bluuebunny/crossref_metadata_2025 huggingface dataset:
Dysregulation of SIRT-1 Signaling in Multiple Sclerosis and Neuroimmune Disorders: A Systematic Review of SIRTUIN Activators as Potential Immunomodulators and their Influences on other Dysfunctions
Authors: Sharma Nidhi , Shandilya Ambika , Kumar Nitish , Mehan Sidharth
Published: March 2021

Immune dysregulation, neuronal inflammation, and oligodendrocyte degradation are key
causes for autoimmune disorders like multiple sclerosis (MS) and various other immune dysregulated
neurodegenerative complications responsible for CNS-mediated immune responses. Sirtuin
(SIRT-1) is a nicotinamide adenosine dinucleotide (NAD)-dependent transcriptional protein that
deacetylases and removes acetyl groups from its transcription factors like P53, FOXO, NF-Κb,
PGC-1α. SIRT-1 mediates a wide range of physiological functions, including gene transcription,
metabolism, neuronal apoptosis, and glucose production. SIRT-1 dysregulation targets transcription
factors, and other molecular alterations such as gene expression modification influence neuronal
plasticity, inhibit Th17 cells, and interleukin-1β can aggravate brain diseases. Preclinical and
clinical findings show that the upregulation of SIRT-1 reduces autoimmunity, neurodegeneration,
and neuroexcitation. Even though drugs are being developed for symptomatic therapies in clinical
trials, there are particular pharmacological implications for improving post-operative conditions in
neurodegenerative patients where intensive care is required. Understanding the SIRT-1 signaling
and identifying immune-mediated neuron deterioration can detect major therapeutic interventions
that could prevent neuro complications. Thus, in the current review, we have addressed the manifestations
of disease by the downregulation of SIRT-1 that could potentially cause MS and other neurodegenerative
disorders and provided data on existing available and effective drug therapies and
disease management strategies.
Nutraceuticals and their Derived Nano-Formulations for the Prevention and Treatment of Alzheimer's Disease
Authors: Haque Syed Ehtaishamul , Iqubal Ashif , Iqubal Mohammad Kashif , Fazal Syed Abul , Pottoo Faheem Hyder
Published: March 2021

:

Alzheimer’s disease (AD) is one of the common chronic neurological disorders and associated with cognitive dysfunction, depression and progressive dementia. The presence of β-amyloid or senile plaques, hyper-phosphorylated tau proteins, neurofibrillary tangle, oxidative-nitrative stress, mitochondrial dysfunction, endoplasmic reticulum stress, neuroinflammation and derailed neurotransmitter status are the hallmarks of AD. Currently, donepezil, memantine, rivastigmine and galantamine are approved by the FDA for symptomatic management. It is well-known that these approved drugs only exert symptomatic relief and possess poor patient-compliance. Additionally, various published evidence showed the neuroprotective potential of various nutraceuticals via their antioxidant, anti-inflammatory and anti-apoptotic effects in the preclinical and clinical studies. These nutraceuticals possess a significant neuroprotective potential and hence, can be a future pharmacotherapeutic for the management and treatment of AD. However, nutraceuticals suffer from certain major limitations such as poor solubility, low bioavailability, low stability, fast hepatic- metabolism and larger particle size. These pharmacokinetic attributes restrict their entry into the brain via the blood-brain barrier. Therefore, to overcome such issues, various nanoformulations of nutraceuticals have been developed, that allow their effective delivery into the brain owing to reduced particle size, increased lipophilicity, increased bioavailability and avoidance of fast hepatic metabolism. Thus, in this review, we have discussed the etiology of AD, focusing on the pharmacotherapeutics of nutraceuticals with preclinical and clinical evidence, discussed pharmaceutical limitations and regulatory aspects of nutraceuticals to ensure safety and efficacy. We have further explored various nanoformulations of nutraceuticals as a novel approach to overcome the existing pharmaceutical limitations and for effective delivery into the brain.
CYP3A4 *1B Gene Polymorphism in Coronary Artery Disease Patients with Obesity Undergoing Statin Treatment
Authors: Gezer Elifcan , Cevik Mehtap , Akdeniz Cansu Selcan , Canbolat Ismail Polat , Yurdakul Selen , Sunbul Murat , Cagatay Penbe , Deliorman Gokce , Karaalp Atila , Ciftci Cavlan , Susleyici Belgin
Published: March 2021

Objective:

Coronary artery disease (CAD) is one of the leading causes of morbidity and
mortality worldwide and statins are frequently prescribed in the treatment of CAD to help lower
blood cholesterol levels. Since the main enzyme involved in the metabolism of statins is CYP3A4,
we aimed to investigate the effect of CYP3A4 * 1B genotypes on plasma lipid profile in Turkish
cardiovascular disease subjects with and without obesity taking statin.

Materials and Methods:

The study group consisted of 85 cardiovascular disease patients who were
prescribed statins and had routine biochemical analysis data. Polymerase chain reaction followed
by restriction fragment length polymorphism (PCR-RFLP) assay was performed for genotyping of
CYP3A4 *1B (rs2740574) polymorphism.

Results:

Genotype distribution of CYP3A4 *1B polymorphism was found for homozygous wild
(AA) and homozygous polymorphic (GG) genotypes as 94.1% and 5.9%, respectively. We did not
detect patients with heterozygous genotype in our study group. We found that the mean LDL-c, TG
and TC levels were higher in patients with CYP3A4 *1B GG compared to the AA genotype. The
frequency of CYP3A4 *1B GG genotype frequency (9.5%) was detected higher in the obese patients
compared to the non-obese patients (7.7%) (χ2=0.037, p=0.85).

Conclusions:

Our results demonstrate that CYP3A4 *1B homozygous polymorphic genotype distribution
tends to be higher in obese patients compared to non-obese patients with cardiovascular disease
which may point to *1B allele having a slight effect on serum lipids during statin therapy. Additional
studies with higher samples are needed for evaluating the role of CYP3A4 *1B on lipids in
patients under statin therapy.
A Low Power SAR ADC with Digital Error Correction Technique for Wearable and Implantable ECG Devices
Authors: Lakshmi Posani Vijaya , Musala Sarada , Srinivasulu Avireni
Published: March 2021

Aims:

This study aims to propose an 8-bit differential input low-power Successi,e Approximation
Register (SAR) ADC with digital error correction technique for sensing bio-potential
signals in wearable and implantable devices.

Background:

As dynamic comparators have the advantages of full swing output, low power consumption,
high speed, and high impedance at the input, they are preferably used in energy-efficient
SAR ADC’s. However, since the dynamic comparator is the most frequently used block in SAR
ADC, research is ongoing to reduce its μW power further. Also, as the offset voltage of the comparator
affects the linearity of ADC, it must be minimized. Linearity can further be improved by
calibrating the output of ADC, and extensive surveys on the calibration methods prove that the addition-
only digital error correction method is efficient in terms of power.

Objective:

The objective of this study is to design a low-power and low-offset dynamic comparator
intended for SAR ADC to achieve highly linear digital output. In addition to this, the objective
is to implement a power-efficient digital error correction technique for the output of SAR ADC to
overcome the non-idealities due to process variations.

Method:

As power consumption is proportional to the number of transistors, the proposed comparator
is a design obtaining the same output as the existing dynamic comparators with reduced
transistor count. The proposed comparator, along with low power full swing three-input XOR logic
gate, is implemented in SAR ADC with digital error correction technique in cadence 45 nm
technology files, and its performance parameters are simulated.

Results:

The layout of the proposed dynamic comparator occupies an area of 3 μm2. The simulation
results of this comparator with a load of 1 pF show that it has a total offset of 11.2 mV, a delay
of 0.9 ns, and power consumption of 24 nW. It also achieves a gain of 49.5, i.e., 33.86 dB. The
8-bit ADC, along with the digital error correction technique operating at 143-kS/s and under 0.6 V
supply voltage simulated in 45nm technology, consumes only 0.12 μW of power. The DNL and
INL errors obtained are +0.22/-0.2 LSB and -0.28 LSB, respectively. SNR limited by noise is
48.25 dB, SFDR is 48.64 dB, and ENOB achieved is 7.72.

Conclusion:

To satisfy the requirement of the wearable and implantable devices, a low-power
SAR ADC with good linearity is designed using a low-power and low-offset dynamic comparator.
A digital error correction technique using a low-power XOR logic gate is implemented at the SAR
ADC output to minimize the non-idealities due to the process variations.
Withdrawal Notice: Screening of Heavy Metal and Antibiotic Resistance
among Proteus Vulgaris Isolates from Hospital Wastewater of Northern India
Authors: Alam Manzar , Imran Mohd , Ahmad Syed Sayeed
Published: March 2021

The article has been withdrawn at the request of the editors of the journal Anti-Infective Agents due to incoherent
content.

Bentham Science apologizes to the readers of the journal for any inconvenience this may have caused.

The Bentham Editorial Policy on Article Withdrawal can be found at https://benthamscience.com/editorial-policies-main.php

Bentham Science Disclaimer:

It is a condition of publication that manuscripts submitted to this journal have not been published and will not be simultaneously
submitted or published elsewhere. Furthermore, any data, illustration, structure or table that has been published elsewhere
must be reported, and copyright permission for reproduction must be obtained. Plagiarism is strictly forbidden, and by submitting
the article for publication the authors agree that the publishers have the legal right to take appropriate action against the
authors, if plagiarism or fabricated information is discovered. By submitting a manuscript, the authors agree that the copyright
of their article is transferred to the publishers if and when the article is accepted for publication.
Recent Reviews on Machine Vision-Based 3D Reconstruction
Authors: Zhang Hongxin , Ma Shaowei , Li Meng , Jiang Hanghang , Li Jiaming
Published: March 2021

Background:

In machine vision, 3D reconstruction is widely used in the medical system, autonomous
navigation, aviation and remote sensing measurement, industrial automation, and other fields,
and the demand for reconstruction precision is significantly highlighted. Therefore, 3D reconstruction is
of great research value and will be an important research direction in the future.

Objective:

By reviewing the latest development and patent on 3D reconstruction, this paper provides
references to researchers in related fields.

Methods:

Machine vision-based 3D reconstruction patents and articles were analyzed from the aspects
of the algorithm, innovation, and application. Among them, there are over 30 patents and nearly 30 articles
that have been published in the past ten years.

Results:

Researches on machine vision-based 3D reconstruction in the recent 10 years were reviewed,
and the typical characteristics were concluded. The main problems in its development were analyzed,
the development trend was foreseen, and the current and future research on the productions and patents
related to machine vision-based 3D reconstruction was discussed.

Conclusion:

The reconstruction result of binocular vision and multi-vision is better than monocular vision
in most cases. Current researches of 3D reconstruction focus on robot vision navigation, intelligent
vehicle environment sensing system and virtual reality. The aspects that need to be improved in the future
include improving robustness, reducing computational complexity, and reducing operating equipment
requirements, etc. Furthermore, more patents on machine vision-based 3D reconstruction should
also be invented.
A Pharmacist and Health Coach–Delivered Mobile Health Intervention for Type 2 Diabetes: Protocol for a Randomized Controlled Crossover Study
Authors: Sharp Lisa Kay , Biggers Alana , Perez Rosanne , Henkins Julia , Tilton Jessica , Gerber Ben S
Published: March 2021

Background

Aggressive management of blood glucose, blood pressure, and cholesterol through medication and lifestyle adherence is necessary to minimize the adverse health outcomes of type 2 diabetes. However, numerous psychosocial and environmental barriers to adherence prevent low-income, urban, and ethnic minority populations from achieving their management goals, resulting in diabetes complications. Health coaches working with clinical pharmacists represent a promising strategy for addressing common diabetes management barriers. Mobile health (mHealth) tools may further enhance their ability to support vulnerable minority populations in diabetes management.

Objective

The aim of this study is to evaluate the impact of an mHealth clinical pharmacist and health coach–delivered intervention on hemoglobin A1c (HbA1c, primary outcome), blood pressure, and low-density lipoprotein (secondary outcomes) in African-Americans and Latinos with poorly controlled type 2 diabetes.

Methods

A 2-year, randomized controlled crossover study will evaluate the effectiveness of an mHealth diabetes intervention delivered by a health coach and clinical pharmacist team compared with usual care. All patients will receive 1 year of team intervention, including lifestyle and medication support delivered in the home with videoconferencing and text messages. All patients will also receive 1 year of usual care without team intervention and no home visits. The order of the conditions received will be randomized. Our recruitment goal is 220 urban African-American or Latino adults with uncontrolled type 2 diabetes (HbA1c ≥8%) receiving care from a largely minority-serving, urban academic medical center. The intervention includes the following: health coaches supporting patients through home visits, phone calls, and text messaging and clinical pharmacists supporting patients through videoconferences facilitated by health coaches. Data collection includes physiologic (HbA1c, blood pressure, weight, and lipid profile) and survey measures (medication adherence, diabetes-related behaviors, and quality of life). Data collection during the second year of study will determine the maintenance of any physiological improvement among participants receiving the intervention during the first year.

Results

Participant enrollment began in March 2017. We have recruited 221 patients. Intervention delivery and data collection will continue until November 2021. The results are expected to be published by May 2022.

Conclusions

This is among the first trials to incorporate health coaches, clinical pharmacists, and mHealth technologies to increase access to diabetes support among urban African-Americans and Latinos to achieve therapeutic goals.

International Registered Report Identifier (IRRID)

DERR1-10.2196/17170
Why We Are Losing the War Against COVID-19 on the Data Front and How to Reverse the Situation
Authors: Prieto-Merino David , Bebiano Da Providencia E Costa Rui , Bacallao Gallestey Jorge , Sofat Reecha , Chung Sheng-Chia , Potts Henry
Published: March 2021

With over 117 million COVID-19–positive cases declared and the death count approaching 3 million, we would expect that the highly digitalized health systems of high-income countries would have collected, processed, and analyzed large quantities of clinical data from patients with COVID-19. Those data should have served to answer important clinical questions such as: what are the risk factors for becoming infected? What are good clinical variables to predict prognosis? What kinds of patients are more likely to survive mechanical ventilation? Are there clinical subphenotypes of the disease? All these, and many more, are crucial questions to improve our clinical strategies against the epidemic and save as many lives as possible. One might assume that in the era of big data and machine learning, there would be an army of scientists crunching petabytes of clinical data to answer these questions. However, nothing could be further from the truth. Our health systems have proven to be completely unprepared to generate, in a timely manner, a flow of clinical data that could feed these analyses. Despite gigabytes of data being generated every day, the vast quantity is locked in secure hospital data servers and is not being made available for analysis. Routinely collected clinical data are, by and large, regarded as a tool to inform decisions about individual patients, and not as a key resource to answer clinical questions through statistical analysis. The initiatives to extract COVID-19 clinical data are often promoted by private groups of individuals and not by health systems, and are uncoordinated and inefficient. The consequence is that we have more clinical data on COVID-19 than on any other epidemic in history, but we have failed to analyze this information quickly enough to make a difference. In this viewpoint, we expose this situation and suggest concrete ideas that health systems could implement to dynamically analyze their routine clinical data, becoming learning health systems and reversing the current situation.
Smartphone Usage Among Doctors in the Clinical Setting in Two Culturally Distinct Countries: Cross-sectional Comparative Study
Authors: Nair Anjali Ajay , Afroz Samreen , Ahmed Bushra Urooj , Ahmed Uzma Urooj , Foo Chi Chung , Zaidan Hind , Corbally Martin
Published: March 2021

Background

Smartphones and mobile applications have seen a surge in popularity in recent years, a pattern that has also been reflected in the health care system. Despite increased reliance among clinicians however, limited research has been conducted on the uptake and impact of smartphone usage in medical practice, especially outside the Western world.

Objective

This study aimed to identify the usage of smartphones and medical apps by doctors in the clinical setting in 2 culturally distinct countries: King Hamad University Hospital (KHUH), Bahrain and Queen Mary Hospital (QMH), Hong Kong.

Methods

A cross-sectional, comparative study was conducted where doctors in both hospitals were asked to take part in a 15-item online survey. The questions were categorized into the following groups: demographics of the study population, ownership and main use of smartphones, number and names of medical apps currently owned, rating usage of smartphones for medical purposes, time spent on a smartphone related to clinical use, clinical reliance on smartphones, and views on further integration of smartphones. The results were then tabulated and analyzed using SPSS Statistics 25 for Mac (IBM Corp Inc, Armonk, NY).

Results

A total of 200 doctors were surveyed, with a total of 99.0% (99/100) of the doctors owning a smartphone in both KHUH and QMH; 58% (57/99) and 55% (54/99) of the doctors from KHUH and QMH, respectively, identified communication as their main use of smartphones in the clinical setting (P=.004). Doctors from KHUH were likely to spend more time on medical apps than doctors from QMH (P=.002). According to the overall results of both hospitals, 48% (32/67) of the junior doctors claimed high reliance on smartphones, whereas only 32.3% (41/127) of the senior doctors said the same (P=.03). Of doctors in KHUH and QMH, 78.0% (78/100) and 69.0% (69/100), respectively, either strongly agreed or agreed that smartphones need to be integrated into the clinical setting. In terms of preferences for future apps, 48% (48/100) and 56% (56/100) of the doctors in KHUH and QMH, respectively, agreed that more medical applications need to be created in order to support smartphone use in the clinical setting.

Conclusions

These results suggest a substantial acceptance of smartphones by doctors in the clinical setting. It also elicits the need to establish policies to officially integrate smartphone technology into health care in accordance with ethical guidelines. More emphasis should be placed on creating medical applications that aid health care professionals in attaining their information from accurate sources and also regulate a system to monitor the usage of mobile devices within hospitals to prevent a breach of patient privacy and confidentiality.
User-Centered Development of a Web Platform Supporting Community-Based Health Care Organizations for Older Persons in Need of Support: Qualitative Focus Group Study
Authors: Biehl Verena , Becker Heidrun , Ogrin Alenka , Reissner Alenka , Burger Johannes , Glaessel Andrea
Published: March 2021

Background

The ongoing changes in population demographics increase the relevance of dignified aging across Europe. Community-based health care (CBHC) organizations are necessary to provide sustainable strategies for organizing care for older persons in need of support. To support the digitalization of these organizations, new business models and suitable web platforms are necessary.

Objective

This study, which is part of the European Active and Assisted Living (AAL) project called “ICareCoops”, aimed to explore concepts, approaches, and workflows of CBHC organizations to achieve a comprehensive understanding of extant services offered and relevant requirements to support these services with information and computer technology (ICT) solutions.

Methods

A qualitative study with six focus groups (FGs) with 40 participants was conducted in Switzerland and Slovenia to identify potential stakeholders’ needs and requirements for the user-centered development of a web platform. Data were collected from three different stakeholder groups: (1) older persons in need of support as care receivers, (2) significant others of older persons in need of support, and (3) managers or care providers of CBHC organizations. A semistructured interview guide with open questions was used for data collection. FG sessions were audio-recorded and transcribed verbatim. Thematic content analysis was used to analyze the content of the FG sessions. To assist with further web platform development, the responses of the FG participants were translated into user stories to describe technical requirements.

Results

By analyzing the transcripts, five main categories were identified: (1) ICT usage behavior of users, (2) challenges of web platform usage, (3) content and technical requirements for the web platform, (4) form and services of CBHC organizations, and (5) rationales of CBHC organizations. The main issues identified were the need for seniors to have individual contact with the CBHC organization and the possibility to coordinate routine services via the web platform, such as ordering meals-on-wheels or booking a caregiver to accompany an older person to the doctor.

Conclusions

The majority of participants showed a lack of familiarity with the usage of ICT. Nevertheless, they were open-minded regarding web platform usage to facilitate workflows and to benefit CBHC organizations. Cooperatives as an organizational model demonstrate a high potential to address users’ needs. Therefore, the web platform offers an essential tool for innovative health care models in the future. Searching for care services, contacting care providers, and communicating with care providers was preferred via personal contact and seemed to be the key element for user acceptance and for the successful implementation of a web platform like “ICareCoops” to support CBHC organizations.
Using Machine Learning Imputed Outcomes to Assess Drug-Dependent Risk of Self-Harm in Patients with Bipolar Disorder: A Comparative Effectiveness Study
Authors: Nestsiarovich Anastasiya , Kumar Praveen , Lauve Nicolas Raymond , Hurwitz Nathaniel G , Mazurie Aurélien J , Cannon Daniel C , Zhu Yiliang , Nelson Stuart James , Crisanti Annette S , Kerner Berit , Tohen Mauricio , Perkins Douglas J , Lambert Christophe Gerard
Published: March 2021

Background

Incomplete suicidality coding in administrative claims data is a known obstacle for observational studies. With most of the negative outcomes missing from the data, it is challenging to assess the evidence on treatment strategies for the prevention of self-harm in bipolar disorder (BD), including pharmacotherapy and psychotherapy. There are conflicting data from studies on the drug-dependent risk of self-harm, and there is major uncertainty regarding the preventive effect of monotherapy and drug combinations.

Objective

The aim of this study was to compare all commonly used BD pharmacotherapies, as well as psychotherapy for the risk of self-harm, in a large population of commercially insured individuals, using self-harm imputation to overcome the known limitations of this outcome being underrecorded within US electronic health care records.

Methods

The IBM MarketScan administrative claims database was used to compare self-harm risk in patients with BD following 65 drug regimens and drug-free periods. Probable but uncoded self-harm events were imputed via machine learning, with different probability thresholds examined in a sensitivity analysis. Comparators included lithium, mood-stabilizing anticonvulsants (MSAs), second-generation antipsychotics (SGAs), first-generation antipsychotics (FGAs), and five classes of antidepressants. Cox regression models with time-varying covariates were built for individual treatment regimens and for any pharmacotherapy with or without psychosocial interventions (“psychotherapy”).

Results

Among 529,359 patients, 1.66% (n=8813 events) had imputed and/or coded self-harm following the exposure of interest. A higher self-harm risk was observed during adolescence. After multiple testing adjustment (P≤.012), the following six regimens had higher risk of self-harm than lithium: tri/tetracyclic antidepressants + SGA, FGA + MSA, FGA, serotonin-norepinephrine reuptake inhibitor (SNRI) + SGA, lithium + MSA, and lithium + SGA (hazard ratios [HRs] 1.44-2.29), and the following nine had lower risk: lamotrigine, valproate, risperidone, aripiprazole, SNRI, selective serotonin reuptake inhibitor (SSRI), “no drug,” bupropion, and bupropion + SSRI (HRs 0.28-0.74). Psychotherapy alone (without medication) had a lower self-harm risk than no treatment (HR 0.56, 95% CI 0.52-0.60; P=8.76×10-58). The sensitivity analysis showed that the direction of drug-outcome associations did not change as a function of the self-harm probability threshold.

Conclusions

Our data support evidence on the effectiveness of antidepressants, MSAs, and psychotherapy for self-harm prevention in BD.

Trial Registration

ClinicalTrials.gov NCT02893371; https://clinicaltrials.gov/ct2/show/NCT02893371
Effectiveness of an Integrated Care Package for Refugee Mothers and Children: Protocol for a Cluster Randomized Controlled Trial
Authors: Al Azdi Zunayed , Islam Khaleda , Khan Muhammad Amir , Khan Nida , Ejaz Amna , Khan Muhammad Ahmar , Warraitch Azza , Jahan Ishrat , Huque Rumana
Published: March 2021

Background

Thousands of Rohingya refugee mothers at the world’s largest refugee camp located in Bangladesh are at risk of poor mental health. Accordingly, their children are also vulnerable to delayed cognitive and physical development.

Objective

The aim of this study is to evaluate the effectiveness of an integrated care package in reducing the prevalence of developmental delays among children aged 1 year and improving their mothers’ mental health status.

Methods

This is a parallel, two-arm, single-blind, cluster randomized controlled trial (cRCT). A total of 704 mother-child dyads residing at the Kutupalong refugee camp in Cox’s Bazar, Bangladesh, will be recruited from 22 clusters with 32 mother-child dyads per cluster. In the intervention arm, an integrated early childhood development and maternal mental health package will be delivered every quarter to mothers of newborns by trained community health workers until the child is 1 year old. Our primary outcome is a reduction in the prevalence of two or more childhood developmental delays of infants aged 1 year compared to the usual treatment. The secondary outcomes include reduced stunting among children and the prevalence of maternal depression. We will also assess the cost-effectiveness of the integrated intervention, and will further explore the intervention’s acceptability and feasibility.

Results

At the time of submission, the study was at the stage of endpoint assessment. The data analysis started in December 2020, and the results are expected to be published after the first quarter of 2021.

Conclusions

This study will address the burden of childhood developmental delays and poor maternal mental health in a low-resource setting. If proven effective, the delivery of the intervention through community health workers will ensure the proposed intervention’s sustainability.

Trial Registration

ISRCTN Registry ISRCTN10892553; https://www.isrctn.com/ISRCTN10892553

International Registered Report Identifier (IRRID)

DERR1-10.2196/25047
Impact of the COVID-19 Pandemic on Older Adults: Rapid Review
Authors: Lebrasseur Audrey , Fortin-Bédard Noémie , Lettre Josiane , Raymond Emilie , Bussières Eve-Line , Lapierre Nolwenn , Faieta Julie , Vincent Claude , Duchesne Louise , Ouellet Marie-Christine , Gagnon Eric , Tourigny André , Lamontagne Marie-Ève , Routhier François
Published: March 2021

Background

The COVID-19 pandemic has drastically changed the lives of countless members of the general population. Older adults are known to experience loneliness, age discrimination, and excessive worry. It is therefore reasonable to anticipate that they would experience greater negative outcomes related to the COVID-19 pandemic given their increased isolation and risk for complications than younger adults.

Objective

This study aims to synthesize the existing research on the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults. The secondary objective is to investigate the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults with Alzheimer disease and related dementias.

Methods

A rapid review of the published literature was conducted on October 6, 2020, through a search of 6 online databases to synthesize results from published original studies regarding the impact of the COVID-19 pandemic on older adults. The Human Development Model conceptual framework–Disability Creation Process was used to describe and understand interactions between personal factors, environmental factors, and life habits. Methods and results are reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement.

Results

A total of 135 records were included from the initial search strategy of 13,452 individual studies. Of these, 113 (83.7%) studies were determined to be of level 4 according to the levels of evidence classification by the Centre for Evidence-Based Medicine. The presence of psychological symptoms, exacerbation of ageism, and physical deterioration of aged populations were reported in the included studies. Decreased social life and fewer in-person social interactions reported during the COVID-19 pandemic were occasionally associated with reduced quality of life and increased depression. Difficulties accessing services, sleep disturbances, and a reduction of physical activity were also noted.

Conclusions

Our results highlight the need for adequate isolation and protective measures. Older adults represent a heterogeneous group, which could explain the contradictory results found in the literature. Individual, organizational, and institutional strategies should be established to ensure that older adults are able to maintain social contacts, preserve family ties, and maintain the ability to give or receive help during the current pandemic. Future studies should focus on specific consequences and needs of more at-risk older adults to ensure their inclusion, both in public health recommendations and considerations made by policy makers.
Echo Chamber Effect in Rumor Rebuttal Discussions About COVID-19 in China: Social Media Content and Network Analysis Study
Authors: Wang Dandan , Qian Yuxing
Published: March 2021

Background

The dissemination of rumor rebuttal content on social media is vital for rumor control and disease containment during public health crises. Previous research on the effectiveness of rumor rebuttal, to a certain extent, ignored or simplified the structure of dissemination networks and users’ cognition as well as decision-making and interaction behaviors.

Objective

This study aimed to roughly evaluate the effectiveness of rumor rebuttal; dig deeply into the attitude-based echo chamber effect on users’ responses to rumor rebuttal under multiple topics on Weibo, a Chinese social media platform, in the early stage of the COVID-19 epidemic; and evaluate the echo chamber’s impact on the information characteristics of user interaction content.

Methods

We used Sina Weibo’s application programming interface to crawl rumor rebuttal content related to COVID-19 from 10 AM on January 23, 2020, to midnight on April 8, 2020. Using content analysis, sentiment analysis, social network analysis, and statistical analysis, we first analyzed whether and to what extent there was an echo chamber effect on the shaping of individuals’ attitudes when retweeting or commenting on others’ tweets. Then, we tested the heterogeneity of attitude distribution within communities and the homophily of interactions between communities. Based on the results at user and community levels, we made comprehensive judgments. Finally, we examined users’ interaction content from three dimensions—sentiment expression, information seeking and sharing, and civility—to test the impact of the echo chamber effect.

Results

Our results indicated that the retweeting mechanism played an essential role in promoting polarization, and the commenting mechanism played a role in consensus building. Our results showed that there might not be a significant echo chamber effect on community interactions and verified that, compared to like-minded interactions, cross-cutting interactions contained significantly more negative sentiment, information seeking and sharing, and incivility. We found that online users’ information-seeking behavior was accompanied by incivility, and information-sharing behavior was accompanied by more negative sentiment, which was often accompanied by incivility.

Conclusions

Our findings revealed the existence and degree of an echo chamber effect from multiple dimensions, such as topic, interaction mechanism, and interaction level, and its impact on interaction content. Based on these findings, we provide several suggestions for preventing or alleviating group polarization to achieve better rumor rebuttal.
A Pharmacist and Health Coach–Delivered Mobile Health Intervention for Type 2 Diabetes: Protocol for a Randomized Controlled Crossover Study (Preprint)
Authors: Sharp Lisa Kay , Biggers Alana , Perez Rosanne , Henkins Julia , Tilton Jessica , Gerber Ben S
Published: March 2021

BACKGROUND

Aggressive management of blood glucose, blood pressure, and cholesterol through medication and lifestyle adherence is necessary to minimize the adverse health outcomes of type 2 diabetes. However, numerous psychosocial and environmental barriers to adherence prevent low-income, urban, and ethnic minority populations from achieving their management goals, resulting in diabetes complications. Health coaches working with clinical pharmacists represent a promising strategy for addressing common diabetes management barriers. Mobile health (mHealth) tools may further enhance their ability to support vulnerable minority populations in diabetes management.

OBJECTIVE

The aim of this study is to evaluate the impact of an mHealth clinical pharmacist and health coach–delivered intervention on hemoglobin A1c (HbA1c, primary outcome), blood pressure, and low-density lipoprotein (secondary outcomes) in African-Americans and Latinos with poorly controlled type 2 diabetes.

METHODS

A 2-year, randomized controlled crossover study will evaluate the effectiveness of an mHealth diabetes intervention delivered by a health coach and clinical pharmacist team compared with usual care. All patients will receive 1 year of team intervention, including lifestyle and medication support delivered in the home with videoconferencing and text messages. All patients will also receive 1 year of usual care without team intervention and no home visits. The order of the conditions received will be randomized. Our recruitment goal is 220 urban African-American or Latino adults with uncontrolled type 2 diabetes (HbA1c ≥8%) receiving care from a largely minority-serving, urban academic medical center. The intervention includes the following: health coaches supporting patients through home visits, phone calls, and text messaging and clinical pharmacists supporting patients through videoconferences facilitated by health coaches. Data collection includes physiologic (HbA1c, blood pressure, weight, and lipid profile) and survey measures (medication adherence, diabetes-related behaviors, and quality of life). Data collection during the second year of study will determine the maintenance of any physiological improvement among participants receiving the intervention during the first year.

RESULTS

Participant enrollment began in March 2017. We have recruited 221 patients. Intervention delivery and data collection will continue until November 2021. The results are expected to be published by May 2022.

CONCLUSIONS

This is among the first trials to incorporate health coaches, clinical pharmacists, and mHealth technologies to increase access to diabetes support among urban African-Americans and Latinos to achieve therapeutic goals.

CLINICALTRIAL

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/17170
User-Centered Development of a Web Platform Supporting Community-Based Health Care Organizations for Older Persons in Need of Support: Qualitative Focus Group Study (Preprint)
Authors: Biehl Verena , Becker Heidrun , Ogrin Alenka , Reissner Alenka , Burger Johannes , Glaessel Andrea
Published: March 2021

BACKGROUND

The ongoing changes in population demographics increase the relevance of dignified aging across Europe. Community-based health care (CBHC) organizations are necessary to provide sustainable strategies for organizing care for older persons in need of support. To support the digitalization of these organizations, new business models and suitable web platforms are necessary.

OBJECTIVE

This study, which is part of the European Active and Assisted Living (AAL) project called “ICareCoops”, aimed to explore concepts, approaches, and workflows of CBHC organizations to achieve a comprehensive understanding of extant services offered and relevant requirements to support these services with information and computer technology (ICT) solutions.

METHODS

A qualitative study with six focus groups (FGs) with 40 participants was conducted in Switzerland and Slovenia to identify potential stakeholders’ needs and requirements for the user-centered development of a web platform. Data were collected from three different stakeholder groups: (1) older persons in need of support as care receivers, (2) significant others of older persons in need of support, and (3) managers or care providers of CBHC organizations. A semistructured interview guide with open questions was used for data collection. FG sessions were audio-recorded and transcribed verbatim. Thematic content analysis was used to analyze the content of the FG sessions. To assist with further web platform development, the responses of the FG participants were translated into user stories to describe technical requirements.

RESULTS

By analyzing the transcripts, five main categories were identified: (1) ICT usage behavior of users, (2) challenges of web platform usage, (3) content and technical requirements for the web platform, (4) form and services of CBHC organizations, and (5) rationales of CBHC organizations. The main issues identified were the need for seniors to have individual contact with the CBHC organization and the possibility to coordinate routine services via the web platform, such as ordering meals-on-wheels or booking a caregiver to accompany an older person to the doctor.

CONCLUSIONS

The majority of participants showed a lack of familiarity with the usage of ICT. Nevertheless, they were open-minded regarding web platform usage to facilitate workflows and to benefit CBHC organizations. Cooperatives as an organizational model demonstrate a high potential to address users’ needs. Therefore, the web platform offers an essential tool for innovative health care models in the future. Searching for care services, contacting care providers, and communicating with care providers was preferred via personal contact and seemed to be the key element for user acceptance and for the successful implementation of a web platform like “ICareCoops” to support CBHC organizations.
Online Mindfulness-Based Cognitive Behavioral Therapy Intervention for Youth With Major Depressive Disorders: Randomized Controlled Trial (Preprint)
Authors: Ritvo Paul , Knyahnytska Yuliya , Pirbaglou Meysam , Wang Wei , Tomlinson George , Zhao Haoyu , Linklater Renee , Bai Shari , Kirk Megan , Katz Joel , Harber Lillian , Daskalakis Zafiris
Published: March 2021

BACKGROUND

Approximately 70% of mental health disorders appear prior to 25 years of age and can become chronic when ineffectively treated. Individuals between 18 and 25 years old are significantly more likely to experience mental health disorders, substance dependencies, and suicidality. Treatment progress, capitalizing on the tendencies of youth to communicate online, can strategically address depressive disorders.

OBJECTIVE

We performed a randomized controlled trial (RCT) that compared online mindfulness-based cognitive behavioral therapy (CBT-M) combined with standard psychiatric care to standard psychiatric care alone in youth (18-30 years old) diagnosed with major depressive disorder.

METHODS

Forty-five participants were randomly assigned to CBT-M and standard care (n=22) or to standard psychiatric care alone (n=23). All participants were provided standard psychiatric care (ie, 1 session per month), while participants in the experimental group received an additional intervention consisting of the CBT-M online software program. Interaction with online workbooks was combined with navigation coaching delivered by phone and secure text messaging.

RESULTS

In a two-level linear mixed-effects model intention-to-treat analysis, significant between-group differences were found for the Beck Depression Inventory-II score (difference –8.54, P=.01), Quick Inventory of Depressive Symptoms score (difference –4.94, P=.001), Beck Anxiety Inventory score (difference –11.29, P<.001), and Brief Pain Inventory score (difference –1.99, P=.03), while marginal differences were found for the Five Facet Mindfulness Questionnaire–Nonjudging subscale (difference –2.68, P=.05).

CONCLUSIONS

These results confirm that youth depression can be effectively treated with online CBT-M that can be delivered with less geographic restriction.

CLINICALTRIAL

Clinical Trials.gov NCT03406052; https://www.clinicaltrials.gov/ct2/show/NCT03406052
Making the COVID-19 Pandemic a Driver for Digital Health: Brazilian Strategies (Preprint)
Authors: Donida Bruna , da Costa Cristiano André , Scherer Juliana Nichterwitz
Published: March 2021

UNSTRUCTURED

The COVID-19 outbreak exposed several problems faced by health systems worldwide, especially concerning the safe and rapid generation and sharing of health data. However, this pandemic scenario has also facilitated the rapid implementation and monitoring of technologies in the health field. In view of the occurrence of the public emergency caused by SARS-CoV-2 in Brazil, the Department of Informatics of the Brazilian Unified Health System created a contingency plan. In this paper, we aim to report the digital health strategies applied in Brazil and the first results obtained during the fight against COVID-19. Conecte SUS, a platform created to store all the health data of an individual throughout their life, is the center point of the Brazilian digital strategy. Access to the platform can be obtained through an app by the patient and the health professionals involved in the case. Health data sharing became possible due to the creation of the National Health Data Network (Rede Nacional de Dados em Saúde, RNDS). A mobile app was developed to guide citizens regarding the need to go to a health facility and to assist in disseminating official news about the virus. The mobile app can also alert the user if they have had contact with an infected person. The official numbers of cases and available hospital beds are updated and published daily on a website containing interactive graphs. These data are obtained due to creating a web-based notification system that uses the RNDS to share information about the cases. Preclinical care through telemedicine has become essential to prevent overload in health facilities. The exchange of experiences between medical teams from large centers and small hospitals was made possible using telehealth. Brazil took a giant step toward digital health adoption, creating and implementing important initiatives; however, these initiatives do not yet cover the entire health system. It is expected that the sharing of health data that are maintained and authorized by the patient will become a reality in the near future. The intention is to obtain better clinical outcomes, cost reduction, and faster and better services in the public health network.
Social Media as a Platform for Recruitment to a National Survey During the COVID-19 Pandemic: Feasibility and Cost Analysis (Preprint)
Authors: Green Heidi , Fernandez Ritin , MacPhail Catherine
Published: March 2021

BACKGROUND

With improved accessibility to social media globally, health researchers are capitalizing on social media platforms to recruit participants for research studies. This has particularly been the case during the COVID-19 pandemic, when researchers were not able to use traditional methods of recruitment. Nevertheless, there is limited evidence on the feasibility of social media for recruiting a national sample.

OBJECTIVE

This paper describes the use of social media as a tool for recruiting a national sample of adults to a web-based survey during the COVID-19 pandemic.

METHODS

Between August and October 2020, participants were recruited through Facebook via two advertisement campaigns (paid option and no-cost option) into a web-based survey exploring the relationship between social determinants of health and well-being of adults during the COVID-19 pandemic. Data were analyzed using SPSS software and Facebook metrics that were autogenerated by Facebook Ads Manager. Poststratification weights were calculated to match the Australian population on the basis of gender, age, and state or territory based on the 2016 Australian census data.

RESULTS

In total, 9594 people were reached nationally with the paid option and potentially 902,000 people were reached through the no-cost option, resulting in a total of 1211 survey responses. The total cost of the advertisement campaign was Aus $649.66 (US $489.23), resulting in an overall cost per click of Aus $0.25 (US $0.19).

CONCLUSIONS

Facebook is a feasible and cost-effective method of recruiting participants for a web-based survey, enabling recruitment of population groups that are considered hard to reach or marginalized. Recruitment through Facebook facilitated diversity, with participants varying in socioeconomic status, geographical location, educational attainment, and age.
Redundancy of Terms in Search Strategies. Comment on “Searching PubMed to Retrieve Publications on the COVID-19 Pandemic: Comparative Analysis of Search Strings” (Preprint)
Authors: Campos Daniel Melo De Oliveira , Fulco Umberto Laino , Oliveira Jonas Ivan Nobre
Published: March 2021

UNSTRUCTURED

N/A