bluuebunny/crossref_metadata_2025 huggingface dataset:
Inexpensive Weight-Reducing Aid (L-Carnitine) as An Efficient Catalyst for Synthesis of Benzimidazoles
Authors: Zhang Min , Huang Guoling , Zhang Xuefang , Lin Zhenyuan , Li Yibiao , Li Bin , Chen Lu
Published: October 2018

Aim and Objective:

The benzimidazole derivatives have been obtained via weightreducing
aid (L-Carnitine) as a cheap catalyst. A wide range of aromatic aldehydes easily undergo
condensations with substituted o-phenylendiamine under mild condition to afford the target
molecular in excellent yields.

Materials and Methods:

Melting points were measured on an Electrothemal X6 microscopy digital
melting point apparatus. 1H NMR and 13C NMR spectra were recorded in DMSO-d6 on a Bruker
AVANCE 400 (400 MHz) instrument with the TMS at d 0.00 ppm as an internal standard. C, H and
N analysis were performed by a Perkin-Elmer 2400 CHN elemental analyzer. Chemicals used were
of commercial grade without further purification.

An equimloar (1.0 mmol) mixture of o-phenylenediamine 1, aromatic aldehyde 2, and L-Carnitine
(10 mol%) was vigorously stirred at 60°C in EtOH (3 mL) for the specific time indicated by TLC
(petroleum: ethyl acetate ether = 4:1). After completion of the reaction, the mixture was quenched by
adding H2O (20 mL), extracted with EtOAc (3 x 10 mL), and the combined extracts were dried by
anhydrous MgSO4. The filtrate was evaporated and the corresponding benzimidazole was obtained
as the only product. The products 3a–3r were obtained in 82–95% yields. The structures of the
products 3 were identified by their IR, 1H NMR, 13C NMR and elemental analysis spectra.

Results:

The products were obtained in 82–95% yields in 30–80 min. The method has several
advantages such as simple, clean and environmentally process, excellent yield and avoiding use of
inconvenient preparation of catalyst. Meanwhile, the catalyst L-Carnitine is a kind of weightreducing
aid, which might be applied to broad green catalyzed system.

Conclusion:

A facile synthesis of benzimidazoles comprising the reaction of various aldehydes with
substituted o-phenylendiamine in good to excellent yield is provided using L-Carnitine as an
efficient catalyst. The protocol overcomes the earlier disadvantages like harsh reaction conditions,
tedious work-up, expensive process, wastes generation and the use of metallic oxide, which might be
applied to the synthesis of benzimidazoles pharmaceticals in order to meet friendly environmental
demands.
A Novel Systemic Indicator of Periodontal Tissue Damage: Ischemia Modified Albumin
Authors: Tayman Mahmure A. , Önder Canan , Kurgan Şivge , Serdar Muhittin A. , Günhan Meral
Published: October 2018

Background:

Ischemia-modified albumin (IMA) is a systemic indicator of inflammatory
diseases and is suggested as an oxidative stress marker.

Objective:

To determine the IMA and high-sensitivity C-reactive protein (hsCRP) serum levels for
patients with chronic periodontitis (CP) and to evaluate the impact of non-surgical periodontal
therapy on serum IMA and hsCRP levels.

Methods:

Twenty one systemically healthy patients with CP and 15 systemically and periodontally
healthy controls (C) were enrolled in the study. Periodontal pocket depth (PPD), bleeding on probing
(BOP) and attachment loss (AL) were recorded at the time of diagnosis and 6 weeks after the nonsurgical
periodontal therapy. Blood samples were obtained before and after treatment from all
groups, and serum IMA and hsCRP levels were evaluated by ELISA method.

Results:

All of the clinical findings were found to be elevated in the CP group in comparison to C
group (p<0.05). Levels of IMA and hsCRP were higher in the CP group (p<0.05) and decreased after
non-surgical periodontal therapy (p<0.05). Positive correlations were determined between PPD, BOP
and hsCRP (p<0.05) as well as between PPD, AL, BOP and IMA levels (p<0.01) before treatment. A
significant positive correlation was also observed between hsCRP and IMA (p<0.01) before and after
treatment.

Conclusion:

IMA is a marker indicating systemic inflammation during periodontal disease, and is
significantly reduced as a result of non-surgical periodontal therapy. Therefore, IMA might be
suggested as a useful indicator of periodontal disease.
Continuous Vector-free Gene Transfer with a Novel Microfluidic Chip and Nanoneedle Array
Authors: Huang Dong , Zhao Deyao , Li Jinhui , Wu Yuting , Du Lili , Xia Xin-Hua , Li Xiaoqiong , Deng Yulin , Li Zhihong , Huang Yuanyu
Published: October 2018

Background:

Delivery of foreign cargoes into cells is of great value for bioengineering research
and therapeutic applications.

Objective:

In this study, we proposed and established a carrier-free gene delivery platform utilizing
staggered herringbone channel and silicon nanoneedle array, to achieve high-throughput in vitro gene
transfection.

Methods: With this microchip, fluidic micro vortices could be induced by the staggered-herringboneshaped
grooves within the channel, which increased the contact frequency of the cells with the channel
substrate. Transient disruptions on the cell membrane were well established by the nanoneedle array on
the substrate.

Result: Compared to the conventional nanoneedle-based delivery system, proposed microfluidic chip
achieved flow-through treatment with high gene transfection efficiency (higher than 20%) and ideal cell
viability (higher than 95%).

It provides a continuous processing environment that can satisfy the transfection requirement
of large amounts of biological molecules, showing high potential and promising prospect for both
basic research and clinical application.
Optimization of Cellulase Production by Aspergillus niger Isolated from Forest Soil
Authors: Akula Srilakshmi , Golla Narasimha
Published: October 2018

Background:

An impressive increase in the application of cellulases in various fields over the last few decades demands extensive research in improving its quality and large-scale production. Therefore, the current investigation focuses on factors relevant for optimal production of cellulase byAspergillus nigerisolated from forest soil.

Method:

Throughout this study, the fungal strainAspergillus nigerwas maintained under the submerged condition for a period of 7 days at 120 rpm rotational speed. Various physical and chemical conditions were employed in examining their influence on cellulase production by the selected fungal strain. After appropriate incubation, culture filtrates were withdrawn and checked for FPase, CMCase, and β-D-glucosidase activities.

Results:

The optimum pH and temperature for cellulase production were found to be 5.0 and 32°C, respectively. Among the various carbon sources tested in the present study, amendment of lactose in the medium yielded peak values of FPase (filter paperase) and CMCase (Carboxy-methyl cellulase) whereas fructose supported the higher titers of β-glucosidase. Among the nitrogen sources, profound FPase and CMCase activity were recorded when urea was used but higher β-glucosidase activity was noticed when yeast extract was added. Various natural lignocellulosic substrates like bagasse, coir, corncob, groundnut shells, litter, rice bran, rice husk, sawdust and wheat bran were tested to find out the induction of cellulase. Among the lignocelluloses, sawdust and litter served as good substrates for cellulase production byAspergillus niger.

Conclusion:

In gist, the outcome of this study sheds light on the cellulolytic potentiality of the fungal strainAspergillus nigerpromising in its future commercial applications which may be economically feasible.
Prevalence and Determinants of Dyslipidemia: Data from a Saudi University Clinic
Authors: Al-Hassan Yasser Taher , Fabella Eduardo L. , Estrella Edric , Aatif Mohammad
Published: October 2018

Background:

Dyslipidemia is a risk factor for cardiovascular diseases. The relationship between demographic factors and dyslipidemia in Saudi Arabia is not completely explored.

Objectives:

This analytic cross-sectional study was conducted to describe the lipid profile, determine the proportion and identify significant demographic determinants of dyslipidemia among patients who have undergone lipid profile analysis in a university multispecialty clinic.

Methods:

The results of lipid profile examination of 1,541 King Faisal University clinic patients from 1 April, 2014 to 7 March, 2016 were compiled and subjected to descriptive and analytical statistics using STATA MP version 14. Multivariable logistic regression model using Adjusted Odds Ratio (AOR) and 95% Confidence Interval (CI) was fitted to analyze the independent predictors of dyslipidemia.

Results:

The prevalence of hypercholesterolemia, hypertriglyceridemia, hypo-HDL-cholesterolemia, and hyper-LDL-cholesterolemia were 13.8%, 17.0%, 40.0% 12.85%, respectively. Logistic regression revealed that in comparison with those who were 20 years old and below, those who were between the age of 40-49 years were 4.5 times more likely to have hypercholesterolemia and 3.5 times more likely to have hyper-LDL-cholesterolemia. Similarly, those who were 30-39 years old were 4.3 times and 3 times more likely to have hypertriglyceridemia and hypercholesterolemia, respectively. The same stage group was 3 times more likely to develop hyper-LDL-cholesterolemia. Females were 1.4 times more like to have hypercholesterolemia; non-Saudis were nearly twice as likely to develop hypertriglyceridemia than Saudis.

Conclusion:

Hypo-HDL-cholesterolemia was the most prevalent form of dyslipidemia. Age, gender and nationality were significant determinants of specific types of dyslipidemia.
Computer Programming: Should Medical Students Be Learning It? (Preprint)
Authors: Morton Caroline E , Smith Susan F , Lwin Tommy , George Michael , Williams Matt
Published: October 2018

BACKGROUND

The ability to construct simple computer programs (coding) is being progressively recognized as a life skill. Coding is now being taught to primary-school children worldwide, but current medical students usually lack coding skills, and current measures of computer literacy for medical students focus on the use of software and internet safety. There is a need to train a cohort of doctors who can both practice medicine and engage in the development of useful, innovative technologies to increase efficiency and adapt to the modern medical world.

OBJECTIVE

The aim of the study was to address the following questions: (1) is it possible to teach undergraduate medical students the basics of computer coding in a 2-day course? (2) how do students perceive the value of learning computer coding at medical school? and (3) do students see computer coding as an important skill for future doctors?

METHODS

We developed a short coding course to teach self-selected cohorts of medical students basic coding. The course included a 2-day introduction on writing software, discussion of computational thinking, and how to discuss projects with mainstream computer scientists, and it was followed on by a 3-week period of self-study during which students completed a project. We explored in focus groups (FGs) whether students thought that coding has a place in the undergraduate medical curriculum.

RESULTS

Our results demonstrate that medical students who were complete novices at coding could be taught enough to be able to create simple, usable clinical programs with 2 days of intensive teaching. In addition, 6 major themes emerged from the FGs: (1) making sense of coding, (2) developing the students’ skill set, (3) the value of coding in medicine, research, and business, (4) role of teaching coding in medical schools, (5) the concept of an enjoyable challenge, and (6) comments on the course design.

CONCLUSIONS

Medical students can acquire usable coding skills in a weekend course. They valued the teaching and identified that, as well as gaining coding skills, they had acquired an understanding of its potential both for their own projects and in health care delivery and research. They considered that coding skills teaching should be offered as an optional part of the medical curriculum.
A Mobile Phone App for the Self-Management of Pediatric Concussion: Development and Usability Testing (Preprint)
Authors: Sandhu Harminder , Wilson Katherine , Reed Nick , Mihailidis Alex
Published: October 2018

BACKGROUND

Concussion is a common injury among Canadian children and adolescents that leads to a range of neurobehavioral deficits. However, noticeable gaps continue to exist in the management of pediatric concussion, with poor health outcomes associated with the inadequate application of best practice guidelines.

OBJECTIVE

The aim of this study was to describe the development and assess the usability of a mobile phone app to aid youth in the self-management of concussion. A secondary objective was to assess the usefulness of the app.

METHODS

An agile user-centered design approach was used to develop the technology, followed by a formative lab-based usability study for assessment and improvement proposals. Youths aged 10 to 18 years with a history of concussion and health care professionals involved in concussion management were recruited. This study included participants performing 12 tasks with the mobile phone app while using the think aloud protocol and the administration of the System Usability Scale (SUS), posttest questionnaire, and a semistructured interview.

RESULTS

A mobile phone app prototype called NeuroCare, an easily accessible pediatric concussion management intervention that provides easy access to expert-informed concussion management strategies and helps guide youth in self-managing and tracking their concussion recovery, was developed. A total of 7 youths aged between 10 and 18 years with a history of concussion and 7 health care professionals were recruited. The mean SUS score was 81.9, mean task success rates were greater than 90% for 92% (11/12) of the tasks, 92% (11/12) of tasks had a total error frequency of less than 11 errors, and mean task completion times were less than 2 min for 100% of the tasks.

CONCLUSIONS

Results suggest that participants rated this app as highly usable, acceptable to users, and that it may be useful in helping youth self-manage concussion.
The Added Value of In-Hospital Tracking of the Efficacy of Decongestion Therapy and Prognostic Value of a Wearable Thoracic Impedance Sensor in Acutely Decompensated Heart Failure With Volume Overload: Prospective Cohort Study (Preprint)
Authors: Smeets Christophe J P , Lee Seulki , Groenendaal Willemijn , Squillace Gabriel , Vranken Julie , De Cannière Hélène , Van Hoof Chris , Grieten Lars , Mullens Wilfried , Nijst Petra , Vandervoort Pieter M
Published: October 2018

BACKGROUND

Incomplete relief of congestion in acute decompensated heart failure (HF) is related to poor outcomes. However, congestion can be difficult to evaluate, stressing the urgent need for new objective approaches. Due to its inverse correlation with tissue hydration, continuous bioimpedance monitoring might be an effective method for serial fluid status assessments.

OBJECTIVE

This study aimed to determine whether in-hospital bioimpedance monitoring can be used to track fluid changes (ie, the efficacy of decongestion therapy) and the relationships between bioimpedance changes and HF hospitalization and all-cause mortality.

METHODS

A wearable bioimpedance monitoring device was used for thoracic impedance measurements. Thirty-six patients with signs of acute decompensated HF and volume overload were included. Changes in the resistance at 80 kHz (R80kHz) were analyzed, with fluid balance (fluid in/out) used as a reference. Patients were divided into two groups depending on the change in R80kHz during hospitalization: increase in R80kHz or decrease in R80kHz. Clinical outcomes in terms of HF rehospitalization and all-cause mortality were studied at 30 days and 1 year of follow-up.

RESULTS

During hospitalization, R80kHz increased for 24 patients, and decreased for 12 patients. For the total study sample, a moderate negative correlation was found between changes in fluid balance (in/out) and relative changes in R80kHz during hospitalization (rs=-0.51, P<.001). Clinical outcomes at both 30 days and 1 year of follow-up were significantly better for patients with an increase in R80kHz. At 1 year of follow-up, 88% (21/24) of patients with an increase in R80kHz were free from all-cause mortality, compared with 50% (6/12) of patients with a decrease in R80kHz (P=.01); 75% (18/24) and 25% (3/12) were free from all-cause mortality and HF hospitalization, respectively (P=.01). A decrease in R80kHz resulted in a significant hazard ratio of 4.96 (95% CI 1.82-14.37, P=.003) on the composite endpoint.

CONCLUSIONS

The wearable bioimpedance device was able to track changes in fluid status during hospitalization and is a convenient method to assess the efficacy of decongestion therapy during hospitalization. Patients who do not show an improvement in thoracic impedance tend to have worse clinical outcomes, indicating the potential use of thoracic impedance as a prognostic parameter.
Assessing Epidemic Diseases and Public Opinion through Popular Search Behavior Using Non-English Language Google Trends (Preprint)
Authors: Chang Yu-Wei , Chiang Wei-Lun , Wang Wen-Hung , Lin Chun-Yu , Hung Ling-Chien , Tsai Yi-Chang , Chen Yen-Hsu
Published: October 2018

BACKGROUND

Web social media has identified to utilize as an epidemic outbreaks surveillance tool. However, the correlation between non-English language queries search data and epidemic diseases remains unclear.

OBJECTIVE

This study aimed to confirm the suitable non-English language keywords research relative intensities that were sensitive and specific to estimate the level of epidemic disease and the public opinion in non-English language country. Moreover, our approach indicated that a surveillance system based on Internet activity can be served an essential tool for detecting emerging diseases with distinct symptoms (e.g. zika virus fever in Brazil, 2015), and estimating the local epidemic diseases (e.g. enterovirus infectious disease in Taiwan, 2012). Otherwise, we further evaluated whether the social media reflected social uneasiness and fear during epidemic outbreaks and natural catastrophes. Our specific aim is to develop a suitable surveillance system for monitoring epidemic outbreak and observing related public opinion in the non-English language countries.

METHODS

The present study was based on freely available weekly epidemic incidence data from Taiwan Center for Disease Control, and the web search query data obtained from Google Trends between October 4, 2015, and April 2, 2016. To validate whether the non-English query keywords were the excellent surveillance tools, we estimated the correlation between the web query data and epidemic incidence in Taiwan.

RESULTS

Based on our approach, the total of 8 influenza-related queries was introduced to the analysis. The keywords, “感冒(common cold), 發燒(fever), and 咳嗽(cough)”, revealed good to excellent correlation between the Google Trends query data and influenza incidence (r= 0.89, P< 0.001; r= 0.77, p< 0.001; r= 0.79, p< 0.001, respectively). Moreover, those also displayed a high correlation with the influenza-like illness emergency and outpatient visits. We further found the query ”腸病毒 (enteroviruses)” in Google Trends, which showed excellent correlation with enterovirus infected patients in the emergency department (r= 0.91, p< 0.001).

CONCLUSIONS

This result suggested that Google Trends can serve as a good surveillance tool for epidemic outbreaks even in non-English language countries. Due to online search activity indicated people’s concerns for epidemic diseases even when they do not visit hospitals, it prompted us to develop the effectiveness of epidemic monitoring in web social media, which reflected the infectious trend more timeliness than traditional reporting system. In addition, the web queries data in suitable non-English search terms can provide more advantage information for medical education, healthcare, and disease prevention.
Use of a Biofeedback Breathing App to Augment Poststress Physiological Recovery: Randomized Pilot Study (Preprint)
Authors: Plans David , Morelli Davide , Sütterlin Stefan , Ollis Lucie , Derbyshire Georgia , Cropley Mark
Published: October 2018

BACKGROUND

The speed of physiological recovery from stress may be a marker for cardiovascular disease risk. Stress management programs that incorporate guided breathing have been shown to moderate the stress response and augment recovery.

OBJECTIVE

The aim of this study was to examine the effectiveness of an app-based brief relaxation intervention (BioBase) for facilitating physiological recovery in individuals exposed to a brief psychological stressor.

METHODS

A total of 75 participants (44 women) completed a stressor speech task and were randomly assigned to one of three conditions: control, rumination, or an app-based relaxation breathing (BioBase) conditions. Heart rate variability (HRV) was assessed as a measure of autonomic function at baseline (6 min), during stress (6 min), and during recovery (6 min).

RESULTS

There was a significant increase in subjective stress following stress exposure, but the ratings returned to baseline after recovery in all three groups. In addition, there was a significant decrease in vagally mediated HRV in the poststress period. During recovery, the root mean square of successive differences (P<.001), the percentage of successive interbeat (RR) intervals that differ by >50 ms (pNN50; P<.001), and high-frequency (P<.02) HRV were significantly higher in the BioBase breathing condition than the rumination and control conditions. There was no difference in HRV values between the rumination and control conditions during recovery.

CONCLUSIONS

App-based relaxed breathing interventions could be effective in reducing cardiovascular disease risk. These results provide additional utility of biofeedback breathing in augmenting physiological recovery from psychological stress.
What Patients Want in a Smartphone App That Supports Colonoscopy Preparation: Qualitative Study to Inform a User-Centered Smartphone App (Preprint)
Authors: Sewitch Maida J , Fallone Carlo A , Ghali Peter , Lee Ga Eun
Published: October 2018

BACKGROUND

The preparation for colonoscopy is elaborate and complex. In the context of colorectal cancer screening, up to 11% of patients do not keep their colonoscopy appointments and up to 33% of those attending their appointments have inadequately cleansed bowels that can delay cancer diagnosis and treatment. A smartphone app may be an acceptable and wide-reaching tool to improve patient adherence to colonoscopy.

OBJECTIVE

The aim of this qualitative study was to employ a user-centered approach to design the content and features of a smartphone app called colonAPPscopy to support individuals preparing for their colonoscopy appointments.

METHODS

We conducted 2 focus group discussions (FGDs) with gastroenterology patients treated at the McGill University Health Centre in Montreal, Canada. Patients were aged 50 to 75 years, were English- or French-speaking, and had undergone outpatient colonoscopy in the previous 3 months; they did not have inflammatory bowel disease or colorectal cancer. FGDs were 75 to 90 min, conducted by a trained facilitator, and audiotaped. Participants discussed the electronic health support tools they might use to help them prepare for the colonoscopy, the content needed for colonoscopy preparation, and the features that would make the smartphone app useful. Recordings of FGDs were transcribed and analyzed using thematic analysis to identify key user-defined content and features to inform the design of colonAPPscopy.

RESULTS

A total of 9 patients (7 male and 2 female) participated in one of 2 FGDs. Main content areas focused on bowel preparation instructions, medication restrictions, appointment logistics, communication, and postcolonoscopy expectations. Design features to make the app useful and engaging included minimization of data input, reminders and alerts for up to 7 days precolonoscopy, and visual aids. Participants wanted a smartphone app that comes from a trusted source, sends timely and tailored messages, provides reassurance, provides clear instructions, and is simple to use.

CONCLUSIONS

Participants identified the need for postcolonoscopy information as well as reminders and alerts in the week before colonoscopy, novel content, and features that had not been included in previous smartphone-based strategies for colonoscopy preparation. The ability to tailor instructions made the smartphone app preferable to other modes of delivery. Study findings recognize the importance of including potential users in the development phase of building a smartphone app.
Mobile Phone–Based Use of the Photoplethysmography Technique to Detect Atrial Fibrillation in Primary Care: Diagnostic Accuracy Study of the FibriCheck App (Preprint)
Authors: Proesmans Tine , Mortelmans Christophe , Van Haelst Ruth , Verbrugge Frederik , Vandervoort Pieter , Vaes Bert
Published: October 2018

BACKGROUND

Mobile phone apps using photoplethysmography (PPG) technology through their built-in camera are becoming an attractive alternative for atrial fibrillation (AF) screening because of their low cost, convenience, and broad accessibility. However, some important questions concerning their diagnostic accuracy remain to be answered.

OBJECTIVE

This study tested the diagnostic accuracy of the FibriCheck AF algorithm for the detection of AF on the basis of mobile phone PPG and single-lead electrocardiography (ECG) signals.

METHODS

A convenience sample of patients aged 65 years and above, with or without a known history of AF, was recruited from 17 primary care facilities. Patients with an active pacemaker rhythm were excluded. A PPG signal was obtained with the rear camera of an iPhone 5S. Simultaneously, a single‑lead ECG was registered using a dermal patch with a wireless connection to the same mobile phone. PPG and single-lead ECG signals were analyzed using the FibriCheck AF algorithm. At the same time, a 12‑lead ECG was obtained and interpreted offline by independent cardiologists to determine the presence of AF.

RESULTS

A total of 45.7% (102/223) subjects were having AF. PPG signal quality was sufficient for analysis in 93% and single‑lead ECG quality was sufficient in 94% of the participants. After removing insufficient quality measurements, the sensitivity and specificity were 96% (95% CI 89%-99%) and 97% (95% CI 91%-99%) for the PPG signal versus 95% (95% CI 88%-98%) and 97% (95% CI 91%-99%) for the single‑lead ECG, respectively. False-positive results were mainly because of premature ectopic beats. PPG and single‑lead ECG techniques yielded adequate signal quality in 196 subjects and a similar diagnosis in 98.0% (192/196) subjects.

CONCLUSIONS

The FibriCheck AF algorithm can accurately detect AF on the basis of mobile phone PPG and single-lead ECG signals in a primary care convenience sample.
Effectiveness and Feasibility of a Remote Lifestyle Intervention by Dietitians for Overweight and Obese Adults: Pilot Study (Preprint)
Authors: Haas Karin , Hayoz Stefanie , Maurer-Wiesner Susanne
Published: October 2018

BACKGROUND

To tackle the problem of obesity and related diseases in Switzerland, cost-efficient, effective, and innovative primary health care interventions for weight management are required. In this context, Oviva has developed a scalable technology for registered dietitians to counsel overweight and obese patients via a mobile phone app.

OBJECTIVE

The aim of this study was to evaluate the effectiveness and feasibility of weight loss counseling by dietitians using a mobile phone app for patients with overweight and obesity.

METHODS

In this pre- and posttest pilot study, overweight and obese adults participated in a 1-year behavioral intervention to lose weight through remote counseling by dietitians in the German-speaking part of Switzerland. The study started in April 2016 and finished in May 2018. Participants received individual counseling through the app and the exchange with the dietitian focused on regular feedback on photo-based food log, motivation, and education. The contents were tailored to the individual lifestyle goal set. The predefined intensity of remote counseling decreased during the year. Group chat could be used. The outcomes examined were changes in weight (primary outcome), hemoglobin A1c, fasting glucose, fasting insulin, triglyceride, high-density lipoprotein cholesterol, blood pressure (BP), body mass index (BMI), waist circumference, body fat, and responses to a self-administered questionnaire with questions regarding participants’ physical activity, dietary assessment, and health-related quality of life. Changes were tested at baseline, after 3 months, and after 12 months, as well as between the third and the 12th month.

RESULTS

In total, 36 women and 7 men, with a mean age of 40.6 years, participated and 36 participants completed the study. Median weight change after the first 12 weeks was −3.8 kg (range: −15 to 2.4 and P<.001), between week 12 and week 52 it was −1.1 kg (range: −9.7 to 7 and P=.08), and the median change during the entire period of intervention was −4.9 kg (range: −21.9 to 7.5 and P<.001). Furthermore, changes in BMI, waist circumference, body fat, and BP between baseline and 12 weeks and between baseline and 52 weeks were also significant. Significant changes in certain eating habits were also demonstrated (higher frequency of vegetable, fruit, and breakfast consumption and lower frequency of alcohol, sweet, and fat consumption).

CONCLUSIONS

In addition to the professional skills of a dietitian, a profession-specific app such as Oviva can provide effective support that meets the needs of dietitians and clients on the long path of behavioral change and sustainable weight reduction.

CLINICALTRIAL

ClinicalTrials.gov NCT02694614; https://clinicaltrials.gov/ct2/show/NCT02694614 (Archived by WebCite at http://www.webcitation.org/76gYkGOIc)
The Efficacy of Mobile Phone Apps for Lifestyle Modification in Diabetes: Systematic Review and Meta-Analysis (Preprint)
Authors: Wu Xinghan , Guo Xitong , Zhang Zhiwei
Published: October 2018

BACKGROUND

Diabetes and related complications are estimated to cost US $727 billion worldwide annually. Type 1 diabetes, type 2 diabetes, and gestational diabetes are three subtypes of diabetes that share the same behavioral risk factors. Efforts in lifestyle modification, such as daily physical activity and healthy diets, can reduce the risk of prediabetes, improve the health levels of people with diabetes, and prevent complications. Lifestyle modification is commonly performed in a face-to-face interaction, which can prove costly. Mobile phone apps provide a more accessible platform for lifestyle modification in diabetes.

OBJECTIVE

This review aimed to summarize and synthesize the clinical evidence of the efficacy of mobile phone apps for lifestyle modification in different subtypes of diabetes.

METHODS

In June 2018, we conducted a literature search in 5 databases (Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL, and PsycINFO). We evaluated the studies that passed screening using The Cochrane Collaboration’s risk of bias tool. We conducted a meta-analysis for each subtype on the mean difference (between intervention and control groups) at the posttreatment glycated hemoglobin (HbA1c) level. Where possible, we analyzed subgroups for short-term (3-6 months) and long-term (9-12 months) studies. Heterogeneity was assessed using the I2 statistic.

RESULTS

We identified total of 2669 articles through database searching. After the screening, we included 26 articles (23 studies) in the systematic review, of which 18 studies (5 type 1 diabetes, 11 type 2 diabetes, and 2 prediabetes studies) were eligible for meta-analysis. For type 1 diabetes, the overall effect on HbA1c was statistically insignificant (P=.46) with acceptable heterogeneity (I2=39%) in the short-term subgroup (4 studies) and significant heterogeneity between the short-term and long-term subgroups (I2=64%). Regarding type 2 diabetes, the overall effect on HbA1c was statistically significant (P<.01) in both subgroups, and when the 2 subgroups were combined, there was virtually no heterogeneity within and between the subgroups (I2 range 0%-2%). The effect remained statistically significant (P<.01) after adjusting for publication bias using the trim and fill method. For the prediabetes condition, the overall effect on HbA1c was statistically insignificant (P=.67) with a large heterogeneity (I2=65%) between the 2 studies.

CONCLUSIONS

There is strong evidence for the efficacy of mobile phone apps for lifestyle modification in type 2 diabetes. The evidence is inconclusive for the other diabetes subtypes.
Effects of a Smartphone-Based Approach-Avoidance Intervention on Chocolate Craving and Consumption: Randomized Controlled Trial (Preprint)
Authors: Meule Adrian , Richard Anna , Dinic Radomir , Blechert Jens
Published: October 2018

BACKGROUND

Repeatedly pushing high-calorie food stimuli away based on joystick movements has been found to reduce approach biases toward these stimuli. Some studies also found that such avoidance training reduced consumption of high-calorie foods.

OBJECTIVE

This study aimed to test effects of a smartphone-based approach-avoidance intervention on chocolate craving and consumption, to make such interventions suitable for daily use.

METHODS

Within a 10-day period, regular chocolate eaters (n=105, 86% female) performed five sessions during which they continuously avoided (ie, swiped upward) chocolate stimuli (experimental group, n=35), performed five sessions during which they approached and avoided chocolate stimuli equally often (placebo control group, n=35), or did not perform any training sessions (inactive control group, n=35). Training effects were measured during laboratory sessions before and after the intervention period and further continuously through daily ecological momentary assessment.

RESULTS

Self-reported chocolate craving and consumption as well as body fat mass significantly decreased from pre- to postmeasurement across all groups. Ecological momentary assessment reports evidenced no differences in chocolate craving and consumption between intervention days and rest days as a function of the group.

CONCLUSIONS

A smartphone-based approach-avoidance training did not affect eating-related and anthropometric measures over and above measurement-based changes in this study. Future controlled studies need to examine whether other techniques of modifying food approach tendencies show an add-on benefit over conventional, monitoring-based intervention effects.

CLINICALTRIAL

AsPredicted 8203; https://aspredicted.org/pt9df.pdf.
Word embedding for French natural language in healthcare: a comparative study (Preprint)
Authors: Dynomant Emeric , Lelong Romain , Dahamna Badisse , Massonaud Clément , Kerdelhué Gaétan , Grosjean Julien , Canu Stéphane , Darmoni Stefan J
Published: October 2018

BACKGROUND

Word embedding technologies are now used in a wide range of applications. However, no formal evaluation and comparison have been made on models produced by the three most famous implementations (Word2Vec, GloVe and FastText).

OBJECTIVE

The goal of this study is to compare embedding implementations on a corpus of documents produced in a working context, by health professionals.

METHODS

Models have been trained on documents coming from the Rouen university hospital. This data is not structured and cover a wide range of documents produced in a clinic (discharge summary, prescriptions ...). Four evaluation tasks have been defined (cosine similarity, odd one, mathematical operations and human formal evaluation) and applied on each model.

RESULTS

Word2Vec had the highest score for three of the four tasks (mathematical operations, odd one similarity and human validation), particularly regarding the Skip-Gram architecture.

CONCLUSIONS

Even if this implementation had the best rate, each model has its own qualities and defects, like the training time which is very short for GloVe or morphosyntaxic similarity conservation observed with FastText. Models and test sets produced by this study will be the first publicly available through a graphical interface to help advance French biomedical research.
The use of social media in US healthcare and its facilitators and barriers: Systematic literature review (Preprint)
Authors: Tanna Shaneil , Luengo Cubillo Susana , Bhogal Rosie , Sethi Sonika , Gokani Nishma , Zuberi Sharukh , Grewal Jagvir
Published: October 2018

BACKGROUND

With the advent of internet-based communications, face-to-face interactions are becoming increasingly uncommon and inconvenient, including those between the doctor and the patient. Social media (SM) has been recognized as a tool that could potentially help nourish and expand relationships in healthcare; however, much remains to be explored.

OBJECTIVE

A systematic literature Review (SLR) was conducted to explore the use of SM in the United States (US) healthcare setting, and the characteristics of its use, including barriers and facilitators.

METHODS

A SLR was conducted using three peer-reviewed databases; PubMed, MEDLINE and EMBASE. EBSCOhost database was included to gain a deeper understanding of companies’ use of SM and any lessons that can be learnt and applied to the healthcare setting.

RESULTS

Over the last decade there has been a rapid shift in the US towards the uptake of SM technologies, with many hospitals now using platforms such as Twitter and Facebook for communication, health promotion, education and research. SM can also present a competitive and financial advantage to increase a hospital’s reputation and reduce costs. However, despite its many proven or apparent uses, SM also brings with it many challenges, such as ethical considerations, need for clear guidelines and evaluation, perceptions and attitudes of patients and staff, and the possibility of mismatched offer versus patients’ needs.

CONCLUSIONS

The future of SM lies first of all in developing sound practices, and in its integration into the hospitals’ overall communication strategies, as well as expanding the number of uses and stakeholders involved.
Negative-Pressure Wound Therapy Versus Standard Treatment of Adult Patients With Conflict-Related Extremity Wounds: Protocol for a Randomized Controlled Trial (Preprint)
Authors: Älgå Andreas , Wong Sidney , Haweizy Rawand , Conneryd Lundgren Kalle , von Schreeb Johan , Malmstedt Jonas
Published: October 2018

BACKGROUND

In armed conflict, injuries commonly affect the extremities and contamination with foreign material often increases the risk of infection. The use of negative-pressure wound therapy has been described in the treatment of acute conflict-related wounds, but reports are retrospective and with limited follow-up.

OBJECTIVE

The objective of this study is to investigate the effectiveness and safety of negative-pressure wound therapy use in the treatment of patients with conflict-related extremity wounds.

METHODS

This is a multisite, superiority, pragmatic randomized controlled trial. We are considering for inclusion patients 18 years of age and older who are presenting with a conflict-related extremity wound within 72 hours after injury. Patients are block randomly assigned to either negative-pressure wound therapy or standard treatment in a 1:1 ratio. The primary end point is wound closure by day 5. Secondary end points include length of stay, wound infection, sepsis, wound complications, death, and health-related quality of life. We will explore economic outcomes, including direct health care costs and cost effectiveness, in a substudy. Data are collected at baseline and at each dressing change, and participants are followed for up to 3 months. We will base the primary statistical analysis on intention-to-treat.

RESULTS

The trial is ongoing. Patient enrollment started in June 2015. We expect to publish findings from the trial by the end of 2019.

CONCLUSIONS

To the best of our knowledge, there has been no randomized trial of negative-pressure wound therapy in this context. We expect that our findings will increase the knowledge to establish best-treatment strategies.

CLINICALTRIAL

ClinicalTrials.gov NCT02444598; http://clinicaltrials.gov/ct2/show/NCT02444598 (Archived by WebCite at http://www.webcitation.org/72hjI2XNX)

INTERNATIONAL REGISTERED REPOR

DERR1-10.2196/12334
Flutracking Australia Influenza-like Illness Surveillance System: Evolution of methods from 2006-2016 (Preprint)
Authors: Carlson Sandra Jane , Dalton Craig Brian
Published: October 2018

UNSTRUCTURED

This paper documents the evolution of Flutracking from a pilot online influenza-like illness (ILI) survey of 394 participants in a local health region to a national surveillance system with over 30,000 participants in 2016. In 2018, there were over 40,000 survey responses per week in most weeks. In particular, this paper will describe how the methods have developed to meet the 1) changing aims of the system; 2) developing capabilities of the system; and 3) participant growth. The aim of this paper is to provide insights to other groups initiating participatory public health surveillance systems and to assist users of our data and reports to better understand Flutracking methods.

Some of the key changes to Flutracking from 2006 to 2016 include: allowing participants to respond on behalf of other household members from 2008; adding health seeking behaviour questions in 2011; and offering an express survey and follow-up of unknown test results from 2016 onwards.

The Flutracking system has demonstrated its ability to adapt to changes with minimal disruption to participants, and maintain consistency in data collection and reporting. As an example of success, Flutracking has been integrated in the Australian Government Department of Health’s regular influenza reports, and is now contributing weekly data to the transmissibility and impact measures for the Australian Government Department of Health’s application of the Pandemic Influenza Severity Assessment system.

Flutracking data have consistently aligned with the timing of the peak level of influenza activity from other Australian influenza surveillance systems. Flutracking provided a unique insight into 2009 H1N1 influenza pandemic in 2009 demonstrating that the community level ILI attack rates were only slightly higher than 2008, and lower than 2007 in the community. Flutracking has demonstrated to be significantly less biased by treatment seeking behaviour and laboratory testing protocols than other surveillance systems during the 2009 influenza pandemic. In 2018, Flutracking expanded to New Zealand, with an average of over 2,800 surveys per week so far. The evolution of Flutracking’s methods has been pivotal to the success of this surveillance system.
Understanding Determinants of Health Care Professionals’ Perspectives on Mobile Health Continuance and Performance (Preprint)
Authors: Hsiao Ju-Ling , Chen Rai-Fu
Published: October 2018

BACKGROUND

With the widespread use of mobile technologies, mobile information systems have become crucial tools in health care operations. Although the appropriate use of mobile health (mHealth) may result in major advances in expanding health care coverage (increasing decision-making speeds, managing chronic conditions, and providing suitable health care in emergencies), previous studies have argued that current mHealth research does not adequately evaluate mHealth interventions, and it does not provide sufficient evidence regarding the effects on health.

OBJECTIVE

The aim of this study was to facilitate the widespread use of mHealth systems; an accurate evaluation of the systems from the users’ perspective is essential after the implementation and use of the system in daily health care practices. This study extends the expectation-confirmation model by using characteristics of individuals, technology, and tasks to identify critical factors affecting mHealth continuance and performance from the perspective of health care professionals (HCPs).

METHODS

A questionnaire survey was used to collect data from HCPs who were experienced in using mHealth systems of a Taiwanese teaching hospital. In total, 282 questionnaires were distributed, and 201 complete and valid questionnaires were returned, thus indicating a valid response rate of 71.3% (201/282). The collected data were analyzed using WarpPLS version 5.0 (ScriptWarp Systems).

RESULTS

The results revealed that mHealth continuance (R2=0.522) was mainly affected by perceived usefulness, technology maturity, individual habits, task mobility, and user satisfaction, whereas individual performance (R2=0.492) was affected by mHealth continuance. In addition, user satisfaction (R2=0.548) was affected by confirmation and perceived usefulness of mHealth, whereas perceived usefulness (R2=0.521) was affected by confirmation. This implied that confirmation played a key role in affecting perceived usefulness and user satisfaction. Furthermore, the results showed that mHealth continuance positively affected individual performance.

CONCLUSIONS

The identified critical factors influencing mHealth continuance and performance can be used as a useful assessment tool by hospitals that have implemented mHealth systems to facilitate the use and infusion of the systems. Furthermore, the results can help health care institutions that intend to introduce or develop mHealth applications to identify critical issues and effectively allocate limited resources to mHealth systems.