bluuebunny/crossref_metadata_2025 huggingface dataset:
Variability and Change Over Time of Weight and BMI Among Adolescents and Adults with Prader-Willi Syndrome: A 6-month text-based observational study
Authors: Vrana-Diaz Caroline , Balasubramanian Priya , Kayadjanian Nathalie , Bohonowych Jessica , Strong Theresa V.
Published: April 2020

Background: Prader-Willi syndrome (PWS) is a rare neurodevelopmental disorder in which hyperphagia (excessive appetite) is a hallmark feature. Understanding how weight changes over time in this population is important for capturing the contemporary natural history of the disorder as well as assessing the impact of new treatments for hyperphagia.Methods: We developed a text message-based, prospective cohort study of adolescents and adults with PWS to assess changes in weight and body mass index (BMI) over a six-month period. Weight was collected weekly, while changes in height, living situation, access to food, activity level, and medication were collected at three-month intervals.Results: One hundred and sixty-five participants enrolled in the study, with a mean age of 19.7 years (range 12 - 48). There was considerable variability in weight across participants (range: 76.8 – 207.7 kg). Thirty-three percent of the participants were normal weight, while 15% were overweight and 52% were obese. Overall, the weight of the study participants increased over the study period (mean weight change +2.35%), while BMI was relatively stable, albeit high (mean BMI of 31.4 at baseline, mean BMI percent change + 1.42%). Changes in living situation, activity, food access, and medication had limited impact on weight and BMI changes. Multivariable analysis found that time, sex, age, and percentage of life on growth hormone (GH) therapy were statistically significant fixed effects.Conclusions: This remote, observational study of weight change in PWS showed small increases in weight and BMI over a six-month period. Participants were highly compliant with this text message-based study, suggesting that mobile technology-based data collection was manageable for the participants. We anticipate that the results of this study will inform clinical trials for hyperphagia/obesity related therapies in PWS and provide a basis for understanding the efficacy of new therapies for hyperphagia in the real-world setting.
Classification and morphology of middle mesial canals of mandibular first molars in a Southern Chinese subpopulation: a cone-beam computed tomographic study
Authors: Yang Yeqing , Chen Ming , Zeng Junkai , Wu Buling
Published: April 2020

Background：Cone-beam computed tomography (CBCT) was used to study the morphology and curvature of the middle mesial canals (MMCs) of the mandibular first molars (MFMs).Methods：CBCT scanning was performed on the MFMs of 1100 patients. The pa tients' images which met the inclusion criteria were divided into group A (<40 years old) and group B (≥40 years old) for further study. To study the incidence of the MMCs at different ages, to measure the curvature of MMCs of mesiodistal and buccolingual direction by Schneider method, and to observe the anatomical morphology of the mesial root canal system.Results：In 875 patients, 1750 MFM images met the inclusion criteria, among which 158 MFMs contained a MMC, with an incidence rate of 9.03%. The incidence rate of MMCs was 11.22% in group A and 6.61% in group B, with statistically significant differences (P<0.05). The curvature in group A was 29.39±8.53° in mesiodistal direction while group B was 26.06±8.50 °, with statistical differences (P＜0.05). It has been shown that curved regions in group A and B were often found out in the middle 1/3. There is no significant difference in the distance between MMC orifices and mesiobuccal canal orifices or mesiolingual canal orifices (P>0.05). The most common mesial root canal morphology type was type II (3-2) (53.80%). Conclusion：The incidence of MMCs in MFMs was showed to decline along with the increase of age. The canal system of MMCs was varied and complex, mostly with mesiodistal curve obviously. CBCT is an outstanding assistant examination to the root canal therapy.
Using the modified Ponseti method to treat complex clubfoot: early results
Authors: Bozkurt Celal , Sipahioğlu Serkan , Sarıkaya Baran , Altay Mehmet Akif , Çetin Baki Volkan
Published: April 2020

Objectives In complex clubfoot, equinus, varus of the heel, forefoot adduction, and supination are more severe than in typical clubfoot. The feet are short and stubby, with deep creases above the heel and on the plantar surface. To successfully treat this subgroup of patients, orthopaedic clinicians must be able to recognise the clinical characteristics of complex clubfoot and implement the appropriate treatment effectively.Methods A total of 11 patients with 16 clubfeet were included in this study. Demographic features, clubfoot severity, number of casts, position of each foot before cast removal, ankle dorsiflexion (DF), complications, and additional procedures were noted at all clinical visits.Results The mean follow-up period was 13.3 months. All patients were initially corrected using a mean of 7 (5–8) casts and Achilles tenotomy. Relapses occurred in three patients (18.75%), but all recovered after recasting. The creases above the heels disappeared in all of the patients, whereas plantar creases persisted on two (12.5%) feet. The mean Pirani scores calculated at the first visit, after tenotomy, and at the final visit were 5.22± 0.52,, 0.72 ± 0.41and 0.41 ± 0.42, respectively. The mean DF measurements recorded before tenotomy, after tenotomy, and at the final visit were 8.31° ± 3.03°, 15.19° ± 3.75 °, and 20.19° ± 4.46°, respectively. Pirani scores and DF improved statistically significantly after treatment, and DF improved significantly between tenotomy and the final visit.Conclusions The modified Ponseti method is an effective treatment for complex clubfoot. It is crucial that orthopaedic clinicians can recognise this deformity at any stage and implement the modified Ponseti method effectively.
Derivation and validation of a novel clinical decision aid to distinguish between uncomplicated and complicated appendicitis in children.
Authors: Loukogeorgakis Stavros P. , Major Christina , Jones Ceri E , Corbett Harriet J. , Folaranmi Semiu Eniola , Stanton Michael P , Rex Dean , Hall Nigel J
Published: April 2020

Aim of Study:Non-operative treatment of acute uncomplicated appendicitis (UA) in children might be equally effective to surgery but requires accurate discrimination from those with complicated appendicitis (CA) to ensure safety and maximise efficacy. We aimed to identify specific clinical and laboratory parameters that would aid distinction between UA and CA in children.Methods:Retrospective review of consecutive children with a clinical +/- radiological diagnosis of acute appendicitis that underwent appendicectomy in three specialist paediatric surgical centres between March 2017 and February 2018. Demographic, clinical and laboratory data were retrieved and analysed in relation to intra-operative and histopathological findings. CA was defined as gangrene and/or perforation seen intra-operatively and/or in histopathological analysis. Multiple logistic regression analysis was used to derive a novel prediction model that could accurately distinguish UA and CA. A priori we set analytical parameters so as to ensure the score had a positive predictive value (PPV) for UA of >95%. The resulting scoring system was validated in an independent cohort of children.Main Results: The prediction model was derived from 130 children (UA: 71; CA: 59) with median age (range) 10 (2-15) years. Initial univariate analysis identified six factors significantly associated (p<0.01) with CA (duration of abdominal pain, presence of rebound tenderness, temperature, , white cell count, , neutrophil count and C-reactive protein [CRP]). These variables were entered in the regression model, and points awarded based on the adjusted odds ratios. Receiver operating characteristic analysis demonstrated a threshold of ≥4 points for prediction of CA. The scoring system was validated in an independent cohort of 112 children (UA: 51; CA: 61); it was found to have a sensitivity of 98% and specificity 78%. A score of <4 points had a PPV for UA of 98%.Conclusions: Our novel scoring system can discriminate between UA and CA in children with high accuracy. Children with a score <4 could be eligible for non-operative treatment.
YAP promotes sorafenib resistance in hepatocellular carcinoma by upregulating survivin
Authors: Sun Ting , Mao Wenhao , Jiao Lin , Wan Junhu , Ming Liang
Published: April 2020

Background

Sorafenib is the standard first-line treatment for advanced hepatocellular carcinoma (HCC), but its use is hampered by the secondary drug resistance. Yes-associated protein (YAP) is the crucial downstream effector of the Hippo signaling pathway, which is crucial for liver tumorigenesis. However, the underlying mechanism regarding YAP and sorafenib resistance remains unclear.
Methods

Western blotting, flow cytometry, and CCK-8 assay were used to confirm the role of YAP in HCC sorafenib resistance. RT-PCR and western blotting were then performed to identify survivin as downstream of YAP, whereas rescue experiments were performed to confirm that YAP induces sorafenib resistance via survivin. Further, western blotting, flow cytometry, and an in vivo xenograft model were used to evaluate the function of verteporfin in combination with sorafenib in HCC.
Results

We found that sorafenib enhances YAP nuclear accumulation and activates YAP, which promotes sorafenib resistance by inhibiting apoptosis in HCC cells. Moreover, survivin acted as a downstream mediator of YAP to resist sorafenib-induced apoptosis. Pharmacological inhibition of YAP by verteporfin inhibited HCC cells proliferation and restored the sensitivity to sorafenib. Moreover, verteporfin in combination with sorafenib significantly suppressed HepG2 xenograft tumor growth.
Conclusions

Our study indicates that YAP promotes sorafenib resistance in HCC through upregulating survivin expression. Targeting YAP may be a potential therapeutic strategy to improve the antitumor effects of sorafenib in HCC.
O RECONHECIMENTO DO DIREITO À CIDADANIA ITALIANA POR BRASILEIROS E COMO A COMUNIDADE INTERNACIONAL ENCARA A POLIPATRIDIA
Authors: ALVES Renato Vercesi Almada Nogueira , ROCHA Manoel Ilson Cordeiro
Published: April 2020

O presente artigo busca apresentar os meios necessários para que um brasileiro, descendente de italianos, possa ter reconhecido esse direito à cidadania italiana através do critério jus sanguinis, que é o adotado pela legislação italiana para a atribuição da nacionalidade. Para tal, é necessária a comprovação dos lações familiares com esse italiano que agora vive (ou viveu) no Brasil, montando-se uma verdadeira árvore genealógica até que se chegue ao interessado em requerer tal prerrogativa, e o estudo em questão demonstrará quais os documentos necessários para trilhar esse caminho até o almejado reconhecimento, por parte do Estado italiano, desse laço parental. Após ser apresentado o melhor caminho e o rol de documentos necessários, com o qual o impacto dessa aquisição no direito nacional, é demonstrado como a Comunidade Internacional vislumbra o indivíduo que possuir duas nacionalidades, tendo assim a proteção de dois Estados diferentes, como os problemas que isso pode gerar, principalmente, no que diz respeito à proteção diplomática dada por estes Estados.
POLÍTICAS PÚBLICAS LIGADAS À SEGURIDADE SOCIAL
Authors: OLIVER Renata Cristina Faria
Published: April 2020

O presente trabalho visa elucidar e pontuar como as políticas públicas voltadas à seguridade social são efetivadas, tecendo considerações sobre a Saúde, Previdência Social e Assistência Social. O constituinte de 1988 concebeu a seguridade social como um conjunto de ações do Estado, por meio de políticas públicas, com o intuito de proporcionar aos cidadãos brasileiros condições mínimas existenciais. É demonstrado através de um estudo interdisciplinar como é o orçamento público e o custeio dos direitos fundamentais, a teoria da reserva do possível e do mínimo existencial.
O FIM DA JURISPRUDÊNCIA DEFENSIVA PELO NOVO CÓDIGO DE PROCESSO CIVIL?
Authors: OKUMOTO Mariane Vergara , MELO FILHO Renato Luis
Published: April 2020

O presente artigo discorre sobre a dicotomia que reside em delimitar os contornos da nova jurisprudência brasileira, com o advento do Novo Código de Processo Civil em vigor pela Lei nº 13.105/2015 e já alterado em vacatio legis pela Lei nº 13.256/2016 e a fixação de precedentes obrigatórios e de sistemas formadores de fontes jurisprudenciais como o Incidente de Resolução de Demandas Repetitivas (IRDR), Incidente de Assunção de Competência (IAC) e Sistema de Recursos Repetitivos. Visa, ainda, analisar a postura defensiva – e até mesmo repressiva - dos Tribunais de Segundo Grau de Jurisdição bem como, principalmente, dos Tribunais Superiores frente a essas fontes jurisprudenciais novas.
RESPONSABILIDADE CIVIL DECORRENTE DO ABANDONO AFETIVO PARENTAL E SUA CONSEQUÊNCIAS À FILIAÇÃO
Authors: ANJOLETTO Joyce de Paula , BIANCO João Carlos
Published: April 2020

Este estudo tem como objetivo inserir um debate sobre a eficácia do cabimento ou não da aplicação da  responsabilidade civil no abandono afetivo, com ênfase às sérias consequências para com a filiação. A presente pesquisa propõe-se a apresentar os graves malefícios que o abandono afetivo possa vir a refletir na vida de crianças e adolescentes atingidos, trazendo concomitantemente, os respectivos aspectos favoráveis e contrários à introdução do instituto da responsabilidade civil como reparador dessas mazelas. Assim, por meio da exposição de estudos realizados a respeito do tema, mostra-se evidente a importância do afeto dentro do núcleo familiar, pois a sua ausência representa um desrespeito aos princípios e garantias constitucionais, porque apesar de inexistir legislação acerca do abandono afetivo, a proteção à integridade de crianças e adolescentes encontra-se amparada pela Constituição Federal e o Estatuto da Criança e do Adolescente responsáveis por assegurar direitos fundamentais que garantem seu desenvolvimento.
ASPECTOS GERAIS DA EFICIÊNCIA DO ESTADO NA INCLUSÃO DAS PESSOAS COM DEFICIÊNCIA
Authors: SOUSA Isabela Francisco de
Published: April 2020

As pessoas com deficiência, que, em um conceito bem amplo e genérico, podem ser definidas como aquelas que apresentam diferentes níveis de limitações (físicas, sensoriais, cognitivas, entre outras), foram, ao longo da história, relegadas a uma posição segregada na estrutura social. Durante muito tempo, foram consideradas “inválidas” ou “incapazes”, acreditando-se que eram merecedoras da caridade privada e/ou do assistencialismo por parte do Estado. Esse “status social” foi se alterando com o passar do tempo, advindo a percepção de que esses indivíduos devem ser incluídos na sociedade, necessitando de suportes e adaptações necessárias para terem plena capacidade de exercerem suas atividades e seus direitos de forma igualitária, nascendo a ideia de que a deficiência está diretamente ligada ao ambiente em que a pessoa está inserida, sendo que quanto menos obstáculos, menos a sua limitação será relevante e impeditiva.
Change and Continuity in the Urban Semiosphere of Post-Soviet Kharkiv
Authors: Malykhina Svitlana
Published: April 2020

The paper studies change and continuity in the urban semiosphere of Kharkiv in the post-Maidan period, focusing on themes such as the interplay of languages, street art, toponyms, and the significance of political, ideological, commercial, and artistic discourses in the urban space. The urban vernacular of Kharkiv is examined via the concept of the palimpsest that helps to expose the process of acceptance or rejection of the past, and to assess how things are remembered and forgotten through the tropes of the old narrative that were scrapped and replaced with new ones. The analysis of the linguistic landscape in this study focuses on a broader, more inclusive set of components that are part of public spaces, such as street graffiti metaphors and reactions to the text on graffiti. Thus, а multimodal approach is essential to provide deeper meanings and interpretations of public spaces. To examine the complex linguistic landscape, I bring together a representative collection of public signage that mirrors the dynamics of different historical, linguistic, and ideological factors that shape the contemporary Ukrainian identity, along with the too obvious and simultaneous presence within it of markers of the collective identity from the Soviet period. The juxtaposition of overlapping narratives provides a means to discuss the city’s community-building efforts. My paper introduces a few familiar cases of how post-Soviet urban dwellers have shaped social spaces.
Review of Volodymyr Yavorivsky. The Chornobyl Madonna & Valeriy Shevchuk. Breath of Evil: Novellas Written by the Goatherd Ivan Shevchuk and Fashioned for Literary Use by His Great-Grandnephew.
Authors: Pavlyshyn Marko
Published: April 2020

Review of:

Volodymyr Yavorivsky. The Chornobyl Madonna. Translated from the Ukrainian by Yuri Tkacz, Bayda Books, 2016. 192 pp. Paper.

Valeriy Shevchuk. Breath of Evil: Novellas Written by the Goatherd Ivan Shevchuk and Fashioned for Literary Use by His Great-Grandnephew. Translated from the Ukrainian by Yuri Tkacz, foreword by Marko R. Stech, Bayda Books, 2016. 246 pp. Paper.
Fen Eğitimine Yönelik Öz-Yeterliğin Öğrenme Yaklaşımları ve Öğrenme-Öğretme Ortamına Yönelik Algılara Etkisinin İncelenmesi
Authors: Ültay Neslihan , Dönmez Usta Necla , Ültay Eser
Published: April 2020

Çalışmanın temel amacı; okul öncesi öğretmen adaylarının fen eğitimine yönelik öz-yeterliklerinin, öğrenme yaklaşımlarının ve öğrenme-öğretme ortamına yönelik algılarının incelenmesidir. Çalışma, ilişkisel tarama modeli kullanılarak yürütülmüştür. Çalışmanın örneklemini Giresun Üniversitesi Eğitim Fakültesi Okul Öncesi Öğretmenliği 1., 2., 3. ve 4. sınıflarında öğrenim görmekte olan 384 okul öncesi öğretmeni adayı oluşturmaktadır. Araştırmada veri toplama aracı olarak “Fen eğitimine yönelik öz-yeterlik ölçeği”, “Öğrenme yaklaşımları ölçeği” ve “Öğrenme-öğretme ortamına yönelik algı ölçeği” kullanılmıştır. Araştırmanın bulguları dikkate alındığında, okul öncesi 3. ve 4. sınıf öğretmen adaylarının fen öz-yeterliklerinin 1.sınıf öğretmen adaylarına oranla daha yüksek olduğu bulunmuştur. Araştırmadan elde edilen bir diğer sonuç da okul öncesi öğretmen adaylarının öğrenme yaklaşımlarının “derinlemesine” alt boyutunun 1. sınıflar lehine anlamlı derecede yüksek olduğu bulunmuştur. Sınıf seviyesi arttıkça derinlemesine öğrenme yaklaşımlarını tercih edenlerin sayısı azalmaktadır. Ayrıca öğrenme yaklaşımlarının “stratejik” alt boyutu için de yine 1. ve 2. sınıflar lehine anlamlı fark çıkmıştır. Öğrenme yaklaşımlarının “yüzeysel” alt boyutu için sınıf seviyelerine göre anlamlı bir farklılaşma görülmemiştir. Araştırmanın ulaştığı bir diğer sonuç da, okul öncesi öğretmen adaylarının sınıf seviyelerine göre öğrenme-öğretme ortamına yönelik algıları arasında 1. ve 2. sınıflar lehine farkın bulunması ve sınıf seviyeleri arttıkça öğretmen adaylarının öğrenme-öğretme ortamına yönelik algı puanlarının gittikçe düşmesidir. Araştırmanın dördüncü alt probleminden elde edilen sonuç ise okul öncesi öğretmen adaylarının fen eğitimine yönelik öz-yeterlikleri ile öğrenme yaklaşımlarını tercih etmeleri arasında orta düzeyde pozitif yönlü bir ilişkinin olmasıdır. Ayrıca okul öncesi öğretmen adaylarının fen eğitimine yönelik öz-yeterlikleri ile öğrenme-öğretme ortamına yönelik algıları arasında da öğrenme yaklaşımlarına oranla daha düşük yine pozitif yönlü bir ilişki bulunmuştur. Okul öncesi öğretmen adaylarının öğrenme yaklaşımlarını tercih etmeleri ise öğrenme-öğretme ortamına yönelik algıları ile daha yüksek oranda ilişkili çıkmıştır.
The Therapeutic Potential and Usage Patterns of Cannabinoids in People with Spinal Cord Injuries: A Systematic Review
Authors: Nabata Kylie J. , Tse Emmanuel K. , Nightingale Tom E. , Lee Amanda H.X. , Eng Janice J. , Querée Matthew , Walter Matthias , Krassioukov Andrei V.
Published: April 2020

Background:

People with spinal cord injuries (SCI) commonly experience pain and spasticity;
limitations of current treatments have generated interest in cannabis as a possible therapy.

Objectives:

We conducted this systematic review to: 1) examine usage patterns and reasons for cannabinoid
use, and 2) determine the treatment efficacy and safety of cannabinoid use in people with
SCI.

Methods:

PubMed, Embase, Web of Science and Cumulative Index to Nursing and Allied Health
Literature databases were queried for keywords related to SCI and cannabinoids.

Results:

7,232 studies were screened, and 34 were included in this systematic review. Though 26
studies addressed cannabinoid usage, only 8 investigated its therapeutic potential on outcomes such
as pain and spasticity. The most common method of use was smoking. Relief of pain, spasticity and
recreation were the most common reasons for use. A statistically significant reduction of pain and
spasticity was observed with cannabinoid use in 83% and 100% of experimental studies, respectively.
However, on examination of randomized control trials (RCTs) alone, effect sizes ranged from -
0.82 to 0.83 for pain and -0.95 to 0.09 for spasticity. Cannabinoid use was associated with fatigue
and cognitive deficits.

Conclusion:

Current evidence suggests that cannabinoids may reduce pain and spasticity in people
with SCI, but its effect magnitude and clinical significance are unclear. Existing information is lacking
on optimal dosage, method of use, composition and concentration of compounds. Long-term,
double-blind, RCTs, assessing a wider range of outcomes should be conducted to further understand
the effects of cannabinoid use in people with SCI.
Online Romance Scams: Relational Dynamics and Psychological Characteristics of the Victims and Scammers. A Scoping Review
Authors: Coluccia Anna , Pozza Andrea , Ferretti Fabio , Carabellese Fulvio , Masti Alessandra , Gualtieri Giacomo
Published: April 2020

Background:

Digital communication technologies can overcome physical, social and psychological barriers in building romantic relationships. Online romance scams are a modern form of fraud that has spread in Western societies along with the development of social media and dating apps. Through a fictitious Internet profile, the scammer develops a romantic relationship with the victim for 6-8 months, building a deep emotional bond to extort economic resources in a manipulative dynamic. There are two notable features: on the one hand, the double trauma of losing money and a relationship, on the other, the victim's shame upon discovery of the scam, an aspect that might lead to underestimation of the number of cases.

Objectives:

This paper presents a scoping review of the quantitative and qualitative evidence on this issue, focusing on epidemiological aspects, relational dynamics, and the psychological characteristics of victims and scammers.

Methods:

A literature scoping review was conducted using electronic databases and descriptors. Studies were included if they had analyzed the phenomenon in any population or the relationship dynamics characterizing it through whatsoever typology of design. Scoping reviews are a form of knowledge synthesis, which incorporates a range of study designs and wide eligibility criteria to comprehensively summarize evidence with the aim of informing practice, programs, and policy and providing direction to future research priorities.

Results:

Twelve studies were included. Sixty-three percent of social media users and 3% of the general population report having been a victim at least once. Some psychological variables appear to be associated with the risk of being scammed, such as female gender, middle-age, higher levels of neuroticism, tendencies to the romantic idealization of affective relations, sensation seeking, impulsiveness and susceptibility to addiction. We analyse literature limitations and future directions.

Conclusion:

Since this emerging phenomenon is still largely unrecognized, understanding the psychological characteristics of victims and scammers will allow at-risk personality profiles to be identified and prevention/intervention strategies to be developed.
Mobile Applications for the Promotion and Support of Healthy Nutrition and Physical Activity Habits: A Systematic Review, Extraction of Features and Taxonomy Proposal
Authors: Villasana María Vanessa , Pires Ivan Miguel , Sá Juliana , Garcia Nuno M. , Zdravevski Eftim , Chorbev Ivan , Lameski Petre , Flórez-Revuelta Francisco
Published: April 2020

Background:

Mobile applications can be used for the monitoring of lifestyles and physical activity. It can be installed in commodity mobile devices, which are currently used by different types of people in their daily activities worlwide .

Objective:

This paper reviews and categorizes the mobile applications related to diet, nutrition, health, physical activity and education, showing the analysis of 73 mobile applications available on Google Play Store with the extraction of the different features.

Methods:

The mobile applications were analyzed in relation to each proposed category and their features, starting with the definition of the search keywords used in the Google Play Store. Each mobile application was installed on a smartphone, and validated whether it was researched in scientific studies. Finally, all mobile applications and features were categorized.

Results:

These mobile applications were clustered into four groups, including diet and nutrition, health, physical activity and education. The features of mobile applications were also categorized into six groups, including diet, anthropometric parameters, social, physical activity, medical parameters and vital parameters. The most available features of the mobile applications are weight, height, age, gender, goals, calories needed calculation, diet diary, food database with calories, calories burned and calorie intake.

Conclusion:

With this review, it was concluded that most mobile applications available in the market are related to diet, and they are important for different types of people. A promising idea for future work is to evaluate the acceptance by young people of such mobile applications.
In Vitro Cytotoxicity Evaluation of Oxytetracycline Loaded Cockle Shell Derived Calcium Carbonate Aragonite Nanoparticles
Authors: Idris Sherifat B. , Arifah Abdul K. , Jesse Faez F.A. , Ramanoon Siti Z. , Basit Muhammad A. , Zakaria Mohammad Z.A.B.
Published: April 2020

Background:

Evaluation of the toxic effects of nanoparticle-drug in vitro is an important
step in the design of new pharmaceutical formulations. Rapid results, reduced cost and easy handling
make cell culture models first line in initial toxicological assessment of nano-drug preparations.

Objective:

To evaluate the in vitro cytotoxicity of oxytetracycline loaded calcium carbonate aragonite
nanoparticle in normal mouse fibroblast (NIH3T3) cell line.

Methods:

NIH3T3 cells were exposed to varying concentrations (6.25-100 μg/mL) of calcium carbonate
aragonite nanoparticle (CS-CaCO3NP), oxytetracycline loaded calcium carbonate aragonite
nanoparticle (OTC-CS-CaCO3NP) and oxytetracycline (OTC) in 96 well plates for 24, 48 and 72
hours. Cell viability was determined by MTT and trypan blue assays.

Result:

Both assays showed that CS-CaCO3NP and OTC-CS-CaCO3NP had higher cell viability
values compared to OTC.

Conclusion:

Encapsulating OTC into CS-CaCO3NP reduced its cytotoxicity to NIH3T3 cells using
both MTT and trypan blue assay.
Lima, Tiempo Social y Desplazamientos Motorizados
Authors: Conto Quispe Zulema
Published: April 2020

A pesar de que, desde hace décadas, el uso generalizado del automóvil, como medio de transporte en las ciudades, ha sido cuestionado, y hoy muchas ciudades se enfocan en calmar el tráfico con políticas de restricción del uso del automóvil, en la ciudad de Lima el actual modelo de movilidad prioriza los modos motorizados privados, a pesar de que la mayoría de la población se desplaza en transporte público. El propósito de este artículo es evidenciar el tiempo social que pierden los limeños a causa del sistema de transporte, tanto si se desplazan en automóvil propio, como en transporte público.
Associations of Electronic Device Use Before and After Sleep With Psychological Distress Among Chinese Adults in Hong Kong: Cross-Sectional Study
Authors: Lee Jung Jae , Wang Man Ping , Luk Tzu Tsun , Guo Ningyuan , Chan Sophia Siu-Chee , Lam Tai Hing
Published: April 2020

Background

Hong Kong has a high rate of electronic device (e-device; computer, smartphone, and tablet) use. However, little is known about the associations of the duration of e-device use before and after sleep with psychological symptoms.

Objective

This study aimed to investigate the associations of the duration of e-device use before and after sleep with psychological distress.

Methods

A probability-based telephone survey was conducted on 3162 Hong Kong adults (54.6% female; mean age 47.4 years, SD 18.3 years) in 2016. Multivariate linear and Poisson regressions were used to calculate adjusted regression coefficients (aBs) and prevalence ratios (aPRs) of anxiety and depressive symptoms (measured by Patient Health Questionnaire-4) for the duration from waking to the first e-device use (≥61, 31-60, 6-30, and ≤5 minutes) and the duration of e-device use before sleeping (≤5, 6-30, 31-60, and ≥61 minutes).

Results

The first e-device use in ≤5 (vs ≥61) minutes after waking was associated with anxiety (aB 0.35, 95% CI 0.24-0.46; aPR 1.74, 95% CI 1.34-2.25) and depressive symptoms (aB 0.27, 95% CI 0.18-0.37; aPR 1.84, 95% CI 1.33-2.54). Using e-devices for ≥61 (vs ≤5) minutes before sleeping was also associated with anxiety (aB 0.17, 95% CI 0.04-0.31; aPR 1.32, 95% CI 1.01-1.73) and depressive symptoms (aB 0.17, 95% CI 0.05-0.28; aPR 1.47, 95% CI 1.07-2.02). E-device use both ≤5 minutes after waking and for ≥61 minutes before sleeping was strongly associated with anxiety (aB 0.68, 95% CI 0.47-0.90; aPR 2.64, 95% CI 1.90-3.67) and depressive symptoms (aB 0.55, 95% CI 0.36-0.74; aPR 2.56, 95% CI 1.69-3.88).

Conclusions

E-device use immediately (≤5 minutes) after waking and use for a long duration (≥61 minutes) before sleeping were associated with anxiety and depressive symptoms among Chinese adults in Hong Kong.
Menstrual Cycle Length and Patterns in a Global Cohort of Women Using a Mobile Phone App: Retrospective Cohort Study
Authors: Grieger Jessica A , Norman Robert J
Published: April 2020

Background

There is increasing information characterizing menstrual cycle length in women, but less information is available on the potential differences across lifestyle variables.

Objective

This study aimed to describe differences in menstrual cycle length, variability, and menstrual phase across women of different ages and BMI among a global cohort of Flo app users. We have also reported on demographic and lifestyle characteristics across median cycle lengths.

Methods

The analysis was run based on the aggregated anonymized dataset from a menstrual cycle tracker and ovulation calendar that covers all phases of the reproductive cycle. Self-reported information is documented, including demographics, menstrual flow and cycle length, ovulation information, and reproductive health and diseases. Data from women aged ≥18 years and who had logged at least three cycles (ie, 2 completed cycles and 1 current cycle) in the Flo app were included (1,579,819 women).

Results

Of the 1.5 million users, approximately half (638,683/1,579,819, 40.42%) were aged between 18 and 24 years. Just over half of those reporting BMIs were in the normal range (18.5-24.9 kg/m2; 202,420/356,598, 56.76%) and one-third were overweight or obese (>25 kg/m2; 120,983/356,598, 33.93%). A total of 16.32% (257,889/1,579,819) of women had a 28-day median cycle length. There was a higher percentage of women aged ≥40 years who had a 27-day median cycle length than those aged between 18 and 24 years (22,294/120,612, 18.48% vs 60,870/637,601, 9.55%), but a lower percentage with a 29-day median cycle length (10,572/120,612, 8.77% vs 79,626/637,601, 12.49%). There were a higher number of cycles with short luteal phases in younger women, whereas women aged ≥40 years had a higher number of cycles with longer luteal phases. Median menstrual cycle length and the length of the follicular and luteal phases were not remarkably different with increasing BMI, except for the heaviest women at a BMI of ≥50 kg/m2.

Conclusions

On a global scale, we have provided extensive evidence on the characteristics of women and their menstrual cycle length and patterns across different age and BMI groups. This information is necessary to support updates of current clinical guidelines around menstrual cycle length and patterns for clinical use in fertility programs.
The Impact of Video-Mediated Communication on Closed Wound Assessments in Postoperative Consultations: Conversation Analytical Study
Authors: Stommel Wyke J P , van Goor Harry , Stommel Martijn W J
Published: April 2020

Background

Research on the use of video-mediated technology for medical consultations is increasing rapidly. Most research in this area is based on questionnaires and focuses on long-term conditions. The few studies that have focused on physical examinations in video consultations indicated that it poses challenges for the participants. The specific activity of wound assessment through video in postsurgery consultations has not yet been studied. Furthermore, a comparative analysis of face-to-face and video settings on the moment-to-moment organization of such an activity is original.

Objective

The aim of this study was to examine the impact of video technology on the procedure of postsurgery wound assessment and its limits.

Methods

We recorded 22 postoperative video consultations and 17 postoperative face-to-face consultations. The primary purpose of the consultation was to inform the patient about the final pathology results of the resected specimen, and the secondary purpose was to check on the patient’s recovery, including an assessment of the closed wound. The recordings were transcribed in detail and analyzed using methods of conversation analysis.

Results

The way that an assessment of the wound is established in video consultations differs from the procedure in face-to-face consultations. In the consultation room, wound assessments overwhelmingly (n=15/17) involve wound showings in the context of surgeons reporting their observations formatted with evidentials (“looks neat”) and subsequently assessing what these observations imply or what could be concluded from them. In contrast, wound assessments in video consultations do not tend to involve showing the wound (n=3/22) and, given the technological restrictions, do not involve palpation. Rather, the surgeon invites the patient to assess the wound, which opens up a sequence of patient and physician assessments where diagnostic criteria such as redness or swollenness are made explicit. In contrast to observations in regular consultations, these assessments are characterized by epistemic markers of uncertainty (“I think,” “sounds...good”) and evidentials are absent. Even in cases of a potential wound problem, the surgeon may rely on questioning the patient rather than requesting a showing.

Conclusions

The impact of video technology on postoperative consultations is that a conclusive wound assessment is arrived at in a different way when compared to face-to-face consultations. In video consultations, physicians enquire and patients provide their own observations, which serve as the basis for the assessment. This means that, in video consultations, patients have a fundamentally different role. These talking-based assessments are effective unless, in cases of a potential problem, patient answers seem insufficient and a showing might be beneficial.
Predictive performance and impact of algorithms in remote monitoring of chronic conditions: a systematic review and meta-analysis (Preprint)
Authors: Castelyn Grant , Laranjo Liliana , Schreier Günter , Gallego Blanca
Published: April 2020

BACKGROUND

The use of telehealth interventions, such as the remote monitoring of patient clinical data (e.g. blood pressure, blood glucose, heart rate, medication use), has been proposed as a strategy to better manage chronic conditions and to reduce the impact on patients and healthcare systems. The use of algorithms for data acquisition, analysis, transmission, communication and visualisation are now common in remote patient monitoring. However, their use and impact on chronic disease management has not been systematically investigated.

OBJECTIVE

To investigate the use, impact, and performance of remote monitoring algorithms across various types of chronic conditions.

METHODS

A literature search of MEDLINE complete, CINHAL complete, and EMBASE was performed using search terms relating to the concepts of remote monitoring, chronic conditions, and data processing algorithms. Comparable outcomes from studies describing the impact on process measures and clinical and patient-reported outcomes were pooled for a summary effect and meta-analyses. A comparison of studies reporting the predictive performance of algorithms was also conducted using the Youden Index.

RESULTS

A total of 89 articles were included in the review. There was no evidence of a positive impact on healthcare utilisation [OR 1.09 (0.90 to 1.31); P=.35] and mortality [OR 0.83 (0.63 to 1.10); P=.208], but there was a positive effect on generic health status [SDM 0.29 (0.06 to 0.51); P=.010] and diabetes control [SDM -0.53 (-0.74 to -0.33); P<.001; I2 = 15.71] (with two of the three diabetes studies being identified as having a high risk of bias). While the majority of impact studies made use of heuristic threshold-based algorithms (n=27 ,87%), most performance studies (n=36, 62%) analysed non-sequential machine learning methods. There was considerable variance in the quality, sample size and performance amongst these studies. Overall, algorithms involved in diagnosis (n=22, 47%) had superior performance to those involved in predicting a future event (n=25, 53%). Detection of arrythmia and ischaemia utilising ECG data showed particularly promising results.

CONCLUSIONS

The performance of data processing algorithms involved with the diagnosis of a current condition, particularly those related to the detection of arrythmia and ischaemia, is promising. However, there appears to minimal testing in experimental studies, with only two included impact studies citing a performance study as support for the intervention algorithm used. Thus, there is currently limited evidence of the effect of integrating advanced inference algorithms in remote monitoring interventions.

CLINICALTRIAL
The Influence of Electronic Health Record Use on Physician Burnout: Cross-Sectional Survey (Preprint)
Authors: Tajirian Tania , Stergiopoulos Vicky , Strudwick Gillian , Sequeira Lydia , Sanches Marcos , Kemp Jessica , Ramamoorthi Karishini , Zhang Timothy , Jankowicz Damian
Published: April 2020

BACKGROUND

Physician burnout has a direct impact on the delivery of high-quality health care, with health information technology tools such as electronic health records (EHRs) adding to the burden of practice inefficiencies.

OBJECTIVE

The aim of this study was to determine the extent of burnout among physicians and learners (residents and fellows); identify significant EHR-related contributors of physician burnout; and explore the differences between physicians and learners with regard to EHR-related factors such as time spent in EHR, documentation styles, proficiency, training, and perceived usefulness. In addition, the study aimed to address gaps in the EHR-related burnout research methodologies by determining physicians’ patterns of EHR use through usage logs.

METHODS

This study used a cross-sectional survey methodology and a review of administrative data for back-end log measures of survey respondents’ EHR use, which was conducted at a large Canadian academic mental health hospital. Chi-square and Fisher exact tests were used to examine the association of EHR-related factors with general physician burnout. The survey was sent out to 474 individuals between May and June 2019, including physicians (n=407), residents (n=53), and fellows (n=14), and we measured physician burnout and perceptions of EHR stressors (along with demographic and practice characteristics).

RESULTS

Our survey included 208 respondents, including physicians (n=176) and learners (n=32). The response rate was 43.2% for physicians (full-time: 156/208, 75.0%; part-time: 20/199, 10.1%), and 48% (32/67) for learners. A total of 25.6% (45/176) of practicing physicians and 19% (6/32) of learners reported having one or more symptoms of burnout, and 74.5% (155/208) of all respondents who reported burnout symptoms identified the EHR as a contributor. Lower satisfaction and higher frustration with the EHRs were significantly associated with perceptions of EHR contributing toward burnout. Physicians’ and learners’ experiences with the EHR, gathered through open-ended survey responses, identified challenges around the intuitiveness and usability of the technology as well as workflow issues. Metrics gathered from back-end usage logs demonstrated a 13.6-min overestimation in time spent on EHRs per patient and a 5.63-hour overestimation of after-hours EHR time, when compared with self-reported survey data.

CONCLUSIONS

This study suggests that the use of EHRs is a perceived contributor to physician burnout. There should be a focus on combating physician burnout by reducing the unnecessary administrative burdens of EHRs through efficient implementation of systems and effective postimplementation strategies.
Archetypes of Gamification: Analysis of mHealth Apps (Preprint)
Authors: Schmidt-Kraepelin Manuel , Toussaint Philipp A. , Thiebes Scott , Hamari Juho , Sunyaev Ali
Published: April 2020

BACKGROUND

Nowadays, numerous health-related mobile apps implement gamification in an attempt to draw on the motivational potential of video games and thereby increase user engagement or foster certain health behaviors. However, research on effective gamification is still in its infancy and researchers increasingly recognize methodological shortcomings of existing studies. What we actually know about the phenomenon today stems from fragmented pieces of knowledge, and a variety of different perspectives. Existing research primarily draws on conceptual knowledge that is gained from research prototypes, and isolated from industry best practices. We still lack knowledge on how gamification has been successfully designed and implemented within the industry and whether certain gamification approaches have shown to be particularly suitable for certain health behaviors.

OBJECTIVE

We address this lack of knowledge concerning best practices in the design and implementation of gamification for health-related mobile apps by identifying archetypes of gamification approaches that have emerged in pertinent health-related mobile apps and analyzing to what extent those gamification approaches are influenced by the underlying desired health-related outcomes.

METHODS

A 3-step research approach is employed. As a first step, a database of 143 pertinent gamified health-related mobile apps from the Apple App Store and Google Play Store is set up. Second, the gamification approach of each app within the database is classified based on an established taxonomy for gamification in health-related apps. Finally, a 2-step cluster analysis is conducted in order to identify archetypes of the most dominant gamification approaches in pertinent gamified health-related mobile apps.

RESULTS

Eight archetypes of gamification emerged from the analysis of health-related mobile apps: (1) competition and collaboration, (2) pursuing self-set goals without rewards, (3) episodical compliance tracking, (4) inherent gamification for external goals, (5) internal rewards for self-set goals, (6) continuous assistance through positive reinforcement, (7) positive and negative reinforcement without rewards, and (8) progressive gamification for health professionals. The results indicate a close relationship between the identified archetypes and the actual health behavior that is being targeted.

CONCLUSIONS

By unveiling salient best practices and discussing their relationship to targeted health behaviors, this study contributes to a more profound understanding of gamification in mobile health. The results can serve as a foundation for future research that advances the knowledge on how gamification may positively influence health behavior change and guide practitioners in the design and development of highly motivating and effective health-related mobile health apps.
Early forecasts of the evolution of the COVID-19 outbreaks and quantitative assessment of the effectiveness of countering measures. (Preprint)
Authors: Daddi Emanuele , Giavalisco Mauro
Published: April 2020

UNSTRUCTURED

We discovered that the time evolution of the inverse fractional daily growth of new infections, N/dN, in the current outbreak of COVID-19 is
accurately described by a universal function, namely the two-parameter Gumbel cumulative function, in all countries that we have investigated. While the two Gumbel parameters, as determined bit fits to the data, vary from country to country (and even within different regions of the same country), reflecting the diversity and efficacy of the adopted containment measures, the functional form of the evolution of N/dN appears to be universal. The result of the fit in a given region or country appears to be stable against variations of the selected time interval. This makes it possible to robustly estimate the two parameters from the data data even over relatively small time periods. In turn, this allows one to predict with large advance and well-controlled confidence levels, the time of the peak in the daily new infections, its magnitude and duration (hence the total
infections), as well as the time when the daily new infections decrease to a pre-set value (e.g. less than about 2 new infections per day per million
people), which can be very useful for planning the reopening of economic and social activities. We use this formalism to predict and compare
these key features of the evolution of the COVID-19 disease in a number of countries and provide a quantitative assessment of the degree of
success in in their efforts to countain the outbreak.