bluuebunny/crossref_metadata_2025 huggingface dataset:
Resveratrol: Targeting Cancer Stem Cells and ncRNAs to
Overcome Cancer Drug Resistance
Authors: Rezakhani Leila , Salmani Sima , Eliyasi Dashtaki Masoumeh , Ghasemi Sorayya
Published: August 2023

A major challenge in treating cancer is the development of drug resistance,
which can result in treatment failure and tumor recurrence. Targeting cancer stem cells
(CSCs) and non-coding RNAs (ncRNAs) with a polyphenolic substance called
resveratrol has the ability to combat this problem by lowering cancer resistance to drugs
and opening up new therapeutic options. Resveratrol alters the expression of genes
related to self-renewal, modulating important signaling pathways involved in cancer
initiation and CSC control. Additionally, resveratrol affects non-coding RNAs (ncRNAs),
including Micro-RNAs (miRNAs) and long non-coding RNAs (lncRNAs which are
essential for stemness, drug resistance, and other cancer-related activities. Numerous
studies have shown that resveratrol has the potential to be an effective anticancer drug
when used in combination therapy, but issues with absorption and pharmacokinetics still
need to be resolved before it can be used in clinical applications. Reducing chemotherapy
resistance by better understanding the intricate mechanisms by which resveratrol
affects cancer cells and CSCs, as well as its impact on ncRNA expression, could
eventually contribute to more effective cancer treatments. To completely understand
these pathways and optimize the utilization of resveratrol in combination treatments,
additional study is necessary.
Hydroquinidine Demonstrates Remarkable Antineoplastic Effects
on Non-small Cell Lung Cancer Cells
Authors: Yavuz Mervenur , Demircan Turan
Published: August 2023

Background:

Despite recent progress in drug development, lung cancer
remains a complex disease that poses a major public health issue worldwide, and new
therapeutic strategies are urgently needed because of the failure of standard treatments.
Ion channels play a critical role in various cellular processes that regulate cell
proliferation, differentiation, and cell death.

Objectives:

The potential of ion channel modulators as tumor growth suppressors has been highlighted in recent studies. Therefore, we hypothesized that hydroquinidine (HQ), a previously understudied potassium channel modulator, might have anticarcinogenic activity against A549 cells.

Methods:

The anticancer potential of HQ was investigated using various wellestablished
in vitro assays.

Results:

HQ significantly decreased colony formation and tumorigenicity and exhibited a
significant anti-migratory effect in A549 cells. Our results demonstrated that HQ
significantly inhibited the growth of cancer cells by decreasing the proliferation rate while
increasing cell death. The altered gene expression profile in response to treatment with
HQ was consistent with the observed cellular effects. Incubation of cells with HQ
resulted in the downregulation of genes involved in cell division and survival, while
genes promoting cell cycle arrest and apoptosis were upregulated.

Conclusion:

Our findings suggest that HQ has the potential to limit lung cancer growth
as a novel potent anticarcinogenic agent. However, more investigations are needed to
gain further insight into the mechanism of action of HQ and to evaluate its efficacy in invivo
models.
Synergistic Effect of Naringin and Glimepiride in Streptozotocin-induced Diabetic Rats
Authors: Rath Deepankar , Kar Biswakanth , Pattnaik Gurudutta , Bhukta Pallishree
Published: August 2023

Objective:

Evaluation of the synergistic effect of Naringin and Glimepiride in streptozotocin (STZ)-induced diabetic rats.

Methods:

Wistar rats were chosen and divided into five groups (n=6). STZ was used for the induction of diabetes. The combination of naringin and glimepiride was administered to diabetic rats. The changes in fasting blood sugar, body weight, Hb, HbA1c, and creatinine were evaluated, and urine was collected and the volume was observed. The lipid profiles like TC, HDL, LDL, and TG were measured. The biochemical parameters SGOT, SGPT, and ALP were analysed. Besides, endogenous antioxidant parameters like SOD, GSH, and catalase were also assessed. Lastly, the histopathological study of the beta cells in islets of the pancreas, glomerulus, and tubules of kidney and liver cells was conducted in all groups.

Results:

The result shows significant reduction (p<0.001) of blood sugar in the naringin and glimepiride-treated group when compared with the control group (diabetes). Additionally, the combination of Naringin (100 mg/kg) and Glimepiride (0.1 mg/kg) significantly restores the creatinine levels and urine volumes, SGOT, SGPT, and ALP when compared to a single dose of administration. Further, the abnormal lipid profile levels (TC, LDL, TG, and HDL), and endogenous antioxidant enzymes (SOD, GSH, catalase) in diabetic control rats were restored to normal levels in a significant manner. The histopathological result reveals significant alterations, including hypertrophy of islets and mild degeneration, renal necrosis, and inflammation of hepatocytes.

Conclusion:

A synergistic effect of Naringin and glimepiride was observed during the estimation of various biochemical parameters like body weight, fasting blood sugar, creatinine, urine level, TG, total cholesterol, SGOT, SGPT, ALP, Insulin, HbA1c, antioxidant parameters like SOD, GSH, and catalase in STZ-induced diabetic rats. Further, the combination of therapy improves the protective effect of the pancreas, kidney, and liver, suggesting a potential antidiabetic effect.
Unveiling Diabetes: Categories, Genetics, Diagnostics, Treatments, and Future Horizons
Authors: Alam Aftab , Dhoundiyal Shivang , Ahmad Niyaz , Rao G.S.N. Koteswara
Published: August 2023

Diabetes mellitus is a global epidemic affecting millions of individuals worldwide. This comprehensive review aims to provide a thorough understanding of the categorization, disease identity, genetic architecture, diagnosis, and treatment of diabetes. The categorization of diabetes is discussed, with a focus on type 1 and type 2 diabetes, as well as the lesser-known types, type 3 and type 4 diabetes. The geographical variation, age, gender, and ethnic differences in the prevalence of type 1 and type 2 diabetes are explored. The impact of disease identity on disease management and the role of autoimmunity in diabetes are examined. The genetic architecture of diabetes, including the interplay between genotype and phenotype, is discussed to enhance our understanding of the underlying mechanisms. The importance of insulin injection sites and the insulin signalling pathway in diabetes management are highlighted. The diagnostic techniques for diabetes are reviewed, along with advancements for improved differentiation between types. Treatment and management approaches, including medications used in diabetes management are presented. Finally, future perspectives are discussed, emphasizing the need for further research and interventions to address the global burden of diabetes. This review serves as a valuable resource for healthcare professionals, researchers, and policymakers, providing insights to develop targeted strategies for the prevention, diagnosis, and management of this complex disease.
COVID-19 Detection using Hybrid CNN-RNN Architecture with Transfer
Learning from X-Rays
Authors: Deshwal Deepti , Sangwan Pardeep , Dahiya Naveen , Lilhore Umesh Kumar , Dalal Surjeet , Simaiya Sarita
Published: August 2023

Introduction::

Millions of people have been infected with COVID-19, which has spread quickly worldwide since the start of 2020, resulting in numerous fatalities. Identification of infected individuals is essential to control the spread of the virus.

Aims::

In this study, we propose a hybrid architecture that combines Convolutional Neural Networks (CNNs) with Recurrent Neural Networks (RNNs) and leverages transfer learning to enhance the accuracy of COVID-19 detection from X-ray images.

Methods::

The proposed work utilizes 4 pre-trained CNN architectures, namely, InceptionnetV3, Densenet121, Inception-ResNet V2, and VGG19, to extract high-level features from the input X-ray images. These features are then fed into the second component, an RNN-based network, which captures the temporal dependencies within the extracted features. To evaluate the performance of the proposed architecture, a comprehensive dataset consisting of X-ray images from COVID-19 positive cases, non-COVID-19 pneumonia cases, and healthy individuals is used. Gradient class activation map (Grad-CAM) analysis has been applied to the obtained results to provide heat-map pictures specific to each class and coloured visualizations of the COVID-19-infected areas in CXR images.

Results::

Experimental results demonstrate that the proposed hybrid CNN-RNN architecture achieves promising results in COVID-19 detection from X-ray images. The model exhibits high accuracy, precision, recall, area under the receiver operating characteristics (ROC) curve (AUC), and F1-score, outperforming other state-of-the-art methods.

Conclusion::

The combination of CNNs and RNNs enables the model to effectively capture spatial and temporal information, leading to improved performance in COVID-19 detection. The proposed hybrid architecture with transfer learning from X-ray images provides a robust and efficient solution for COVID-19 detection. The model can potentially assist healthcare professionals in making accurate and timely diagnoses, thereby contributing to the global efforts to combat the COVID-19 pandemic. In the present work, VGG19-RNN architecture outperformed all other networks in terms of accuracy. The most effective training and validation accuracy for the VGG19-RNN architecture is 99% & 97.70%, respectively, and the loss was 0.02 & 0.09 at epoch 100.
Dietary Phytoactives in the Management of Gastric Cancer - A Mini Review
Authors: Sharma Vivek , Ashawat Mahendra Singh , Kumar Pravin
Published: August 2023

Gastric cancer is the fourth leading cause of morbidity worldwide and is known to affect
various gastric organs, including the esophagus, intestine, colon, and pancreas. There are variable factors
responsible for the development of gastric tumors, such as environmental factors, EPV, hepatitis
B and C, and other genetic factors. Phytoactives, or secondary metabolites of plants, have a wide
range of biological impacts, including the capacity to prevent cancer in humans. They have this anticancerous
impact because of their multi-target mechanism of action, which also includes antioxidant,
anti-proliferative, cell apoptosis, and anti-mutagenic effects. To epitomize the role of vital dietary phytoactives
as a new approach for treating gastric cancer and explains various mechanisms for their anticancerous
activity. H. pylori-associated gastric tumors are the most common, and Phytoactives such as
curcumin, piperine, walnut oil, tea, and others possess anticancer properties. They have shown anticancer
activity against gastric tumor cell lines via different mechanisms like cell cycle arrest, apoptosis,
inhibition of cell proliferation, adhesion, colonization of cancer cells, inhibition of inflammatory
mediators, tumor cell bioenergetics, up and down-regulation of various gene and protein expression,
and chelation and scavenging of ROS.
Molecular Contrivance of Deed of Neuroprotective Biomolecules
Authors: Pal Rashmi Saxena , Pal Yogendra , Lagah Jaspreet , Katiyar Deepti , Punniyakotti Saranya
Published: August 2023

Numerous herbal-based Ayurvedic and Chinese medications contain a variety of phytochemicals
that may have a neuroprotective impact and help treat a variety of neurodegenerative diseases.
The natural medicinal drug has long been used to treat neural signs and symptoms. There has
been an enormous public and clinical interest in the use of Phytoconstituents for neuroprotection or
the prevention of neurodegenerative illnesses. Various compounds, isolated from exclusive natural
sources with multiple objectives seem as a capacity and promising class of therapeutics for the remedy
of illnesses associated with neuro-related issues. It is vitally important to identify and create novel
therapeutic strategies. The possibility for safe, naturally occurring secondary metabolites with neuroprotective
characteristics is present in plants and other natural products. This review intends to take a
closer look at some specific elements of natural phytoactives that are thought to be significant for the
treatment of neuro-related illnesses.
In-depth Chemistry and Pharmacological Potential of Propolis: A Critical
Review of Recent Developments
Authors: Dwivedi Jyotsana , Sachan Pranjal , Wal Pranay , Rai A. K.
Published: August 2023

Background:

One of the most popular beekeeping products is propolis. The word "propolis," which alludes to a beehive, has Greek sources and implies "defense for the community." Propolis is a resinous material that honey worker bees (Apis mellifera L.) and other bee species make for a variety of uses. Since 300 BC, propolis has been used as a traditional remedy. Various pharmacological effects of distinct propolis extracts as well as those of its ingredients, including antioxidant, antiulcer, anticancer, antiviral, anti-microbial, anti-inflammatory, and antifungal characteristics, have recently been identified.

Objective:

In this review article, we focus on the origin, recent advances in the chemical constituents, and new therapeutic potential of propolis.

Material and Methods:

An exhaustive analysis of the literature search was conducted. The standard keywords "propolis," "origin," "chemical constituents," "pharmacological activity," "recent advances," and "traditional uses" have been used to search a variety of the standard databases, such as Scopus and Elsevier, PubMed, ScienceDirect, and Science Web, for research and review articles published between 1998 and 2023.

Results:

This review article included over 150 articles (research and reviews) that were appraised and researched.

Conclusion:

Since 2012, more than 300 substances have been shown to have pharmacological action against a variety of illnesses, including cancer, inflammation, ulcers, wound healing, diabetes, bacterial, viral, and fungal infections, hepatic disorders, dental problems, brain diseases, etc. Overall, propolis may be considered a source of bioactive compounds for pharmaceutical development. Future studies should consider plant types, regional conditions, bee subspecies, and variations.
Application of nanoparticles in the management of polycystic ovary syndrome
Authors: Abdul Kareem Al-Hetty Hussein Riyadh , Saleh Marwan Mahmood , Jalil Abduladheem Turki
Published: August 2023

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder characterized by hyperandrogenism, menstrual abnormalities, polycystic ovaries, chronic anovulation, and decreased fertility. It is also associated with obesity, type 2 diabetes, and premature atherosclerosis, all of which are indicative of an underlying metabolic disorder. The etiology of PCOS remains incompletely understood. It is marked by dysregulation of enzymes involved in androgen biosynthesis and excessive androgen production, which is considered to be a central feature of this disorder. In addition, women with PCOS show insulin resistance and altered adipose tissue metabolism, which contributes to the development of both diabetes and obesity. Nanotechnology has sparked new hopes for addressing diverse human concerns, including the prevention and treatment of PCOS. Nanomaterials possess fascinating characteristics, like customizable size, faster passage through biological barriers, improved solubility, and increased reactivity. This review aimed to present an overview of how nanomaterials are being used to treat PCOS. We begin by examining the general features of nanomaterials. Next, we discuss recent advancements in nanosystems for delivering drugs in experimental PCOS models, and finally, we present the findings of clinical studies.
The Effect of Fenugreek on the Severity of Dysmenorrhea: A Systematic
Review and Meta-analysis
Authors: Hassanzadeh Robab , Shabani Fatemeh , Montazeri Maryam , Mirghafourvand Mojgan
Published: August 2023

Introduction:

Dysmenorrhea is the most common periodic pain, which affects more
than 50% of women with regular menstruation. Fenugreek is one of the medicinal plants with analgesic
properties. This study aimed to determine the effect of fenugreek application in the severity
of dysmenorrhea and its side effects in women with dysmenorrhea.

PICO:

Population: women with dysmenorrhea; Intervention: fenugreek; Comparison: control
groups; and Outcome: reduction in the severity of dysmenorrhea and its side effects

Methods:

English database (PubMed, Cochrane Library, Scopus, and Web of Science) and Persian
database [SID (Scientific Information Database) and Magiran] were used for research until
February 11, 2023, using the keywords “Dysmenorrhea [Mesh],” “Foenum [Mesh],” “fenugreek
[Mesh],” and “Trigonella [Mesh].” The reference list of the selected articles was also checked.
The quality assessment was conducted through the Cochrane Handbook for Systematic Reviews
of Interventions version 5.2.0. The RevMan 5.3 software was used to analyze and report the data
of the entered studies. Meta-analysis results were reported with the standardized mean difference
(95% confidence interval). A subgroup analysis was performed based on the type of control
groups. The quality of evidence was assessed using the GRADE approach.

Results:

After removing duplicates and ineligible cases, four articles were included in the systematic
review out of the 1526 records obtained. The results showed that the pain intensity caused by
primary dysmenorrhea decreased with fenugreek compared to placebo (pooled result SMD: -2.21;
95% CI: -3.26 to -1.17; Z: 4.17; p <0.001). There was no significant difference between fenugreek
with mefenamic acid (SMD: 0.05; 95% CI: -0.57 to 0.67; Z: 0.17; p = 0.86) and fenugreek with
Chandrasura churna (SMD: 0.06; 95% CI: -0.56 to 0.68; Z: 0.19; p = 0.85). Bias, in terms of incomplete
outcome data and selective reporting, was low risk in all studies, and the available evidence
was low quality according to the GRADE approach.

Conclusion:

The results showed that the effect of fenugreek on pain intensity in dysmenorrhea is highly
uncertain. The true effect is likely to be substantially different from the estimate of effect. Regarding
the importance of the health and quality of life of women of reproductive age and the low quality of
evidence of the studies, clinical trials with stronger methodology are suggested in this field.
A Simplified Method for Determining Blood-to-Plasma Ratios in vitro and ex vivo by Matrix Matching with Blank Blood or Plasma
Authors: Zhang Xiaomei , Jenkins Gary J. , Desino Kelly E. , Liu Jinrong , Larsen Mary , Stresser David M.
Published: August 2023

Objective:

This work describes a simplified, 96-well plate method for determining the blood-to-plasma concentration ratio (BP ratio) for small molecules.

Methods:

The need for calibration curves was eliminated using a matrix-matching approach in which blood samples were mixed with blank plasma and plasma samples were mixed with blank blood. As a result, both blood- and plasma-origin samples shared an equivalent matrix ahead of bioanalysis. In the in vitro assay, identical sample matrices were achieved by using the same source of blank plasma and blood.

Results:

In humans, a good correlation (R2 = 0.84) was observed between the data obtained in this ma-trix-matching method and literature values for 11 commercial compounds possessing a wide range of logD values across multiple chemical classes. In addition, this method showed good agreement with in vitro BP ratios for 10 proprietary compounds determined radiometrically (R2 = 0.72) in human and preclinical species. Finally, the in vitro matrix matching method compared favorably to BP ratios de-termined ex vivo for 13 proprietary and literature compounds (R2 = 0.87) in rat.

Conclusion:

This method, suitable for in vitro and ex vivo BP ratio determinations, is operationally efficient, robust, and a useful improvement upon previously published methods.
From the formulation to the implementation of the tourism sector policy with an Afro-descendant enclave
Authors: Carabalí-Méndez Iliana Johanna
Published: August 2023

In rural environments of various nations in the Americas, such as Ecuador, in recent decades the emergence of entrepreneurship initiatives linked to the tourism sector has been seen, many of them aligned with the philosophy of rural and community tourism. An example is the tourist experience offered by the Afrochoteño Territory, in the northern Andes of the country. In this region, the communities of El Chota, Juncal, Mascarilla and Salinas have ventured for about two decades in the provision of tourism services of this type. The objective is to demonstrate the impact of the tourism sectoral public policy on the tourist experience in the Afro-Chotan territory. This is how, after the combination of secondary information review techniques, in contrast to the collection of field data that involves various actors in the Afro-Colombian tourist experience, the result was that they remain valid despite the significant gap in implementation. of public policy in favor of these initiatives.
Mobile Apps for COVID-19 Detection and Diagnosis for Future Pandemic Control: Multidimensional Systematic Review
Authors: Gheisari Mehdi , Ghaderzadeh Mustafa , Li Huxiong , Taami Tania , Fernández-Campusano Christian , Sadeghsalehi Hamidreza , Afzaal Abbasi Aaqif
Published: August 2023

Background

In the modern world, mobile apps are essential for human advancement, and pandemic control is no exception. The use of mobile apps and technology for the detection and diagnosis of COVID-19 has been the subject of numerous investigations, although no thorough analysis of COVID-19 pandemic prevention has been conducted using mobile apps, creating a gap.

Objective

With the intention of helping software companies and clinical researchers, this study provides comprehensive information regarding the different fields in which mobile apps were used to diagnose COVID-19 during the pandemic.

Methods

In this systematic review, 535 studies were found after searching 5 major research databases (ScienceDirect, Scopus, PubMed, Web of Science, and IEEE). Of these, only 42 (7.9%) studies concerned with diagnosing and detecting COVID-19 were chosen after applying inclusion and exclusion criteria using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol.

Results

Mobile apps were categorized into 6 areas based on the content of these 42 studies: contact tracing, data gathering, data visualization, artificial intelligence (AI)–based diagnosis, rule- and guideline-based diagnosis, and data transformation. Patients with COVID-19 were identified via mobile apps using a variety of clinical, geographic, demographic, radiological, serological, and laboratory data. Most studies concentrated on using AI methods to identify people who might have COVID-19. Additionally, symptoms, cough sounds, and radiological images were used more frequently compared to other data types. Deep learning techniques, such as convolutional neural networks, performed comparatively better in the processing of health care data than other types of AI techniques, which improved the diagnosis of COVID-19.

Conclusions

Mobile apps could soon play a significant role as a powerful tool for data collection, epidemic health data analysis, and the early identification of suspected cases. These technologies can work with the internet of things, cloud storage, 5th-generation technology, and cloud computing. Processing pipelines can be moved to mobile device processing cores using new deep learning methods, such as lightweight neural networks. In the event of future pandemics, mobile apps will play a critical role in rapid diagnosis using various image data and clinical symptoms. Consequently, the rapid diagnosis of these diseases can improve the management of their effects and obtain excellent results in treating patients.
Acceptance and Usability of an Innovative mDentistry eHygiene Model Amid the COVID-19 Pandemic Within the US National Dental Practice-Based Research Network: Mixed Methods Study
Authors: Xiao Jin , Kopycka-Kedzierawski Dorota , Ragusa Patricia , Mendez Chagoya Luis Alberto , Funkhouser Kimberly , Lischka Tamara , Wu Tong Tong , Fiscella Kevin , Kar Kumari Saswati , Al Jallad Nisreen , Rashwan Noha , Ren Johana , Meyerowitz Cyril ,   National Dental Practice-Based Research Network (PBRN) Collaborative Group
Published: August 2023

Background

Amid the COVID-19 pandemic and other possible future infectious disease pandemics, dentistry needs to consider modified dental examination regimens that render quality care and ensure the safety of patients and dental health care personnel (DHCP).

Objective

This study aims to assess the acceptance and usability of an innovative mDentistry eHygiene model amid the COVID-19 pandemic.

Methods

This pilot study used a 2-stage implementation design to assess 2 critical components of an innovative mDentistry eHygiene model: virtual hygiene examination (eHygiene) and patient self-taken intraoral images (SELFIE), within the National Dental Practice-Based Research Network. Mixed methods (quantitative and qualitative) were used to assess the acceptance and usability of the eHygiene model.

Results

A total of 85 patients and 18 DHCP participated in the study. Overall, the eHygiene model was well accepted by patients (System Usability Scale [SUS] score: mean 70.0, SD 23.7) and moderately accepted by dentists (SUS score: mean 51.3, SD 15.9) and hygienists (SUS score: mean 57.1, SD 23.8). Dentists and patients had good communication during the eHygiene examination, as assessed using the Dentist-Patient Communication scale. In the SELFIE session, patients completed tasks with minimum challenges and obtained diagnostic intraoral photos. Patients and DHCP suggested that although eHygiene has the potential to improve oral health care services, it should be used selectively depending on patients’ conditions.

Conclusions

The study results showed promise for the 2 components of the eHygiene model. eHygiene offers a complementary modality for oral health data collection and examination in dental offices, which would be particularly useful during an infectious disease outbreak. In addition, patients being able to capture critical oral health data in their home could facilitate dental treatment triage and oral health self-monitoring and potentially trigger oral health–promoting behaviors.
Web-Based Cognitive Behavioral Therapy for Depression Among Homebound Older Adults: Development and Usability Study
Authors: Xiang Xiaoling , Kayser Jay , Ash Samson , Zheng Chuxuan , Sun Yihang , Weaver Addie , Dunkle Ruth , Blackburn James A , Halavanau Alex , Xue Jia , Himle Joseph A
Published: August 2023

Background

Homebound older adults are a high-risk group for depression. However, many of them face barriers to accessing evidence-supported mental health treatments. Digital mental health interventions can potentially improve treatment access, but few web-based interventions are explicitly tailored for depression in older adults.

Objective

This paper describes the development process of Empower@Home, a web-delivered intervention for depression in homebound older adults that is based on cognitive behavioral therapy, and reports on the outcomes of usability studies.

Methods

Empower@Home was developed in collaboration with community agencies, stakeholders, and older adults, guided by user-centered design principles. User needs were assessed through secondary data analysis, demographic and health profiles from administrative data, and interviews and surveys of community partners. A comparative usability evaluation was conducted with 10 older adults to assess the usability of Empower@Home compared to 2 similar programs. Field testing was conducted with 4 end users to detect additional usability issues.

Results

Feedback and recommendations from community partners heavily influenced the content and design of Empower@Home. The intervention consists of 9 sessions, including psychoeducation and an introduction to cognitive behavioral therapy skills and tools through short video clips, in-session exercises, an animated storyline, and weekly out-of-session home practice. A printed workbook accompanies the web-based lessons. In comparative usability testing (N=10), Empower@Home received a System Usability Scale score of 78 (SD 7.4), which was significantly higher than the 2 comparator programs (t9=3.28; P=.005 and t9=2.78; P=.011). Most participants, 80% (n=8), preferred Empower@Home over the comparators. In the longitudinal field test (n=4), all participants reported liking the program procedures and feeling confident in performing program-related tasks. The single-subject line graph showed an overall downward trend in their depression scores over time, offering an encouraging indication of the intervention’s potential effects.

Conclusions

Collaboration with community stakeholders and careful consideration of potential implementation issues during the design process can result in more usable, engaging, and effective digital mental health interventions.
The Journey of Zanzibar’s Digitally Enabled Community Health Program to National Scale: Implementation Report
Authors: Layer Erica , Slim Salim , Mussa Issa , Al-Mafazy Abdul-Wahid , Besana Giulia V R , Msellem Mwinyi , Fulcher Isabel , Hornung Heiko , Lampariello Riccardo
Published: August 2023

Background

While high-quality primary health care services can meet 80%-90% of health needs over a person’s lifetime, this potential is severely hindered in many low-resource countries by a constrained health care system. There is a growing consensus that effectively designed, resourced, and managed community health worker programs are a critical component of a well-functioning primary health system, and digital technology is recognized as an important enabler of health systems transformation.

Objective

In this implementation report, we describe the design and rollout of Zanzibar’s national, digitally enabled community health program–Jamii ni Afya.

Methods

Since 2010, D-tree International has partnered with the Ministry of Health Zanzibar to pilot and generate evidence for a digitally enabled community health program, which was formally adopted and scaled nationally by the government in 2018. Community health workers use a mobile app that guides service delivery and data collection for home-based health services, resulting in comprehensive service delivery, access to real-time data, efficient management of resources, and continuous quality improvement.

Results

The Zanzibar government has documented increases in the delivery of health facilities among pregnant women and reductions in stunting among children younger than 5 years since the community health program has scaled. Key success factors included starting with the health challenge and local context rather than the technology, usage of data for decision-making, and extensive collaboration with local and global partners and funders. Lessons learned include the significant time it takes to scale and institutionalize a digital health systems innovation due to the time to generate evidence, change opinions, and build capacity.

Conclusions

Jamii ni Afya represents one of the world’s first examples of a nationally scaled digitally enabled community health program. This implementation report outlines key successes and lessons learned, which may have applicability to other governments and partners working to sustainably strengthen primary health systems.
An mHealth Text Messaging Program Providing Symptom Detection Training and Psychoeducation to Improve Hypoglycemia Self-Management: Intervention Development Study
Authors: Lin Yu Kuei , Aikens James E , de Zoysa Nicole , Hall Diana , Funnell Martha , Nwankwo Robin , Kloss Kate , DeJonckheere Melissa J , Pop-Busui Rodica , Piatt Gretchen A , Amiel Stephanie A , Piette John D
Published: August 2023

Background

Hypoglycemia remains a challenge for roughly 25% of people with type 1 diabetes (T1D) despite using advanced technologies such as continuous glucose monitors (CGMs) or automated insulin delivery systems. Factors impacting hypoglycemia self-management behaviors (including reduced ability to detect hypoglycemia symptoms and unhelpful hypoglycemia beliefs) can lead to hypoglycemia development in people with T1D who use advanced diabetes technology.

Objective

This study aims to develop a scalable, personalized mobile health (mHealth) behavioral intervention program to improve hypoglycemia self-management and ultimately reduce hypoglycemia in people with T1D who use advanced diabetes technology.

Methods

We (a multidisciplinary team, including clinical and health psychologists, diabetes care and education specialists, endocrinologists, mHealth interventionists and computer engineers, qualitative researchers, and patient partners) jointly developed an mHealth text messaging hypoglycemia behavioral intervention program based on user-centered design principles. The following five iterative steps were taken: (1) conceptualization of hypoglycemia self-management processes and relevant interventions; (2) identification of text message themes and message content development; (3) message revision; (4) patient partner assessments for message readability, language acceptability, and trustworthiness; and (5) message finalization and integration with a CGM data–connected mHealth SMS text message delivery platform. An mHealth web-based SMS text message delivery platform that communicates with a CGM glucose information-sharing platform was also developed.

Results

The mHealth SMS text messaging hypoglycemia behavioral intervention program HypoPals, directed by patients’ own CGM data, delivers personalized intervention messages to (1) improve hypoglycemia symptom detection and (2) elicit self-reflection, provide fact-based education, and suggest practical health behaviors to address unhelpful hypoglycemia beliefs and promote hypoglycemia self-management. The program is designed to message patients up to 4 times per day over a 10-week period.

Conclusions

A rigorous conceptual framework, a multidisciplinary team (including patient partners), and behavior change techniques were incorporated to create a scalable, personalized mHealth SMS text messaging behavioral intervention. This program was systematically developed to improve hypoglycemia self-management in advanced diabetes technology users with T1D. A clinical trial is needed to evaluate the program’s efficacy for future clinical implementation.
Role of Incentives in the Use of Blockchain-Based Platforms for Sharing Sensitive Health Data: Experimental Study (Preprint)
Authors: Esmaeilzadeh Pouyan , Mirzaei Tala
Published: August 2023

BACKGROUND

Blockchain is an emerging technology that enables secure and decentralized approaches to reduce technical risks and governance challenges associated with sharing data. Although blockchain-based solutions have been suggested for sharing health information, it is still unclear whether a suitable incentive mechanism (intrinsic or extrinsic) can be identified to encourage individuals to share their sensitive data for research purposes.

OBJECTIVE

This study aimed to investigate how important extrinsic incentives are and what type of incentive is the best option in blockchain-based platforms designed for sharing sensitive health information.

METHODS

In this study, we conducted 3 experiments with 493 individuals to investigate the role of extrinsic incentives (ie, cryptocurrency, money, and recognition) in data sharing with research organizations.

RESULTS

The findings highlight that offering different incentives is insufficient to encourage individuals to use blockchain technology or to change their perceptions about the technology’s premise for sharing sensitive health data. The results demonstrate that individuals still attribute serious risks to blockchain-based platforms. Privacy and security concerns, trust issues, lack of knowledge about the technology, lack of public acceptance, and lack of regulations are reported as top risks. In terms of attracting people to use blockchain-based platforms for data sharing in health care, we show that the effects of extrinsic motivations (cryptoincentives, money, and status) are significantly overshadowed by inhibitors to technology use.

CONCLUSIONS

We suggest that before emphasizing the use of various types of extrinsic incentives, the users must be educated about the capabilities and benefits offered by this technology. Thus, an essential first step for shifting from an institution-based data exchange to a patient-centric data exchange (using blockchain) is addressing technology inhibitors to promote patient-driven data access control. This study shows that extrinsic incentives alone are inadequate to change users’ perceptions, increase their trust, or encourage them to use technology for sharing health data.
Determinants of Patient Use and Satisfaction With Synchronous Telemental Health Services During the COVID-19 Pandemic: Systematic Review (Preprint)
Authors: Neumann Ariana , König Hans-Helmut , Bokermann Josephine , Hajek André
Published: August 2023

BACKGROUND

Several recent studies examined patient use and satisfaction with synchronous telemental health services in response to the widespread implementation during the COVID-19 pandemic. However, a systematic review of recent literature on the determinants of these outcomes is missing.

OBJECTIVE

The aim of this systematic review was to give an extensive overview of the literature on and highlight the influential determinants of patient use and satisfaction with synchronous telemental health services during the COVID-19 pandemic.

METHODS

This review satisfied the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was registered in PROSPERO. Peer-reviewed, quantitative studies that observed the determinants of patient use or satisfaction with synchronous telemental health services during the COVID-19 pandemic were included. PubMed, PsycInfo, and Web of Science database searches were conducted in August 2022 for English and German language studies published from 2020 onward. Key steps were performed by 2 reviewers. Determinants were synthesized into major categories informed by the dimensions of the widely used and established Unified Theory of Acceptance and Use of Technology.

RESULTS

Of the 20 included studies, 10 studies examined determinants of patient use, 7 examined determinants of patient satisfaction, and 3 observed both outcomes. The quality of the studies was mainly good or fair. There was substantial heterogeneity in the study designs, methods, and findings. Sociodemographic characteristics and health-related determinants were mostly considered. Some of the major dimensions of the Unified Theory of Acceptance and Use of Technology were neglected in recent studies. Although most findings were mixed or nonsignificant, some indications for potential relationships were found (eg, for sex, age, and symptom severity).

CONCLUSIONS

The findings revealed potential target groups (eg, female and young patients with mild symptoms) for future postpandemic telemental health interventions. However, they also identified patient groups that were harder to reach (eg, older patients with severe symptoms); efforts may be beneficial to address such groups. Future quantitative and qualitative research is needed to secure and expand on recent findings, which could help improve services.

CLINICALTRIAL

PROSPERO CRD42022351576; https://tinyurl.com/yr6zrva5
Dermoscopy Differential Diagnosis Explorer (D3X) Ontology to Aggregate and Link Dermoscopic Patterns to Differential Diagnoses: Development and Usability Study (Preprint)
Authors: Lin Rebecca Z , Amith Muhammad Tuan , Wang Cynthia X , Strickley John , Tao Cui
Published: August 2023

BACKGROUND

Dermoscopy is a growing field that uses microscopy to allow dermatologists and primary care physicians to identify skin lesions. For a given skin lesion, a wide variety of differential diagnoses exist, which may be challenging for inexperienced users to name and understand.

OBJECTIVE

In this study, we describe the creation of the dermoscopy differential diagnosis explorer (D3X), an ontology linking dermoscopic patterns to differential diagnoses.

METHODS

Existing ontologies that were incorporated into D3X include the elements of visuals ontology and dermoscopy elements of visuals ontology, which connect visual features to dermoscopic patterns. A list of differential diagnoses for each pattern was generated from the literature and in consultation with domain experts. Open-source images were incorporated from DermNet, Dermoscopedia, and open-access research papers.

RESULTS

D3X was encoded in the OWL 2 web ontology language and includes 3041 logical axioms, 1519 classes, 103 object properties, and 20 data properties. We compared D3X with publicly available ontologies in the dermatology domain using a semiotic theory–driven metric to measure the innate qualities of D3X with others. The results indicate that D3X is adequately comparable with other ontologies of the dermatology domain.

CONCLUSIONS

The D3X ontology is a resource that can link and integrate dermoscopic differential diagnoses and supplementary information with existing ontology-based resources. Future directions include developing a web application based on D3X for dermoscopy education and clinical practice.
Healthcare Workers’ Motivations for Enrolling in Massive Open Online Courses During a Public Health Emergency: Evidence from a Case Study of COVID-19 Training (Preprint)
Authors: Jones Jennifer , Johnston Jamie Sewan , Ndiaye Ngouille Yabsa , Tokar Anna , Singla Saumya , Skinner Nadine Ann , Strehlow Matthew , Utunen Heini
Published: August 2023

BACKGROUND

Massive Open Online Courses (MOOCs) are increasingly used to educate healthcare workers in low-income and lower-middle-income countries (LICs/LMICs). Early in 2020, the World Health Organization developed a series of MOOCs for COVID-19, introducing the disease and strategies to control its outbreak, with six courses specifically targeting healthcare workers as learners. In August 2020, Stanford University also launched a MOOC, the “COVID-19 Training for Healthcare Workers”, designed to deliver accurate and timely education on COVID-19 for healthcare workers across the globe, improving their ability to provide healthcare safely and effectively to patients suffering from the novel infectious disease. While MOOCs in LICs/LMICs have expanded during the COVID-19 public health emergency, more descriptive data is needed in the literature regarding healthcare participants' characteristics and motivations for enrolling in MOOCs.

OBJECTIVE

In this study, we conducted a descriptive analysis of the types of healthcare workers who enrolled in COVID-19 MOOCs. Furthermore, we sought insight into healthcare workers' motivations for enrolling in and completing COVID-19 MOOCs. Previous studies have shown that a primary intrinsic motivator for MOOC enrollment generally is for their personal interest or knowledge acquisition; however, there is minimal available data on motivating factors for enrollment in healthcare-specific MOOCs. We aimed to understand better the types of learners who enroll in healthcare-related MOOCs and their motivations for participation.

METHODS

Surveys were distributed to all course completers of six OpenWHO COVID-19 courses and Stanford’s “COVID-19 Training for Healthcare Workers” course. This study combines enrollment data, with survey responses, including demographic data, ranked motivations for course enrollment, and perceptions of the MOOCs.

RESULTS

Among healthcare workers, the primary motivator for COVID-19 MOOC enrollment generally and across subgroup analyses was to improve clinical practice and for personal learning. To earn a certificate ranked consistently as a middle-tier motivator. However, 70% of respondents reported they chose to earn the certificate, with 59% indicating they would provide a copy to their employer and 63% indicating they would use the certificate to fulfill continuing education requirements.

CONCLUSIONS

The results demonstrate that the primary reason most healthcare workers enrolled in COVID-19-related MOOCs was for clinical practice improvement and personal learning. Furthermore, most healthcare workers used course certificates professionally. Identifying the motivations for specific groups of learners, like those in LICs/LMICs, will help the future design of MOOCs to encourage participation and completion.
Green Open Space and Barren Land Mapping for Flood Mitigation in Jakarta, the Capital of Indonesia
Authors: Dammayatri Retno , Susantoro Tri Muji , Wikantika Ketut
Published: August 2023

High levels of rainfall, tidal flooding, land subsidence, intensified urban development, scarce barren land and a shortage of green open spaces (GOS) are contributing factors to the persistent flooding in Jakarta. Therefore, this study was conducted to map the GOS, built-up, and barren land in the city in order to calculate the biopore infiltration hole (LRB) potential for water infiltration as part of Jakarta's flood mitigation efforts using the Landsat 8 operational land imager (OLI). The Landsat data acquired on September 11, 2019, with path/row 122/064 were processed using the Fast Line-of-Sight Atmospheric Analysis of Spectral Hypercubes (FLAASH) method for the radiometric correction, and geometric correction with a root mean square error (RMSE) of 7.57 meters. Moreover, the normalized difference vegetation index (NDVI) was applied to classify the GOS, the normalized difference built-up index (NDBI) for the built-up areas, and the normalized difference barren land index (NDBaI) for barren land areas which were further confirmed using NDBI to distinguish them from the built-up areas. It is also important to note that the LRB potential was calculated by adding the GOS and barren land, dividing the result by the ideal land area multiplied by the ideal number of holes. The results showed that the GOS, built-up area, and barren land were 8.34%, 85.29%, and 2.48%, respectively. Furthermore, the LRB potential through the optimization of GOS and barren land was found to be 70.06 km2 and produced 16,816,248 LRB (18.27% of total needed). The realization of this value is expected to reduce the potential inundation in Jakarta by 15.6%.