOUR AU - Gehringer, E. James AU - Woodruff Jameson, Anne AU - Boyer, Hailey AU - Konieczny, Jennifer AU - Thomas, Ryan AU - Pierce III, James AU - Cunha, B. Andrea AU - Willett, Sandra PY - 2024/9/6 TI - Feasibility of At-Home Hand Arm Bimanual Intensive Training in Virtual Reality: Case Study JO - JMIR Form Res SP - e57588 VL - 8 KW - cerebral palsy KW - HABIT KW - home intervention KW - virtual reality KW - rehabilitation KW - VR KW - case study KW - hand KW - hands KW - arm KW - arms KW - intensive training KW - feasibility KW - game KW - games KW - gaming KW - hand arm bimanual intensive training KW - motor KW - movement KW - home setting KW - home-based KW - child KW - children KW - male KW - males KW - men KW - quasi-experimental KW - parent KW - parents KW - intervention KW - interventions UR - https://formative.jmir.org/2024/1/e57588 UR - http://dx.doi.org/10.2196/57588 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/57588 ER - TY - JOUR AU - Mancinelli, Elisa AU - Magnolini, Simone AU - Gabrielli, Silvia AU - Salcuni, Silvia PY - 2024/8/14 TI - A Chatbot (Juno) Prototype to Deploy a Behavioral Activation Intervention to Pregnant Women: Qualitative Evaluation Using a Multiple Case Study JO - JMIR Form Res SP - e58653 VL - 8 KW - chatbot prototype KW - co-design KW - pregnancy KW - prevention KW - behavioral activation KW - multiple case study N2 - Background: Despite the increasing focus on perinatal care, preventive digital interventions are still scarce. Furthermore, the literature suggests that the design and development of these interventions are mainly conducted through a top-down approach that limitedly accounts for direct end user perspectives. Objective: Building from a previous co-design study, this study aimed to qualitatively evaluate pregnant women?s experiences with a chatbot (Juno) prototype designed to deploy a preventive behavioral activation intervention. Methods: Using a multiple?case study design, the research aims to uncover similarities and differences in participants? perceptions of the chatbot while also exploring women?s desires for improvement and technological advancements in chatbot-based interventions in perinatal mental health. Five pregnant women interacted weekly with the chatbot, operationalized in Telegram, following a 6-week intervention. Self-report questionnaires were administered at baseline and postintervention time points. About 10-14 days after concluding interactions with Juno, women participated in a semistructured interview focused on (1) their personal experience with Juno, (2) user experience and user engagement, and (3) their opinions on future technological advancements. Interview transcripts, comprising 15 questions, were qualitatively evaluated and compared. Finally, a text-mining analysis of transcripts was performed. Results: Similarities and differences have emerged regarding women?s experiences with Juno, appreciating its esthetic but highlighting technical issues and desiring clearer guidance. They found the content useful and pertinent to pregnancy but differed on when they deemed it most helpful. Women expressed interest in receiving increasingly personalized responses and in future integration with existing health care systems for better support. Accordingly, they generally viewed Juno as an effective momentary support but emphasized the need for human interaction in mental health care, particularly if increasingly personalized. Further concerns included overreliance on chatbots when seeking psychological support and the importance of clearly educating users on the chatbot?s limitations. Conclusions: Overall, the results highlighted both the positive aspects and the shortcomings of the chatbot-based intervention, providing insight into its refinement and future developments. However, women stressed the need to balance technological support with human interactions, particularly when the intervention involves beyond preventive mental health context, to favor a greater and more reliable monitoring. UR - https://formative.jmir.org/2024/1/e58653 UR - http://dx.doi.org/10.2196/58653 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/58653 ER - TY - JOUR AU - Iliakis, Ioannis AU - Anagnostouli, Maria AU - Chrousos, George PY - 2024/7/25 TI - Assessing the Impact of the Mindfulness-Based Body Scan Technique on Sleep Quality in Multiple Sclerosis Using Objective and Subjective Assessment Tools: Single-Case Study JO - JMIR Form Res SP - e55408 VL - 8 KW - multiple sclerosis KW - MS KW - sleep problems KW - electronic portable device KW - EPD KW - mindfulness-based body scan technique KW - sleep quality KW - neurodegenerative disease KW - quality of life KW - anxiety KW - pain KW - nocturia KW - assessment tools KW - single-case study KW - effectiveness N2 - Background: Multiple sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system, often leading to poor sleep quality and diminished quality of life (QoL) for affected patients. Sleep disturbances in MS do not always correlate linearly with other symptoms such as anxiety, depression, fatigue, or pain. Various approaches, including stress reduction techniques such as mindfulness-based interventions, have been proposed to manage MS-related sleep issues. Objective: The aim of this study was to evaluate the effects of the mindfulness-based body scan technique on sleep quality and QoL in patients with MS using both subjective (questionnaires) and objective (electronic portable device) measures. Methods: A single-case study was performed involving a 31-year-old woman diagnosed with relapsing-remitting MS. The patient practiced the mindfulness-based body scan technique daily before bedtime and outcomes were compared to measures evaluated at baseline. Results: The mindfulness-based body scan intervention demonstrated positive effects on both sleep quality and overall QoL. Biometric data revealed a notable dissociation between daily stress levels and sleep quality during the intervention period. Although self-report instruments indicated significant improvement, potential biases were noted. Conclusions: While this study is limited to a single patient, the promising outcomes suggest the need for further investigation on a larger scale. These findings underscore the potential benefits of the mindfulness-based body scan technique in managing sleep disturbances and enhancing QoL among patients with MS. UR - https://formative.jmir.org/2024/1/e55408 UR - http://dx.doi.org/10.2196/55408 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/55408 ER - TY - JOUR AU - Jacobucci, Ross AU - Ammerman, Brooke AU - Ram, Nilam PY - 2024/3/20 TI - Examining Passively Collected Smartphone-Based Data in the Days Prior to Psychiatric Hospitalization for a Suicidal Crisis: Comparative Case Analysis JO - JMIR Form Res SP - e55999 VL - 8 KW - screenomics KW - digital phenotyping KW - passive assessment KW - intensive time sampling KW - suicide risk KW - suicidal behaviors KW - risk detection KW - Comparative Analysis KW - suicide KW - suicidal KW - risk KW - risks KW - behavior KW - behaviors KW - detection KW - prediction KW - Smartphone-Based KW - screenomic KW - case review KW - participant KW - participants KW - smartphone KW - smartphones KW - suicidal ideation N2 - Background: Digital phenotyping has seen a broad increase in application across clinical research; however, little research has implemented passive assessment approaches for suicide risk detection. There is a significant potential for a novel form of digital phenotyping, termed screenomics, which captures smartphone activity via screenshots. Objective: This paper focuses on a comprehensive case review of 2 participants who reported past 1-month active suicidal ideation, detailing their passive (ie, obtained via screenomics screenshot capture) and active (ie, obtained via ecological momentary assessment [EMA]) risk profiles that culminated in suicidal crises and subsequent psychiatric hospitalizations. Through this analysis, we shed light on the timescale of risk processes as they unfold before hospitalization, as well as introduce the novel application of screenomics within the field of suicide research. Methods: To underscore the potential benefits of screenomics in comprehending suicide risk, the analysis concentrates on a specific type of data gleaned from screenshots?text?captured prior to hospitalization, alongside self-reported EMA responses. Following a comprehensive baseline assessment, participants completed an intensive time sampling period. During this period, screenshots were collected every 5 seconds while one?s phone was in use for 35 days, and EMA data were collected 6 times a day for 28 days. In our analysis, we focus on the following: suicide-related content (obtained via screenshots and EMA), risk factors theoretically and empirically relevant to suicide risk (obtained via screenshots and EMA), and social content (obtained via screenshots). Results: Our analysis revealed several key findings. First, there was a notable decrease in EMA compliance during suicidal crises, with both participants completing fewer EMAs in the days prior to hospitalization. This contrasted with an overall increase in phone usage leading up to hospitalization, which was particularly marked by heightened social use. Screenomics also captured prominent precipitating factors in each instance of suicidal crisis that were not well detected via self-report, specifically physical pain and loneliness. Conclusions: Our preliminary findings underscore the potential of passively collected data in understanding and predicting suicidal crises. The vast number of screenshots from each participant offers a granular look into their daily digital interactions, shedding light on novel risks not captured via self-report alone. When combined with EMA assessments, screenomics provides a more comprehensive view of an individual?s psychological processes in the time leading up to a suicidal crisis. UR - https://formative.jmir.org/2024/1/e55999 UR - http://dx.doi.org/10.2196/55999 UR - http://www.ncbi.nlm.nih.gov/pubmed/38506916 ID - info:doi/10.2196/55999 ER -