bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of non-proportional structural damping using experimental modal analysis data
Authors: Oktav Akın
Published: March 2020

A verified computational model of a complex structure is crucial for reliable vibro-acoustic simulations. Mass and stiffness matrices of such a computational model may be constructed correctly, provided all the design information is available. Since it is an unknown, the damping matrix is usually populated through mathematical models based on some assumptions. In the current study, it is proposed to use the identified non-proportional structural damping matrix in the computational model. Structural damping matrix can be identified using the complex frequency response functions obtained from experimental modal analysis data. No matter what type of a damping mechanism a structure has; proportional or non-proportional, the frequency response functions of the system can be measured. First, the calculation procedure for the non-proportional structural damping matrix is explained. The damping matrix of an analytical model is identified successfully using the proposed procedure. The same procedure is then applied through a case study. Computational model of a test vehicle is constructed. Next, the test vehicle is subjected to a modal test to measure the frequency response functions of the structure. Incompleteness of the measured data and the requirements of the procedure are discussed, as well. The described procedure can be used in any model updating framework.
A New Look at an Old Drug: Cumulative Effects of Low Ribavirin Doses in Amphetamine-Sensitized Rats
Authors: Petković Branka , Kesić Srđan , Ristić Slavica , Pavković Željko , Podgorac Jelena , Stojadinović Gordana , Pešić Vesna
Published: March 2020

Background:

Psychotic states related to psychostimulant misuse in patients with hepatitis C virus
infection may complicate acceptance and reaction to antiviral treatment. This observation equally applies to the
widely used ribavirin therapy.

Objective:

We examined psychomotor and body weight gain responses to low ribavirin doses after cessation of
intermittent amphetamine treatment in adult rats to assess its role in neurobehavioral outcome during psychostimulant
withdrawal.

Method:

The model of amphetamine-induced (1.5 mg/kg/day, i.p., 7 consecutive days) motor sensitization and
affected body weight gain was established in adult male Wistar rats. Then, additional cohort of amphetaminesensitized
rats was subjected to saline (0.9% NaCl; 1 mL/kg/day; i.p.) or ribavirin (10, 20 and 30 mg/kg/day, i.p.)
treatment for 7 consecutive days. Animals’ motor activity in a novel environment was monitored after the 1st and
the 7th saline/ribavirin injection. Body weight gain was calculated as appropriate. Determination and quantification
of ribavirin in the brain tissue were performed also.

Results:

The 1st application of ribavirin to amphetamine-sensitized rats affected/decreased their novelty-induced
motor activity only at a dose of 30 mg/kg. After the 7th application, ribavirin 30 mg/kg/day still decreased, while
10 and 20 mg/kg/day increased novelty-induced motor activity. These behavioral effects coincided with the time
required to reach maximum ribavirin concentration in the brain. Body weight gain during withdrawal was not
influenced by any of the doses tested.

Conclusion:

Ribavirin displays central effects that in repeated treatment, depending on the applied dose, could
significantly influence psychomotor response but not body weight gain during psychostimulant/amphetamine
withdrawal.
Hyaluronic Acid and Regenerative Medicine: New Insights into the Stroke Therapy
Authors: Shahi Maryam , Mohammadnejad Daruosh , Karimipour Mohammad , Rasta Seyed Hossein , Rahbarghazi Reza , Abedelahi Ali
Published: March 2020

Stroke is known as one of the very important public health problems that are related to societal burden and tremendous economic losses. It has been shown that there are few therapeutic approaches for the treatment of this disease. In this regard, the present therapeutic platforms aim to obtain neuroprotection, reperfusion, and neuro recovery. Among these therapies, regenerative medicine-based therapies have appeared as new ways of stroke therapy. Hyaluronic acid (HA) is a new candidate, which could be applied as a regenerative medicine-based therapy in the treatment of stroke. HA is a glycosaminoglycan composed of disaccharide repeating elements (N-acetyl-Dglucosamine and D-glucuronic acid). Multiple lines of evidence demonstrated that HA has critical roles in normal tissues. It can be a key player in different physiological and pathophysiological conditions such as water homeostasis, multiple drug resistance, inflammatory processes, tumorigenesis, angiogenesis, and changed viscoelasticity of the extracellular matrix. HA has very important physicochemical properties i.e., availability of reactive functional groups and its solubility, which make it a biocompatible material for application in regenerative medicine. Given that HAbased bioscaffolds and biomaterials do not induce inflammation or allergies and are hydrophilic, they are used as soft tissue fillers and injectable dermal fillers. Several studies indicated that HA could be employed as a new therapeutic candidate in the treatment of stroke. These studies documented that HA and HA-based therapies exert their pharmacological effects via affecting stroke-related processes. Herein, we summarized the role of the extracellular matrix in stroke pathogenesis. Moreover, we highlighted the HA-based therapies for the treatment of stroke.
Influence of Carbohydrate Residues on Antibacterial Activity of Vancomycin
Authors: Samaszko-Fiertek Justyna , Szulc Monika , Dmochowska Barbara , Jaśkiewicz Maciej , Kamysz Wojciech , Ślusarz Rafał , Madaj Janusz
Published: March 2020

This paper presents synthesis of vancomycin derivatives modified with selected 1- and
2-aminoalditols to carboxylic function and 2,5-anhydro-D-mannose and D-talose to amino function of
vancosamine via reductive alkylation. MIC and MBC of these derivatives were determined for reference
strains of bacteria: Staphylococcus aureus ATCC 25923, ATCC 6538, ATCC 6538/P, S. epidemidis
ATCC 14490, E. faecium PCM 1859, E. faecalis PCM 2673, S. pyogenes PCM 465, and
S. pneumonia ATCC 49619 and compared with the activity of vancomycin and its aglycone. Our findings
confirm that sugar fragments can play an important role in the mechanism of interaction of vancomycin
with bacterial cell wall peptidoglycan.
An Efficient, Potassium Carbonate-Catalysed, Three-Component Reaction of Aldehydes, Malononitrile and Amidines Leading to Highly Functionalized Pyrimidines in Aqueous Media
Authors: Mohammadi Seddigheh , Ghazanfari Dadkhoda , Karimi-Jaberi Zahed
Published: March 2020

Various 4-amino-5-cyanopyrimidines were readily prepared in a few minutes with good yields through a one-pot, three-component reaction of aldehydes, malononitrile and amidines in aqueous media in the presence of catalytic amounts of potassium carbonate. Short reaction times, high efficiency, generality of the method, synthesis of new derivatives, inexpensiveness, and non-toxicity of the catalyst/solvent are the interesting features of this method, which make it eco-friendly and highly attractive.
A Combined Topological ELF, NCI and QTAIM Study of Mechanism and Hydrogen Bond Controlling the Selectivity of the IMDC Reaction of Nitrone-alkene Obtained from m-allyloxybenzaldehyde
Authors: Chafaa Fouad , Nacereddine Abdelmalek Khorief , Djerourou Abdelhafid
Published: March 2020

The selectivity and molecular mechanism of the intramolecular [3+2] cycloaddition (IMDC) reaction of nitrone-alkene generated from m-allyloxybenzaldehyde has been studied computationally using B3LYP/6-31G(d) theoretical method. The energy profiles indicate that this IMDC reaction favours kinetically the formation of the fused-endo, as observed experimentally. The solvent has no influence on the mechanism and selectivity, but it increases slightly the activation energy and decreases the exothermic character of this IMDC reaction. The analysis through electron localisation function (ELF) of the favourable fused-endo pathway shows that the formation of the C–O and C–C new bonds occurred via a non-concerted synchronous one-step mechanism. The analysis of noncovalent interaction using Non-covalent interaction (NCI) and QTAIM analyses of the structure of the fused-endo transition state indicates that the hydrogen-bond formed at this approach is the origin for the favouring of the fused-endo pathway.
Diarylmethanols Synthesis by Nickel(II)-catalyzed Addition of Arylboronic Acids to Aryl Aldehydes
Authors: Bie Fusheng , Liu Xuejing , Wang Meng , Cui Haizhu , Li Tang , Ma Jie , Cao Han
Published: March 2020

A practical procedure for the addition of arylboronic acids to aromatic aldehydes has been
developed in the presence of NiCl2(PPh3)2/1,3-bis-(2,6-diisopropylphenyl)imidazolium chloride
(IPr·HCl) system with good yield. Generally, electron-rich and -neutral aryl aldehydes showed excellent
reactivity and provided desired products in high yields. This procedure will provide new way to
the synthesis of diarylmethanols.
Pd/C-catalyzed Synthesis of 4-biaryl Substituted 2-amino benzo[h] chromene Derivatives as Potential Cytotoxic Agents
Authors: Rani Chekuri Sharmila , Haritha Meda , Basaveswara Rao Mandava V. , Pal Manojit
Published: March 2020

Background:

We report the design, synthesis and evaluation of a series of 4-biaryl
substituted 2-amino benzo[h]chromene derivatives as potential cytotoxic agents.

Methods:

The one-pot synthesis of this class of compounds was carried out under
ultrasound irradiation using an MCR involving Pd/C-catalyzed Suzuki-Miyaura coupling as a
key step.

Result and Conclusion:

Several of these compounds showed promising cytotoxicities when tested
against cancer cell lines but no or little effects on non-cancerous cell lines.
High Throughput Screening and Molecular Docking of Calmodulin with Antagonists of Trifluoperazine and Phenothiazine Chemical Class
Authors: Messaoudi Abdelmonem , Basharat Zarrin , Naqvi Asif
Published: March 2020

Background:

Calmodulin (CaM) is a ubiquitous, calcium-binding protein that can bind
to and regulate a multitude of different protein targets, thereby affecting many different cellular
functions. Binding ofsmall, hydrophobic molecules alter its function, as in the case of Phenothiazine
(PTZ). PTZ isan organic compound with a history of use as an antihelminth and frequently
quoted as a classic example of a pharmaceutical lead structure.Its derivatives are currently used as
antipsychotic drugs. Triflouperazine (TFP) is a phenothiazine derivative and a dopamine antagonist,
with antiemetic and antipsychotic activities. TFP exerts its antipsychotic effect by blocking central
dopamine receptors, thereby preventing effects like delusions and hallucinations caused by an excess
of dopamine. This agent also functions as a calmodulin inhibitor, thereby leading to an elevation
of cytosolic calcium. We have attempted to screen the extent of CaM specificity towards different
classes of TFP and PTZ.

Methods:

Molecular docking approach using the Lamarckian Genetic Algorithm was used to elucidate
the basis of structural similarity of TFP and PTZ with CaM. In total, 3000 compounds were
studied. All of the antagonists were taken from PubChem database on the basis of the structural
similarity of TFP and PTZ.

Results:

The docking result of these molecules with CaM demonstrated favored binding energies in
the range of -11.50 kcal/mol to -4.51 kcal/mol, with 8 molecules showing hydrogen bonds with the
active site residue Met124. Compound 1 was found to be the best CaM inhibitor. The Drug like and
chemical toxicity was also predicted for this compound.

Conclusion:

Computational docking is a feasible method to screen inhibitor compounds against a
biomolecule of interest.
The Effect of Feeding Date Palm Fruit (Phoeix dactylifera L.) on Energy, Macronutrient, and Fiber Intakes of a Convenient Sample of Females
Authors: Al-Sayyed Hiba F. , Takruri Hamed R. , Bakir Nawal A. , Takruri Dima H.
Published: March 2020

Background:

Female menstrual changes in hormone concentration influence appetite and
eating behavior. As well, eating pattern has some influences on menstrual hormonal status. Feeding
date palm fruit has been found in our previous report to affect menstrual hormones and some menstrual
parameters.

Objective:

The aim of this research is to study the effect of feeding dates on energy, macronutrient,
and fiber intakes, body weight, and body fat%. Additionally, this study aims to find any correlation
between menstrual hormone concentration and the above-mentioned parameters.

Methods:

A convenient sample (n=37) of not-sexually active females aged 20-30 were divided into
two groups; one group (dates group) was fed 7 dates and the other served as a control group. The participants
of the control group were exposed to the same experimental conditions except for eating
dates. Throughout the feeding trial, the volunteers filled a 3-day food record; one menses day and
two non-menses days.

Results:

There was a significant effect of the menstrual status-feeding duration interaction in terms
of protein and fat intakes. Additionally, menstrual status, as well as feeding duration, affected energy
and macronutrient intakes significantly. Furthermore, feeding duration affected fiber intake significantly.
Despite the above-mentioned differences in energy and macronutrient intakes, these effects
didn’t affect the body weight and body mass index of the study participants, neither their body fat%.
Moreover, we have found significant correlations between nutrient intakes and menstrual hormone
concentration.

Conclusion:

Feeding dates affected energy, macronutrient, and fiber intakes significantly. These effects
were related to the changes in menstrual hormone concentration.
Application of Nanomaterials in Neurodegenerative Diseases
Authors: Cui Weitong , Fu Wei , Lin Yunfeng , Zhang Tianxu
Published: March 2020

Neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, and Huntington's disease are very harmful brain lesions. Due to the difficulty in obtaining therapeutic drugs, the best treatment for neurodegenerative diseases is often not available. In addition, the bloodbrain barrier can effectively prevent the transfer of cells, particles and macromolecules (such as drugs) in the brain, resulting in the failure of the traditional drug delivery system to provide adequate cellular structure repair and connection modes, which are crucial for the functional recovery of neurodegenerative diseases. Nanomaterials are designed to carry drugs across the blood-brain barrier for targets. Nanotechnology uses engineering materials or equipment to interact with biological systems at the molecular level to induce physiological responses through stimulation, response and target site interactions, while minimizing the side effects, thus revolutionizing the treatment and diagnosis of neurodegenerative diseases. Some magnetic nanomaterials play a role as imaging agents or nanoprobes for Magnetic Resonance Imaging to assist in the diagnosis of neurodegenerative diseases. Although the current research on nanomaterials is not as useful as expected in clinical applications, it achieves a major breakthrough and guides the future development direction of nanotechnology in the application of neurodegenerative diseases. This review briefly discusses the application and advantages of nanomaterials in neurodegenerative diseases. Data for this review were identified by searches of PubMed, and references from relevant articles published in English between 2015 and 2019 using the search terms “nanomaterials”, “neurodegenerative diseases” and “blood-brain barrier”.
A magyarországi romák népességszámának prognózisa regionális szinten 2061-ig
Authors: Hablicsek Laszlo , Hablicsekne Richter Maria , Langi Tamas
Published: March 2020

Tanulmányunkban megkísérelünk átfogó képet adni a magyarországi roma népesség országos és területi demográfiai jellemzőiről, előreszámítást készíteni akövetkező évtizedekre 2061-ig, régiók szerinti bontásban. A vizsgálat aktualitását jelzi, hogy az elmúlt évtizedekben a hazai roma népesség létszáma, illetve a népességen belüli aránya folyamatosan és jelentősen emelkedett. A következő évtizedekben mindkét téren további emelkedés várható, viszont a növekedés üteme lelassul. A roma népesség esetében a termékenység tovább csökken, a halálozás is mérséklődik, a várható élettartam emelkedik, ezek következményeként az idősek aránya egyre jobban nő. Becslésünk azt mutatja, hogy 2061-re a besorolás szerinti cigányság korfája átalakul, egyre inkább hasonlóvá válik a jelenlegi, teljes magyarországi népességéhez.

Journal of Economic Literature (JEL) kódok: C82, J11, J13, J19
Исследования процессов транспорта носителей заряда в изотипных гетероструктурах типа n-=SUP=-+-=/SUP=--GaAs/n-=SUP=-0-=/SUP=--GaAs/n-=SUP=-+-=/SUP=--GaAs с тонким широкозонным барьером AlGaAs
Authors: Слипченко С.О. , Подоскин А.А. , Соболева О.С. , Юферев В.С. , Головин В.С. , Гаврина П.С. , Романович Д.Н. , Мирошников И.В. , Пихтин Н.А.
Published: March 2020

Abstract Experimental studies of n ^+-GaAs/ n ^0-GaAs/ n ^+-GaAs isotype heterostructures with a 100-nm-thick wide-gap N ^0-AlGaAs barrier situated in the n ^0-GaAs region are carried out. It is shown that the current–voltage characteristic of the structures under study has a negative-differential-resistance (NDR) portion, with the transition to this region occurring with a time delay that may reach tens of nanoseconds. It is found that operation in the NDR region is associated with the onset of impact-ionization process. Numerical analysis in terms of the energy-balance model demonstrated that the transition to the NDR region is associated with the formation of an electric field domain that covers a part of the lightly doped region between the thin wide-gap N ^0-AlGaAs barrier and the heavily doped n ^+-GaAs layer and with the onset of impact ionization at the interface with the heavily doped n ^+-GaAs layer. A comparative analysis of the experimental data and the modeling results showed that, for the current–voltage characteristics of the heterostructures under study to be correctly described, the model should take into account the less pronounced ability of a heterojunction to restrict carrier transport in the barrier layer.
Импедансные характеристики γ-облученных твердых растворов (TlGaSe-=SUB=-2-=/SUB=-)-=SUB=-1-x-=/SUB=-(TlInS-=SUB=-2-=/SUB=-)-=SUB=-x-=/SUB=-
Authors: Сардарлы Р.М. , Салманов Ф.Т. , Алиева Н.А. , Аббаслы Р.М.
Published: March 2020

Abstract Charge transport in (TlGaSe_2)_1 –_ x (TlInS_2)_ x solid solutions in the frequency range of 20–10^6 Hz before and after γ irradiation is studied using impedance-spectroscopy methods. The relaxation character of the permittivity dispersion and the nature of the dielectric loss are established. The frequency dependence of the dissipation factor tanδ in the crystals of the (TlGaSe_2)_1 –_ x (TlInS_2)_ x solid solutions is caused not only by relaxation polarization, but also by reach-through conductivity. The relaxation times are found to be τ = 10^–3 s. It is determined that, in the frequency range of 10^5–5 × 10^5 Hz, the electrical conductivity obeys the regularity σ ~ f ^ S (0.1 ≤ S ≤ 1.0), which is indicative of the conductivity over localized states. It is shown that a further increase in the frequency leads to an increase in the ionic conductivity and transition of the system to the superionic state.
Особенности переноса заряда в легированных слоях сульфида цинка в низкочастотном переменном электрическом поле
Authors: Аванесян В.Т. , Жаркой A.Б. , Ракина А.В.
Published: March 2020

Abstract The behavioral features of the spectra of impedance components and electric module for copper-doped polycrystalline zinc-sulfide layers are investigated. The dispersion of the frequency dependences of the electrical parameters corresponding to the distribution of the relaxation time is established. An equivalent sample circuit that includes a constant phase element and describes electric transport features in the polycrystalline system under study is used to interpret the experimental data.
Information About Sunscreen on YouTube and Considerations for Sun Safety Promotion: Content Analysis
Authors: Julian Anne K , Welch Jessica , Bean Maddison M , Shahid Sarah , Perna Frank M
Published: March 2020

Background

Sunscreen use is a popular sun protection method; however, application of sunscreen rarely meets the standards recommended for effectiveness. Access to information about how to effectively use sunscreen may play a role in proper sunscreen application. The internet is a common health information source; however, the quality of sunscreen-related content varies.

Objective

The objective of this study was to examine information about sunscreen in YouTube videos by video source.

Methods

In November 2017, the authors identified the 20 most popular YouTube videos (sorted by view count and relevance) for each of these 5 search terms: sunscreen cancer, sunscreen health, sunscreen information, sunscreen ingredients, and sunscreen natural. The inclusion criteria were English language and view count >1000 (N=111 unique videos). We double-coded videos for standard recommendations for sunscreen use (eg, apply 20 minutes before sun exposure), use of outdated terminology, and recommendation of complementary sun safety strategies.

Results

The view counts ranged from 1100 to 671,142 (median 17,774, SD 109,651) and the average daily views ranged from 1 to 1448 (median 23, SD 234). End users (46/111, 41.4%) and health care providers (24/111, 21.6%) were the most common sources, and none of the most popular videos were produced by federal agencies or cancer-related nongovernmental organizations. Health care provider videos included marginally more recommendations than end user videos (mean 1.46, SD 1.96 vs mean 1.05, SD 1.20), but few (19/111, 17.1%) mentioned reapplication. The videos were generally positive toward sunscreen (82/111, 73.9%); however, some videos were negative (29/111, 26.1%), with warnings about the health risks of chemical sunscreens and their ingredients. Do-it-yourself sunscreen tutorials represented 19/111 (17.1%) of the sample.

Conclusions

YouTube is a potential source for disseminating sun safety messages; however, the quality of its sunscreen content varies. Most of the videos in our study failed to include important sunscreen use recommendations. Clinicians should be prepared to address the information needs of patients by discussing effective, evidence-based sunscreen application and recommending a combined sun safety approach.
The Impact of a Social Networking Service–Enhanced Smart Care Model on Stage 5 Chronic Kidney Disease: Quasi-Experimental Study
Authors: Yang Feng-Jung , Hou Ying-Hui , Chang Ray-E
Published: March 2020

Background

Stage 5 chronic kidney disease (CKD) presents a high risk for dialysis initiation and for complications such as uremic encephalopathy, uremic symptoms, gastrointestinal bleeding, and infection. One of the most common barriers to health care for patients with stage 5 CKD is poor continuity of care due to unresolved communication gaps.

Objective

Our aim was to establish a powerful care model that includes the use of a social networking service (SNS) to improve care quality for patients with CKD and safely delay dialysis initiation.

Methods

We used a retrospective cohort of CKD patients aged 20-85 years who received care between 2007 and 2017 to evaluate the efficacy of incorporating an SNS into the health care system. In 2014, author F-JY, a nephrologist at the National Taiwan University Hospital Yunlin Branch, started to use an SNS app to connect with stage 5 CKD patients and their families. In cases of emergency, patients and families could quickly report any condition to F-JY. Using this app, F-JY helped facilitate productive interactions between these patients and the health care system. The intention was to safely delay the initiation of dialysis therapy. We divided patients into four groups: group 1 (G1) included patients at the study hospital during the 2007-2014 period who had contact only with nephrologists other than F-JY; group 2 (G2) included patients who visited F-JY during the 2007-2014 period before he began using the SNS app; group 3 (G3) included patients who visited nephrologists other than F-JY during the 2014-2017 period and had no interactions using the SNS; and group 4 (G4) included patients who visited F-JY during the 2014-2017 period and interacted with him using the SNS app.

Results

We recruited 209 patients with stage 5 CKD who had been enrolled in the study hospital’s CKD program between 2007 and 2017. Each of the four groups initiated dialysis at different times. Before adjusting for baseline estimated glomerular filtration rate (eGFR), the G4 patients had a longer time to dialysis (mean 761.7 days, SD 616.2 days) than the other groups (G1: mean 403.6 days, SD 409.4 days, P=.011 for G4 vs G1; G2: 394.8 days, SD 318.8 days, P=.04; G3: 369.1 days, SD 330.8 days, P=.049). After adjusting for baseline eGFR, G4 had a longer duration for each eGFR drop (mean 84.8 days, SD 65.1 days) than the other groups (G1: mean 43.5 days, SD 45.4 days, P=.005; G2: mean 42.5 days, SD 26.5 days, P=.03; G3: mean 3.8.7 days, SD 33.5 days, P=.002).

Conclusions

The use of an SNS app between patients with stage 5 CKD and their physicians can reduce the communication gap between them and create benefits such as prolonging time-to-dialysis initiation. The role of SNSs and associated care models should be further investigated in a larger population.
The Effectiveness of Digital Health Interventions in the Management of Musculoskeletal Conditions: Systematic Literature Review
Authors: Hewitt Stephanie , Sephton Ruth , Yeowell Gillian
Published: March 2020

Background

Musculoskeletal conditions are the second greatest contributor to disability worldwide and have significant individual, societal, and economic implications. Due to the growing burden of musculoskeletal disability, an integrated and strategic response is urgently required. Digital health interventions provide high-reach, low-cost, readily accessible, and scalable interventions for large patient populations that address time and resource constraints.

Objective

This review aimed to investigate if digital health interventions are effective in reducing pain and functional disability in patients with musculoskeletal conditions.

Methods

A systematic review was undertaken to address the research objective. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review protocol was registered with the International Prospective Register of Systematic Reviews before commencement of the study. The following databases were searched: Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), Cumulative Index to Nursing and Allied Health Literature, and Scopus from January 1, 2000, to November 15, 2019, using search terms and database specific−medical subject headings terms in various combinations appropriate to the research objective.

Results

A total of 19 English language studies were eligible for inclusion. Of the 19 studies that assessed musculoskeletal pain, 9 reported statistically significant reductions following digital intervention. In all, 16 studies investigated functional disability; 10 studies showed a statistically significant improvement. Significant improvements were also found in a range of additional outcomes. Due to the heterogeneity of the results, a meta-analysis was not feasible.

Conclusions

This review has demonstrated that digital health interventions have some clinical benefits in the management of musculoskeletal conditions for pain and functional disability. Digital health interventions have the potential to contribute positively toward reducing the multifaceted burden of musculoskeletal conditions to the individual, economy, and society.

Trial Registration

PROSPERO CRD42018093343; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=93343
Finding the Best Way to Deliver Online Educational Content in Low-Resource Settings: Qualitative Survey Study
Authors: Kynge Lucy
Published: March 2020

Background

The reach of internet and mobile phone coverage has grown rapidly in low- and middle-income countries (LMICs). The potential for sharing knowledge with health care workers in low-resource settings to improve working practice is real, but barriers exist that limit access to online information. Burns affect more than 11 million people each year, but health care workers in low-resource settings receive little or no training in treating burn patients. Interburns' training programs are tailor-made to improve the quality of burn care in Asia, Africa, and the Middle East; the challenge is to understand the best way of delivering these resources digitally toward improved treatment and care of burn patients.

Objective

The aim of the study, funded by the National Institute for Health Research (NIHR), was to understand issues and barriers that affect health care worker access to online learning in low-resource settings in order to broaden access to Interburns' training materials and improve burn-patient care.

Methods

A total of 546 participants of Interburns' Essential Burn Care (EBC) course held in Bangladesh, Nepal, Ethiopia, and the West Bank, the occupied Palestinian Territories, between January 2016 and June 2018 were sent an online survey. EBC participants represent the wide range of health care professionals involved with the burn-injured patient. A literature review was carried out as well as research into online platforms.

Results

A total of 207 of 546 (37.9%) participants of the EBC course did not provide an email address. Of the 339 email addresses provided, 81 (23.9%) “bounced” back. Surgeons and doctors were more likely to provide an email address than nurses, intern doctors, or auxiliary health care workers. A total of 258 participants received the survey and 70 responded, giving a response rate of 27.1%. Poor internet connection, lack of time, and limited access to computers were the main reasons for not engaging with online learning, along with lack of relevant materials. Computers were seen as more useful for holding information, while mobile phones were better for communicating and sharing knowledge. Health care workers in LMICs use mobile phones professionally on a daily basis. A total of 80% (56/70) felt that educational content on burns should be available through mobile apps.

Conclusions

Health care workers in low-resource settings face a variety of barriers to accessing educational content online. The reliance on email for sign-up to learning management systems is a significant barrier. Materials need to be relevant, localized, and easy to consume offline if necessary, to avoid costs of mobile phone data. Smartphones are increasingly used professionally every day for communication and searching for information, pointing toward the need for tailored educational content to be more available through mobile- and web-based apps.
Association Between HIV-Related Tweets and HIV Incidence in the United States: Infodemiology Study
Authors: Stevens Robin , Bonett Stephen , Bannon Jacqueline , Chittamuru Deepti , Slaff Barry , Browne Safa K , Huang Sarah , Bauermeister José A
Published: March 2020

Background

Adolescents and young adults in the age range of 13-24 years are at the highest risk of developing HIV infections. As social media platforms are extremely popular among youths, researchers can utilize these platforms to curb the HIV epidemic by investigating the associations between the discourses on HIV infections and the epidemiological data of HIV infections.

Objective

The goal of this study was to examine how Twitter activity among young men is related to the incidence of HIV infection in the population.

Methods

We used integrated human-computer techniques to characterize the HIV-related tweets by male adolescents and young male adults (age range: 13-24 years). We identified tweets related to HIV risk and prevention by using natural language processing (NLP). Our NLP algorithm identified 89.1% (2243/2517) relevant tweets, which were manually coded by expert coders. We coded 1577 HIV-prevention tweets and 17.5% (940/5372) of general sex-related tweets (including emojis, gifs, and images), and we achieved reliability with intraclass correlation at 0.80 or higher on key constructs. Bivariate and multivariate analyses were performed to identify the spatial patterns in posting HIV-related tweets as well as the relationships between the tweets and local HIV infection rates.

Results

We analyzed 2517 tweets that were identified as relevant to HIV risk and prevention tags; these tweets were geolocated in 109 counties throughout the United States. After adjusting for region, HIV prevalence, and social disadvantage index, our findings indicated that every 100-tweet increase in HIV-specific tweets per capita from noninstitutional accounts was associated with a multiplicative effect of 0.97 (95% CI [0.94-1.00]; P=.04) on the incidence of HIV infections in the following year in a given county.

Conclusions

Twitter may serve as a proxy of public behavior related to HIV infections, and the association between the number of HIV-related tweets and HIV infection rates further supports the use of social media for HIV disease prevention.
Evaluating Engagement in a Digital and Dietetic Intervention Promoting Healthy Weight Gain in Pregnancy: Mixed Methods Study
Authors: Willcox Jane C , Chai Daniel , Beilin Lawrence J , Prescott Susan L , Silva Desiree , Neppe Cliff , Huang Rae-Chi
Published: March 2020

Background

Early excess and inadequate gestational weight gain (GWG) have been associated with negative outcomes for mother and child. The use of digital media to deliver pregnancy lifestyle interventions is increasing, but there is little data on participant engagement. The Pregnancy Lifestyle Activity and Nutrition (PLAN) intervention pilot study was an electronic health and dietetic-delivered intervention program promoting healthy GWG in early pregnancy.

Objective

This study aims to explore the interactions of participants with the program and to assess its acceptability.

Methods

This study uses both quantitative and qualitative methods using data from parent randomized controlled trial (ACTRN12617000725369). Quantitative data from 22 participants in the intervention arm who completed the study provided measures of the interactions participants had with the digital components of the program and with dietetic consultations. A descriptive qualitative analysis employed semistructured interviews with 9 participants to elicit views on the acceptability of the intervention and its components.

Results

The electronic delivery of information and recording of weight from 8 to 20 weeks of gestation were universally accepted. Component (face-to-face dietitian, weight tracker, website information delivery, and SMS goal prompting) acceptability and engagement differed between individuals. A total of 4 key themes emerged from the qualitative analysis: supporting lifestyle change, component acceptability and value, delivery platforms, and engagement barriers.

Conclusions

The PLAN intervention and its delivery via a blend of personal dietetic consultations and digital program delivery was found to be acceptable and valuable to pregnant women. Individuals responded differently to various components, emphasizing the importance of including women in the development of lifestyle interventions and allowing participants to choose and tailor programs. Larger randomized controlled trials using these insights in a broader section of the community are needed to inform the iterative development of practical, time-efficient, and cost-effective ways of supporting optimal GWG with the potential to optimize outcomes for pregnant women and their child.
Standardized Protocol Items Recommendations for Observational Studies (SPIROS) for Observational Study Protocol Reporting Guidelines: Protocol for a Delphi Study
Authors: Mahajan Raman , Burza Sakib , Bouter Lex M , Sijtsma Klaas , Knottnerus André , Kleijnen Jos , Dael Peter Van , Zeegers Maurice P
Published: March 2020

Background

Approximately 90% of currently published clinical and public health research is in the form of observational studies. Having a detailed and registered study protocol prior to data collection is important in any empirical study. Without this, there is no reliable way to assess the occurrence of publication bias, outcome reporting bias, and other protocol deviations. However, there is currently no solid guidance available on the information that a protocol for an observational study should contain.

Objective

The aim of this study is to formulate the Standardized Protocol Items Recommendations for Observational Studies (SPIROS) reporting guidelines, which focus on 3 main study designs of analytical epidemiology: cohort, case-control, and cross-sectional studies.

Methods

A scoping review of published protocol papers of observational studies in epidemiology will identify candidate items for the SPIROS reporting guidelines. The list of items will be extended with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist items and recommendations from the SPIROS steering committee. This long list serves as the basis for a 2-round Delphi survey among experts to obtain consensus on which items to include. Each candidate item from the long list will be rated on a 5-point Likert scale to assess relevance for inclusion in the SPIROS reporting guidelines. Following the Delphi survey, an expert-driven consensus workshop will be convened to finalize the reporting guidelines.

Results

A scoping review of published observational study protocols has been completed, with 59 candidate items identified for inclusion into the Delphi survey, itself launched in early 2020.

Conclusions

This project aims to improve the timeliness, completeness, and clarity of study protocols of observational studies in analytical epidemiology by producing expert-based recommendations of items to be addressed. These reporting guidelines will facilitate and encourage researchers to prepare and register study protocols of sufficient quality prior to data collection in order to improve the transparency, reproducibility, and quality of observational studies.

International Registered Report Identifier (IRRID)

PRR1-10.2196/17864
User Perspectives of Mood-Monitoring Apps Available to Young People: Qualitative Content Analysis (Preprint)
Authors: Widnall Emily , Grant Claire Ellen , Wang Tao , Cross Lauren , Velupillai Sumithra , Roberts Angus , Stewart Robert , Simonoff Emily , Downs Johnny
Published: March 2020

BACKGROUND

Mobile health apps are increasingly available and used in a clinical context to monitor young people’s mood and mental health. Despite the benefits of accessibility and cost-effectiveness, consumer engagement remains a hurdle for uptake and continued use. Hundreds of mood-monitoring apps are publicly available to young people on app stores; however, few studies have examined consumer perspectives. App store reviews held on Google and Apple platforms provide a large, rich source of naturally generated, publicly available user reviews. Although commercial developers use these data to modify and improve their apps, to date, there has been very little in-depth evaluation of app store user reviews within scientific research, and our current understanding of what makes apps engaging and valuable to young people is limited.

OBJECTIVE

This study aims to gain a better understanding of what app users consider useful to encourage frequent and prolonged use of mood-monitoring apps appropriate for young people.

METHODS

A systematic approach was applied to the selection of apps and reviews. We identified mood-monitoring apps (n=53) by a combination of automated application programming interface (API) methods. We only included apps appropriate for young people based on app store age categories (apps available to those younger than 18 years). We subsequently downloaded all available user reviews via API data scraping methods and selected a representative subsample of reviews (n=1803) for manual qualitative content analysis.

RESULTS

The qualitative content analysis revealed 8 main themes: accessibility (34%), flexibility (21%), recording and representation of mood (18%), user requests (17%), reflecting on mood (16%), technical features (16%), design (13%), and health promotion (11%). A total of 6 minor themes were also identified: notification and reminders; recommendation; privacy, security, and transparency; developer; adverts; and social/community.

CONCLUSIONS

Users value mood-monitoring apps that can be personalized to their needs, have a simple and intuitive design, and allow accurate representation and review of complex and fluctuating moods. App store reviews are a valuable repository of user engagement feedback and provide a wealth of information about what users value in an app and what user needs are not being met. Users perceive mood-monitoring apps positively, but over 20% of reviews identified the need for improvement.
Evaluation of the MoMba Live Long Remote Smoking Detection System During and After Pregnancy: Development and Usability Study (Preprint)
Authors: Valencia Stephanie , Callinan Laura , Shic Frederick , Smith Megan
Published: March 2020

BACKGROUND

The smoking relapse rate during the first 12 months after pregnancy is around 80% in the United States. Delivering remote smoking cessation interventions to women in the postpartum period can reduce the burden associated with frequent office visits and can enable remote communication and support. Developing reliable, remote, smoking measuring instruments is a crucial step in achieving this vision.

OBJECTIVE

The study presents the evaluation of the MoMba Live Long system, a smartphone-based breath carbon monoxide (CO) meter and a custom iOS smartphone app. We report on how our smoking detection system worked in a controlled office environment and in an out-of-office environment to examine its potential to deliver a remote contingency management intervention.

METHODS

In-office breath tests were completed using both the MoMba Live Long system and a commercial monitor, the piCO+ Smokerlyzer. In addition, each participant provided a urine test for smoking status validation through cotinine. We used in-office test data to verify the validity of the MoMba Live Long smoking detection system. We also collected out-of-office tests to assess how the system worked remotely and enabled user verification. Pregnant adult women in their second or third trimester participated in the study for a period of 12 weeks. This study was carried out in the United States.

RESULTS

Analyses of in-office tests included 143 breath tests contributed from 10 participants. CO readings between the MoMba Live Long system and the piCO+ were highly correlated (r=.94). In addition, the MoMba Live Long system accurately distinguished smokers from nonsmokers with a sensitivity of 0.91 and a specificity of 0.94 when the piCO+ was used as a gold standard, and a sensitivity of 0.81 and specificity of 1.0 when cotinine in urine was used to confirm smoking status. All participants indicated that the system was easy to use.

CONCLUSIONS

Relatively inexpensive portable and internet-connected CO monitors can enable remote smoking status detection in a wide variety of nonclinical settings with reliable and valid measures comparable to a commercially available CO monitor.

CLINICALTRIAL

ClinicalTrials.gov NCT02237898; https://clinicaltrials.gov/ct2/show/NCT02237898
Computer-Controlled Virtual Humans in Patient-Facing Systems: Systematic Review and Meta-Analysis (Preprint)
Authors: Chattopadhyay Debaleena , Ma Tengteng , Sharifi Hasti , Martyn-Nemeth Pamela
Published: March 2020

BACKGROUND

Virtual humans (VH) are computer-generated characters that appear humanlike and simulate face-to-face conversations using verbal and nonverbal cues. Unlike formless conversational agents, like smart speakers or chatbots, VH bring together the capabilities of both a conversational agent and an interactive avatar (computer-represented digital characters). Although their use in patient-facing systems has garnered substantial interest, it is unknown to what extent VH are effective in health applications.

OBJECTIVE

The purpose of this review was to examine the effectiveness of VH in patient-facing systems. The design and implementation characteristics of these systems were also examined.

METHODS

Electronic bibliographic databases were searched for peer-reviewed articles with relevant key terms. Studies were included in the systematic review if they designed or evaluated VH in patient-facing systems. Of the included studies, studies that used a randomized controlled trial to evaluate VH were included in the meta-analysis; they were then summarized using the PICOTS framework (population, intervention, comparison group, outcomes, time frame, setting). Summary effect sizes, using random-effects models, were calculated, and the risk of bias was assessed.

RESULTS

Among the 8,125 unique records identified, 53 articles describing 33 unique systems, were qualitatively, systematically reviewed. Two distinct design categories emerged — simple VH and VH augmented with health sensors and trackers. Of the 53 articles, 16 (26 studies) with 44 primary and 22 secondary outcomes were included in the meta-analysis. Meta-analysis of the 44 primary outcome measures revealed a significant difference between intervention and control conditions, favoring the VH intervention (SMD = .166, 95% CI .039-.292, P=.012), but with evidence of some heterogeneity, I2=49.3%. There were more cross-sectional (k=15) than longitudinal studies (k=11). The intervention was delivered using a personal computer in most studies (k=18), followed by a tablet (k=4), mobile kiosk (k=2), head-mounted display (k=1), and a desktop computer in a community center (k=1).

CONCLUSIONS

We offer evidence for the efficacy of VH in patient-facing systems. Considering that studies included different population and outcome types, more focused analysis is needed in the future. Future studies also need to identify what features of virtual human interventions contribute toward their effectiveness.