bluuebunny/crossref_metadata_2025 huggingface dataset:
Observando la mentalización en psicoterapias con adolescentes: Diseño de un sistema de observación de la interacción terapéutica
Authors: Moran Kneer Javier , Martínez Guzmán Claudio , Díaz Salinas María Francisca , Gonzalez Chamorro Silvia , Arce Beas Karla , Duarte Javiera
Published: March 2021

Objetivo: Basado en la falta de medidas que permitan evaluar la mentalización como variable de proceso en psicoterapias con adolescentes, el siguiente estudio apunta a presentar el diseño de un sistema observacional para evaluar el despliegue de esta variable tanto en pacientes como en terapeutas. Método: mediante el proceso de codificación abierta de la teoría fundamentada y análisis temático de tres niveles, se analizó el despliegue de la mentalización tanto en terapeutas como en pacientes en 10 episodios de ruptura y 10 episodios de resolución elegidos aleatoriamente de cinco psicoterapias con adolescentes. Resultados: A partir del análisis efectuado se desarrolló un sistema observacional de seis dimensiones emergentes (foco en los estados mentales, opacidad de los estados mentales, comunicación contingente, causalidad de los estados mentales, naturaleza dinámica de los estados mentales y foco en el momento presente) denominado “Sistema de Observación de la mentalización en Psicoterapia con adolescentes” (OMP-A) que permite evaluar cuantitativamente la mentalización de terapeutas y pacientes. Discusión y conclusiones: el OMP-A es un instrumento que responde a debilidades de otros sistemas para evaluar mentalización en psicoterapia con adolescentes, permitiendo la observación de aspectos lingüísticos y paralingüísticos del mentalizar y toma en consideración aspectos particulares que caracterizan las intervenciones con adolescentes. Se discute su posible uso para la formación y supervisión en psicoterapia, y los desafíos metodológicos para desarrollos futuros.
Relación de supervisión: adaptación del S-SRQ en psicoterapeutas argentinos
Authors: Santangelo Pablo Rafael , Conde Karina
Published: March 2021

Introducción: En los últimos años se ha reconocido la importancia de evaluar la supervisión clínica y su rol en el proceso psicoterapéutico. No obstante, son escasos los instrumentos que cumplen con este propósito, particularmente en Latinoamérica. En este estudio, se buscó adaptar al castellano la versión breve del Cuestionario de relación de supervisión (S-SRQ, por sus siglas en inglés de: Short Supervisory Relationship Questionnaire), compuesto de tres dimensiones: base segura, educación reflexiva y estructura; y aportar evidencias sobre su desempeño psicométrico. Método: El S-SRQ fue traducido y retraducido a su idioma original. Posteriormente, fue administrado a 374 psicoterapeutas argentinos (muestra no probabilística). Se realizaron análisis de consistencia interna (alfa de Cronbach), dimensionales (análisis paralelo y factorial confirmatorio), y a nivel del ítem (coeficientes estandarizados y correlación ítem-escala). Resultados: Los coeficientes de consistencia interna fueron adecuados para la escala total y, en general, para cada dimensión. Los análisis dimensionales se ajustaron a un modelo de tres dimensiones, base segura, educación reflexiva y estructura. El desempeño de los ítems fue bueno con relación a la escala total y cada dimensión. Discusión: El desempeño psicométrico del S-SRQ en castellano fue similar al de la escala original, con algunas diferencias. La escala presenta potencial para ser aplicada en el contexto argentino, tanto en el ámbito científico como en la práctica.
Comprensión del cambio psicoterapéutico en adolescentes: voces de pacientes y terapeutas
Authors: Fernandez Olga María , Fernández Sanz Sofía Alejandra , Krause Mariane
Published: March 2021

Este estudio tuvo como objetivo comprender el proceso de cambio psicoterapéutico desde las perspectivas subjetivas de adolescentes y terapeutas que participaron en una terapia. Método: se utilizó un enfoque cualitativo; la recolección de información se realizó a través de entrevistas semiestructuradas audiograbadas, luego de finalizar la terapia. Participaron 17 díadas terapéuticas (adolescentes: edad promedio 15,8 años; 64,7% género femenino; terapeutas: edad promedio 30,3 años; 55,5 % género femenino), que realizaron sus terapias en contextos naturales y con diferentes enfoques teóricos. Codificadores entrenados analizaron los datos a través de los procedimientos propuestos por la Teoría Fundamentada, codificación abierta y axial, y procesos de reorganizaciones y triangulaciones permanentes. Resultados: se identificaron dos fenómenos comprensivos relacionados con los procesos de cambio psicoterapéutico: (a) El encuentro con “otro” como plataforma segura y sustrato relacional generador del cambio y, (b) El cambio como empoderamiento y desarrollo. Discusión: se examina el rol central que ocupan la relación terapéutica y el logro de las tareas del desarrollo (identidad, autonomía y autodeterminación) en el cambio psicoterapéutico. Además, se reflexiona acerca de las habilidades y acciones de los terapeutas.
Voices of Gender Discrimination: A Feministic Analysis of Khaled Hosseini's a Thousand splendid suns
Authors: C Ms.Neenu , Jaisankar Dr. D.
Published: March 2021

THE RESEARCH FEATURED BY A BRIEF STUDY OF THE AUTHOR AND HIS NOVEL A THOUSAND SPLENDID SUNS TO UNDERSTAND THE NOVEL. IT IS OUR HOPE THAT THE RESEARCH HERE WILL ELEVATE THE READER TO ENRICH THEIR QUEST FOR CRITICAL APPRECIATION. THE PERSISTENT CONDITIONS OF CONFLICT AND VIOLENCE IN AFGHANISTAN, CONTINUING FOR ALMOST FIFTY YEARS NOW, HAS CAUSED HUGE DESTRUCTION IN TERMS OF HUMAN AND MATERIAL LOSSES. IT HAS ALSO LED TO A RADICAL TRANSFORMATION IN ITS SOCIO-CULTURAL FABRIC ALMOST IRREVERSIBLY. BECAUSE OF THEIR VULNERABLE POSITION IN ITS SOCIETY, THE AFGHAN WOMEN HAVE ENDURED A TOUGH EXISTENCE AS THEY CAME TO GRIPS WITH A DOUBLE SUBJUGATION IN THE FORM OF PATRIARCHAL AUTHORITY AND THE OPPRESSION EMANATING FROM THE PERSISTENT CONDITIONS OF THE CONFLICT. HOWEVER, THERE IS OFTEN A TENDENCY TO CAST AFGHANISTAN AND ITS PEOPLE IN ESSENTIALIST TERMS BOTH IN ACADEMIC AND NON-ACADEMIC ENDEAVOURS. BY CONTEXTUALISING THE AFGHAN WOMEN’S EXPERIENCE IN A SPECIFIC SET OF HISTORICAL, POLITICAL AND SOCIAL FACTORS, THIS WOULD HOPEFULLY OFFER AN ALTERNATIVE VIEW OF THE CONDITION OF AFGHAN WOMEN RATHER THAN THE USUAL STEREOTYPED DESCRIPTIONS. I CONCLUDE THAT THE RESEARCH MAY BE IMPERFECT AS IT IS NOT ABLE TO SATISFY EVERY READERS AND THEIR TASTE.
Inhibiting the “Undruggable” RAS/Farnesyltransferase (FTase) Cancer
Target by Manumycin-related Natural Products
Authors: Silva Leandro Rocha , da Silva-Júnior Edeildo Ferreira
Published: March 2021

:

Cancer is an uncontrolled cell growth that can generate diverse types of cancer, in which these will also present a different behavior in the face of pharmacological treatment. These cancers’ types are found in one of the three categories, leukemias (also named lymphomas), carcinomas, and sarcomas. In general, cancer's pathogenesis is associated with three genetic mutations, where could emerge from oncogenes, tumor suppressor genes, and/or genes responsible for regulating DNA replication. The term “undruggable” is frequently related to the difficulty to design drugs to specific targets, such as MYC, MYB, NF-κB, and RAS family of proteins. This last comprises more than 140 proteins, and these are responsible for 30% of mutations in human cancers. Also, there are three ras genes transcribed in human cells, called H-, K-, and N-ras oncogenes. Still, the RAS proteins (farnesyltransferase (FTase) and geranylgeranyltransferase (GGTase) enzymes) perform essential steps in post-translational modification of eukaryotes cells, such as (1) the farnesylation of the cysteine residue at the C-terminal tetrapeptide CAAX; (2) proteolytic cleavage of the three C-terminal AAX oligopeptide; and (3) carboxymethylation of the new C-terminal prenylated cysteine. Thus, the inhibition of this undruggable RAS family of proteins has been considered a promising alternative to design new anticancer agents since they are responsible for many types of human cancers. Then, the manumycin A (obtained from the Streptomyces parvulus Tü64) and its analogs (epoxyquinol core with or without their southern and eastern side chains; and dihydroxycyclohexenones core) have been described as promising FTase inhibitors, which have demonstrated their benefits against several types of cancer. In this review, a complete introduction about cancer and its relation with RAS proteins is provided, as well as, the prenylation mechanism of the cysteine residue is discussed in detail. Posteriorly, studies involving manumycin-related compounds are described, showing some synthetic routes for obtaining them and utilizing these natural products in monotherapies or combined therapies with other anticancer drugs.
Therapeutic Journey of Andrographis paniculata (Burm.f.) Nees from Natural to Synthetic and Nanoformulations
Authors: Mehta Sharuti , Sharma Anil Kumar , Singh Rajesh K.
Published: March 2021

:

Andrographis paniculata (Burm.f.) Nees (Acanthaceae) is a herbaceous plant and commonly called 'King of Bitters'. It has gained attraction as a potential hepatoprotective agent and a natural molecule with various biological activities viz. anticancer, immunomodulatory, anti-inflammatory, antibacterial, neuroprotective, and so on. The andrographolide is one of the main diterpenoids responsible for the drug's bitter taste and various therapeutic activities. The poor cellular permeability, solubility and short biological half-life of its pure components limit its distribution to the target tissue. To conquer this obstacle, various researchers worldwide have been working on designing the synthetic derivatives of its active components and nanoformulations to improve the drug's efficiency and selectivity to develop more active leads for biomedical applications. This article discussed the recent research on synthetic derivatives, including their possible therapeutic applications and structure-activity relationship (SAR). Additionally, this article also presents the essential information concerning the various nanoformulations developed to increase the delivery of pure compound/plant extract to the target site, thereby improving the drug's efficacy for multiple ailments.
Pharmacologic Activities of 5, 6-Diaryl/heteroaryl-3-substituted-1, 2, 4-
triazines as a Privileged Scaffold in Drug Development
Authors: Khatir Zahra Zakeri , Irannejad Hamid
Published: March 2021

:

1, 2, 4-Triazine derivatives have received much attention due to their multifunctional nature,
especially in diverse pharmacological properties as well as a key fragment in many drug candidates.
Introduction of a vicinal 5, 6-diaryl/heteroaryl moiety on the 1, 2, 4-triazine ring has attracted
plentiful attention in the field of medicinal chemistry. 5, 6-Diaryl/heteroaryl-3-substituted-1, 2, 4-
triazine is a prominent scaffold in many drug candidates, which has shown a wide range of pharmacological
activities such as anti-diabetic, antifungal, anti-inflammatory, anticancer, anti-HIV, neuroprotective,
anticonvulsant, anti-Alzheimer, anti-Parkinson, and antioxidant. In this review, we have discussed
synthesis, various pharmacological activities of 5, 6-diaryl/heteroaryl-3-substituted-1, 2, 4-
triazines, their structure-activity relationship (SAR), pharmacophoric elements, and their mechanism
of action reported in the published articles during 2000-2019. Evaluation of compounds by PAINS
filtering tool was accomplished and showed that this versatile structure could be considered as a privileged
structure. Compilation of the biological data confirmed that position 3 of the 1,2,4-triazine is a
key location to determine the affinity and selectivity of the 5,6-diaryl/heteroaryl-3-substituted-1, 2, 4-
triazines towards different biologic targets. Specific geometrical and thermodynamic characters of this
motif have prompted it as a frequent hitter.
In Silico Investigations on the Probable Macromolecular Drug Targets Involved in the Anti-Schizophrenia Activity of Terminalia bellerica
Authors: Fei Lim Chiew , Gaurav Anand , Al-Nema Mayasah
Published: March 2021

Background:

Schizophrenia is a severe mental disorder that affects around 1% of the population worldwide. The available antipsychotics alleviate the positive symptoms of the illness. However, their effect on the negative and cognitive symptoms is limited. The fruit powder of Terminalia bellerica has been found to possess antipsychotic activity, which might be useful in treating the symptoms of schizophrenia.

Objective:

The present study was performed to evaluate the affinity of the active constituents of Terminalia bellerica towards macromolecular drug targets involved in the pathophysiology of schizophrenia and, thereby, determine the structural features of the ligands involved in the interactions with the proposed targets.

Methods:

A molecular docking study was carried out on ten active constituents of Terminalia bellerica with four-drug targets involved in the aetiology of schizophrenia. These targets are dopamine, N-methyl- D-aspartate, Gamma-aminobutyric acid, and phosphodiesterase 10A receptors. The binding interactions between the target proteins and the ligands with the highest affinities were studied thoroughly.

Results:

β-sitosterol, ellagic acid, and quercetin displayed high binding affinity toward all the macromolecular drug targets. β -sitosterol possesses a high binding affinity for the dopamine receptor, while quercetin has high binding affinities for both dopamine and N-methyl-D-aspartate receptor. On the other hand, ellagic acid formed stronger binding interactions with Gamma-aminobutyric acid and phosphodiesterase 10A.

Conclusion:

Terminalia bellerica can serve as a new anti-psychotic drug from natural sources with more promising development.
Long-Term Outcomes of Neoadjuvant Chemotherapy in Locally Advanced Gastric
Cancer/Esophagogastric Junction Cancer: A Systematic Review and Meta-Analysis
Authors: Chen Ping , Wu Feng , Hong Jiaze , Du Nannan , Wang Yiran , Chen Juan , He Yuanfang
Published: March 2021

Background:

Neoadjuvant chemotherapy (NAC) has been defined as any preoperative chemotherapy
scheme aiming to reduce tumor staging and to control preoperative micrometastasis, which has been extensively
used as a treatment for resectable gastric cancer. However, its effect on the long-term survival of patients with
locally advanced gastric cancer (AGC) or esophagogastric junction cancer (EGC) remains unknown.

Objective:

This study aimed at investigating the long-term efficacy of NAC in locally AGC/EGC.

Methods:

The following databases were searched for articles published from their inception to April 2020:
PubMed, Web of Science, EBSCO, and Cochrane library. The primary outcomes were overall survival (OS) and
progression-free survival (PFS).

Results:

A total of 19 articles were included in this meta-analysis, with a total of 4,446 patients. The results
showed that NAC increased the patients’ 3-year OS (HR: 0.56, 95% CI, 0.21 - 0.91, p < 0.001), 3-year PFS (HR:
0.76, 95% CI, 0.66 - 0.87, p < 0.001), 5-year OS (HR: 0.71, 95% CI, 0.64 - 0.78, p < 0.001), and 5-year PFS
(HR: 0.70, 95% CI, 0.61 - 0.79, p < 0.001). Besides, subgroup analysis showed that Asian countries have
benefited significantly from NAC (HR: 0.65, 95% CI, 0.55 - 0.74, p < 0.001), and other countries have also
benefited (HR: 0.79, 95% CI, 0.68 - 0.89, p < 0.001).

Conclusions:

Compared with adjuvant chemotherapy and surgery alone, NAC can improve the long-term survival
outcomes (OS and PFS) of patients with resectable AGC or EGC.
Anti-Proliferative and Anti-Telomerase Effects of Blackberry Juice and Berry-
Derived Polyphenols on HepG2 Liver Cancer Cells and Normal Human Blood
Mononuclear Cells
Authors: Moghadam Delaram , Zarei Reza , Tatar Mohsen , Khoshdel Zahra , Mashayekhi Farideh Jalali , Naghibalhossaini Fakhraddin
Published: March 2021

Background:

Previous studies have provided strong evidence for the anticancer activity of berry
fruits.

Objective:

In this study, we investigated the effects of blackberry juice and three berry- polyphenolic compounds
on cell proliferation and telomerase activity in human hepatoma HepG2 and normal peripheral blood
mononuclear cells (PBMCs).

Methods:

The cell viability and telomerase activity were measured by MTT and TRAP assay, respectively. Berry
effects on the expression of genes were determined by quantitative RT-PCR assay.

Results:

Blackberry, gallic acid, and resveratrol inhibited proliferation of both HepG2 and PBMC cells in a dosedependent
manner. Resveratrol was more effective than gallic acid for reducing the viability of HepG2 cells, but
both showed the same level of growth inhibition in PBMC cells. Berry, resveratrol, and gallic acid significantly
inhibited telomerase activity in HepG2 cells. The antiproliferative effect of berry was associated with apoptotic
DNA fragmentation. Gallic acid was more effective for reducing telomerase activity than resveratrol, but
anthocyanin moderately increased telomerase activity in cancer cells. Telomerase activity was induced by all
three polyphenols in PBMCs. Overall, Krumanin chloride was more effective to induce telomerase than gallic
acid and resveratrol in PBMC cells. There was no significant difference in hTERT, hTR, and Dnmts expressions
between berry treated and the control untreated HepG2 cells. But, a significant downregulation of HDAC1 and
HDAC2 and upregulation of SIRT1 were observed in berry-treated cells.

Conclusion :

These data indicate that the berry anticancer effect is associated with antitelomerase activity and
changes in HDACs expression. The data also suggest that berry antitelomerase activity is mainly related to its
gallic acid and resveratrol, but not anthocyanin content.
A Review on Repurposed Drugs and Vaccine Trials for Combating SARS CoV-2
Authors: Khanna Nikita , Pawar Sandip V. , Kumar Anil
Published: March 2021

Background:

The novel coronavirus disease 2019 (COVID-19), emerged in Wuhan,
China in December 2019 and then spread worldwide rapidly. The records from World Health Organisation
(WHO), Centres of Disease Control and Prevention (CDC) and Food and Drug Administration
(FDA) backup the fact that no medications have proven to be completely effective for prevention
or treatment of SARS-CoV-2. The clinical trials are underway for many repurposed, investigational
drugs and vaccine candidates. BioNTech and Pfizer Inc, Moderna, Gamaleya institute
and University of Oxford (collaboration with AstraZeneca) announced positive results in the Phase
3 interim analyses of vaccine trials in November 2020. Twelve countries have approved Pfizer-
BioNTech COVID-19 vaccine for emergency use, as of December 2020.

Objectives:

The objective was to summarize the repurposed/investigational drugs, their mechanism
of action, and rationale for their use in COVID-19 treatment. The article also aimed to summarize
the vaccine trials that are currently undergoing across the globe.

Methods:

In order to find the content for review, studies defining COVID-19 chronology, repurposed
drugs along with their mode of action and potential vaccine trials were studied and summarized.

Results and Conclusion:

The article summarizes potential therapeutic candidates (repurposed and
investigational agents) for SARS-CoV-2, their possible mechanism of action and discussion related
to their involvement in recent clinical trials. Innovative vaccine platform technologies are also highlighted
that are recently being used in the vaccine production pipeline.
Forced and Child Marriage at the Intersection of Health, Gender and Human Rights: Understanding the Determinants in Morocco and the Impact of the Migratory Context in Belgium
Authors: Sabbe Alexia
Published: March 2021

With over 650 million women alive today already suffering the consequences of child marriage, the practice of forced and child marriage disproportionally affects girls and women. Given its impact on physical and psychological wellbeing, it is a serious form of violence against women.

In view of the global magnitude of forced and child marriage, and the increasing numbers of international migrants, the general objective of this research is to ascertain the determinants of forced and child marriage in Morocco and the impact of the migratory context on the issue among Moroccan migrants in Belgium.

Our research analysed forced and child marriage in both settings from two angles. First, we studied policies and the socio-cultural context in a top-down perspective through the analysis of legislation, public debates and through expert/stakeholder interviews. Secondly, we investigated the determinants of forced and child marriage in both research settings from a bottom-up perspective through Focus Group Discussions and household interviews, as well as investigating the impact of legislative conditions and restrictions on migrants and their families.

KEY WORDS: CHILD AND FORCED MARRIAGE, WOMEN’S RIGHTS, SEXUAL AND REPRODUCTIVE HEALTH, VIOLENCE, MOROCCO, MIGRATION, BELGIUM
Etiology of end-stage renal disease amongst hemodialysis patients in Makkah city, Saudi Arabia
Authors:   Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia, et al. Qadhi
Published: March 2021

In recent years, the number of hemodialysis (HD) patients has increased in the Kingdom of Saudi Arabia. End-stage renal disease (ESRD) is associated with increased rates of hospital admission, morbidity, and mortality. Globally, the most common causes of ESRD are diabetic nephropathy, hypertension, glomerulonephritis, infections, and chronic obstruction. However, very limited data have been presented regarding the etiology of ESRD in Saudi Arabia, especially in Makkah City. Therefore, this cross-sectional study is designed to determine the underlying etiologies of ESRD in hemodialysis patients. The study was conducted among 306 patients who were recruited from Makkah hospitals and HD centers. The obtained data showed that diabetes was the most common cause of ESRD (34.3%), followed by hypertension (20.9%), drug misuse (12.1%), hereditary conditions (10.1%), urinary tract obstruction, and urinary retention (9.8%), unknown reason (8.2%), and chronic inflammation of the kidneys (3.3%). In conclusion, this study highlights the most important factors contributing to ESRD in the Makkah region. Thus, national campaigns should be performed to increase awareness about these factors and to possibly reduce the incidence of the disease.
Web-Based Smartphone Algorithm for Calculating Blood Pressure From Photoplethysmography Remotely in a General Adult Population: Validation Study
Authors: Holyoke Paul , Yogaratnam Karthika , Kalles Elizabeth
Published: March 2021

Background

Outside of a clinical setting, oscillometric devices make remote monitoring of blood pressure and virtual care more convenient and feasible. HeartBeat Technologies Ltd developed a novel approach to measuring blood pressure remotely after an initial blood pressure reading by a nurse using the conventional measurement method. Using a finger pulse oximeter, a photoplethysmogram wave is transmitted by Bluetooth to a smartphone or tablet. A smartphone app (MediBeat) transmits the photoplethysmogram to a server for analysis by a proprietary algorithm—the person’s current blood pressure is sent back to the smartphone and to the individual’s health care provider.

Objective

This study sought to determine whether the HeartBeat algorithm calculates blood pressure as accurately as required by the European Society of Hypertension International Protocol revision 2010 (ESH-IP2) for validation of blood pressure measuring devices.

Methods

ESH-IP2 requirements, modified to conform to a more recent international consensus statement, were followed. The ESH-IP2 establishes strict guidelines for the conduct and reporting of any validation of any device to measure blood pressure, including using the standard manual blood pressure instrument as a comparator and specific required accuracy levels for low, medium, and high ranges of blood pressure readings. The consensus statement requires a greater number of study participants for each of the blood pressure ranges. The validation of the accuracy of the algorithm was conducted with a Contec CMS50EW pulse oximeter and a Samsung Galaxy XCover 4 smartphone.

Results

The differences between the HeartBeat-calculated and the manually measured blood pressures of 62 study participants did not meet the ESH-IP2 standards for accuracy for either systolic or diastolic blood pressure measurements. There was no discernible pattern in the inaccuracies of the HeartBeat-calculated measurements.

Conclusions

The October 4, 2019 version of the HeartBeat algorithm, implemented in combination with the MediBeat app, a pulse oximeter, and an Android smartphone, was not sufficiently accurate for use in a general adult population.

Trial Registration

ClinicalTrials.gov NCT04082819; http://clinicaltrials.gov/ct2/show/NCT04082819
Parents’ Perspectives on Using Artificial Intelligence to Reduce Technology Interference During Early Childhood: Cross-sectional Online Survey
Authors: Glassman Jill , Humphreys Kathryn , Yeung Serena , Smith Michelle , Jauregui Adam , Milstein Arnold , Sanders Lee
Published: March 2021

Background

Parents’ use of mobile technologies may interfere with important parent-child interactions that are critical to healthy child development. This phenomenon is known as technoference. However, little is known about the population-wide awareness of this problem and the acceptability of artificial intelligence (AI)–based tools that help with mitigating technoference.

Objective

This study aims to assess parents’ awareness of technoference and its harms, the acceptability of AI tools for mitigating technoference, and how each of these constructs vary across sociodemographic factors.

Methods

We administered a web-based survey to a nationally representative sample of parents of children aged ≤5 years. Parents’ perceptions that their own technology use had risen to potentially problematic levels in general, their perceptions of their own parenting technoference, and the degree to which they found AI tools for mitigating technoference acceptable were assessed by using adaptations of previously validated scales. Multiple regression and mediation analyses were used to assess the relationships between these scales and each of the 6 sociodemographic factors (parent age, sex, language, ethnicity, educational attainment, and family income).

Results

Of the 305 respondents, 280 provided data that met the established standards for analysis. Parents reported that a mean of 3.03 devices (SD 2.07) interfered daily in their interactions with their child. Almost two-thirds of the parents agreed with the statements “I am worried about the impact of my mobile electronic device use on my child” and “Using a computer-assisted coach while caring for my child would help me notice more quickly when my device use is interfering with my caregiving” (187/281, 66.5% and 184/282, 65.1%, respectively). Younger age, Hispanic ethnicity, and Spanish language spoken at home were associated with increased technoference awareness. Compared to parents’ perceived technoference and sociodemographic factors, parents’ perceptions of their own problematic technology use was the factor that was most associated with the acceptance of AI tools.

Conclusions

Parents reported high levels of mobile device use and technoference around their youngest children. Most parents across a wide sociodemographic spectrum, especially younger parents, found the use of AI tools to help mitigate technoference during parent-child daily interaction acceptable and useful.
Concerns Discussed on Chinese and French Social Media During the COVID-19 Lockdown: Comparative Infodemiology Study Based on Topic Modeling
Authors: Schück Stéphane , Foulquié Pierre , Mebarki Adel , Faviez Carole , Khadhar Mickaïl , Texier Nathalie , Katsahian Sandrine , Burgun Anita , Chen Xiaoyi
Published: March 2021

Background

During the COVID-19 pandemic, numerous countries, including China and France, have implemented lockdown measures that have been effective in controlling the epidemic. However, little is known about the impact of these measures on the population as expressed on social media from different cultural contexts.

Objective

This study aims to assess and compare the evolution of the topics discussed on Chinese and French social media during the COVID-19 lockdown.

Methods

We extracted posts containing COVID-19–related or lockdown-related keywords in the most commonly used microblogging social media platforms (ie, Weibo in China and Twitter in France) from 1 week before lockdown to the lifting of the lockdown. A topic model was applied independently for three periods (prelockdown, early lockdown, and mid to late lockdown) to assess the evolution of the topics discussed on Chinese and French social media.

Results

A total of 6395; 23,422; and 141,643 Chinese Weibo messages, and 34,327; 119,919; and 282,965 French tweets were extracted in the prelockdown, early lockdown, and mid to late lockdown periods, respectively, in China and France. Four categories of topics were discussed in a continuously evolving way in all three periods: epidemic news and everyday life, scientific information, public measures, and solidarity and encouragement. The most represented category over all periods in both countries was epidemic news and everyday life. Scientific information was far more discussed on Weibo than in French tweets. Misinformation circulated through social media in both countries; however, it was more concerned with the virus and epidemic in China, whereas it was more concerned with the lockdown measures in France. Regarding public measures, more criticisms were identified in French tweets than on Weibo. Advantages and data privacy concerns regarding tracing apps were also addressed in French tweets. All these differences were explained by the different uses of social media, the different timelines of the epidemic, and the different cultural contexts in these two countries.

Conclusions

This study is the first to compare the social media content in eastern and western countries during the unprecedented COVID-19 lockdown. Using general COVID-19–related social media data, our results describe common and different public reactions, behaviors, and concerns in China and France, even covering the topics identified in prior studies focusing on specific interests. We believe our study can help characterize country-specific public needs and appropriately address them during an outbreak.
Attitudes of Health Care Professionals Toward Older Adults’ Abilities to Use Digital Technology: Questionnaire Study
Authors: Mannheim Ittay , Wouters Eveline J M , van Boekel Leonieke C , van Zaalen Yvonne
Published: March 2021

Background

Digital technologies (DTs) for older adults focus mainly on health care and are considered to have the potential to improve the well-being of older adults. However, adoption rates of these DTs are considered low. Although previous research has investigated possible reasons for adoption and acceptance of DT, age-based stereotypes (eg, those held by health care professionals) toward the abilities of older adults to use DTs have yet to be considered as possible barriers to adoption.

Objective

The aim of this study was to investigate the influencing role of ageism in the context of health care professionals attitudes toward older adults’ abilities to use health care DT. A further goal was to examine if social comparison and stereotype activation affect and moderate this association.

Methods

A new measurement to assess health care professionals’ attitudes toward older adults using technology (ATOAUT-10) was developed and used in 2 studies. Study 1 involved the development of the ATOAUT-10 scale using a principal component analysis and further examined health care professionals’ attitudes toward the use of health care DTs and correlations with ageism. Study 2 further explored the correlation between ageism and ATOAUT in an experimental design with health care professionals.

Results

In study 1, physiotherapists (N=97) rated older adults as young as 50 years as less able to use health care DT compared to younger adults (P<.001). A multiple regression analysis revealed that higher levels of ageism, beyond other predictors, were predictive of more negative ATOAUT, (β=.36; t=3.73; P<.001). In study 2, the salience of age was manipulated. Health care professionals (N=93) were randomly assigned to rate the abilities of a young or old person to use health care DT. Old age salience moderated the correlation between ageism and ATOAUT (R2=0.19; F6,85=3.35; P=.005), such that higher levels of ageism correlated with more negative ATOAUT in the old age salient condition, but not the young condition. Stereotype activation accounted for health care professionals’ attitudes more than did the experience of working with older patients or the professionals’ age.

Conclusions

Negative and ageist attitudes of health care professionals can potentially affect how older adults are viewed in relation to DT and consequently might influence actual use and adoption of technology-based treatment. Future studies should broaden the validation of the ATOAUT-10 scale on more diverse samples and focus on the discriminatory aspect of ageism and self-ageism of older adults. This study calls for a focus on ageism as a determinant of adoption of DT.
Usage Patterns of Web-Based Stroke Calculators in Clinical Decision Support: Retrospective Analysis (Preprint)
Authors: Kummer Benjamin , Shakir Lubaina , Kwon Rachel , Habboushe Joseph , Jetté Nathalie
Published: March 2021

BACKGROUND

Clinical scores are frequently used in the diagnosis and management of stroke. While medical calculators are increasingly important support tools for clinical decisions, the uptake and use of common medical calculators for stroke remain poorly characterized.

OBJECTIVE

We aimed to describe use patterns in frequently used stroke-related medical calculators for clinical decisions from a web-based support system.

METHODS

We conducted a retrospective study of calculators from MDCalc, a web-based and mobile app–based medical calculator platform based in the United States. We analyzed metadata tags from MDCalc’s calculator use data to identify all calculators related to stroke. Using relative page views as a measure of calculator use, we determined the 5 most frequently used stroke-related calculators between January 2016 and December 2018. For all 5 calculators, we determined cumulative and quarterly use, mode of access (eg, app or web browser), and both US and international distributions of use. We compared cumulative use in the 2016-2018 period with use from January 2011 to December 2015.

RESULTS

Over the study period, we identified 454 MDCalc calculators, of which 48 (10.6%) were related to stroke. Of these, the 5 most frequently used calculators were the CHA2DS2-VASc score for atrial fibrillation stroke risk calculator (5.5% of total and 32% of stroke-related page views), the Mean Arterial Pressure calculator (2.4% of total and 14.0% of stroke-related page views), the HAS-BLED score for major bleeding risk (1.9% of total and 11.4% of stroke-related page views), the National Institutes of Health Stroke Scale (NIHSS) score calculator (1.7% of total and 10.1% of stroke-related page views), and the CHADS2 score for atrial fibrillation stroke risk calculator (1.4% of total and 8.1% of stroke-related page views). Web browser was the most common mode of access, accounting for 82.7%-91.2% of individual stroke calculator page views. Access originated most frequently from the most populated regions within the United States. Internationally, use originated mostly from English-language countries. The NIHSS score calculator demonstrated the greatest increase in page views (238.1% increase) between the first and last quarters of the study period.

CONCLUSIONS

The most frequently used stroke calculators were the CHA2DS2-VASc, Mean Arterial Pressure, HAS-BLED, NIHSS, and CHADS2. These were mainly accessed by web browser, from English-speaking countries, and from highly populated areas. Further studies should investigate barriers to stroke calculator adoption and the effect of calculator use on the application of best practices in cerebrovascular disease.
Evaluating the Impact of a Digital Nutrition Platform on Cholesterol Levels in Users With Dyslipidemia: Longitudinal Study (Preprint)
Authors: Hu Emily A , Scharen Jared , Nguyen Viet , Langheier Jason
Published: March 2021

BACKGROUND

A strong association exists between consuming a healthy diet and lowering cholesterol levels among individuals with high cholesterol. However, implementing and sustaining a healthy diet in the real world is a major challenge. Digital technologies are at the forefront of changing dietary behavior on a massive scale, as they can reach broad populations. There is a lack of evidence that has examined the benefit of a digital nutrition intervention, especially one that incorporates nutrition education, meal planning, and food ordering, on cholesterol levels among individuals with dyslipidemia.

OBJECTIVE

The aim of this observational longitudinal study was to examine the characteristics of people with dyslipidemia, determine how their status changed over time, and evaluate the changes in total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), non-HDL-C, and triglycerides among individuals with elevated lipids who used Foodsmart, a digital nutrition platform that integrates education, meal planning, and food ordering.

METHODS

We included 653 adults who used Foodsmart between January 2015 and February 2021, and reported a lipid marker twice. Participants self-reported age, gender, weight, and usual dietary intake in a 53-item food frequency questionnaire, and lipid values could be provided at any time. Dyslipidemia was defined as total cholesterol ≥200 mg/dL, HDL-C ≤40 mg/dL, LDL-C ≥130 mg/dL, or triglycerides ≥150 mg/dL. We retrospectively analyzed distributions of user characteristics and their associations with the likelihood of returning to normal lipid levels. We calculated the mean changes and percent changes in lipid markers among users with elevated lipids.

RESULTS

In our total sample, 54.1% (353/653) of participants had dyslipidemia at baseline. Participants with dyslipidemia at baseline were more likely to be older, be male, and have a higher weight and BMI compared with participants who had normal lipid levels. We found that 36.3% (128/353) of participants who had dyslipidemia at baseline improved their lipid levels to normal by the end of follow-up. Using multivariate logistic regression, we found that baseline obesity (odds ratio [OR] 2.57, 95% CI 1.25-5.29; P=.01) and Nutriscore (OR 1.04, 95% CI 1.00-1.09; P=.04) were directly associated with achieving normal lipid levels. Participants with elevated lipid levels saw improvements as follows: HDL-C increased by 38.5%, total cholesterol decreased by 6.8%, cholesterol ratio decreased by 20.9%, LDL-C decreased by 12.9%, non-HDL-C decreased by 7.8%, and triglycerides decreased by 10.8%.

CONCLUSIONS

This study characterized users of the Foodsmart platform who had dyslipidemia and found that users with elevated lipid levels showed improvements in the levels over time.
Weight Loss in a Digital Diabetes Prevention Program Powered by Artificial Intelligence: Retrospective Cohort Study (Preprint)
Authors: Graham Sarah A , Hori Jonathan H , Shemaj Fjori , Stein Natalie , Branch OraLee H
Published: March 2021

BACKGROUND

The National Diabetes Prevention Program (DPP), governed by the Centers for Disease Control and Prevention (CDC), reduces the incidence of diabetes and diabetes-associated medical costs. Typically, providing this program is staffing-intensive, limiting the ability to scale the DPP and keep pace with the growing incidence of prediabetes.

OBJECTIVE

We investigated the average weight loss of users of a program called Lark DPP that has full CDC recognition and is powered by conversational artificial intelligence (AI).

METHODS

We analyzed weight loss of 674 users who met CDC qualifications (completed ≥3 lessons in months 1-6 with ≥9 months between first and last lessons). In addition to the weight loss expected from the CDC curriculum, we investigated whether user characteristics and engagement with AI coaching increased the likelihood of achieving the CDC’s benchmark of ≥5% weight loss at 12 months using logistic regression.

RESULTS

We observed that 279 users met CDC qualifications and achieved an average of 5.2% (SE=.4) weight loss at 12 months (46% achieved ≥5%). CDC qualifiers completed an average of 20.7 (SE=.4) of 26 available educational missions/lessons. The number of weeks with >2 weigh-ins (standardized coefficient β=.39; P<.001); days with an exchange with the AI coach (β=.24; P=.016); and days since last coaching exchange at final weigh-in (β=-.45; P<.001) were significantly associated with the likelihood of achieving ≥5% weight loss.

CONCLUSIONS

The Lark DPP resulted in weight loss and sustained engagement for 12 months that was equal to or greater than in-person or hybrid-digital DPPs. Beyond the association between educational mission completion and weight loss, the synchronous personalized feedback and exchanges with the AI coach increased the likelihood of achieving ≥5% weight loss. An AI-powered program is one method to deliver DPPs in a scalable and resource-effective manner to keep pace with the prediabetes epidemic.
Knowledge and Attitude Toward Evidence-Based Medicine and Associated Factors Among Medical Interns in Amhara Regional State Teaching Hospitals, Northwest Ethiopia: Cross-sectional Study (Preprint)
Authors: Emwodew Delelegn , Melese Tesfahun , Takele Adamu , Mesfin Nebiyu , Tariku Binyam
Published: March 2021

BACKGROUND

Evidence-based medicine (EBM) is widely accepted in medicine. It is necessary to improve the knowledge and attitudes of medical students in the use of evidence. In Ethiopia, little is known about medical students’ knowledge and attitudes toward EBM.

OBJECTIVE

This study aimed to assess the knowledge and attitudes toward EBM and its associated factors among medical interns in teaching hospitals.

METHODS

A cross-sectional survey was conducted using a random sample of medical interns in teaching hospitals in Ethiopia. Multivariable logistic regression analyses were used to identify the factors associated with the knowledge and attitudes toward EBM. Adjusted odds ratio (AOR) with 95% confidence interval and P≤.05 was used to quantify strength of association between variables.

RESULTS

Out of a sample of 423 medical interns, 403 completed the questionnaire (95.3% response rate). Overall, 68.0% (274/403 of respondents had a favorable attitude toward EBM and 57.1% (230/403) had good knowledge of EBM. The majority (355/403, 88.1%) of participants had internet access. Only 19.6% (79/403) of respondents had received EBM-related training. Respondents’ knowledge of EBM was associated with previous EBM training (AOR 2.947, 95% CI 1.648-5.268, P<.001), understanding of sensitivity (AOR 2.836, 95% CI 1.824-4.408, P=.003), and internet access (AOR 2.914, 95% CI 1.494-5.685, P=.002). The use of an electronic database as a source of information (AOR 1.808, 95% CI 1.143-2.861, P=.01) and understanding of absolute risk reduction (AOR 2.750, 95% CI 1.105-6.841, P=.03) were predictors of positive attitudes.

CONCLUSIONS

This study demonstrates a lack of formal EBM training and awareness of basic concepts of EBM among medical interns. Medical intern attitudes toward EBM are relatively good. To enhance EBM knowledge and skills, formal teaching of EBM should be integrated into medical education.
DETERMINATION OF QUALITY PARAMETERS AND TEST ANTIOXIDANT ACTIVITIES OF 70% ETHANOL EXTRACT OF SEROJA LEAVES (NELUMBO NUCIFERA GAERTN.)
Authors: DJAMIL RATNA , PRATAMI DIAH KARTIKA , PUTRI FEBI AYU , OCTAVIA THALIA BREBA
Published: March 2021

Objective: The purpose of this study was to evaluated the quality parameters and analyzed the antioxidant activity of seroja leaves Nelumbo nucifera Gaertn.

Methods: The quantification of the chemical compound was determined by its total phenol and flavonoid levels. The evaluate the antioxidant activity was determined by the comparability of the four common radical scavenging assays using 2,2′-azino-bis-3-ethylbenzthiazoline-6-sulphonic acid (ABTS); 1, 1-diphenyl-2-picrylhydrazyl (DPPH) radical; cupric ion reducing antioxidant capacity (CUPRAC); ferric reducing antioxidant power (FRAP); and 2-thiobarbituric acid (TBA) methods.

Results: The results of phytochemical screening for simplicia powder and 70% ethanol extract of seroja leaves contain secondary metabolites of alkaloids, flavonoids, saponins, tannins, coumarin, quinones, and triterpenoid steroids. The results of the determination of the quality parameters meet the requirements of quality and safety standard of the medicinal herb. The result of the determination of total phenol content from 70% ethanol extract of Seroja leaves was 181.62±0.82 mg GAE/g extract. The results of the determination of total flavonoid levels from 70% ethanol extract of seroja leaves amounted to 289.83±1.04 mg QE/g extract. The results of antioxidant activity tests using the ABTS, DPPH, and TBA methods showed IC50 respectively 287.7 mg/l, 22.3 mg/l, and 352.6 mg/l and CUPRAC and FRAP methods had an antioxidant capacity of 160.76±0.35 and 253.36±0.48 mg AAE/g extract.

Conclusion: Seroja leaves (Nelumbo nucifera Gaertn.) have the potential to be used as an antioxidant medicinal herb and its extract meet the standard of quality control and safety.
ISOLATION OF PROTEIN FROM THE SPINE VENOM OF PTEROIS VOLITANS FOUND IN THE INDONESIAN OCEAN, USING A HEATING PROCESS, FOR ANTICANCER, ANTIRETROVIRAL, ANTIBACTERIAL, AND ANTIOXIDANT ASSAYS
Authors: IBRAHIM FERA , SAHLAN MUHAMAD , GINTING MIKAEL JANUARDI , PRATAMI DIAH KARTIKA , HERMANSYAH HERI , WIJANARKO ANONDHO
Published: March 2021

Objective: This research investigates the antibacterial, anticancer, antioxidant, and antiretroviral activities of the lionfish spine poison extract.

Methods: Isolation and purification of the phospholipase A2 (PLA2) protein obtained from the spine poison were conducted through the following stages, including, extraction of the venom by sonication, heating, and purification using gradual saturation levels of ammonium sulfate. Furthermore, the purity and concentration of PLA2 were analyzed using the Lowry test and Marinetti’s method, respectively, while its protein content was ascertained through SDS-PAGE. Toxicity was then evaluated employing the brine shrimp lethality test (BSLT), and its anticancer activity was assessed in human cervical carcinoma cells (HeLa cells). Finally, its antioxidant, antibacterial, and antiretroviral activities were analyzed using the DPPH method, agar diffusion test against Salmonella sp. and E. coli, and SRV-2 and RT-qPCR tests, respectively.

Results: The protein demonstrated 37.79% inhibition for anticancer activity, IC50 1312 ppm for antioxidant activity, 98.81%, and 89.28% inhibition of E. coli and Salmonella sp. respectively for antibacterial activity and 98.13% inhibition for antiretroviral activity.

Conclusion: It can be concluded that lionfish (Pterois volitans) has the potential to be developed as an antioxidant, anticancer, antibacterial, and antiretroviral agent. Furthermore, the pharmacological activity of its spine venom was determined by isolating PLA2 protein from its extract, using an optimum heating temperature of 70 °C and an ammonium sulfate saturation level of 80%.