bluuebunny/crossref_metadata_2025 huggingface dataset:
Terretonins from Aspergillus Genus: Structures, Biosynthesis, Bioactivities,
and Structural Elucidation
Authors: Ibrahim Sabrin R.M. , Mohamed Gamal A. , Kamal Hani M.K. , Mohamed Shaimaa G.A. , Khedr Amgad I.M.
Published: April 2021

:

Fungi are considered a prosperous pool of microbial bio-metabolites. Terretonins are meroterpenoids
that are reported mainly from the Aspergillus genus. They exhibit unique tetracyclic core
skeletons and various bioactivities. The current review summarizes the published researches on the
source, biosynthesis, isolation, structural characterization, and bioactivities of terretonins that have been
reported from Aspergillus species, as well as from synthetic sources. A literature search on the published
studies was conducted over different databases, including Web of Science, MedLine (PubMed),
Scopus, SpringerLink, Google Scholar, SciFinder, Wiley, and ACS Publications up to 2020. In this
work, 18 compounds from Aspergillus species and synthetic sources are depicted. They have unrivaled
and diversified skeletons as well as various bioactivities. Moreover, 37 references are included. Terretonins
form a class of fungal bio-metabolites that attain all the characters for becoming lead compounds
in their particular therapeutic category.
Nanophotocatalysis for the Removal of Pharmaceutical Residues from
Water Bodies: State of Art and Recent Trends
Authors: Rajan Mekha Susan , John Anju , Thomas Jesty
Published: April 2021

Background:

The occurrence of pharmaceuticals in surface and drinking water is ubiquitous
and is a major concern of researchers. These compounds cause a destructive impact on
aquatic and terrestrial life forms, and the removal of these compounds from the environment is a
challenging issue. Existent conventional wastewater treatment processes are generally inefficacious
because of their low degradation efficiency and inadequate techniques associated with the disposal
of adsorbed pollutants during comparatively effective methods like the adsorption process.

Remediation Method:

Semiconductor-mediated photocatalysis is an attractive technology for the
efficient removal of pharmaceutical compounds. Among various semiconductors, TiO2 and ZnObased
photocatalysts gained much interest during the last years because of their efficiency in decomposing
and mineralizing the lethal organic pollutants with the utilization of UV-visible light.
Incessant efforts are being undertaken for tuning the physicochemical, optical, and electronic properties
of these photocatalysts to strengthen their overall photocatalytic performance with good recycling
efficiency.

Results:

This review attempts to showcase the recent progress in the rational design and fabrication
of nanosized TiO2 and ZnO photocatalysts for the removal of pollutants derived from the pharmaceutical
industry and hospital wastes.

Conclusion:

Photocatalysis involving TiO2 and ZnO provides a positive impact on pollution management
and could be successfully applied to remove pharmaceuticals from wastewater streams.
Structure modifications, the introduction of heteroatoms, and the integration of polymers with
these nano photocatalysts offer leapfrogging opportunities for broader applications in the field of
photocatalysis.
Effects of Sambucus ebulus Extract on Cell Proliferation and Viability of Triple-
Negative Breast Cancer: An In Vitro and In Vivo Study
Authors: Omrani Vahid F. , Koochaki Ameneh , Behzad Sahar , Kia Vahid , Ghasemi Peyman , Razaviyan Javad , Moosavian Hamid Reza , Rezapour Maysam , Vasei Mohammad , Asouri Mohsen , Mohammadi-Yeganeh Samira
Published: April 2021

Background:

Triple-negative breast cancer (TNBC) accounts for 15% of all breast cancer (BC) cases
and is a severe type of BC. Since medicinal herbs containing biocompatible substances that are accepted by
patient more than chemical therapeutics, they can be considered a safe option for treating BC.

Objective:

This study evaluated the effect of Sambucus Ebulus (S. ebulus) extract on a model of TNBC.

Methods:

S. ebulus extract was prepared using petroleum ether, ethyl acetate, and methanol. The petroleum ether
extract was fractionated and analyzed using vacuum liquid chromatography and GC-MS, respectively. MDAMB-
231 and MCF-10A were used as TNBC and normal breast cells, respectively. Flowcytometry and MTT
assays were performed to evaluate cell cycle, apoptosis, and viability of the cells. Gene expression analysis was
performed using RT-qPCR. Nude mouse allograft tumor models were used, and pathological sections were
evaluated.

Results:

The findings indicated that S. ebulus extract remarkably decreased cell proliferation and viability. The
extract had no toxicity to the normal breast cells but efficiently killed the cancer cells. Cell cycle- and apoptosisrelated
gene expression showed that fraction 4 of S. ebulus extract significantly increased the expression of Bax,
Bak, P53, and c-MYC.

Conclusion:

This study showed satisfactory results of the effect of S. ebulus extract on clearing BC cells both in
vitro and in vivo. Thus, S. ebulus extract may be a safe herbal compound for eliminating BC cells without
toxicity to host cells.
Modulation of Huntington’s Disease in Drosophila
Authors: Subhan Iqra , Siddique Yasir Hasan
Published: April 2021

Huntington’s disease (HD) is a progressive neurodegenerative disorder which deteriorates
the physical and mental abilities of the patients. It is an autosomal dominant disorder and is
mainly caused by the expansion of a repeating CAG triplet. A number of animal models ranging
from worms, fruit flies, mice and rat, pig, sheep and monkeys are available, which have been helpful
in understanding various pathways involved during the progression of the disease. Drosophila
is one of the most commonly used model organisms for biomedical science, due to low cost maintenance,
short life span and easy implications of genetic tools. The present review provides a brief description
of HD and the studies carried out for HD to date, taking Drosophila as a model.
Incidence and Management of Carfilzomib-induced Cardiovascular Toxicity; A Systematic Review and Meta-analysis
Authors: Latif Azka , Kapoor Vikas , Lateef Noman , Ahsan Muhammad J. , Usman Rana M. , Malik Saad U. , Ahmad Naqib , Rosko Nathaniel , Rudoni Joslyn , William Preethi , Khouri Jack , Anwer Faiz
Published: April 2021

Background:

The ASPIRE and ENDEAVOUR trials have shown cardiovascular adverse
effects in patients treated with carfilzomib-based regimens. Therefore, we conducted this meta-
analysis of published clinical trials to identify the cumulative incidence and risk of cardiovascular
adverse effects due to carfilzomib.

Methods:

A systematic search of PubMed, Embase, Web of Science, and Cochrane library was performed,
and we identified 45 prospective trials of carfilzomib with data on 5583 patients. Among
all patients being treated with carfilzomib (N=5,583), 8.9% sustained all grade cardiotoxicity,
while 4.4% sustained high-grade cardiotoxicity. All-grade hypertension was present in 13.2%,
while the incidence of high-grade hypertension was 5.3%.

Result:

The observed incidences of all-grade heart failure, edema, and ischemia were 5.1%,
20.7%, and 4.6%, respectively. Likewise, for high-grade heart failure and edema observed incidence
was 3.2%, and 2.7%, respectively. There was no difference in the event rate of all and highgrade
cardiotoxicity between newly diagnosed multiple myeloma and relapsed/refractory (p-value
0.42 and 0.86, respectively). Likewise, we did not observe any difference in the event rate of all
and high-grade cardiotoxicity when carfilzomib was used as a single agent versus when used in
combination therapy with other agents (p-value 0.43 and 0.73, respectively).

Conclusion:

Carfilzomib is associated with a significant risk of cardiovascular toxicity and hypertension.
With the increasing utilization of carfilzomib, it is critical for primary care physicians, oncologists
and cardiologists to be aware of the risk of cardiotoxicity associated with the use of carfilzomib
to recognize and treat baseline cardiovascular risk factors in such patients.
Current Utility of Sequential Organ Failure Assessment Score: A Literature Review and Future Directions
Authors: Kashyap Rahul , Sherani Khalid M. , Dutt Taru , Gnanapandithan Karthik , Sagar Malvika , Vallabhajosyula Saraschandra , Vakil Abhay P. , Surani Salim
Published: April 2021

The Sequential Organ Failure Assessment (SOFA) score is commonly used in the Intensive Care Unit (ICU) to evaluate, prognosticate and assess patients. Since its validation, the SOFA score has served in various settings, including medical, trauma, surgical, cardiac, and neurological ICUs. It has been a strong mortality predictor and literature over the years has documented the ability of the SOFA score to accurately distinguish survivors from non-survivors on admission. Over the years, multiple variations have been proposed to the SOFA score, which have led to the evolution of alternate validated scoring models replacing one or more components of the SOFA scoring system. Various SOFA based models have been used to evaluate specific clinical populations, such as patients with cardiac dysfunction, hepatic failure, renal failure, different races and public health illnesses, etc. This study is aimed to conduct a review of modifications in SOFA score in the past several years. We review the literature evaluating various modifications to the SOFA score such as modified SOFA, Modified SOFA, modified Cardiovascular SOFA, Extra-renal SOFA, Chronic Liver Failure SOFA, Mexican SOFA, quick SOFA, Lactic acid quick SOFA (LqSOFA), SOFA in hematological malignancies, SOFA with Richmond Agitation-Sedation scale and Pediatric SOFA. Various organ systems, their relevant scoring and the proposed modifications in each of these systems are presented in detail. There is a need to incorporate the most recent literature into the SOFA scoring system to make it more relevant and accurate in this rapidly evolving critical care environment. For future directions, we plan to put together most if not all updates in SOFA score and probably validate it in a large database a single institution and validate it in multisite data base.
Radiation Exposure in The Treatment of Pediatric Supracondylar Humerus Fractures: Comparison of Two Fixation Methods
Authors: Tzatzairis Themistoklis , Firth Gregory , Bijlsma Paulien , Manoukian Dimitrios , Maizen Claudia , Ramachandran Manoj
Published: April 2021

Aim:

The study aims to determine the estimated radiation exposure of two different types of fixation (crossed vs lateral-entry K-wires) for displaced supracondylar fractures at a Major Trauma Centre in London.

Methods:

A retrospective review was performed between 2015 and 2019 in children (<16 years old) who underwent either Closed Reduction and Percutaneous Pinning (CRPP) or open reduction and K wire fixation for a displaced supracondylar fracture (Gartland II, III and IV) of the humerus.

Results:

The overall mean radiation dose and duration with crossed K-wire fixation was statistically lower when compared with two lateral K-wires. The mean radiation dose increased with increasing Gartland Grade - for Gartland Grades II, III and IV respectively.

Conclusion:

The current study showed statistically significant decreased radiation dose in crossed K-wire fixation method, compared to lateral-entry fixation. No difference was found regarding the cosmetic/functional outcome when Flynn’s criteria were applied.
COVID-19 Pandemic: The Vaccine of a Society is its Education
Authors: Plotas Panagiotis , Konstantopoulou Ariadni , Andriotis Antonios , Jelastopulu Eleni
Published: April 2021

After the outbreak of COVID-19, societies were called to face its spread with several measures. However, the health of every human being is a good that is necessary for the prosperity of a society. Public health is everyone's individual responsibility. Health education is the process that will lead to the proper and prepared behavior of societies in any virus outbreak, and this should be cultivated from a very young age starting from school.
A concise review on certain important veterinary viruses in the Americas
Authors: Giraldo-Ramirez Sebastian , Rendon-Marin Santiago , Ruiz-Saenz Julian
Published: April 2021

Animals have become an essential member for our society, with roles related to company, human well-being and therapy for some diseases, and as a source of food in many populations around the world. Animals intended for human consumption like pigs and cattle, as well as companion animals, specifically cats and dogs, are constantly threatened by multiple viral agents. This puts at risk pet owners and threatens food security in the region. Considering that control or eradication is a complex problem that involves several aspects, there is a limited success in this regard for viral diseases such as foot-and-mouth disease, rabies and classical or African swine fever, this review aims to show the most important characteristics, in the epidemiological context, from farm animals virus, re-emerging viruses affecting companion animals, and emerging and re-emerging zoonotic viruses. Since viral pathogens affect animal populations and human well-being, there is a need to increase efforts to control, monitor and eradicate them from livestock and companion animals. The following sections contribute to improve the understanding of these viral agents and orchestrate actions of control entities in the Americas.
Typology and Impact of YouTube Videos Posted in Response to a Student Suicide Crisis: Social Media Metrics and Content Analyses
Authors: Cheng Qijin , Lui Carrie , Ip Flora Wai Lam , Yip Paul Siu Fai
Published: April 2021

Background

Videos relating to suicide are available on YouTube, but their characteristics and impacts have seldom been examined.

Objective

This study aimed to examine YouTube videos posted in response to a sudden spate of student suicides in Hong Kong during the 2015-2016 school year and evaluate the impacts of those videos.

Methods

Keyword search was performed on YouTube, and relevant videos were identified. Video typology was examined through content analysis, specifically grouping the videos by who uploaded the videos, what presentation formats were used in the videos, whether the videos were originally created by the uploaders, and whether the videos disclosed the uploaders’ personal experiences with suicide. Impacts of the videos were assessed in terms of reach (measured by view count), engagement (measured by comment count), and insights (measured as to what extent the comments to each video could reveal personal suicide risk and attitude toward help-seeking). Statistical analysis was conducted to compare the impacts of different types of videos. The 7 most impactful videos that were originally created by the YouTubers were selected for further analysis. They were compared with 7 videos uploaded by the same YouTubers right before the student suicide videos and 7 right after the student suicide videos. The comparison focused on their impacts and the network structure of the comments to those videos.

Results

A total of 162 relevant YouTube videos were identified. They were uploaded by 7 types of stakeholders, and the most common format was one person talking to the camera. A total of 87.0% (141/162) of the videos were originally created by the uploaders and only 8.0% (13/162) of the videos disclosed uploader personal experiences with suicide. The uploader profiles being popular or top YouTubers and the video containing disclosure of the uploader’s personal experiences were found to be significantly correlated with greater impacts (P<.001). Focusing on the 7 most impactful original videos, it is found that those videos generated more engagement, especially more interactions between the viewers, and more insights than regular videos uploaded by the same YouTubers.

Conclusions

When responding to a youth suicide crisis, videos made by key opinion leaders on YouTube sharing their own experiences of overcoming suicide risks could generate significant positive impacts. These types of videos offer a precious opportunity to craft online campaigns and activities to raise suicide prevention awareness and engage vulnerable youth.
Integrating Patient Data Into Skin Cancer Classification Using Convolutional Neural Networks: Systematic Review
Authors: Höhn Julia , Hekler Achim , Krieghoff-Henning Eva , Kather Jakob Nikolas , Utikal Jochen Sven , Meier Friedegund , Gellrich Frank Friedrich , Hauschild Axel , French Lars , Schlager Justin Gabriel , Ghoreschi Kamran , Wilhelm Tabea , Kutzner Heinz , Heppt Markus , Haferkamp Sebastian , Sondermann Wiebke , Schadendorf Dirk , Schilling Bastian , Maron Roman C , Schmitt Max , Jutzi Tanja , Fröhling Stefan , Lipka Daniel B , Brinker Titus Josef
Published: April 2021

Background

Recent years have been witnessing a substantial improvement in the accuracy of skin cancer classification using convolutional neural networks (CNNs). CNNs perform on par with or better than dermatologists with respect to the classification tasks of single images. However, in clinical practice, dermatologists also use other patient data beyond the visual aspects present in a digitized image, further increasing their diagnostic accuracy. Several pilot studies have recently investigated the effects of integrating different subtypes of patient data into CNN-based skin cancer classifiers.

Objective

This systematic review focuses on the current research investigating the impact of merging information from image features and patient data on the performance of CNN-based skin cancer image classification. This study aims to explore the potential in this field of research by evaluating the types of patient data used, the ways in which the nonimage data are encoded and merged with the image features, and the impact of the integration on the classifier performance.

Methods

Google Scholar, PubMed, MEDLINE, and ScienceDirect were screened for peer-reviewed studies published in English that dealt with the integration of patient data within a CNN-based skin cancer classification. The search terms skin cancer classification, convolutional neural network(s), deep learning, lesions, melanoma, metadata, clinical information, and patient data were combined.

Results

A total of 11 publications fulfilled the inclusion criteria. All of them reported an overall improvement in different skin lesion classification tasks with patient data integration. The most commonly used patient data were age, sex, and lesion location. The patient data were mostly one-hot encoded. There were differences in the complexity that the encoded patient data were processed with regarding deep learning methods before and after fusing them with the image features for a combined classifier.

Conclusions

This study indicates the potential benefits of integrating patient data into CNN-based diagnostic algorithms. However, how exactly the individual patient data enhance classification performance, especially in the case of multiclass classification problems, is still unclear. Moreover, a substantial fraction of patient data used by dermatologists remains to be analyzed in the context of CNN-based skin cancer classification. Further exploratory analyses in this promising field may optimize patient data integration into CNN-based skin cancer diagnostics for patients’ benefits.
A Provider-Facing eHealth Tool for Transitioning Youth With Special Health Care Needs From Pediatric to Adult Care: Mixed Methods, User-Engaged Usability Study
Authors: McMaughan Darcy Jones , Lin Sherry , Ozmetin Jennifer , Beverly Judith Gayle , Brog Joshua , Naiser Emily
Published: April 2021

Background

There is a need for medical education on health care transitions for youth with special health care needs. The Texas Transition Toolkit (the tool) supports providers through a one-stop shop for researching literature on care transitions, a catalog of care transition tools, and guides for developing care transition programs.

Objective

This study aims to assess the functionality and usability of the tool with providers working with transition-aged children and youth with special health care needs (representative users).

Methods

The tool was evaluated using a triangulated mixed methods case study approach consisting of a concurrent think-aloud phase, a satisfaction survey, and a survey of problem relevance and task performance to operationalize and capture functionality and usability. Our mixed methods deep dive into the functionality and usability of the tool focused on 10 representative users from one medical home in Texas and 5 website design experts.

Results

Representative users found the tool to be highly relevant, as demonstrated by the satisfaction score for relevance (138/150, 92%). According to the users, the tool provided comprehensive information related to health care transitions for youth with special health care needs, with a satisfaction score of 87.3% (131/150) for comprehensive. Overall satisfaction with the tool was high at 81.92% (1065/1300) with a cutoff score of 73.33% (953.4/1300) indicating high satisfaction, but users reported relatively lower satisfaction with search (114/150, 76%) and navigation (ease of use: 114/150, 76%; hyperlinks: 163/200, 81.5%; structure: 159/200, 79.5%). They experienced search- and navigation-related problems (total problems detected: 21/31, 68%) and, based on quality checks, had a relatively low task completion rate for tasks involving finding information (60/80, 75%), which required searching and navigation. The problems identified around search and navigation functionality were relevant (relevance scores ranging from 14.5 to 22, with a cutoff score of 11.7 indicating relevance).

Conclusions

The tool may help bridge the gaps in training on health care transitions for youth with special health care needs in US medical education. The tool can be used to create structured protocols to help improve provider knowledge, collaboration across pediatric and adult care providers, and the continuity of care as youth with special health care needs transition from pediatric to adult care. The results provided a road map for optimizing the tool and highlighted the importance of evaluating eHealth technologies with representative users.
Learning From the Experiences of COVID-19 Survivors: Web-Based Survey Study
Authors: Prioleau Temiloluwa
Published: April 2021

Background

There are still many unanswered questions about the novel coronavirus; however, a largely underutilized source of knowledge is the millions of people who have recovered after contracting the virus. This includes a majority of undocumented cases of COVID-19, which were classified as mild or moderate and received little to no clinical care during the course of illness.

Objective

This study aims to document and glean insights from the experiences of individuals with a first-hand experience in dealing with COVID-19, especially the so-called mild-to-moderate cases that self-resolved while in isolation.

Methods

This web-based survey study called C19 Insider Scoop recruited adult participants aged 18 years or older who reside in the United States and had tested positive for COVID-19 or antibodies. Participants were recruited through various methods, including online support groups for COVID-19 survivors, advertisement in local news outlets, as well as through professional and other networks. The main outcomes measured in this study included knowledge of contraction or transmission of the virus, symptoms, and personal experiences on the road to recovery.

Results

A total of 72 participants (female, n=53; male, n=19; age range: 18-73 years; mean age: 41 [SD 14] years) from 22 US states were enrolled in this study. The top known source of how people contracted SARS-CoV-2, the virus known to cause COVID-19, was through a family or household member (26/72, 35%). This was followed by essential workers contracting the virus through the workplace (13/72, 18%). Participants reported up to 27 less-documented symptoms that they experienced during their illness, such as brain or memory fog, palpitations, ear pain or discomfort, and neurological problems. In addition, 47 of 72 (65%) participants reported that their symptoms lasted longer than the commonly cited 2-week period even for mild cases of COVID-19. The mean recovery time of the study participants was 4.5 weeks, and exactly one-half of participants (50%) still experienced lingering symptoms of COVID-19 after an average of 65 days following illness onset. Additionally, 37 (51%) participants reported that they experienced stigma associated with contracting COVID-19.

Conclusions

This study presents preliminary findings suggesting that emphasis on family or household spread of COVID-19 may be lacking and that there is a general underestimation of the recovery time even for mild cases of illness with the virus. Although a larger study is needed to validate these results, it is important to note that as more people experience COVID-19, insights from COVID-19 survivors can enable a more informed public, pave the way for others who may be affected by the virus, and guide further research.
Expanding the Reach of Research: Quantitative Evaluation of a Web-Based Approach for Remote Recruitment of People Who Hear Voices
Authors: Buck Benjamin , Chander Ayesha , Brian Rachel M , Wang Weichen , Campbell Andrew T , Ben-Zeev Dror
Published: April 2021

Background

Similar to other populations with highly stigmatized medical or psychiatric conditions, people who hear voices (ie, experience auditory verbal hallucinations [AVH]) are often difficult to identify and reach for research. Technology-assisted remote research strategies reduce barriers to research recruitment; however, few studies have reported on the efficiency and effectiveness of these approaches.

Objective

This study introduces and evaluates the efficacy of technology-assisted remote research designed for people who experience AVH.

Methods

Our group developed an integrated, automated and human complementary web-based recruitment and enrollment apparatus that incorporated Google Ads, web-based screening, identification verification, hybrid automation, and interaction with live staff. We examined the efficacy of that apparatus by examining the number of web-based advertisement impressions (ie, number of times the web-based advertisement was viewed); clicks on that advertisement; engagement with web-based research materials; and the extent to which it succeeded in representing a broad sample of individuals with AVH, assessed through the self-reported AVH symptom severity and demographic representativeness (relative to the US population) of the sample recruited.

Results

Over an 18-month period, our Google Ads advertisement was viewed 872,496 times and clicked on 11,183 times. A total amount of US $4429.25 was spent on Google Ads, resulting in 772 individuals who experience AVH providing consent to participate in an entirely remote research study (US $0.40 per click on the advertisement and US $5.73 per consented participant) after verifying their phone number, passing a competency screening questionnaire, and providing consent. These participants reported high levels of AVH frequency (666/756, 88.1% daily or more), distress (689/755, 91.3%), and functional interference (697/755, 92.4%). They also represented a broad sample of diversity that mirrored the US population demographics. Approximately one-third (264/756, 34.9%) of the participants had never received treatment for their AVH and, therefore, were unlikely to be identified via traditional clinic-based research recruitment strategies.

Conclusions

Web-based procedures allow for time saving, cost-efficient, and representative recruitment of individuals with AVH and can serve as a model for future studies focusing on hard-to-reach populations.
Formative Study of Mobile Phone Use for Family Planning Among Young People in Sierra Leone: Global Systematic Survey
Authors: Chukwu Emeka , Gilroy Sonia , Addaquay Kojo , Jones Nki Nafisa , Karimu Victor Gbadia , Garg Lalit , Dickson Kim Eva
Published: April 2021

Background

Teenage pregnancy remains high with low contraceptive prevalence among adolescents (aged 15-19 years) in Sierra Leone. Stakeholders leverage multiple strategies to address the challenge. Mobile technology is pervasive and presents an opportunity to reach young people with critical sexual reproductive health and family planning messages.

Objective

The objectives of this research study are to understand how mobile health (mHealth) is used for family planning, understand phone use habits among young people in Sierra Leone, and recommend strategies for mobile-enabled dissemination of family planning information at scale.

Methods

This formative research study was conducted using a systematic literature review and focus group discussions (FGDs). The literature survey assessed similar but existing interventions through a systematic search of 6 scholarly databases. Cross-sections of young people of both sexes and their support groups were engaged in 9 FGDs in an urban and a rural district in Sierra Leone. The FGD data were qualitatively analyzed using MAXQDA software (VERBI Software GmbH) to determine appropriate technology channels, content, and format for different user segments.

Results

Our systematic search results were categorized using Grading of Recommended Assessment and Evaluation (GRADE) into communication channels, audiovisual messaging format, purpose of the intervention, and message direction. The majority of reviewed articles report on SMS-based interventions. At the same time, most intervention purposes are for awareness and as helpful resources. Our survey did not find documented use of custom mHealth apps for family planning information dissemination. From the FGDs, more young people in Sierra Leone own basic mobile phones than those that have feature capablilities or are smartphone. Young people with smartphones use them mostly for WhatsApp and Facebook. Young people widely subscribe to the social media–only internet bundle, with the cost ranging from 1000 leones (US $0.11) to 1500 leones (US $0.16) daily. Pupils in both districts top-up their voice call and SMS credit every day between 1000 leones (US $0.11) and 5000 leones (US $0.52).

Conclusions

mHealth has facilitated family planning information dissemination for demand creation around the world. Despite the widespread use of social and new media, SMS is the scalable channel to reach literate and semiliterate young people. We have cataloged mHealth for contraceptive research to show SMS followed by call center as widely used channels. Jingles are popular for audiovisual message formats, mostly delivered as either push or pull only message directions (not both). Interactive voice response and automated calls are best suited to reach nonliterate young people at scale.
Counselor Efficiency at Providing Feedback in a Technology-Based Behavioral Weight Loss Intervention: Longitudinal Analysis
Authors: Fahey Margaret C , Klesges Robert C , Kocak Mehmet , Gladney Leslie A , Talcott Gerald W , Krukowski Rebecca A
Published: April 2021

Background

Feedback for participants’ self-monitoring is a crucial and costly component of technology-based weight loss interventions. Detailed examination of interventionist time when reviewing and providing feedback for online self-monitoring data is lacking.

Objective

The aim of this study was to longitudinally examine the time counselors spent providing feedback on participant self-monitoring data (ie, diet, physical activity, weight) in a 12-month technology-based weight loss intervention. We hypothesized that counselors would compose feedback for participants more quickly over time.

Methods

The time the lay counselors (N=10) spent reviewing self-monitoring records and providing feedback to participants via email was longitudinally examined for all counselors across the three years of study implementation. Descriptives were observed for counselor feedback duration across counselors by 12 annual quarters (ie, 3-month periods). Differences in overall duration times by each consecutive annual quarter were analyzed using Wilcoxon-Mann-Whitney tests.

Results

There was a decrease in counselor feedback duration from the first to second quarter (mean 53 to 46 minutes; P<.001), and from the second to third (mean 46 to 30 minutes; P<.001). A trend suggested a decrease from the third to fourth quarter (mean 30 to 26 minutes; P=.053), but no changes were found in subsequent quarters. Consistent with the hypothesis, counselors may be increasing their efficiency in providing feedback; across 12 months, counselors spent less time reviewing participant self-monitoring and composing feedback (decreasing from mean 53 to 26 minutes).

Conclusions

Counselors used increasingly less time to review online self-monitoring data and compose feedback after the initial 9 months of study implementation. Results inform counselor costs for future technology-based behavioral weight loss interventions. For example, regardless of increasing counselor efficiency, 25-30 minutes per feedback message is a high cost for interventions. One possibility for reducing costs would be generating computer-automated feedback.

Trial Registration

ClinicalTrials.gov NCT02063178; https://clinicaltrials.gov/ct2/show/NCT02063178
Using a Web-Based Platform as an Alternative for Conducting International, Multidisciplinary Medical Conferences During the Novel COVID-19 Pandemic: Analysis of a Conference
Authors: Ko Po-Jen , Yu Sheng-Yueh , Chang John Chien-Hwa , Hsieh Ming-Ju , Chu Sung-Yu , Tan Jimmy Wei-Hwa , Cheng Wan-Ling , Ho Pei
Published: April 2021

Background

The COVID-19 pandemic has stunted medical education activities, resulting in most conferences being cancelled or postponed. To continue professional education during this crisis, web-based conferences can be conducted via livestream and an audience interaction platform as an alternative.

Objective

The unprecedented COVID-19 pandemic has affected human connections worldwide. Conventional conferences have been replaced by web-based conferences. However, web-based conferencing has its challenges and limitations. This paper reports the logistics and preparations required for converting an international, on-site, multidisciplinary conference into a completely web-based conference within 3 weeks during the pandemic.

Methods

The program was revised, and a teleconference system, live recording system, director system setup, and broadcasting platform were arranged to conduct the web-based conference.

Results

We used YouTube (Alphabet Inc) and WeChat (Tencent Holdings Limited) for the web-based conference. Of the 24 hours of the conventional conference, 21.5 hours (90%) were retained in the web-based conference via live broadcasting. The conference was attended by 71% (37/52) of the original international faculties and 71% (27/38) of the overall faculties. In total, 61 out of 66 presentations (92%) were delivered. A special session—“Dialysis access management under the impact of viral epidemics”—was added to replace precongress workshops and competitions. The conference received 1810, 1452, and 1008 visits on YouTube and 6777, 4623, and 3100 visits on WeChat on conference days 1, 2, and 3, respectively.

Conclusions

Switching from a conventional on-site conference to a completely web-based format within a short period is a feasible method for maintaining professional education in a socially responsible manner during a pandemic.
Professionals’ and Students’ Perceived Needs for an Online Supportive Application for Reducing School Absence and Stimulating Reintegration: Concept Mapping Study
Authors: Hoogsteder Mariette H H , Douma Linda N , Eskens Charlotte G A , Berendsen Renske L , Vanneste Yvonne T M , Schaafsma Frederieke G
Published: April 2021

Background

To limit students’ medical absenteeism and premature school dropout in the Netherlands, the Medical Advice for Sick-reported Students (MASS) intervention was developed to enhance collaboration between students, parents, school, and health care professionals. MASS reduces medical absenteeism. However, it does not yet optimally support professionals in monitoring students nor automatically stimulating students’ autonomy regarding their situation.

Objective

This study aimed to identify professionals’ and students’ perceived need for an online supportive application to monitor and reduce absenteeism and stimulate student autonomy and school reintegration.

Methods

Concept mapping sessions were held with professionals (n=23) and secondary school students (n=27) in group meetings or online to identify their perspectives and needs. Multidimensional scaling and hierarchical clustering were done with Ariadne 3.0 software. The resulting concept maps were reclustered and interpreted by 4 researchers.

Results

Three heterogeneous groups of professionals generated 17 clusters (135 unique statements), with a mean importance rating ranging from 2.9 to 4.6 on a Likert scale with scores ranging from 1 to 5. Three heterogeneous groups of secondary school students generated 18 clusters (95 unique statements), with a mean importance rating ranging from 3.2 to 4.6. Professionals considered as most important the following: easily accessible contact with students; supporting, motivating, and rewarding students; monitoring absent students; providing information to students and their parents; exchanging information between professionals. Students considered as most important the following: better teacher-student communication and respect; communication between school professionals on the one hand and parents, other professionals, and students on the other hand; guidance in missed learning materials and tests. Students perceived an online format for support as the obvious option.

Conclusions

Both professionals and students were positive about an online application to support students in dealing with medical absenteeism, especially considering the need for better and easily accessible contact between students and professionals. An eHealth or mobile health (mHealth) application addressing these aspects could stimulate student autonomy and have positive effects on medical absenteeism.
A Data-Free Digital Platform to Reach Families With Young Children During the COVID-19 Pandemic: Online Survey Study
Authors: Richter Linda Marleine , Naicker Sara Naomi
Published: April 2021

Background

The COVID-19 pandemic and containment measures have severely affected families around the world. It is frequently assumed that digital technologies can supplement and perhaps even replace services for families. This is challenging in conditions of high device and data costs as well as poor internet provision and access, raising concerns about widening inequalities in availability of support and consequent effects on child and family outcomes. Very few studies have examined these issues, including in low- and middle-income countries.

Objective

The study objectives were two-fold. The first objective was to gather data on the impact of the COVID-19 pandemic on families of young children using an online survey. The second objective was to assess the feasibility of using a data-free online platform to conduct regular surveys and, potentially, to provide support for parents and families of young children in South Africa.

Methods

We used a data-free mobile messenger platform to conduct a short digital survey of the impact of the COVID-19 pandemic on caring for young children in South Africa. We report on the methodological processes and preliminary findings of the online survey.

Results

More than 44,000 individuals accessed the survey link and 16,217 consented to the short survey within 96 hours of its launch. Respondents were predominantly from lower classes and lower-middle classes, representing the majority of the population, with urban residential locations roughly proportionate to national patterns and some underrepresentation of rural households. Mothers comprised 70.2% (11,178/15,912) of respondents and fathers comprised 29.8% (4734/15,912), representing 18,672 children 5 years of age and younger. Response rates per survey item ranged from 74.8% (11,907/15,912) at the start of the survey to 50.3% (8007/15,912) at completion. A total of 82.0% (12,729/15,912) of parents experienced at least one challenge during the pandemic, and 32.4% (2737/8441) did not receive help when needed from listed sources. Aggregate and individual findings in the form of bar graphs were made available to participants to view and download once they had completed the survey. Participants were also able to download contact details for support and referral services at no data cost.

Conclusions

Data-free survey methodology breaks new ground and demonstrates potential not previously considered. Reach is greater than achieved through phone surveys and some social media platforms, men are not usually included in parent surveys, costs are lower than phone surveys, and the technology allows for immediate feedback to respondents. These factors suggest that zero-rated, or no-cost, services could provide a feasible, sustainable, and equitable basis for ongoing interactions with families of young children.
Intention to Use Behavioral Health Data From a Health Information Exchange: Mixed Methods Study
Authors: Cochran Randyl A , Feldman Sue S , Ivankova Nataliya V , Hall Allyson G , Opoku-Agyeman William
Published: April 2021

Background

Patients with co-occurring behavioral health and chronic medical conditions frequently overuse inpatient hospital services. This pattern of overuse contributes to inefficient health care spending. These patients require coordinated care to achieve optimal health outcomes. However, the poor exchange of health-related information between various clinicians renders the delivery of coordinated care challenging. Health information exchanges (HIEs) facilitate health-related information sharing and have been shown to be effective in chronic disease management; however, their effectiveness in the delivery of integrated care is less clear. It is prudent to consider new approaches to sharing both general medical and behavioral health information.

Objective

This study aims to identify and describe factors influencing the intention to use behavioral health information that is shared through HIEs.

Methods

We used a mixed methods design consisting of two sequential phases. A validated survey instrument was emailed to clinical and nonclinical staff in Alabama and Oklahoma. The survey captured information about the impact of predictors on the intention to use behavioral health data in clinical decision making. Follow-up interviews were conducted with a subsample of participants to elaborate on the survey results. Partial least squares structural equation modeling was used to analyze survey data. Thematic analysis was used to identify themes from the interviews.

Results

A total of 62 participants completed the survey. In total, 63% (n=39) of the participants were clinicians. Performance expectancy (β=.382; P=.01) and trust (β=.539; P<.001) predicted intention to use behavioral health information shared via HIEs. The interviewees (n=5) expressed that behavioral health information could be useful in clinical decision making. However, privacy and confidentiality concerns discourage sharing this information, which is generally missing from patient records altogether. The interviewees also stated that training for HIE use was not mandatory; the training that was provided did not focus specifically on the exchange of behavioral health information.

Conclusions

Despite barriers, individuals are willing to use behavioral health information from HIEs if they believe that it will enhance job performance and if the information being transmitted is trustworthy. The findings contribute to our understanding of the role HIEs can play in delivering integrated care, particularly to vulnerable patients.
Anomaly Detection Algorithm for Real-World Data and Evidence in Clinical Research: Implementation, Evaluation, and Validation Study
Authors: Churová Vendula , Vyškovský Roman , Maršálová Kateřina , Kudláček David , Schwarz Daniel
Published: April 2021

Background

Statistical analysis, which has become an integral part of evidence-based medicine, relies heavily on data quality that is of critical importance in modern clinical research. Input data are not only at risk of being falsified or fabricated, but also at risk of being mishandled by investigators.

Objective

The urgent need to assure the highest data quality possible has led to the implementation of various auditing strategies designed to monitor clinical trials and detect errors of different origin that frequently occur in the field. The objective of this study was to describe a machine learning–based algorithm to detect anomalous patterns in data created as a consequence of carelessness, systematic error, or intentionally by entering fabricated values.

Methods

A particular electronic data capture (EDC) system, which is used for data management in clinical registries, is presented including its architecture and data structure. This EDC system features an algorithm based on machine learning designed to detect anomalous patterns in quantitative data. The detection algorithm combines clustering with a series of 7 distance metrics that serve to determine the strength of an anomaly. For the detection process, the thresholds and combinations of the metrics were used and the detection performance was evaluated and validated in the experiments involving simulated anomalous data and real-world data.

Results

Five different clinical registries related to neuroscience were presented—all of them running in the given EDC system. Two of the registries were selected for the evaluation experiments and served also to validate the detection performance on an independent data set. The best performing combination of the distance metrics was that of Canberra, Manhattan, and Mahalanobis, whereas Cosine and Chebyshev metrics had been excluded from further analysis due to the lowest performance when used as single distance metric–based classifiers.

Conclusions

The experimental results demonstrate that the algorithm is universal in nature, and as such may be implemented in other EDC systems, and is capable of anomalous data detection with a sensitivity exceeding 85%.