bluuebunny/crossref_metadata_2025 huggingface dataset:
Elucidation of gastric motor function caused by gastroesophageal reflux in Rumination syndrome
Authors: Nakagawa Kenichiro
Published: April 2023

Rumination syndrome (RS) is a disease of the gastrointestinal (GI) tract characterised by repeated regurgitation of recently digested food back into the mouth. It can be difficult to distinguish from gastro-oesophageal reflux disease (GERD) and it is likely that many RS patients are
treated for GERD due to being misdiagnosed. Assistant Professor Kenichiro Nakagawa is leading a team of experts based in the Division of Gastroenterology, Tohoku University Graduate School of Medicine, Japan, investigating the causes of gastroesophageal reflux. The researchers have already
found that RS and GERD are very different in terms of pathology. They are using high-resolution impedance manometry (HRIM) as a diagnostic tool to comprehensively assess the motor function and bolus transit of food through the oesophagus. They are also utilising oesophageal multichannel intraluminal
impedance-pH (MII-pH) monitoring to assess the pH of targeted oesophageal and gastric regions of the GI tract. In doing so, the team can pinpoint gastroesophageal reflux patterns, in turn highlighting the differences in gastroesophageal reflux patterns between RS and GERD patients and healthy
control subjects. Using oesophagogastric scintigraphy, the researchers can compare the ratio of regurgitated food during gastroesophageal reflux in their three test groups, analysing where the food residue in RS and GERD patients and healthy control subjects localises in the proximal stomach.
Comprehensive quantitative analysis of single-molecule proteins using ribosome fusion nanopore technology
Authors: Uemura Sotaro
Published: April 2023

The detection and analysis of proteins is important for science and medicine and methods for sequencing and synthesising proteins have been developed to assist with this. The analysis of single molecules provides more detailed and targeted information and the development of single-molecule
techniques has helped to advance molecular research. Professor Sotaro Uemura, The University of Tokyo, Japan, has over 20 years experience in this field of research, with a focus on singling out and measuring single-molecule proteins using optical tweezers, fluorescence imaging and other techniques.
Labelling is a key technology that facilitates the detection of target molecules and molecular sorting by the labelling process provides numerous advantages. However, there are restrictions to this technique, leading to Uemura's involvement in utilising label-free technology
to assist in the detection and measurement of single molecules. Nanopore measurement is interesting, especially in its use as a DNA sequencer but, using this method, it isn't possible to pinpoint which molecule each signal comes from. Uemura is interested in using Artificial
Intelligence (AI) as an additional analysis method that can link the signals. He is working with collaborators to use machine learning to determine which molecules are producing the signals identified by nanopore measurement.
Investigation of the effect and prediction factors of bevacizumab on immunoregulation in glioblastoma
Authors: Tanaka Toshihide
Published: April 2023

Glioblastoma (GB) is one of the most common and malignant tumours that originates in the brain. It has a high likelihood of recurrence and a poor survival rate. Professor Toshihide Tanaka, Chief Medical Officer, Jikei University School of Medicine, conducts translational research based
on clinical samples of glioblastoma tumours obtained from brain tumour surgery procedures as well as animal studies. He heads up a multidisciplinary team focused on the design and selection of personalised treatments for hypervascular malignant gliomas. In their current project, the researchers
are investigating the use of Bevacizumab (Bev), a monoclonal antibody that targets vascular endothelial growth factor (VEGF). VEGF enhances tumour growth by changing the surrounding environment to one more favourable for tumour growth. The effect of Bev on cancers is transient and the mechanisms
of resistance to Bev are yet to be investigated in detail. The researchers are therefore seeking to discover predictive biomarkers of microenvironment-targeted therapy for GB. In order to investigate the effect and prediction factors of Bev on immunoregulation in GB, Tanaka and the team perform
in situ observations using histological techniques including immunohistochemistry using tumour tissues from patients who have undergone surgical resection. The researchers have been able to demonstrate a decrease in microvascular density and an improvement in the tumour microenvironment after
treatment with Bev.
Development of detection kit for bad oral bacteria - a NASH factor
Authors: Nagamine Kentaro
Published: April 2023

Oral and systemic health are linked, with bad Streptococcus mutans (S. mutans) linked to increased risk of intracerebral micro-bleeding and heart disease, and Porphyromonas gingivalis (P. gingivalis) reports of links between periodontal disease and non-alcoholic steatohepatitis (NASH),
diabetes, rheumatoid arthritis, Alzheimer's disease, premature birth, and underweight birth. Dr Kentaro Nagamine, Department of Clinical Nutrition, Hiroshima International University, Japan, was involved in the loop-mediated isothermal amplification (LAMP) method and is applying this to oral
health, developing primers for LAMP of S. mutans and P. gingivalis and has also developed methods to culture oral bacteria. In one project, he is developing a detection kit for bad S. mutans (cnm gene positive S. mutans). The method he is developing is simple and effective compared to existing
methods that tend to be complicated and lengthy. It involves taking a saliva sample, which is then cultured and put into the LAMP reaction solution. Then, the target gene is amplified and gene amplification is seen, this confirms that the bacteria is present. Not only can a result be obtained
within two days, but the method also has the ability to amplify multiple types of bacteria. Nagamine is collaborating with a dental clinic that is utilising his method and, in the future, he hopes it can be used for dental examinations in numerous countries and regions, particularly in developing
countries.
Deep learning in detecting tumor spread through air spaces
Authors: Chung I-Fang
Published: April 2023

Lung cancer is a leading cause of death on a global scale. Professor I-Fang Chung leads a team of researchers at the Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taiwan, investigating how machine learning can help predict the risk of tumour recurrence
following lung cancer surgery. The standard treatment for early-stage lung cancer patients is complete surgical resection of the tumour but disease recurrence within the first five years following surgery is common. The route of this recurrence is usually tumour spread through the air spaces
(STAS) and the presence of STAS has recently been identified as a risk factor for recurrence of tumours. The researchers are exploring the importance of STAS and how targeting this phenomenon and using machine learning methods to aid in the analysis of medical imaging of diseased tissues can
help in predicting the recurrence risk of post-surgery lung cancer patients. Dr Yi-Chen Yeh, a pathologist from the Taipei Veterans General Hospital, is working with Chung to employ a variety of deep-learning object detection methodologies to detect STAS in pathology images. Regions of interest
(ROI) images extracted from pathology whole slide images (WSI) are marked and annotated, which provides location information for STAS. Deep learning object detection methods are used to train a model which can find STAS, then additional techniques including using pre-trained model parameters,
augmenting random image data and modifying loss function are used to improve the detection rates for the model. Their model helps pathologists identify STAS and accurately predicts patient outcomes.
Establishing a predictive model for unsafe driving in the elderly using artificial intelligence and elucidating the neural basis
Authors: Yamagata Bun
Published: April 2023

In Japan, there is a social issue associated with accidents caused by elderly drivers. Although mandatory cognitive function tests when renewing driving lessons screen for dementia, they cannot account for risk of unsafe driving due to the natural ageing process. In his work, Associate
Professor Bun Yamagata, Department of Neuropsychiatry, Keio University School of Medicine, has been using imaging techniques such as MRI and NIRS and combining the data obtained with neuropsychological evaluations and artificial intelligence (AI) technology to better understand brain function
and structural abnormalities within the brain. In partnership with ergonomics and mechanical engineering specialist Associate Professor Motoki Shino, from The University of Tokyo, he is conducting an innovative study on driving behaviours and brain atrophy patterns. By combining engineering
and neuropsychology techniques the researchers will develop algorithms that predict the risk of dangerous driving behaviours in elderly drivers. In research exploring the relationship between the structural connectivity of white matter in the brain and the driving ability of healthy older
people Yamagata found that changes in the white matter within the dorsal attention network may contribute to a higher risk of unsafe driving behaviours in healthy elderly people. The researchers have used machine learning to develop a model that predicts the risk of unsafe driving in healthy
older people with high accuracy from neuropsychological tests and practical visual acuity.
Co-evolution of Human and AI-Robots to Expand Science Frontiers
Authors: Harada Kanako
Published: April 2023

The possibility for Artificial Intelligence (AI)-robot scientists to work alongside human scientists is an exciting area of exploration in the world of AI, robotics and automated machines. Moonshot R&D is a flagship program in Japan that brings researchers together on R&D projects
with the goal of overcoming challenging societal issues. Toshio Fukuda is Program Director of Goal three of the program's nine goals and envisions a future in which AI robots and humans co-exist. As such, one of the targets of Goal three is the: "Realization of Artificial Intelligence (AI)
robots that autonomously learn, adapt to their environment, evolve itself in intelligence, and act alongside human beings, by 2050". Associate Professor Kanako Harada, Center for Disease Biology and Integrative Medicine (CDBIM), Graduate School of Medicine, The University of Tokyo, Japan,
is a Project Manager working on this target. She is currently managing a project entitled the 'Co-Evolution of Human and AI-Robots to Expand Science Frontiers', in which she and her collaborators are developing AI-robot scientists that can collaborate in the lab, autonomously performing scientific
experiments in challenging environments. The researchers anticipate that this could lead to the discovery of scientific principles and solutions by autonomous AI-robots in scientific fields by 2050.
"Strengthening research and partnerships for Sub-Saharan health"
Authors: Annette Lucy
Published: April 2023

In sub-Saharan Africa, infectious diseases are causing illness, death and impacting income, education and economic growth and development. There is a need for global action. The European and Developing Countries Clinical Trials Partnership (EDCTP) supports global health research in
sub-Saharan Africa and the United Nations Sustainable Development Goals (SDGs). It does this by funding clinical research for medical tools to detect, treat and prevent poverty-related infectious diseases in sub-Saharan Africa. EDCTP1 supported clinical trials on drugs, vaccines, microbicides
and diagnostics, with a focus on HIV/ AIDS, tuberculosis and malaria. EDCTP2 was set up in 2014 and will run until 2024. It is supported by Horizon 2020 and will advance international and national health policy and practise for poverty-related diseases. The Global Health EDCTP3 Joint Undertaking
(GH EDCTP3 JU) was launched in May 2022 and will run until the end of 2031. At its launch, Commissioner Mariya Gabriel delivered an opening speech in which she celebrated the progress made by EDCTP to date. 'So far, we have jointly invested over 1.4 billion euros in 440
grants, including 140 clinical trials projects and over 210 fellowships' she said. Impacts include a malaria vaccine for children and a child-friendly tablet formulation of the medication to treat the acute and chronic disease caused by parasitic worms. Gabriel said that
four EDCTP Regional Networks of Excellence have been established in order to facilitate high-quality clinical research and networking and praised EDCTP's resiliency through the COVID-19 pandemic.
Research for Community Oriented Approach for Comprehensive Healthcare in Emergency Situations (COACHES)
Authors: Kinoshita Mari
Published: April 2023

Japan has a high prevalence of natural disasters and it is essential that local and national governments and other organisations develop effective means of handling the impacts of disasters and the resulting emergencies. A research team led by Professor Mari Kinoshita based within the
Faculty of Nursing at the University of Kochi in Japan has helped propose a system called the Community Oriented Approach for Comprehensive Healthcare in Emergency Situations (COACHES) that has the potential to be implemented across Japan and lead to more effective and efficient responses
to the impacts of disasters and emergencies. Kinoshita has identified shortfalls with current methods of accumulating information about a disaster affected population and, through COACHES, wants to detect hidden or missed data and provide a whole picture of the situation to be able to provide
more optimised relief. COACHES provides information to relief personnel that is vital in an emergency situation, including data on where the affected people are located and how they are doing at the present time, which enables rescue and relief teams to prioritise according to the most urgent
need. Data is recorded so that it can be reviewed and analysed later, enabling continuous improvements.
Entrepreneurial intentions and perceived advantages by eastern students
Authors: Ali Shujahat , Alshiqi Sevdie , Ferasso Marcos , Sahiti Arbana , Bekteshi Xhelil
Published: April 2023

This study clarifies the student’s perspective in the disputed territory, to inculcate the influence of personality traits, moral obligation, entrepreneurial education, entrepreneurial intentions, and these relationships mediated by perceived advantage. A framework for the judgment of entrepreneurial mindset in the context of disputed territory and special administrative zones is presented. The data was collected from Eastern students at four universities. The current survey was conducted using purposive sampling, and the sample size was 344 students from four different universities. The study used CFA (Confirmatory Factor Analysis) and SEM (Structural Equation Modeling) for data analysis by using Smart PLS 3.2.9 and SPSS 26. The findings revealed the direct and indirect influence of personality traits entrepreneurial education and moral obligation on the intentions mediated by perceived advantage. Diversely, moral obligations do affect entrepreneurial intention in the presence of perceived advantage. The counterintuitive situation arises in the case of and helpful situation, where moral obligations are not playing role in the case of the disputed territory. The study contributes to enhancing the understanding of the entrepreneurial intention of university students in disputed territories. It brings into light the research agenda of entrepreneurship in disputed territories and special administrative areas. Specifically, the perceived advantage proved unique and verifiable intervening in the role between entrepreneurial education, personality traits, and the moral obligation with entrepreneurial intentions. This research supplies the basis for compatible academic and economic policy formulation. This study supplies a knowledge base for startups in special and disputed territories. It enhances innovation by making students fit their needs.
Сomparison of biomechanical properties of non-absorbable and partially absorbable mesh implants used in surgery for urinary incontinence and genital prolapse: experimental study
Authors: Shkarupa D. D. , Shakhaliev R. A. , Shulgin A. S. , Filipenko T. S. , Kubin N. D. , Labetov I. A. , Suchkov D. A.
Published: April 2023

Introduction. The amount of non-absorbable synthetic material used in the surgical treatment of pelvic organ prolapse and stress urinary incontinence has been shown to directly correlate with the risks of mesh-associated complications. Previously, we developed a partially absorbable implant. Currently, there are insufficient data on the use of partially absorbable implants in female pelvic floor reconstruction, which requires comparative biomechanical and pathomorphological studies.

Objective. To compare the biomechanical properties of a new generation partially absorbable implants and nonabsorbable polypropylene mesh implants during animal model.

Materials & methods. Thirty-nine rabbits weighing 3200 ± 250 g were randomised into three groups depending on the implanted endoprosthesis: group 1 (n = 15) — “Axilen” implant (polydioxanone 98%, polypropylene 2%), group 2 (n = 15) — “Axilen Rapid” implant (polyglycapron 98%, polypropylene 2%), group 3 (n = 9) — “Urosling 1” implant. After implantation, rabbits of all 3 groups were divided into 3 subgroups according to the withdrawal period from the experiment: 14 days, 60 days, and 180 days. The biomaterial obtained was subjected to two studies: evaluation of the macroscopic view of the explanted mesh endoprosthesis with the formed capsule and the surrounding tissues, study of the biomechanical properties of the formed connective tissue capsule with the implant.

Results. According to macroscopic evaluation, there was a less significant tissue reaction to partially absorbed implants. A comparative analysis of biomechanical indices revealed no statistically significant difference in rupture elongation at all follow-up periods among the presented groups. Tensile strength, at 60 and 180 days, was not statistically different between the groups described. At 14 days, there was a statistically significant difference in tensile strength between groups 1 and 3 (p = 0.003).

Conclusion. During biomechanical animal experiments, the connective tissue capsule formed on the partially absorbable implant was not inferior to the similar parameter of the non-absorbable sample in its tensile strength, which explains a great potential for the use of partially absorbable implants in reconstructive surgery of pelvic organ prolapse and stress urinary incontinence.
The use of platelet-rich plasma (PRP) in urology
Authors: Popov S. V. , Orlov I. N. , Topuzov T. M. , Gorelik M. L. , Perfil’yev M. A. , Kotlov M. A.
Published: April 2023

Platelet-rich plasma (PRP) is one of the most common and practicable plasma-therapy techniques. The wide therapeutic range for the use of this technique in various medical fields is due to its high content of growth factors, cytokines, and chemokines. The property of PRP to induce tissue regeneration is particularly highlighted, which is used actively for the treatment of a broad range of urological diseases. The review aimed to highlight the accumulated material on the topic of the use of autologous biomaterials based on blood in urology. This article highlights the urgent need for further study of the prospects for the use of autoplasma technologies in wide multicenter studies.
Risk factors for urinary incontinence in patients undergoing radical robot-assisted prostatectomy
Authors: Shvedov A. M. , Kolontarev K. B. , Bormotin A. V. , Dyakov V. V. , Vitoslavsky A. A. , Pushkar D. Yu.
Published: April 2023

Introduction. Prostate cancer (PCa) is one of the most common cancers among men, and the tactic to treat this disease stage-depends directly. The “gold” standard for localized PCa is radical robot-assisted prostatectomy (RARP). Patients often have excessive surgery requirements and are concerned about the development of postoperative complications. One of the most frequent functional complications after this operation is urinary incontinence (UI), whose formation mechanism is not fully understood. Clinical studies have described many UI predisposing factors, but the results obtained are often contradictory, which requires a repeated and deeper study of the issue.

Objective. To identify predisposing factors for urinary incontinence in patients undergoing radical robot-assisted prostatectomy.

Materials & methods. The search results for the scientific databases PubMed, Medline, Web of Science, Embase, Cochrane Library and PEDro, Wang-fang Database and CNKI, Edline were analyzed for the queries "robot-assisted prostatectomy", "radical prostatectomy", "incontinence", "predictors", "urinary incontinence".

Results. The predisposing factors to UI after RARP were studied. The review discusses and illustrates in detail all known predisposing factors for UI and shows the inconsistency of the data obtained by different researchers, which once again emphasizes the need for further study of this issue.

Conclusion. Despite the long history of studying postoperative complications of RARP, reliable and consistent data on all the risks of UI after RARP have not yet been obtained. Therefore, this literature review summarizes and analyzes the results of the latest research in recent years.
Prostate cancer diagnosis as part of high-tech advanced outpatient medical care
Authors: Gevorkyan A. R. , Molodtsov M. S. , Aleksandrov E. V.
Published: April 2023

Introduction. The primary focus for improving medical care is introduction of inpatient-replacement forms of healthcare for patients, particularly, with prostate cancer (PCa). Day-care facilities at outpatient institutions and hospitals are considered the most cost-effective and convenient for patients. It is expected that the introduction of new survey methodologies and the optimization of their use in day-hospitals of outpatient clinics will reduce the use of other diagnostic procedures, including invasive ones, and will allow the specialist to determine the treatment tactics and method.

Objective. To improve the quality of PCa diagnosis with the use of high-tech advanced outpatient medical care.

Materials & methods. To assess the appropriateness and effectiveness of transrectal prostate biopsies (TRPBs) in the day hospital, we have compared the statistics obtained in outpatient clinics with inpatient hospital divisions of the corresponding urban district. A comparative analysis of the data obtained using a standard examination algorithm was carried out: prostate-specific antigen analysis, digital rectal examination and transrectal ultrasound examination with a group of men who used multiparametric magnetic resonance imaging (mpMRI) in the examination algorithm prior to TRPB.

Results. The average annual number of TRPBs performed in inpatient urology divisions (three сapital hospitals from Western urban district) was 344, and the PCa detection was 142 (41%). In the outpatient urological unit of the Branch No. 2, Moscow Outpatient Clinics No. 195 for the period from 2010 to 2017, the average annual number of TRPBs was 440, and the PCa detection was 153 (35%) Thus, from the above data, it appears that with inpatient-like PCa detection, one large outpatient urological unit performed on average 24% more TRPBs (440 versus 344) than three inpatient urological divisions in a comparable period of time. When comparing histological data obtained after TRPBs in the absence and presence of pelvic mpMRT, a reliable difference (42% vs 35%) was found in PCa detection, respectively.

Conclusion. mpMRI due to its high sensitivity and specificity in PCa diagnosis, which can be recommended as a mandatory diagnostic step before TRPB. In addition, mpMRI can significantly reduce the number of unnecessary TRPBs, increase the effectiveness of timely PCa diagnosis at the early stages.
Just-In-Time Adaptive Intervention to Sit Less and Move More in People With Type 2 Diabetes: Protocol for a Microrandomized Trial
Authors: Daryabeygi-Khotbehsara Reza , Dunstan David W , Islam Sheikh Mohammed Shariful , Zhang Yuxin , Abdelrazek Mohamed , Maddison Ralph
Published: April 2023

Background

Reducing sedentary behavior and increasing physical activity in people with type 2 diabetes (T2D) are associated with various positive health benefits. Just-in-time adaptive interventions offer the potential to target both of these behaviors through more contextually aware, tailored, and personalized support. We have developed a just-in-time adaptive intervention to promote sitting less and moving more in people with T2D.

Objective

This paper presents the study protocol for a microrandomized trial to investigate whether motivational messages are effective in reducing time spent sitting in people with T2D and to determine what behavior change techniques are effective and in which context (eg, location, etc).

Methods

We will use a 6-week microrandomized trial design. A total of 22 adults with T2D will be recruited. The intervention aims to reduce sitting time and increase time spent standing and walking and comprises a mobile app (iMove), a bespoke activity sensor called Sedentary Behavior Detector (SORD), a messaging system, and a secured database. Depending on the randomization sequence, participants will potentially receive motivational messages 5 times a day.

Results

Recruitment was initiated in October 2022. As of now, 6 participants (2 female and 4 male) have consented and enrolled in the study. Their baseline measurements have been completed, and they have started using iMove. The mean age of 6 participants is 56.8 years, and they were diagnosed with T2D for 9.4 years on average.

Conclusions

This study will inform the optimization of digital behavior change interventions to support people with T2D Sit Less and Move More to increase daily physical activity. This study will generate new evidence about the immediate effectiveness of sedentary behavior interventions, their active ingredients, and associated factors.

Trial Registration

Australian New Zealand Clinical Trial Registry ACTRN12622000426785; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=383664

International Registered Report Identifier (IRRID)

DERR1-10.2196/41502
Use of Social Media for Patient Education in Dermatology: Narrative Review
Authors: Wojtara Magda Sara
Published: April 2023

Background

Social media has rapidly become one of the main avenues for news and communication among those with access to technology. Nearly 60% or 4.7 billion people worldwide use social media. Different social media networks provide users with a barrage of posts, opinions, and transformations. With this noticeable uptick in physician and patient education usage of social media, exploration of the impacts of social media on patient education in dermatology is crucial.

Objective

The goal of this narrative review was to evaluate existing peer-reviewed literature examining the use of social media for patient education in dermatology and to establish trends and implications. Additional attention was given to different social media sites, and potential differences in modalities of posts such as short-form videos on TikTok and Instagram Reels, long-form videos on YouTube, and infographics on Twitter, Instagram, and Facebook.

Methods

PubMed, Access DermatologyDxRx, and Scopus searches of peer-reviewed publications were performed to discover articles with social media and patient education keywords in combination with other health care–relevant or dermatology-relevant keywords. Subsequently, the screening of these studies was performed by the author who has experience with education and research experience in health care, dermatology, social media, and telehealth. Ultimately, the selected articles were summarized through qualitative analysis of key points and presented for further discussion.

Results

Through this narrative review, the researcher was able to identify several publications focusing on dermatology and social media. Some common subject areas included the use of social media for the promotion of private dermatology practices, residency programs, and research journals. So long as providers, such as dermatologists, take ethical considerations into account, these platforms can provide patients with curated educational content. In addition, several publications emphasized the use of social media as a form of patient education on dermatologic conditions but also as a source of misinformation.

Conclusions

This narrative review illuminated the use of social media as a form of patient education for dermatology, with its applications addressed across many demographics and situations. As social media platforms continue to update their algorithms, content filters, and posts, social media may become a reputable form of patient education in dermatology. Future studies and innovations should continue to explore innovations in this space, the efficacy of different modalities of posts, and longitudinal differences in patient outcomes and health literacy.
Learning From Experience and Finding the Right Balance in the Governance of Artificial Intelligence and Digital Health Technologies
Authors: Gilbert Stephen , Anderson Stuart , Daumer Martin , Li Phoebe , Melvin Tom , Williams Robin
Published: April 2023

Artificial intelligence (AI) and machine learning medical tools have the potential to be transformative in care delivery; however, this change will only be realized if accompanied by effective governance that ensures patient safety and public trust. Recent digital health initiatives have called for tighter governance of digital health. A correct balance must be found between ensuring product safety and performance while also enabling the innovation needed to deliver better approaches for patients and affordable efficient health care for society. This requires innovative, fit-for-purpose approaches to regulation. Digital health technologies, particularly AI-based tools, pose specific challenges to the development and implementation of functional regulation. The approaches of regulatory science and “better regulation” have a critical role in developing and evaluating solutions to these problems and ensuring effective implementation. We describe the divergent approaches of the European Union and the United States in the implementation of new regulatory approaches in digital health, and we consider the United Kingdom as a third example, which is in a unique position of developing a new post-Brexit regulatory framework.
Obstacles to Evidence-Based Procurement, Implementation, and Evaluation of Health and Welfare Technologies in Swedish Municipalities: Mixed Methods Study
Authors: Norgren Therese , Richardson Matt X , Wamala-Andersson Sarah
Published: April 2023

Background

Health and welfare technologies (HWTs) are interventions that aim at maintaining or promoting health, well-being, quality of life, and increasing efficiency in the service delivery system of welfare, social, and health care services, while improving the working conditions of the staff. Health and social care must be evidence-based according to national policy, but there are indications that evidence for HWT effectiveness is lacking in related Swedish municipal work processes.

Objective

This study aimed to investigate whether the evidence is used when Swedish municipalities procure, implement, and evaluate HWT, and if so, the kinds of evidence and the manner of their use. The study also aimed to identify if municipalities currently receive adequate support in using evidence for HWT, and if not, what support is desired.

Methods

An explanatory sequential mixed methods design was used with quantitative surveys and subsequent semistructured interviews with officials in 5 nationally designated “model” municipalities regarding HWT implementation and use.

Results

In the past 12 months, 4 of 5 municipalities had required some form of evidence during procurement processes, but the frequency of this varied and often consisted of references from other municipalities instead of other objective sources. Formulating requirements or requests for evidence during procurement was viewed as difficult, and gathered evidence was often only assessed by procurement administration personnel. In total, 2 of 5 municipalities used an established process for the implementation of HWT, and 3 of 5 had a plan for structured follow-up, but the use and dissemination of evidence within these were varying and often weakly integrated. Standardized processes for follow-up and evaluation across municipalities did not exist, and those processes used by individual municipalities were described as inadequate and difficult to follow. Most municipalities desired support for using evidence when procuring, establishing evaluation frameworks for, and following up effectiveness of HWT, while all municipalities suggested tools or methods for this kind of support.

Conclusions

Structured use of evidence in procurement, implementation, and evaluation of HWT is inconsistent among municipalities, and internal and external dissemination of evidence for effectiveness is rare. This may establish a legacy of ineffective HWT in municipal settings. The results suggest that existing national agency guidance is not sufficient to meet current needs. New, more effective types of support to increase the use of evidence in critical phases of municipal procurement and implementation of HWT are recommended.
Stimulant Use Associated With Psychosocial Factors, HIV Risk, and Concurrent Hazardous Alcohol Use Among US Adults: Exploratory Cross-Sectional Questionnaire Study
Authors: Lee Frank , Jain Jennifer Payaal , Duthely Lunthita M , Ikeda Janet , Santos Glenn-Milo
Published: April 2023

Background

Stimulant use is a major public health problem that contributes to morbidity and mortality among men who have sex with men (MSM) in the United States. To reduce the harms associated with stimulant use, there is a need to identify the factors associated with stimulant use to inform interventions. Additionally, there is a need to use large crowdsourcing platforms like Amazon Mechanical Turk (MTurk) to engage more individuals who use substances across the United States.

Objective

We identified the correlates of stimulant use among people who use alcohol or stimulants in the United States recruited using MTurk.

Methods

Participants who were aged ≥18 years in the United States and reported alcohol or stimulant (ie, cocaine, crack cocaine, and methamphetamine) use were deemed eligible and recruited via the web platform MTurk. Participants completed a baseline survey, which assessed sociodemographics, psychosocial (ie, depression, affect, self-esteem, and stress) factors, substance use, and sexual behaviors. Data were collected and analyzed with STATA (version 17; StataCorp). Stratifying by MSM status, bivariate and multivariable logistic regression models were built in STATA to examine the correlates of stimulant use. Multivariable models controlled for age, race, health insurance, and relationship status.

Results

Of 272 participants, 201 (73.9%) identified as male, 134 (49.2%) were MSM, 52 (19.1%) were from racial and ethnic minoritized communities, and 158 (58%) were in a relationship. The mean age was 36.10 (SD 10.3) years. A total of 40 (14.7%) participants reported stimulant use in the past 6 months. Factors significantly associated with stimulant use were being MSM (adjusted odds ratio [aOR] 4.61, 95% CI 1.97-10.81), a higher Alcohol Use Disorders Identification Test-Concise score (aOR 1.24, 95% CI 1.08-1.42), more intense cravings for alcohol in the past 24 hours (aOR 1.03, 95% CI 1.01-1.04), a higher depression score (aOR 1.06, 95% CI 1.01-1.12), a greater number of male partners in the last 6 months (aOR 1.32, 95% CI 1.08-1.61), a greater number of female partners in the last 6 months (aOR 1.42, 95% CI 1.04-1.92), and being diagnosed with a sexually transmitted infection (eg, syphilis, gonorrhea, chlamydia, herpes simplex virus, human papillomavirus, and other) in the last 6 months (aOR 14.61, 95% CI 3.45-61.87). Additionally, there was a significant additive interaction between MSM status and negative affect, such that the impact of negative affect on stimulant use was significantly greater among MSM compared with non-MSM (relative excess risk due to interaction 0.085, 95% CI 0.037-0.13).

Conclusions

Interventions that address stimulant use should use evidence-based approaches that reduce negative affect, depression, and cravings for alcohol. Additionally, interventions should be customized for MSM populations.
Perceived Risk of Diabetes Among Vietnamese Americans With Prediabetes: Mixed Methods Study (Preprint)
Authors: Nguyen Angelina , McEwen Marylyn Morris , Loescher Lois J
Published: April 2023

BACKGROUND

Vietnamese Americans have a relatively high risk of developing diabetes at younger ages, yet there are no published studies exploring their risk perceptions.

OBJECTIVE

This mixed methods study describes perceived diabetes risk in the context of an underserved population.

METHODS

This study was guided by the Common-Sense Model of Self-Regulation. Snowball sampling was used to recruit 10 Vietnamese Americans with prediabetes and achieve data saturation. Qualitative and quantitative descriptive methodologies with data transformation were used to analyze data from semistructured interviews and questionnaires to explore the dimensions of perceived diabetes risk.

RESULTS

Participants were between the ages of 30 and 75 years with diversity also noted in diabetes risk factors. The 3 risk perception domains from qualitative data were risk factors, disease severity, and preventing diabetes. The main perceived diabetes risk factors were eating habits (including cultural influences), sedentary lifestyle, and family history of diabetes. Quantitative data supported qualitative findings of a low-to-moderate level of perceived diabetes risk. Despite the lower levels of perceived diabetes risk, Vietnamese Americans do believe that the severity of diabetes is a “big concern.”

CONCLUSIONS

Vietnamese Americans with prediabetes have a low-to-moderate level of perceived diabetes risk. Understanding the perceived diabetes risk in this population provides a foundation for diabetes prevention interventions that consider cultural influences on diet and exercise.
Learning From Experience and Finding the Right Balance in the Governance of Artificial Intelligence and Digital Health Technologies (Preprint)
Authors: Gilbert Stephen , Anderson Stuart , Daumer Martin , Li Phoebe , Melvin Tom , Williams Robin
Published: April 2023

UNSTRUCTURED

Artificial intelligence (AI) and machine learning medical tools have the potential to be transformative in care delivery; however, this change will only be realized if accompanied by effective governance that ensures patient safety and public trust. Recent digital health initiatives have called for tighter governance of digital health. A correct balance must be found between ensuring product safety and performance while also enabling the innovation needed to deliver better approaches for patients and affordable efficient health care for society. This requires innovative, fit-for-purpose approaches to regulation. Digital health technologies, particularly AI-based tools, pose specific challenges to the development and implementation of functional regulation. The approaches of regulatory science and “better regulation” have a critical role in developing and evaluating solutions to these problems and ensuring effective implementation. We describe the divergent approaches of the European Union and the United States in the implementation of new regulatory approaches in digital health, and we consider the United Kingdom as a third example, which is in a unique position of developing a new post-Brexit regulatory framework.
Evaluation of an Innovative Colon Capsule Endoscopy Service in Scotland From the Perspective of Patients: Mixed Methods Study (Preprint)
Authors: Bond Sarah , Kyfonidis Charalampos , Jamieson Matthew , Maguire Roma , McCann Lisa , Watson Angus , Brogan Michelle , Lennon Marilyn
Published: April 2023

BACKGROUND

Colonoscopy is the gold standard for lower gastrointestinal diagnostics. The procedure is invasive, and its demand is high, resulting in long waiting times. Colon capsule endoscopy (CCE) is a procedure that uses a video capsule to investigate the colon, meaning that it can be carried out in a person’s own home. This type of “hospital-at-home” service could potentially reduce costs and waiting times, and increase patient satisfaction. Little is currently understood, however, about how CCE is actually experienced and accepted by patients.

OBJECTIVE

The aim of this study was to capture and report patient experiences of the CCE technology (the capsule and associated belt and recorder) and of the new clinical pathway for the CCE service being rolled out as part of routine service in Scotland.

METHODS

This was a mixed methods service evaluation of patient experiences of a real-world, deployed, managed service for CCE in Scotland. Two hundred and nine patients provided feedback via a survey about their experiences of the CCE service. Eighteen of these patients took part in a further telephone interview to capture more in-depth lived experiences to understand the barriers and opportunities for the further adoption and scaling up of the CCE service in a way that supports the patient experience and journey.

RESULTS

Patients overall perceived the CCE service to be of significant value (eg, mentioning reduced travel times, reduced waiting times, and freedom to complete the procedure at home as perceived benefits). Our findings also highlighted the importance of clear and accessible information (eg, what to expect and how to undertake the bowel preparation) and the need for managing expectations of patients (eg, being clear about when results will be received and what happens if a further colonoscopy is required).

CONCLUSIONS

The findings led to recommendations for future implementations of managed CCE services in National Health Service (NHS) Scotland that could also apply more widely (United Kingdom and beyond) and at a greater scale (with more patients in more contexts). These include promoting CCE with, for, and among clinical teams to ensure adoption and success; capturing and understanding reasons why patients do and do not opt for CCE; providing clear information in a variety of appropriate ways to patients (eg, around the importance of bowel preparation instructions); improving the bowel preparation (this is not specific to CCE alone); providing flexible options for issuing and returning the kit (eg, dropping off at a pharmacy); and embedding formative evaluation within the service itself (eg, capturing patient-reported experiences via surveys in the information pack when the equipment is returned).
Using User-Centered Design to Facilitate Adherence to Annual Lung Cancer Screening: Protocol for a Mixed Methods Study for Intervention Development (Preprint)
Authors: Hirsch Erin A , Studts Jamie L
Published: April 2023

BACKGROUND

Lung cancer is the leading cause of cancer-related death in the United States, with the majority of lung cancer occurrence diagnosed after the disease has already metastasized. Lung cancer screening (LCS) with low-dose computed tomography can diagnose early-stage disease, especially when eligible individuals participate in screening on a yearly basis. Unfortunately, annual adherence has emerged as a challenge for academic and community screening programs, endangering the individual and population health benefits of LCS. Reminder messages have effectively increased adherence rates in breast, colorectal, and cervical cancer screenings but have not been tested with LCS participants who experience unique barriers to screening associated with the stigma of smoking and social determinants of health.

OBJECTIVE

This research aims to use a theory-informed, multiphase, and mixed methods approach with LCS experts and participants to develop a set of clear and engaging reminder messages to support LCS annual adherence.

METHODS

In aim 1, survey data informed by the Cognitive-Social Health Information Processing model will be collected to assess how LCS participants process health information aimed at health protective behavior to develop content for reminder messages and pinpoint options for message targeting and tailoring. Aim 2 focuses on identifying themes for message imagery through a modified photovoice activity that asks participants to identify 3 images that represent LCS and then participate in an interview about the selection, likes, and dislikes of each photo. A pool of candidate messages for multiple delivery platforms will be developed in aim 3, using results from aim 1 for message content and aim 2 for imagery selection. The refinement of message content and imagery combinations will be completed through iterative feedback from LCS experts and participants.

RESULTS

Data collection began in July 2022 and will be completed by May 2023. The final reminder message candidates are expected to be completed by June 2023.

CONCLUSIONS

This project proposes a novel approach to facilitate adherence to annual LCS through the development of reminder messages that embrace content and imagery representative of the target population directly in the design process. Developing effective strategies to increase LCS adherence is instrumental in achieving optimal LCS outcomes at individual and population health levels.

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/46657