bluuebunny/crossref_metadata_2025 huggingface dataset:
Hyperglycemia Promotes Pancreatic Cancer Initiation and Progression by Activating the Wnt/β-Catenin Signaling Pathway
Authors: Chen Huiming , Zhao Junfeng , Jiang Ningning , Wang Zheng , Liu Chang
Published: February 2021

Background:

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal diseases, with a 5-
year survival rate of less than 10% because of the limited knowledge of tumor-promoting factors and their underlying
mechanism. Diabetes mellitus (DM) and hyperglycemia are risk factors for many cancers, including
PDAC, that modulate multiple downstream signaling pathways, such as the wingless/integrated (Wnt)/β--
catenin signaling pathway. However, whether hyperglycemia promotes PDAC initiation and progression by activating
the Wnt/β-catenin signaling pathway remains unclear.

Methods:

In this study, we used bioinformatics analysis and clinical specimen analysis to evaluate the activation
states of the Wnt/β-catenin signaling pathway. In addition, colony formation assays, Transwell assays and
wound-healing assays were used to evaluate the malignant biological behaviors of pancreatic cancer cells (PCs)
under hyperglycemic conditions. To describe the effects of hyperglycemia and the Wnt/β-catenin signaling pathway
on the initiation of PDAC, we used pancreatitis-driven pancreatic cancer initiation models in vivo and pancreatic
acinar cell 3-dimensional culture in vitro.

Results:

Wnt/β-catenin signaling pathway-related molecules were overexpressed in PDAC tissues/cells and correlated
with poor prognosis in PDAC patients. In addition, hyperglycemia exacerbated the abnormal activation
of β-catenin in PDAC and enhanced the malignant biological behaviors of PCs in a Wnt/β-catenin signaling
pathway-dependent manner. Indeed, hyperglycemia accelerated the formation of precancerous pancreatic lesions
by activating the Wnt/β-catenin signaling pathway in vivo and in vitro.

Conclusion:

Hyperglycemia promotes pancreatic cancer initiation and progression by activating the Wnt/β-
catenin signaling pathway.
Potential Interactions between miRNAs and Hypoxia: A New Layer in Cancer Hypoxia
Authors: Tapeh Behnam Emamgolizadeh-Gurt , Alivand Mohammad R. , Solalii Saeed
Published: February 2021

Hypoxia pathway and aberrant miRNA expression profile play crucial roles in the development of
various cancers. Recent studies have emphasized that there are many collaborations in this cases because both
of them are involved in cancer cell processes, including differentiation, metastasis, and cell proliferation and
signaling pathways. Further studies have elucidated that miRNAs affect the hypoxia route, and more interestingly,
the hypoxia pathway also affects miRNAs expression profile. The literature review summarizes the fundamental
roles of hypoxia-related miRNAs in different cancers. The mutual interactions between miRNAs and hypoxia
are a new layer of complexity in cancer hypoxia, which might be helpful in controlling cancer progression.
It is also possible that the hypoxia pathway is initiated by miRNAs. In contrast, the hypoxia pathway regulates
the expression of a large group of miRNAs. In this review for the first time, we discussed the significant
interactions between hypoxia and miRNAs in order to determine new perspectives for new therapeutic aims in
the field of cancer.
Identification of New Hsp90 Inhibitors: Structure Based Virtual Screening, Molecular Dynamic Simulation, Synthesis and Biological Evaluation
Authors: Abbasi Maryam , Amanlou Massoud , Aghaei Mahmoud , Hassanzadeh Farshid , Sadeghi-Aliabadi Hojjat
Published: February 2021

Background:

Heat shock protein90 (Hsp90) is overexpressed in tumor cells, thus the inhibition of the Hsp90 ATPase activity would be a meaningfully an effective strategy in cancer therapy.

Objective:

The present work was aimed at four steps: designing new Hsp90 inhibitors as anti-cancer by a virtual screening study; synthesize designed compounds; biological evaluation of them and finally molecular dynamic (MD) simulations of best compounds.

Methods:

A virtual screening study was performed on a library (100 compounds) of the ZINC database with
benzimidazole scaffold; then an extracted compound and two derivatives were synthesized. The anti-proliferative
and ATPase inhibitory activities of these compounds were evaluated by MTT and ATPase inhibition assays,
respectively. The western blot analysis was performed to the evaluation of the expression level of Hsp70 and
Her2 proteins. Finally, 200 ns molecular dynamic simulation was carried out to confirm the stability of the
strongest synthesized compound in Hsp90 active site.

Results:

ZINC00173501 compound with an aminobenzimidazole scaffold was chosen by the virtual screening
study. ZINC00173501 compound and two of its derivatives were synthesized. ATPase inhibitory activity of
three synthesized compounds shown that ZINC00173501 compound was the most potent inhibitor (IC50= 8.6
μM) with the anti-proliferative activity 14.41 μM, 19.07 μM and more than 100 μM against MCF-7, HeLa and
HUVEC cell lines, respectively. The high level of Hsp70 expression and low level of Her2 expression confirmed
ZINC00173501 as an Hsp90 inhibitor. Finally, molecular dynamics simulation showed that ZINC00173501 was
stable in Hsp90 active site during 200 ns simulation.

Conclusion:

The biological evaluation results show that 2-aminobenzimidazole scaffold could be suggested as a lead for inhibition of Hsp90.
Statistical Review of the Suicide Attempts Rates Committed on Polish Railway Tracks between the Years 2013-2016
Authors: Makara-Studzinska Marta , Czabański Adam , Gronowska Katarzyna , Leszek Jerzy , Mikhaylenko Elizaveta V. , Avila-Rodriguez Marco F. , Muresanu Cristian , Somasundaram Siva G. , Kirkland Cecil E. , Aliev Gjumrakch
Published: February 2021

Suicides on railway tracks are one of the most drastic ones. No research concerning this
phenomenon has been conducted to this date in Poland. This article focuses on the connection between
suicidal behaviors on Polish railway tracks and sociodemographic traits and presents risk factors.

Background:

The Incidence of suicide is spread across many European countries. Of these, Poland
ranks 22nd in terms of suicide attempts. This study aims to highlight the suicide attempts rates
on Polish railways lines and their main risk factors. Limited available of statistical data before
2013.

Methods:

Statistical review of the available Central Police headquarters database and analyses of
the influence of the risk factors on people’s awareness during the suicide attempts and their geographical
distribution in Poland during the years 2013-2016. The prevalence of railway suicides in
individual voivodeships (provinces) in Poland has been indicated in a 3D map.

Results:

There were 834 cases of railway suicide fatalities across the entire country. Of the total
suicide statistics by any means, 3.75% are railway related. The average known age of those committing
railway suicides were: 37.9 years for men (n = 627) and 34.6 for women (n = 155). In most
cases, suicides were committed by bachelors (54.3%). The largest group of people who committed
suicide had a primary level of education (42.0%). Among the suicides, a significant group are unemployed
(45.2%). Alcohol intoxication was found established responsible for a person’s low
awareness of his actions in 70.9% of cases. Almost 63.3% of people had a higher propensity for
suicidal ideation and behavior, resulting in their being treated for mental health issues.

Conclusion:

Alcohol intoxication, illegal narcotics and psychotropic medication are responsible for a
person’s lower awareness of his or her actions, in most of the cases of suicide on Polish railway lines.
Ticagrelor Ameliorates Bleomycin-Induced Pulmonary Fibrosis in Rats by
the Inhibition of TGF-β1/Smad3 and PI3K/AKT/mTOR Pathways
Authors: Wanas Hanaa , El Shereef Zeinab , Rashed Laila , Aboulhoda Basma Emad
Published: February 2021

Background:

Idiopathic pulmonary fibrosis (IPF) is a serious disease with high mortality rate. Activation of transforming growth factor (TGF)-β1 production and signalling is considered the corner stone in the epithelial-mesenchymal transition (EMT) process. EMT plays a central role in development of fibrosis in many organs including the lungs. Activated platelets are an important source of TGF-β1 and play a pivotal role in EMT and fibrosis process. The antiplatelet, ticagrelor was previously found to inhibit the EMT in different types of cancer cells, but its ability to serve as an anti-pulmonary fibrosis (PF) agent was not previously investigated.

Objective:

In this study, we aim to investigate the potential ability of ticagrelor to ameliorate bleomycin-induced fibrosis in rats.

Methods:

PF was induced in rats by intratracheal BLM at a dose of 3 mg/kg. The effect of daily daily 20 mg/kg oral ticagrelor on different histological and biochemical parameters of fibrosis was investigated.

Results:

Our results revealed that ticagrelor can alleviate lung fibrosis. We found that ticagrelor inhibited TGF-β1 production and suppressed Smad3 activation and signaling pathway with subsequent inhibition of Slug and Snail. In addition, ticagrelor antagonized PI3K/AKT/mTOR pathway signaling. Moreover, ticagrelor inhibited the EMT that revealed by its ability to up-regulate the epithelial markers as E-cadherin (E-cad) and to decrease the expression of the mesenchymal markers as vimentin (VIM) and alpha-smooth muscle actin (α-SMA).

Conclusion:

Our results suggest that the P2Y12 inhibitor, ticagrelor may have a therapeutic potential in reducing the progression of PF.
Application of Artificial Intelligence in Drug Repurposing: A mini-review
Authors: Selvaraj Gurudeeban , Kaliamurthi Satyavani , Peslherbe Gilles H. , Wei Dong-Qing
Published: February 2021

Background and aim:

This study aims at the advancement of extra-ordinary biomedical
data (genomics, proteomics, metabolomics, drug libraries, and patient care data), evolution of supercomputers,
and continuous development of new algorithms that lead to a generous revolution in artificial
intelligence (AI). Currently, many biotech and pharmaceutical companies made reasonable
investments in and have co-operation with AI companies increasing the chance of better healthcare
tools development, includes biomarker and drug target identification, designing a new class of drugs
and drug repurposing. Thus, the study is intended to project the pros and cons of AI in the application
of drug repositioning.

Methods:

Using the search term “AI” and “drug repurposing” the relevant literature retrieved and
reviewed from different sources includes PubMed, Google Scholar, and Scopus.

Results:

Drug discovery is a lengthy process; however, leveraging the AI approaches in drug repurposing
via quick virtual screening may enhance and speed-up the identification of potential drug
candidates against communicable and non-communicable diseases. Therefore, in this mini-review,
we have discussed different algorithms, tools and techniques, advantages, limitations on predicting
the target in repurposing a drug.

Conclusions:

AI technology in drug repurposing with the association of pharmacology can efficiently
identify drug candidates against pandemic diseases.
Ultrahigh-efficiency Enhanced Four-wave-mixing in Si-Ge-Graphene Photonic Crystal Waveguide
Authors: Hou Yujun , Jiang Chun
Published: February 2021

Background:

All-optical processing has a huge superiority in speed and efficiency than
traditional optical-electrical-optical signal processing. Four-wave-mixing is an important nonlinear
parametric process to achieve all-optical processing.

Objective:

We proposed the photonic crystal waveguide to enhance the conversion efficiency of
four-wave-mixing significantly in practical application.

Results:

We demonstrated a waveguide composed of silicon with mono-layer graphene-coated as
core and Si-Ge distributed periodically on both sides as cladding. By the introduction of the slow
light effect of Si-Ge photonic crystal and the localization effect of graphene, the conversion efficiency
of four-wave-mixing had enhanced dramatically.

Results::

The conversion efficiency can be increased by 16dB compared with a silicon waveguide.
The maximum efficiency as high as -9.1dB can be achieved in the Si-Ge-Graphene photonic crystal
waveguide (SGG-PhCWG). The propagation loss can be decreased to 0.032dB/cm.

Conclusion::

Numerical results of the proposed SGG-PhCWG matched well with nonlinear coupled-
mode theory. This configuration offered a new physical mechanism and solution for alloptical
signal processing and high-efficiency nonlinear nanoscale devices.
Revisiting Feature Ranking Methods using Information-Centric and Evolutionary Approaches: Survey
Authors: Gandhi Rashmi , Ghose Udayan , Thakur Hardeo Kumar
Published: February 2021

Feature ranking can have a severe impact on the feature selection problem. Feature ranking methods refer to the structure of features that can accept the designed data and have a positive effect on the quality of features. Moreover, accessing useful features helps in reducing cost and improving the performance of a feature ranking algorithm. There are numerous methods for ranking the features that are available in the literature. The developments of the past 20 years in the domain of knowledge research have been explored and presented in terms of relevance and various known concepts of feature ranking problems. The latest developments are mostly based on the evolutionary approaches which broadly include variations in ranking, mutual information, entropy, mutation, parent selection, genetic algorithm, etc. For a variety of algorithms based on differential evolution, it has been observed that although the suitability of the mutation operator is extremely important for feature selection yet other operators can also be considered. Therefore, the special emphasis of various algorithms is observing and reviewing the algorithms and finding new research directions: The general approach is to review a rigorous collection of articles first and then obtain the most accurate and relevant data followed by the narrow down of research questions. Research is based on the research questions. These are reviewed in four phases: designing the review, conducting the review, analyzing, and then writing the review. Threats to validity is also considered with research questions. In this paper, many feature ranking methods have been discussed to find further direction in feature ranking and differential evolution. A literature survey is performed on 93 papers to find out the performance in relevance, redundancy, correlation with differential evolution. Discussion is suitable for cascading the direction of differential evolution in integration with information-theoretic, entropy, and sparse learning. As differential evolution is multiobjective in nature so it can be incorporated with feature ranking problems. The survey is being conducted on many renowned journals and is verified with their research questions. Conclusions of the survey prove to be essential role models for multiple directions of a research entity. In this paper, a comprehensive view on the current-day understanding of the underlying mechanisms describing the impact of algorithms and review current and future research directions for use of evolutionary computations, mutual information, and entropy in the field of feature ranking is complemented by the list of promising research directions. However, there are no strict rules for the pros and cons of alternative algorithms.
A Review on Lyotropic Liquid Crystals and Its Potential Applications
Authors: Kumar Hitesh , Sureshkumar Aishwarya , Badduri Nihal , Jain Vikas
Published: February 2021

Backgraound:

Novel drug delivery systems have always been of immense interest for research. Majority of the drugs suffers from solubity related constraints. Lipid based drug delivery systems provide a promising approach to address this issue.Amogst various approaches, liquid crystalline systems offers distinct advantages over other available options. It maintains the phase stablility between solid and liquid phases.

Objective:

Lyotropic Liquid Crystals (LLCs) have highly ordered internal structure forming capabilities thereby assisting the controlled release of a therapeutic agent of varying sizes and polarities.

Methods:

The present article covers the structural features of dispersed mesophases (cubosomes and hexosomes), components used to prepare various mesophases, method of preparation, characterization techniques and potential applications.

Results:

LLCsoffers a distinct choice for delivering hydrophobic as well as hydrophilic drug. They are also suitable for the delivery of macromolecules such as peptide and protiens through various routes of administration.Lyotropic liquid crystals are extremely versatile drug delivery systems that can be used for delivering drugs across topical, oral, buccal, pulmonary and intravenous routes. Their use in the delivery of tough to deliver drugs, hormones, peptides, biomolecules and vaccines is particularly important.

Conclusion:

This review discussed the composition, methods of preparation and characterization of LLCs. The LLCs offer promsing delivery choice for the drugs with lower solubility and higher toxicity.
Towards a Shift in Regression Test Suite Development Approach in Agile
Authors: Sharma Sarika , Kumar Deepak
Published: February 2021

Objective:

From the literature review, it is evident that the concept of “regression testing” inherited in agile
software testing originates from software maintenance practices. Therefore, the existing algorithms for regression testing
revolve around the software maintenance principles rather than agile methodology. The objective of this paper is to
evaluate the degree of fitness of the existing regression test-suite development algorithms for performing the regression
testing in agile.

Methods:

This paper performs a systematic literature review for research work published from 2006 to 2018, which
includes survey of the existing regression testing algorithms to identify and overcome the challenges associated with them
while performing regression testing in agile. This research paper considers the four research questions into scope for
analyzing the fitness of existing regression test-suite development algorithm for performing regression testing under agile
methodology. Further, this paper attempts to propose approach for the development of the regression test-suite suitable for
regression testing under agile methodology.

Results:

The current regression test-suite development algorithm were found unsuitable for performing the regression
testing under agile methodology due to the newly identified four key challenges associated with them.

Conclusion:

The current regression test-suite development algorithms aligned with software maintenance principles
rather than agile methodology. In addition, the newly proposed approach for regression test-suite development found to be
easily adaptable by agile teams as it aligns with agile methodology principles. Finally, this paper recommends the
adoption of agile principle through the newly proposed approach for developing regression test-suite for performing
regression testing under agile methodology.
Hongos asociados al mangle rojo Rhizophora mangle (Rhizophoraceae) en la Reserva de la Biosfera Isla Cozumel, Quintana Roo, México
Authors: García-Martínez Yenitze , Heredia Abarca Gabriela , Guzmán-Guillermo Jorge , Valenzuela Ricardo , Raymundo Tania
Published: February 2021

Antecedentes y Objetivos: Los manglares proporcionan beneficios ecológicos y económicos. Además, albergan una alta diversidad de organismos dentro de los cuales están los hongos, que por su versatilidad proliferan tanto en restos vegetales como en la vegetación viviente en estos ecosistemas. No obstante su importancia, el conocimiento micológico en los manglares mexicanos es aún escaso. El objetivo central del presente trabajo es aportar información sobre la riqueza fúngica asociada a Rhizophora mangle, una de las especies arbóreas dominantes en los manglares del Caribe Mexicano.Métodos: Durante el año 2019 se recolectaron ejemplares fúngicos desarrollándose en ramas vivas y muertas, troncos caídos, raíces y hojarasca. Las colectas se efectuaron en manchones con poblaciones de R. mangle en la Reserva de la Biosfera Isla de Cozumel. La determinación taxonómica se llevó a cabo de acuerdo con las técnicas tradicionales en micología. Los ejemplares están depositados en el herbario de la Universidad Veracruzana (XALU) y en la colección de hongos de la Escuela Nacional de Ciencias Biológicas (ENCB).Resultados clave: Se determinarón 20 especies de hongos sobre diferentes estructuras de R. mangle. Se presentan 19 nuevos registros para la Isla de Cozumel, mientras que Arthonia conferta, Halorosellinia oceanica, Phyllosticta capitalensis, Pseudocamarosporium propinquum y Chaetosphaerella fusca son nuevos registros para México. La clase Arthoniomycetes presentó la mayor riqueza taxonómica. Los sustratos con mayor riqueza y abundancia fueron las cortezas de ramas. Conclusiones: La comunidad de hongos asociados a R. mangle esta dominada por ascomicetos. Los hábitos mejor representados son saprobios lignícolas y liquenizados epífitos.
Variación de la longitud de la seta y la refutación de Hedwigidium=Braunia (Hedwigiaceae, Bryopsida)
Authors: De Luna Efraín
Published: February 2021

Antecedentes y Objetivos: Tradicionalmente considerado monotípico, Hedwigidium fue recientemente propuesto idéntico a Braunia, porque “… some Braunia species have a seta as short as that of Hedwigidium”. Este trabajo ofrece datos y análisis para refutar la hipótesis taxonómica Hedwigidium=Braunia. Métodos: Se midió la longitud de la seta (n=682) en 20 especies de los cuatro géneros de Hedwigiaceae para comparar la variación entre Hedwigia (n=10), Hedwigidium (n=40), Braunia (n=614) y Pseudobraunia (n=18). Las mediciones se sometieron a análisis de varianza y comparaciones múltiples para revelar si algunas especies de Braunia tienen setas tan cortas como las de Hedwigidium, o no. Resultados clave: Los análisis de varianza seguidos de comparaciones pareadas de Mann-Whitney revelaron que el promedio de la seta en Hedwigidium imberbe (0.7 mm, sd=0.21) es diferente del promedio de la longitud de la seta en cada una de las siete especies de Braunia con setas cortas, todas en el rango de 2.0-2.3 mm. Por primera vez, se documenta y se mapea la distribución geográfica de Hedwigidium. Se verifican los registros para Europa (Reino Unido, Noruega, Francia, Italia, España), África (Camerún, RD Congo, Malawi, Tanzania, Uganda, Zimbabue, Sudáfrica, Isla Reunión, Kenia) y el Sureste de Asia (India, Sri Lanka, Indonesia). En el Nuevo Mundo, Hedwigidium se confirma para México, Guatemala, El Salvador, Honduras, Costa Rica, República Dominicana, y América del Sur (Venezuela, Colombia, Ecuador, Perú, Bolivia, Chile, Argentina, Brasil). Conclusiones: Los datos y análisis estadísticos presentados aquí refutan la conclusión taxonómica que Hedwigidium es idéntico a Braunia. Ninguna de las especies de Braunia tienen setas tan cortas como las de Hedwigidium. Por lo tanto, aun sobrevive sin refutar la hipótesis alternativa de que Hedwigidium es un género separado. Se discuten caracteres taxonómicos adicionales importantes en la distinción de este género de otros géneros en las Hedwigiaceae.
The legal and legitimate rooting for the issue of alimony in the Iraqi Personal Status Law
Authors: Othman Nasren Abubakr , Salah Khaled Mohammad
Published: February 2021

Marital alimony is one of the inalienable rights of the wife over her husband according to the correct marriage contract, and it is one of the effects of the marriage contract, and this alimony has great importance in marital life and a prominent role in the stability of the family, which is the basic building block of society. The alimony comes in exchange for the wife's obedience to her husband And devote herself to manage her home and rearing her children .In recent times, some doubts have been raised about the feasibility and justification of alimony, as some feminist organizations considered Feminism  it a means of humiliating women and a reason for the wife’s subordination to her husband.  So she demanded to be removed from the law.  The purpose of this research is to demonstrate the legal and legitimate basis for the issue of alimony, and the extent of the legislator’s authority to raise or amend it, with an indication of the legality and legitimately of the amendments made to the articles related to alimony in the Iraqi Personal Status Law under the Amendment Law No. (15) of 2008,  and it’s through  the statement of the verses, hadiths, and legal texts related to alimony, and the views of the jurists in their analysis and interpretation.
A Clinical Journey Mobile Health App for Perioperative Patients: Cross-sectional Study (Preprint)
Authors: Willems Stijn J , Coppieters Michel W , Pronk Yvette , Diks Miranda J F , van der Heijden Klaas W A P , Rooker Servan , Scholten-Peeters Gwendolyne G M
Published: February 2021

BACKGROUND

Mobile eHealth apps are important tools in personal health care management. The Patient Journey app was developed to inform patients with musculoskeletal disorders during their perioperative period. The app contains timely information, video exercises, and functional tasks. Although the Patient Journey app and other health apps are widely used, little research is available on how patients appreciate these apps.

OBJECTIVE

The primary aim of this study was to evaluate the user-friendliness of the Patient Journey app in terms of its usability and the attitudes of users toward the app. The secondary aim was to evaluate positive and negative user experiences.

METHODS

A web-based questionnaire was sent to 2114 patients scheduled for surgery for a musculoskeletal disorder. Primary outcomes were usability (measured with the System Usability Scale) and user attitudes regarding the Patient Journey app (assessed with the second part of the eHealth Impact Questionnaire). The secondary outcomes were evaluated with multiple choice questions and open-ended questions, which were analyzed via inductive thematic content analyses.

RESULTS

Of the 940 patients who responded, 526 used the Patient Journey app. The usability of the app was high (System Usability Scale: median 85.0, IQR 72.5-92.5), and users had a positive attitude toward the Information and Presentation provided via the app (eHealth Impact Questionnaire: median 78.0, IQR 68.8-84.4). The app did not adequately improve the users’ confidence in discussing health with others (eHealth Impact Questionnaire: median 63.9, IQR 50.0-75.0) or motivation to manage health (eHealth Impact Questionnaire: median 61.1, IQR 55.6-72.2). Three core themes emerged regarding positive and negative user experiences: (1) content and information, (2) expectations and experiences, and (3) technical performance. Users experienced timely information and instructions positively and found that the app prepared and guided them optimally through the perioperative period. Negative user experiences were overly optimistic information, scarcely presented information about pain (medication), lack of reference data, insufficient information regarding clinical course deviations and complications, and lack of interaction with clinicians.

CONCLUSIONS

The Patient Journey app is a usable, informative, and presentable tool to inform patients with musculoskeletal disorders during their perioperative period. The qualitative analyses identified aspects that can further improve the user experiences of the app.
The Role of Transparency, Trust, and Social Influence on Uncertainty Reduction in Times of Pandemics: Empirical Study on the Adoption of COVID-19 Tracing Apps (Preprint)
Authors: Oldeweme Andreas , Märtins Julian , Westmattelmann Daniel , Schewe Gerhard
Published: February 2021

BACKGROUND

Contact tracing apps are an essential component of an effective COVID-19 testing strategy to counteract the spread of the pandemic and thereby avoid overburdening the health care system. As the adoption rates in several regions are undesirable, governments must increase the acceptance of COVID-19 tracing apps in these times of uncertainty.

OBJECTIVE

Building on the Uncertainty Reduction Theory (URT), this study aims to investigate how uncertainty reduction measures foster the adoption of COVID-19 tracing apps and how their use affects the perception of different risks.

METHODS

Representative survey data were gathered at two measurement points (before and after the app’s release) and analyzed by performing covariance-based structural equation modeling (n=1003).

RESULTS

We found that uncertainty reduction measures in the form of the transparency dimensions disclosure and accuracy, as well as social influence and trust in government, foster the adoption process. The use of the COVID-19 tracing app in turn reduced the perceived privacy and performance risks but did not reduce social risks and health-related COVID-19 concerns.

CONCLUSIONS

This study contributes to the mass adoption of health care technology and URT research by integrating interactive communication measures and transparency as a multidimensional concept to reduce different types of uncertainty over time. Furthermore, our results help to derive communication strategies to promote the mass adoption of COVID-19 tracing apps, thus detecting infection chains and allowing intelligent COVID-19 testing.
Literature Review on the Efficacy of Laser, Pharmacotherapy and Combination of Both for the Treatment of Papulopustular and Erythemato-telangiectatic Rosacea (Preprint)
Authors: Portillo Mauricio Jonathon , Banez Joel
Published: February 2021

BACKGROUND

Rosacea is a chronic inflammatory skin disease that is classified into 4 subtypes depending on the clinical presentation. There is no definitive treatment but many options are available to target characteristic symptoms. Laser therapy is increasingly becoming used to treat erythema and telangiectasias in rosacea patients. New literature is demonstrating that a combination of alpha2-adrenergic agonists (oxymetazoline and brimonidine) may have greater efficacy than laser or pharmacotherapy alone.

OBJECTIVE

This paper looks to compare clinical trial literature of physician measurement scales on symptom control in patients with rosacea who use standard pharmacotherapy, laser therapy, or a combination of both. As well as look at the adverse effects and long-term outcomes between the two types of treatment.

METHODS

Peer-reviewed articles were compared to each other based on laser, pharmacotherapy, or a combination of both treatment options. The efficacy and adverse events of each article were compared by reviewing their standardized scoring systems.

RESULTS

A combination of both pharmacotherapy and laser therapy showed improved benefit (90% decrease in symptoms) and reduced recurrence rates (34% recurrence after 6-month follow-up) in patients with erythremato-telangiectatic rosacea compared to either options monotherapy alone. However, more adverse events were found in the combination studies.

CONCLUSIONS

Combination therapy demonstrates improved benefit compared to monotherapy however it comes at a greater cost and higher adverse events. Future studies should look to compare the efficacy of all three treatment options in one study design with a standardized scale of scoring to better quantify the improved benefits.

CLINICALTRIAL
Engaging Caregivers and Providers of Children With Sickle Cell Anemia in Shared Decision Making for Hydroxyurea: Protocol for a Multicenter Randomized Controlled Trial (Preprint)
Authors: Hood Anna M , Strong Heather , Nwankwo Cara , Johnson Yolanda , Peugh James , Mara Constance A , Shook Lisa M , Brinkman William B , Real Francis J , Klein Melissa D , Hackworth Rogelle , Badawy Sherif M , Thompson Alexis A , Raphael Jean L , Yates Amber M , Smith-Whitley Kim , King Allison A , Calhoun Cecelia , Creary Susan E , Piccone Connie M , Hildenbrand Aimee K , Reader Steven K , Neumayr Lynne , Meier Emily R , Sobota Amy E , Rana Sohail , Britto Maria , Saving Kay L , Treadwell Marsha , Quinn Charles T , Ware Russell E , Crosby Lori E
Published: February 2021

BACKGROUND

Sickle cell anemia (SCA) is a genetic blood disorder that puts children at a risk of serious medical complications, early morbidity and mortality, and high health care utilization. Until recently, hydroxyurea was the only disease-modifying treatment for this life-threatening disease and has remained the only option for children younger than 5 years. Evidence-based guidelines recommend using a shared decision-making (SDM) approach for offering hydroxyurea to children with SCA (HbSS or HbS/β0 thalassemia) aged as early as 9 months. However, the uptake remains suboptimal, likely because caregivers lack information about hydroxyurea and have concerns about its safety and potential long-term side effects. Moreover, clinicians do not routinely receive training or tools, especially those that provide medical evidence and consider caregivers’ preferences and values, to facilitate a shared discussion with caregivers.

OBJECTIVE

The aim of this study is to understand how best to help parents of young children with sickle cell disease and their clinicians have a shared discussion about hydroxyurea (one that considers medical evidence and parent values and preferences).

METHODS

We designed our study to compare the effectiveness of two methods for disseminating hydroxyurea guidelines to facilitate SDM: a clinician pocket guide (ie, usual care) and a clinician hydroxyurea SDM toolkit (H-SDM toolkit). Our primary outcomes are caregiver reports of decisional uncertainty and knowledge of hydroxyurea. The study also assesses the number of children (aged 0-5 years) who were offered and prescribed hydroxyurea and the resultant health outcomes.

RESULTS

The Ethics Committee of the Cincinnati Children’s Hospital Medical Center approved this study in November 2017. As of February 2021, we have enrolled 120 caregiver participants.

CONCLUSIONS

The long-term objective of this study is to improve the quality of care for children with SCA. Using multicomponent dissemination methods developed in partnership with key stakeholders and designed to address barriers to high-quality care, caregivers of patients with SCA can make informed and shared decisions about their health.

CLINICALTRIAL

ClinicalTrials.gov NCT03442114; https://clinicaltrials.gov/ct2/show/NCT03442114

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/27650
Needs and views on healthy lifestyles for the prevention of dementia through mobile health (mHealth) interventions in China: a qualitative study. (Preprint)
Authors: Zhang Jinxia , Eggink Esmé , Zhang Xiaoyu , Li Xingming , Jiang Bin , Liu Hongmei , Ge Siqi , Zhang Wei , Lyu Jihui , Niu Yixuan , Yu Yueyi , Hou Haifeng , Xu Xizhu , Ye Xiaoyan , Wang Wenzhi , Terlou Ruben , Richard Edo , Wang Wei , Wang Youxin , Moll van Charante Eric P , Song Manshu
Published: February 2021

BACKGROUND

China is expected to face among the largest increase of people with dementia worldwide in the coming decades, seriously challenging the Chinese healthcare system. Approximately 40% of all dementia cases might be attributable to potentially modifiable risk factors, suggesting the potential to delay or prevent dementia when targeting these risk factors. Mobile health (mHealth) may improve the accessibility of such dementia prevention strategies in China, given the wide and increasing use of smartphones by the entire Chinese population, including older adults.

OBJECTIVE

The aim of this qualitative study is to explore the needs and views of Chinese older adults regarding healthy lifestyles to prevent cardiovascular disease (CVD) and dementia through mHealth, facilitating development and cultural adaptation of a coach-supported mHealth platform for the Prevention of Dementia using Mobile Phone Applications (PRODEMOS) study.

METHODS

We performed semi-structured interviews with older adults, aged 55 and over, from Beijing and Tai’an, China, with an increased dementia risk without a diagnosis of dementia, who possess a smartphone. Participants were recruited through seven hospitals that participate in the PRODEMOS study, and were purposively sampled on age, sex, living situation, and history of CVD and diabetes. Data were analysed using thematic analysis.

RESULTS

Between February and December 2019 we performed 26 interviews with participants aged 55-86 years. Three main themes were identified: valuing a healthy lifestyle, sociocultural expectations, and need for guidance. First, following a healthy lifestyle was generally deemed important. In addition to generic healthy behaviours, participants regarded certain specific Chinese behaviours as important to prevent disease. Second, the sociocultural context played a crucial role, as an important motive to avoid disease was to limit the burden put on family members. However, time-consuming family and other social obligations could also impede healthy behaviours, such as regular physical activity and a healthy diet. Finally, there seemed to be a need for reliable and personalised lifestyle advice and for guidance from a health professional.

CONCLUSIONS

In spite of their clear appreciation of healthy lifestyles, Chinese older adults express a need for personalised lifestyle support in order to adopt healthy behaviours. Potentially, the PRODEMOS mHealth intervention can meet these needs through blended lifestyle support to improve risk factors for CVD and dementia.
Google Trends in Dermatology: Scoping Review of the Literature (Preprint)
Authors: Sivesind Torunn Elise , Szeto Mindy D , Kim William , Dellavalle Robert Paul
Published: February 2021

BACKGROUND

Google Trends is a powerful online database and analytics tool of popular Google search queries over time and has the potential to inform medical practice and priorities.

OBJECTIVE

This review aimed to survey Google Trends literature in dermatology and elucidate its current roles and relationships with the field.

METHODS

A literature search was performed using PubMed to access and review relevant dermatology-related Google Trends studies published within the last 5 years.

RESULTS

Current research utilizing Google Trends data provides insight related to skin cancer, pruritus, cosmetic procedures, and COVID-19. We also found that dermatology is presently the highest-searched medical specialty—among 15 medical and surgical specialties as well as general practitioners. Google searches related to dermatology demonstrate a seasonal nature for various skin conditions and sun-related topics, depending on a region’s inherent climate and hemi-sphere. In addition, celebrity social media and other viral posts have been found to potentiate Google searches about dermatology and drive public interest.

CONCLUSIONS

A limited number of relevant studies may have been omitted by the simplified search strategy of this study, as well as by restriction to English language articles and articles indexed in the PubMed database. This could be expanded upon in a secondary systematic review. Future re-search is warranted to better understand how Google Trends can be utilized to improve the quality of clinic visits, drive public health campaigns, and detect disease clusters in real time.
Cross-Canada Release of the Post-Secondary Student Stressors Index (PSSI): Protocol for a Cross-sectional, Repeated Measures Study (Preprint)
Authors: Linden Brooke
Published: February 2021

BACKGROUND

The prevalence of mental health–related problems, including stress, psychological distress, and symptoms of mental illnesses, continues to increase among Canadian postsecondary student populations. Excessive stress in this population has been linked to a number of negative academic and health outcomes. Despite attempts to improve mental health at postsecondary institutions, a persistent gap exists in the evaluation of the specific sources of stress for students within the postsecondary setting.

OBJECTIVE

The purpose of this paper is to report the study protocol for a cross-Canada, multisite launch of the Post-Secondary Student Stressors Index (PSSI), which will engage postsecondary institutions across the country as partners and facilitate improved measurement of the sources of student stress, in addition to contributing toward improved tailoring of upstream mental health services and support.

METHODS

Created in collaboration with students, the PSSI is a validated 46-item tool assessing stressors across five domains: academics, learning environment, campus culture, interpersonal, and personal stressors. The tool is designed to be applicable to students at all years, levels, and areas of study. Data will be collected longitudinally at multiple time points over the course of each academic year.

RESULTS

We recruited 15 postsecondary institutions across Canada for the first year, inviting students to participate in an online survey including questions concerning sociodemographic characteristics, stress, mental health, and resiliency. Analyses, including appropriate data visualization, will be conducted to determine the impact of specific stressors on mental health, linking responses over time to allow for the observation of changes in trends.

CONCLUSIONS

The PSSI is an intuitive and evidence-informed tool that can aid postsecondary institutions in evaluating the sources of student stress on their campuses. This multisite project will make a substantial contribution to the current literature regarding postsecondary student stress and allow institutions across the country to improve the tailoring of upstream mental health services in order to directly support the unique needs of their student body. Opportunities for knowledge translation and exchange are discussed.

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/27713
National-Level Disparities in Internet Access Among Low-Income and Black and Hispanic Youth: Current Population Survey (Preprint)
Authors: Dolcini M Margaret , Canchola Jesse A , Catania Joseph A , Song Mayeda Marissa M , Dietz Erin L , Cotto-Negrón Coral , Narayanan Vasudha
Published: February 2021

BACKGROUND

Internet access is increasingly critical for adolescents with regard to obtaining health information and resources, participating in web-based health promotion, and communicating with health practitioners. However, past work demonstrates that access is not uniform among youth in the United States, with lower access found among groups with higher health-related needs. Population-level data yield important insights about access and internet use in the United States.

OBJECTIVE

The aim of this study is to examine internet access and mode of access by social class and race and ethnicity among youth (aged 14-17 years) in the United States.

METHODS

Using the Current Population Survey, we examined internet access, cell phone or smartphone access, and modes of connecting to the internet for adolescents in 2015 (unweighted N=6950; expanded weights N=17,103,547) and 2017 (unweighted N=6761; expanded weights N=17,379,728).

RESULTS

Internet access increased from 2015 to 2017, but socioeconomic status (SES) and racial and ethnic disparities remained. In 2017, the greatest disparities were found for youth in low-income households (no home access=23%) and for Black youth (no home access=18%) and Hispanic youth (no home access=14%). Low-income Black and Hispanic youth were the most likely to lack home internet access (no home access, low SES Black youth=29%; low SES Hispanic youth=21%). The mode of access (eg, from home and smartphone) and smartphone-only analyses also revealed disparities.

CONCLUSIONS

Without internet access, web-based dissemination of information, health promotion, and health care will not reach a significant segment of youth. Currently, SES and racial and ethnic disparities in access prolong health inequalities. Moreover, the economic impact of COVID-19 on Black, Hispanic, and low-income communities may lead to losses in internet access for youth that will further exacerbate disparities.
Attrition Within Digital Health Interventions for People With Multiple Sclerosis: Systematic Review and Meta-analysis (Preprint)
Authors: Bevens William , Weiland Tracey , Gray Kathleen , Jelinek George , Neate Sandra , Simpson-Yap Steve
Published: February 2021

BACKGROUND

Digital health interventions have revolutionized multiple sclerosis (MS) care by supporting people with MS to better self-manage their disease. It is now understood that the technological elements that comprise this category of digital health interventions can influence participant engagement in self-management programs, and people with MS can experience significant barriers, influenced by these elements, to remaining engaged during a period of learning. It is essential to explore the influence of technological elements in mitigating attrition.

OBJECTIVE

This study aimed to examine the study design and technological elements of documented digital health interventions targeted at people with MS—digital health interventions that were intended to support a program of engagement over a defined period—and to explore how these correlated with attrition among participants of randomized controlled trials (RCTs).

METHODS

We conducted a systematic review and meta-analysis of RCTs (n=32) describing digital health self-management interventions for people with MS. We analyzed attrition in included studies, using a random-effects model and meta-regression to measure the association between potential moderators.

RESULTS

There were no measured differences in attrition between the intervention and control arms; however, some of the heterogeneity observed was explained by the composite technological element score. The pooled attrition rates for the intervention and control arms were 14.7% and 15.6%, respectively.

CONCLUSIONS

This paper provides insight into the technological composition of digital health interventions designed for people with MS and describes the degree of attrition in both study arms. This paper will aid in the design of future studies in this area, particularly for digital health interventions of this type.
Understanding Mental Health App Use Among Community College Students: Web-Based Survey Study (Preprint)
Authors: Borghouts Judith , Eikey Elizabeth V , Mark Gloria , De Leon Cinthia , Schueller Stephen M , Schneider Margaret , Stadnick Nicole , Zheng Kai , Mukamel Dana B , Sorkin Dara H
Published: February 2021

BACKGROUND

Mental health concerns are a significant issue among community college students, who often have less access to resources than traditional university college students. Mobile apps have the potential to increase access to mental health care, but there has been little research investigating factors associated with mental health app use within the community college population.

OBJECTIVE

This study aimed to understand facilitators of and barriers to mental health app use among community college students.

METHODS

A web-based survey was administered to a randomly selected sample of 500 community college students from April 16 to June 30, 2020. Structural equation modeling was used to test the relationships between the use of mental health apps, perceived stress, perceived need to seek help for mental health concerns, perceived stigma, past use of professional mental health services, privacy concerns, and social influence of other people in using mental health apps.

RESULTS

Of the 500 participants, 106 (21.2%) reported use of mental health apps. Perceived stress, perceived need to seek help, past use of professional services, and social influence were positively associated with mental health app use. Furthermore, the effect of stress was mediated by a perceived need to seek help. Privacy concerns were negatively associated with mental health app use. Stigma, age, and gender did not have a statistically significant effect.

CONCLUSIONS

These findings can inform development of new digital interventions and appropriate outreach strategies to engage community college students in using mental health apps.