bluuebunny/crossref_metadata_2025 huggingface dataset:
Anaerococcus ihuae sp. nov., and Mediannikovicoccus vaginalis gen. nov., sp. nov., two new bacteria isolated from human vaginal samples
Authors: Ly Claudia , Chacra Linda Abou , Birsal Eva , Haddad Gabriel , LO Cheikh Ibrahima , Amstrong Nicholas , Alibar Stéphane , Courbière Blandine , Bretelle Florence , FENOLLAR Florence
Published: March 2022

Strains Marseille-Q5893 (= CSUR Q5893 = CECT 30496) and Marseille-Q5883 (= CSUR Q5883 = CECT 30497) were isolated from vaginal samples using the culturomics approach. The 16S rRNA gene sequences of each strain were sequenced and then compared by BLASTn to the NCBI database. Strains Marseille-Q5893 and Marseille-Q5883 were most closely related to Anaerococcus obesiensis and Finegoldia magna, with identities of 98.56% and 90.01%, respectively. Strain Marseille-Q5893 is strictly anaerobic, while strain Marseille-Q5883 is facultative anaerobic. Both strains are Gram-positive, coccus-shaped, oxidase- and catalase-negative. The most abundant fatty acid for both strains is hexadecanoic acid, followed by 9-octadecenoic acid and tetradecanoic acid. Strain Marseille-Q5893 has a genome size of 1,831,271 bp with a G + C content of 29.4 mol%, whereas strain Marseille-Q5883 has a genome of 1,997,945 bp with a 33.6 mol% G + C content. The genomic comparison of closely related species with strains Marseille-Q5893 and Marseille-Q5883 showed that all digital DNA-DNA hybridization (dDDH) and orthologous average nucleotide identity (OrthoANI) values were lower than the published species thresholds (70% and 95–96%, respectively). Based on these data, we conclude that strain Marseille-Q5893 belongs to a new species in the family Peptoniphilaceae and strain Marseille-Q5883 belongs to a new genus in the family Peptostreptococcaceae. For these two new bacterial species, the names Anaerococcus ihuae sp. nov. and Mediannikovicoccus vaginalis gen. nov., sp. nov., were proposed.
Corn Growth and Phenology Modeling
Authors: Silva Adelaide Cristielle Barbosa , Oliveira Rubens Alves , Cecon Paulo Roberto , Galvão João Carlos Cardoso , Santos Robson Argolo , Faria Rodrigo Magalhães
Published: March 2022

To obtain predictions of the dynamic processes that occur during the crop cycle, agricultural modeling techniques are being adopted. The validation of a model for a given area, in the environmental conditions in which the culture is exposed, is important to assess the adequacy of the dynamic system to reality. The research aimed to evaluate the use of the STELLA software in the characterization of the morphophysiological aspects of the maize crop, cultivated in the Zona da Mata Mineira. The experiment was conducted at the Federal University of Viçosa, Viçosa, Minas Gerais, Brazil, from October 2018 to April 2019. A completely randomized design was used, whose treatments were ten evaluations, with 40 replications, of the area index leaf and net photosynthesis, measured throughout the crop cycle. The phenological simulation was based on the accumulation of temperature. The simulated and observed data were compared using the “t” test and the d index, to verify the equality and agreement between the models. The values modeled by STELLA were statistically equal to the measured values and there was an agreement between the studied techniques. The use of the model developed using the STELLA software is useful for determining the morphophysiological processes that occur during the maize crop cycle, grown in the Zona da Mata Mineira.
Fetal-type variant of the posterior cerebral artery and concurrent bilateral cerebral infarctions in a Korean male cadaver
Authors: Maeng Young Hee , Yoon Sang-Pil
Published: March 2022

Purpose: Fetal-type variant of the posterior cerebral artery is a relatively common variant of the circle of Willis, but concurrent cerebral pathologies have not been well reported. Methods: We describe a case of fetal-type variant of the posterior cerebral artery and concurrent bilateral cerebral infarctions in the territories of the middle cerebral artery in a 78-year-old Korean male cadaver.Results: Fetal-type variant of the posterior cerebral artery was found the right circle of Willis, arose from the internal carotid artery with larger diameter than the pre-communicating segment from the basilar artery. Histopathological examination revealed that left supramarginal gyrus and right infraparietal lobule showed characteristic cerebral infarctions with chronological changes, respectively.Conclusion: Knowledge on the variation in the posterior cerebral artery combined with clinical features including cerebral infarction plays a pivotal role to anatomists and clinicians.
Research on the efficacy of anti-alcoholism of Botanic Probiotics
Authors: Lu Shan , Peng Lu , Cheng Lili , Dai Chensheng , Yang Zhiming , Hou Lili , Ling Yuanjian , Guo Yongchao , Wu Dong
Published: March 2022

Background and Aims: Alcohol consumption adversely affects the functions of liver and increase the risks of liver disease, including the liver cancer. Botanic probiotics are regarded as one effective product to reduce such risky. In this study, we investigated the effect of botanic probiotics (BPFB-p) on the anti-alcoholism and protection of liver on mice, compared with other kinds of commercially available probiotics. Ebriety rate, ebriety latency time and ebriety time were tested, and the level of alanine aminotransferase (ALT), aspartate aminotransferase (AST) in serum were also investigated. The experimental results demonstrated that BPFB-p could obviously decrease the ebriety rate and lower the ALT & AST level in serum. BPFB-p is a promising probiotic agent to protect liver for ethanol consumer.Methods: Male KM mice were randomly assigned into five groups, diagnosed with Ebriety rate, ebriety latency time and ebriety time, the level of ALT & AST in serum.Results: Compared with the control model group, the ebriety time in the BPFB-p group was significantly shorter (p < 0.01). AST content in the Acetic Bacteria and BPFB-p group was significantly decreased, too. (p < 0.05).Conclusions: These results clearly demonstrated that the BPFB-p was a promising agent to protect the liver from hepatoxicity and fatty liver induced by ethanol intaker.
Leukocyte DNA methylation in Alzheimer´s disease associated genes: replication of findings from neuronal cells
Authors: Karlsson Ida K , Ploner Alexander , Wang Yunzhang , Gatz Margaret , Pedersen Nancy L , Hägg Sara
Published: March 2022

Differences in gene-wide DNA methylation of the Alzheimer’s disease (AD) associated genes BIN1, HLA-DRB5, SORL1, SLC24A4, and ABCA7 are reported to be associated with AD in post-mortem brain samples. We investigated whether the same associations could be found in leukocytes collected pre-mortem. Using cohort data of 544 Swedish twins (204 dementia diagnoses), we replicated the findings in HLA-DRB5 and SLC24A4 at p < 0.05. However, co-twin control analyses indicated that the associations were partly explained by familial confounding. Thus, DNA methylation differences in HLA-DRB5 and SLC24A4 are present in both neuronal cells and leukocytes, but may be influenced by familial factors.
Fusionable and Fissionable waves of (2+1)-dimensional shallow water wave equation
Authors: Wang Jing , Li Biao , Ding Xue-li
Published: March 2022

We investigate a (2+1)-dimensional shallow water wave equation and describe its nonlinear dynamical behavior in physics. Based on the N-soliton solutions, the higher-order fissionable and fusionable waves, fissionable or fusionable waves mixed with soliton molecular and breather waves can be obtained by a series of special parameter constraints. At the same time, by the long wave limit method, the interaction waves of fissionable or fusionable waves with higher-order lumps are acquired. Combined with the dynamic image of the waves, the properties of the solution are deeply studied to reveal the physical significance of the waves.
The Anatomic Distribution of Malignant Cutaneous Neoplasms of the Face and their Relationships with Lymphatic and Distant Metastases: A Hospital-based Retrospective Study in Damascus, Syria
Authors: Alshaher Merry Abdul Karim , Armashi Humam , Olabi Homam , Nahas Louei
Published: March 2022

Skin cancers of the face and neck are among of the most common and important cancers, accounting for one out of every three new recorded cases of skin cancer according to the World Health Organization (WHO), and posing unique therapeutic challenges because of their functional and aesthetic impacts on patients. Our study aims to collect and analyze data about cutaneous neoplasms of the face and neck and their relationships with lymphatic and distant metastases, and to provide recommendations for early detection and patient care in order to achieve the best possible treatment outcomes. Methods: In this retrospective study, data about patient characteristics and tumor type, location, histology, stage, and classification was recorded for patients diagnosed with malignant skin tumors from the archives of Al-Mouwasat University Hospital, and then analyzed. Results: Out of a total of 67 patients, 55.2% were female, 44.8% were male, and those over the age of 60 comprised largest age group at 46.3%. The majority of patients (48.5%) worked in professions with low occupational exposure to sunlight, compared to 42.4% with high occupational exposure to sunlight, and 9.1% with no occupational exposure to sunlight. Most patients (73.2%) were smokers, 22% consumed both tobacco smoke and alcohol, and 4.9% consumed alcohol only. The largest proportion of patients hailed from central and eastern Syria (26.9% and 22.4% respectively). The most common chief complaint was chronic skin ulcers (79.7%). The most common site of malignancy was the nasal dorsum, ala, and tip (41.8%). The most common type was squamous cell carcinoma (SCC) (62.7%). The most common type of basal cell carcinoma (BCC) was the sclerotic type (87.5%). Conclusion: We found statistically significant relationships between the incidence of skin cancers and high exposure to sunlight, female gender, smoking, and age over 60 years. Chronic ulcers were the most common symptom, and the nasal dorsum, ala, and tip were the most commonly affected sites. The dominant histological pattern was SCC. Most patients (76.1%) had no metastases. Surgical treatment was the most common form of curative management (88.1%). The most important recommendation is to minimize sunlight exposure due to its significant association with facial skin cancer and subsequent metastases.
Factors Associated with Increased Risk of High-Grade Cervical Squamous Intraepithelial Lesions in Women with Common HR-HPV Infection in Yangqu County, Shanxi Province
Authors: Zhao Weihong , Li Yaqin , Zhang Honglei , Bai Ying , Ding Ling , Zhang Lili , Wang Yonghong , Wang Tong , Hao Min
Published: March 2022

Background: To explore the factors associated with high-grade cervical squamous intraepithelial lesions (HSIL) in women with the common high-risk, human papillomavirus (HR-HPV) infection. Methods: Twenty thousand Han women (20-65 years) were enrolled. A questionnaire on demographic characteristics and factors related to cervical lesions was administered and a cervical liquid-based cytology test was conducted for each participant. We identified 1325 cases with atypical squamous cells of undetermined significance (ASC-US); 68 were excluded for refusal to consent, and 1257 patients were further assessed by HPV typing, colposcopy biopsy, and histopathological examination. Of these, 372 patients with pathologically diagnosed cervical intraepithelial neoplasia (CIN) became the case group, and 877 patients with a normal cervix (NC) became the control group (total participants 1249). HPV infection types were detected by flow-through hybridization. Results: From the 20,000 women assessed 877 had ASC-US with a NC (4.39%) and 372 had CIN (1.86%), including 247 with low-grade cervical squamous intraepithelial lesions (LSIL) (1.24%) and 125 with HSIL (0.63%). Of these 460 had HR-HPV infection, and the five most frequent types were 16, 52, 58, 56, and 33. After adjusting for demographics and other related variables, HPV16 was associated with an 11.363 times (95% CI: 6.639-19.449) higher risk of HSIL, while HPV58 was associated with a 5.758 times (95% CI: 2.542-13.045) higher risk of HSIL. HPV52 infection was not associated with an increased risk of HSIL. Menopause was a common protective factor against infection with HPV16 and HPV58, while multiple parity was a risk factor for HPV16 infection. Low educational attainment, high frequency of perineal washing, and low frequency of underwear changing were risk factors for HPV58 infection. HPV16, HPV58, other HR-HPV types, and younger age at menarche were risk factors for HSIL, while menopause and tea drinking were protective factors.Conclusion: The detection rate of HSIL was relatively high (0.63%). The most common highly pathogenic HR-HPV types in this area are HPV16 and HPV58. Focusing efforts on the prevention of local highly pathogenic HPV infections and identifying the risk factors associated with HSIL after infection are important to reduce the incidence of HSIL and cervical cancer.
Gastrosplenic fistula due to splenic lymphoma: Two case reports and literature Review
Authors: Ksontini Feryel Letaief , Zaimi Yosra , Nefzi Isaad , Khrouf Salim , Ayari Myriam , Sghaier Sonia , Zidi Asma , Maghrebi Houcine , Ayadi Mouna
Published: March 2022

Background: Gastrosplenic fistula (GSF) is a rare and potentially fatal complication of various diseases. Lymphoma is the most common cause. It can occur spontaneously or after chemotherapy. This rare entity may be misdiagnosed. Treatment modalities include surgical resection, chemotherapy or a combination of both. Actually, more and more are headed towards a chemotherapy regimen only to treat GSF.Case presentation: Here we report two cases of GSF due to diffuse large B cell lymphoma patients. First case is of a 54-year-old woman with a primary enormous spleen diffuse large B cell lymphoma (DLBCL) leading to a spontaneous fistula in the stomach. The second one is of a 48 year-old-male patient with a primary spleen DLBCL which fistula complicating chemotherapy. The evolution was fatal for both of them after undergoing surgeryConclusions: GSF complicating lymphomas is a rare disease entity, our case report and a systematic review of the literature may help physicians to diagnose and to treat it.
Peculiarities of Formation of the Region's Logistics Infrastructure on the Basis of Eco-Innovations Within the Framework of Stakeholders' Partnership in the Enterprise-Region-State System
Authors: Jianming Mu , Chortok Yuliia V. , Yaremenko Anastasiia H.
Published: March 2022

Implementation of Ukraine's European integration in all spheres of development increases the requirements for regional policy and expands the criteria for its effectiveness. It is important to choose effective methods and approaches to management, the use of which will ensure the competitiveness and sustainable development of the region. Under such conditions, the task of regional authorities is to initiate the formation of qualitatively new institutional foundations for a new regional development model, which harmoniously combines economic, social and environmental factors, which will be implemented in active cooperation with other businesses. Many years of experience in the development of cross-sector partnerships in European countries show that such a partnership contributes to a constant and well-established dialogue in society. Therefore, in the context of Ukraine, the issue of developing and adhering to the rules and principles of partnership, constructive cooperation of stakeholders and creating a model that will increase socio-environmental and economic responsibility of all participants in implementing measures to ensure sustainable development of the region. Taking into account the interests of all stakeholders becomes especially important in the logistics infrastructure development; its functioning affects both the socio-economic development of the region and the state of the environment. The main purpose of the investigation was to study the problems of forming the regional logistics infrastructure, which necessitates a responsible attitude of business and government to society and the environment. Foreign and Ukrainian publications on the formation of regional logistics infrastructure and allegations of social and environmental responsibility of stakeholders were analyzed. The study proposes the basic principles of logistics infrastructure planning based on cross-sector stakeholder partnership, which, according to the authors, would contribute to sustainable development of the region and increase the level and efficiency of regional logistics.
Intensified geopolitical conflicts and herding behavior: An evidence from selected Nifty sectoral indices during India-China tensions in 2020
Authors: T. A. Krishna , B. Suresha
Published: March 2022

The recent India-China geopolitical conflicts have presented enormous uncertainty to the investors in various sectoral indices of the Indian stock market. This empirical study aims to examine the impact of intensified India-China geopolitical conflicts 2020 on investors’ herding behavior in the National Stock Exchange sectoral indices. The high-frequency data of three major NIFTY sectoral indices (Auto, Energy, and Pharma) are used in an intensified geopolitical event window to spot precisely the traces of the investors’ herding behavior. Furthermore, multifractal detrended fluctuation analysis (MFDFA) is employed to obtain Hurst Exponent values (h(q)) for the NIFTY sectoral indices. The findings reveal that these NIFTY sectoral indices exhibited profound traces of herding behavior on the event day (t = 0) due to the heightened India-China geopolitical clashes. In addition, these indices depicted an overall higher level herding behavior with the (h(q)) values close to 0.72 throughout the intensified geopolitical event window. The study concludes that the sectors highly reliant on the Chinese supplies and with significant trade linkages with China depicted a higher level of herding behavior in their indices. Further, the presence of herding behavior in these sectoral indices is due to the operational and supply-chain risks posed by the geopolitical event.
AcknowledgmentsThe authors express their sincere thanks of gratitude to Dr. Bikramaditya Ghosh (Associate Professor, Symbiosis Institute of Business and Management, Bangalore, India) and Dr. Iqbal Thonse Hawaldar (Professor, College of Business Administration, Kingdom University, Riffa, Bahrain) for their instrumental role in encouraging and motivating them to accomplish this publication. The authors also extend their sincere thanks to Dr. Manu K.S and Dr. Surekha Nayak (Assistant Professor, School of Business and Management, CHRIST (Deemed to be university), Bangalore, India) for their continued support throughout this empirical investigation.
Assessing design principles for climate services training courses: educational design principles assessment of six C3S Blended Training courses within the Copernicus Climate Change Service
Authors: del Pozo Maria , Gulikers Judith , van Slobbe Erik , den Brok Perry , Ludwig Fulco
Published: March 2022

The current climate service creation practice misses clear provider–user collaborations, and this presents a challenge for the educational design of capacity-building programs. This study analyses the formation of educational principles in six training courses aimed at tailored climate services. The design principles are analyzed using the constructive alignment and three curriculum perspectives as analytical frameworks. Three main issues were identified: overambitious one-size-fits-all learning goals; the role of a case study in overcoming the lack of knowledge and skills; and ambiguity in assessments. These issues guided the implementation for improvements in the courses and need to be addressed in creation processes for user-tailored climate services in general by the wide community of climate service providers and users. Our findings reflect the tendency to insufficiently involve users in the creation of climate services and in capacity building more specifically. Although we use examples in the water sector and link them to collaborative processes in water governance, our findings potentially have implications for other sectors where collaboration between users and providers is needed as well. It also highlights not only the usefulness of educational and pedagogical disciplines as a pillar of capacity building but also their active inclusion in the design and implementation of climate services.
Aşırı yeşil çay tüketimi ile ilişkili mani: bir olgu sunumu
Authors: SÖNMEZ Doğancan , HOCAOGLU Cicek
Published: March 2022

Günümüzde ilerleyen teknolojinin beraberinde getirdiği sağlık sorunlarından kaçınmak için doğaya ve doğal ürünlere dönüş eğilimi gittikçe artmaktadır. Dünya genelinde son zamanlardabirçok insan bitkisel ürünlerin doğal ve güvenli olduğunu düşünerek bu tarz ürünleri sağlıklı beslenmek, kilo vermek ve kozmetik amacıyla kullanmaktadır. Fakat bu bitkisel ürünler doğalve güvenilir olduğu kadar bazı ciddi yan etkilere de neden olabilmektedir. Bu tür yan etkiler arasında mide bulantısı, uykusuzluk, ishal, deri döküntüsü, anaflaktik reaksiyonlar ve ciddi ruhsal belirtiler yer almaktadır. Bitkisel ürün pazarının büyümesine paralel olarak bu ürünlerin bilinçsizce ve yaygın kullanımına bağlı ortaya çıkan istenmeyen etkileri bildiren olgu raporları da artmaktadır. Bu çalışmada öncesinde herhangi bir ruhsal hastalık öyküsü bulunmayan ve kilo vermek amacıyla aşırı yeşil çay tüketmesi sonrası psikotik özellikli mani dönemi belirtileri ile psikiyatri polikliniğine başvuran 41 yaşındaki bir kadın olgu literatür bulguları ışığında sunulmuştur. Klinisyenlerin âni başlangıçlı psikiyatrik belirtiler ile aşırı tüketilen bitkisel ürünler arasındaki ilişki konusunda duyarlı olması önemlidir.
Relación entre la indecisión a vacunas de la madre y el esquema de vacunación del niño menor de 5 años
Authors: Bernal-Vaquera Bruno Michel , Guerrero-Castañeda Raúl Fernando , Vega-Macía Héctor Daniel , Silva-Vera Marisol
Published: March 2022

Introducción: Indecisión a las vacunas es “la demora en la aceptación o rechazo de la vacunación a pesar de la disponibilidad de los servicios. Objetivo: Relacionar la indecisión a las vacunas de la madre y el esquema de vacunación del menor de 5 años. Materiales y métodos: Estudio transversal, correlacional, no experimental. Se aplicó el cuestionario Actitudes de los Padres ante las Vacunas de los Niños para medir Indecisión a las Vacunas en madres de niños menores de cinco años, se registró el esquema de vacunación. Se realizó análisis descriptivo e inferencial para comparar, asociar y relacionar variables. Resultados: En madres de niños con esquema de vacunación completo 21% presentan nivel intermedio y 1,75% nivel alto de indecisión a las vacunas, madres de hijos con esquema incompleto 26% presenta nivel intermedio y 5% nivel alto. No se encontró relación entre indecisión a vacunas y esquema de vacunación (p=0,265). Se encontraron asociaciones entre ocupación e indecisión a las vacunas (p=0,034); entre esquema de vacunación con escolaridad (p=0,013), ocupación (p=0,034) y motivos de no vacunación (p=0,000), correlaciones negativas entre esquema de vacunación, escolaridad (p=0,003) edad del hijo (p=0,037). Conclusión: No se encontró correlación entre indecisión a las vacunas y esquema de vacunación.
Efectos de un programa de ejercicio multicomponente en adultos con enfermedad crónica en atención primaria
Authors: Zambrano-Urbano Jose Leonel , Ocampo-Chaparro José Mauricio , Etayo-Ruiz Edwin , Realpe-Loaiza Jose , Reyes-Ortiz Carlos
Published: March 2022

Tanto las enfermedades crónicas como la inactividad física influyen negativamente sobre la independencia, funcionalidad y autonomía de personas adultas a corto y largo plazo. Existe escasa evidencia en cuanto a la implementación y resultados en salud de protocolos de ejercicio en adultos con enfermedades crónicas en atención primaria. Se determinaron los cambios clínicos, funcionales, de dolor y salud en general de un programa de ejercicio multicomponente de 6 semanas de duración con un estudio de diseño antes y después, unicéntrico donde participaron 523 pacientes con edad promedio de 68,3±10,5 años. Mediante análisis bivariado a través de prueba de t-test pareado y la prueba de McNemar se encontraron diferencias antes y después en las puntuaciones de batería SPPB 3,80 (3,65-3,96) p<0,0001, fuerza de agarre 3,79 (3,50-4,09) p<0,0001, escala de Barthel 0,53 (0,20-0,87) p=0,0019 y el perímetro de la pantorrilla 0,55(0,21-0,88) p=0,0014. Posterior a la intervención la proporción de pacientes sin dolor o con dolor leve aumentó en 46% (p<0,0001) y con de autopercepción de salud excelente o buena el 85% (p<0,0001). En conclusión 6 semanas de ejercicio multicomponente protocolizado y supervisado mejoraron las variables funcionales, biológicas, de dolor y de salud.
Knighthood and noble society in the European Middle Ages
Authors: Raven Matt
Published: March 2022

Review of David Crouch and Jeroen Deploige, eds, Knighthood and society in the High Middle Ages, Mediaevalia Lovaniensia 48 (Leuven: Leuven University Press, 2020, xii + 317 p., ill., index).
Lions or lilies? The dynastic identity of Margaret of Burgundy (1374-1441) as represented by material objects
Authors: Brandsma Margreet
Published: March 2022

As a result of her marriage to William of Bavaria, eldest son of the count of Hainault, Holland and Zeeland, Margaret of Burgundy (1374-1441) personified the political alliance between the Burgundian and Bavarian dynasties. During her marriage she was highly loyal to both, but the struggle for power which ensued after her husband’s death caused a shift in her dynastic loyalty. By supporting her only daughter Jacqueline of Bavaria’s right of succession she acted against the interests of the Burgundian dynasty, which in the end seized power over the three counties. This article discusses how material objects originating from different periods of her life reflected changes in how she perceived and expressed her dynastic identity, focussing on her seals and on memorial objects in her funeral chapel.
The Effectiveness of a Brief Telehealth and Smartphone Intervention for College Students Receiving Traditional Therapy: Longitudinal Study Using Ecological Momentary Assessment Data
Authors: Taylor Madison E , Lozy Olivia , Conti Kaileigh , Wacha-Montes Annmarie , Bentley Kate H , Kleiman Evan M
Published: March 2022

Background

Brief interventions such as mental health apps and single-session interventions are increasingly popular, efficacious, and accessible delivery formats that may be beneficial for college students whose mental health needs may not be adequately met by college counseling centers. However, no studies so far have examined the effectiveness of these modes of treatment for college students who are already receiving traditional therapy, despite it being common among this population.

Objective

The aim of this study was to compare the differences in self-reported momentary negative affect between college students in therapy and not in therapy who received a brief single-session intervention delivered by counseling center staff and a supplemental mobile app.

Methods

Data for this study were drawn from E-Manage, a brief mobile health intervention geared toward college students. Participants in the study were 173 college students who indicated whether they had received therapy. We conducted a multilevel model to determine whether there were differences between those in therapy versus not in therapy in negative affect reported throughout the study. Following this, we conducted multilevel models with therapy status as the predictor and negative affect as the outcome.

Results

Results of the multilevel model testing showed that the cross-level interaction between the time point (ie, pre- vs postexercise) and therapy status was significant (P=.008), with the reduction in negative affect from pre- to postexercise greater for those in therapy (b=–0.65, 95% CI –0.91 to –0.40; P<.001) than it was for those not in therapy (b=–0.31, 95% CI –0.43 to –0.19; P<.001). Therapy status was unassociated with both the pre-exercise (b=–1.69, 95% CI –3.51 to 0.13; P=.07) and postexercise (b=–1.37, 95% CI –3.17 to 0.43; P=.14) ratings of negative affect.

Conclusions

These findings suggest that app-based and single-session interventions are also appropriate to use among college students who are receiving traditional therapy. A randomized controlled trial comparing students receiving therapy to students receiving therapy and E-Manage will be necessary to determine to what extent E-Manage contributed to the reductions in negative affect that therapy-attending college students experienced.
A Smartphone-Based Intervention as an Adjunct to Standard-of-Care Treatment for Schizophrenia: Randomized Controlled Trial (Preprint)
Authors: Ghaemi S Nassir , Sverdlov Oleksandr , van Dam Joris , Campellone Timothy , Gerwien Robert
Published: March 2022

BACKGROUND

Antipsychotic medications have limited benefits in schizophrenia, and cognitive behavioral therapy may be beneficial as an adjunct. There may be potential for implementing mobile cognitive behavioral therapy–based treatment for schizophrenia in addition to standard antipsychotic medications.

OBJECTIVE

This study aims to determine whether PEAR-004, a smartphone-based investigational digital therapeutic, improves the symptoms of an acute psychotic exacerbation of schizophrenia when it is added to standard treatments.

METHODS

This was a 12-week, multicenter, randomized, sham-controlled, rater-blinded, parallel group proof‑of‑concept study of 112 participants with moderate acute psychotic exacerbation in schizophrenia. This study was conducted in 6 clinical trial research sites in the United States from December 2018 to September 2019. The primary outcome, change in Positive and Negative Syndrome Scale (PANSS) from baseline to week 12 or the last available visit, was analyzed using the mixed-effects regression model for repeated measures, applied to an intent-to-treat sample.

RESULTS

The total PANSS scores slightly decreased from baseline over the study period in both groups; the treatment difference at day 85 between PEAR-004 and sham was 2.7 points, in favor of the sham (2-sided P=.09). The secondary scales found no benefit, except for transient improvement in depressive symptoms with PEAR-004. Application engagement was good, and patient and clinical investigator satisfaction was high. No safety concerns were observed. There was some evidence of study site heterogeneity for the onboarding processes and directions on PEAR-004 product use at baseline and throughout the study. However, these differences did not affect the efficacy results.

CONCLUSIONS

In the largest-to-date randomized, sham-controlled study of a digital therapeutic in schizophrenia, PEAR-004 did not demonstrate an effect on the primary outcome—total PANSS scores—when compared with a nonspecific digital sham control. The secondary and exploratory results also did not demonstrate any notable benefits, except for possible temporary improvement in depressive symptoms. This study provided many useful scientific and operational insights that can be used in the further clinical development of PEAR-004 and other investigational digital therapeutics.

CLINICALTRIAL

ClinicalTrials.gov NCT03751280; https://clinicaltrials.gov/ct2/show/NCT03751280
Measuring Adherence Within a Self-Guided Online Intervention for Depression and Anxiety: Secondary Analyses of a Randomized Controlled Trial (Preprint)
Authors: Hanano Maria , Rith-Najarian Leslie , Boyd Meredith , Chavira Denise
Published: March 2022

BACKGROUND

Self-guided online interventions offer users the ability to participate in an intervention at their own pace and address some traditional service barriers (eg, attending in-person appointments, cost). However, these interventions suffer from high dropout rates, and current literature provides little guidance for defining and measuring online intervention adherence as it relates to clinical outcomes.

OBJECTIVE

This study aims to develop and test multiple measures of adherence to a specific self-guided online intervention, as guided by best practices from the literature.

METHODS

We conducted secondary analyses on data from a randomized controlled trial of an 8-week online cognitive behavioral program that targets depression and anxiety in college students. We defined multiple behavioral and attitudinal adherence measures at varying levels of effort (ie, low, moderate, and high). Linear regressions were run with adherence terms predicting improvement in the primary outcome measure, the 21-item Depression, Anxiety, and Stress Scale (DASS-21).

RESULTS

Of the 947 participants, 747 initiated any activity and 449 provided posttest data. Results from the intent-to-treat sample indicated that high level of effort for behavioral adherence significantly predicted symptom change (F4,746=17.18, P<.001; and β=–.26, P=.04). Moderate level of effort for attitudinal adherence also significantly predicted symptom change (F4,746=17.25, P<.001; and β=–.36, P=.03). Results differed in the initiators-only sample, such that none of the adherence measures significantly predicted symptom change (P=.09-.27).

CONCLUSIONS

Our findings highlight the differential results of dose-response models testing adherence measures in predicting clinical outcomes. We summarize recommendations that might provide helpful guidance to future researchers and intervention developers aiming to investigate online intervention adherence.

CLINICALTRIAL

ClinicalTrials.gov NCT04361045; https://clinicaltrials.gov/ct2/show/NCT04361045
A Novel Experience Sampling Method Tool Integrating Momentary Assessments of Cognitive Biases: Two Compliance, Usability, and Measurement Reactivity Studies (Preprint)
Authors: Boemo Teresa , Socastro Angela , Blanco Ivan , Martin-Garcia Oscar , Pacheco-Romero Ana Mar , Rodríguez-Carvajal Raquel , Sanchez-Lopez Alvaro
Published: March 2022

BACKGROUND

Experience sampling methods (ESMs) are increasingly being used to study ecological emotion dynamics in daily functioning through repeated assessments taken over several days. However, most of these ESM approaches are only based on self-report assessments, and therefore, studies on the ecological trajectories of their underlying mechanisms are scarce (ie, cognitive biases) and require evaluation through experimental tasks. We developed a novel ESM tool that integrates self-report measures of emotion and emotion regulation with a previously validated app-based cognitive task that allows for the assessment of underlying mechanisms during daily functioning.

OBJECTIVE

The objective of the study is to test this new tool and study its usability and the possible factors related to compliance with it in terms of latency and missing responses. Among the compliance predictors, we considered psychological and time-related variables, as well as usability, measurement reactivity, and participants’ satisfaction with the tool.

METHODS

We conducted 2 extensive ESM studies—study 1 (N=84; a total of 3 assessments per day for 5 days) and study 2 (N=135; a total of 3 assessments per day for 10 days).

RESULTS

In both studies, participants found the tool highly usable (average usability score >81). By using mixed regression models, we found both common and specific results for the compliance predictors. In both study 1 and study 2, latency was significantly predicted by the day (P<.001 and P=.003, respectively). Participants showed slower responses to the notification as the days of the study progressed. In study 2 but not in study 1, latency was further predicted by individual differences in overload with the use of the app, and missing responses were accounted for by individual differences in stress reactivity to notifications (P=.04). Thus, by using a more extensive design, participants who experienced higher overload during the study were characterized by slower responses to notifications (P=.01), whereas those who experienced higher stress reactivity to the notification system were characterized by higher missing responses.

CONCLUSIONS

The new tool had high levels of usability. Furthermore, the study of compliance is of enormous importance when implementing novel ESM methods, including app-based cognitive tasks. The main predictors of latency and missing responses found across studies, specifically when using extensive ESM protocols (study 2), are methodology-related variables. Future research that integrates cognitive tasks in ESM designs should take these results into consideration by performing accurate estimations of participants’ response rates to facilitate the optimal quality of novel eHealth approaches, as in this study.
Effectiveness of Self-Collected, Ambient Temperature–Preserved Nasal Swabs Compared to Samples Collected by Trained Staff for Genotyping of Respiratory Viruses by Shotgun RNA Sequencing: Comparative Study (Preprint)
Authors: Soto Raymond , Paul Litty , Porucznik Christina A , Xie Heng , Stinnett Rita Czako , Briggs Benjamin , Biggerstaff Matthew , Stanford Joseph , Schlaberg Robert
Published: March 2022

BACKGROUND

The SARS-CoV-2 pandemic has underscored the need for field specimen collection and transport to diagnostic and public health laboratories. Self-collected nasal swabs transported without dependency on a cold chain have the potential to remove critical barriers to testing, expand testing capacity, and reduce opportunities for exposure of health professionals in the context of a pandemic.

OBJECTIVE

We compared nasal swab collection by study participants from themselves and their children at home to collection by trained research staff.

METHODS

Each adult participant collected 1 nasal swab, sampling both nares with the single swab, after which they collected 1 nasal swab from 1 child. After all the participant samples were collected for the household, the research staff member collected a separate single duplicate sample from each individual. Immediately after the sample collection, the adult participants completed a questionnaire about the acceptability of the sampling procedures. Swabs were placed in temperature-stable preservative and respiratory viruses were detected by shotgun RNA sequencing, enabling viral genome analysis.

RESULTS

In total, 21 households participated in the study, each with 1 adult and 1 child, yielding 42 individuals with paired samples. Study participants reported that self-collection was acceptable. Agreement between identified respiratory viruses in both swabs by RNA sequencing demonstrated that adequate collection technique was achieved by brief instructions.

CONCLUSIONS

Our results support the feasibility of a scalable and convenient means for the identification of respiratory viruses and implementation in pandemic preparedness for novel respiratory pathogens.
Examining usage behavior of a goal-supporting mHealth app in primary care among patients with multiple chronic conditions: A qualitative study (Preprint)
Authors: Tahsin Farah , Austin Tujuanna , McKinstry Brian , Mercer Stewart W , Mayura Loganathan , Thavorn Kednapa , Upshur Ross , Steele Gray Carolyn
Published: March 2022

BACKGROUND

Although mobile health (mHealth) applications are increasingly being used to support patients with multiple chronic conditions (multimorbidity), the majority of mHealth apps experience low interaction and eventual abandonment. To tackle this engagement issue, it is important to understand social-behavioral factors that impact patients’ usage behavior when developing a mHealth program.

OBJECTIVE

This study aims to explore the social and behavioral factors contributing to the patients’ usage behavior of a mHealth app called the electronic Patient Reported Outcome (ePRO). The ePRO app supports goal-oriented care delivery in interdisciplinary primary care models.

METHODS

A descriptive qualitative study was used to analyze interview data collected for a larger mixed-method pragmatic trial. The original 15-month trial was conducted in six primary care teams across Ontario between 2018 and 2019. For this analysis, patients were classified as long-term or short-term users based on their length of usage of the ePRO app during the trial. Bandura’s Social Cognitive Theory (SCT) was used to categorize social-behavioral factors that contributed to patients' decisions to continue/discontinue the app.

RESULTS

The patient-provider relationship emerged as a key factor that shaped patients’ experiences with the app and subsequent decisions to continue using the app. Other factors that contributed to the patients’ decisions to continue using the app were: personal and social circumstances, perceived usefulness, patients’ prior experience in goal-related behaviors, and confidence in one’s capability to achieve goals and/or use technology. There was an overlap of experience between long-term and short-term app users but in general, long-term users perceived the app to be more useful and their goals to be more meaningful than short-term users. This observation was complicated by the fact that patient health-related goals are dynamic and changed over time.

CONCLUSIONS

Multimorbid patients’ usage behavior of a goal-supporting mHealth is shaped by an array of socio-behavioral factors that can evolve. To tackle this dynamism, there should be an emphasis on creating adaptable health technologies that are easily customizable by patients and able to respond to their changing contexts and needs.

CLINICALTRIAL

ClinicalTrials.gov NCT02917954; https://clinicaltrials.gov/ct2/show/NCT02917954
Defining recommendations to guide user interface design: a multimethod approach (Preprint)
Authors: Diehl Ceci , Martins Ana , Almeida Ana , Silva Telmo , Ribeiro Óscar , Santinha Gonçalo , Rocha Nelson , Silva Anabela
Published: March 2022

BACKGROUND

For the development of digital solutions different aspects of user interface design must be taken into consideration. Different technologies and interaction paradigms, user characteristics and needs, and interface design components are some of the aspects that designers and developers should pay attention to when designing a solution. A large number of user interface design recommendations for different digital solutions and user profiles are found in the literature, but these recommendations have many similarities, contradictions and different levels of detail. A detailed critical analysis is needed that compares, evaluates, and validates existing recommendations and allows the definition of a practical set of recommendations.

OBJECTIVE

This study aimed to analyze and synthesize existing user interface design recommendations and propose a practical set of recommendations that guide the development of different technologies.

METHODS

Based on previous studies a set of recommendations on user interface design was generated following four steps: i) interview with user interface design experts; ii) analysis of the experts’ feedback and drafting of a set of recommendations, iii) reanalysis of the shorter list of recommendations by a group of experts and iv) refining and finalizing the list.

RESULTS

The research findings allowed the definition of a set of 174 recommendations divided into 12 categories, according to Usability Principles, and organized into two levels of hierarchy: Generic (69 recommendations) and Specific (105 recommendations).

CONCLUSIONS

The study shows that user interface design recommendations can be divided according to usability principles and organized into levels of detail, and that specific recommendations, as they address different technologies and interaction paradigms, need further work.

CLINICALTRIAL

N/A
Assessment of Mentions of Adverse Drug Events in Social Media Through Natural Language Processing (Preprint)
Authors: Yu Deahan , Vydiswaran VG Vinod
Published: March 2022

BACKGROUND

Adverse reactions of drugs attract significant concerns in both clinical practice and public health monitoring. Multiple measures have been put into place to increase postmarketing surveillance of drug adverse effects and improve drug safety. These include implementing spontaneous reporting systems and developing automated natural language processing (NLP) systems from electronic health records and social media data to collect evidence of adverse drug events (ADEs) that can be further investigated as possible adverse reactions.

OBJECTIVE

While using social media for this purpose has potential, it is not clear whether it is a reliable source for this information. Our work aims to 1) develop NLP approaches to identify ADEs on social media and 2) assess the reliability of social media data to identify ADEs.

METHODS

We propose a collocated Long Short-Term Memory network model with attentive pooling and aggregated, contextual representation generated by a pretrained model. We applied the model on large-scale Twitter data to identify ADE-related tweets. We conducted a qualitative content analysis on those tweets to validate the reliability of social media data as a means to collect such information.

RESULTS

The model outperforms the variant without the contextual representations during both the validation and evaluation phases. Through the content analysis on ADE tweets, we observe that ADE-related discussions referred to seven ADE themes. Mental health-related, sleep-related, and pain-related ADE discussions were most frequent. We also contrast known adverse drug reactions to f those mentioned in tweets.

CONCLUSIONS

We observe a distinct improvement in the model using contextual information. However, results reveal weak generalizability of the current systems on unseen data. Additional research is needed to fully utilize social media data, and improve the robustness and reliability of NLP systems. The content analysis, on the other hand, shows that Twitter covers a sufficiently wide range of ADEs as well as known adverse reactions for drugs mentioned in tweets. Our work demonstrates that social media can be a reliable data source for collecting ADE mentions.
Online messages connecting young people with mental health support: “Reaching out in real life” (Preprint)
Authors: Adeane Emily , Gibson Kerry
Published: March 2022

BACKGROUND

Young people experience high rates of mental health problems but make poor use of the formal services available to them. As youth are high internet users, there may be untapped potential to use online messages to encourage young people to make better use of their local mental health services.

OBJECTIVE

This research aimed to identify what kinds of online messages young people identified as more likely to prompt youth engagement with mental health services.

METHODS

This research used a qualitative design conducted within a social constructionist epistemology that recognised the importance of youth empowerment in mental health. Digital interviews using WhatsApp instant messenger were conducted with 37 young people aged 16-23 years. The data was analysed thematically to identify the kinds of online messages participants believed would encourage young people to reach out to a mental health service for support.

RESULTS

The results indicate messages should provide young people with transparent information about relevant mental health services and make use of the various modes of communication to give young people greater insight into how these actually work. The research also indicates that young people might require messages that challenge the stigma surrounding mental health and highlight the value of mental health services. Finally, young people are more likely to respond to ‘relatable’ stories of using mental health services in the context of a personal connection with someone they trust.

CONCLUSIONS

This research highlights the potential of the internet to improve young people’s use of mental health services. It offers recommendations for professionals and service providers on how to better engage young people with mental health support using online resources.