Currently about 2.71 billion humans use a smartphone worldwide. Although smartphone technology has brought many advances, a growing number of scientists discuss potential detrimental effects due to excessive smartphone use. Of importance, the likely culprit to understand over-usage is not the smartphone itself, but the excessive use of applications installed on smartphones. As the current business model of many app-developers foresees an exchange of personal data for allowance to use an app, it is not surprising that many design elements can be found in social media apps and Freemium games prolonging app usage. It is the aim of the present work to analyze several prominent smartphone apps to carve out such elements. As a result of the analysis, a total of six different mechanisms are highlighted to illustrate the prevailing business model in smartphone app development. First, these app-elements are described and second linked to classic psychological/economic theories such as the mere-exposure effect, endowment effect, and Zeigarnik effect, but also to psychological mechanisms triggering social comparison. It is concluded that many of the here presented app-elements on smartphones are able to prolong usage time, but it is very hard to understand such an effect on the level of a single element. A systematic analysis would require insights into app data usually only being available for the app-designers, but not for independent scientists. Nevertheless, the present work supports the notion that it is time to critically reflect on the prevailing business model of ‘user data in exchange for app-use allowance’. Instead of using a service in exchange for data, it ultimately might be better to ban or regulate certain design elements in apps to come up with less addictive products. Instead, users could pay a reasonable fee for an app service.

Purpose Surgical navigation systems rely on a monitor placed in the operating room to relay information. Optimal monitor placement can be challenging in crowded rooms, and it is often not possible to place the monitor directly beside the situs. The operator must split attention between the navigation system and the situs. We present an approach for needle-based interventions to provide navigational feedback directly on the instrument and close to the situs by mounting a small display onto the needle. Methods By mounting a small and lightweight smartwatch display directly onto the instrument, we are able to provide navigational guidance close to the situs and directly in the operator’s field of view, thereby reducing the need to switch the focus of view between the situs and the navigation system. We devise a specific variant of the established crosshair metaphor suitable for the very limited screen space. We conduct an empirical user study comparing our approach to using a monitor and a combination of both. Results Results from the empirical user study show significant benefits for cognitive load, user preference, and general usability for the instrument-mounted display, while achieving the same level of performance in terms of time and accuracy compared to using a monitor. Conclusion We successfully demonstrate the feasibility of our approach and potential benefits. With ongoing technological advancements, instrument-mounted displays might complement standard monitor setups for surgical navigation in order to lower cognitive demands and for improved usability of such systems.