Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Information and communication technologies are tools that are able to support cognitive functions, monitor health and movements, provide reminders to maintain residual memory abilities, and promote social support, especially among patients with dementia. Among these technologies, embodied conversational agents (ECAs) are seen as screen-based entities designed to stimulate human face-to-face conversation skills, allowing for natural human-machine interaction. Unfortunately, the evidence that such agents deliver care benefits in supporting people affected by dementia and their caregivers has not yet been well studied. Therefore, research in this area is essential for the entire scientific community. Objective: This study aims to evaluate the usability and acceptability of the virtual agent Anne by people living with dementia. The study is also designed to assess the ability of target users to use the system independently and receive valuable information from it. Methods: We conducted a 4-week trial that involved 20 older adults living with dementia and 14 family caregivers in home environment settings in Italy. This study used a mixed methods approach, balancing quantitative and qualitative instruments to gather data from users. Telemetry data were also collected. Results: Older users were particularly engaged in providing significant responses and participating in system improvements. Some of them clearly discussed how technical problems related to speech recognition had a negative impact on the intention to use, adaptiveness, usefulness, and trust. Moreover, the usability of the system achieved an encouraging score, and half of the sample recognized a role of the agent Anne. This study confirms that the quality of automatic speech recognition and synthesis is still a technical issue and has room for improvement, whereas the touch screen modality is almost stable and positively used by patients with dementia. Conclusions: This study demonstrated the ability of target users to use the system independently in their home environment; overall, the involved participants shared good engagement with the system, approaching the virtual agents as a companion able to support memory and enjoyment needs. Therefore, this research provides data that sustain the use of ECAs as future eHealth systems that are able to address the basic and higher-level needs of people living with dementia. This specific field of research is novel and poorly discussed in the scientific community. This could be because of its novelty, yet there is an urgent need to strengthen data, research, and innovation to accelerate the implementation of ECAs as a future method to offer nonpharmacological support to community-dwelling people with dementia.

Background: The integration of technology-based interventions into health and care provision in our aging society is still a challenge especially in the care pathway for people with dementia. Objective: The study aims to: (1) identify which socio-demographic characteristics are independently associated with the use of the embodied conversational agent among subjects with dementia, (2) uncover patient cluster profiles based on these characteristics, and (3) discuss technology-based interventions challenges. Methods: A virtual agent was used for four weeks by 55 persons with dementia living in their home environment. Results: Participants evaluated the agent as easy-to-use and quickly learnable. They felt confident while using the system and expressed the willingness to use it frequently. Moreover, 21/55 of the patients perceived the virtual agent as a friend and assistant who they could feel close to and who would remind them of important things. Conclusions: Technology-based interventions require a significant effort, such as personalized features and patient-centered care pathways, to be effective. Therefore, this study enriches the open discussion on how such virtual agents must be evidence-based related and designed by multidisciplinary teams, following patient-centered care as well as user-centered design approaches.

A novel ball bond process optimization method based on a thermal signal from an integrated aluminum microsensor is reported. The in-situ temperature during the ball bonding is measured and analyzed. The ultrasonic period shows distinct features corresponding to the scrubbing of the ball on the pad and the intermetallic bond growth, and the ball deformation by ultrasonic softening. A peak of the signal indicates the end of interconnection growth. This can be used for bond time optimization. When optimizing bonding force, the sensor signal correlates with ball shear strength. Using this method, bonding force process windows can be determined by on-line measurements. Maximum shear strength and maximum microsensor signal were within 20 mN at 34/spl deg/C. In summary, the method produces a wealth of new insights in transient thermal phenomena of the ball bonding process and promises to simplify the evaluation of ball bonding process windows.

BACKGROUND Information and Communication Technologies are seen as tools able to support cognitive functions, monitor health and movements, provide reminders to maintain residual memory abilities and promote social support, especially among patients with dementia. Among these technologies, Embodied Conversational Agents (ECAs) are seen as screen-based entities, designed to stimulate human face-to-face conversation skills and thus allow for natural human-machine interaction. Unfortunately, the efficacy of ECA in supporting people affected by dementia and their caregivers is not yet well studied. Therefore, research in this area is essential for the entire scientific community. OBJECTIVE This study aims to evaluate the usability and acceptance of the ECA Anne by seniors affected with dementia. The study is also designed to assess the ability of target users to utilize the system independently and receive valuable information from it. METHODS A 4-week trial was conducted involving 20 older adults with dementia and 14 family caregivers in home environment settings in Italy. This study used a mixed method approach, balancing quantitative and qualitative instruments to gather data from users. Telemetry data was also collected. RESULTS It emerges that older users were particularly engaged in providing significant responses and participated in system improvements. Some of them clearly discussed how technical problems related to speech recognition negatively impacted on the intention to use, adaptiveness, usefulness and trust. Moreover, the usability of the system achieved an encouraging score and the half of the sample recognized a role in the ECA. This study confirms that the quality of automatic speech recognition and synthesis is still a technical issue and has room for improvement, whereas touchscreen modality is almost stable and positively used by patients with dementia. CONCLUSIONS This specific field of research is novel and poorly discussed in the scientific community. This could be due to its newness, yet there is an urgent need to strengthen data, research and innovation to accelerate the implementation of ECA as a future way to offer non-pharmacological support to community-dwelling persons with dementia.