bluuebunny/crossref_metadata_2025 huggingface dataset:
Sleep status and the associated factors, a large cross-sectional study in Shaanxi province of China
Authors: Zhang Yaxuan , Wang Jiwei , Lu Xinyuan , Che Beibei , Wang Rui , Yu Jinming
Published: September 2020

Background
This study aimed at investigating the sleep status and its associated factors in Shaanxi province of China.
Methods
This cross-sectional study was conducted among 11399 subjects in Shaanxi Province, China. Data was collected via spot field questionnaire survey. The contents included demographic characteristics, sleep status, lifestyles, disease history and other associated factors. Logistic regression analysis was used to estimate the effect of associated factors for sleep quality. Crude odds ratio (cOR) and adjusted odds ratio (aOR) and their 95% confident intervals (CI) were calculated.
Results
A total of 11036 subjects were included in the final analysis. There were 12.8% participants having a bad or very bad sleep. In the last month, 8.4% participants had difficulty in initiating sleep, 7.6% participants had difficulty in maintaining sleep, 8.8% participants suffered from awakening earlier and 10.3% participants had the problem of feeling sleepy during the day ≥ 3 times per week. There were 16.5% participants having one of the above sleep problems (difficulty in initiating sleep, difficulty in maintaining sleep, awakening early) > 3 months. Poorer sleep quality was associated with female (aOR = 1.792, p < 0.001), unmarried or without cohabiting with boyfriend/girlfriend (aOR = 1.319, 95% CI = 1.022–1.704), divorced or widowed (aOR = 1.436, 95% CI = 1.052–1.960), heart diseases (aOR = 1.478, p = 0.002), musculoskeletal diseases (aOR = 1.460, p = 0.018), concerning about their own health (aOR = 1.113, p = 0.016), alcohol drinking (aOR = 1.201, p < 0.001), taking hypnotics (aOR = 1.643, p < 0.001), a longer daily screen time (aOR = 1.055, p < 0.001). Better sleep quality was associated with medium education level (aOR = 0.748, p = 0.003), high family monthly income (aOR = 0.939, p = 0.004), good self-reported health status (aOR = 0.490, p < 0.001), having breakfast regularly (aOR = 0.935, p = 0.016).
Conclusions
The self-reported sleep quality was generally good in Shaanxi, China. Sleep quality was associated with gender, marital status, educational level, family monthly income, heart disease, musculoskeletal diseases, degree of concerning about their own health, self-reported health status, alcohol drinking, having breakfast, take hypnotics and daily screen time.
Prevalence of people at risk of developing type 2 diabetes mellitus and the involvement of community pharmacies in a national screening campaign: a pioneer action in Brazil
Authors: Correr Cassyano Januário , Coura-Vital Wendel , Frade Josélia Cintya Quintao Pena , Nascimento Renata Cristina Rezende Macedo do , Nascimento Lúbia Guaima , Pinheiro Eliete Bachrany , Ferreira Wesley Magno , Reis Janice Sepúlveda , de Melo Karla Fabiana Santana , Pontarolo Roberto , Lenzi Mônica Soares Amaral , de Almeida José Vanilton , Pedrosa Hermelinda Cordeiro , João Walter da Silva Jorge
Published: September 2020

Background: Brazil is one of top 10 countries with the highest number of people with diabetes mellitus (DM), affecting 16.8 million peoples. It is estimated that 7.7 million people (20–79 years) in the country have not yet been diagnosed, representing an under-diagnosis rate of 46.0%. Herein we aimed to screen people for high blood glucose or risk for developing type 2 DM (T2DM) through community pharmacies in Brazil.Methods: A cross-sectional study was carried out in November 2018, involving 977 pharmacists from 345 municipalities in Brazil. The study evaluated people between 20 and 79 years old without a previous diagnosis of DM. Glycemia was considered high when its value was ≥100 mg/dL fasting and ≥ 140 mg/dL in a casual feeding state. The FINDRISC (Finnish Diabetes Risk Score) was used to estimate the risk for developing T2DM. The prevalence of high blood glucose was estimated and the associated factors were obtained using Poisson's multivariate analysis with robust variance.Results: During the national screening campaign, 17,580 people were tested with the majority of the consultations (78.2%) being carried out in private pharmacies. The population was composed mainly of women (59.5%) and people aged between 20 and 45 years (47.9%). The frequency of participants with high blood glucose was 18.4% (95% CI 17.9–19.0). Considering the FINDRISC, 22.7% of people had a high or very high risk for T2DM. The risk factors associated with high blood glucose were: Body Mass Index > 25 kg/m 2 , abdominal circumference> 94 cm for men and> 80 cm for women; education level below 15 years of study, no daily intake of vegetables and fruits; previous diagnosis of arterial hypertension; history of high blood glucose and family history of DM.Conclusions: This is the largest screening study that evaluated the frequency of high blood glucose and its associated factors in a population without a previous diagnosis ever performed in community pharmacies in Brazil. These results may help to improve public health policies and reinforce the role of pharmacists in screening and education actions aimed at this undiagnosed population in a continent-size country such as Brazil.
The Role of Body Mass Index in High and Low Velocity Trauma Causing Knee Injury Associated to Popliteal Artery Lesions.
Authors: Marchetti Andrea Ascoli , Naldi Valerio , Potenza Vito , Oddi Fabio Massimo , De Maio Fernando , Ciattaglia Riccardo , Farsetti Pasquale , Ippoliti Arnaldo
Published: September 2020

Background: Osteoarticular traumas are particularly dangerous among arterial traumas, those associated with the popliteal artery are associated with a high amputation rate. Despite representing a minority of arterial traumas, with an incidence that considerably varies by population and geographic location, traumatic lesions of the popliteal artery are a challenge. This study aimed to verify the impact of Body Mass Index (BMI) on arterial trauma damage and outcome. Methods: Data were retrospectively collected from the emergency and operating rooms’ electronic medical reports at our Institution between 1 January 2005 and 1 May 2018 of all osteoarticular and vascular associated lesion. 41 pts presented with lower limb arterial trauma (43.2%), and popliteal artery lesions occurred in 11 (26.8%). 11 patients were eligible for inclusion in the study. In addition, the lesion mechanism was dislocation by high-velocity trauma in 9 cases and by low-velocity trauma in 3. All 7 males (63.6%) were affected by high-velocity trauma, and 2 of the 3 females by low-velocity trauma. Only one patient had an isolated popliteal artery lesion associated with fractures in the leg or in contralateral limb. Patients with low-velocity traumas were older than 54 years while those with high-velocity were aged from 22 to 71 years. Results: The lesion mechanism was dislocation due to high-velocity trauma in eight patients and due to low-velocity trauma in three. In 10/11 patients (90.9%). revascularization was performed after osteoarticular stabilization. after reduction of the dislocation or fracture. Intraoperative angiography was selectively used. Two patients required above-knee amputation after the procedure: one due to infection of the surgical access and the other due to severe soft tissue injury. One patient died during hospitalization due to trauma-related complications and comorbidities. Conclusions: High-velocity traumas, and low-velocity traumas with a body mass index >35kg/m2 with knee lesions are associated with popliteal artery lesion. Revascularization success is not associated with high or low velocity traumas.
Rv3131, a gene encoding nitroreductase, is essential for metronidazole activation in Mycobacterium tuberculosis under hypoxic condition
Authors: Dong Wenzhu , Shi Jin , Chu Ping , Liu Rongmei , Wen Shu’an , Zhang Tingting , Pang Yu , Lu Jie
Published: September 2020

ObjectivesThe impressive potency of metronidazole (MTZ) against anaerobic bacteria indicates the potential for killing anaerobic Mtb. However, how MTZ is activated in Mtb still remains unknown. We aimed to characterize the endogenous nitroreductase responsible for MTZ activation in anaerobic Mtb.MethodsThe minimal inhibitory concentrations (MICs) of Mtb isolates against MTZ were determined by microplate Alamar Blue assay. Intracellular anti-TB activities of MTZ and pyrazinamide (PZA) were tested in THP-1 cells infected by Mycobacterium tuberculosis (Mtb) H37Rv with a multiplicity of infection (MOI) of 10. The nitroreductase activity of purified wild-type Rv3131 and mutants were measured under anaerobic conditions generated by glucose oxidase/catalase system. Two-tailed unpaired Student’s t test was used to compare the difference between various groups.Results180 Mtb isolates (81.8%, 180/220) had MIC values higher than 16 μg/mL, and 40 had MIC values of 16 μg/mL, demonstrating high-level resistance to MTZ under aerobic condition. The number of viable bacteria in macrophages treated with MTZ was dramatically decreased by 71.3% after 5-day MTZ treatment, indicating significant inhibition of MTZ against anaerobic Mtb. In vitro biochemical analysis demonstrated that Rv3131 exhibited the NADPH oxidase activity under anaerobic condition. The substitutions of Cys75Ser and Cys279Ser could maintain 41.7% and 71.1% of enzyme activity compared to wild-type protein, respectively.ConclusionsOur data demonstrate that MTZ has more potent efficacy against intracellular Mtb than PZA. Rv3131 is identified as a nitroreductase enzyme in the activation of MTZ, and Cys75 of Rv3131 is the major active residue for nitroreductase activity.
Analgesic Efficacy of Rectus Sheath Bupivacaine and Intrathecal Morphine With Bupivacaine Compared to Intravenous Patient-controlled Analgesia in Males Undergoing Robot-Assisted Laparoscopic Prostatectomy: A Prospective, Observational Parallel-Cohort Study
Authors: Shim Jung-Woo , Cho Yun Jeong , Kim Minhee , Hong Sang Hyun , Moon Hyong Woo , Hong Sung Hoo , Chae Min Suk
Published: September 2020

Background: We explored the analgesic outcomes on postoperative day (POD) 1 of males undergoing robot-assisted laparoscopic prostatectomy (RALP) who received intravenous (IV) patient-controlled analgesia (PCA), a rectus sheath bupivacaine block (RSB), or an intrathecal morphine with bupivacaine (ITMB) block. Methods: This was a prospective, observational parallel-cohort trial. Patients were divided into three groups: IV-PCA (n = 30), RSB (n = 30), and ITMB block (n = 30). Peak pain scores at rest and when coughing, cumulative IV-PCA drug consumption, the need for IV rescue opioids, and Quality of Recovery-15 (QoR-15) questionnaire scores collected on POD 1 were compared among the groups.Results: The preoperative and intraoperative findings were comparable among the groups; the ITMB block group required the least remifentanil of all groups. During POD 1, the ITMB block group reported lower levels of pain at rest and when coughing than did the other two groups. After adjustment for age, body mass index, comorbidities, and intraoperative remifentanil infusion, severe pain at rest was 0.167-fold less common in the ITMB block than in the IV-PCA group, and pain when coughing was 0.1-fold lower in the ITMB block group and 0.306-fold lower in the RSB group compared to the IV-PCA group. The ITMB block group required lower cumulative IV-PCA drug infusions and less IV rescue opioids, and exhibited a better QoR-15 global score than did the other two groups.Conclusion: An ITMB block seems to provide appropriate analgesia with tolerable complications and enhances early patient recovery after RALP.Trial registration: Clinical Research Information Service, Republic of Korea, (approval number: KCT0005040) on May 20, 2020https://cris.nih.go.kr/cris/search/search_result_st01_kren.jsp?seq=15943&sLeft=2<ype=my&rtype=my
Calcium-dependent cytosolic phospholipase A2 activation is implicated in neuroinflammation and oxidative stress associated with ApoE4
Authors: Wang Shaowei , Li Boyang , Solomon Victoria , Fonteh Alfred , Rapoport Stanley I. , Bennett David A. , Arvanitakis Zoe , Chui Helena C. , Miller Carol A. , Sullivan Patrick M. , Yassine Hussein
Published: September 2020

Background
Apolipoprotein E4 (APOE4) is associated with a greater response to neuroinflammation and risk of developing late-onset Alzheimer disease (AD), but the mechanisms for this association are not clear. Activation of calcium-dependent cytosolic phospholipase A2 (cPLA2) is involved in inflammatory signaling and is elevated within plaques of the AD brain. The relation between APOE4 genotype and cPLA2 activity is not known.
Methods
Mouse primary astrocytes, mouse and human brain samples differing by APOE genotypes were collected for measuring cPLA2 expression, phosphorylation and activity in relation to measures of inflammation and oxidative stress.
Results
Greater cPLA2 phosphorylation and activity were identified in ApoE4 compared to ApoE3 in primary astrocytes and brains of ApoE-targeted replacement (ApoE-TR) mice. These differences were also demonstrated in brain homogenates from the inferior frontal cortex from AD patients carrying APOE3/4 compared to APOE3/3. Higher cPLA2 activation with APOE4 was associated with greater activation of the MAPK p38 pathway, as well as with higher levels of leukotriene B4 (LTB4), reactive oxygen species (ROS) and inducible nitric oxide synthase (iNOS). Inhibition of cPLA2 reduced LTB4, ROS and iNOS levels in ApoE4 primary astrocytes to those of ApoE3 astrocytes.
Conclusions
Our findings implicate greater activation of cPLA2 signaling system with APOE4, that could represent a potential drug target for mitigating the increased neuroinflammation with APOE4 and AD.
Real-time in Situ Navigation System with Indocyanine Green Fluorescence for Sentinel Lymph Node Biopsy in Patients with Breast Cancer
Authors: Wang Zhaorui , Yang Xiaowei , Liu Peng , Han Chunguang , Pan Yubo , Pei Jing
Published: September 2020

Background: The naked-eye invisibility of indocyanine green fluorescence limits the application of near-infrared fluorescence imaging (NIR) systems for real-time navigation during sentinel lymph node biopsy (SLNB) in patients with breast cancer undergoing surgery. This study aims to evaluate the effectiveness and safety of a novel NIR system in visualizing indocyanine green fluorescence images in the surgical field and the application value of combined methylene blue (MB) and the novel NIR system in SLNB.Methods: Sixty patients with clinical node-negative breast cancer received indocyanine green (ICG) and MB as tracers. Two NIR system instruments, namely, lymphatic fluorescence imaging system (LFIS) designed by the University of Science and Technology of China and vascular imager by Langfang Mingde Medical Biotechnology Co., Ltd. (Langfang vascular imager), were used as navigation assistance to locate sentinel lymph nodes (SLNs). Excising the lymph nodes developed by both MB and ICG by two NIR systems or palpably suspicious as SLNs and undergoing rapid pathological examination.Results: Both instruments exhibited 95% (57/60) success for real-time lymphatic fluorescent images. A total of 186 SLNs were identified, of which two were pathologically confirmed as lacking any lymph node tissue. SLN identification rate was 100% (184/184) for MB plus LFIS and 86.96% (160/184) for MB alone. The median number of SLNs identified by LFIS combined with MB was 3 (range of 1–8), which was significantly higher than that by MB alone at 2 (range 1–7) (P<0.05).Conclusion: LFIS effectively detects SLNs in breast cancer, projects the fluorescence signals during surgery, and provides a continuous surgical navigation system without the need for a remote monitor. The ICG method navigated by combined LFIS and MB may be a promising alternative tracer for radioisotope in SLN mapping.
Comparison and Interpretation of Characteristics of Rhizosphere Microbial Communities in Three Blueberry Varieties: The Benefits to Blueberry Production
Authors: Zhang Yan , Wang Wei , Shen Zhangjun , Wang Jingjing , Chen Yajun , Wang Dong , Liu Gang , Han Maozhen
Published: September 2020

Background: Rhizosphere microbiota play a critical role in biogeochemical cycles and carry out various vital functions in plant production. Studies on the rhizosphere microbiome of various plants proved that rhizosphere microbiota can regulate the growth and improve the yield of plants. However, the rhizosphere microbiome of commercial blueberry remains elusive. Hence, the characteristics of rhizosphere microbial communities of blueberry should be compared and interpreted for improving production. Methods: We collected 15 rhizosphere soil samples of three different blueberry varieties and five bulk soil samples to profile the composition of blueberry microbial communities by high-throughput sequencing. Results: Our results demonstrated significant differences in both alpha diversity and beta diversity of rhizosphere microbial communities of different blueberry varieties and bulk soil. We found that the distribution patterns of taxonomical, functional, and phenotypic composition of rhizosphere microbiome differ across the blueberry varieties. The rhizosphere microbial communities of three different blueberry varieties could be distinctly separated and 28 discriminative biomarkers were selected to distinguish these three blueberry varieties. Core rhizosphere microbiota for blueberry was identified, and it contained 201 OTUs, which were mainly affiliated with Proteobacteria, Actinobacteria, and Acidobacteria. Moreover, we explored the interactions between OTUs of blueberry rhizosphere microbial communities by constructing the co-occurrence network of OTUs from an ecological perspective. Conclusions: This pilot study explored the characteristics of blueberry’s rhizosphere microbial community, such as the beneficial microorganisms, and provided an integrative perspective on blueberry’s rhizosphere microbiome, which was beneficial to blueberry health and production.
Facile investigation of reversible nanostructure changes in flexible crystals
Authors: Hayashi Shotaro
Published: September 2020

Detailed investigation of macroscopic deformation and nanoscopic structural changes in flexible organic crystals pose challenges for investigators. Herein, applied stress and subsequent relaxation of elastic organic crystals resulted in reversible macroscopic crystal deformation. X-ray diffraction with a curved jig revealed reversible nanoscopic structural changes in the crystal structure under the bending stress and relaxation. The crystal lattice changed quantitatively under the applied macroscopic stress-strain (%). This method enables quantitative monitoring of the dynamic nanoscopic structural changes in detail associated with crystal deformation through the use of standard laboratory X-ray diffraction analysis. Importantly, the developed method offers a way of quantitatively measuring reversible structural changes, without synchrotron X-ray analysis. Moreover, the analysis derives Poisson’s ratio, i.e., the ratio of the change in the width per unit width of materials. It is important in materials science, normally has a positive value in the range of 0.2–0.5. However, the crystals show not only the "Poisson effect" but also the unusual "negative Poisson effect". This novel approach for investigation generates unprecedented opportunities for understanding dynamic nanostructure changes in flexible organic crystals.
A Comparative Survival Study between Familial and Sporadic Breast Cancer in Iranian Women
Authors: Kashi Amir Shahram Yousefi
Published: September 2020

Background: Breast cancer (BC) is the most common cancer in Iranian women, with 13400 new cases annually. A few studies have reported that BC patients with a positive familial history had different prognoses and outcomes.Objectives: The aim of the present study was to evaluate and compare survival between familial breast cancer (FBC) patients and sporadic breast cancer (SBC) patients in Iranian women.Methods: In a longitudinal study, 1710 patients with complete medical records from the Cancer Research Center, database were extracted and divided into two groups: the FBC group (n=311) and the SBC group (n=1399). Then, five-year overall survival (OS) and five-year disease -free survival (DFS) for these two groups were evaluated and compared.Results: The FBC group and SBC group represented 18.22% % and 81.8% of all cases, with mean ages of 44.2 years and 47.7 years, respectively (p=0.0024). There were more advanced stage and positive lymph nodes, higher grade of tumor, more positive lymphovascular invasion and P53 status and higher degrees of negative progesterone receptor status in the FBC group than in the SBC group (p=0.0200, p=0.0001, p=0.0001, p=0.0386, p=0.0182 and p=0.0003, respectively). In the FBC group and SBC group, the five -year DFS was 81% and 86.5%, (p=0.0121), and the five -year OS was 71.1% and 76.5%, respectively (p=0.0401).Conclusions: The findings of this study showed that better five-year OS, five-year DFS and favorable prognostic factors in the SBT group than in the FBC group. The initial results might be helpful as better treatment modalities and careful follow-up in the FBC group.
Screening for Proteins Related to The Biosynthesis of Hispidin and Its Derivatives in Phellinus Igniarius Using iTRAQ Proteomic Analysis
Authors: Guo Jinjing , Liu Xiaoxi , Li Yuanjie , Ji Hongyan , Liu Cheng , Zhou Li , Huang Yu , Bai Changcai , Jiang Zhibo , Wu Xiuli
Published: September 2020

Background: Hispidin (HIP) and its derivatives, a class of natural fungal metabolites, possess extremely complex and interesting chemical structures with extensive pharmacological activities. Phellinus igniarius, which is the most common sources of HIP, can be used as both medicine and food. The biosynthetic pasthway of HIP in P. igniarius is not yet clear and hence effective regulatory mechanism of HIP is absent.The purpose of this paper was to illustrate a biosynthesis system for hispidin and its derivatives at the protein level. Results: We found that tricetolatone (TL) is a key biosynthetic precursor in the biosynthetic pathway of hispidin and that its addition led to increased production of hispidin and various hispidin derivatives. Based on the changes in the concentrations of precursors and intermediates, key timepoints in the biosynthetic process were identified. We used isobaric tags for relative and absolute quantification (iTRAQ) to study dynamic changes of related proteins in vitro. The 270 differentially expressed proteins were determined by GO enrichment analysis to be primarily related to energy metabolism, oxidative phosphorylation, and environmental stress responses after TL supplementation. The differentially expressed proteins were related to ATP synthase, NAD binding protein, oxidoreductase, and other elements associated with electron transfer and dehydrogenation reactions during the biosynthesis of hispidin and its derivatives. Multiple reaction monitoring (MRM) technology was used to selectively verify the iTRAQ results, leading us to screen 11 proteins that were predicted to be related to the biosynthesis pathways.Conclution: These findings help to clarify the molecular mechanism of biosynthesis of hispidin and its derivatives and may serve as a foundation for future strategies to identify new hispidin derivatives.
Utility of Self-rated Adherence and Assessment of Participant Feedback of the Healthy Diet and Lifestyle Study Pilot.
Authors: O’Reilly Holly , Panizza Chloe , Lim Unhee , Yonemori Kim M , Wilkens Lynne R , Shvetsov Yurii B , Harvie Michelle N , Shepherd John , Zhu Fengqing Maggie , Marchand Loïc Le , Boushey Carol J , Cassel Kevin D
Published: September 2020

Background: We examined the utility of self-rated adherence to monitor intervention compliance and facilitate goal setting and assessed participants’ qualitative feedback of the Healthy Diet and Lifestyle Study (HDLS) in order to inform the study design of the main HDLS intervention. HDLS, a randomized pilot intervention, compared the effect of intermittent energy restriction combined with a Mediterranean diet (IER+MED) to a euenergetic Dietary Approaches to Stop Hypertension (DASH) diet, with matching physical activity regimens, for reducing visceral adipose tissue area (VAT) and weight.Methods: Our analysis included the 59 (98%) participants who completed at least one week of HDLS. Self-rated adherence scores to dietary and physical activity prescriptions were collected 8 times across the 12-week intervention, using a 0-10 scale (0=Not at all, 4=Somewhat, and 10=Following the plan very well). Adherence scores for each participant were averaged and assigned to high and low adherence categories using the group median (7.3 for diet, 7.1 for physical activity). Mean changes in VAT and weight from baseline to 12 weeks are reported by adherence level, overall and by randomization arm. The participants’ qualitative feedback at completion of HDLS and 6 months post intervention were examined.Results: Overall, compared to participants with low self-rated adherence to dietary prescriptions, those with high adherence lost significantly more VAT (22.9 ± 3.7 cm2 vs. 11.7 ± 3.9 cm2; p=0.044) and weight at Week 12 (5.4 ± 0.8 kg vs. 3.5 ± 0.6 kg; p=0.045). For physical activity, compared to participants with low adherence, those with high adherence lost significantly more VAT (22.3 ± 3.7 cm2 vs. 11.6 ± 3.6 cm2; p=0.035). Participants’ qualitative feedback of HDLS was positive and the most common response, on how to improve the study, was to provide cooking education classes.Conclusions: Results support the use of self-rated adherence to dietary and physical activity prescriptions as an effective method to monitor compliance and facilitate participant goal setting. Study strategies were found to be effective with promoting compliance to dietary and physical activity prescriptions. The incorporation of cooking classes and demonstrations into future larger trials may further complement dietary adherence.Trial registration: ClinicalTrials.gov Identifier: NCT03639350. Registered 21st August 2018- Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03639350
Comparing Gender Homophily among the Multilayer Media Social Networks of Face-to-Face, Instant Messenger and Social Networking Services: A Case Study of a High School Classroom
Authors: Maejima Naoki
Published: September 2020

In which social worlds does gender homophily operate more strongly – offline or online? To address this question, the following two aspects must be considered. First, people currently use many types of online communication media. Second, to examine the homophily effects exclusively, it is necessary to control for other network formation mechanisms such as ‘foci’ and ‘triadic closure.’ For this study, I conducted a mixed-method research in a high school in rural Japan. I asked students about who they interacted with face-to-face (F2F), through instant messenger (IM), and social networking services (SNS) and then analyzed the social networks using exponential random graph models (ERGMs). Subsequently, I conducted semi-structured interviews to uncover the practices and social contexts of each communication media and explain the results of the quantitative analysis. The results showed that SNS was more gender heterogeneous than offline. In the IM network, a small gender homophily effect was initially observed. However, three months later, its strength decreased to almost the same as that in the SNS networks. From the qualitative research, some key mechanisms producing the difference in gender homophily are specified, such as precedence of F2F communication to IM interaction, independence of SNS communication from F2F, recommending functions, and hobby homophily. Overall, this study implies that considering offline or online alone may cause misunderstanding regarding homophily in organizations because the observed strength of homophily effects depends on whether the space is examined offline or online, what kind of media is examined, and when the online social network data are collected.
Use of Decision Support Tools to Empower Pregnant Women: Systematic Review (Preprint)
Authors: Ngo Elin , Truong Maria Bich-Thuy , Nordeng Hedvig
Published: September 2020

BACKGROUND

Women face many health-related decisions during pregnancy. Digitalization, new technology, and a greater focus on empowering patients have driven the development of patient-centered decision support tools.

OBJECTIVE

This systematic review provides an overview of studies investigating the effect of patient-centered decision support tools for pregnant women.

METHODS

We searched 5 online databases, MEDLINE, EMBASE, Web of Science, PsycINFO, and Scopus, from inception to December 1, 2019. Two independent researchers screened titles, abstracts, and full-texts against the inclusion criteria. All studies investigating the effect of patient-centered decision support tools for health-related issues among pregnant women were included. Study characteristics and results were extracted using the review management tool Rayyan and analyzed according to topic, type of decision support tools, control group, outcome measurements, and results.

RESULTS

The 25 eligible studies covered a range of health topics, including prenatal screening (n=10), gestational diabetes and weight gain (n=7), lifestyle (n=3), blood pressure and preeclampsia (n=2), depression (n=1), asthma (n=1), and psychological well-being (n=1). In general, the use of decision support tools increased women's knowledge, and recording symptoms enhanced satisfaction with maternity care.

CONCLUSIONS

The opportunities created by digitalization and technology should be used to develop innovative patient-centered decision support tools tailored to support pregnant women. Effect on clinical outcomes should be documented.
Detection of Bulbar Involvement in Patients With Amyotrophic Lateral Sclerosis by Machine Learning Voice Analysis: Diagnostic Decision Support Development Study (Preprint)
Authors: Tena Alberto , Claria Francec , Solsona Francesc , Meister Einar , Povedano Monica
Published: September 2020

BACKGROUND

Bulbar involvement is a term used in amyotrophic lateral sclerosis (ALS) that refers to motor neuron impairment in the corticobulbar area of the brainstem, which produces a dysfunction of speech and swallowing. One of the earliest symptoms of bulbar involvement is voice deterioration characterized by grossly defective articulation; extremely slow, laborious speech; marked hypernasality; and severe harshness. Bulbar involvement requires well-timed and carefully coordinated interventions. Therefore, early detection is crucial to improving the quality of life and lengthening the life expectancy of patients with ALS who present with this dysfunction. Recent research efforts have focused on voice analysis to capture bulbar involvement.

OBJECTIVE

The main objective of this paper was (1) to design a methodology for diagnosing bulbar involvement efficiently through the acoustic parameters of uttered vowels in Spanish, and (2) to demonstrate that the performance of the automated diagnosis of bulbar involvement is superior to human diagnosis.

METHODS

The study focused on the extraction of features from the phonatory subsystem—jitter, shimmer, harmonics-to-noise ratio, and pitch—from the utterance of the five Spanish vowels. Then, we used various supervised classification algorithms, preceded by principal component analysis of the features obtained.

RESULTS

To date, support vector machines have performed better (accuracy 95.8%) than the models analyzed in the related work. We also show how the model can improve human diagnosis, which can often misdiagnose bulbar involvement.

CONCLUSIONS

The results obtained are very encouraging and demonstrate the efficiency and applicability of the automated model presented in this paper. It may be an appropriate tool to help in the diagnosis of ALS by multidisciplinary clinical teams, in particular to improve the diagnosis of bulbar involvement.
Advice to use infant formula and free samples are common in both urban and rural areas in China: A cross-sectional survey (Preprint)
Authors: Li Jia , Nguyen Tuan T , Duan Yifan , Mathisen Roger , Yang Zhenyu
Published: September 2020

BACKGROUND

Previous studies focused on the promotion of infant formula in big cities and among families of high socioeconomic status in China.

OBJECTIVE

To examine the association between the place of residence and receiving free samples and advice to feed the baby with infant formula.

METHODS

We analyzed cross-sectional data from face-to-face interviews with 5,112 mothers with infants aged 0-5 months from 12 districts/regions in China. The study outcomes were exposure to free samples of infant formula and receiving advice to feed the baby with infant formula. The main exposure variables were the place of residence of the mothers.

RESULTS

About 16% of the mothers received free samples of infant formula: 6.3% during pregnancy, 3.5% during hospital stay, and 6.3% after discharge. During pregnancy, this likelihood was higher among mothers in small and medium cities (OR: 1.96; 95% CI: 1.14, 3.38) and non-poor rural counties (OR: 4.65; 95% CI: 1.65, 13.14) compared to in big cities; during the hospital stay, this likelihood was lower in big cities than in the other areas; and after discharge, it was lower in poor rural counties (OR: 0.14; 95% CI: 0.05, 0.41). About 26% of the mothers across all areas received advice to feed the baby with infant formula from: hospitals (11.4%), traditional mass media (5.1%), and modern mass media (8.6%). The likelihood of receiving advice to feed the baby with infant formula from hospitals was lower in non-poor rural counties (OR: 0.37; 95% CI: 0.21, 0.66) and poor rural counties (OR: 0.35; 95% CI: 0.13, 0.91) than in big cities. Mothers in non-poor rural counties were less likely to receive advice from traditional mass media (OR: 0.17; 95% CI: 0.06, 0.48), while in small and medium cities were more likely to receive advice form modern mass media (OR: 1.84; 95% CI: 1.20, 2.80) compared with mothers in big cities.

CONCLUSIONS

The promotion of infant formula in the form of free samples and advice is common in surveyed areas in China. Promotional efforts have targeted women from different places of residence, and during the first 1000 days -- pregnancy, during delivery and after birth. The study findings suggest the need to strengthen regulation and enforcement of the Code, which restricts the promotion of breastmilk substitutes, especially within health facilities and through modern forms of media.
Role of Machine Learning Techniques to Tackle the COVID-19 Crisis: Systematic Review (Preprint)
Authors: Syeda Hafsa Bareen , Syed Mahanazuddin , Sexton Kevin Wayne , Syed Shorabuddin , Begum Salma , Syed Farhanuddin , Prior Fred , Yu Jr Feliciano
Published: September 2020

BACKGROUND

SARS-CoV-2, the novel coronavirus responsible for COVID-19, has caused havoc worldwide, with patients presenting a spectrum of complications that have pushed health care experts to explore new technological solutions and treatment plans. Artificial Intelligence (AI)–based technologies have played a substantial role in solving complex problems, and several organizations have been swift to adopt and customize these technologies in response to the challenges posed by the COVID-19 pandemic.

OBJECTIVE

The objective of this study was to conduct a systematic review of the literature on the role of AI as a comprehensive and decisive technology to fight the COVID-19 crisis in the fields of epidemiology, diagnosis, and disease progression.

METHODS

A systematic search of PubMed, Web of Science, and CINAHL databases was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines to identify all potentially relevant studies published and made available online between December 1, 2019, and June 27, 2020. The search syntax was built using keywords specific to COVID-19 and AI.

RESULTS

The search strategy resulted in 419 articles published and made available online during the aforementioned period. Of these, 130 publications were selected for further analyses. These publications were classified into 3 themes based on AI applications employed to combat the COVID-19 crisis: Computational Epidemiology, Early Detection and Diagnosis, and Disease Progression. Of the 130 studies, 71 (54.6%) focused on predicting the COVID-19 outbreak, the impact of containment policies, and potential drug discoveries, which were classified under the Computational Epidemiology theme. Next, 40 of 130 (30.8%) studies that applied AI techniques to detect COVID-19 by using patients’ radiological images or laboratory test results were classified under the Early Detection and Diagnosis theme. Finally, 19 of the 130 studies (14.6%) that focused on predicting disease progression, outcomes (ie, recovery and mortality), length of hospital stay, and number of days spent in the intensive care unit for patients with COVID-19 were classified under the Disease Progression theme.

CONCLUSIONS

In this systematic review, we assembled studies in the current COVID-19 literature that utilized AI-based methods to provide insights into different COVID-19 themes. Our findings highlight important variables, data types, and available COVID-19 resources that can assist in facilitating clinical and translational research.
The Effect of Socio-Demographic Characteristics on e-health Literacy Among Adolescents in Turkey (Preprint)
Authors: Çınar Sevil , Boztepe Handan , Özcebe Hilal
Published: September 2020

BACKGROUND

As a result of having easy access to the internet and mobile devices, a great part of the population uses the internet in order to search for information related to health; therefore, health literacy on the internet has gained importance.

OBJECTIVE

The study aimed to determine the e-health literacy levels of adolescents in Turkey and assess the correlation between e-health literacy and socio-demographic and health statuses.

METHODS

The sample was composed of 1082 adolescents in the age group of 14–18 years, studying in the 9th, 10th, 11th, and 12th grades of three high schools, from low, middle, and high socioeconomic backgrounds. The data were collected using a data collection form consisting of questions related to the adolescents and the socio-demographic characteristics of their parents, as well as the E-Health Literacy Scale for Adolescents. The predictors of e-health literacy among adolescents were analyzed through linear regression.

RESULTS

It was determined in the study that the level of e-health literacy was affected by factors such as age (P<.05), number of siblings (P<.05), family income status (P<.05), having a computer (P<.05), and reading about health issues in general (P<.001). and about their own health on the Internet (P<.05). In the study, the e-health mean scores of adolescents having high socioeconomic levels were found to be statistically higher (F = 2.153, P<.001).

CONCLUSIONS

The results revealed the significance of improving the e-health literacy skills of male adolescents at low socioeconomic levels, using the Internet less, so that they can effectively access online health information. In the near future, more training programs suitable for the developmental period of the adolescents could be organized in the schools to increase the e-health literacy of adolescents.

CLINICALTRIAL
Factors Influencing Clinicians’ Willingness to Prescribe Pre-exposure Prophylaxis for Persons at High Risk of HIV in China: Cross-sectional Online Survey Study (Preprint)
Authors: Cui Sitong , Ding Haibo , Huang Xiaojie , Wang Hui , Tang Weiming , Leuba Sequoia I , Ye Zehao , Jiang Yongjun , Geng Wenqing , Xu Junjie , Shang Hong
Published: September 2020

BACKGROUND

Pre-exposure prophylaxis (PrEP) is an effective HIV prevention measure. Clinicians play a crucial role in PrEP implementation, and their knowledge, attitudes, and career experience may affect their willingness to prescribe PrEP. However, little is known about the attitudes and willingness of clinicians to prescribe PrEP in countries without PrEP-specific guidelines.

OBJECTIVE

We aimed to determine the factors associated with clinicians being willing to prescribe PrEP in China.

METHODS

Between May and June 2019, we conducted an online cross-sectional survey of clinicians in 31 provinces across the six administrative regions in China on the WeChat smartphone app platform. Multivariable logistic regression was used to determine factors associated with willingness to prescribe PrEP.

RESULTS

Overall, 777 HIV clinicians completed the survey. Most of the respondents had heard of PrEP (563/777, 72.5%), 31.9% (248/777) thought that PrEP was extremely effective for reducing the risk of HIV infection, and 47.2% (367/777) thought that it was necessary to provide PrEP to high-risk groups. After adjusting for age, gender, ethnicity, and educational background of the clinicians, the following factors signiﬁcantly increased the odds of the clinicians being willing to prescribe PrEP: having worked for more than 10 years, compared to 5 years or less (adjusted odds ratio [aOR] 2.82, 95% CI 1.96-4.05); having treated more than 100 patients living with HIV per month, compared to 50 patients or fewer (aOR 4.16, 95% CI 2.85-6.08); and having heard of PrEP (aOR 7.32, 95% CI 4.88-10.97). Clinicians were less likely to be willing to prescribe PrEP if they were concerned about poor adherence to PrEP (aOR 0.66, 95% CI 0.50-0.88), the lack of PrEP clinical guidelines (aOR 0.47, 95% CI 0.32-0.70), and the lack of drug indications for PrEP (aOR 0.49, 95% CI 0.32-0.76).

CONCLUSIONS

About half of all clinicians surveyed were willing to prescribe PrEP, but most surveyed had a low understanding of PrEP. Lack of PrEP clinical guidelines, lack of drug indications, and less than 11 years of work experience were the main barriers to the surveyed clinicians’ willingness to prescribe PrEP. Development of PrEP clinical guidelines and drug indications, as well as increasing the availability of PrEP training, could help improve understanding of PrEP among clinicians and, thus, increase the number willing to prescribe PrEP.
A Moderated Mediation Analysis of Condom Negotiation and Sexual Orientation on the Relationship Between Sexual Coercion and Condom Use in Chinese Young Women: Cross-Sectional Study (Preprint)
Authors: Zhang Wen , Choi Edmond Pui Hang , Fong Daniel Yee-Tak , Wong Janet Yuen-Ha
Published: September 2020

BACKGROUND

The high prevalence of sexual coercion against young women has become a significant public health issue in China and other regions around the world. Young women are also especially vulnerable to engage in inconsistent condom use because of low sexual control. Although the relationship between sexual coercion and condom use has been widely demonstrated, the mechanism of this relationship is still unclear.

OBJECTIVE

The objective of this study was to test condom negotiation as a mediator of the relationship between sexual coercion and condom use in young Chinese women and to investigate whether sexual orientation is a moderator.

METHODS

Data were collected using web-based questionnaires and a total of 402 young Chinese women were included in the analysis. Sexual coercion was measured using a subscale of the Revised Conflict Tactics Scales and condom negotiation was measured using a subscale of the UCLA Multidimensional Condom Attitudes Scale. Sexual orientation was assessed using an item adopted from a previous study and condom use was calculated by the total number of times condoms were used divided by the total number of times sexual intercourse was engaged in during the past 3 months. Moderated mediation analyses were conducted with sexual coercion as the independent variable, condom use consistency as the dependent variable, condom negotiation as the mediator variable, and sexual orientation as a moderator.

RESULTS

The moderated mediation analysis indicated that the relationship between sexual coercion and condom use was significantly mediated by condom negotiation and moderated by sexual orientation. The indirect effect of condom negotiation was significant in heterosexual women (indirect effect: –0.80, 95% boot CI –1.67 to –0.36) but not in sexual minority women (indirect effect: –0.33, 95% boot CI –0.86 to 0.31).

CONCLUSIONS

The results showed that sexual orientation meaningfully affects the relationship between sexual coercion and condom negotiation. The difference in the mechanism of the relation between sexual coercion and sexual behaviors in heterosexual and sexual minority women should be considered for future research and interventions aimed at mitigating the adverse effects of sexual coercion.
Enhancing Data Linkage to Break the Chain of COVID-19 Spread: The Taiwan Experience (Preprint)
Authors: Lo Wei-Cheng , Wang Fu-Chung , Lin Li-Yin , Jyan Hong-Wei , Wu Hsuan-Chien , Huang Yao-Liang , Parng I-Ming , Chiou Hung-Yi
Published: September 2020

UNSTRUCTURED

Digital technology has been widely used in health care systems and disease management, as well as in controlling the spread of COVID-19. As one of the most successful countries in combating the COVID-19 pandemic, Taiwan has successfully used digital technology to strengthen its efforts in controlling the COVID-19 pandemic. Taiwan has a well-established National Health Insurance System (NHIS), which provides a great opportunity to develop a nationwide data linkage model in an agile manner. Here we provide an overview of the application of data linkage models for strategies in combating COVID-19 in Taiwan, including NHIS centralized data linkage systems and “from border to community” information-driven data linkage systems during the COVID-19 pandemic. Furthermore, we discuss the dual role of digital technologies in being an “enabler” and a “driver” in early disease prevention. Lastly, Taiwan’s experience in applying digital technology to enhance the control of COVID-19 potentially highlights lessons learned and opportunities for other countries to handle the COVID-19 situation better.
Can GPT-3 Pass a Writer’s Turing Test?
Authors: Elkins Katherine , Chun Jon
Published: September 2020

Until recently the field of natural language generation relied upon formalized grammar systems, small-scale statistical models, and lengthy sets of heuristic rules. This older technology was fairly limited and brittle: it could remix language into word salad poems or chat with humans within narrowly defined topics. Recently, very large-scale statistical language models have dramatically advanced the field, and GPT-3 is just one example. It can internalize the rules of language without explicit programming or rules. Instead, much like a human child, GPT-3 learns language through repeated exposure, albeit on a much larger scale. Without explicit rules, it can sometimes fail at the simplest of linguistic tasks, but it can also excel at more difficult ones like imitating an author or waxing philosophical.