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BackgroundSleep games are an emerging topic in the realm of serious health game research. However, designing features that are both enjoyable and effective at engaging users, particularly university students, to develop healthy sleep habits remains a challenge. ObjectiveThis study aims to investigate user preferences for 3 sleep game prototypes, that is, Hero’s Sleep Journey, Sleep Tamagotchi, and Sleepland, and to explore their popularity and perceived utility in promoting sleep health. MethodsA mixed methods approach was used in this study. Quantitative and qualitative data were collected through a co-design workshop involving 47 university students. Participants were presented with storyboard cards of game features and were asked to provide an overall rating on each game, as well as ratings for individual features. They were also encouraged to provide free-form comments on the features and suggest improvements. In addition, participants were asked to express their preferences among the 3 games regarding which game they would most like to play and which one they found most useful for promoting sleep health. ResultsSurprisingly, while Hero’s Sleep Journey was the most popular choice among participants, Sleep Tamagotchi was perceived as the most beneficial for improving sleep health. Relevance emerged as an overarching theme in the qualitative data analysis, with 3 interconnected dimensions: psychological relevance to users’ personal lives, logical relevance to sleep health, and situational relevance to users’ circumstantial context. We discussed how the 3 dimensions of relevance address the autonomy and relatedness constructs outlined in the self-determination theory and proposed 3 design recommendations. ConclusionsOur serious sleep game prototypes demonstrated the potential to engage university students to develop healthy sleep hygiene. Future sleep game designs should aim to create a sense of relevance to users’ personal lives, sleep health goals, and situational contexts. Rather than a one-size-fits-all approach, it is essential to develop a wide range of game genres and features to cater to diverse users. Aligning game features with sleep health goals and educating users on the design rationale through sleep knowledge are also important aspects. Furthermore, allowing users to customize their game experience and manage technology boundaries is necessary to nurture a sense of control and autonomy in the process of forming good sleep hygiene.

BackgroundSound therapy methods have seen a surge in popularity, with a predominant focus on music among all types of sound stimulation. There is substantial evidence documenting the integrative impact of music therapy on psycho-emotional and physiological outcomes, rendering it beneficial for addressing stress-related conditions such as pain syndromes, depression, and anxiety. Despite these advancements, the therapeutic aspects of sound, as well as the mechanisms underlying its efficacy, remain incompletely understood. Existing research on music as a holistic cultural phenomenon often overlooks crucial aspects of sound therapy mechanisms, particularly those related to speech acoustics or the so-called “music of speech.” ObjectiveThis study aims to provide an overview of empirical research on sound interventions to elucidate the mechanism underlying their positive effects. Specifically, we will focus on identifying therapeutic factors and mechanisms of change associated with sound interventions. Our analysis will compare the most prevalent types of sound interventions reported in clinical studies and experiments. Moreover, we will explore the therapeutic effects of sound beyond music, encompassing natural human speech and intermediate forms such as traditional poetry performances. MethodsThis review adheres to the methodological guidance of the Joanna Briggs Institute and follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist for reporting review studies, which is adapted from the Arksey and O’Malley framework. Our search strategy encompasses PubMed, Web of Science, Scopus, and PsycINFO or EBSCOhost, covering literature from 1990 to the present. Among the different study types, randomized controlled trials, clinical trials, laboratory experiments, and field experiments were included. ResultsData collection began in October 2022. We found a total of 2027 items. Our initial search uncovered an asymmetry in the distribution of studies, with a larger number focused on music therapy compared with those exploring prosody in spoken interventions such as guided meditation or hypnosis. We extracted and selected papers using Rayyan software (Rayyan) and identified 41 eligible papers after title and abstract screening. The completion of the scoping review is anticipated by October 2024, with key steps comprising the analysis of findings by May 2024, drafting and revising the study by July 2024, and submitting the paper for publication in October 2024. ConclusionsIn the next step, we will conduct a quality evaluation of the papers and then chart and group the therapeutic factors extracted from them. This process aims to unveil conceptual gaps in existing studies. Gray literature sources, such as Google Scholar, ClinicalTrials.gov, nonindexed conferences, and reference list searches of retrieved studies, will be added to our search strategy to increase the number of relevant papers that we cover. International Registered Report Identifier (IRRID)DERR1-10.2196/54030

This study delves into the relationship between students' response time and response accuracy in Kahoot! quiz games, within the context of an app development course for first year university students. Previous research on response time in standardized tests has suggested that longer response time are often linked to correct answers, a phenomenon known as speed-accuracy trade-off. However, our study represents one of the initial investigations into this relationship within gamified online quizzes. Unlike standardized tests, each of our Kahoot! quiz modules consisted of only five single choice or true/false questions, with a time limit for each question and instantaneous feedback provided during game play. Drawing from data collected from 21 quiz modules spanning from 2022 to 2023, we compiled a dataset comprising 4640 response-time/accuracy entries. Mann-Whitney U tests revealed significant differences in normalized response time between correct answers and wrong answers in 17 out of the 21 quiz modules, with wrong answers exhibiting longer response time. The effect size of this phenomenon varied from modest to moderate. Additionally, we observed significant negative correlations between normalized overall response time and overall accuracy across all quiz modules, with only two exceptions. These findings challenge the notion of the speed-accuracy trade-off but align with some previous studies that have identified heterogeneity speed-accuracy relationships in standardized tests. We contextualized our findings within the framework of dual processing theory and underscored their implications to learning assessment in online quiz environments.

People form impressions about others during daily social encounters and infer personality traits from others' behaviors. Such trait inference is thought to rely on two universal dimensions: competence and warmth. These two dimensions can be used to construct a ‘social cognitive map’ organizing massive information obtained from social encounters efficiently. Originating from spatial cognition, the neural codes supporting the representation and navigation of spatial cognitive maps have been widely studied. Recent studies suggest similar neural mechanism subserves the map-like architecture in social cognition as well. Here we investigated how spatial codes operate beyond the physical environment and support the representation and navigation of social cognitive map. We designed a social value space defined by two dimensions of competence and warmth. Behaviorally, participants were able to navigate to a learned location from random starting locations in this abstract social space. At the neural level, we identified the representation of distance in the precuneus, fusiform gyrus, and middle occipital gyrus. We also found partial evidence of grid-like representation patterns in the medial prefrontal cortex and entorhinal cortex. Moreover, the intensity of grid-like response scaled with the performance of navigating in social space and social avoidance trait scores. Our findings suggest a neurocognitive mechanism by which social information can be organized into a structured representation, namely cognitive map and its relevance to social well-being.

Prompt engineering, the process of arranging input or prompts given to a large language model to guide it in producing desired outputs, is an emerging field of research that shapes how these models understand tasks, process information, and generate responses in a wide range of natural language processing (NLP) applications. Digital mental health, on the other hand, is becoming increasingly important for several reasons including early detection and intervention, and to mitigate limited availability of highly skilled medical staff for clinical diagnosis. This short review outlines the latest advances in prompt engineering in the field of NLP for digital mental health. To our knowledge, this review is the first attempt to discuss the latest prompt engineering types, methods, and tasks that are used in digital mental health applications. We discuss three types of digital mental health tasks: classification, generation, and question answering. To conclude, we discuss the challenges, limitations, ethical considerations, and future directions in prompt engineering for digital mental health. We believe that this short review contributes a useful point of departure for future research in prompt engineering for digital mental health.

University students often experience sleep disturbances and disorders. Personal digital technologies present a great opportunity for sleep health promotion targeting this population. However, studies that engage university students in designing and implementing digital sleep health technologies are scarce. This study sought to understand how we could build digital sleep health technologies that meet the needs of university students through a co-design process. We conducted three co-design workshops with 51 university students to identify design opportunities and to generate features for sleep health apps through workshop activities. The generated ideas were organized using the stage-based model of self-tracking so that our findings could be well-situated within the context of personal health informatics. Our findings contribute new design opportunities for sleep health technologies targeting university students along the dimensions of sleep environment optimization, online community, gamification, generative AI, materializing sleep with learning, and personalization.

Objective Sleep apnea is a common sleep disorder affecting a significant portion of the population, but many apnea patients remain undiagnosed because existing clinical tests are invasive and expensive. This study aimed to develop a method for easy sleep apnea screening. Methods Three supervised machine learning algorithms, including logistic regression, support vector machine, and light gradient boosting machine, were applied to develop apnea screening models at two apnea–hypopnea index cutoff thresholds: ≥ 5 and ≥ 30 events/hours. The SpO2 recordings of the Sleep Heart Health Study database ( N = 5786) were used for model training, validation, and test. Multiscale entropy analysis was performed to derive a set of multiscale attention entropy features from the SpO2 recordings. Demographic features including age, sex, body mass index, and blood pressure were also used. The dependency among the multiscale attention entropy features were handled with the independent component analysis. Results For cutoff ≥ 5/hours, logistic regression model achieved the highest Matthew’s correlation coefficient (0.402) and area under the curve (0.747), and reasonably good sensitivity (75.38%), specificity (74.02%), and positive predictive value (92.94%). For cutoff ≥ 30/hours, support vector machine model achieved the highest Matthew’s correlation coefficient (0.545) and area under the curve (0.823), and good sensitivity (82.00%), specificity (82.69%), and negative predictive value (95.53%). Conclusions Our models achieved better performance than existing methods and have the potential to be integrated with home-use pulse oximeters.

BackgroundOver the past few decades, there has been a rapid increase in the number of wearable sleep trackers and mobile apps in the consumer market. Consumer sleep tracking technologies allow users to track sleep quality in naturalistic environments. In addition to tracking sleep per se, some sleep tracking technologies also support users in collecting information on their daily habits and sleep environments and reflecting on how those factors may contribute to sleep quality. However, the relationship between sleep and contextual factors may be too complex to be identified through visual inspection and reflection. Advanced analytical methods are needed to discover new insights into the rapidly growing volume of personal sleep tracking data. ObjectiveThis review aimed to summarize and analyze the existing literature that applies formal analytical methods to discover insights in the context of personal informatics. Guided by the problem-constraints-system framework for literature review in computer science, we framed 4 main questions regarding general research trends, sleep quality metrics, contextual factors considered, knowledge discovery methods, significant findings, challenges, and opportunities of the interested topic. MethodsWeb of Science, Scopus, ACM Digital Library, IEEE Xplore, ScienceDirect, Springer, Fitbit Research Library, and Fitabase were searched to identify publications that met the inclusion criteria. After full-text screening, 14 publications were included. ResultsThe research on knowledge discovery in sleep tracking is limited. More than half of the studies (8/14, 57%) were conducted in the United States, followed by Japan (3/14, 21%). Only a few of the publications (5/14, 36%) were journal articles, whereas the remaining were conference proceeding papers. The most used sleep metrics were subjective sleep quality (4/14, 29%), sleep efficiency (4/14, 29%), sleep onset latency (4/14, 29%), and time at lights off (3/14, 21%). Ratio parameters such as deep sleep ratio and rapid eye movement ratio were not used in any of the reviewed studies. A dominant number of the studies applied simple correlation analysis (3/14, 21%), regression analysis (3/14, 21%), and statistical tests or inferences (3/14, 21%) to discover the links between sleep and other aspects of life. Only a few studies used machine learning and data mining for sleep quality prediction (1/14, 7%) or anomaly detection (2/14, 14%). Exercise, digital device use, caffeine and alcohol consumption, places visited before sleep, and sleep environments were important contextual factors substantially correlated to various dimensions of sleep quality. ConclusionsThis scoping review shows that knowledge discovery methods have great potential for extracting hidden insights from a flux of self-tracking data and are considered more effective than simple visual inspection. Future research should address the challenges related to collecting high-quality data, extracting hidden knowledge from data while accommodating within-individual and between-individual variations, and translating the discovered knowledge into actionable insights.

This research presents a cross-platform application, developed with Flutter, for the efficient integration and management of real-time data from wearable sensors including Apple Watch, Android Wear, and Empatica E4. Compatible with iOS and Android, the app collects various physiological signals for easy analysis by health professionals. Utilizing InfluxDB, a time-series database, our development ensures efficient data handling, even from multiple sources, and enables real-time analytics. This robust, scalable tool signifies a notable advancement in mHealth, offering seamless data integration and management for those utilizing wearable sensor technology in healthcare research and practice.

In this paper, we developed ensemble classifiers with SpO2 signals for sleep apnea screening. The ensemble classifiers (eclf) were built on top of five base classifiers, including logistic regression (LR), random forest (RF), support vector machine (SVM), linear discrimination analysis (LDA), and light gradient boosting machine (LGMB). Performance evaluation showed that when heavier weights were assigned to the LR and SVM classifiers, the ECLF achieved a better balance between sensitivity (0.81 ± 0.02) and specificity (0.80 ± 0.02) while maintaining the overall performance as measured by AUC (0.81 ± 0.01).

It is often assumed that healthy people have the genuine ability to maintain tight blood glucose regulation. However, a few recent studies revealed that glucose dysregulation such as hyperglycemia may occur even in people who are considered normoglycemic by standard measures and were more prevalent than initially thought, suggesting that more investigations are needed to fully understand the within-day glucose dynamics of healthy people. In this paper, we conducted an analysis on a multi-modal dataset to examine the relationships between glycemic variability when people were awake and that when they were sleeping. The interstitial glucose levels were measured with a wearable continuous glucose monitoring (CGM) technology FreeStyle Libre 2 at every 15 min interval. In contrast to the traditional single-time-point measurements, the CGM data allow the investigation into the temporal patterns of glucose dynamics at high granularity. Sleep onset and offset timestamps were recorded daily with a Fitbit Charge 3 wristband. Our analysis leveraged the sleep data to split the glucose readings into segments of awake-time and in-sleep, instead of using fixed cut-off time points as has been done in existing literature. We combined repeated measure correlation analysis and quantitative association rules mining, together with an original post-filtering method, to identify significant and most relevant associations. Our results showed that low overall glucose in awake time was strongly correlated to low glucose in subsequent sleep, which in turn correlated to overall low glucose in the next day. Moreover, both analysis techniques identified significant associations between the minimal glucose reading in sleep and the low blood glucose index the next day. In addition, the association rules discovered in this study achieved high confidence (0.75–0.88) and lift (4.1–11.5), which implies that the proposed post-filtering method was effective in selecting quality rules.

Micro-expressions are fleeting and subtle emotional expressions. As they are spontaneous and uncontrollable by one’s mind, micro-expressions are considered an indicator of genuine emotions. Their accurate recognition and interpretation promote interpersonal interaction and social communication. Therefore, enhancing the ability to recognize micro-expressions has captured much attention. In the current study, we investigated the effects of training on micro-expression recognition with a Chinese version of the Micro-Expression Training Tool (METT). Our goal was to confirm whether the recognition accuracy of spontaneous micro-expressions could be improved through training and brain stimulation. Since the right temporal parietal junction (rTPJ) has been shown to be involved in the explicit process of facial emotion recognition, we hypothesized that the rTPJ would play a role in facilitating the recognition of micro-expressions. The results showed that anodal transcranial direct-current stimulation (tDCS) of the rTPJ indeed improved the recognition of spontaneous micro-expressions, especially for those associated with fear. The improved accuracy of recognizing fear spontaneous micro-expressions was positively correlated with personal distress in the anodal group but not in the sham group. Our study supports that the combined use of tDCS and METT can be a viable way to train and enhance micro-expression recognition.

People with mental stress often experience disturbed sleep, suggesting stress-related abnormalities in brain activity during sleep. However, no study has looked at the physiological oscillations in brain hemodynamics during sleep in relation to stress. In this pilot study, we aimed to explore the relationships between bedtime stress and the hemodynamics in the prefrontal cortex during the first sleep cycle. We tracked the stress biomarkers, salivary cortisol, and secretory immunoglobulin A (sIgA) on a daily basis and utilized the days of lower levels of measured stress as natural controls to the days of higher levels of measured stress. Cortical hemodynamics was measured using a cutting-edge wearable functional near-infrared spectroscopy (fNIRS) system. Time-domain, frequency-domain features as well as nonlinear features were derived from the cleaned hemodynamic signals. We proposed an original ensemble algorithm to generate an average importance score for each feature based on the assessment of six statistical and machine learning techniques. With all channels counted in, the top five most referred feature types are Hurst exponent, mean, the ratio of the major/minor axis standard deviation of the Poincaré plot of the signal, statistical complexity, and crest factor. The left rostral prefrontal cortex (RLPFC) was the most relevant sub-region. Significantly strong correlations were found between the hemodynamic features derived at this sub-region and all three stress indicators. The dorsolateral prefrontal cortex (DLPFC) is also a relevant cortical area. The areas of mid-DLPFC and caudal-DLPFC both demonstrated significant and moderate association to all three stress indicators. No relevance was found in the ventrolateral prefrontal cortex. The preliminary results shed light on the possible role of the RLPCF, especially the left RLPCF, in processing stress during sleep. In addition, our findings echoed the previous stress studies conducted during wake time and provides supplementary evidence on the relevance of the dorsolateral prefrontal cortex in stress responses during sleep. This pilot study serves as a proof-of-concept for a new research paradigm to stress research and identified exciting opportunities for future studies.

Consumer wearable activity trackers, such as Fitbit are widely used in ubiquitous and longitudinal sleep monitoring in free-living environments. However, these devices are known to be inaccurate for measuring sleep stages. In this study, we develop and validate a novel approach that leverages the processed data readily available from consumer activity trackers (i.e., steps, heart rate, and sleep metrics) to predict sleep stages. The proposed approach adopts a selective correction strategy and consists of two levels of classifiers. The level-I classifier judges whether a Fitbit labeled sleep epoch is misclassified, and the level-II classifier re-classifies misclassified epochs into one of the four sleep stages (i.e., light sleep, deep sleep, REM sleep, and wakefulness). Best epoch-wise performance was achieved when support vector machine and gradient boosting decision tree (XGBoost) with up sampling were used, respectively at the level-I and level-II classification. The model achieved an overall per-epoch accuracy of 0.731 ± 0.119, Cohen's Kappa of 0.433 ± 0.212, and multi-class Matthew's correlation coefficient (MMCC) of 0.451 ± 0.214. Regarding the total duration of individual sleep stage, the mean normalized absolute bias (MAB) of this model was 0.469, which is a 23.9% reduction against the proprietary Fitbit algorithm. The model that combines support vector machine and XGBoost with down sampling achieved sub-optimal per-epoch accuracy of 0.704 ± 0.097, Cohen's Kappa of 0.427 ± 0.178, and MMCC of 0.439 ± 0.180. The sub-optimal model obtained a MAB of 0.179, a significantly reduction of 71.0% compared to the proprietary Fitbit algorithm. We highlight the challenges in machine learning based sleep stage prediction with consumer wearables, and suggest directions for future research.

Fraud can cause severe financial losses and affect the physical and mental health of victims. This study aimed to explore the manipulative characteristics of fraudsters and their relationship with other psychological variables. Thirty-four fraudsters were selected from a medium-security prison in China, and thirty-one healthy participants were recruited online. Both groups completed an emotional face-recognition task and self-report measures assaying emotional manipulation, psychopathy, emotion recognition, and empathy. Results showed that imprisoned fraudsters had higher accuracy in identifying fear and surprise faces but lower accuracy in identifying happiness than controls (t = 5.26, p < 0.001; t = 2.38, p < 0.05; t = 3.75, p < 0.001). Significantly lower scores on non-prosocial factors on the Managing the Emotions of Others scale (MEOS) were found for imprisoned fraudsters, relative to controls (t = 3.21, p < 0.01). Imprisoned fraudsters had low scores in the assessment of psychopathy than the control group, especially Factor 1 (t = 2.04, p = 0.05). For empathy, imprisoned fraudsters had significantly higher scores in perspective-taking than controls (t = 2.03, p = 0.05). Correlation analyses revealed that psychopathic traits were positively correlated with non-prosocial factors in both groups. However, the relationships between emotional manipulation and emotional recognition and empathy were not consistent across the groups. The results suggest that fraudsters may pretend to be as prosocial as healthy controls, who had lower antisocial tendencies, normal empathy ability, and would like to manipulate others’ emotions positively during social interaction.

Deception varies across individuals and social contexts. The present research explored how individual difference measured by social value orientations, and situations, affect deception in moral hypocrisy. In two experiments, participants made allocations between themselves and recipients with an opportunity to deceive recipients where recipients cannot reject their allocations. Experiment 1 demonstrated that proselfs were more deceptive and hypocritical than prosocials by lying to be apparently fair, especially when deception was unrevealed. Experiment 2 showed that proselfs were more concerned about social image in deception in moral hypocrisy than prosocials were. They decreased apparent fairness when deception was revealed and evaluated by a third-party reviewer and increased it when deception was evaluated but unrevealed. These results show that prosocials and proselfs differed in pursuing deception and moral hypocrisy social goals and provide implications for decreasing deception and moral hypocrisy.

Consumer sleep tracking devices are known to be inaccurate, but there is a lack of understanding of how user characteristics may affect the accuracy of these devices. This study aims to examine the effect of age, gender, subjective sleep quality, sleep hygiene and sleep structure on the accuracy of two consumer sleep trackers, i.e. Fitbit Charge 2 and Neuroon. Sleep data were collected from 27 healthy participants using consumer devices and a medical device concurrently. Analysis found that age, sleep hygiene and sleep structure were significantly associated to the accuracy of consumer sleep trackers, whereas no association was found on gender and subjective sleep quality. Both consumer devices had improved accuracy on total sleep time and sleep efficiency for participants who had longer, deeper and less interrupted sleep. Our findings suggest that consumer devices may not be suited for young adults and for people with short and fragmented sleep.

Assessing trunk coordination has many potential applications in health promotion. However, traditional bio-mechanical approaches are not suited for daily use as they require expensive devices and manual analysis. This study aimed to develop an approach for automatic classification of good and poor trunk coordination using widely available mobile devices. Weinvestigated different combinations of sensor locations (i.e. chest and pelvis), sensing modalities (i.e. accelerometer and gyroscope) and classification techniques (i.e. SVM, KNN, and decision tree). Results showed that using both sensing modalities at chest and pelvis with SVM produced the best classification accuracy: 96% for chest rotation and 100% forpelvis rotation. In practice, however, using one device with both sensing modalities (i.e. accelerometer and gyroscope) will achieve a better trade-off between feasibility and accuracy. In this case, the device should be fixed on the chest. KNN should be selected as the classification technique for chest rotation (best accuracy 95%), and SVM should be selected asthe classification technique for pelvis rotation (best accuracy 79%). Post hoc analysis found that poor coordination during chest rotation was associated to weak cross-correlation of angular velocity between chest and pelvis in the frontal plane, while poor coordination during pelvis rotation was associated to weak correlations of angular velocity between the threeorthogonal components at chest. This study demonstrated how simple mobile devices can capture relevant motion data and extract key features that help construct computational models for automatic assessment of trunk coordination.

Prompt engineering, the process of arranging input or prompts given to a large language model to guide it in producing desired outputs, is an emerging field of research that shapes how these models understand tasks, process information, and generate responses in a wide range of natural language processing (NLP) applications. Digital mental health, on the other hand, is becoming increasingly important for several reasons including early detection and intervention, and to mitigate limited availability of highly skilled medical staff for clinical diagnosis. This short review outlines the latest advances in prompt engineering in the field of NLP for digital mental health. To our knowledge, this review is the first attempt to discuss the latest prompt engineering types, methods, and tasks that are used in digital mental health applications. We discuss three types of digital mental health tasks: classification, generation, and question answering. To conclude, we discuss the challenges, limitations, ethical considerations, and future directions in prompt engineering for digital mental health. We believe that this short review contributes a useful point of departure for future research in prompt engineering for digital mental health. [ABSTRACT FROM AUTHOR]