STAT+: Acting head of NIH’s infectious disease institute reported to have stepped down

Yet another leadership position at the National Institutes of Health appears to be vacant. Jeffery Taubenberger, who has been serving as acting head of the National Institute for Allergy and Infectious Diseases, has stepped down, Sen. Tammy Baldwin revealed Thursday during a hearing of the Senate Appropriations Committee.

It was unclear when Taubenberger, who has been serving in the role since April 2025, stepped down, or why, though there has been chatter in infectious diseases research circles that  Taubenberger had stepped down about two weeks ago. STAT has asked the Department of Health and Human Services about his status several times; those queries have gone unanswered and unacknowledged. 

Taubenberger was still listed as acting director on the institute’s website on Thursday. In the HHS employee directory he is listed as the chief of the viral pathogenesis and evolution section. He has not responded to repeated queries from STAT about his status.

Continue to STAT+ to read the full story…

The Download: online safety’s future and climate tech’s big pivot

This is today’s edition of The Download, our weekday newsletter that provides a daily dose of what’s going on in the world of technology.

Tech researchers are suing the Trump administration over the future of online safety

For months, the Trump administration has been going after researchers who study and try to counter hate speech, harassment, propaganda, and disinformation online. Now, some of those researchers are fighting back. 

In a new lawsuit, they’re seeking to strike down a visa restriction policy against “foreign officials and other persons” announced last year by US Secretary of State Marco Rubio.

They say the policy violates the speech and due process rights of foreign-born workers whose “work supports greater moderation of content on the [tech] platforms.” Find out how the case could impact online safety and free speech.

—Eileen Guo

Climate tech companies are pivoting to critical minerals

We’re over a year into the second Trump administration, and support for climate causes in the US is weak. But climate tech companies are finding ways to survive and even thrive in this new environment, including by looking beyond decarbonization.

One example is Boston Metal. The startup has raised a $75 million round to produce critical metals, MIT Technology Review can exclusively report.

The company is best known for its efforts to clean up steel production, an industry that’s responsible for about 8% of global greenhouse gas emissions. But the new focus and fresh funds could help it survive a period of waning support for industrial decarbonization.

Read the full story on its high-stakes shift. And discover more about the new strategy for climate tech companies in our analysis of how they’re reframing their missions.

—Casey Crownhart 

Our story on the climate tech pivot is from The Spark, our weekly newsletter giving you the inside track on all things climate. Sign up to receive it in your inbox every Wednesday.

Can AI learn to understand the world?

As the limits of LLMs become clearer, researchers are developing a new kind of AI designed to understand the physical environment: world models. 

Recent developments from Google DeepMind, Fei-Fei Li’s World Labs, and Yann LeCun’s new startup have pushed these systems to the forefront of AI. At an exclusive virtual event today, MIT Technology Review will examine the progress—and what comes next.

Join editor in chief Mat Honan, senior AI editor Will Douglas Heaven, and AI reporter Grace Huckins for the subscriber-only Roundtables discussion on world models. Register here to take part in the session at 19:30 GMT / 2:30 PM ET / 11:30 AM PT.

World models are one of our 10 Things That Matter in AI Right Now, MIT Technology Review’s new list of the technologies and ideas shaping the future of AI.

The must-reads

I’ve combed the internet to find you today’s most fun/important/scary/fascinating stories about technology.

1 SpaceX has filed for an IPO expected to be the largest ever
It could make Elon Musk the world’s first trillionaire. (BBC
+ But he’s also a risk factor in the prospectus. (The Verge)
+ The filing exposes SpaceX’s finances for the first time. (NYT $)
+ AI spending pushed it to a $1.94 billion loss in Q1 2026. (Reuters $)
+ And rivals are challenging its launch dominance. (MIT Technology Review)

2 Nvidia reported record revenues thanks to the AI boom
It’s blown past Wall Street expectations, despite losing the Chinese market. (Guardian)
+ It has “largely conceded” China’s AI chip market to Huawei. (CNBC)
+ It generated no revenue from H200 chip sales in China. (SCMP)

3 Samsung has averted a massive strike over AI profit-sharing
It reached a tentative deal on bonuses with workers. (FT $)
+ The last-minute deal averts an 18-day walkout. (Engadget
+ But the compromise has exposed deep divisions. (Reuters $)
+ Anti-AI protests are increasing. (MIT Technology Review)

4 President Trump will sign a cybersecurity directive as soon as today
But it stops short of mandatory federal approval of models before they’re released. (Bloomberg $)
+ AI is making online crimes easier. (MIT Technology Review)

5 OpenAI may file for an IPO within days
The ChatGPT-maker wants to go public as early as September. (WSJ $)

6 Robotics won’t be transformed by a single AI breakthrough
Don’t expect a ChatGPT moment. (IEE Spectrum)
+ Human work behind humanoid robots is being hidden. (MIT Technology Review)

7 Rocks could generate hydrogen while storing CO2
New research shows they could also produce geothermal power. (New Scientist)
+ AI is uncovering hidden geothermal energy resources. (MIT Technology Review)

8 The EU is accelerating a Trump-fueled breakup with Big Tech
Geopolitical tensions are driving a shift toward homegrown software. (Wired $)

9 Solid-state breakthroughs could soon transform commercial batteries
They’d be faster and safer than today’s lithium-ion equivalents. (The Economist $)

10 Two researchers are rebuilding math from the ground up
By replacing the most fundamental concept in topology. (Quanta)
+ OpenAI claims its solved an 80-year-old math problem. (TechCrunch)

Quote of the day

“This isn’t a blip, it’s an inflection point.” 

—Gurjeet Grewal, CEO of UK-based Octopus Electric Vehicles, tells Reuters that the Iran war has been a boon for European EV sales.

One More Thing

""
Keisy Plaza looks at her daughter Arantza Plaza with disappointment after failing to get an appointment on the CBP One app in Ciudad Juárez, Mexico.
ALICIA FERNáNDEZ


The new US border wall is an app

At the US southern border in 2023, asylum seekers had to request appointments with immigration officials via a mobile app. The Biden administration said the app, named CBP One, would make migration more orderly and discourage unauthorized crossings. But for many migrants, it became another obstacle.

While waiting in dangerous border cities, they reported frozen screens, facial recognition issues, spotty connectivity, and difficulty securing appointments. Advocates argue that requiring vulnerable people to rely on smartphones, internet access, and digital literacy creates a system that leaves many behind.

Find out how CBP One endangered some of the people most in need of protection.

—Lorena Ríos

We can still have nice things

A place for comfort, fun, and distraction to brighten up your day. (Got any ideas? Drop me a line.)

+ See how big countries really are with this interactive tool.
+ Explore the entire Star Wars galaxy in detail through this interactive map.
+ Chart the origins of historical events with this interactive cause-and-effect explorer.
+ Discover the surprising origins of global currency symbols in this deep dive into financial history.

Tech researchers are suing the Trump administration over the future of online safety

Since its earliest days back in office, the Trump administration has been going after researchers who study and try to counter hate speech, harassment, propaganda, and disinformation online. 

Now, some of those researchers are fighting back. Last week their lawsuit—which could have global repercussions for online safety and free speech—made its first appearance in court

This fight started a year ago, when US Secretary of State Marco Rubio announced on X what he called a “visa restriction policy” against “foreign officials and other persons” who were “complicit in censoring Americans.” Since then, a handful of foreign officials and researchers have been barred from travel to the US, and in theory, anyone working in fact-checking or online trust and safety more broadly could face the same restrictions. 

Still, the exact implications of Rubio’s announcement are unclear—purposefully so, argues Carrie DeCell, a lawyer representing the researchers. “This policy is expansive and incredibly vague, and the chilling effects are correspondingly enormous,” DeCell said outside the courthouse in Washington, DC, on May 13.  

The case has been brought by the Coalition for Independent Technology Research (CITR), an advocacy organization for tech researchers. It is suing Rubio, former US secretary of homeland security Kristi Noem, and former US attorney general Pam Bondi and asking the court to strike down the policy as unconstitutional. In their complaint, the plaintiffs say the policy violates the speech and due process rights of foreign-born tech researchers and workers whose “work supports greater moderation of content on the [tech] platforms.”

CITR is represented by Columbia University’s Knight First Amendment Institute and the legal nonprofit Protect Democracy. DeCell, a senior staff attorney at the Knight Institute, tells MIT Technology Review that they’re in court because the Trump administration is effectively “using immigration law to punish people for expressing views that it disagrees with.” 


This story is part of MIT Technology Review’s “America Undone” series, examining how the foundations of US success in science and innovation are currently under threat. You can read the rest here.


Most immediately, the plaintiffs are asking the government to halt these visa restrictions while the case proceeds. Zachariah Lindsey, the assistant US attorney representing Rubio and the other defendants, argued in last week’s hearing that the government is not targeting speech but, rather, “conduct [that] is assisting or facilitating foreign government censorship of free speech.” At the end of the week, the government filed a motion to dismiss the case.

The judge has yet to rule on either motion, and his questions so far appeared to focus on parsing what (and who) is actually affected by the State Department’s announcements, as well as other procedural issues. 

The outcome of the case may ultimately affect how much the public knows about the risks of social media and AI, says Nicole Schneidman, head of Protect Democracy’s technology and data governance team. The workers bringing this suit, she says, “serve a really, really important function in educating the public, holding tech companies accountable, doing research on the ramifications that advanced technology has on our society.” 

“A political witch hunt”

CITR’s lawsuit is the latest salvo in a yearslong battle over how the internet should be moderated, and by whom—a question that has become increasingly political and entangled in allegations of censorship. 

For years, Trump and his allies have claimed to be victims of a vast conspiracy between government agencies, civil society groups, academics, and Big Tech platforms to specifically censor conservative voices online. According to this narrative, a so-called “censorship-industrial complex” helped the Biden administration subvert First Amendment protections on speech by allegedly outsourcing censorship to these groups.

The State Department claims Rubio was able to implement the immigration policy because the Immigration and Nationality Act authorizes him to “render inadmissible any alien whose entry into the United States ‘would have potentially serious adverse foreign policy consequences for the United States.’” Before the current Trump administration, the statute was rarely invoked, and when it was, it was typically with more limited, specific criteria, rather than its current application against anyone who has participated in alleged censorship—an action that has no legal definition. 

The administration first deployed the policy in July 2025, when Rubio issued a statement announcing the revocation of visas for Alexandre de Moraes, the lead justice on the Brazilian Supreme Federal Court, and “his allies on the court” who were involved in prosecuting Jair Bolsonaro, Brazil’s former president. The prosecution was a “political witch hunt,” said Rubio, calling it evidence of a “censorship complex so sweeping that it not only violates basic rights of Brazilians, but also … targets Americans.”

Then, in early December, the State Department issued instructions to embassies to reject H-1B visa applications from individuals who had worked specifically in fact-checking, online trust and safety, and mis- or disinformation research, as Reuters first reported. 

A few weeks later, on December 23, the agency announced visa restrictions for five Europeans whom it accused of censoring Americans. This included two CITR members: Imran Ahmed, founder and CEO of the Center for Countering Digital Hate, which documents hate speech on social media platforms, and Clare Melford, cofounder of the Global Disinformation Index, which ranks websites according to how often they publish hate speech and disinformation. Also banned were the former European Union commissioner Thierry Breton, a key architect of the European Union’s Digital Services Act (which the State Department has called “Orwellian” and an example of censorship), and Josephine Ballon and Anna-Lena von Hodenberg, co-CEOs of HateAid, a German nonprofit that fights online hate speech. 

Ahmed, who lives in the US with his American wife and child, quickly filed his own lawsuit to stave off deportation and halt the policy. A preliminary injunction preventing his detention and deportation is in place as the lawsuit continues. 

The Department of Homeland Security referred questions from MIT Technology Review to the State Department, which referred “specific questions” to the Department of Justice, while also writing that “the Trump Administration believes that aliens who are or were involved or complicit in censoring American citizens must face appropriate consequences. An American visa is a privilege not a right.” The Department of Justice did not respond to a request for comment. 

“A gut punch”

Now, more tech researchers are fighting back. 

CITR represents 500 individual and institutional members in 47 countries; 40 are based in the United States, including around 30 noncitizens. The organization argues that US-based tech researchers are experiencing a widespread chilling effect and are having to change or reframe what they’re studying so that it’s less explicitly (or less obviously) about content moderation or countering disinformation. Alternatively, some are leaving the US altogether, or making plans to do so, in order to safely carry out their work. 

CITR member Eirliani Abdul Rahman, a Singaporean online safety expert and a founding member of Twitter’s Trust and Safety Council, is one of these individuals. Her experience was included, though described anonymously, in CITR’s initial legal complaint. 

Back in December 2022, shortly after Elon Musk purchased Twitter, Abdul Rahman and two other Trust and Safety Council members publicly resigned. They spoke out against “red lines” the new owner had crossed, including his reinstatement of accounts that had previously been banned, and noted the marked increase in hate speech on the platform. 

Musk disbanded the council days later, but first he retweeted a post that tagged Abdul Rahman and the others and said: “You all belong in jail.” This led to a level of online harassment, doxxing, and death threats that she had never before experienced. “I was trained as an economist, and I could just see line graphs form in my head of the stochastic jump in what happened,” Abdul Rahman says, referring to the way the dangerous attention spiked after Musk effectively endorsed the other user’s provocation. 

This experience inspired her to pursue a new area of research: using quantitative methods to study and hopefully stop social media harassment “in real time,” she says. 

“The ones that are most harassed are people [who] have historically been marginalized,” she adds. “Most of us know about this already, like it’s intuitive. But until you quantify it, sometimes it’s just not seen and taken seriously.”   

But then Trump was reelected, making the work feel untenable. The US quickly became “a funding desert” for scientific research, she says, with federal support for any research perceived by conservatives to focus on mis/disinformation getting cut. At the same time, tech companies shifted their positions on content moderation to align with the president’s, meaning that her research would be unlikely to have any practical implications: “There’s simply no guardrails around social media anymore,” she says. 

Fast-forward to December 2025, and the travel bans on the five Europeans felt like “a gut punch to the stomach,” Abdul Rahman says. She and Ahmed had both testified earlier in the year before the UK Parliament on the role social media played in spreading false claims about the supposed Muslim identity of a murderer who had killed three British girls; this online activity contributed to violent anti-immigrant and Islamophobic riots across the country in the summer of 2024. 

The targeting of Ahmed and the other Europeans “was the last straw” for Abdul Rahman. Soon after, she left the US for a six-year fellowship in Germany aimed at supporting “international academic freedom”—coincidentally arriving in the country on the same day CITR filed its lawsuit. 

“My body just calmed down,” Abdul Rahman says of landing in Germany. “I didn’t wake up in the middle of the night … always wondering about the next executive order and how it pertained to my situation.”

Abdul Rahman believes this legal battle has implications that reach beyond CITR members and their families. It “pertains to all immigrants in the US to protect our First Amendment rights,” she says.

Additionally, whether fact-checkers, online trust and safety workers, and tech researchers can continue to do their work has a broader impact on anyone who uses the internet. 

Earlier this year, for example, Ahmed’s Center for Countering Digital Hate published widely cited research that Grok’s image-editing feature had generated an estimated 3 million sexualized images, including 23,000 images of children, in an 11-day period. This led to government investigations, lawsuits, and even temporary bans for Grok’s parent company, xAI, across the United States and world. 

“The threats have really sharpened”

MIT Technology Review has reported extensively on this right-wing war on supposed censorship; one of our stories revealing that State Department leadership requested communications records from a now-shuttered office focused on countering foreign disinformation has been included as an exhibit in the CITR lawsuit. This request sought insight into communications with a slew of individuals some far-right activists allege are involved in the “censorship-industrial complex,” including journalists, the German foreign minister, and numerous researchers studying disinformation and hate speech (including Medford, Ahmed, and their organizations).

DeCell tells us that over the past year and a half, there have been more lawsuits against the Trump administration regarding free speech—because “the threats have really sharpened,” she says.

Last year, the Knight Institute sued Rubio on behalf of of university faculty and students who have been arrested, detained, and deported for their pro-Palestinian speech; this past January, a judge ruled that the administration’s deportation policy was unconstitutional. The risk to free speech rights is “palpable” when the government “decides to target people specifically with the threat of rounding them off the streets, throwing them into a detention center, and then potentially deporting them from this country,” DeCell says. 

Though Abdul Rahman is safely abroad for now, she says she’s watching the CITR lawsuit closely. Ultimately, she says, she believes it will determine whether researchers will be able to continue to do their work, “which is to take social media platforms to account,” she says—“making sure there’s actual accountability and independent oversight is critical to protecting our democracies.” 

Lifestyle, psychological and demographic predictors of anxiety: insights from a large-scale survey and machine learning analysis

ObjectiveAnxiety is influenced by a combination of lifestyle, psychological, and demographic factors. This study aimed to evaluate these associations and explore the potential of machine learning in predicting anxiety severity.MethodsAnxiety levels were evaluated using a large survey-based dataset of 11, 000 adults alongside demographic, physiological, and psychological measures. Descriptive statistics and inferential analyses were conducted in IBM SPSS to identify associations between key variables. Several machine learning regression algorithms, including linear, regularized, and ensemble models, were implemented in Python to predict anxiety levels. Model performance was evaluated using standard error metrics.ResultsOur findings revealed significant associations of anxiety with stress and sleep duration, while demographic attributes such as family history of anxiety and occupation also influenced outcomes. Ensemble machine learning algorithms achieved superior performance compared to single and linear-model approaches. Feature importance analysis identified stress, sleep, and caffeine intake as top predictors of anxiety.ConclusionsThe integration of statistical approaches with machine learning applications highlights the multifactorial nature of anxiety and demonstrates the potential of predictive modeling in mental health care. Future research should emphasize longitudinal designs and the incorporation of biological and digital markers to enhance clinical applicability and prediction.

Seasonal and gender-specific patterns in prescriptions for hypnotic and sedative medications in primary care

IntroductionPopulation-level prevalence of sleep disorders can be assessed using prescription data for hypnotic and sedative medications. Such prescribing patterns exhibit seasonality that may be linked to variations in daylight exposure. The aim of this study was to analyze temporal trends in prescriptions for drugs with sedative-hypnotic properties.MethodsPrescription data for hypnotics and sedatives were analyzed retrospectively and stratified by month, year, and patient gender. Seasonal patterns, associations with day length, and the effects of transitions between daylight saving time and standard time were examined. Changes in prescription numbers during the COVID-19 pandemic were also assessed. Relative differences in prescription counts were evaluated using incidence rate ratios (IRR).ResultsPrescription numbers were lowest in summer (May–August) and highest in winter and early spring. Increasing day length was significantly associated with reduced prescription rates. A decline in prescriptions occurred earlier and was more pronounced in men (February–September; IRR 0.88–0.95), whereas in women the changes were weaker and mainly limited to summer months (June–August; IRR 0.94–0.97), with a slight increase observed in February. During the COVID-19 pandemic, prescription numbers decreased significantly. Transitions between standard and daylight saving time exerted measurable short-term effects on sleep-related health at the population level.ConclusionsBased on data from a single primary care center in Poland, prescribing patterns for hypnotic and sedative medications demonstrate clear seasonality and significant gender differences. Longer daylight exposure and transitions to daylight saving time are associated with lower prescription rates. The COVID-19 pandemic substantially disrupted previous trends in sleep medication prescribing, which may be related to reduced access to healthcare services and changes in healthcare delivery. In addition, transitions between standard and daylight saving time were associated with statistically significant short-term changes in prescription rates.

Exploring the life stories of young adult men in prison with a history of dual harm

People who engage in both self-harm and violence (‘dual harm’) in prison cause widespread disruption to prison services. Whilst the behavioural profile of such individuals is gaining attention, there is very little research which explores their life histories and how these contextualise their dual harm. This study qualitatively explored how five young men in a medium secure prison in England with a history of dual harm (in the community, prison, or both) made sense of their life experiences and engagement in dual harm behaviours. Participants were interviewed using an in-depth life story interview protocol. A narrative analysis identified three themes: ‘Beginning: Making sense of a traumatic childhood’, ‘Middle: Exploring challenges during late adolescence’ and ‘End: Who I am now, and who I must be’. These themes, grounded in life experiences and associated meaning, offer valuable insights into the underpinnings of dual harm behaviours and direction for interventions addressing dual harm in prisons. The paper concludes with a discussion of key implications and directions for future research and practice in relation to the support and management of people who dual harm in custody.

Aspects of Quality of Life in Interstitial Lung Disease: Pilot Observational Cross-Sectional Study in a Single Center

Background: Quality of life (QOL) is an important aspect of every chronic disease, including interstitial lung disease (ILD). QOL is perceived as a significant patient-centered outcome. Objective: This study aims to identify factors correlating with different aspects of QOL in patients with various ILDs. Methods: We recruited 57 participants hospitalized in a tertiary care clinical center to this pilot observational cross-sectional study. These included 22 patients with idiopathic interstitial pneumonia (IIP), 19 patients with connective tissue disease–associated ILD (CTD-ILD), and 16 patients with interstitial pneumonia with autoimmune features (IPAF). The Saint George’s Respiratory Questionnaire (SGRQ) and World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) were used to assess QOL, and the Hospital Anxiety and Depression Scale – Modified Version (HADS-M) and Patient Health Questionnaire – 9 (PHQ-9) were used to evaluate depression severity. Functional parameters including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV), transfer lung capacity for carbon monoxide (TLCO), and 6-minute walk distance (6MWD) were assessed. Assessment of QOL was a secondary outcome measure in a multicenter prospective study aimed at determining the characteristics of Polish patients with interstitial pneumonia with autoimmune features. Results: In each study group, positive correlations existed between the WHOQOL-BREF physical domain score and FEV % predicted value (=.001) and TLCO % predicted value (=.03). Regardless of diagnosis, higher depression, anxiety, and aggression scores (ie, worse mental health) correlated negatively with multiple domains of QOL measured using the WHOQOL-BREF. Predictors of QOL aspects varied in each study group. In the IPAF group, the TLCO % predicted value was a predictor of QOL expressed as the SGRQ total score (=.005). In the CTD-ILD group, short 6MWD (<.001) and high HADS-M aggression score (=.01) correlated with low QOL (expressed as a high SGRQ total score). In the IIP group, 6MWD (=.002) and PHQ-9 scores (<.001) were predictors for SGRQ symptoms score. Gender-based differences were revealed: In all study groups, men had higher scores in the psychological, social, and environmental domains of the WHOQOL-BREF, indicating better QOL, without a statistically significant difference in the physical domain scores between genders. Diagnosis-based differences in the psychological aspects of QOL were also revealed: The QOL psychological domain scores were significantly lower in the CTD-ILD and IPAF groups than in the IIP group, indicating worse QOL (=.01). Conclusions: QOL is a multifaceted issue with various factors impacting its assessment. 6MWD, TLCO predicted value, and worse functional ability might specifically impact QoL in ILD. Mental health is an important aspect of QOL in the ILD population, as patients with a chronic, potentially life-limiting disease may be more prone to developing depression or anxiety. Assessment of QOL should be taken into account in clinical decision-making and research on chronic diseases, as this patient-related outcome may impact therapeutic decisions and patient compliance. Trial Registration: ClinicalTrials.gov NCT03870828; https://clinicaltrials.gov/study/NCT03870828

Multigesture Electromyographic Control Complexity in Upper Limb Prostheses Actuated via Single Sensor Input Contraction Magnitude: Qualitative Study for Evaluating Performance and Cognitive Load

<strong>Background:</strong> Lack of functionality is one factor that contributes to prosthetic rejection rates. Electromyographic upper limb prostheses are controlled through muscle contractions in the user’s residual limb. The incorporation of multigesture controls into a novel, in-house developed upper limb prosthesis requires users to differentiate between the strengths of muscle contractions to trigger programmed gestures. Little research exists on the limitations of expanding device capabilities. This expansion may lead to a decline in accuracy and perceived usability or an increase in training time and cognitive workload. <strong>Objective:</strong> This study aimed to determine the feasibility of implementing multiple gestures when learning electromyographic controls during a single training session. <strong>Methods:</strong> Participants with full upper extremity control were fitted with a Flex Controller, a surface electromyography device that measures muscle contraction. Contractions were visualized as peaks and calibrated through an adjustable scale on a tablet. A training app was developed in-house to test novice users on an electromyography control system. Users interacted with 1, 3, or 5 zones on the screen. Each horizontal zone represented a threshold required to trigger a distinct gesture on the prosthesis. The cohorts were labeled A1 (n=9), A2 (n=10), A3 (n=9), and B1 (n=26). Every participant completed 3 trials per arm, and each trial consisted of 15 randomized cues. Each cue was represented by a green color change, with 1 point earned after a successful peak. Collected outcomes included performance, the System Usability Scale, and the National Aeronautics and Space Administration Task Load Index. <strong>Results:</strong> Scores decreased significantly as zones increased (Kruskal-Wallis H<sub>3</sub>=24.9, <i>P</i>&lt;.001). The mean scores were 15.0 (SD 0.0) for 1 zone, 9.1 (SD 1.1) for 3 zones, and 5.5 (SD 1.1) for 5 zones. Perceived usability, measured by System Usability Scale, showed modest omnibus difference across cohorts (Kruskal-Wallis H<sub>3</sub>=5.22, <i>P</i>=.16); however, a pairwise comparison showed the 5-gesture cohort rated usability lower than the progressive cohort (2-tailed Welch t<sub>11</sub>=–2.19, <i>P</i>=.05). The 5-gesture cohort rated the system lowest (mean 63.3, SD 16.2). Cognitive workload, assessed through the National Aeronautics and Space Administration Task Load Index, increased with the number of gestures. The performance subscale showed a significant omnibus difference across cohorts (Kruskal-Wallis H<sub>3</sub>=21.4, <i>P</i>&lt;.001). Mean performance subscale scores were 84.4 (SD 14.7) for the single-gesture condition, 30.6 (SD 21.7) for the 5-gesture condition, and 44.2 (SD 21.2) for the progressive cohort, reflecting increasing perceived difficulty with more gestures. The sample size for quantitative analysis was 54. <strong>Conclusions:</strong> These findings support the implementation of progressive training for 3 gestures. Usability perceptions were the highest among the more complicated progressive cohort, which is likely related to perceived improvement. Progressively learning 3 gestures enables a balance between device capability, user intention, perceived usability, and cognitive workload.

Patients’ mHealth Apps Usage and Data Privacy, Security, and Confidentiality Concerns: Exploratory Study

Background: The Technology Adoption Model (TAM) offers a potential framework for elucidating the relationships between data privacy or security concerns and behavioral intention, perceived usefulness (PU), and perceived ease of use (PEOU) of mobile health (mHealth) apps, particularly for patients’ self-care management. In Saudi Arabia, limited information is available on these pertinent research areas despite the government’s relentless efforts to bolster the use of mHealth apps. Objective: This study applies the TAM and the psychosociocultural framework to explore the influence of patients’ data privacy and security concerns on the PU, PEOU, and behavioral intention to use mHealth apps for self-care management in Saudi Arabia. Methods: A cross-sectional study was conducted by recruiting patients using mHealth apps for self-care from various provinces in Saudi Arabia. Research instruments were developed based on the components of 2 theories: the psychosociocultural framework and TAM, which were then piloted, validated, and distributed to participants via Google Forms. Linear regression models were performed to test the hypothesized relationships. Results: Overall, 567 patients using mHealth apps participated in the study. Slightly more than one-third (217/567, 38.2%; range 35.6%‐41.4%) of the participants expressed a high level of concern regarding data privacy, confidentiality, and security, with significant predictors being female gender, higher educational qualifications, and younger age groups (<46 years). About 18% to 25% of the variance in PU, PEOU, and behavioral intention to use mHealth apps was explained by the tested factors. Patients were more likely to have higher PU following a unit decrease in data confidentiality (=.31; =.01) and security concerns (=.47; =.01). The PEOU of mHealth apps increased as users demonstrated less concern regarding data privacy (=.18; =.001), confidentiality (=.24; <.001), and security (=.43; =.02). Likewise, behavioral intention to use mHealth apps also increased significantly following a reduction in respondents’ concerns toward data privacy (=.18; =.02), confidentiality (=.24; =.03), and security issues (=.36; =.01). Conclusions: Specific demographic factors and concerns regarding data security and privacy influence patients’ PU, PEOU, and behavioral intention to use mHealth apps for self-care management. Targeting the age-, education-, and gender-based differences regarding the usage of mHealth apps. Health care providers and policymakers may consider age-, education-, and gender-based differences when developing strategies to improve the adoption of mHealth apps among the Saudi patient population.