bluuebunny/crossref_metadata_2025 huggingface dataset:
Determination of Molecular Weight and Antimicrobial Activities of a Purified Bacteriocin from Lactiplantibacillus plantarum MDP 5
Authors: Punithavalli T
Published: December 2021

Nowadays, unlimited use of antibiotics and preservatives have become a big concern regarding the human health which turn the interest of biotech industries into their research on biologically active molecules from probiotic microbes, since they are nontoxic and suitable for many safer applications. On this background, the present investigation focused on the characterization of a bacteriocin from a Lactobacillus strain. The characterization of a bacteriocin was done using a Lactiplantibacillus plantarum MDP 5 isolated from the local markets of Puducherry and production was performed under standardized cultural conditions. The study on the maximum recovery of bacteriocin using ammonium sulphate precipitation method revealed that the 60% saturation rate evidenced highest activity of 6500 AU/ml with 4.113g/L dry weight followed by the purification was done with RP-HPLC method using C18 column. The purified bacteriocin revealed a novel molecular weight of 22 kDa with the help of SDS-PAGE which has not been reported from Lactobacillus species. Further, the purified bacteriocin evidenced appreciable antimicrobial activities against all the tested human bacterial pathogens of this study. The highest antimicrobial activity was recorded against Escherichia coli MTCC 443 followed by Staphylococcus aureus MTCC 96, Vibrio parahemolyticus MTCC 451, Enterococcus faecalis MTCC 9845, Pseudomonas aeruginosa MTCC 741 and Klebsiella pneumoniae MTCC 109 in the concentrations of 8AU/ml, 16AU/ml, 32AU/ml, 64AU/ml, 256AU/ml and 512AU/ml, respectively. From the overall observation, this study explored a novel bacteriocin purified from a probiotic bacterium represented potential antimicrobial activities against many human pathogens which suggesting its possible use for the safe therapeutic applications.
Evaluation of Antioxidant and Antidiabetic Potential of Polyherbal Drug Made with Three Herbs: An In vitro Cell Culture Model
Authors: Chandrasekaran P.
Published: December 2021

In diabetes, the postprandial phase is characterized by a rapid and large increase in blood glucose levels, and the possibility that the postprandial “hyperglycemic spikes” may be relevant to the onset of cardiovascular complications has recently received much attention. Medicinal use of herbal medicine in the treatment and prevention of diseases including diabetes has a long history compared to conventional medicine. These plants have no side effects and many existing medicines are derived from the plants. Hence, the current investigation was planned to make a poly herbal drug (PHD) through Punica granatum (fruits), Illicium verum (flowers) and Nyctanthes arbor (leaves) and assess their antioxidant and antidiabetic activities in vitro and in HepG2 cell line. The respective plant methanolic extracts and PHD are exposed to phytochemical assessment and to discriminate the bioactive factors by Gas Chromatography–Mass Spectrometry. We evaluated the antioxidant properties 2, 2-diphenyl-1-picrylhydrazyl scavenging, hydrogen peroxide scavenging, thiobarbituric acid reactive substances and total antioxidant activity of individual plant extracts and the PHD. At the same time, In vitro and cell culture approaches were used to assess the anti-diabetic activity. The PHD has a higher concentration of secondary metabolites than individual plant extracts, according to our findings. On the other hand, we also notice that PHD demonstrated higher antioxidant capability and considerable in vitro glucose-lowering effects along with noteworthy inhibition of ɑ-amylase, glucosidase, lipase, dipeptidyl peptidase-IV, collagenase and protein glycation in HepG2 cell line. In conclusion, this study clearly demonstrated the significant antioxidant and antidiabetic activities of the PHD. Hence, PHD may be used as a potential source in the management of diabetes, hyperglycemia and the related state of oxidative stress.
An Instrumented Assessment of Cerebral Palsy: A Systematic Review
Authors: Singh Shikha
Published: December 2021

Cerebral palsy is a neurological problem which mainly affects the children and is a frequent reason of physical inability. It affects both motor as well as sensory system. Due to physical disability quality treatment is required for CP children. For an effective treatment proper assessment and selection of correct assessment tool is necessary. This review was aimed to recognize the various assessment scales which are available to assess different domains in person of cerebral palsy patient along with their psychometric properties. We had done a review of literature through Cochrane library, Ovid MEDLINE and GOOGLE SCHOLAR, CINAHL till March 2020. The studies in English-language related to the assessment scales for the cerebral palsy were reviewed. Many scales were evaluated for different symptoms and good psychometric properties in CP child. We reviewed many research and review article related to assessment for CP. Various titles, abstracts, and references were checked for the relevancy.Review was done for the assessment of alteration in muscle tone, impaired voluntary movement, pain, gross motor function, balance, cognition and gait. Cerebral palsy was the primary goal of findings in 198 studies. Out of these, 58 studies were not proved the definition of cerebral palsy. 96 studies reported assessment of cerebral palsy for different domain, 25 studies used etiology and incidence and 19 studies for other domain which are related to CP. Many cerebral palsy scales are available, but only a very small number of scales were thoroughly validated for use in clinical practice in India. This review will help therapist in selection of appropriate tool and study of various symptoms in CP child before starting the treatment..
Molecular Detection of epsA-Mediated and Extracellular Polysaccharide-Mediated Biofilm Formation Among Multidrug Resistant Strains of Acinetobacter baumannii
Authors: K Sarojini
Published: December 2021

The epsA associated biofilm formation attributes to potent virulence in the drug resistant strains of Acinetobacter baumannii. This study is aimed to molecularly characterize the epsA gene among the multidrug resistant clinical isolates of A. baumannii and to assess the frequency of the same in different drug resistant groups. To detect the biofilm formation among the selected MDR strains of A. baumannii, semi-quantitative adherent bioassay was performed using crystal violet staining method. Further PCR amplification was done to screen the presence of epsA gene with further sequencing of the amplicons. Pearson’s correlation analysis was done to check the correlation of the occurrence of epsA gene with drug resistant strains (p-value<0.05). 58.9%, 31.5% and 0.9% of the strains were recorded as high grade, low grade and negative biofilm formers under biofilm assay. The epsA gene was observed in 14 MDR strains (19.17%) of A. baumannii with an amplicon size of 451bp. Co-occurrence of epsA gene was 100% in β-lactam, cephem and folate resistant strains followed by 71.4% among aminoglycosides, 57.1% against carbapenems and 14.2% in fluoroquinolone and efflux pump mediated resistant strains. The findings of the study suggest the co-occurrence of epsA gene mediated biofilm formation among the multidrug resistant strains of A. baumannii. Further studies on the same helps in designing new vaccines and drugs for the prevention and treatment of A. baumannii infections.
Expanded Reproduction of Chernozem Fertility in Biological Agriculture
Authors: Azarov Vladimir Borisovich
Published: December 2021

The current stage of development of zonal farming systems in the Central Black Earth region involves the creation of balanced, highly productive, and sustainable agricultural landscapes, maximally adapted to the natural conditions of the region and ensuring the preservation and improvement of soil fertility. The solution to the problem of reproduction of soil fertility in traditional agriculture is associated with the use of a large number of energy-intensive resources and, first of all, irreplaceable ones. However, the level and direction of soil/biological processes are not sufficiently taken into account, whereas they to a certain extent ensure the reproduction of soil fertility. In this regard, the problem of the formation of the scientific foundations of the reproduction of soil fertility through the integrated use of methods of biologization of agriculture in the Central Black Earth Region and the activation on this basis of the soil/biological factor in the long-used chernozems acquires special importance. The purpose of the study is to review the changes in soil fertility indicators in conditions of biological agriculture. The paper presents the results of a study to determine changes in soil fertility indicators in typical chernozem of the Belgorod region (Russia) in a field experiment with various technologies of crop cultivation. The study demonstrates the regularities of the transformation of the fertility of chernozem. In terms of its fertilizing efficiency, compost in the applied norm turned out to be equivalent to a half dose of mineral fertilizers since both variants under consideration provided equivalent increases in the corn yield. The full dose of mineral fertilizers on the background of organic matter turned out to be excessive since its introduction did not contribute to a reliable increase in corn productivity.
Substantiation of Priority Areas to Ensure Food Security in the Russian Federation: A System-Cognitive Analysis
Authors: Gayduk Vladimir Ivanovich
Published: December 2021

Currently, the Russian population's need for vegetables is satisfied due to domestic production only by 87percent (at a rate of at least 90percent), fruits and berries – by 40percent (at a rate of at least 60percent), and milk – by 84percent (at a rate of at least 90percent). The present work clarifies the defining role of agricultural production taking into account the calculated indicators of food security. The analysis of the population’s provision with basic foodstuffs has led to the need to strengthen the competitiveness of Russian agricultural producers. The article predicts managerial decisions that would allow improving the performance efficiency of economic entities on the example of the agricultural sector of the Krasnodar Territory. The article presents an automated system-cognitive analysis of the effect of various factors on the efficiency of agricultural organizations. The degree and areas of the influence of various factors were assessed using SWOT analysis based on empirical data, namely, financial and economic indicators of agricultural enterprises of the Krasnodar Territory. The results of the automated system-cognitive analysis confirmed that subsidies for reimbursement of part of the costs of purchasing agricultural machinery and equipment, as well as subsidies aimed at increasing the productivity of farm animals have a significant impact on profits in the production of livestock products. The problem of modernization of agricultural production is associated with the problem of information and consulting services of agribusiness. The article substantiates the necessity of preparing a spiral scheme of the food security model, as well as emphasizes the importance of establishing and developing various service-providing consulting centers.
Comparative Rheological Properties of Soy Lecithins Produced in Russia
Authors: Butina Elena
Published: December 2021

The work is devoted to a comparative study of the features of the structural and mechanical properties of soybean lecithins, produced in Russia, in their relationship with the composition and other characteristics. Considering that the cultivation of transgenic agricultural crops is prohibited in Russia, Russian plant raw materials and products of its processing, including lecithin, are of interest and are in demand in a number of European countries. Despite the fact that the main raspberry raw material in Russia is sunflower, the volume of processing of soybeans grown without the use of genetic modification methods, the main plantations of which are located in the Far East, ranks second after sunflower. Lecithin production technologies in Russia are mostly focused on the production of so-called "raw" liquid lecithins and do not provide for the operation of their subsequent conditioning in order to ensure special characteristics of the composition and consumer properties. Despite this, raw soy lecithins produced by Russian enterprises mostly meet the requirements of GOST 32052-2013 and the European Union E 322 requirements and can be positioned as standard liquid lecithins. At the same time, during the release of such lecithins, problems associated with an increase in their viscosity during storage are periodically observed. This article presents the results of comparative studies of the composition and properties of liquid soybean lecithins of various consistencies and presents conclusions on the factors that determine the features of their structural and mechanical properties.
The Logistic Function of Cooperation in the Agro-Food Supply with Digitalization in the Russian Federation
Authors: Suglobov Alexander E.
Published: December 2021

Currently, digital solutions are increasingly penetrating consumer cooperation. The need for the use of innovative technologies is increasing to improve the efficiency of logistics of consumer societies of the Centrosoyuz of Russia. Consumer societies have a solid opportunity to combine their economic activities into a single system based on a digital platform and become the undisputed leader in the segment of national food security. Operational processes are developing and improving in the digital economy simultaneously with the development of scientific and technological progress, the introduction of innovations, and the modernization of production. Cooperative formations participate in replenishing the resources of agricultural products to ensure the food security of the country. Consumer societies of the Centrosoyuz of Russia play a significant role in providing a guaranteed channel for the sale of agricultural products and raw materials for small agricultural businesses. Various approaches to the participation of consumer cooperation in food security are revealed in the conditions of the digital economy with the industrialization of production. Therewith, the relevance of consumer cooperation in replenishing food supplies is increasing. Its role in the development of small agricultural business in rural areas is revealed, the need for more complete use of the resources available in consumer cooperation in the organization of procurement activities in the field of procurement of agricultural products and raw materials in the households of the population, individual entrepreneurs and peasant farms is argued. The use of the achievements of the digital economy in the system of consumer cooperation is considered as one of its practical applications in modern conditions to increase competitiveness in the domestic and international food market, improving the quality of life of the working population of rural areas.
Universal Robotic Platform for Diagnosis and Spot Spraying of Trees and Shrubs
Authors: Bykov Sergey Nikolaevich
Published: December 2021

The number of threats to the plants is constantly increasing. The harmful impact of pests and plant diseases costs billions of dollars to the global economics each year. Chemical protection of plants from diseases and insects became an urgent problem in crop production, forestry and parks. The study aimed to develop an effective mobile robot for treating trees and shrubs from insects and diseases by spraying with chemicals. The work used monographic and general scientific research methods. A review of existing designs and technologies, as well as an analysis of publications in leading scientific journals, led to the conclusion that there is no one generally accepted technology for remote diagnosis and spot spraying of single trees and shrubs. Most of the technical means used have significant technical and environmental limitations. Currently, there is no unambiguous decision about which machine and technology to choose for solving the problems of remote diagnostics and spot spraying of single plant objects with a height of 2 to 4 meters. Taking into account the identified requirements, a robotic platform was developed for diagnosing and spot spraying of ornamental and fruit trees and tall shrubs. The developed robot is equipped with the necessary set of equipment for moving around the territory and spraying objects, has an increased cross-country ability, works according to a given program, has a minimal environmental impact, and can record data for diagnosing problems on plants. The proposed universal robot can work in agricultural, forest and urban areas, in warehouses and production facilities.
Big Data Analytics Strategy Framework: A Case of Crowd Management During the Hajj Pilgrimage, Mecca, Saudi Arabia
Authors: Aldahawi Hanaa Ali
Published: December 2021

The objective of the present study was an investigation of applications of big data analytics in Hajj and Umrah for pilgrims, who come to Saudi Arabia every year for tourism and observation of religious rites as per the sacred beliefs of Islam. It has now become a necessity to see more applications of big data analytics in these pilgrimages because of the growing number of people every year. Therefore, crowd control, crowd management and conflict management are essential for reduction of stress, troubles, fatalities, accidents, theft and possible deaths during Hajj and Umrah events. Developing a predictive data analytic model for Hajj and Umrah will improve the efficiency, gross domestic product (GDP), surveillance, revenue generation, opportunities and satisfaction for the pilgrimages. In this paper, review of big data tools was presented along with their use in the decision support system and how it can be used for surveillance and crowd management. A robust big data framework applicable for Hajj and Umrah events was also presented in this paper. This was meant to aid seamless adoption and implementation of big data applications across sectors and government parastatals involved in Hajj and Umrah. The presented framework was also included all the relevant use cases related to these pilgrimages.
COVID-19 OUTBREAK AND ROLE OF TOURISM DEVELOPMENT ON ECONOMIC GROWTH IN PAKISTAN
Authors: Abdul Latip Normah , Karim Rehmat , Marzuki Azizan , Muhammad Faqeer , Shah Attaullah , Yilret Nanle Veronica , Umar Mohd Umzarulazijo
Published: December 2021

The current research aimed to find out the effect of tourism development on economic growth in Pakistan for the period (1995 to 2017) by using Canonical Regression Analysis (CCR) and Dynamic Least Square (DOLS) method. In addition, a unit root test is used to find out the static nature of the variables, and for the robust check, the authors utilize the Fully Modified Least Square (FMOLS) method. The results of the CCR and DOLS shows the key role of tourism development on growth, and FMOLS confirms these findings. In addition, the contribution of financial development is insignificant and positive. However, inflation harms economic growth, which depicts that the government of Pakistan will face severe challenges to achieve the targeted level of growth in future. In addition, an outbreak of Coronavirus Disease (Covid-19) is another challenge that will cause a significant decline in tourism receipts.
APPLICATION OF KERNEL DENSITY ESTIMATION TO IDENTIFY MOTORCYCLE THEFT HOT SPOTS IN KUCHING, SARAWAK
Authors: Jubit Norita , Masron Tarmiji , Marzuki Azizan
Published: December 2021

Motorcycle theft is the most frequently reported cases worldwide, including in Malaysia. This study aims to identify the hot spot areas for motorcycle theft in Kuching. The spatial data include police station sector boundary, road data and latitud and longitude data while attribute data consists of motorcycle theft by year, address of the incident and time. Kernel Density Estimation (KDE) helps to find the hot spot areas of motorcycle theft. Motorcycle theft in Kuching has been reported as more frequent during the day at 54.8% and at 45% during the night from the year 2015 to 2017. Hot spot locations change by year and time. The study found that most of the hot spot areas of motorcycle theft were detected within the Sentral boundary. This indicates that the city centre is an area with a high density of motorcycle theft. This study can help authorities to improve the prevention measures for motorcycle theft while the findings can help in preventing motorcycle theft by police sector boundary.
HOUSING CRISIS IN ALGERIA: CHALLENGES AND PERSPECTIVES
Authors: Riyadh Djafri , Mohamed Osman Mariana
Published: December 2021

The provision of good quality housing remains a major problem facing policymakers in developing countries, with Algeria being no exception. The Algerian policy focuses on ensuring the provision of housing to low-income households who cannot house themselves adequately. This article presents an overview of the Algerian housing policies focusing on the issues encountered by governments since independence in 1962. This entails presenting the history of Algerian housing policy, including colonial, after independence and new Algeria. This will not be completed without reviewing the different national housing plans and policies introduced by the Algerian government, focusing on the housing achievements and deficits. Using qualitative analysis of secondary data through narrative and inductive approaches, this research argues that a significant change in how these programmes are currently structured is urgent. Thus, there is a need to find a new approach to finance the construction of public and private housing units and reduce dependence on the Public Treasury.
Recursos zoogenéticos: Conservación, caracterización y gestión de su biodiversidad
Authors: Tibaduiza Castañeda Leidy Patricia , Jiménez Sabogal Hugo Rodolfo , Rugeles Barandica Luisa Alejandra , Cañar Serna Dubert Yamil , González Almario Carolina , Azcárate Rodriguez Steffany , Manrique Perdomo Carlos , Grajales Lombana Henry Alberto , Lucero Casanova Carlos Edmundo , Telo da Gama Luis , Cortes Gardyn Oscar , Amaral Gomes Barbosa Fonseca Andreia de Jesus , Revidatti Maria Antonia
Published: December 2021

Esta publicación hace parte de las acciones de promoción y divulgación de los Bancos de Germoplasma para la Alimentación y la Agricultura en Colombia, en su interés de fortalecer capacidades técnicas, científicas y metodológicas en conservación, caracterización y aprovechamiento de las razas criollas colombianas del Banco de Germoplasma Animal, además de promover condiciones para el fortalecimiento de capacidades que nos permitan la interconectividad e interoperabilidad de las acciones que se desarrollan en los núcleos de conservación. El conocimiento plasmado en este libro constituye la sumatoria de las capacidades de expertos de nivel internacional, sumado con los aportes de los investigadores participantes de los cursos internacionales desarrollados por el Departamento de Agrobiodiversidad de AGROSAVIA en el contexto del proyecto Image. Entregamos este libro como una estrategia de gestión de conocimiento que plasma los avances en conservación, caracterización y manejo de la información generada en las acciones de conservación de los recursos genéticos animales, lo cual será un aporte para el uso sostenible de la agrobiodiversidad y contribuirá de forma eficiente al crecimiento económico del país.
Manual técnico para la propagación masiva de semilla vegetativa de yuca por miniestacas en campo
Authors: Rodríguez Henao Eberto , Garavito Morales Lina Vanessa , Osorio Cardona Ómar , Aguilera Arango Germán Andrés , Cañar Serna Dubert Yamil
Published: December 2021

Desde tiempo atrás, el productor de semilla de yuca afronta diversos retos que han limitado el buen desempeño dentro de la cadena de abastecimiento y logística de producción y acondicionamiento del material de siembra de calidad. Entre las brechas identi­ficadas se encuentra la incidencia de plagas y enfermedades, la resiliencia al cambio climático, el desalineamiento de los inventarios y la calidad de la semilla en uso. Este último factor se ha convertido en una de las claves para mejorar el desempeño agrícola en las unidades productivas. Por eso, este manual propone recomendaciones mínimas requeridas para producir semilla con atributos de calidad, originadas desde la ciencia y la tecnología, con el objetivo de salvaguardar plenamente los atributos sanitarios, genéticos, físicos y ­fisiológicos del material de reproducción para su puesta en práctica en campo. De manera breve y mediante un lenguaje sencillo, el manual describe las actividades encaminadas a la propagación masiva de semilla vegetativa de yuca por miniestacas, con el ánimo de promover la calidad (genética, física, fi­siológica y fitosanitaria) como una de las características más importantes que debe tener el material de siembra. Creemos que este mensaje, originado en la ciencia, será una herramienta útil que ha de llegar a quienes más lo requieren, con el ­n de reducir la vulnerabilidad de pérdida y mejorar las condiciones productivas del sistema de yuca.
Assessing Cognitive Function in Multiple Sclerosis With Digital Tools: Observational Study
Authors: Hsu Wan-Yu , Rowles William , Anguera Joaquin A , Anderson Annika , Younger Jessica W , Friedman Samuel , Gazzaley Adam , Bove Riley
Published: December 2021

Background

Cognitive impairment (CI) is one of the most prevalent symptoms of multiple sclerosis (MS). However, it is difficult to include cognitive assessment as part of MS standard care since the comprehensive neuropsychological examinations are usually time-consuming and extensive.

Objective

To improve access to CI assessment, we evaluated the feasibility and potential assessment sensitivity of a tablet-based cognitive battery in patients with MS.

Methods

In total, 53 participants with MS (24 [45%] with CI and 29 [55%] without CI) and 24 non-MS participants were assessed with a tablet-based cognitive battery (Adaptive Cognitive Evaluation [ACE]) and standard cognitive measures, including the Symbol Digit Modalities Test (SDMT) and the Paced Auditory Serial Addition Test (PASAT). Associations between performance in ACE and the SDMT/PASAT were explored, with group comparisons to evaluate whether ACE modules can capture group-level differences.

Results

Correlations between performance in ACE and the SDMT (R=–0.57, P<.001), as well as PASAT (R=–0.39, P=.01), were observed. Compared to non-MS and non-CI MS groups, the CI MS group showed a slower reaction time (CI MS vs non-MS: P<.001; CI MS vs non-CI MS: P=.004) and a higher attention cost (CI MS vs non-MS: P=.02; CI MS vs non-CI MS: P<.001).

Conclusions

These results provide preliminary evidence that ACE, a tablet-based cognitive assessment battery, provides modules that could potentially serve as a digital cognitive assessment for people with MS.

Trial Registration

ClinicalTrials.gov NCT03569618; https://clinicaltrials.gov/ct2/show/NCT03569618
Paving the Way for Electronic Patient-Centered Measurement in Team-Based Primary Care: Integrated Knowledge Translation Approach
Authors: Davis Selena , Antonio Marcy , Smith Mindy , Burgener Paul , Lavallee Danielle C , Price Morgan , Fletcher Sarah C , Lau Francis
Published: December 2021

Background

Patient-centered measurement (PCM) aims to improve the overall quality of care through the collection and sharing of patient values, outcomes, and perspectives. However, the use of PCM in care team decisions remains limited. Integrated knowledge translation (IKT) offers a collaborative, adaptive approach to explore best practices for incorporating PCM into primary care practices by involving knowledge users, including patients and providers, in the exploratory process.

Objective

This study aims to test the feasibility of using patient-generated data in team-based care; describe the use of these data for team-based mental health care; and summarize patient and provider care experiences with PCM.

Methods

We conducted a multi-method exploratory study in a rural team-based primary care clinic using IKT to co-design, implement, and evaluate the use of PCM in team-based mental health care. Care pathways, workflows, and quality improvement activities were adjusted iteratively to improve integration efforts. Patient and provider experiences were evaluated using individual interviews relating to the use of PCM and patient portals in practice. All meeting notes, interview summaries, and emails were analyzed to create a narrative evaluation.

Results

During co-design, a care workflow was developed to incorporate electronically collected patient-generated data from the patient portal into the electronic medical record, and customized educational tools and resources were added. During implementation, care pathways and patient workflows for PCM were developed. Patients found portal use easy, educational, and validating, but data entries were not used during care visits. Providers saw the portal as extra work, and the lack of portal and electronic medical record integration was a major barrier. The IKT approach was invaluable for addressing workflow changes and understanding the ongoing barriers to PCM use and quality improvement.

Conclusions

Although the culture toward using PCM is changing, the use of PCM during care has not been successful. Patients felt validated and supported through portal use and could be empowered to bring these data to their visits. Training, modeling, and adaptable PCM methods are required before PCM can be integrated into routine care.
Virtual Reality in Medical Students’ Education: Scoping Review
Authors: Jiang Haowen , Vimalesvaran Sunitha , Wang Jeremy King , Lim Kee Boon , Mogali Sreenivasulu Reddy , Car Lorainne Tudor
Published: December 2021

Background

Virtual reality (VR) produces a virtual manifestation of the real world and has been shown to be useful as a digital education modality. As VR encompasses different modalities, tools, and applications, there is a need to explore how VR has been used in medical education.

Objective

The objective of this scoping review is to map existing research on the use of VR in undergraduate medical education and to identify areas of future research.

Methods

We performed a search of 4 bibliographic databases in December 2020. Data were extracted using a standardized data extraction form. The study was conducted according to the Joanna Briggs Institute methodology for scoping reviews and reported in line with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines.

Results

Of the 114 included studies, 69 (60.5%) reported the use of commercially available surgical VR simulators. Other VR modalities included 3D models (15/114, 13.2%) and virtual worlds (20/114, 17.5%), which were mainly used for anatomy education. Most of the VR modalities included were semi-immersive (68/114, 59.6%) and were of high interactivity (79/114, 69.3%). There is limited evidence on the use of more novel VR modalities, such as mobile VR and virtual dissection tables (8/114, 7%), as well as the use of VR for nonsurgical and nonpsychomotor skills training (20/114, 17.5%) or in a group setting (16/114, 14%). Only 2.6% (3/114) of the studies reported the use of conceptual frameworks or theories in the design of VR.

Conclusions

Despite the extensive research available on VR in medical education, there continue to be important gaps in the evidence. Future studies should explore the use of VR for the development of nonpsychomotor skills and in areas other than surgery and anatomy.

International Registered Report Identifier (IRRID)

RR2-10.1136/bmjopen-2020-046986
Assessing Cognitive Function in Multiple Sclerosis With Digital Tools: Observational Study (Preprint)
Authors: Hsu Wan-Yu , Rowles William , Anguera Joaquin A , Anderson Annika , Younger Jessica W , Friedman Samuel , Gazzaley Adam , Bove Riley
Published: December 2021

BACKGROUND

Cognitive impairment (CI) is one of the most prevalent symptoms of multiple sclerosis (MS). However, it is difficult to include cognitive assessment as part of MS standard care since the comprehensive neuropsychological examinations are usually time-consuming and extensive.

OBJECTIVE

To improve access to CI assessment, we evaluated the feasibility and potential assessment sensitivity of a tablet-based cognitive battery in patients with MS.

METHODS

In total, 53 participants with MS (24 [45%] with CI and 29 [55%] without CI) and 24 non-MS participants were assessed with a tablet-based cognitive battery (Adaptive Cognitive Evaluation [ACE]) and standard cognitive measures, including the Symbol Digit Modalities Test (SDMT) and the Paced Auditory Serial Addition Test (PASAT). Associations between performance in ACE and the SDMT/PASAT were explored, with group comparisons to evaluate whether ACE modules can capture group-level differences.

RESULTS

Correlations between performance in ACE and the SDMT (R=–0.57, P<.001), as well as PASAT (R=–0.39, P=.01), were observed. Compared to non-MS and non-CI MS groups, the CI MS group showed a slower reaction time (CI MS vs non-MS: P<.001; CI MS vs non-CI MS: P=.004) and a higher attention cost (CI MS vs non-MS: P=.02; CI MS vs non-CI MS: P<.001).

CONCLUSIONS

These results provide preliminary evidence that ACE, a tablet-based cognitive assessment battery, provides modules that could potentially serve as a digital cognitive assessment for people with MS.

CLINICALTRIAL

ClinicalTrials.gov NCT03569618; https://clinicaltrials.gov/ct2/show/NCT03569618
The Effect of Video Game–Based Interventions on Performance and Cognitive Function in Older Adults: Bayesian Network Meta-analysis (Preprint)
Authors: Yang Chao , Han Xiaolei , Jin Mingxue , Xu Jianhui , Wang Yiren , Zhang Yajun , Xu Chonglong , Zhang Yingshi , Jin Enshi , Piao Chengzhe
Published: December 2021

BACKGROUND

The decline in performance of older people includes balance function, physical function, and fear of falling and depression. General cognitive function decline is described in terms of processing speed, working memory, attention, and executive functioning, and video game interventions may be effective.

OBJECTIVE

This study evaluates the effect of video game interventions on performance and cognitive function in older participants in terms of 6 indicators: balance function, executive function, general cognitive function, physical function, processing speed, and fear of falling and depression.

METHODS

Electronic databases were searched for studies from inception to June 30, 2020. Randomized controlled trials and case-controlled trials comparing video game interventions versus nonvideo game control in terms of performance and cognitive function outcomes were incorporated into a Bayesian network meta-analysis. All data were continuous variables.

RESULTS

In total, 47 studies (3244 participants) were included. In pairwise meta-analysis, compared with nonvideo game control, video game interventions improved processing speed, general cognitive function, and depression scores. In the Bayesian network meta-analysis, interventions with video games improved balance function time (standardized mean difference [SMD] –3.34, 95% credible interval [CrI] –5.54 to –2.56), the cognitive function score (SMD 1.23, 95% CrI 0.82-1.86), processing speed time (SMD –0.29, 95% CrI –0.49 to –0.08), and processing speed number (SMD 0.72, 95% CrI 0.36-1.09), similar to the pairwise meta-analysis. Interventions with video games with strong visual senses and good interactivity ranked first, and these might be more beneficial for the elderly.

CONCLUSIONS

Our comprehensive Bayesian network meta-analysis provides evidence that video game interventions could be considered for the elderly for improving performance and cognitive function, especially general cognitive scores and processing speed. Games with better interactivity and visual stimulation have better curative effects. Based on the available evidence, we recommend video game interventions for the elderly.

CLINICALTRIAL

PROSPERO CRD42020197158; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=197158
A Mobile App With Multimodality Prehabilitation Programs for Patients Awaiting Elective Surgery: Development and Usability Study (Preprint)
Authors: Wang Tianyu , Stanforth Philip R , Fleming R Y Declan , Wolf Jr J Stuart , Stanforth Dixie , Tanaka Hirofumi
Published: December 2021

BACKGROUND

Complying with a prehabilitation program is difficult for patients who will undergo surgery, owing to transportation challenges and a limited intervention time window. Mobile health (mHealth) using smartphone apps has the potential to remove barriers and improve the effectiveness of prehabilitation.

OBJECTIVE

This study aimed to develop a mobile app as a tool for facilitating a multidisciplinary prehabilitation protocol involving blood flow restriction training and sport nutrition supplementation.

METHODS

The app was developed using “Appy Pie,” a noncoding app development platform. The development process included three stages: (1) determination of principles and requirements of the app through prehabilitation research team meetings; (2) app prototype design using the Appy Pie platform; and (3) app evaluation by clinicians and exercise and fitness specialists, technical professionals from Appy Pie, and non–team-member users.

RESULTS

We developed a prototype of the app with the core focus on a multidisciplinary prehabilitation program with accessory features to improve engagement and adherence to the mHealth intervention as well as research-focused features to evaluate the effects of the program on frailty status, health-related quality of life, and anxiety level among patients awaiting elective surgery. Evaluations by research members and random users (n=8) were consistently positive.

CONCLUSIONS

This mobile app has great potential for improving and evaluating the effectiveness of the multidisciplinary prehabilitation intervention in the format of mHealth in future.
Validation of a Wrist-Worn Reflectance Pulse Oximeter During Sleep and Prediction of Obstructive Sleep Apnea: A Proof-of-Concept Study (Preprint)
Authors: Jung Hyunjun , Kim Dongyeop , Lee Wonkyu , Seo Hyejung , Seo Jinwoo , Choi Jongmin , Joo Eun Yeon
Published: December 2021

BACKGROUND

Obstructive sleep apnea (OSA) is a common sleep disorder characterized by repetitive upper airway obstruction during sleep, thereby resulting in oxygen desaturation, frequent arousals, and increased sympathetic activity. Wearable devices that measure peripheral oxygen saturation have been developed for the screening of OSA.

OBJECTIVE

This study aimed to validate and characterize the estimation function of oxygen saturation measured by wrist-worn reflectance pulse oximetry during sleep and to predict the derived OSA using the oxygen desaturation index (ODI).

METHODS

Oxygen saturation was simultaneously measured using reflectance pulse oximetry from the Samsung Galaxy Watch 4 series (SM-R890N, SM-R860N, Samsung Electronics Co.; GW4) and transmittance pulse oximetry from polysomnography as a reference (SpO2Ref). The performance was evaluated by the root mean squared error (RMSE) and coverage rate, and it was compared according to the apnea-hypopnea index (AHI). The GW4-ODI was used to predict moderate to severe OSA.

RESULTS

A total of 97 adults (44.4 ± 13.0 years; men 76.3%, women 23.7%) participated in this study. Depending on the AHI, participants were classified as either normal (n=18), mild (n=21), moderate (n=23), or severe OSA (n=35). Wrist-worn reflectance pulse oximetry showed an overall RMSE of 2.3% and negligible bias of -0.2%. A Bland-Altman density plot showed good agreement of oxygen saturation between GW4 and the reference pulse oximeter. RMSEs were 1.65 ± 0.57%, 1.76 ± 0.65%, 1.93 ± 0.54%, and 2.93 ± 1.71% for normal, mild, moderate, and severe OSA, respectively. GW4-ODI ≥5/h had the highest predictive ability for moderate to severe OSA with a sensitivity of 89.7%, a specificity of 64.1%, an accuracy of 79.4%, and an area under the curve of 0.908 (95% CI, 0.852–0.963).

CONCLUSIONS

GW4 was successfully validated for measuring oxygen saturation with reflectance pulse oximetry during sleep. This study demonstrates the feasibility of GW4 for screening moderate to severe OSA.
Physical Activity Classification with Wearable Sensor Data in an eCoach Recommendation System (Preprint)
Authors: Chatterjee Ayan
Published: December 2021

UNSTRUCTURED

Leading a sedentary lifestyle may cause numerous health problems. Therefore, sedentary lifestyle changes should be given priority to avoid severe damage. Research in eHealth can provide methods to enrich personal healthcare with Information and Communication Technologies (ICTs). An eCoach system may allow people to manage a healthy lifestyle with health state monitoring and personalized recommendations. Using machine learning (ML) techniques, this study investigated the possibility of classifying daily physical activity for adults into the following classes - sedentary, low active, active, active, highly active, and rigorous active. The daily total step count, total daily minutes of sedentary time, low physical activity (LPA), medium physical activity (MPA), and vigorous physical activity (VPA) served as input for the classification models. We first used publicly available Fitbit data to build the classification models. Second, using the transfer learning approach, we re-used the top five best-performing models on a real dataset as collected from the MOX2-5 wearable medical-grade activity sensor. We found that ensemble ExtraTreesClassifier with an estimator value of 150 outperformed other classifiers with a mean accuracy score of 99.72% for single feature and support vector classifier (SVC) with “linear” kernel outpaced other classifiers with a mean accuracy score of 99.14% for five features, for the public Fitbit datasets. To demonstrate the practical usefulness of the classifiers, we conceptualized how the classifier model can be used in an eCoach prototype system to attain personalized activity goals (e.g., stay active for the entire week). After transfer learning, K-Nearest-Neighbor (KNN) outpaced the other four classifiers for a single feature, and SVC with a “linear” kernel outdid the other four classifiers for multiple features.
Researching the Links Between Smartphone Behavior and Adolescent Well-being With the FUTURE-WP4 (Modeling the Future: Understanding the Impact of Technology on Adolescent’s Well-being Work Package 4) Project: Protocol for an Ecological Momentary Assessment Study (Preprint)
Authors: Elavsky Steriani , Blahošová Jana , Lebedíková Michaela , Tkaczyk Michał , Tancos Martin , Plhák Jaromír , Sotolář Ondřej , Smahel David
Published: December 2021

BACKGROUND

Smartphone ownership has increased among teens within the last decade, with up to 89% of adolescents owning a smartphone and engaging daily with the online world through it. Although the results of recent meta-analyses suggest that engaging digital technology plays only a small role in adolescent well-being, parents, professionals, and policymakers remain concerned about the impact that the instant connectivity of smartphones has on adolescent well-being.

OBJECTIVE

Herein, we introduce the protocol of a research study investigating the associations between adolescent smartphone use and different facets of well-being (social, physical, and psychological), with the aim to apply innovative methods to address the limitations of existing empirical studies.

METHODS

This 12-month prospective study of adolescents uses a repeated measurement-burst design with the ecological momentary assessment methodology. Adolescents (N=203; age range 13-17 years) complete baseline assessments through online questionnaires, four 14-day intensive data collection bursts, and an online questionnaire at the end of the study. As part of the 4 measurement bursts, adolescent smartphone behavior is assessed objectively by passive data collection of smartphone data logs and through self-reports in short questionnaires administered via a custom-built Android app.

RESULTS

The protocol describes the study objectives, research tools (including the development of the Android app and specialized software), and process (including pilot studies, the main study, and targets for machine learning approaches). Two of the 203 enrolled participants provided no data during the first data collection burst of the main study. Preliminary analyses of the data from the first data collection burst indicated an acceptable level of compliance (72.25%) with the daily questionnaires. The design of the study will allow for the assessment of both within- and between-person variabilities in smartphone behavior, as well as short-term variation and long-term change in smartphone behavior and how it impacts the indicators of social, physical, and psychological well-being.

CONCLUSIONS

The innovative methods applied in this study (objective smartphone logs, ecological momentary assessment, and machine learning) will allow for a more nuanced assessment of the links between smartphone use and well-being, informing strategies to help adolescents navigate the online world more constructively in terms of the development of their physical, social, and psychological well-being.

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/35984
Clinical Outcomes After Use of Inhaled Corticosteroids or Oral Steroids in a COVID-19 Telemedicine Clinic Cohort: Retrospective Chart Review (Preprint)
Authors: Cellai Michele , Roberts Jodi , Moore Miranda A , Gandrakota Nikhila
Published: December 2021

BACKGROUND

COVID-19 concerns remain among health care providers, as there are few outpatient treatment options. In the early days of the pandemic, treatment options for nonhospitalized patients were limited, and symptomatic treatment and home-grown guidelines that used recommendations from the Global Initiative for Asthma Management and Treatment were used.

OBJECTIVE

The possibility that inhaled corticosteroids (ICS) might reduce the risk of respiratory symptoms and promote recovery was the impetus for this review, as it has already been shown that in the nonhospitalized patient population, oral corticosteroids (OCS) in the acute phase could have an adverse effect on recovery. We investigated if (1) patients treated with ICS were less likely to require referral to a post–COVID-19 clinic or pulmonary specialist than patients without ICS treatment or with OCS therapy, and (2) if OCS use was associated with worse health outcomes.

METHODS

In a retrospective chart review, we identified all patients with acute illness due to COVID-19 that were followed and managed by a telemedicine clinic team between June and December 2020. The data were electronically pulled from electronic medical records through April 2021 and reviewed to determine which patients eventually required referral to a post–COVID-19 clinic or pulmonary specialist due to persistent respiratory symptoms of COVID-19. The data were then analyzed to compare outcomes between patients prescribed OCS and those prescribed ICS. We specifically looked at patients treated acutely with ICS or OCS that then required referral to a pulmonary specialist or post–COVID-19 clinic. We excluded any patients with a history of chronic OCS or ICS use for any reason.

RESULTS

Prescribing ICS during the acute phase did not reduce the possibility of developing persistent symptoms. There was no difference in the referral rate to a pulmonary specialist or post–COVID-19 clinic between patients treated with OCS versus ICS. However, our data may not be generalizable to other populations, as it represents a patient population enrolled in a telemedicine program at a single center.

CONCLUSIONS

We found that ICS, as compared to OCS, did not reduce the risk of developing persistent respiratory symptoms. This finding adds to the body of knowledge that ICS and OCS medications remain potent treatments in patients with acute and postacute COVID-19 seen in an outpatient setting.