bluuebunny/crossref_metadata_2025 huggingface dataset:
Applying tools of digital economics in view of corruption risk minimization and anti-corruption consciousness shaping
Authors: Mamitova N. V. , Akhmatova J. R.
Published: October 2018

Corruption, its scale, specificity and dynamics arise from general political, social and economic problems in the country. Today Russia is not passing only through a process of modernization but a drastic restructuring of public, state, economic, social and psychological foundations. Therefore, we can observe a scientific and practical need in studying issues of corruption counteraction. Corruption offences act as destabilizing factors in society and state functioning. They exert adverse affect on state governance and on public relations in general. Corruption holds back the economic growth of the country, reduces people confidence to the authority. The article investigates new technologies, which are being introduced within the frames of digital economics and considered as tools of corruption minimization. Such methods asanalysis and synthesis were used. The authors provide the definition of the smart-contracts and describe their basic advantages in view of fight against corruption. At the same time key problems arising at legal regulation of block-chain status are discussed. Block-chain technology provides an opportunity to take into account all materialized contradictions in different spheres of public and state life, which form the foundation for corruption, which proliferated actually in all countries of the world. The authors put forward their suggestions dealing with methods and ways of resolving the problem.
Microwave-assisted One-pot Synthesis of 7-Dimethylamino-4-Aryl-2- methylamino-3-nitro-4H-chromenes
Authors: Nagaraju Pallava , Padmaja Pannala , Reddy Pedavenkatagari Narayana
Published: October 2018

4-Aryl-2-amino-4H-chromenes possessing N,N-dimethylamino group have been reported as potential anticancer drugs. Despite few synthetic methods reported in the literature for their synthesis, there appear to be no reports on the direct use of N,N-dimethyl-3-aminophenol for the synthesis of 4- aryl-2-methylamino-3-nitro-4H-chromenes. One-pot condensation of N,N-dimethyl-3-aminophenol, aromatic aldehydes and (E)-N-methyl-1-(methylthio)-2-nitro-ethenamine was carried out using MW irradiation to get the 4-aryl-2-methylamino-3-nitro-4H-chromenes under catalyst-free conditions. This transformation presumably occurs via o-quinone methide formation, Michael addition-intramolecular O-cyclization-elimination sequence of reactions creating new two C-C bonds and one C-O bond. Various substituted aromatic aldehydes reacted smoothly with N,N-dimethyl-3-aminophenol and (E)-Nmethyl- 1-(methylthio)-2-nitro-ethenamine to give the corresponding 4-aryl-2-methylamino-3-nitro-4Hchromenes in good yields. We have developed a one-pot three component condensation of N,Ndimethyl- 3-aminophenol, aromatic aldehyde and NMSM for the synthesis of N,N-dimethylamino substituted 4-aryl-2-methylamino-3-nitro-4H-chromenes in good yields. The significant features of this reaction include catalyst-free, solvent free, no column chromatographic purification, short reaction time and good yields.
Synthesis of Novel 2-Amino-substituted 6-Methyl-pyrimidin-4-ol Derivatives and Their Biological Evaluation
Authors: Yengoyan Aleksandr P. , Pivazyan Vergush A. , Ghazaryan Emma A. , Azaryan Zhermen A.
Published: October 2018

A series of novel derivatives based on 2-amino-substituted 4-methylpyrimidin-4-ols were
synthesized by simple, accessible and efficient methods. 4-N-triazolyl derivatives were obtained from
the corresponding 4-chloro derivatives, and O-substituted products, including compounds with a combination
of the pyrimidine and oxadiazole rings in the molecule, were synthesized from the sodium
salts of 2-amino-substituted pyrimidin-4-ols. The synthesized compounds showed a pronounced stimulating
action on plants growth. Their growth stimulant activities were in the range of 46-93% compared
to heteroauxin.
Diphenyl Diselenide – catalyzed Reductive Coupling of Nitroarenes to Aromatic Azo and Azoxy Compounds with Sodium Borohydride in Alkaline Ethanol
Authors: Belattar Nadjah , Benayache Samir , Benayache Fadila
Published: October 2018

Aim and Objective: A simple catalytic method has been developed to achieve the reduction of nitroarenes
with NaBH4 using diphenyl diselenide catalyst in order to obtain the azoxyarene, azoarene products
under mild conditions.

Materials and Methods:

The reduction of different substituted nitroarenes was realized in alkaline ethanolic
solution using mild sodium borohydride in the presence of diphenyl diselenide as an electron-transfer catalyst.
The reactions were performed sometimes at room temperature and sometimes at refluxing conditions.

Results:

Diphenyl diselenide which is reduced to sodium phenylselenolate, presenting an electron transfer
agent successfully permitted to reduce several nitroarenes, bearing different substituent groups whose electronic
effects promote the formation of the azoxy or azo compounds.

Conclusion:

Treatment of nitroarenes with sodium borohydride in alkaline ethanol in the presence of catalytic
amounts of diphenyl diselenide at room temperature leads to obtain the corresponding azoxy compounds in
good yields by reaction with sodium phenylselenolate generated in situ. At higher temperature, further reduction
to azo compounds occurs. Therefore, the results have indicated that the electronic effects of substituent
groups rigorously take part in determination of their reduction efficiencies.
Effect of Sodium Metabisulfite on Oxidative Stress and Lipid Peroxidation Biomarkers
Authors: Shekarforoush Shahnaz , Ebrahimi Parisa , Fathabad Akbar Afkhami , Farzanfar Elaheh
Published: October 2018

Background:

Sulfites are widely used as preservatives in the foods and pharmaceutical agents. It has been demonstrated that sulfites can react with a variety of cellular components and cause toxicity.

Objective:

The present study was designed to investigate the effects of ingested sodium metabisulfite (SMB) on serum antioxidant status in rats.

Methods:

Thirty-two male Wistar rats were randomly divided into control and treated groups. Treated groups received 10, 100, and 260 mg/kg body weight of SMB for 28 days. After 28 days, serum was assayed for measuring superoxide dismtase (SOD), glutathione peroxidase (GPx), glutathione reductase (GR), catalase (CAT) activities, glutathion (GSH) level and lipid peroxidation.

Results:

The results showed that the activities of GPx, GR, CAT and GSH levels were significantly decreased in 100 and 260 mg/kg SMB treated rats, while malondialdehyde (MDA) level was significantly increased in 260 mg/kg treated group when compared with the control group.

Conclusion:

It is concluded that SMB administration as dose-dependent is associated with decreased serum antioxidant enzyme activities and increased lipid peroxidation.
Impurity Profiling-A Significant Approach in Pharmaceuticals
Authors: Nath Dipankar , Sharma Bidhya
Published: October 2018

There has been ever increasing interest in impurities present in Active Pharmaceutical Ingredient’s
(API’s). Nowadays, not only purity profile but also impurity profile has become mandatory according
to the various regulatory authorities. In the pharmaceutical world, an impurity is considered as
an inorganic or organic material, or residual solvents other than the drug substances, or ingredients,
arising out of synthesis or unwanted chemicals that remains with APIs. Impurity profiling includes identification,
structure elucidation and quantitative determination of impurities and degradation products in
bulk drug materials and pharmaceutical formulation. The control of impurities in Formulated products
and API’s were regulated by various regulatory authorities like ICH, USFDA, Canadian Drug, and
Health Agency. Impurity profiling is very important in the modern pharmaceutical analysis due to the
fact that unidentified, potentially toxic impurities are hazardous to health and in order to increase the
safety of drug therapy, impurities should be identified and determined by the selective method. Nowadays,
it is a mandatory requirement in various pharmacopeias to know the impurities present in APIs
and finished drug products. Thus, impurity profiling can act as a Quality Control tool. It can provide
crucial data regarding the toxicity, safety, various limits of detection and limits of quantitation of several
organic and inorganic impurities, usually accompany with APIs and finished products. There is a
strong requirement to have unique specifications/standards with regard to impurities.
Development of Two Phase H-bridge Converter for 250W Switched Reluctance Machine
Authors: Ahammed Shaik A. , Seshadri Arjun , Chokkalingam Lenin N.
Published: October 2018

Background:

Advancements in Power Electronics made a huge breakthrough in the industrial
sector majorly in the development of Switched Reluctance Machines (SRM). The main objective
of this paper is to develop a two Phase H-bridge converter for 250W SRM and compare its
advantages and disadvantages over the other converters.

Methods:

A time based simulation has been carried out to evaluate the performance of the converter
at various loads. Different parameters of the machine and converter are studied and the results are
verified experimentally.

Results:

The obtained test results of the converter performance are found to be in good agreement
with the simulation and the efficiency of the converter is compared with the existing R-Dump topology.

Conclusion:

It is concluded that the proposed H-Bridge converter for a two phase SRM is better
than the R-Dump converter in terms of efficiency and reduced size.
Mobile messaging support versus usual care for people with type 2 diabetes in sub-Saharan Africa: a protocol for a multicentre randomized controlled trial (StAR2D) (Preprint)
Authors: Farmer Andrew , Bobrow Kirsten , Leon Natalie , Williams Nicola , Phiri Enita , Namadingo Hazel , Cooper Sarah , Prince John , Crampin Amelia , Besada Donnela , Daviaud Emmanuelle , Yu Ly-Mee , N'goma Jonathan , Springer David , Bruno Pauly , Tarassenko Lionel , Nyirenda Moffat , Levitt Naomi
Published: October 2018

UNSTRUCTURED

Background: Health outcomes for people treated for type 2 diabetes could be substantially improved in sub-Saharan Africa. Failure to take medicines regularly to treat diabetes has been identified as a major problem. Resources to identify and support patients who are not making best use of medicine in low and middle-income settings are scarce. Mobile phones are widely available in these settings including among people with diabetes, and linked technologies such as SMS-text messaging have shown promise in delivering low-cost interventions efficiently. However, evidence that these interventions will work when carried out at a larger scale, and of the extent to which they will improve health outcomes when added to usual care is limited.
Methods: We will carry out a randomised clinical trial in two contrasting settings in sub-Saharan Africa, Cape Town in South Africa and Lilongwe in Malawi, to provide information about the impact of sending brief automated messages via SMS text-messaging. The messages will advise people about the benefits of their diabetes treatment and offer motivation and encouragement around lifestyle and use of medication. We will allocate patients using a randomly-generated assignment plan to receive either intervention messages, or an active control. We will follow up people for twelve months measuring important risk factors for poor health outcomes and complications in diabetes so we can estimate potential health benefits, including HbA1c as a marker for long-term blood glucose control and blood pressure control, We will record the costs of doing this, and estimate cost-effectiveness. We will also capture collection of medication and assess the reception of the intervention by participants and health care workers.
Discussion: The knowledge gained will have wide application and advance the evidence base for effectiveness of mobile-phone based brief text-messaging on clinical outcomes and in large-scale, operational settings. It will provide evidence for cost-effectiveness that will further inform policy development and decision-making. We will work with a wide network that includes patients, clinicians, academics, industry, and policy makers to help us identify opportunities for informing people about the work and raise awareness of what is being developed and studied.
Trial Registration: ISRCTN70768808 (Registered on 3 August 2015)
Online Information-Seeking About Potential Breast Cancer Symptoms: Capturing Online Behavior With an Internet Browsing Tracking Tool (Preprint)
Authors: Marcu Afrodita , Muller Cecile , Ream Emma , Whitaker Katriina L
Published: October 2018

BACKGROUND

People engage in health information-seeking online when experiencing unusual or unfamiliar bodily changes. It is not well understood how people consult the internet for health information after the onset of unfamiliar symptoms and before receiving a potential diagnosis and how online information-seeking can help people appraise their symptoms. This lack of evidence may be partly due to methodological limitations in capturing in real time the online information-seeking process.

OBJECTIVE

We explored women’s symptom attribution and online health information-seeking in response to a hypothetical and unfamiliar breast change suggestive of cancer (nipple rash). We also aimed to establish the feasibility of capturing in real time the online information-seeking process with a tool designed to track participant online searches and visited websites, the Vizzata browser tracker.

METHODS

An online survey was completed by 56 cancer-free women (mean age 60.34 [SD 7.73] years) responding to a scenario asking them to imagine noticing a red scaly rash on the nipple. Participants were asked to make symptom attributions when presented with the scenario (T1) and again after seeking information online (T2). The online tracking tool, embedded in the survey, was used to capture in real time participant search terms and accessed websites.

RESULTS

The tracking tool captured the search terms and accessed websites of most of the participants (46/56, 82%). For the rest (10/56, 18%), there was evidence of engagement in online information-seeking (eg, medical terminology and cancer attribution at T2) despite their searching activity not being recorded. A total of 25 participants considered cancer as a potential cause for the nipple rash at T1, yet only one of these used cancer as a search term. Most participants (40/46, 87%) used rash-related search terms, particularly nipple rash and rash on nipple. The majority (41/46, 89%) accessed websites containing breast cancer information, with the National Health Service webpage “Paget disease of the nipple” being the most visited one. At T2, after engaging in the internet search task, more participants attributed the nipple rash to breast cancer than at T1 (37/46, 66% vs 25/46, 45%), although a small number of participants (6/46) changed from making a cancer attribution at T1 to a noncancer one at T2.

CONCLUSIONS

Making a cancer attribution for an unfamiliar breast change did not necessarily translate into cancer-termed searches. Equally, not all internet searches led to a cancer attribution. The findings suggest that online information-seeking may not necessarily help women who experience unfamiliar breast cancer symptoms understand their condition. Despite some technical issues, this study showed that it is feasible to use an online browser tracking tool to capture in real time information-seeking about unfamiliar symptoms.
Effective Information Provision About the Side Effects of Treatment for Malignant Lymphoma: Protocol of a Randomized Controlled Trial Using Video Vignettes (Preprint)
Authors: Labrie Nanon , van Dulmen Sandra , Kersten Marie José , de Haes Hanneke JCM , Pieterse Arwen H , van Weert Julia CM , van Spronsen Dick Johan , Smets Ellen MA ,   INSTRUCT Group
Published: October 2018

BACKGROUND

Informing patients with cancer about the possible implications of prospective treatment is a crucial yet challenging task. Unfortunately, patients’ recall of medical information is generally poor and their information needs are not met. Effective information giving entails that oncologists help patients understand and recall the implications of their treatment, meanwhile fostering a trusting physician-patient relationship. Communication strategies that are often suggested to be effective are structuring and tailoring (cognition-oriented) but also are oncologists’ expressions of caring or empathy (affect-oriented).

OBJECTIVE

The aim of this study is to provide evidence concerning the pathways linking physician communication to (improved) consultation outcomes for patients. More specifically, the aim is to determine the effects of information structuring and information tailoring, combined with physician caring, on information recall, satisfaction with information, and trust in the physician (primary objective) and on symptom distress (secondary objective).

METHODS

A randomized controlled trial, systematically testing the effects of information structuring and information tailoring, each combined with caring, in 2 video-vignette experiments (2×2 and 2×2×2 design). Using an online survey platform, participants will be randomly allocated (blinded) to 1 of 12 conditions in which they are asked to view a video vignette (intervention) in which an oncologist discusses a treatment plan for malignant lymphoma with a patient. The independent variables of interest are systematically varied across conditions. The outcome measures are assessed in a survey, using validated instruments. Study participants are (former) patients with cancer and their relatives recruited via online panels and patient organizations. This protocol discusses the trial design, including the video-vignette design, intervention pretesting, and a pilot study.

RESULTS

Data collection has now been completed, and preliminary analyses will be available in Spring 2019. A total of 470 participants completed the first part of the survey and were randomized to receive the intervention.

CONCLUSIONS

The results of the proposed trial will provide evidence concerning the pathways linking physician information, giving skills to (improved) consultation outcomes for patients.

CLINICALTRIAL

Netherlands Trial Register NTR6153; https://www.trialregister.nl/trial/6022 (Archived by Webcite at http://www.webcitation.org/76xVV9xC8).

INTERNATIONAL REGISTERED REPOR

DERR1-10.2196/12453
Translating/Creating a Culturally Responsive Spanish-Language Mobile App for Visit Preparation: Case Study of “Trans-Creation” (Preprint)
Authors: Ruvalcaba Denise , Nagao Peck Hidemi , Lyles Courtney , Uratsu Connie S , Escobar Patricia R , Grant Richard W
Published: October 2018

BACKGROUND

Health information technology (IT) tools are increasingly used to improve patient care. However, implementation of English-only health IT tools could potentially worsen health disparities for non-English speakers.

OBJECTIVE

We aim to describe the “trans-creation” process of developing linguistically and culturally appropriate health IT tools through a detailed case analysis of a waiting room health mobile app designed to help Spanish-speaking Latino people prepare for primary care visits.

METHODS

We adapted the English-language Visit Planner mobile app for Spanish-speaking Latino patients. We applied culturally defined themes derived from prior published research and input by both skilled linguists and potential end users. Initial changes were iteratively reviewed and edited by a team of writers, health care educators, subject matter experts, patients, and providers.

RESULTS

The trans-creation process resulted in the following key culturally mediated changes to the tool: replacing the “provider” actors with “patient” actors; changing the choice of “Stress at Home or Work” (represented by an icon of a house) to “Mi Familia” (translation: my family; icon is an outline of family members holding hands); replacing the English terms “anxiety” and “depression” with “Me siento desanimado”(translation: I am feeling down) to avoid mental health stigma; and using more concise text translation to ensure the wording fit the available on-screen space.

CONCLUSIONS

The trans-creation process of cultural and linguistic adaptation led to several design changes that would not have been implemented if we had simply translated the words from English to Spanish.
Social Support Patterns of Middle-Aged and Older Adults Within a Physical Activity App: Secondary Mixed Method Analysis (Preprint)
Authors: Lewis Zakkoyya H , Swartz Maria C , Martinez Eloisa , Lyons Elizabeth J
Published: October 2018

BACKGROUND

Physical activity (PA) is critical for maintaining independence and delaying mobility disability in aging adults. However, 27 to 44% of older adults in the United States are meeting the recommended PA level. Activity trackers are proving to be a promising tool to promote PA adherence through activity tracking and enhanced social interaction features. Although social support has been known to be an influential behavior change technique to promote PA, how middle-aged and older adults use the social interaction feature of mobile apps to provide virtual support to promote PA engagement remains mostly underexplored.

OBJECTIVE

This study aimed to describe the social support patterns of middle-aged and older adults using a mobile app as part of a behavioral PA intervention.

METHODS

Data from 35 participants (mean age 61.66 [SD 6] years) in a 12-week, home-based activity intervention were used for this secondary mixed method analysis. Participants were provided with a Jawbone Up24 activity monitor and an Apple iPad Mini installed with the UP app to facilitate self-monitoring and social interaction. All participants were given an anonymous account and encouraged to interact with other participants using the app. Social support features included comments and likes. Thematic coding was used to identify the type of social support provided within the UP app and characterize the levels of engagement from users. Participants were categorized as superusers or contributors, and passive participants were categorized as lurkers based on the literature.

RESULTS

Over the 12-week intervention, participants provided a total of 3153 likes and 1759 comments. Most participants (n=25) were contributors, with 4 categorized as superusers and 6 categorized as lurkers. Comments were coded as emotional support, informational support, instrumental support, self-talk, and other, with emotional support being the most prevalent type.

CONCLUSIONS

Our cohort of middle-aged and older adults was willing to use the social network feature in an activity app to communicate with anonymous peers. Most of our participants were contributors. In addition, the social support provided through the activity app followed social support constructs. In sum, PA apps are a promising tool for delivering virtual social support to enhance PA engagement and have the potential to make a widespread impact on PA promotion.

CLINICALTRIAL

ClinicalTrials.gov NCT01869348; https://clinicaltrials.gov/ct2/show/NCT01869348
Using Values Affirmation to Reduce the Effects of Stereotype Threat on Hypertension Disparities: Protocol for the Multicenter Randomized Hypertension and Values (HYVALUE) Trial (Preprint)
Authors: Daugherty Stacie L , Vupputuri Suma , Hanratty Rebecca , Steiner John F , Maertens Julie A , Blair Irene V , Dickinson L Miriam , Helmkamp Laura , Havranek Edward P
Published: October 2018

BACKGROUND

Medication nonadherence is a significant, modifiable contributor to uncontrolled hypertension. Stereotype threat may contribute to racial disparities in adherence by hindering a patient’s ability to actively engage during a clinical encounter, resulting in reduced activation to adhere to prescribed therapies.

OBJECTIVE

The Hypertension and Values (HYVALUE) trial aims to examine whether a values-affirmation intervention improves medication adherence (primary outcome) by targeting racial stereotype threat.

METHODS

The HYVALUE trial is a patient-level, blinded randomized controlled trial comparing a brief values-affirmation writing exercise with a control writing exercise among black and white patients with uncontrolled hypertension. We are recruiting patients from 3 large health systems in the United States. The primary outcome is patients’ adherence to antihypertensive medications, with secondary outcomes of systolic and diastolic blood pressure over time, time for which blood pressure is under control, and treatment intensification. We are comparing the effects of the intervention among blacks and whites, exploring possible moderators (ie, patients’ prior experiences of discrimination and clinician racial bias) and mediators (ie, patient activation) of intervention effects on outcomes.

RESULTS

This study was funded by the National Heart, Lung, and Blood Institute. Enrollment and follow-up are ongoing and data analysis is expected to begin in late 2020. Planned enrollment is 1130 patients. On the basis of evidence supporting the effectiveness of values affirmation in educational settings and our pilot work demonstrating improved patient-clinician communication, we hypothesize that values affirmation disrupts the negative effects of stereotype threat on the clinical interaction and can reduce racial disparities in medication adherence and subsequent health outcomes.

CONCLUSIONS

The HYVALUE study moves beyond documentation of race-based health disparities toward testing an intervention. We focus on a medical condition—hypertension, which is arguably the greatest contributor to mortality disparities for black patients. If successful, this study will be the first to provide evidence for a low-resource intervention that has the potential to substantially reduce health care disparities across a wide range of health care conditions and populations.

CLINICALTRIAL

ClinicalTrials.gov NCT03028597; https://clinicaltrials.gov/ct2/show/NCT03028597 (Archived by WebCite at http://www.webcitation.org/72vcZMzAB).

INTERNATIONAL REGISTERED REPOR

DERR1-10.2196/12498
Is Blockchain Technology Suitable for Managing Personal Health Records? Mixed-Methods Study to Test Feasibility (Preprint)
Authors: Park Yu Rang , Lee Eunsol , Na Wonjun , Park Sungjun , Lee Yura , Lee Jae-Ho
Published: October 2018

BACKGROUND

There are many perspectives on the advantages of introducing blockchain in the medical field, but there are no published feasibility studies regarding the storage, propagation, and management of personal health records (PHRs) using blockchain technology.

OBJECTIVE

The purpose of this study was to investigate the usefulness of blockchains in the medical field in relation to transactions with and propagation of PHRs in a private blockchain.

METHODS

We constructed a private blockchain network using Ethereum version 1.8.4 and conducted verification using the de-identified PHRs of 300 patients. The private blockchain network consisted of one hospital node and 300 patient nodes. In order to verify the effectiveness of blockchain-based PHR management, PHRs at a time were loaded in a transaction between the hospital and patient nodes and propagated to the whole network. We obtained and analyzed the time and gas required for data transaction and propagation on the blockchain network. For reproducibility, these processes were repeated 100 times.

RESULTS

Of 300 patient records, 74 (24.7%) were not loaded in the private blockchain due to the data block size of the transaction block. The remaining 226 individual health records were classified into groups A (80 patients with outpatient visit data less than 1 year old), B (84 patients with outpatient data from between 1 and 3 years before data collection), and C (62 patients with outpatient data 3 to 5 years old). With respect to mean transaction time in the blockchain, C (128.7 seconds) had the shortest time, followed by A (132.2 seconds) and then B (159.0 seconds). The mean propagation times for groups A, B, and C were 1494.2 seconds, 2138.9 seconds, and 4111.4 seconds, respectively; mean file sizes were 5.6 KB, 18.6 KB, and 45.38 KB, respectively. The mean gas consumption values were 1,900,767; 4,224,341; and 4,112,784 for groups A, B, and C, respectively.

CONCLUSIONS

This study confirms that it is possible to exchange PHR data in a private blockchain network. However, to develop a blockchain-based PHR platform that can be used in practice, many improvements are required, including reductions in data size, improved personal information protection, and reduced operating costs.
Complementary and Alternative Medicine in Patients With Breast Cancer: Exploratory Study of Social Network Forum Data (Preprint)
Authors: Lognos Béatrice , Carbonnel François , Boulze Launay Isabelle , Bringay Sandra , Guerdoux-Ninot Estelle , Mollevi Caroline , Senesse Pierre , Ninot Gregory
Published: October 2018

BACKGROUND

Patients and health care professionals are becoming increasingly preoccupied in complementary and alternative medicine (CAM) that can also be called nonpharmacological interventions (NPIs). In just a few years, this supportive care has gone from solutions aimed at improving the quality of life to solutions intended to reduce symptoms, supplement oncological treatments, and prevent recurrences. Digital social networks are a major vector for disseminating these practices that are not always disclosed to doctors by patients. An exploration of the content of exchanges on social networks by patients suffering from breast cancer can help to better identify the extent and diversity of these practices.

OBJECTIVE

This study aimed to explore the interest of patients with breast cancer in CAM from posts published in health forums and French-language social media groups.

METHODS

The retrospective study was based on a French database of 2 forums and 4 Facebook groups between June 3, 2006, and November 17, 2015. The extracted, anonymized, and compiled data (264,249 posts) were analyzed according to the occurrences associated with the NPI categories and NPI subcategories, their synonyms, and their related terms.

RESULTS

The results showed that patients with breast cancer use mainly physical (37.6%) and nutritional (31.3%) interventions. Herbal medicine is a subcategory that was cited frequently. However, the patients did not mention digital interventions.

CONCLUSIONS

This exploratory study of the main French forums and discussion groups indicates a significant interest in CAM during and after treatments for breast cancer, with primarily physical and nutritional interventions complementing approved treatments. This study highlights the importance of accurate information (vs fake medicine), prescription and monitoring of these interventions, and the mediating role that health professionals must play in this regard.
A Peer-Led Electronic Mental Health Recovery App in a Community-Based Public Mental Health Service: Pilot Trial (Preprint)
Authors: Gulliver Amelia , Banfield Michelle , Morse Alyssa R , Reynolds Julia , Miller Sarah , Galati Connie
Published: October 2018

BACKGROUND

There is an increasing need for peer workers (people with lived experience of mental health problems who support others) to work alongside consumers to improve recovery and outcomes. In addition, new forms of technology (tablet or mobile apps) can deliver services in an engaging and innovative way. However, there is a need to evaluate interventions in real-world settings.

OBJECTIVE

This exploratory proof-of-concept study aimed to determine if a peer worker–led electronic mental health (e-mental health) recovery program is a feasible, acceptable, and effective adjunct to usual care for people with moderate-to-severe mental illness.

METHODS

Overall, 6 consumers and 5 health service staff participated in the evaluation of a peer-led recovery app delivered at a community-based public mental health service. The peer worker and other health professional staff invited attendees at the drop-in medication clinics to participate in the trial during June to August 2017. Following the intervention period, participants were also invited by the peer worker to complete the evaluation in a separate room with the researcher. Consumers were explicitly informed that participation in the research evaluation was entirely voluntary. Consumer evaluation measures at postintervention included recovery and views on the acceptability of the program and its delivery. Interviews with staff focused on the acceptability and feasibility of the app itself and integrating a peer worker into the health care service.

RESULTS

Consumer recruitment in the research component of the study (n=6) fell substantially short of the target number of participants (n=30). However, from those who participated, both staff and consumers were highly satisfied with the peer worker and somewhat satisfied with the app. Health care staff overall believed that the addition of the peer worker was highly beneficial to both the consumers and staff.

CONCLUSIONS

The preliminary findings from this proof-of-concept pilot study suggest that a peer-led program may be a feasible and acceptable method of working on recovery in this population. However, the e-mental health program did not appear feasible in this setting. In addition, recruitment was challenging in this particular group, and it is important to note that these study findings may not be generalizable. Despite this, ensuring familiarity of technology in the target population before implementing e-mental health interventions is likely to be of benefit.
Guided Self-Help Works: Randomized Waitlist Controlled Trial of Pacifica, a Mobile App Integrating Cognitive Behavioral Therapy and Mindfulness for Stress, Anxiety, and Depression (Preprint)
Authors: Moberg Christine , Niles Andrea , Beermann Dale
Published: October 2018

BACKGROUND

Despite substantial improvements in technology and the increased demand for technology-enabled behavioral health tools among consumers, little progress has been made in easing the burden of mental illness. This may be because of the inherent challenges of conducting traditional clinical trials in a rapidly evolving technology landscape.

OBJECTIVE

This study sought to validate the effectiveness of Pacifica, a popular commercially available app for the self-management of mild-to-moderate stress, anxiety, and depression.

METHODS

A total of 500 adults with mild-to-moderate anxiety or depression were recruited from in-app onboarding to participate in a randomized waitlist controlled trial of Pacifica. We conducted an all-virtual study, recruiting, screening, and randomizing participants through a Web-based participant portal. Study participants used the app for 1 month, with no level of use required, closely mimicking real-world app usage. Participants in the waitlist group were given access to the app after 1 month. Measurements included self-reported symptoms of stress, anxiety, depression, and self-efficacy. We performed an intent-to-treat analysis to examine the interactive effects of time and condition.

RESULTS

We found significant interactions between time and group. Participants in the active condition demonstrated significantly greater decreases in depression, anxiety, and stress and increases in self-efficacy. Although we did not find a relationship between overall engagement with the app and symptom improvement, participants who completed relatively more thought record exercises sustained improvements in their symptoms through the 2-month follow-up to a greater degree than those who completed fewer. In addition, we found that participants who reported concomitantly taking psychiatric medications during the trial benefitted less from the app, as measured by the symptoms of anxiety and stress.

CONCLUSIONS

This study provides evidence that Pacifica, a popular commercially available self-help app, is effective in reducing self-reported symptoms of depression, anxiety, and stress, particularly among individuals who utilize thought records and are not taking psychiatric medication.

CLINICALTRIAL

ClinicalTrials.gov NCT03333707; https://clinicaltrials.gov/ct2/show/NCT03333707 (Archived by WebCite at http://www.webcitation.org/78YE07ADB)
The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions (Preprint)
Authors: Acuña Roberto
Published: October 2018

BACKGROUND

According to the World Health Organization (WHO) close to 800,000 people worldwide death by suicidal each year. Many more attempt to do it. In consequence, the WHO recognizes suicide as a global public health priority, which affects not only rich countries, but poor and middle income countries as well.

OBJECTIVE

The aim of this study is to evaluate several supervised classifiers for detecting messages with suicidal ideation in order to know if these systems can be used in automatic suicide prevention systems.

METHODS

We used machine learning techniques to make a systematic analysis of 28 supervised classifier algorithms with parameters by defect. The Life Corpus, used in this research, is a bilingual corpus (English and Spanish) oriented to suicide. The corpus was constructed by two annotation experts, retrieving texts from several social networks. The corpus quality was measured using mutual annotation agreement.

RESULTS

The different experiments determined that the classifier with the best performance was KStar, with the corpus version POS-SYNSETS-NUM; and the cycle with 2 classes Urgent and No Risk was the one that achieved the best results with the PRC-Area metrics of 0,81036 and F-measure of 0,7148.

CONCLUSIONS

The present research fulfilled the objective of discovering which characteristics are the most suitable for the automatic classification of messages with suicidal ideation, using the Life Corpus. The results of this evaluation demonstrate that the Life Corpus and machine learning techniques could be suitable for detecting suicide ideation messages.
Patient Attitudes About Viewing Their Radiology Images Online: Preintervention Survey (Preprint)
Authors: Halaska Ciarra , Sachs Peter , Sanfilippo Kate , Lin Chen-Tan
Published: October 2018

BACKGROUND

Although patient data is available through electronic portals, little information exists about the benefits and/or challenges of providing patients with online access to their radiology images.

OBJECTIVE

The aims of this quality improvement project were to understand patient attitudes toward being able to view their radiology images online and determine how information should be presented to ensure the images are helpful to the patients, rather than causing confusion and anxiety.

METHODS

An online survey of consumers was conducted to evaluate attitudes toward online access to personal radiological images.

RESULTS

A total of 105 responses were received from 686 community members (15.3%). Of 105 consumers, 94 (89.5%) reported a desire to have access to the radiology images within their online patient portal; 86.7% (91/105) believed it would help them better understand their medical conditions and 81.0% (85/105) said this would help them feel more in control of their care. Most respondents (74/105, 70.5%) said it would help them feel reassured that their doctor was doing the right thing, and 63.8% (67/105) said it would increase their level of trust in their doctor. Among surveyed patients, 78.1% (82/105) valued viewing their radiology images online, while 92.4% (97/105) valued their online radiology reports. Most patients (69/105, 65.7%) wished to discuss their results with their ordering clinician, 29.5% (31/105) wished to discuss with their interpreting radiologist, and 3.8% (4/105) wished to share their images on social media. The biggest potential concern among 23.8% (25/105) was that the images would be confusing.

CONCLUSIONS

A large majority of surveyed patients desired the ability to view their radiology images online and anticipated many benefits and few risks. Health care organizations with electronic health records and online patient portals should consider augmenting their existing portals with this highly desired feature. To avoid the biggest patient concern, radiology reports should accompany images. Patients wanted to discuss their results with their ordering physician and their interpreting radiologist. Some even would like to share results on social media. Further research on the actual experience with such a tool will be needed.
Reliability of Hammersmith Examination in Prediction of Neurological Outcomes (REHAPENO) - Research Protocol (Preprint)
Authors: Fleifel Mohamed , Abdelghani Rawya , Ameen Mohamed
Published: October 2018

BACKGROUND

Background: Studying the neurological developmental outcomes and comparing correlations with MRI (Magnetic resonance image) versus the Hammersmith Infant Neurological Examination (HINE)

OBJECTIVE

Objective: To investigate the non-inferiority of MRI to HINE in infant developmental outcomes

METHODS

Settings: Hospital settings including pediatrics and neonatal care units

Intervention: No medical or surgical intervention is planned, only correlation and extra analyses would take place to standardize the current practice
Measurements: HINE, Brain MRI, Brain Ultrasound and developmental outcomes after 12 months

RESULTS

Results: The observations collected and correlations measured to figure out the reliability of both HINE and MRI in order to figure to what extent can we rely on HINE alone in expecting the developmental outcomes

CONCLUSIONS

The more reliability would expressed by HINE assessment the accurate expectation of developmental in preterm infants

CLINICALTRIAL

https://clinicaltrials.gov/ct2/show/NCT03580252
YouTube Videos as a Source of Information About Immunology for Medical Students: Cross-Sectional Study (Preprint)
Authors: Van den Eynde Jef , Crauwels Alexander , Demaerel Philip Georg , Van Eycken Lisa , Bullens Dominique , Schrijvers Rik , Toelen Jaan
Published: October 2018

BACKGROUND

The use of the internet as a source of information has grown exponentially in the last decade. YouTube is currently the second most visited website and a major Web-based educational resource for medical students.

OBJECTIVE

The aim of this study was to evaluate the quality, accuracy, and attractiveness of the information acquired from YouTube videos about 2 central concepts in immunology.

METHODS

YouTube videos posted before August 27, 2018 were searched using selected keywords related to either antigen presentation or immunoglobulin gene rearrangement. Video characteristics were recorded, and the Video Power Index (VPI) was calculated. Videos were assessed using 5 validated scoring systems: understandability and attractiveness, reliability, content and comprehensiveness, global quality score (GQS), and a subjective score. Videos were categorized by educational usefulness and by source.

RESULTS

A total of 82 videos about antigen presentation and 70 about immunoglobulin gene rearrangement were analyzed. Videos had a mean understandability and attractiveness score of 6.57/8 and 5.84/8, content and comprehensiveness score of 9.84/20 and 5.84/20, reliability score of 1.65/4 and 1.53/4, GQS of 3.38/5 and 2.76/5, and subjective score of 2.00/3 and 2.00/3, respectively. The organized channels group tended to have the highest VPI and GQS.

CONCLUSIONS

YouTube can provide medical students with some useful information about immunology, although content wise it cannot substitute textbooks and academic courses. Students and teachers should be aware of the educational quality of available videos if they intend to use them in the context of blended learning.
Timing of Exposure to High-Concentrates versus High-Quality Forages on Growth and Marbling Deposition in Steers
Authors: Koch Brandon M. , Pavan Enrique , Andrae John G. , Duckett Susan K.
Published: October 2018

Forty Angus-cross steers (280 ± 21.4 kg BW, 8 mo.) were used to examine the effects of exposure to 2 diets [high concentrate diets (CONC) versus high quality forages (FOR)] during 2 time periods [early (EARLY; at 30-d post weaning) or late (LATE; just prior to slaughter)] on animal growth, marbling deposition and tenderness. Steers were blocked by weight and randomly assigned to four dietary treatments: 1) CONC-FOR, 2) CONC-CONC, 3) FOR-CONC, or 4) FOR-FOR. Exposure to CONC during the EARLY or LATE period increased (P < 0.05) growth and fat deposition compared to FOR-FOR. Hot carcass weight was greater (P < 0.05) for CONC-CONC and FOR-CONC steers than FOR-FOR and CONC-FOR due to changes in dressing percent. Marbling score was greater (P < 0.05) for CONC-CONC and CONC-FOR compared to FOR-FOR. Exposure to CONC during the EARLY period (CONC-FOR and CONC-CONC) increased (P < 0.05) n-6 polyunsaturated fatty acids (PUFA) deposition in longissimus muscle (LM) and subcutaneous adipose tissue (SQ); whereas, exposure to CONC during the LATE period (CONC-CONC and FOR-CONC) reduced (P < 0.05) n-3 PUFA, trans-11 octadecenoic acid and cis-9 trans-11 isomer of conjugated linoleic acid (CLA). Warner-Bratzler shear force at d 2 and 7 of postmortem aging in ribeye steaks from CONC-CONC and FOR-CONC was greater (P < 0.05) than FOR-FOR and CONC-FOR. Lipogenic gene expression was up-regulated (P < 0.05) and lipolytic gene expression was downregulated (P < 0.06) in SQ from CONC-CONC and FOR-CONC compared to FOR-FOR. Overall, exposure to CONC in both periods increased growth rate and marbling deposition but LATE exposure had the greatest impact on adipose lipogenesis and lipolysis, fatty acid composition, and tenderness.
La Cartografía de las Unidades Inferiores de la Regionalización Físico-Geográfica (RFG) de Michoacán
Authors: Espinoza Maya Alejandra , Bollo Manent Manuel
Published: October 2018

El presente trabajo propone la Regionalización físico-geográfica (RFG) para Michoacán. Se basa en el método de distinción de unidades de la regionalización, a partir del mapa de la tipología regional de los paisajes, por medio de la asociación de paisajes de esta tipología en cada nivel taxonómico de la RFG. Se parte de la diferenciación de las Provincias físico-geográficas del territorio como unidad taxonómica superior que es posible representar a la escala de estudio y posteriormente se establecen las unidades inferiores de la taxonomía a su interior. Para Michoacán se distinguieron: 2 Provincias, 7 Subprovincias, 17 Distritos y 36 Regiones físico-geográficas en una superficie de 58,296.11 km2, a escala 1:500,000. La delimitación de estas unidades espaciales, resulta útil en diversos ámbitos, particularmente en la gestión, manejo y planeamiento del territorio, ya que están constituidas por niveles jerárquicos de unidades anidadas por medio de una taxonomía que permite abarcar diferentes escalas.