bluuebunny/crossref_metadata_2025 huggingface dataset:
A Tale of Two Eras: Mining Big Data from Electronic Health Records to Determine Limb Salvage Rates with Podiatry
Authors: Schmidt Brian M. , Holmes Crystal M. , Ye Wen , Pop-Busui Rodica
Published: October 2018

Aims/Hypothesis:

Diabetic foot complications remain very prevalent in the US and worldwide,
and a major risk for devastating amputations. We evaluated the impact of establishing a fully integrated
and specialized Podiatry service into a large tertiary academic health system to implement
structured and targeted preventative foot care on limb salvage rates.

Methods:

Cross-sectional cohorts’ data mining analysis was conducted of all encounters for diabetes
and any foot complications between 2000-2005 and 2010-2015, preceding and after full implementation
of podiatry service, respectively. The primary outcome was the change in major non-traumatic
lower extremity amputations. Secondary outcomes included minor non-traumatic lower extremity amputations,
other diabetic foot complications, limb salvage procedures as documented by procedural coding,
and location (outpatient, inpatient, ED) of service rendered.

Results:

We analyzed 100 million patient encounters that met the above criteria. Compared with the
initial cohort, integration of specialized podiatry services resulted in a significant decrease in the number
of major amputations from 127 to 85/year (p<0.05), and halved the amputations rate from 0.004%
to 0.002% (p<0.05). Rates of minor lower extremity amputations remained unchanged (p>0.10), while
the rates of preventative procedures including foot ulcer debridement doubled (0.0002% to 0.0004% ;
p<0.03). Diagnoses of diabetic foot complications increased significantly (p<0.05) and shifted toward
the outpatient setting.

Conclusion:

Full integration of specialized Podiatry service led to a significant decrease in major amputation
rates, supporting teamwork between podiatry and diabetes health-care providers is essential to
performing timely diabetic foot complications management, preventative procedures leading to limb
salvage, and a shift in the care location.
The Potential Roles of Tendon Stem/Progenitor Cells in Tendon Aging
Authors: Li Yingjuan , Dai Guangchun , Shi Liu , Lin Yucheng , Chen Minhao , Li Gang , Rui Yunfeng
Published: October 2018

Aging is a key dangerous factor for the occurrence and severity of tendon injury, but the exact cognition of the relationship is elusive at present. More previous studies suggest age-related changes occur at tendon mechanical properties, structure and composition, but the pathological alternations may be overlooked, which might be a cause for the structure and function variations, and even speed up the progress of age-related disorders. Recently, the presence of tendon stem/progenitor cells (TSPCs) would provide new insights for the pathogenesis of tendon aging. In this review, the tendon mechanical properties, structure and composition are presented in brief, then, the pathological changes of the aging tendon are described firstly, and the latest researches on alterations of TSPCs in the pathogenesis of tendon aging have also been analyzed. At a cellular level, the hypothetical model of altered TSPCs fate for tendon aging is also proposed. Moreover, the regulation of TSPCs as a potential way of the therapies for age-related tendon diseases is discussed. Therefore, reversing the impaired function of TSPCs and promoting the tenogenic differentiation of TSPCs could become hot spots for further study and give the opportunity to establish new treatment strategies for age-related tendon injuries.
A Novel Non-invasive Effective Method for Potential Treatment of Degenerative Disc Disease: A Hypothesis
Authors: Somasundaram Siva G. , Muresanu Cristian , Schield Pamela , Makhmutovа Alfiya , Bovina Elena V. , Fisenko Vladimir P. , Hasanov Nusrat F. , Aliev Gjumrakch
Published: October 2018

The pathophysiology of the intervertebral discs plays a significant role in the people’s life quality. There is not adequate research done in the pathogenesis and treatment of intervertebral disc degeneration. Alternately, self-educated physiology offers a novel and noninvasive method to reverse the degenerated discs. In this single case study, report attempts have been made to highlight the effect of the self-educative physiology, on magnetic resonance imaging investigations, of progressive healing, on the degenerated intervertebral discs. Based on this novel method, an effort has been made to review literature on the degeneration of intervertebral discs and available mode of treatments and then to propose a hypothesis for the biochemical mechanisms of healing. The idea is that transforming growth factor-β1 from seminal plasma secretions may contribute to releasing the osteogenic protein- 1 which induces nucleus pulposus and annulus fibrosus cells in intervertebral discs for repairs. In addition, the patient’s medical history is presented with background information.
Nipple Reconstruction Techniques: Which is the Best Choice?
Authors: Bertozzi Nicolò , Simonacci Francesco , Pesce Marianna , Santi PierLuigi , Raposio Edoardo
Published: October 2018

Nipple-Areolar Complex (NAC) reconstruction represents the final, concluding journey of breast reconstruction by being able to give to reconstructed breasts the shape of a natural breast mound. Nevertheless an enormous amount of nipple reconstruction techniques are described in literature, given the fact that most reconstructive options fail to give satisfactory outcomes in relation to the long-term nipple projection. In this review, the authors will browse most common nipple reconstruction techniques, taking into account: Indication, outcome, and side effect. Composite nipple grafts, traditional flaps, flaps with autologous graft augmentation, flaps with allograft augmentation, and flaps with alloplastic augmentation are the main strategies employed nowadays. Composite nipple grafts give the best guarantee of color-texture match with the contralateral side and show satisfactory nipple projection even at long-term follow-up. Skate, star, C-V, and arrow flap are by far the most commonly employed and the most reliable local flaps, however loss of projection of up to 70 percent are reported in literature. Alloplastic grafts were associated with the lowest rates of projection loss followed by autologous and allogenic ones. Nevertheless allogenic grafts are also associated with the highest complication rate, while autologous and allogenic ones have similar rates. Infection, seroma, and fat necrosis are the more commonly reported complications of autologous grafting along with donor site morbidity, while allogenic and alloplastic augmentation grafts may also experience the risk of overcorrection and graft exposure. Given the numerous techniques described in literature it is clear that the ideal nipple reconstruction hasn’t been found yet. Whereas it should be chosen on case to case basis depending on type of mastectomy, radiotherapy, type of reconstruction, skin thickness, tissue condition, and patients’ expectations to ensure the best cosmetic outcome.
Assessment of Soil Quality in Andosols Using Silvopastoral Systems
Authors: Rosales Hernán R. B. , Hernández Silvino V. , Aguiar Digna I. G. , Rosero Diego C. , Perez Luis C. , Rosero Marcelo I.
Published: October 2018

Background:

An experiment was conducted to evaluate the effect of redesign and management upon soil quality variation using three agro-ecosystems: agro-ecosystem A1 (grasses,Alnus acuminataKunth); agro-ecosystem A2 (grasses, AcaciamelanoxylonR. Br.) and agro-ecosystem A3 (Rangeland).

Methods:

The trees were planted along the contour lines in December 2015. The total area was divided into three agro-ecosystems (AES). These consisted of 7.50, 4.64 and 6.25 ha managed with ten to eleven cows in A1, A2 and A3 respectively. The AES were divided into paddocks by means of electric fences. Composite soil samples were evaluated at the baseline and ten months later. Principles of rational grass management were applied with low input sustainable agriculture. The tree population density was 1000 ha-1, planted in double rows, separated two meters apart. The genetic composition of dairy cows was 80 and 20% of Holstein and crossbreed Holstein x Jersey, respectively.

Results:

The effect of interaction between AES x year was not found. The effect of the agro-ecosystems upon the soil quality only showed significant differences (p <0.05) in pH (5.64, 5.68, 5.55); SOM (14.65, 16.11, 16.23); P2O5(34.67, 19.50, 33.48) and K2O (.16, .19, .12) meq 100 mL-1to A1, A2 y A3, respectively. On the contrary, the year´s effect showed differences (p <0.05) on chemical variables: NH4(-83.00 ppm); SOM (-1.91%); P2O5(-10.79 ppm); K2O (-.04) meq 100 mL-1and Mg (-.42) meq 100 mL-1, excepted pH (.025) and Ca (1.04) meq 100 mL-1when it was compared 2015vs. 2016. It is suggested to continue evaluating the dynamics of soil chemical variables in the subsequent two years to find out the real potential capacity of soil-plant-animal-management interactions to enhance soil quality ofAndosolsin dairy sector, Carchi province, Ecuador.
The Impact of microRNAs in Breast Cancer Angiogenesis and Progression
Authors: Kontomanolis Emmanuel N. , Fasoulakis Zacharias , Papamanolis Valentinos , Koliantzaki Sofia , Dimopoulos Georgios , Kambas Nikolaos J.
Published: October 2018

Objective: The study aims to review the recent data considering the expression profile and
the role of microRNAs in breast tumorigenesis, and their impact on -the vital for breast cancer progression-
angiogenesis.

Methods: PubMed was searched for studies focused on data that associate microRNA with breast
cancer, using the terms ''breast”, “mammary gland”, “neoplasia'', “angiogenesis” and ''microRNA''
between 1997-2018.

Results: Aberrant expression of several circulating and tissue miRNAs is observed in human breast
neoplasms with the deregulation of several miRNAs having a major participation in breast cancer
progression. Angiogenesis seems to be directly affected by either overexpression or down regulation
of many miRNAs, defining the overall prognostic rates. Many miRNAs differentially expressed in
breast cancer that reveal a key role in suppression - progression and metastasis of breast cancer along
with the contribution of the EGF, TNF-a and EGF cytokines.

Conclusion Angiogenesis has proven to be vital for tumor development and metastasis while microRNAs
are proposed to have multiple biological roles, including participation in immunosuppressive,
immunomodulatory and recent studies reveal their implication in angiogenesis and its possible
use as prognostic factors in cancer Even though larger studies are needed in order to reach safe conclusions,
important steps are made that reveal the connection of serum microRNA expression to the
angiogenic course of breast cancer, while miRNAs could be potential prognostic factors for the different
breast cancer types.
Understanding Community College Student Persistence Through Photovoice
Authors: Latz Amanda O.
Published: October 2018

Because it has been noted that a more educated workforce is necessary to meet the demands of the future workplace, community colleges have experienced significant pressures to generate more graduates. High instances of attrition and low rates of credential obtainment among students, however, have historically been tenuous issues for community colleges. The purpose of this article is to put forward, in the form of a constructivist grounded theory, a model of community college student persistence based on the findings from a photovoice project aimed at understanding the educational lives of community college students. The Emergent Model of Community College Student Persistence has the potential to assist community college faculty, administrators, policy makers, and other stakeholders understand student persistence decisions.
Quantitative Evaluation of A First Year Seminar Program
Authors: Jenkins-Guarnieri Michael A. , Horne Melissa M. , Wallis Aaron L. , Rings Jeffrey A. , Vaughan Angela L.
Published: October 2018

In the present study, we conducted a quantitative evaluation of a novel First Year Seminar (FYS) program with a coordinated curriculum implemented at a public, four-year university to assess its potential role in undergraduate student persistence decisions and academic success. Participants were 2,188 first-year students, 342 of whom completed the FYS program designed to develop cognitive variables associated with student outcomes such as motivation and commitment to the university, as well as practical skills such as time management, critical reading, and study strategies. Results from two sequential logistic regression models suggested that participation in this FYS program was associated with increases in the odds of persisting and being in good academic standing, even after controlling for relevant background characteristics. These results suggest that FYS interventions may be effective interventions for improving student outcomes. Important implications for practice and further research are discussed.
Mental Health Mobile Phone App Usage, Concerns, and Benefits Among Psychiatric Outpatients: Comparative Survey Study
Authors: Torous John , Wisniewski Hannah , Liu Gang , Keshavan Matcheri
Published: October 2018

Background

Despite the popularity of mental health apps, it is unknown if they are actually used by those with mental illness. This study assessed whether differences in clinic setting may influence the use of mental health apps and which factors influence patient perception of apps.

Objective

The objective of this study was to gain an understanding of how individuals with mental illness use their mobile phones by exploring their access to mobile phones and their use of mental health apps.

Methods

A single time point survey study was conducted over a 2-week period in February 2018 at two nearby outpatient psychiatry clinics: one serving largely mood and anxiety disorder patients with private insurance staffed by both faculty and residents and the other serving largely psychotic disorder patients in a state Department of Mental Health (DMH) setting. A total of 25 patients at the state DMH clinic also consented for a single time point observation of apps currently installed on their personal mobile phone.

Results

A total of 113 patients at the private insurance clinic and 73 at the state DMH clinic completed the survey. Those in the private insurance clinic were more likely to download a mental health app compared to the state DMH clinic, but actual rates of reported current app usage were comparable at each clinic, approximately 10%. Verifying current apps on patients’ mobile phones at the state DMH clinic confirmed that approximately 10% had mental health apps installed. Patients at both clinics were most concerned about privacy of mental health apps, although those at the state DMH clinic viewed cost savings as the greatest benefit while those at the private clinic reported time as the greatest benefit.

Conclusions

High interest in mental health apps does not automatically translate into high use. Our results of low but similar rates of mental health app use at diverse clinics suggests DMH patients with largely psychotic disorders are as interested and engaged with apps as those in a private insurance clinic treating largely mood and anxiety disorders. Results from our study also highlight the importance of understanding how actual patients are using apps instead of relying on internet-based samples, which often yield higher results due to their likelihood of being selected.
Comparing the Efficacy of an Identical, Tailored Smoking Cessation Intervention Delivered by Mobile Text Messaging Versus Email: Randomized Controlled Trial (Preprint)
Authors: Gram Inger Torhild , Larbi Dillys , Wangberg Silje Camilla
Published: October 2018

BACKGROUND

There is a need to deliver smoking cessation support at a population level, both in developed and developing countries. Studies on internet-based and mobile phone–based smoking cessation interventions have shown that these methods can be as effective as other methods of support, and they can have a wider reach at a lower cost.

OBJECTIVE

This randomized controlled trial (RCT) aimed to compare, on a population level, the efficacy of an identical, tailored smoking cessation intervention delivered by mobile text messaging versus email.

METHODS

We conducted a nationwide 2-arm, double-blinded, fully automated RCT, close to a real-world setting, in Norway. We did not offer incentives to increase participation and adherence or to decrease loss to follow-up. We recruited users of the website, slutta.no, an open, free, multi-component Norwegian internet-based smoking cessation program, from May 2010 until October 2012. Enrolled smokers were considered as having completed a time point regardless of their response status if it was 1, 3, 6, or 12 months post cessation. We assessed 7315 participants using the following inclusion criteria: knowledge of the Norwegian language, age 16 years or older, ownership of a Norwegian cell phone, having an email account, current cigarette smoker, willingness to set a cessation date within 14 days (mandatory), and completion of a baseline questionnaire for tailoring algorithms. Altogether, 6137 participants were eligible for the study and 4378 participants (71.33%) provided informed consent to participate in the smoking cessation trial. We calculated the response rates for participants at the completed 1, 3, 6, and 12 months post cessation. For each arm, we conducted an intention-to-treat (ITT) analysis for each completed time point. The main outcome was 7-day self-reported point prevalence abstinence (PPA) at the completed 6 months post cessation. We calculated effect size of the 7-day self-reported PPA in the text message arm compared with the email arm as odds ratios (ORs) with 95% CIs for the 4 time points post cessation.

RESULTS

At 6 months follow-up, 21.06% (384/1823) of participants in the text message arm and 18.62% (333/1788) in the email arm responded (P=.07) to the surveys. In the ITT analysis, 11.46% (209/1823) of participants in the text message arm compared with 10.96% (196/1788) in the email arm (OR 1.05, 95% CI 0.86-1.30) reported to have achieved 7 days PPA.

CONCLUSIONS

This nationwide, double-blinded, large, fully automated RCT found that 1 in 9 enrolled smokers reported 7-day PPA in both arms, 6 months post cessation. Our study found that identical smoking cessation interventions delivered by mobile text messaging and email may be equally successful at a population level.

CLINICALTRIAL

ClinicalTrials.gov NCT01103427; https://clinicaltrials.gov/ct2/show/NCT01103427
How Women Evaluate Birth Challenges: Analysis of Web-Based Birth Stories (Preprint)
Authors: Konheim-Kalkstein Yasmine L , Miron-Shatz Talya , Israel Leah Jenny
Published: October 2018

BACKGROUND

Birth stories provide an intimate glimpse into women’s birth experiences in their own words. Understanding the emotions elicited in women by certain types of behaviors during labor and delivery could help those in the health care community provide better emotional care for women in labor.

OBJECTIVE

The aim of this study was to understand which supportive reactions and behaviors contributed to negative or positive emotions among women with regard to their labor and delivery experience.

METHODS

We sampled 10 women’s stories from a popular blog that described births that strayed from the plan. Overall, 90 challenging events that occurred during labor and delivery were identified. Each challenge had an emotionally positive, negative, or neutral evaluation by the woman. We classified supportive and unsupportive behaviors in response to these challenges and examined their association with the woman’s emotional appraisal of the challenges.

RESULTS

Overall, 4 types of behaviors were identified: informational inclusion, decisional inclusion (mostly by health care providers), practical support, and emotional support (mostly by partners). Supportive reactions were not associated with emotional appraisal; however, unsupportive reactions were associated with women appraising the challenge negatively (Fisher exact test, P=.02).

CONCLUSIONS

Although supportive behaviors did not elicit any particular emotion, unsupportive behaviors did cause women to view challenges negatively. It is worthwhile conducting a larger scale investigation to observe what happens when patients express their needs, particularly when challenges present themselves during labor, and health care professionals strive to cater to them.
(Preprint)
Authors: Dayalan Dr Malathi , Sharma Dr Sudeshna , Poovani Dr Shweta , Altaf Dr Saher
Published: October 2018

BACKGROUND

Masticatory system is a complex functional unit, primarily engaged in chewing, swallowing and breathing functions, and some parts are involved in taste recognition and determination of food consistency. Sophisticated functional performances of speech and emotional expressions are specifically human qualities. Irregularities in occlusion appears to be the precipitating factor in the pathogenesis of myofascial pain dysfunction syndrome. Tek- Scan III records the bite length, number, distribution, timing, duration and the relative force of each tooth contact. It also records the sequence of occlusal contacts in terms of time and the associated force with each occlusal contact.
The aim of this study was to treat masticatory muscle disorders with occlusal equilibration, and compare the efficacy of treatment outcomes between selective grinding and stabilization splints using Tek-Scan III.

OBJECTIVE

Objective of this study was to compare the efficacy of occlusal equilibration achieved through selective griding and stabilization splints using Tek-Scan III.

METHODS

In this in vivo study, 40 patients with masticatory muscle disorders were selected based on the inclusion and exclusion criteria. The occlusal discrepancies were analyzed using Tek-Scan III. The selected 40 subjects were then randomly divided into 2 groups based on the treatment they recieved; Group I – Selective grinding group (20) and Group II – Stabilization splint group (20). Comparison of pre-treatment and post treatment results were evaluated in terms of pain, mouth opening, left and right side force percentage as recorded through Tek-Scan III and reduction of disclusion time. Statistical analysis was carried out with Kolmogorov Smirnov test, Wilcoxon matched pair test and Mann-Whitney U test.

RESULTS

Wilcoxon matched pairs test demonstrated that there was statistically significant results (
p = 0.0007) in both the groups for reduction of disclusion time, elimination of pain and improved mouth opening. Patients in Group I showed better results as compared to Group II in terms of disclusion time, pain and mouth opening.

CONCLUSIONS

Occlusal equilibration brought about by reducing the disclusion time using the Tek- Scan III reduced the symptoms of pain in masticatory muscles. Patients in group I (Selective grinding) however showed better results when compared to patients in group II (Stabilization splints).
Evaluation of gingival hyperplasia caused by medications (Preprint)
Authors: Robo Ilma
Published: October 2018

BACKGROUND

Drug gingival hyperplasia is an uncommon pathology encountered during routine work in dental units.

OBJECTIVE

The purpose of this topic is to present the clinical appearance of gingival hyperplasia caused by medications. There are already three classes of medications that cause hyperplasia and based on data from the literature, the clinical cases encountered and included in this study have been compared.

METHODS

The study was conducted in a total of 311 patients, out of which 182 patients were included in our study, meeting the inclusion criteria. After each patient's history was recorded and it was found that patients were in their knowledge of chronic illness, undergoing treatment of gingivitis hypertrophic drugs was performed with a clinical examination of oral cavity and assessment by the Vertical Growth Index (GOI) and horizontal for hypertrophy and the index of bacterial plaque.

RESULTS

Of the data collected during the study, it was observed that 97% of patients with gingival hyperplasia are treated with nifedipine. 84% of patients treated with selected medicines and gingival hyperplasia in the oral cavity have been exposed at period of time for more than 1 year and 1 month. According to the GOI index, in the first rank of this index are about 21% of patients, in the second rank are 52%, in the third rank are 24% and in the fourth grade are 3%. According to the horizontal growth index of gingival hyperplasia, grade 1 included about 61% of patients and grade 2 included about 39% of patients with gingival hyperplasia. Bacterial index divides patients by degrees: grading 0 - 8.2%, grading 1 - 32.4%, grading 2 - 14% and grading 3 - 45.1%.

CONCLUSIONS

The highest percentage of gingival hyperplasia caused by drugs is due to dosing of nifedipine for a duration of dosing and application for systemic healing for more than 1 year.

CLINICALTRIAL

-
Design and Implementation of a Novel System for Correcting Posture Through the Use of a Wearable Necklace Sensor (Preprint)
Authors: Chung Hung-Yuan , Chung Yao-Liang , Liang Chih-Yen
Published: October 2018

BACKGROUND

To our knowledge, few studies have examined the use of wearable sensing devices to effectively integrate information communication technologies and apply them to health care issues (particularly those pertaining to posture correction).

OBJECTIVE

A novel system for posture correction involving the application of wearable sensing technology was developed in this study. The system was created with the aim of preventing the unconscious development of bad postures (as well as potential spinal diseases over the long term).

METHODS

The newly developed system consists of a combination of 3 subsystems, namely, a smart necklace, notebook computer, and smartphone. The notebook computer is enabled to use a depth camera to read the relevant data, to identify the skeletal structure and joint reference points of a user, and to compute calculations relating to those reference points, after which the computer then sends signals to the smart necklace to enable calibration of the smart necklace’s standard values (base values for posture assessment). The gravitational acceleration data of the user are collected and analyzed by a microprocessor unit-6050 sensor housed in the smart necklace when the smart necklace is worn, with those data being used by the smart necklace to determine the user’s body posture. When poor posture is detected by the smart necklace, the smart necklace sends the user’s smartphone a reminder to correct his or her posture; a mobile app that was also developed as part of the study allows the smart necklace to transmit such messages to the smartphone.

RESULTS

The system effectively enables a user to monitor and correct his or her own posture, which in turn will assist the user in preventing spine-related diseases and, consequently, in living a healthier life.

CONCLUSIONS

The proposed system makes it possible for (1) the user to self-correct his or her posture without resorting to the use of heavy, thick, or uncomfortable corrective clothing; (2) the smart necklace’s standard values to be quickly calibrated via the use of posture imaging; and (3) the need for complex wiring to be eliminated through the effective application of the Internet of Things as well as by implementing wireless communication between the smart necklace, notebook computer, and smartphone.
Exposure to Potentially Harmful E-Cigarette Emissions via Vape Tricks: Protocol for a Mixed-Methods Study (Preprint)
Authors: Furberg Robert , Ortiz Alexa M , McCombs Michelle , Cress Margaret , Thornburg Jonathan , Pepper Jessica K , Lee Youn Ok
Published: October 2018

BACKGROUND

The number of adolescents and adults using e-cigarettes, referred to as vaping, has dramatically increased. E-cigarettes can be used to perform vape tricks by inhaling and exhaling the e-cigarette aerosol in patterns to create visual effects or large clouds. To create these effects, the puffing patterns associated with vape tricks may be different than standard ad-lib e-cigarette usage. The prevalence of vape tricks and the harm associated with exposure to e-cigarette emissions when performing vape tricks is currently unknown.

OBJECTIVE

Our objectives are to characterize duration, heart rate, respiratory rate, tidal volume, minute volume, and physical activity metrics associated with the performance of vape tricks and to characterize the emission of e-cigarettes when performing vape tricks in a manner suitable to inform novel exposure modeling.

METHODS

The study will recruit e-cigarette users with a history of performing vape tricks. Data collection will occur in two different sessions. In the first session, participants will be asked to puff on their e-cigarette as they normally would for 20 minutes. The second session will be a vape tricks session, where users will be asked to perform a series of up to five different vape tricks with their e-cigarette. Data will be collected through screener surveys, in-person interviews, video recordings, a personal exposure monitor, and a biometric garment.

RESULTS

Data analysis is pending and scheduled to take place in the fall of 2019.

CONCLUSIONS

This study will be used to assess the feasibility of using a biometric garment to complement environmental and observational data. The approach may provide greater insight into the health risks of performing vape tricks compared to typical e-cigarette use.

INTERNATIONAL REGISTERED REPOR

DERR1-10.2196/12304
HIV digital vaccine strategy: An application of blockchain technology in preventing the spread of HIV (Preprint)
Authors: Liu Jia
Published: October 2018

UNSTRUCTURED

The HIV epidemic poses a heavy burden on societal development. Presently, the protection of susceptible populations is the most feasible method for eliminating the spread of HIV. The government and other relevant industries always attempt at solving the problem, in view of the unavailability of biological vaccines, no better measures can take except identify HIV-infected persons, provide treatment and behavioral intervention. This study proposes a HIV digital vaccine strategy. Based on blockchain technology, a decentralized surveillance network has been jointly constructed using HIV high-risk individuals as application nodes and accredited testing agencies as authentication nodes. When testing accomplished at authentication nodes, the results uploaded to the blockchain, thus HIV high-risk populations can determine the HIV infection status of one another in a convenient, anonymous, and credible manner, thereby reducing the occurrences of high-risk sexual behavior and effectively protecting susceptible populations. This is a promising solution to prevent the spread of HIV. The performance of decentralized surveillance network may lead to the restructuring of current government-funded infectious disease prevention and control modes that are centered on centers for disease control and prevention and hospitals to introduce revolutionary changes in public health systems globally.
Designing and Testing Apps to Support Patients with Cancer: Look to Behavioral Science to Lead the Way (Preprint)
Authors: Hamel Lauren M. , Harper Felicity W. K. , Thompson Hayley S. , Albrecht Terrance L.
Published: October 2018

UNSTRUCTURED

We opted to not include an abstract since we are submitting a short viewpoint paper.
eHealth-Based Behavioral Intervention for Increasing Physical Activity in Persons With Multiple Sclerosis: Fidelity Protocol for a Randomized Controlled Trial (Preprint)
Authors: Silveira Stephanie L , McCroskey Justin , Wingo Brooks C , Motl Robert W
Published: October 2018

BACKGROUND

The rate of physical activity is substantially lower in persons with multiple sclerosis (MS) than in the general population. This problem can be reversed through rigorous and reproducible delivery of behavioral interventions that target lifestyle physical activity in MS. These interventions are, in part, based on a series of phase II randomized controlled trials (RCTs) supporting the efficacy of an internet-delivered behavioral intervention, which is based on social cognitive theory (SCT) for increasing physical activity in MS.

OBJECTIVE

This paper outlines the strategies and monitoring plan developed based on the National Institutes of Health Behavior Change Consortium (NIH BCC) treatment fidelity workgroup that will be implemented in a phase III RCT.

METHODS

The Behavioral Intervention for Physical Activity in Multiple Sclerosis (BIPAMS) study is a phase III RCT that examines the effectiveness of an internet-delivered behavioral intervention based on SCT and is supported by video calls with a behavioral coach for increasing physical activity in MS. BIPAMS includes a 6-month treatment condition and 6-month follow-up. The BIPAMS fidelity protocol includes the five areas outlined by the NIH BCC. The study design draws on the SCT behavior-change strategy, ensures a consistent dose within groups, and plans for implementation setbacks. Provider training in theory and content will be consistent between groups with monitoring plans in place such as expert auditing of calls to ensure potential drift is addressed. Delivery of treatment will be monitored through the study website and training will focus on avoiding cross-contamination between conditions. Receipt of treatment will be monitored via coaching call notes and website monitoring. Lastly, enactment of treatment for behavioral and cognitive skills will be monitored through coaching call notes among other strategies. The specific strategies and monitoring plans will be consistent between conditions within the constraints of utilizing existing evidence-based interventions.

RESULTS

Enrollment began in February 2018 and will end in September 2019. The study results will be reported in late 2020.

CONCLUSIONS

Fidelity-reporting guidelines provided by the NIH BCC were published in 2004, but protocols are scarce. This is the first fidelity-monitoring plan involving an electronic health behavioral intervention for increasing physical activity in MS. This paper provides a model for other researchers utilizing the NIH BCC recommendations to optimize the rigor and reproducibility of behavioral interventions in MS.

CLINICALTRIAL

ClinicalTrials.gov NCT03490240; https://www.clinicaltrials.gov/ct2/show/NCT03490240.

INTERNATIONAL REGISTERED REPOR

DERR1-10.2196/12319
Adapting Mobile and Wearable Technology to Provide Support and Monitoring in Rehabilitation for Dementia: Feasibility Case Series (Preprint)
Authors: Thorpe Julia , Forchhammer Birgitte Hysse , Maier Anja M
Published: October 2018

BACKGROUND

Mobile and wearable devices are increasingly being used to support our everyday lives and track our behavior. Since daily support and behavior tracking are two core components of cognitive rehabilitation, such personal devices could be employed in rehabilitation approaches aimed at improving independence and engagement among people with dementia.

OBJECTIVE

The aim of this work was to investigate the feasibility of using smartphones and smartwatches to augment rehabilitation by providing adaptable, personalized support and objective, continuous measures of mobility and activity behavior.

METHODS

A feasibility study comprising 6 in-depth case studies was carried out among people with early-stage dementia and their caregivers. Participants used a smartphone and smartwatch for 8 weeks for personalized support and followed goals for quality of life. Data were collected from device sensors and logs, mobile self-reports, assessments, weekly phone calls, and interviews. This data were analyzed to evaluate the utility of sensor data generated by devices used by people with dementia in an everyday life context; this was done to compare objective measures with subjective reports of mobility and activity and to examine technology acceptance focusing on usefulness and health efficacy.

RESULTS

Adequate sensor data was generated to reveal behavioral patterns, even for minimal device use. Objective mobility and activity measures reflecting fluctuations in participants’ self-reported behavior, especially when combined, may be advantageous in revealing gradual trends and could provide detailed insights regarding goal attainment ratings. Personalized support benefited all participants to varying degrees by addressing functional, memory, safety, and psychosocial needs. A total of 4 of 6 (67%) participants felt motivated to be active by tracking their step count. One participant described a highly positive impact on mobility, anxiety, mood, and caregiver burden, mainly as a result of navigation support and location-tracking tools.

CONCLUSIONS

Smartphones and wearables could provide beneficial and pervasive support and monitoring for rehabilitation among people with dementia. These results substantiate the need for further investigation on a larger scale, especially considering the inevitable presence of mobile and wearable technology in our everyday lives for years to come.
A Mobile Phone–Based Intervention to Improve Mental Health Among Homeless Young Adults: Pilot Feasibility Trial (Preprint)
Authors: Schueller Stephen M , Glover Angela C , Rufa Anne K , Dowdle Claire L , Gross Gregory D , Karnik Niranjan S , Zalta Alyson K
Published: October 2018

BACKGROUND

Youth homelessness is a substantial issue, and many youths experiencing homelessness have mental health issues as both a cause and consequence of homelessness. These youths face many barriers to receiving traditional mental health services, and as a result, only a few youths experiencing homelessness receive any form of mental health care.

OBJECTIVE

This project aimed to develop and determine the feasibility and acceptability of engaging young adults (ie, individuals aged 18-24 years) experiencing homelessness in a remotely delivered mental health intervention. This intervention provided brief emotional support and coping skills, drawing from cognitive behavioral principles as an introduction into psychosocial support. The intervention was piloted in a homeless shelter network.

METHODS

A total of 35 young adults experiencing homelessness participated in a single-arm feasibility pilot trial. Participants received a mobile phone, a service and data plan, and 1 month of support from a coach consisting of up to 3 brief phone sessions, text messaging, and mobile mental health apps. We evaluated feasibility by looking at completion of sessions as well as the overall program and acceptability with satisfaction ratings. We also collected clinical symptoms at baseline and the end of the 1-month support period. We used validity items to identify participants who might be responding inappropriately and thus only report satisfaction ratings and clinical outcomes from valid responses.

RESULTS

Most participants (20/35, 57%) completed all 3 of their phone sessions, with an average of 2.09 sessions (SD 1.22) completed by each participant. Participants sent an average of 15.06 text messages (SD 12.62) and received an average of 19.34 messages (SD 12.70). We found higher rates of satisfaction among the participants with valid responses, with 100% (23/23) of such participants indicating that they would recommend participation to someone else and 52% (12/23) reporting that they were very or extremely satisfied with their participation. We found very little change from pre- to posttreatment on measures of depression (d=0.27), post-traumatic stress disorder (d=0.17), and emotion regulation (d=0.10).

CONCLUSIONS

This study demonstrated that it was feasible to engage homeless young adults in mental health services in this technology-based intervention with high rates of satisfaction. We did not find changes in clinical outcomes; however, we had a small sample size and a brief intervention. Technology might be an important avenue to reach young adults experiencing homelessness, but additional work could explore proper interventions to deliver with such a platform.

CLINICALTRIAL

ClinicalTrials.gov NCT03620682; https://clinicaltrials.gov/ct2/show/NCT03620682
Impact of Training and Integration of Apps Into Dietetic Practice on Dietitians’ Self-Efficacy With Using Mobile Health Apps and Patient Satisfaction (Preprint)
Authors: Chen Juliana , Allman-Farinelli Margaret
Published: October 2018

BACKGROUND

The use of mobile health (mHealth) apps in dietetic practice could support the delivery of nutrition care in medical nutrition therapy. However, apps are underutilized by dietitians in patient care.

OBJECTIVE

This study aimed to determine the feasibility of an intervention consisting of education, training, and integration of apps in improving dietitians’ perceived self-efficacy with using mHealth apps.

METHODS

Private practice Accredited Practising Dietitians who were not regular users or recommenders of mHealth apps were recruited into the intervention. The intervention consisted of 2 phases: (1) a workshop that incorporated an educational lecture and skill-building activities to target self-efficacy, capability, opportunity, and motivation factors and (2) a 12-week intervention phase allowing for the integration of an app into dietetic practice via an app platform. During the 12-week intervention phase, dietitians prescribed an Australian commercial nutrition app to new (intervention) patients receiving nutrition care. Existing (control) patients were also recruited to provide a measure of patient satisfaction before the apps were introduced. New patients completed their patient satisfaction surveys at the end of the 12 weeks. Usability feedback about the app and app platform was gathered from intervention patients and dietitians.

RESULTS

A total of 5 dietitians participated in the study. On the basis of an analysis of variance with the Tukey post hoc tests, the educational and skills training workshop component of the intervention produced immediate improvements in mean ratings for dietitians’ self-efficacy with using mHealth apps compared with baseline (P=.02), particularly with regard to familiarity with apps factor (P<.001). The self-efficacy factor integration into dietetic work systems achieved significant improvements from baseline to 12 weeks (P=.03). Patient satisfaction with dietetic services did not differ significantly between intervention (n=17) and control patients (n=13). Overall, dietitians and their patients indicated that they would continue using the app platform and app, respectively, and would recommend it to others. To improve usability, enhancing patient-dietitian communication mediums in the app platform and reducing the burden of entering in meals cooked at home should be considered.

CONCLUSIONS

Administering an educational and skills training workshop in conjunction with integrating an app platform into dietetic practice was a feasible method for improving the self-efficacy of dietitians toward using mHealth apps. Further translational research will be required to determine how the broader dietetic profession responds to this intervention.
A Clinical Care Monitoring and Data Collection Tool (H3 Tracker) to Assess Uptake and Engagement in Mental Health Care Services in a Community-Based Pediatric Integrated Care Model: Longitudinal Cohort Study (Preprint)
Authors: McCreary Michael , Arevian Armen C , Brady Madeline , Mosqueda Chichits Ana E , Zhang Lily , Tang Lingqi , Zima Bonnie
Published: October 2018

BACKGROUND

National recommendations for pediatric integrated care models include improved capacity for care coordination and communication across primary care and specialty mental health providers using technology, yet few practical, short-term solutions are available for low-resource, community-based pediatric integrated care clinics.

OBJECTIVE

The goal of the paper is to describe the development and features of a Web-based tool designed for program evaluation and clinician monitoring of embedded pediatric mental health care using a community-partnered approach. In addition, a longitudinal study design was used to assess the implementation of the tool in program evaluation, including clinical monitoring and data collection.

METHODS

Biweekly meetings of the partnered evaluation team (clinic, academic, and funding partners) were convened over the course of 12 months to specify tool features using a participatory framework, followed by usability testing and further refinement during implementation.

RESULTS

A data collection tool was developed to collect clinic population characteristics as well as collect and display patient mental health outcomes and clinical care services from 277 eligible caregiver/child participants. Despite outreach, there was little uptake of the tool by either the behavioral health team or primary care provider.

CONCLUSIONS

Development of the H3 Tracker (Healthy Minds, Healthy Children, Healthy Chicago Tracker) in two community-based pediatric clinics with embedded mental health teams serving predominantly minority children is feasible and promising for on-site program evaluation data collection. Future research is needed to understand ways to improve clinic integration and examine whether promotion of primary care/mental health communication drives sustained use.

CLINICALTRIAL

ClinicalTrials.gov NCT02699814; https://clinicaltrials.gov/ct2/show/NCT02699814 (Archived by WebCite at http://www.webcitation.org/772pV5rWW)
The impact of selective DNA methyltrasferase inhibitors on breast cancer: A systematic review protocol (Preprint)
Authors:   Authors, Mohammadamoli 2nd Mahsa , Sarhangi 3rd Negar , Tavangar 4th Seyed Mohammad
Published: October 2018

UNSTRUCTURED

The DNA methyltransferase inhibitors (DNMTi) are the greatest effective epigenetic drugs to date and are still the most widely used as epigenetic modulators, even though their application for oncological diseases is restricted by their relative toxicity and poor chemical stability. Unfortunately, there is no a review related to the studies related to different DNMTi and breast cancer treatment. This review the DNMTi impact on breast cancer therapy, through the available literature we will run a systematic review. The specific review questions to be addressed are: (1) what constitutes current best practice in relation DNMTi interventions for hospitalized breast cancer patients? (2) What are the indications for, and the safety and effectiveness of, the range of interventions available? This protocol represented the methods including: inclusion criteria search strategy, Selection of studies, Quality assessment, and the last but not the least Statistical analysis and data synthesis which will be passed throughout of our research.