bluuebunny/crossref_metadata_2025 huggingface dataset:
Automatic Health Assessment of Smart Home Residents via Unsupervised Learning from Ambient Sensor Data: An Observational Study (Preprint)
Authors: Nguyen Thuong , Zhang Qing , Le Duc , Karunanithi Mohan
Published: July 2018

BACKGROUND

Existing approaches to health assessment for smart home residents mostly rely on the activities recognized by supervised learning methods, which require well-annotated sensor data. Obtaining such labeled data is not a feasible task, especially for senior adults.

OBJECTIVE

Developing an unsupervised learning method to health assessment for smart home residents without the need of labeled data.

METHODS

Ambient sensors are deployed in participants’ home to collect activity data. Home resident’s health is assessed via a two-step approach. In the first step, the clusters of sensor data are discovered using K-means or Gaussian Mixture Models (GMM). In the second step, the time spent on each data cluster is used to compute a health score that represents the physical health of the resident. As we could not obtain ground-truth labels, we conduct this project as an observational study.

RESULTS

We test the first step of our approach (sensor data clustering) on the Aruba dataset, which was acquired from a testbed occupied by a senior resident for more than a year. In this step, GMM achieves its best performance of 0.75 (𝐹1_score) and 0.79 (Rand_index) and outperforms K-means. Qualitative results obtained on our smart home dataset also demonstrate the correlation between the discovered sensor data clusters with resident’s daily routine. The health score derived in the second step of our approach is highly associated with the health events happened to one of our participants.

CONCLUSIONS

The experimental results demonstrate that the sensor data clusters discovered by standard clustering methods are highly correlated with the ground-truth activities or daily routine. Between the two tested methods, GMM outperforms K-means in all metrics. The health score derived by our two-step unsupervised approach is highly related to the health events happened to the resident.

CLINICALTRIAL

The CSIRO Health and Medical Research Human Research Ethics Committee (#12/17).
A Web-Based Course on Public Health Principles in Disaster and Medical Humanitarian Response: Survey Among Students and Faculty (Preprint)
Authors: Tam Greta , Chan Emily Ying Yang , Liu Sida
Published: July 2018

BACKGROUND

Web-based public health courses are becoming increasingly popular. “Public Health Principles in Disaster and Medical Humanitarian Response” is a unique Web-based course in Hong Kong. This course aimed to fill a public health training gap by reaching out to postgraduates who are unable to access face-to-face learning.

OBJECTIVE

The aim of this paper was to use a structured framework to objectively evaluate the effectiveness of a Web-based course according to Greenhalgh et al’s quality framework and the Donabedian model to make recommendations for program improvement.

METHODS

An interim evaluation of the first cohort of students in 2014 was conducted according to the Donabedian model and a quality framework by Greenhalgh et al using objective and self-reported data.

RESULTS

Students who registered for the first cohort (n=1152) from June 16, 2014 to December 15, 2014 (6 months) were surveyed. Two tutors and the course director were interviewed. The Web-based course was effective in using technology to deliver suitable course materials and assessment and to enhance student communication, support, and learning. Of the total number of students registered, 59.00% (680/1152) were nonlocal, originating from 6 continents, and 72.50% (835/1152) possessed a bachelor’s or postgraduate degree. The completion rate was 20.00% (230/1152). The chi-square test comparing students who completed the course with dropouts showed no significant difference in gender (P=.40), age (P=.98), occupation (P=.43), or qualification (P=.17). The cost (HK $272 per student) was lower than that of conducting a face-to-face course (HK $4000 per student).

CONCLUSIONS

The Web-based course was effective in using technology to deliver a suitable course and reaching an intended audience. It had a higher completion rate than other Web-based courses. However, sustainable sources of funding may be needed to maintain the free Web-based course.
Tanzania Health Information Technology (T-HIT) System: Pilot Test of a Tablet-Based System to Improve Prevention of Mother-to-Child Transmission of HIV (Preprint)
Authors: Bull Sheana , Thomas Deborah SK , Nyanza Elias C , Ngallaba Sospatro E
Published: July 2018

BACKGROUND

The prevention of mother-to-child transmission (PMTCT) of HIV requires innovative solutions. Although routine monitoring is effective in some areas, standardized and easy-to-scale solutions to identify and monitor pregnant women, test them for HIV, and treat them and their children is still lacking. Mobile health (mHealth) offers opportunities for surveillance and reporting in rural areas of low- and middle-income countries.

OBJECTIVE

The aim of this study was to document the preliminary impacts of the Tanzania Health Information Technology (T-HIT) system mHealth intervention aimed at health workers for PMTCT care delivery and capacity building in a rural area of Tanzania.

METHODS

We developed T-HIT as a tablet-based system for an electronic data collection system designed to capture and report PMTCT data during antenatal, delivery, and postnatal visits in Misungwi, Tanzania. T-HIT was tested by health workers in a pilot randomized trial comparing seven sites using T-HIT assigned at random to seven control sites; all sites maintained standard paper record-keeping during the pilot intervention period. We compared numbers of antenatal visits, number of HIV tests administered, and women testing positive across all sites.

RESULTS

Health workers recorded data from antenatal visits for 1530 women; of these, 695 (45.42%) were tested for HIV and 3.59% (55/1530) tested positive. Health workers were unable to conduct an HIV test for 103 women (6.73%, 103/1530) because of lack of reagent, which is not captured on paper logs. There was no difference in the activity level for testing when comparing sites T-HIT to non-T-HIT sites. We observed a significant postintervention increase in the numbers of women testing positive for HIV compared with the preintervention period (P=.04), but this was likely not attributable to the T-HIT system.

CONCLUSIONS

T-HIT had a high degree of acceptability and feasibility and is perceived as useful by health workers, who documented more antenatal visits during the pilot intervention compared with a traditional system of paper logs, suggesting potential for improvements in antenatal care for women at risk for HIV.
National Tunisian Registry of Atrial Fibrillation (NATURE-AF): Protocol for the Design and Rationale (Preprint)
Authors: Ben Halima Afef , Ouali Sana , Mourali Mohamed Sami , Chabrak Sonia , Chettaoui Rafik , Ben Halima Manel , Haggui Abdeddayem , Larbi Noureddine , Krichène Salma , Marrakchi Sonia , Kacem Slim , Chrigui Rim , Abbes Mohamed Fahmi , Baccar Hédi , Baraket Nadia , Ben Halima Najeh , Ben Khalfallah Ali , Ben Mbarek Mohamed , Ben Youssef Soraya , Boughzala Essia , Boujnah Mohamed Rachid , Drissa Habiba , Gamra Habib , Gasmi Ali , Haouala Habib , Harrath Youssef , Issa Ines , Jeridi Gouider , Kachboura Salem , Kammoun Samir , Kraiem Sondes , Maatouk Faouzi , Milouchi Sami , Nasraoui Wided , Neji Ali , Sayahi Khaled , Sdiri Wissem , Smati Wajih , Tlili Samir , Abid Leila , Abdesselem Salem , Zakhama Lilia , Mahdhaoui Abdallah , Kammoun Helmi , Ben Omrane Skander , Addad Faouzi
Published: July 2018

BACKGROUND

Atrial fibrillation (AF) is an important health problem in Tunisia. A significant change in the epidemiologic pattern of heart disease has been seen in the last 3 decades; however, no large prospective multicenter trial reflecting national data has been published so far. Robust data on the contemporary epidemiologic profile and management of atrial fibrillation (AF) patients in Tunisia are limited.

OBJECTIVE

The aim of this study was to analyze, follow, and evaluate patients with AF in a large multicenter nationwide trial.

METHODS

A total of 1800 consecutive patients with AF by electrocardiogram, reflecting all populations of all geographical regions of Tunisia, will be included in the study, with the objective to describe the epidemiologic pattern of AF. Patients will be ofﬁcially enrolled in the NATURE-AF only if an electrocardiogram diagnosis (12-lead, 24-hour Holter, or other electrocardiographic documentation) conﬁrming AF is made. The qualifying episode of AF should have occurred within the last year, and patients do not need to be in AF at the time of enrollment. Patients will be followed for 1 year. Incidence of stroke or transient ischemic attack, thromboembolic events, and cardiovascular death will be recorded as the primary end point and hemorrhagic accidents, measurement of international normalized ratio, and time in therapeutic range will be recorded as secondary end points.

RESULTS

Results w be available at the end of the study; the demographic profile and general risk profile of Tunisian AF patients, frequency of anticoagulation, frequency of effective treatment, and risks of thromboembolism and bleeding will be evaluated according to the current guidelines. Major adverse events will be determined. NATURE-AF will be the largest registry for North African AF patients.

CONCLUSIONS

This study would add data and provide a valuable opportunity for real-world clinical epidemiology in North African AF patients with insights into the uptake of contemporary AF management in this developing region.

CLINICALTRIAL

ClinicalTrials.gov NCT03085576; https://clinicaltrials.gov/ct2/show/NCT03085576 (Archived by WebCite at http://www.webcitation.org/6zN2DN2QX)
Diabetes Data Management System to Improve Glycemic Control in People With Type 1 Diabetes: Prospective Cohort Study (Preprint)
Authors: Irace Concetta , Schweitzer Matthias Axel , Tripolino Cesare , Scavelli Faustina Barbara , Gnasso Agostino
Published: July 2018

BACKGROUND

Smartphone and Web technology can improve the health care process, especially in chronic diseases.

OBJECTIVE

The aim of this study was to investigate whether the use of blood glucose (BG) data management system, which enables connection to smartphones, the Web, the cloud, and downloading, can improve glycemic control in subjects with type 1 diabetes mellitus (T1DM).

METHODS

This study was a prospective, single-arm, cohort feasibility study with 6 months of duration. T1DM subjects enrolled had experience in self-monitoring blood glucose, but were download data naïve. Fasting BG and glycated hemoglobin (HbA1c) were collected at the enrollment and at follow-up. Subjects were divided into Downloader (DL) and No-downloader (NDL).

RESULTS

A total of 63 subjects were analyzed, of which 30 were classified as DL and 33 as NDL. At the end of the study, DL had significantly lower HbA1c, mean daily glucose, standard deviation, percentage of BG values above target, and pre- and postprandial (lunch and dinner) values compared with NDL (all P<.05). The percentage of BG values within treatment target was significantly higher in DL compared with NDL (47% [SD 9] vs 37% [SD 13]; P=.001).

CONCLUSIONS

The findings suggest that, in T1DM, downloading of BG from data management system, which enables connection to smartphones, the Web, and the cloud, might be a valuable contributor to improved glycemic control.
mHealth Approaches in Managing Skin Cancer: Systematic Review of Evidence-Based Research Using Integrative Mapping (Preprint)
Authors: Choi Jihye , Cho Youngtae , Woo Hyekyung
Published: July 2018

BACKGROUND

mHealth, which encompasses mobile health technologies and interventions, is rapidly evolving in various medical specialties, and its impact is evident in oncology. In particular, mHealth has established itself as a prominent part of dermatology for cancer screening. Intensified research to seek its use and effectiveness in each phase of the skin cancer continuum is needed in this fast-growing field of teledermatology.

OBJECTIVE

The purpose of this review was to describe current trends in research addressing the integration of mHealth and its contributions across the skin cancer continuum.

METHODS

A systematic review framework was applied to the search using three electronic databases: PubMed, Web of Science, and Embase. We extensively reviewed appropriate studies regarding skin cancer and mobile technology published between 2007 and 2017. Studies of the role and impact of mobile technology in the prevention and management of skin cancer were included. We selected 18 studies adhering to the inclusion and exclusion criteria for analysis.

RESULTS

Of the 18 studies, 5 (28%) evaluated prevention interventions, 6 (33%) assessed diagnostic accuracy, and 7 (39%) pertained to feasibility in the context of mHealth approaches for skin cancer care. These studies portray the potential of mobile teledermatology in the prevention and management of skin cancer. However, not all phases of skin cancer involve mHealth, and not all have been addressed by research.

CONCLUSIONS

This review extends our knowledge not only on the contributions of mHealth technologies, but also on their integration in different phases of skin cancer care. To optimize the effectiveness of mHealth in dermatology, larger numbers of robust, evidence-based studies on teledermatology implementations, distributed evenly across the care continuum, should be conducted so that research can be expanded to systematic reviews.
Comparing the Effects of Oral Contraceptives Containing Levonorgestrel With Products Containing Antiandrogenic Progestins on Clinical, Hormonal, and Metabolic Parameters and Quality of Life in Women With Polycystic Ovary Syndrome: Crossover Randomized Controlled Trial Protocol (Preprint)
Authors: Amiri Mina , Nahidi Fatemeh , Khalili Davood , Bidhendi-Yarandi Razieh , Ramezani Tehrani Fahimeh
Published: July 2018

BACKGROUND

Oral contraceptives (OCs) have been used as a first-line option for medical treatment in women with polycystic ovary syndrome (PCOS). Despite theoretical superiority of products containing antiandrogenic progestins compared to OCs containing levonorgestrel (LNG), the clinical advantage of these compounds remains unclear.

OBJECTIVE

The aim of this study was to compare the effects of OCs containing LNG with products containing antiandrogenic progestins including cyproterone acetate, drospirenone, and desogestrel on clinical, hormonal, and metabolic parameters and quality of life in women with PCOS.

METHODS

We conducted a 6-arm crossover randomized controlled trial with each arm including OCs containing LNG and one of those 3 OCs containing antiandrogenic progestins. The anthropometric and clinical manifestations and hormonal and biochemical parameters of participants were assessed at 6 time points including baseline, after washout period, and 3 and 6 months after intervention.

RESULTS

The study is ongoing and follow-up of recruited women will continue until 2018.

CONCLUSIONS

This study will provide scientific evidence on comparability of OCs with the various progesterones that will assist in decision making taking into account cost effectiveness.

CLINICALTRIAL

Iranian Registry of Clinical Trials IRCT201702071281N2; http://www.irct.ir/searchresult.php?
keyword=&id=1281&number=2&prt=12869&total=10&m=1 (Archived by WebCite at http://www.webcitation.org/6tSP8FNWo)
Technology-Assisted Behavioral Intervention to Extend Sleep Duration: Development and Design of the Sleep Bunny Mobile App (Preprint)
Authors: Baron Kelly Glazer , Duffecy Jennifer , Reid Kathryn , Begale Mark , Caccamo Lauren
Published: July 2018

BACKGROUND

Despite the high prevalence of short sleep duration (29.2% of adults sleep <6 hours on weekdays), there are no existing theory-based behavioral interventions to extend sleep duration. The popularity of wearable sleep trackers provides an opportunity to engage users in interventions.

OBJECTIVE

The objective of this study was to outline the theoretical foundation and iterative process of designing the “Sleep Bunny,” a technology-assisted sleep extension intervention including a mobile phone app, wearable sleep tracker, and brief telephone coaching. We conducted a two-step process in the development of this intervention, which was as follows: (1) user testing of the app and (2) a field trial that was completed by 2 participants with short sleep duration and a cardiovascular disease risk factor linked to short sleep duration (body mass index [BMI] >25).

METHODS

All participants had habitual sleep duration <6.5 hours verified by 7 days of actigraphy. A total of 6 individuals completed initial user testing in the development phase, and 2 participants completed field testing. Participants in the user testing and field testing responded to open-ended surveys about the design and utility of the app. Participants in the field testing completed the Epworth Sleepiness Scale and also wore an actigraph for a 1-week baseline period and during the 4-week intervention period.

RESULTS

The feedback suggests that users enjoyed the wearable sleep tracker and found the app visually pleasing, but they suggested improvements to the notification and reminder features of the app. The 2 participants who completed the field test demonstrated significant improvements in sleep duration and daytime sleepiness.

CONCLUSIONS

Further testing is needed to determine effects of this intervention in populations at risk for the mental and physical consequences of sleep loss.
A Smartphone App to Reduce Sugar-Sweetened Beverage Consumption Among Young Adults in Australian Remote Indigenous Communities: Design, Formative Evaluation and User-Testing (Preprint)
Authors: Tonkin Emma , Jeffs Lauren , Wycherley Thomas Philip , Maher Carol , Smith Ross , Hart Jonathon , Cubillo Beau , Brimblecombe Julie
Published: July 2018

BACKGROUND

The disproportionate burden of noncommunicable disease among Indigenous Australians living in remote Indigenous communities (RICs) is a complex and persistent problem. Smartphones are increasingly being used by young Indigenous adults and therefore represent a promising method to engage them in programs seeking to improve nutritional intake.

OBJECTIVE

This study aimed to consult RIC members to inform the content of a smartphone app that can be used to monitor and reduce sugar-sweetened beverage intake in RICs.

METHODS

The study was conducted in two phases. The formative phase involved a simulated grocery selection activity with think aloud (“think aloud shop”), a semistructured interview, a questionnaire outlining current smartphone and app use, and a paper prototyping activity. A preliminary end-user testing phase involved a think aloud prototype test and a semistructured interview regarding user satisfaction. Convenience sampling was used to recruit 20 18- to 35-year-old smartphone users for each phase from two RICs in the Northern Territory, Australia. Thematic analysis of transcribed audio recordings was used to identify determinants of food choice from the think aloud shop; themes related to the Theory of Planned Behavior (TPB) from the eating behaviors interview; and usability, comprehension, and satisfaction with the app from the preliminary end-user testing.

RESULTS

Smartphone use in RICs is currently different to that found in urban environments; in particular, extremely low use of Facebook, restricted variety of phone types, and limited Internet access. Findings regarding promoting app engagement indicate that utilizing an opt-in approach to social features such as leader boards and team challenges is essential. The inclusion of games was also shown to be important for satisfaction, as were the use of audio features, contextually embedded dissemination, and streamlined app design for comprehension in this target group.

CONCLUSIONS

This research provides critical insights and concrete recommendations for the development of lifestyle improvement apps targeted toward disadvantaged young adults in nonurban settings, specifically RICs. It serves as a framework for future app development projects using a consultative user-centered design approach, supporting calls for the increased use of this strategy in app development.
Importance of Active Participation in Obesity Management Through Mobile Health Care Programs: Substudy of a Randomized Controlled Trial (Preprint)
Authors: Oh Bumjo , Yi Ga-Hye , Han Min Kyu , Kim Jong Seung , Lee Chang Hee , Cho Belong , Kang Hee Cheol
Published: July 2018

BACKGROUND

Due to the prevalence of the westernized dietary pattern and lack of physical activity, the numbers of overweight or obese individuals are increasing, resulting in a growing health burden because of various related diseases. A lifestyle modification approach has additional advantages compared with pharmacological therapies or bariatric surgery. In our randomized controlled trial conducted in 2015, we successfully used a ubiquitous health care (SmartCare) service for patients with metabolic syndrome to achieve a significant weight loss effect. Various useful apps have been developed for the SmartCare Service, which involves using a mobile phone to manage chronic diseases, minimizing time and space restrictions. Many studies have demonstrated weight loss effects using a SmartCare service, but limited data are available regarding the effect of active participation in relation to weight loss.

OBJECTIVE

We aimed to assess the weight loss effect achieved after using the SmartCare service in terms of adherence and participation. We divided the intervention group of the previous study according to participation level, and analyzed whether there was a significant difference in the outcome.

METHODS

We classified participants into 3 groups according to their adherence. Within the intervention group using the SmartCare service, the active group comprised those transmitting anthropometric measurement data using a mobile phone 3 or more times per week or who had a health consultation 5 or more times during a 24-week period. The passive group comprised those who did not adhere to these levels of engagement. The control group comprised those who did not use the SmartCare service. We compared changes in body weight, body mass index (BMI), body fat percentage, waist circumference, and lipid profile among the 3 groups.

RESULTS

We identified 422 participants and analyzed 405, excluding 17 who were missing necessary data for analysis. The active group consisted of 116 participants, compared with 80 in the passive group and 209 in the control group (without SmartCare service). There was a statistically significant difference in improvements to body weight, BMI, body fat percentage, and waist circumference among active participants compared with less active participants and the control group (P<.05). However, the lipid profile changes did not differ significantly between groups.

CONCLUSIONS

The level of participation may be related to improved weight-related outcomes, which may improve health outcomes. To maximize the effectiveness of the SmartCare service, encouraging active participation is important.

CLINICALTRIAL

Clinicaltrials.gov NCT01344811; https://clinicaltrials.gov/ct2/show/NCT01344811 (Archived by WebCite at http://www.webcitation.org/6alT2MmIB)
mHealth applications impact in improving immunization coverage and maternal-child health in Africa (Preprint)
Authors: Kazienga Adama , Tambo Ernest , Giordano Stefano
Published: July 2018

BACKGROUND

Despite laudable efforts and achievement, maternal and child mortality remains high in Africa. The region accounts for 97% of maternal and 94% of children less than five mortality in 2015. Limited resources, lack of infrastructures and shortage of healthcare workers have been identified as the main barriers towards healthcare outcomes improvement. Availability and use of mobile phones is increasing rapidly with 46% of African population having a mobile-cellular subscription in 2015. Mobile health (mHealth) interventions have proven to be beneficial in improving maternal and child health service delivery and outcomes in developed countries and elsewhere. In Africa, only few mhealth pilot research projects and small studies have been conducted, those limiting generalizability

OBJECTIVE

The objective of the project is to provide an overview about the current impact of mHealth applications and innovative strategies in improving large-scale (population-based) immunization coverage and maternal- child health service delivery in African countries

METHODS

Peer-reviewed papers were identified from Medline/PubMed, Google scholar and mHealthEvidence database via a combination of search terms

RESULTS

A total of 1217 articles were found of which only 17 met the inclusion criteria and were included in the project. Our findings indicates that there is some evidence on the potential of mHealth applications benefitsin increasing childhood immunization awareness, retention, coverage and effectiveness as well as maternal- child quality care delivery and outcomes

CONCLUSIONS

Building robust and resilient government and stakeholders leadership, committed partnerships and platform is crucial in investing on large-scale and sustainable ownership of mhealth policies and programs, adequate infrastructure, building capacity and mHealth/eHealth management implementation in strengthening health systems. Moreover, addressing inherent issues of mhealth interoperatibility, patient data privacy. confidentiality and security is needed for socio-economic benefits, cost-effective digital landscape public health solutions and gains across African countries
Use of Patient Generated Health Data collected from consumer wearable devices in clinical care: a systematic review and meta-analysis (Preprint)
Authors: Abdolkhani Robab , Gray Kathleen , Borda Ann
Published: July 2018

BACKGROUND

PGHD (Patient Generated Health Data) are health-related data created or recorded by patients to inform their self-care. The availability of low-cost easy-to-use consumer wearable technologies has facilitated patients’ engagement in their self-care and increased production of PGHD but the uptake of this data in clinical environments has been slow. Studies showing opportunities and challenges affecting PGHD adoption and use in clinical care have not investigated these factors in detail during all stages of the PGHD life cycle.

OBJECTIVE

This study aims to provide deeper insight into various issues influencing the use of PGHD at each stage of its life cycle from the perspectives of key stakeholders including patients, healthcare professionals, and the health IT managers.

METHODS

A systematic review was undertaken on the scholarly and industry literature published from 2012 to 2017. Thematic analysis of content was applied to uncover perspectives of the key PGHD stakeholders on opportunities and challenges related to all life cycle stages of PGHD from consumer wearables.

RESULTS

Thirty-six papers were identified for detailed analysis. Challenges were discussed more frequently than opportunities. Most studies done in real-world settings were limited to the collection stage of PGHD life cycle that captured through consumer wearables.

CONCLUSIONS

There are many gaps in knowledge on opportunities and challenges affecting PGHD captured through consumer wearables in each stage of its life cycle. A conceptual framework involving all the stakeholders in overcoming various technical, clinical, cultural, and regulatory challenges affecting PGHD during its life cycle could help to advance the integration with and use of PGHD in clinical care.
Comparing Short Dental Implants to Standard Dental Implants: Protocol for a Systematic Review (Preprint)
Authors: Rokn Amir Reza , Keshtkar Abbasali , Monzavi Abbas , Hashemi Kazem , Bitaraf Tahereh
Published: July 2018

BACKGROUND

Short dental implants have been proposed as a simpler, cheaper, and faster alternative for the rehabilitation of atrophic edentulous areas to avoid the disadvantages of surgical techniques for increasing bone volume.

OBJECTIVE

This review will compare short implants (4 to 8 mm) to standard implants (larger than 8 mm) in edentulous jaws, evaluating on the basis of marginal bone loss (MBL), survival rate, complications, and prosthesis failure.

METHODS

We will electronically search for randomized controlled trials comparing short dental implants to standard dental implants in the following databases: PubMed, Web of Science, EMBASE, Scopus, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov with English language restrictions. We will manually search the reference lists of relevant reviews and the included articles in this review. The following journals will also be searched: European Journal of Oral Implantology, Clinical Oral Implants Research, and Clinical Implant Dentistry and Related Research. Two reviewers will independently perform the study selection, data extraction and quality assessment (using the Cochrane Collaboration tool) of included studies. All meta-analysis procedures including appropriate effect size combination, sub-group analysis, meta-regression, assessing publication or reporting bias will be performed using Stata (Statacorp, TEXAS) version 12.1.

RESULTS

Short implant effectiveness will be assessed using the mean difference of MBL in terms of weighted mean difference (WMD) and standardized mean difference (SMD) using Cohen’s method. The combined effect size measures in addition to the related 95% confidence intervals will be estimated by a fixed effect model. The heterogeneity of the related effect size will be assessed using a Q Cochrane test and I2 measure. The MBL will be presented by a standardized mean difference with a 95% confidence interval. The survival rate of implants, prostheses failures, and complications will be reported using a risk ratio at 95% confidence interval (P<.05).

CONCLUSIONS

The present protocol illustrates an appropriate method to perform the systematic review and ensures transparency for the completed review. The results will be published in a peer-reviewed journal and social networks. In addition, an ethics approval is not considered necessary.

CLINICALTRIAL

PROSPERO registration number: CRD42016048363; https://www.crd.york.ac.uk/PROSPERO/ display_record.asp?ID=CRD42016048363 (Archived by WebCite at http://www.webcitation.org/6wZ7Fntry)
Using Reddit to recruit hard-to-reach study populations (Preprint)
Authors: Friedman Katherine L. , Norris Alison H. , Gallo Maria F
Published: July 2018

BACKGROUND

Social media websites (e.g., Facebook and Twitter) have been used to recruit hard-to-reach populations for research. One hard-to-reach population is women who are refused reproductive health care due to a provider’s moral or ethical beliefs.

OBJECTIVE

To test methods for recruiting a hard-to-reach population into qualitative research via Reddit, a social news aggregation and discussion site.

METHODS

We employed two recruitment methods: 1) recruitment posts on applicable subreddits (pages dedicated to specific topics) and 2) private messaging Reddit users who had previously posted about being denied this care.

RESULTS

For the first approach, we posted recruitment messages 13 times on 6 subreddits at various times during a five-month interval. This method yielded no interviews. For the second approach, we used key words in Reddit’s search function, which revealed posts from 13 potentially-eligible women. After messaging the women, three completed the interview.

CONCLUSIONS

Social media websites (e.g., Facebook and Twitter) have been used to recruit hard-to-reach populations for research. One hard-to-reach population is women who are refused reproductive health care due to a provider’s moral or ethical beliefs.
Developing Digital Games to Address Airway Clearance Therapy in Children With Cystic Fibrosis: Participatory Design Process (Preprint)
Authors: Balli Fabio
Published: July 2018

BACKGROUND

Children affected with cystic fibrosis do respiratory exercises to release the mucus stuck in their lungs.

OBJECTIVE

The objective of our study was to develop prototypes of digital games that use breath pressure to make this daily physiotherapy more fun.

METHODS

We used a participatory design approach and organized short events to invite contributors from different disciplines to develop game prototypes. From the 6 prototypes, 3 were tested by 10 children during a prestudy. The source code of the games, of which 2 continue to be developed, has been released on the internet under fair use licenses.

RESULTS

We discuss 7 themes of importance in designing games for health, combining our experience with a review a posteriori of literature.

CONCLUSIONS

This study provides examples of games and their pitfalls as well as recommendations to create games for health in a participatory approach that enables everyone to improve and adapt the work done.
Comparative Analysis of Health Information Discrepancies Between Internet Media and Scientific Articles Reporting on Omega-3 Supplement Research (Preprint)
Authors: Nault Daryl , Beccia Ariel , Ito Haruka , Kashdan Sarah , Senders Angela
Published: July 2018

BACKGROUND

Dietary supplements are the most used complementary and alternative health modality in the U.S., and omega-3 supplements continue to be the most popularly used non-vitamin/non-mineral supplements by adults. Supplement users report that they obtain health guidance from internet media resources, but there is question as to whether or not these resources provide the necessary evidence to guide health decisions. Current evidence suggests that there is a mistranslation occurring somewhere between researchers and the media.

OBJECTIVE

We conducted a comparative cross-sectional analysis to identify areas of discordance created when science is translated from the lab to online news media.

METHODS

A Google news search provided our convenience sample of 40 omega-3 supplement based media reports stratified by the years 2009-2012. Media reports (n = 17) were compared to the corresponding scientific article for content. Report and article content was extracted using commonly accepted reporting guideline domains, and domains were then compared to detect underlying omissions or mistranslations in reporting. Mean scores for all of the scientific articles and media reports were assessed for each domain.

RESULTS

Scientific articles (n=14) generally maintained a mean close to complete for each reporting domain. The only domain where there was not a significant difference between Media and Scientific reporting match was within the Objectives domain (x2 = 0.832, p = 0.362). Media reports (n=17) more frequently reported potential caveats and warnings for consumers with a mean domain for Caveat reporting of 0.88, with possible scores falling between 0 and 1.

CONCLUSIONS

There are inherent differences in the intended audience, structure, and goals in scientific and media communications. These differences should be explored further, and consumers should be made aware of them. Additional considerations for balanced reporting and reader accessibility are also necessary to take into account, and are explored further in this analysis.
eHealth Technologies, Multimorbidity, and the Office Visit: Qualitative Interview Study on the Perspectives of Physicians and Nurses (Preprint)
Authors: Macdonald Graham G , Townsend Anne F , Adam Paul , Li Linda C , Kerr Sheila , McDonald Michael , Backman Catherine L
Published: July 2018

BACKGROUND

eHealth is a broad term referring to the application of information and communication technologies in the health sector, ranging from health records to telemedicine and multiple forms of health education and digital tools. By providing increased and anytime access to information, opportunities to exchange experiences with others, and self-management support, eHealth has been heralded as transformational. It has created a group of informed, engaged, and empowered patients as partners, equipped to take part in shared decision making and effectively self-manage chronic illness. Less attention has been given to health care professionals’ (HCPs) experiences of the role of eHealth in patient encounters.

OBJECTIVE

The objective of this study was to examine HCPs’ perspectives on how eHealth affects their relationships with patients living with multiple chronic conditions, as well as its ethical and practical ramifications.

METHODS

We interviewed HCPs about their experiences with eHealth and its impact on the office visit. Eligible participants needed to report a caseload of ≥25% of patients with multimorbidity to address issues of managing complex chronic conditions and coordination of care. We used a semistructured discussion guide for in-depth interviews, and follow-up interviews served to clarify and expand upon initial discussions. Constant comparisons and a narrative approach guided the analyses, and a relational ethics conceptual lens was applied to the data to identify emergent themes.

RESULTS

A total of 12 physicians and nurses (6 male, 6 female; median years of practice=13) participated. eHealth tools most frequently described were Web-based educational resources for patients and Web-based resources for HCPs such as curated scientific summaries on diagnostic criteria, clinical therapies, and dosage calculators. Analysis centered on a grand theme of the two-way conversation between HCPs and patients, which addresses a general recentering of the ethical relationship between HCPs and patients around engagement. Subthemes explain the evolution of the two-way conversation, and having, using, and supporting the two-way conversation with patients, primarily as this relates to achieving adherence and health outcomes.

CONCLUSIONS

Emerging ethical concerns were related to the ambiguity of the ideal of empowered patients and the ways in which health professionals described enacting those ideals in practice, showing how the cultural shift toward truly mutually respectful and collaborative practice is in transition. HCPs aim to act in the best interests of their patients; the challenge is to benefit from emergent technologies that may enhance patient-HCP interactions and effective care, while abiding by regulations, dealing with the strictures of the technology itself, and managing changing demands on their time.
Measuring Engagement in eHealth and mHealth Behavior Change Interventions: Viewpoint of Methodologies (Preprint)
Authors: Short Camille E , DeSmet Ann , Woods Catherine , Williams Susan L , Maher Carol , Middelweerd Anouk , Müller Andre Matthias , Wark Petra A , Vandelanotte Corneel , Poppe Louise , Hingle Melanie D , Crutzen Rik
Published: July 2018

UNSTRUCTURED

Engagement in electronic health (eHealth) and mobile health (mHealth) behavior change interventions is thought to be important for intervention effectiveness, though what constitutes engagement and how it enhances efficacy has been somewhat unclear in the literature. Recently published detailed definitions and conceptual models of engagement have helped to build consensus around a definition of engagement and improve our understanding of how engagement may influence effectiveness. This work has helped to establish a clearer research agenda. However, to test the hypotheses generated by the conceptual modules, we need to know how to measure engagement in a valid and reliable way. The aim of this viewpoint is to provide an overview of engagement measurement options that can be employed in eHealth and mHealth behavior change intervention evaluations, discuss methodological considerations, and provide direction for future research. To identify measures, we used snowball sampling, starting from systematic reviews of engagement research as well as those utilized in studies known to the authors. A wide range of methods to measure engagement were identified, including qualitative measures, self-report questionnaires, ecological momentary assessments, system usage data, sensor data, social media data, and psychophysiological measures. Each measurement method is appraised and examples are provided to illustrate possible use in eHealth and mHealth behavior change research. Recommendations for future research are provided, based on the limitations of current methods and the heavy reliance on system usage data as the sole assessment of engagement. The validation and adoption of a wider range of engagement measurements and their thoughtful application to the study of engagement are encouraged.
ACTD: BRIDGE BETWEEN REGULATORY REQUIREMENTS OF DEVELOPED AND DEVELOPING COUNTRIES
Authors: Jain Achin , Venkatesh M P , Kumar Pramod T.M.
Published: July 2018

Regulatory Dossier contains data which when submitted to the regulatory authority, provides for the review andultimate approval of a drug product. Once approved, an applicant may manufacture and market the drug to provide asafe, effective and low cost which benefits the society. Filing requirements in developed countries differ fromdeveloping countries which makes the approval process tedious and time consuming for the later. To make thisprocess smooth, ASEAN CTD (ACTD) was developed by Association of South East Asian Nations (ASEAN)nations. As format of ACTD resembles the format of Common Technical Document (CTD) with some differences,hence it can be used as a step. Also if both guidelines can be harmonized then differences and variation between boththe guidelines can be minimized. This article focuses on the similarities and differences in between CTD & ACTDand highlights how ACTD can be a initiating step for developing countries to meet pharmaceutical regulations ofdeveloped countries.
A simple relationship of bond dissociation energy and average charge separation to impact sensitivity for nitro explosives
Authors: Mei Zheng , Zhao Fengqi , Xu Siyu , Ju Xuehai
Published: July 2018

The bond dissociation energy (BDE) of the weakest bonds in 33 explosives were calculated and analyzed using the B3LYP method with the 6-311++G** basis set. A comparison between BDE and the impact sensitivity H50 showed that cleavage of the weakest bond plays an important role in the initiation of detonation. Using the generalized gradient approximation (GGA) with the Perdew?Burke?Ernzerhof (PBE) method and dispersion-corrected density functional theory (DFT-D), the simulation of compressed TNT (2-methyl-1,3,5- -trinitrobenzene) and royal demolition explosive (RDX, hexahydro- -1,3,5-trinitro-1,3,5-triazine) crystals showed that an imbalance of the electrostatic surface potential (ESP) leads to molecular deformation and instability of the explosive under impact pressures. The average charge separation (?) of the molecules was calculated and used to demonstrate the ESP balances. Based on the BDE, ? and the experimental H50 values, simple quantitative structure? sensitivity correlations were established for the nitro heterocycles, nitramines, picryl heterocycles and nitro aromatics, respectively. The fitting relationship is simple yet statistically significant with only two variables. The correlation coefficients, R2, are larger than 0.8 with F>F**(0.05) (95 % confidence intervals).
Morphology dependent photocatalytic efficacy of zinc ferrite probed for methyl orange degradation
Authors: Xu Huan-Yan , Li Bo , Li Ping
Published: July 2018

Zinc ferrite (ZnFe2O4) photocatalysts with different morphologies (sizes and shapes) were synthesized to explore the effect of morphology on their photocatalytic efficiency. The results obtained using field emission scanning electron microscopy (FESEM) revealed that the obtained samples had the needle-, cube-, granule- and plate-like morphology, labeled as NZFO, CZFO, GZFO and PZFO, respectively. X-ray diffraction (XRD) patterns showed that all the samples had the spinel structure of ZnFe2O4 without any other impurities. The calculated average crystallite size followed the order NZFO<GZFO<CZFO< GZFO>CZFO>PZFO. The photocatalytic efficiency for the degradation of methyl orange also followed the order NZFO> >GZFO>CZFO>PZFO. The morphology-dependent photocatalytic efficiency of ZnFe2O4 was closely related with its crystallite size and surface area. The smaller the crystallite size was, the larger the surface area was, and the higher the photocatalytic efficiency was.
Force changes associated with different intrusion strategies for deep-bite correction by clear aligners
Authors: Liu Yang , Hu Wei
Published: July 2018

Objectives:

To investigate the relationships among different intrusion patterns of clear overlay aligners and the corresponding orthodontic forces and to provide guidance for clinical treatment.

Materials and Methods:

Five sets of removable thermoplastic-formed aligners with the same thickness, designed for different intrusion procedures (G0 aligners as a control group, with no activation; G1 aligners for intruding canines; G2 aligners for intruding incisors; G3 aligners for intruding canines and incisors with the same activations; G4 aligners for intruding canines and incisors with different activation), were manufactured, and the corresponding intrusion forces were measured with a multiaxis force/torque transducer measurement system in real time.

Results:

With the same activation (0.2-mm intrusion) and rectangular attachments placed on the premolars and first molars, the canines experienced the largest intrusive force when intruded alone using G1 aligners. The canines received a larger intrusive force than incisors in G3. The incisors received similar forces in G2 and G3. First premolars endured the largest extrusive forces when all anterior teeth were intruded with G3 aligners. Extrusion forces were exerted on canines and lateral incisors when using G4 aligners.

Conclusions:

Aligners with different intrusion patterns exert different forces on incisors, canines, and premolars, and the forces were closely related to the designed activation, shape and position of the attachment and relative movement of the adjacent teeth.
Populorum Progressio 50 anos depois
Authors: Ottaviani Edelcio
Published: July 2018

O presente artigo aborda a Populorum Progressio com um olhar carregado de acontecimentos e pensamentos ocorridos 50 anos depois. Não se trata de uma leitura analítica de todos os seus pontos e nem de uma exaustiva análise histórica, embora aborde essas duas dimensões ao mostrar a validade de seu pensamento como alternativa à hegemonia da razão neoliberal, que tem pautado os critérios para avaliar o desenvolvimento e o progresso dos povos na realidade atual. O artigo está dividido em duas partes, seguidas de uma pequena conclusão. Na primeira parte é apresentado o lugar da Populorum Progressio na Doutrina Social da Igreja, bem como o contexto histórico, a estrutura e principais pontos do documento. Na segunda parte procurar-se-á contrapor os valores e os fundamentos do Estado de bem-estar social, sobre o qual está pautada a noção de desenvolvimento na Populorum Progressio, à nova razão do mundo, pautada no pensamento neoliberal. Para tanto, lançamos mão das análises filosóficas de Michel Foucault, Christian Laval e Pierre Dardot, quanto das análises teológicas de José Comblin e dos aportes pastorais do Papa Francisco.