bluuebunny/crossref_metadata_2025 huggingface dataset:
Multidrug Resistance-1 C3435T Polymorphism and Carbamazepine Plasma
Level in Indonesian Temporal Lobe Epilepsy Patients
Authors: Setiabudy Rianto , Budikayanti Astri , Khosama Herlyani , Octaviana Fitri , Hamid Donny H. , Louisa Melva , Ranakusuma Teguh A.S.
Published: April 2022

Background:

Temporal lobe epilepsy (TLE) has the highest probability of becoming resistant.
One of the causes was Polymorphism in multidrug resistant-1 (MDR1) C3435T. In Dr.
Cipto Mangunkusumo Hospital, potential drug-resistant epilepsy prevalence was 84.51%; 66.6%
of them used carbamazepine (CBZ) as antiseizure medication. This comparative cross-sectional
study aimed to investigate MDR1 C3435T polymorphism and CBZ plasma level (plCBZ) in Indonesian
TLE patients.

Methods:

TLE patient was selected consecutively; divided into drug-responsive (DRV) and drugresistant
(DRE) groups. Healthy subjects were included as a control for the gene polymorphism
comparison. MDR1 was identified using the restriction fragment length polymorphism PCR technique;
C allele at 159 and 57bp while T allele at 216bp. High-performance liquid chromatography
was used to determine plCBZ.

Results:

There were 86 subjects; 61 in the study group and 25 controls. The genotype distribution
between them was 0.58 vs 0.42, x2=0.54, p=0.000. In the study group, CBZ within therapeutic doses
(dCBZ) had outreached the therapeutic plCBZ and found similar in all genotypes. DRE criteria
were found in 37 subjects. Distribution of C and T in DRV was 0.63 vs 0.37, x2=10.4; and DRE
0.55 vs 0.45 x2=6.17 (p=0.019). In Tukey’s multiple comparison post hoc test, CT in DRV had
significantly lower dCBZ (330,36 ± 174,91 mg) and plCBZ (7.15 ± 2.64 mcg/mL) compared to all
genotypes in DRE. Whereas mean dCBZ was around 800mg and plCBZ outreached the toxic level;
TT was the highest.

Conclusion:

The genotype MDR1 distribution was similar in the normal population and DRE.
Therapeutic plCBZ was achieved using the low dose. CT genotype responds to lower dCBZ, while
TT genotype outreached the highest toxic plCBZ.
Altering Landscape of Cancer Vaccines: Unique Platforms, Research on
Therapeutic Applications and Recent Patents
Authors: Ray Suman Kumar , Mukherjee Sukhes
Published: April 2022

Recent developments in several areas are rekindling interest and empowering progress
in improving therapeutic cancer vaccines. These advances have been made in target selection,
vaccine technology, and approaches for reversing the immunosuppressive mechanisms exploited
by cancers. Studies on diverse tumor antigens have revealed target properties, including high cell
specificity and adequate immunogenicity, to affect clinical efficiency. Therefore, one of the principal
goals of cancer vaccinology is the development of efficient therapeutic cancer vaccines that
are capable of eliciting an effector as well as memory T cell response specific to tumor antigens.
Neoantigens, which arise from mutated proteins in cancer cells, are cancer-specific and may be
highly immunogenic. However, the vast majority of these are distinctive to each patient’s cancer
and hence require the development of personalised therapies. Novel immunotherapeutic strategies
are focused on breaking immune tolerance to tumor antigens, improving the immunogenicity of
tumor vaccines, in addition to overcoming mechanisms of tumor escape. However, current developments
and patents in cancer immune therapies, together with associated technologies, are significant.
Supreme achievements in immune inhibitor-centered therapies and neo-antigen identification
tools envisage probable improvements in cancer vaccines with respect to treatments of malignancies.
Antibody modulation of T cell function through checkpoint blockade or co-stimulatory
activation may restore survival, proliferation, and effector function. Thus, these tumor-infiltrating
T cells with genetically engineered therapeutic vaccines have the potential to act as curative cancer
immune therapeutics. In this review, target tumor antigens employed in recent years in the development
of therapeutic cancer vaccine approaches are described, and the patents involved in the
process are highlighted.
Caracasine, An ent-kaurane Diterpene with Proapoptotic and Pro-differentiator Activity in Human Leukaemia Cell Lines
Authors: Martínez Gricelis Patricia , Mijares Michael Rodney , Chávez Katiuska , Chirinos Perla , Suárez Alírica Isabel , Compagnone Reinaldo Santi , De Sanctis Juan Bautista
Published: April 2022

Background:

Kaurane-type diterpenoids, obtained from various natural sources, have shown many biological
activities, including anti-inflammatory and antitumor effects. Caracasine, an ent-kaurane diterpenoid isolated from
the flowers of Croton micans, was shown to induce apoptosis in leukaemia cell lines.

Objective:

The present study aimed to ascertain the compound’s mechanism of cell death induction using two leukaemia
cell lines, Jurkat E6.1 (T cell) and HL-60 (promyeloblast cells).

Methods:

Cell death in Jurkat and HL60 cells were evaluated by flow cytometry for apoptosis with annexin-V/PI,
mitochondrial membrane potential disturbance, changes in cell cycle, CD95 expression, caspase activation, Nuclear
Factor kappa B inhibition, and differentiation into a neutrophil-like cell (dHL60).

Results:

Caracasine (10 μM) increased the G0/G1 phase in Jurkat and arrested the cell cycle in the S phase in HL60.
Caracasine increased CD95 expression (p<0.01 in Jurkat and p<0.05 in HL60) and caspase-8 activation (p<0.001 in
Jurkat and p<0.05 in HL60). Caspase-9 was activated in both cell lines (p<0.001) along with the decline in mitochondrial
ΔΨm (p<0.05 in Jurkat and p<0.001 in HL60). In HL60 cells, the kaurane induced neutrophil differentiation was
assessed by CD40 expression and reactive oxygen species production. In Jurkat cells, caracasine inhibited the NF-κB
pathway in cells pretreated with PHA to activate the NF-κB pathway, suggesting a possible role in inflammatory diseases.

Conclusion:

Caracasine induced apoptosis through the intrinsic and extrinsic pathways in both cell lines were evaluated
which could be the leading structure for new anti-leukemic and anti-inflammatory drugs.
Recent Advancements in Prevention and Treatment of Osteoporosis with
Traditional Chinese Medicine: A Long Way from Lab Bench to Bedside
Authors: Wang Jing , Xue Ji-Su , Huang Si-min
Published: April 2022

Osteoporosis is becoming more prevalent in the ageing society, however, its treatment
is still a problem for both society and individuals. Traditional Chinese Medicine (TCM) has a long
history in treating osteoporosis and is receiving increasing attention. Multiple formulas of TCM
showed satisfactory effects in treating osteoporosis in both animal models and clinical patients.
However, because TCM usually consists of multiple plant and/or animal products, it is difficult to
clarify the mechanism of TCM according to the requirements of Western medicine regarding purity,
efficacy, dosage, and safety. With increasing researchers have started to investigate the TCM
using modern scientific tools such as bioinformatics and network pharmaceutics in osteoporosis
and the addition of TCM in the latest version of International Statistical Classification of Diseases
and Related Health Problems (ICD-11 version, 2019) by WHO, TCM is showing large potential in
treating osteoporosis although there is still a long way. The review aimed to summarize recent advancements
of TCM treating osteoporosis.
Hunger Hormones in Adolescents with Disruptive Mood
Dysregulation Disorder: An Exploratory Study
Authors: Krishna Avvaru Guruvamsee , Goyal Nishant , Ram Dushad , Rajan Anjanik Kumar , Kshitiz Kshitij Kumar
Published: April 2022

Background:

Hunger hormones, including ghrelin and leptin, are
associated with appetitive behaviors in various psychiatric disorders. Biochemical
and hormonal status in disruptive mood dysregulation disorder (DMDD) in
adolescents is largely unexplored.

Objectives:

The study aimed to assess levels of leptin and ghrelin and find their
association with lipid profiles in adolescents with DMDD.

Methods:

Twenty adolescents with a DSM 5 diagnosis of DMDD with age and
gender-matched 19 healthy controls were recruited, followed by clinical
assessment. They were assessed for leptin, ghrelin, and lipid profiles, respectively.

Results:

Adolescents with DMDD were comparable in age, education, family
income, domicile status, psychiatric illness in the family, and body mass index
(BMI) with matched controls. There was no difference in mean lipid profile and
ghrelin in both groups. However, the DMDD group had a statistically significant
higher mean level of leptin as compared to the control group (t=1.84, p < 0.05). As
measured by the Modified Overt Aggression Scale in DMDD, aggression showed a
significant positive correlation with lipid profile measures.

Conclusion:

Adolescents with DMDD have elevated serum leptin levels. Further
research is needed to confirm this finding.
Imagery- and Verbally-Based Brooding Rumination in Adolescence: Differential Associations with Depressive Symptoms
Authors: Lawrence Hannah R. , Siegle Greg J. , Schwartz-Mette Rebecca A.
Published: April 2022

Background:

Brooding rumination, or perseverative dwelling on
negative cognitions, prolongs negative affect and is associated with heightened risk
for depressive symptoms. Emerging research suggests that brooding rumination
may be associated with more severe depressive symptoms when individuals brood
in the form of mental imagery relative to verbal thoughts.

Objective:

The present study tested whether rumination was more highly associated
with depressive symptom severity when adolescents ruminated in the form of
mental imagery compared with verbal thoughts.

Methods:

Adolescents (N = 145) were recruited from the community surrounding a
public university in the Northeastern United States. Of these adolescents, 136 were
retained in analyses based on their reports of engaging in brooding rumination at least
some of the time [age range: 13-17 years; M(SD)age = 15.40(1.24) years; 60.29%
female, 32.35% male, 4.41% transgender, 2.94% other genders). In this crosssectional
study, adolescents reported their trait levels of brooding rumination,
whether they tend to ruminate in the form of mental imagery, verbal thought, or both,
and completed a measure of depressive symptom severity. Moderated regression
analyses were used to test whether the strength of the relation between brooding
rumination and depressive symptom severity varied based on rumination style.

Results:

Imagery-based brooding rumination occurred in the majority of
adolescents, and imagery-based rumination was more highly associated with
depressive symptom severity than verbally-based rumination for female adolescents
and those adolescents high in trait brooding rumination.

Conclusion:

Findings emphasize the potential utility of assessing and intervening
on imagery-based rumination.
Antioxidant Activity of a Selenopeptide Modelling the Thioredoxin Reductase
Active Site is Enhanced by NH···Se Hydrogen Bond in the Mixed Selenosulfide
Intermediate
Authors: Iwaoka Michio , Oba Hajime , Matsumura Kotoi , Yamanaka Shuhei , Shimodaira Shingo , Kusano Shuichi , Asami Tatsuya
Published: April 2022

Background:

Thioredoxin reductase (TrxR), one of the representative selenoenzymes, is an important antioxidant enzyme suppressing oxidative stress in living organisms. At the active site of human TrxR, the presence of a Sec•••His•••Glu catalytic triad was previously suggested. Method. In this study, a short selenopeptide mimicking this plausible triad, i.e., H-CUGHGE-OH (1), was designed, synthesized, and evaluated for the TrxR-like catalytic activity.

Method:

In this study, a short selenopeptide mimicking this plausible triad, i.e., H-CUGHGE-OH (1), was designed, synthesized, and evaluated for the TrxR-like catalytic activity

Results:

The molecular simulation in advance by REMC/SAAP3D predicted the preferential formation of Sec•••His•••Glu hydrogen bonding networks in the aqueous solution. Indeed, a significant antioxidant activity was observed for 1 in the activity assay using NADPH as a reductant and H2O2 as a substrate. Tracking the reaction between 1 and GSH by 77Se NMR revealed a reductive cleavage of the selenosulfide (Se-S) bond to generate the diselenide species. The observation suggested that in the transiently formed mixed Se-S intermediate, the NH•••Se hydrogen bond between the Sec and His residues leads a nucleophilic attack of the second thiol molecule not to the intrinsically more electrophilic Se atom but to the less electrophilic S atom of the Se-S bond. Ab initio calculations for the complex between MeSeSMe and an imidazolium ion at the MP2/6-31++G(d,p) level demonstrated that NH•••Se and NH•••S hydrogen bonds are equally favorable as the interaction modes. Thus, importance of the relative spatial arrangement of the Se-S bond with respect to the imidazole ring was suggested for the exertion of the TrxR-like catalytic activity.

Conclusion:

The proposed umpolung effect of NH•••Se hydrogen bond on the reactivity of a Se-S bond will be a useful tool for developing efficient TrxR models with high redox catalytic activity.
Impulse Noise Suppression in Color Images Using Median Filter and Deep
Learning
Authors: Ashpreet  , Biswas Mantosh
Published: April 2022

Refining the quality of a noisy image is essential for many image applications.
Various median filter variants have been introduced to suppress various noises, but they have
their own limitations when detecting noise and restoring noise-free images. Denoising
convolutional neural networks (DnCNNs), primarily developed for Gaussian noise removal, are
influential nonlinear mapping models in image processing. After alterations in training data, they
can be used to suppress other noise with outstanding results. This article suggests a frequency
median filter method combined with deep learning for color images polluted by Salt and Pepper
(SnP) noise. The analysis presented in this paper has primarily used a frequency median filter to
suppress impulse noise wherein the restored value for the center pixel is evaluated by the
frequency median rather than the traditional median. After which, the pretrained denoising
convolutional neural network is hired to suppress the remaining noise and attain the output image
finally. With a visual comparative study, simulation results on the taken test images show that
the proposed method surpasses de-noising methods in terms of PSNR, SSIM, NMSE, Entropy,
IEF, NCC, PCC and Running Time.
PERAN TEKS BRAILLE TERHADAP PENINGKATAN PENGETAHUAN KESEHATAN GIGI DAN MULUT ANAK TUNANETRA: STUDI TINJAUAN LITERATUR
Authors: Puspitasari Ambar , Marisca Christy Abigail , Hartami Edina , Nugraeni Yuli
Published: April 2022

Latar Belakang: Kesehatan rongga mulut pada anak tunanetra cenderung buruk karena tidak dapat mendeteksi gejala awal inflamasi gigi melalui indra penglihatan. Pemberian materi penyuluhan kesehatan gigi dan mulut dengan Braille merupakan penyesuaian agar anak tunanetra dapat memahami kesehatan rongga mulut dengan lebih baik. Tujuan: Mereview peran teks Braille terhadap peningkatan pengetahuan kesehatan gigi dan mulut anak tunanetra. Metode: Literature review bersumber dari 7 jurnal yang didapat melalui database online dengan kata kunci visually impaired children OR blind children AND Braille AND dental health education AND oral hygiene OR oral health knowledge. Hasil: Tingkat pengetahuan awal anak tunanetra terhadap sesama siswa tunanetra adalah rendah dan/atau sedang, sehingga potensi adanya peningkatan pengetahuan kesehatan gigi dan mulut dapat tercapai saat anak tunanetra berhasil untuk memahami penyuluhan yang diberikan dalam teks Braille. Kesimpulan: Pamflet atau booklet Braille diharapkan dapat meningkatkan pengetahuan kesehatan gigi dan mulut anak tunanetra dengan efektif.
UNDERSTANDING ISSUES OF AFFORDABLE HOUSING IN MALAYSIA TO ATTRACT INVESTMENT
Authors: Mohd Daud Mohd Ariff , Rosly Saiful Azhar , Muhamad Sori Zulkarnain
Published: April 2022

This study attempts to investigate the issues that impede the provision of affordable housing for Malaysian population. These issues need to be identified and addressed, as they hinder potential private investments in affordable housing projects. In order to achieve this aim, a qualitative method was adopted, in the form of interviews with several developers and institutional investors. Seven areas were recognised to be the sources of major problems with affordable housing in Malaysia namely, the lax policy; poor urban design and planning; supply and demand; property overhang, financing, and price; lacking innovation and research and development; escalating development costs; as well as obsolete quota and subsidy programmes. These findings may provide invaluable insight for policymakers in identifying and resolving the issues of affordable housing, which may then create potential avenue for private investment to alleviate the issue of shortage of affordable housing.
ENFORCEMENTS AND OFFENCES UNDER THE STRATA MANAGAMENT ACT
Authors: Ahmad Shuhaimi Ainul Ashiqin , Mohamed Osman Mariana , Rabe Suzilawati , Syed Khuzzan Alhabshi Sh. Mazlina , Aripin Damira
Published: April 2022

The rise in the number of strata residential buildings calls for the need for enforcement of governance relating to the wellbeing of strata residents as well as its management. The establishment of Management Body at the stage of Joint Management Body as well as the Management Corporation are both results of the enforcement of the Strata Management Act, that requires their registration with the Commissioner of Buildings (COB) to be given the rights to collect, manage and maintain the assigned residential strata properties. The aim of this study is to identify the most common issues occur under the legislation of strata management that results in the interference and enforcement by the COB, as replicated through to the number of enforcements taken by the COB. The result of the study shows that despite the enforcement of the Strata Management Act over the years, there are still a significant number of enforcement actions by the COB against the reported offences made with regards to the rights of both the residents as well as the management bodies. The constant rate of actions taken proves that there are still rooms for improvements within the Strata Act 757 itself to reduce issues, towards a more enforceable roles, standards and rules for future reference and service quality.
Educando desde la virtualidad. El modelo pedagógico del instituto superior tecnológico Argos
Authors: Bustamante Chán María Monserratt , DELGADO RENDON MARIA JOSE
Published: April 2022

La presencia de la pandemia COVID-19, la transformación virtual en el sector educativo, y las necesidades de formación superior, han conllevado al Instituto Superior Tecnológico Argos, diseñar un modelo pedagógico con componentes de e-learning que aporte a la formación integral de los estudiantes desde la virtualidad. La investigación presenta un desarrollo metodológico con un enfoque cualitativo donde se utilizó el método bibliográfico a través del análisis de contenido y con revisión documentada sistematizada. Este método permitió identificar los beneficios de la modalidad e-learning, así como también de la articulación de las teorías del aprendizaje sobre esta modalidad. Los principales resultados alcanzados, fue la construcción del Modelo Pedagógico ARGOS (MPA), que responde a la las necesidades educativas actuales en el sector de la Educación Superior del país y traza la prospectiva de una educación flexible, con ubicuidad y calidad que se impartirá en las modalidades: presencial, en línea e híbrida.
Motivaciones que influyen en la compra de productos alimenticios orgánicos en el sector de vía Samborondón, parroquia urbana satélite la puntilla
Authors: Garcés Denisse
Published: April 2022

El objetivo de este artículo es conocer cuáles son los factores que motivan la compra de productos alimenticios orgánicos en Samborondón, esto debido a la alta demanda que existe hoy en día. Los productos orgánicos son reconocidos en el mercado por su sello de certificación, existe una amplia categoría de productos, como frutas, verduras, chocolates, maquillaje entre otros. Se ha realizado una metodología de investigación mixta, con enfoques cualitativos y cuantitativos, encuestas y focus group. Los resultados hallados aportarán a los emprendimientos, empresas y sociedad en general a tener un perfil del consumidor de productos orgánicos del sector estudiado y de esta manera poder dirigir todos sus esfuerzos comerciales y de marketing de manera correcta.
An In-Home Medication Dispensing System to Support Medication Adherence for Patients With Chronic Conditions in the Community Setting: Prospective Observational Pilot Study
Authors: Patel Tejal , Ivo Jessica , Pitre Teresa , Faisal Sadaf , Antunes Kristen , Oda Kasumi
Published: April 2022

Background

Innovative digital technology systems that support and monitor real-time medication intake are now available commercially; however, there is limited knowledge of the use of such technology in patients’ homes. One such smart medication dispenser, spencer, provides alerts to patients to take their medications and allows for tracking and reporting real-time medication adherence data.

Objective

The objectives of this study were to examine the use of a smart medication dispenser as a medication adherence and self-management support tool for community dwelling adults over a 6-month period, in addition to usability, usefulness, satisfaction, and impact on caregiver support.

Methods

This prospective, observational study invited community-dwelling adults aged 45 years and older taking at least one chronic medication and their caregivers to use this smart medication dispenser for their medication administration for 6 months. Adherence was defined as a dose intake within 2 hours post scheduled time. Real-time adherence data were collected using the smart medication dispenser and the AdhereNet platform. Usability, usefulness, and satisfaction were measured using the System Usability Scale and the Usefulness, Satisfaction, and Ease of Use questionnaire, respectively. Caregiver burden was measured on a visual analog scale at baseline and at the end of the 6-month study period.

Results

A total of 58 participants were recruited, of which 55% (32/58) were female with a mean age of 66.36 (SD 11.28; range 48-90) years. Eleven caregiver participants were recruited, of whom 91% (10/11) were female. The average monthly adherence over 6 months was 98% (SD 3.1%; range 76.5%-100%). The average System Usability score was 85.74 (n=47; SD 12.7; range 47.5-100). Of the 46 participants who provided data, 44 (96%) rated the product as easy, 43 (93%) as simple to use, and 43 (93%) were satisfied with the product. Caregiver burden prior to and following smart medication dispenser use for 6 months was found to be statistically significantly different (P<.001; CI 2.11-5.98).

Conclusions

Smart medication adherence products such as spencer, when connected and clinically monitored, can be a useful solution for medication management and have the potential to improve caregiver burden.
Quantitative User Data From a Chatbot Developed for Women With Gestational Diabetes Mellitus: Observational Study (Preprint)
Authors: Sagstad Mari Haaland , Morken Nils-Halvdan , Lund Agnethe , Dingsør Linn Jannike , Nilsen Anne Britt Vika , Sorbye Linn Marie
Published: April 2022

BACKGROUND

The rising prevalence of gestational diabetes mellitus (GDM) calls for the use of innovative methods to inform and empower these pregnant women. An information chatbot, Dina, was developed for women with GDM and is Norway’s first health chatbot, integrated into the national digital health platform.

OBJECTIVE

The aim of this study is to investigate what kind of information users seek in a health chatbot providing support on GDM. Furthermore, we sought to explore when and how the chatbot is used by time of day and the number of questions in each dialogue and to categorize the questions the chatbot was unable to answer (fallback). The overall goal is to explore quantitative user data in the chatbot’s log, thereby contributing to further development of the chatbot.

METHODS

An observational study was designed. We used quantitative anonymous data (dialogues) from the chatbot’s log and platform during an 8-week period in 2018 and a 12-week period in 2019 and 2020. Dialogues between the user and the chatbot were the unit of analysis. Questions from the users were categorized by theme. The time of day the dialogue occurred and the number of questions in each dialogue were registered, and questions resulting in a fallback message were identified. Results are presented using descriptive statistics.

RESULTS

We identified 610 dialogues with a total of 2838 questions during the 20 weeks of data collection. Questions regarding blood glucose, GDM, diet, and physical activity represented 58.81% (1669/2838) of all questions. In total, 58.0% (354/610) of dialogues occurred during daytime (8 AM to 3:59 PM), Monday through Friday. Most dialogues were short, containing 1-3 questions (340/610, 55.7%), and there was a decrease in dialogues containing 4-6 questions in the second period (P=.013). The chatbot was able to answer 88.51% (2512/2838) of all posed questions. The mean number of dialogues per week was 36 in the first period and 26.83 in the second period.

CONCLUSIONS

Frequently asked questions seem to mirror the cornerstones of GDM treatment and may indicate that the chatbot is used to quickly access information already provided for them by the health care service but providing a low-threshold way to access that information. Our results underline the need to actively promote and integrate the chatbot into antenatal care as well as the importance of continuous content improvement in order to provide relevant information.
Use of Twitter Amplifiers by Medical Professionals to Combat Misinformation During the COVID-19 Pandemic (Preprint)
Authors: Royan Regina , Pendergrast Tricia Rae , Del Rios Marina , Rotolo Shannon M , Trueger N Seth , Bloomgarden Eve , Behrens Deanna , Jain Shikha , Arora Vineet M
Published: April 2022

UNSTRUCTURED

Social media is an important tool for disseminating accurate medical information and combating misinformation (ie, the spreading of false or inaccurate information) and disinformation (ie, spreading misinformation with the intent to deceive). The prolific rise of inaccurate information during a global pandemic is a pressing public health concern. In response to this phenomenon, health professional amplifiers such as IMPACT (Illinois Medical Professional Action Collaborative Team) have been created as a coordinated response to enhance public communication and advocacy around the COVID-19 pandemic.
Internet-based information provision to families of stroke patients in a rehabilitation hospital during the COVID-19 pandemic: A case-control study (Preprint)
Authors: Murakami Tatsunori , Higuchi Yumi , Ueda Tetsuya , Kozuki Wataru , Hatanaka Ryota , Gen Aki
Published: April 2022

BACKGROUND

The spread of COVID-19 has affected stroke rehabilitation. Given that inpatient visits are restricted in most institutions, alternative ways of providing information to family members are imperative. Informing families about patients’ rehabilitation progress via the Internet may help involve families in the rehabilitation process, enhance patients’ motivation to continue rehabilitation, and contribute overall to improvement of activities of daily living (ADL) in patients.

OBJECTIVE

We aimed to investigate the feasibility of an Internet-based rehabilitation information provision (IRIP) intervention for families of stroke patients at a rehabilitation hospital and to examine the effect of IRIP on patients’ ADL improvement.

METHODS

In this case-control study, participants were inpatients at a rehabilitation hospital between March 2020 and April 2021. The intervention group (ICT group) included patients and families who requested IRIP, which consisted of a progress report on patients’ rehabilitation using text, photos, and movies. Those who did not receive Internet-based information were included in the non-ICT group. The control group, matched with the ICT group based on a 1:1 propensity score, was selected from the non-ICT group. The covariates for calculating the propensity score were patients’ age, sex, and motor and cognitive scores on the Functional Independence Measure (FIM) at admission. The main outcome was the degree of ADL improvement during hospitalization. Multiple regression analysis (forced entry method) was performed to confirm the impact of ICT use on ADL improvement. The independent variables were the presence of intervention, length of hospital stay, and the number of days from onset to hospitalization.

RESULTS

Sixteen groups of patients and families participated in the IRIP. The mean age of patients was 78.6±7.2 and 78.6±8.2 years in the ICT and control groups, respectively. The median total FIM difference was 28.5 (interquartile range 20.3-53.0) and 11.0 (2.8-30.0) in the ICT and control groups, respectively, and the ICT group showed significant improvement in ADL function (p=0.019). In the multiple regression analysis of the ICT and control groups, the unstandardized regression coefficients and 95% confidence intervals were 11.97 (0.09 to 23.84) for ICT use. These results indicate that ICT use was independently and significantly associated with improvement in ADL.

CONCLUSIONS

This study examined the effect of IRIP for family members to improve ADL of hospitalized stroke patients. The results showed that IRIP promotes improvement of patients’ ADL regardless of their age, sex, and motor and cognitive functions at admission, and length of hospital stay.

CLINICALTRIAL

This study was approved by the Research Ethics Committee at Osaka Prefecture University (2018-118).
Rising Inequity and Disparities in Medical Education in India: Challenges to Training a Representative Workforce (Preprint)
Authors: Rahman Faique , Bhat Vivek , Ozair Ahmad , Detchou Donald
Published: April 2022

UNSTRUCTURED

There is a paucity of available medical services in India, attributable to inadequate and indiscriminate distributions of infrastructure and medical practitioners throughout the country. Well-equipped tertiary health care centres are predominantly found in Indian cities, with the rural population bearing the brunt of this inequity. While bridging the gap in resource-limited areas requires a multiprong approach, basic necessities are a must. These necessities include basic laboratory and imaging capabilities, as well as critical care devices, such as ventilators, but foremost among them remains the recruitment of a representative health workforce.
Traditionally, the path to becoming a specialist medical practitioner in India has required industrious efforts and ample resources including financing. Exponential fee hikes have recently occurred, such as a twenty-fold rise in tuition in a primarily government-funded medical school system. Similarly, preparation to write the medical school and residency admission exams (NEET-UG & NEET-PG) entails shelling out approximately fifty to one hundred thousand Indian rupees (₹; INR) per year, which may be further exacerbated by the newly proposed test for residency allotment (NEXT). As it stands, three barriers exists in becoming a specialised medical practitioner in India— NEET-UG to matriculate at a medical school, NEET-PG to qualify for a residency, and expenses associated with attending medical school.
We discuss the current state of affairs and forthcoming changes, and describe how these may limit opportunities for Indian medical students, thereby depriving the and the Indian medical of qualified yet underprivileged candidates, and potentially aggravating the shortage of primary care physicians in the country.
The Efficacy, Safety, and Efficiency of the Off-Label Use of Bevacizumab in Patients Diagnosed With Age-Related Macular Degeneration: Protocol for a Systematic Review and Meta-Analysis (Preprint)
Authors: Estarreja João , Mendes Priscila , Silva Carina , Camacho Pedro , Mateus Vanessa
Published: April 2022

BACKGROUND

Age-related macular degeneration (AMD) is recognized as the leading cause of vision loss in older people. Considering the phenomenon of aging societies worldwide, the prevalence of AMD is expected to increase gradually in the future. AMD can be divided into early, intermediate, and late stages, with the early and intermediate stages being mainly asymptomatic, and the late stage being classified as geographic atrophy, neovascular AMD, or both. Current pharmacological treatments for neovascular AMD include anti–vascular endothelial growth factor agents, such as ranibizumab, pegaptanib, and aflibercept. Additionally, it has been reported that the off-label use of intravitreally administered bevacizumab is effective. It is also lower cost than other agents, which makes it an interesting pharmacological approach.

OBJECTIVE

This review aims to evaluate the efficacy, safety, and efficiency of bevacizumab for the treatment of neovascular AMD.

METHODS

This review will only consider randomized controlled clinical trials that compare the use of bevacizumab with another pharmacological agent or a placebo in patients aged 50 years and older who are diagnosed with vascular AMD. It will exclude studies that include participants diagnosed with polypoidal choroidal vasculopathy or retinal angiomatous proliferation. To identify and select relevant articles, we will develop a highly sensitive search strategy and apply it in MEDLINE via the PubMed platform. Upon selection of the studies and analysis of the titles, abstracts, and full texts, the results will be presented according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The analysis and extraction of the data will be performed by 2 independent reviewers. Risk of bias will be evaluated with the Critical Appraisal Skills Programme (CASP) checklist. Finally, the same reviewers will also perform a quality assessment of the included studies with the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) tool.

RESULTS

The search strategy, after the application of the inclusion and exclusion criteria, identified 15 randomized clinical trials, which are currently being analyzed. This project has no funding and it has been developed by a multidisciplinary research team of pharmacologists and orthoptists. The study was initiated in May 2021 and it is expected to conclude by the end of 2023.

CONCLUSIONS

This review will provide a synthesis of current information and underlying evidence about the off-label use of bevacizumab in neovascular AMD. It will provide a clearer vision of a possible new pharmacological approach, as well as the most suitable treatment designs, for the treatment of neovascular AMD.

CLINICALTRIAL

PROSPERO CRD42021244931; https://tinyurl.com/p6m5ycpk

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/38658
Modified E-Delphi Process for Selection of Patient Reported Outcome Measures for Children and Families with Type-1 Diabetes using Continuous Glucose Monitors (Preprint)
Authors: Shah Payal , Raymond Jennifer K. , Espinoza Juan
Published: April 2022

BACKGROUND

Type 1 Diabetes (T1D) management is complex and associated with significant psychosocial burden. Continuous glucose monitors (CGM) can improve disease management and outcomes, but also introduce new or exacerbate existing psychosocial concerns. Patient Reported Outcome Measures (PROMs) can be used to capture this information, but there is no consensus on which PROMs should be used in pediatric CGM research.

OBJECTIVE

We describe out the process to: 1) identify PROMs that could be used to assess the impact of CGMs on pediatric patients with T1D, 2) implement a modified e-Delphi methodology to arrive at an expert consensus on which PROMs are most suitable for clinical and research applications, and 3) establish a periodicity table for the administration of PROMs over time in Real-World Evidence study.

METHODS

In order to identify appropriate PROMs for pediatric patients and families with T1D and CGMs, we conducted an asynchronous, electronic Delphi (e-Delphi) process with a multidisciplinary group of experts from around the country. We identified candidate instruments through a literature review. The three-round e-Delphi process was conducted via a study website, email, and online forms. Participants provided opinions on usefulness of instruments, age validation, feasibility, time, and frequency of administration.

RESULTS

Sixteen experts participated in the E-Delphi process; four of them consistently in all three rounds. We identified 62 candidate instruments, which were narrowed down to 12 final PROMs across five domains: Diabetes Distress and Burden (4 instruments), Autonomy (2 instruments), Quality of Life (1 instrument), Psychosocial (3 instruments) and Technology Acceptance (2 instruments). A quarterly administration schedule was developed to reduce burden on participants.

CONCLUSIONS

PROMs can provide critical insights into the psychosocial well-being of patients. The specific measures identified in the paper are particularly well suited for pediatric patients with T1D and CGMs. Clinical implementation could help healthcare providers, patients and families engage in more comprehensive disease management.
Characteristics and Design Recommendations for Menstrual Tracking Apps: Scoping Review (Preprint)
Authors: Alamgir Asma , Al-Thani Dena
Published: April 2022

BACKGROUND

Smartphone health tracking applications are increasingly becoming an integral part of our everyday lives. One such technology includes menstrual health applications that allow menstruators to assess, manage and learn about their reproductive health.

OBJECTIVE

This study aims to explore the characteristics of self-tracking menstrual health applications and design recommendations as reported in the literature.

METHODS

A scoping review in line with the guidelines of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews was conducted. Scopus, Association for Computing Machinery, the Institute of Electrical and Electronics Engineers, PubMed, CINAHL, and Google Scholar were searched to identify relevant studies. The search term selected focused on target intervention (mobile application) and objective (menstrual and fertility tracking). A reviewer independently conducted study selection and data extraction. Data extracted from the included studies were synthesized narratively.

RESULTS

Out of 902 citations retrieved, 23 unique studies were included in the review. The studies investigated application characteristics and design recommendations of menstruation or fertility applications as reported in the literature. The data documented by users on the menstruation tracking application provide data deemed beneficial in public health research and observing patterns in population health. Design recommendations presented in studies include scientifically sound information for users, the collaboration between stakeholders during design, user inclusive design, customization abilities, discreet features, and integration to individual’s healthcare and other health tracking application.

CONCLUSIONS

Menstrual health is an important aspect of an individual’s well-being. It is vital for application developers to consider designing such technologies that are a product of collaborative efforts between stakeholders, provide accurate information as well as allow users to customize their tracking experience. Research focusing on how to best provide clinicians with support to understand, adapt, and implement this technology in their practice and support menstrual health is also necessary. Furthermore, we also observe a lack of diversity in the current literature – therefore, there lies an obvious gap in research to explore users from diverse cultures, their perspectives, and requirements for managing their menstrual health over a smartphone application. There is still a lot of work to be done in supporting women's health and aspects around it.
What can we Learn from an Electronic Health Diary Campaign?: An observational nested study in the Swiss Multiple Sclerosis Registry (Preprint)
Authors: Sieber Chloé , Chiavi Deborah , Haag Christina , Kaufmann Marco , Horn Andrea B , Dressel Holger , Zecca Chiara , Calabrese Pasquale , Pot Caroline , Kamm Christian P , Von Wyl Viktor
Published: April 2022

BACKGROUND

Electronic health diaries hold promise in complementing standardized surveys in prospective health studies but are fraught with numerous methodological challenges.

OBJECTIVE

To investigate factors associated with response to an electronic health diary campaign in persons with multiple sclerosis, to identify recurrent topics in free text diary entries, and to assess the content validity of structured diary entries regarding current symptoms and medication intake compared with survey collected information.

METHODS

Data were collected by the Swiss Multiple Sclerosis Registry (SMSR) during a nested electronic health diary campaign and during the SMSR baseline assessment (serving as comparative data). The content of diary free text information was grouped using two descriptive natural language processing methods. The similarity between structured diary and survey collected symptom and medication intake data was examined using the Jaccard index.

RESULTS

Campaign participants were more often female, not working full-time, had a more advanced gait impairment, and were on average five years older compared to eligible non-participants. Diary free text entries most often contained references to body parts or body functioning (57.7%), work (56.4%), or health (55.8%). A high similarity between diary and survey collected data was observed for health-related quality of life, and stable or slow-changing symptoms such as fatigue or gait disorder – but not for immunomodulatory medication use.

CONCLUSIONS

Diary campaign participation seemed dependent on time availability and symptom burden, and was enhanced by reminder emails. Electronic health diaries are a meaningful complement to regular structured surveys but should ideally be embedded into promotional activities or tied to concrete research study tasks to enhance regular and long-term participation.

CLINICALTRIAL

ClinicalTrials.gov NCT02980640
Digital News Navigator: A design fiction raising ethical considerations about systems that help older adults to recover from exposure to misinformation (Preprint)
Authors: McInnis Brian , Eikey Elizabeth , Moore Raeanne C , Wang Shengzhi , Nebeker Camille
Published: April 2022

BACKGROUND

Emotions are central to recognizing, responding, and recovering from an exposure to misinformation in social media. However, older adults are highly susceptible to misinformation in social media, due to the emotions involved with several key factors related to aging.

OBJECTIVE

Research is needed to speculate about the unknown unknown ethical, legal, and social implications (ELSI) associated with technologies that help older adults to recognize, respond, and recover from an exposure to misinformation in social media. Designing for older adult use of social media is challenging, because they exhibit different patterns of use and have limited access to digital literacy training. Additionally, there is a risk that some system designs might further disenfranchise already vulnerable populations.

METHODS

The paper presents research on a design fiction-based approach to speculate about the ELSIs related to a fictitious application called the “Digital News Navigator” (DN2) service. The DN2 was applied as a probe to reflect on potential unintended consequences of system design, reviewing a broad range of academic literature. To guide future research, the Digital Health Checklist for Researchers (DHC-R) was applied to contribute specific considerations related to ELSIs.

RESULTS

Together, the Author Statement and Discussion sections draw attention to how features of the fictitious DN2 service raise concerns about access and usability, privacy, risks & benefits, and data management. Our analysis also demonstrates how the design fiction method might be combined with frameworks for ethical thinking to generate insights about not-yet-possible technologies.

CONCLUSIONS

There are potential ELSIs associated with system designs intended to assist older adults as they are exposed to misinformation through social media. Design fiction and the DHC-R offer a structured approach for identifying and speculating about these risks.
Computationally Effective Gravity Inversion Allows for High-Resolution Regional Density Modeling of Earth's Crust with the Inclusion of the Topography Layer
Authors: Martyshko Pyotr , Byzov Denis , Chernoskutov Aleksandr
Published: April 2022

The problem of inverting measured gravity data for large regions is of a great importance for planetary structure studies. Unfortunately, the usual methods of local gravity field inversion do not scale up well. There are three primary factors that start to play significant role: topography or terrain surface with large height differences, spherical geometry of the planet, and high computational complexity. In our previous work we were separately considering each of those problems in detail. In this paper however, we will address those issues simultaneously, offering a complete and computationally effective method of recovering spherical density model of Earth's crust with the upper topography layer. The method utilizes a closed form expression for the discretized model's gravity field which allows for great accuracy and speed without enforcing restrictions on model geometry or gravity field data grid. Inversion process is based on the conjugate gradient method. An example of inversion for a synthetic regional model is presented.
Selecting Suitable Functionals and Basis Sets on the Study Structural and Adsorption of Urea-Kaolinite System Using Cluster Method
Authors: Mohd Nabil Nur Najwa-Alyani , Ang Lee Sin
Published: April 2022

Kaolinite is an essential mineral with numerous applications across many sectors. One of them is in the agricultural industry, in which it is a crucial component in the method of controlled-release fertilizer. This manuscript reports the use of different functionals and basis sets on the structural and electronic properties of kaolinite's surface, intending to find reliable methods among those tested. Four different functionals, B3LYP, CAM-B3LYP, M06-2X, TPSSTPSS, complemented with various basis sets, were used in this study. The results show that TPSSTPSS complement with 6-311G** provides good agreement with previous research and experimental results among different functionals and basis sets used. The quantitative analysis was done to optimize the kaolinite molecule. Selected extrema points were used to place the urea molecule for the interaction of urea-kaolinite studies. The urea's interaction with kaolinite was reported at a different interaction site in the gas phase and different orientations of the urea molecule. Urea molecule was optimized above the Al–O and Si–O surfaces with their energy difference calculated. Our results showed that both surfaces act as promising adsorbents among the different orientations of the urea on both the Al–O and Si–O surfaces. However, Al–O, and Si–O had another preferable interaction site to the urea molecules.