bluuebunny/crossref_metadata_2025 huggingface dataset:
The Multifunctional Protein p62 and Its Mechanistic Roles in Cancers
Authors: Ning Shunbin , Wang Ling
Published: October 2018

The multifunctional signaling hub p62 is well recognized as a ubiquitin sensor and a selective autophagy receptor. As a ubiquitin sensor, p62 promotes NFκB activation by facilitating TRAF6 ubiquitination and aggregation. As a selective autophagy receptor, p62 sorts ubiquitinated substrates including p62 itself for lysosome-mediated degradation. p62 plays crucial roles in myriad cellular processes including DNA damage response, aging/senescence, infection and immunity, chronic inflammation, and cancerogenesis, dependent on or independent of autophagy. Targeting p62-mediated autophagy may represent a promising strategy for clinical interventions of different cancers. In this review, we summarize the transcriptional and post-translational regulation of p62, and its mechanistic roles in cancers, with the emphasis on its roles in regulation of DNA damage response and its connection to the cGAS-STING-mediated antitumor immune response, which is promising for cancer vaccine design.
Targeting Upstream Kinases of STAT3 in Human Medulloblastoma Cells
Authors: Wei Jia , Ma Ling , Li Chenglong , Pierson Christopher R. , Finlay Jonathan L. , Lin Jiayuh
Published: October 2018

Background:

Medulloblastoma is the most common malignant brain tumor in children. Despite improvement in overall survival rate, it still lacks an effective targeted treatment strategy. The Janus family of cytoplasmic tyrosine kinases (JAKs) and Src kinases, upstream protein kinases of signal transducer and activator of transcription 3 (STAT3), play important roles in medulloblastoma pathogenesis and therefore represent potential therapeutic targets.

Methods:

In this report, we examined the inhibitory efficacy of the JAK1/2 inhibitor, ruxolitinib, the JAK3 inhibitor, tofacitinib and two Src inhibitors, KX2-391 and dasatinib.

Results:

These small molecule drugs significantly reduce cell viability and inhibit cell migration and colony formation in human medulloblastoma cells in vitro. Src inhibitors have more potent efficacy than JAK inhibitors in inhibiting medulloblastoma cell migration ability. The Src inhibitors can inhibit both phosphorylation of STAT3 and Src while JAK inhibitors reduce JAK/STAT3 phosphorylation. We also investigated the combined effect of the Src inhibitor, dasatinib with cisplatin. The results show that dasatinib exerts synergistic effects with cisplatin in human medulloblastoma cells through the inhibition of STAT3 and Src.

Conclusion:

Our results suggest that the small molecule inhibitors of STAT3 upstream kinases, ruxolitinib, tofacitinib, KX2-391, and dasatinib could be novel and attractive candidate drugs for the treatment of human medulloblastoma.
Osimertinib Quantitative and Gene Variation Analyses in Cerebrospinal Fluid and Plasma of a Non-small Cell Lung Cancer Patient with Leptomeningeal Metastases
Authors: Song Yuanyuan , Liu Peng , Huang Yu , Guan Yanfang , Han Xiaohong , Shi Yuankai
Published: October 2018

Background:

Leptomeningeal metastases (LM) are much more frequent in patients of
non-small lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations.
Osimertinib, a third-generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFRTKI)
shows promising efficacy for LM.

Objective:

The aim of this study was to analyze the concentration of osimertinib and gene variation
of circulating tumor DNA (ctDNA) in human plasma and cerebrospinal fluid (CSF). Furthermore,
we explored whether ctDNA in CSF might be used as a biomarker to predict and monitor therapeutic
responses.

Methods:

The dynamic paired CSF and blood samples were collected from the NSCLC patient with
LM acquired EGFR-TKI resistance. A method based on ultra-high performance liquid chromatography-
tandem mass spectrometry (UPLC-MS/MS) was developed and validated for detecting
osimertinib in CSF and plasma samples. Gene variations of ctDNA were tested by next-generation
sequencing with a panel of 1021 genes.

Results:

The concentrations of osimertinib in CSF were significantly lower than that in plasma
(penetration rate was 1.47%). Mutations included mTOR, EGFR, CHECK1, ABCC11, and TP53
were explored in ctDNA from plasma and CSF samples. The detected mutation rate of CSF samples
was higher than that of plasma samples (50% vs. 25%). Our data further revealed that the variations
allele frequency (VAF) and molecular tumor burden index (mTBI) of ctDNA derived from CSF exhibited
the negative correlation with efficacy of treatment.

Conclusion:

ctDNA from CSF might be a useful biomarker for monitoring the efficacy of treatment
and an effective complement to nuclear magnetic resonance imaging (MRI) for LM.
From Endothelial Dysfunction to Arterial Stiffness in Diabetes Mellitus
Authors: Giraldo-Grueso Manuel , Echeverri Darío
Published: October 2018

Prevalence of diabetes mellitus has increased drastically over time, especially in more
populous countries such as the United States, India, and China. Patients with diabetes have an increased
risk of major cardiovascular events such as acute myocardial infarction, cerebrovascular disease,
and peripheral vascular disease. Arterial stiffness is a process related to aging and vascular,
metabolic, cellular and physiological deterioration. In recent years, it has been described as an independent
predictor of cardiovascular mortality and coronary artery disease. Additionally, it plays an
important role in the measurement of chronic disease progression. Recent studies have suggested a
strong relationship between diabetes mellitus and arterial stiffness since they share a similar pathophysiology
involving endothelial dysfunction. The literature has shown that microvascular and macrovascular
complications in diabetic patients could be screened and measured with arterial stiffness.
Additionally, new evidence proposes that there is a relationship between blood glucose levels, microalbuminuria,
and arterial stiffness. Moreover, arterial stiffness predicts cardiovascular risk and is independently
associated with mortality in diabetic patients. Abnormal arterial stiffness values in diabetic
patients should alert the clinician to the presence of vascular disease, which merits early study
and treatment. We await more studies to determine if arterial stiffness could be considered a routine
useful non-invasive tool in the evaluation of diabetic patients. There is enough evidence to conclude
that arterial stiffness is related to the progression of diabetes mellitus.
Synthesis of New Thiosemicarbazones and Semicarbazones Containing the 1,2,3-1H-triazole-isatin Scaffold: Trypanocidal, Cytotoxicity, Electrochemical Assays, and Molecular Docking
Authors: Silva Bianca N.M. , Sales Junior Policarpo A. , Romanha Alvaro J. , Murta Silvane M.F. , Lima Camilo H.S. , Albuquerque Magaly G. , D'Elia Eliane , Rodrigues José G.A. , Ferreira Vitor F. , Silva Fernando C. , Pinto Angelo C. , Silva Bárbara V.
Published: October 2018

Background:

Chagas disease, also known as American trypanosomiasis, is classified as
one of the 17 most important neglected diseases by the World Health Organization. The only drugs
with proven efficacy against Chagas disease are benznidazole and nifurtimox, however both show
adverse effects, poor clinical efficacy, and development of resistance. For these reasons, the search
for new effective chemical entities is a challenge to research groups and the pharmaceutical industry.

Objective:

Synthesis and evaluation of antitrypanosomal activities of a series of thiosemicarbazones
and semicarbazones containing 1,2,3-1H triazole isatin scaffold.

Method:

5&'-(4-alkyl/aryl)-1H-1,2,3-triazole-isatins were prepared by Huisgen 1,3-dipolar
cycloaddition and the thiosemicarbazones and semicarbazones were obtained by the 1:1 reactions
of the carbonylated derivatives with thiosemicarbazide and semicarbazide hydrochloride,
respectively, in methanol, using conventional reflux or microwave heating. The compounds were
assayed for in vitro trypanocidal activity against Trypanosoma cruzi, the aetiological agent of
Chagas disease. Beyond the thio/semicarbazone derivatives, isatin and triazole synthetic
intermediates were also evaluated for comparison.

Results:

A series of compounds were prepared in good yields. Among the 37 compounds evaluated,
18 were found to be active, in particular thiosemicarbazones containing a non-polar saturated
alkyl chain (IC50 = 24.1, 38.6, and 83.2 &µM; SI = 11.6, 11.8, and 14.0, respectively). To further
elucidate the mechanism of action of these new compounds, the redox behaviour of some active
and inactive derivatives was studied by cyclic voltammetry. Molecular docking studies were also
performed in two validated protein targets of Trypanosoma cruzi, i.e., cruzipain (CRZ) and phosphodiesterase
C (TcrPDEC).

Conclusion:

A class of thio/semicarbazones structurally simple and easily accessible was synthesized.
Compounds containing thiosemicarbazone moieties showed the best results in the series, being
more active than the corresponding semicarbazones. Our results indicated that the activity of
these compounds does not originate from an oxidation-reduction pathway but probably from the
interactions with trypanosomal enzymes.
Methamphetamine Abusers’ Personality Traits and its Relational with Spiritual Well-being and Perceived Social Support
Authors: Jalali Amir , Shabrandi Bistoun , Jalali Rostam , Salari Nader
Published: October 2018

Background:

Psychoactive substance abuse is a psychosocial disorder that its, emergence,
continuation, and treatment are associated with personality factors, spiritual well-being, and
social support.

Objective:

This study was conducted to investigate the relationship between personality traits with
spiritual well-being and perceived social support in methamphetamine users undergoing treatment in
2016 in the clinics of Kermanshah City, Iran.

Methods:

This cross-sectional study was conducted on a sample of 117 methamphetamine users undergoing
treatment in addiction clinics of Kermanshah City, Iran. The formed study population was
prepared by convenience sampling according to the inclusion-exclusion criteria. Data were collected
using a demographic form, NEO Five-Factor Inventory, Paloutzian and Ellison’s spiritual wellbeing
scale, and perceived social support inventory of Fleming et al. The collected data were analyzed
by parametric and nonparametric tests in SPSS v.23.

Results:

The results showed that 82.2% of participants had a moderate level of agreeableness,
88.1% had moderate neuroticism, 93.2% had moderate extraversion, 87.2% had moderate conscientiousness,
and 92.2% had a moderate level of openness to experience. In addition, 76.9% of participants
had a low level of spiritual well-being and the remaining 23.1% had a moderate spiritual wellness.
The mean spiritual well-being and perceived social support scores of participants were
69.94±10.86 and 33.94±7.55, respectively. The findings showed a significant relationship between
personality traits and spiritual well-being and social support in methamphetamine users (p = 0.05).

Conclusion:

The results indicate that personality traits, perceived social support, and spiritual wellbeing
can be considered as risk factors for methamphetamine abuse.
Deregulation of miR-21 and miR-29a in Cervical Cancer Related to HPV Infection
Authors: Zamani Sara , Sohrabi Amir , Hosseini Seyed Masoud , Rahnamaye-Farzami Marjan , Akbari Abolfazl
Published: October 2018

Background:

Early diagnosis is an important factor to improve the survival of Invasive Cervical Cancer (ICC) patients. Molecular biomarkers such as micro RNA (miRNA) can be used in the early detection of ICC. The expression of miR-21 and miR-29a are deregulated in many types of human cancers.

Objective:

The aim of this study was to investigate the differences in miR-21 and miR-29a expression patterns in the Human Papilloma Virus (HPV) infection and various grades of cervical cancer among Iranian women.

Methods:

Small RNAs were extracted from positive for HPV, cervical cancer and healthy samples from 43, 50 and 46 individuals, respectively. Expression levels of miR-21 and miR-29a were analyzed by SYBR Green real-time RT-PCR using specific primers, and 5s rRNA as the internal reference gene.

Results:

Results have shown a significant increase in miR-21 and decrease in miR-29 in cancerous samples in comparison with the control groups (P < 0.0001).

Conclusion:

This study illustrated that miR-21 and miR-29a could be operated as an oncogene and tumor-suppressor in cervical cancer progression. More studies are needed to demonstrate the role of miR-21 and miR-29a as potential biomarkers for the diagnosis of cervical cancer in future investigations.
The Mediating Role of Perceived Social Support Between Physical Activity Habit Strength and Depressive Symptoms in People Seeking to Decrease Their Cardiovascular Risk: Cross-Sectional Study
Authors: Storm Vera , Reinwand Dominique Alexandra , Wienert Julian , Tan Shu-Ling , Lippke Sonia
Published: October 2018

Background

Regular physical activity treatment has been advocated for the prevention and rehabilitation of patients at risk of cardiovascular diseases and depressive symptoms. How physical activity is related to depressive symptoms is widely discussed.

Objective

The aim of this internet-based study was to investigate the role of perceived social support in the relationship between physical activity habit strength and depressive symptoms.

Methods

In total, 790 participants (mean 50.9 years, SD 12.2, range 20-84 years) who were interested in reducing their cardiovascular risk were recruited in Germany and the Netherlands. Data collection was conducted via an internet-based questionnaire addressing physical activity habit strength, depressive symptoms, and perceived social support. Cross-sectional data analysis was done with SPSS version 24 using the Macro PROCESS version 2 16.3 by Hayes with bootstrapping (10,000 samples), providing 95% CIs.

Results

Physical activity habit strength was negatively related to depressive symptoms (r=–.13, P=.006), but this interrelation disappeared when controlling for perceived social support (beta=–.14, SE 0.09, P=.11). However, there was an indirect relationship between physical activity habit strength and depressive symptoms, which was mediated via perceived social support (beta=–.13; SE 0.04, 95% CI –0.21 to 0.06). The negative relationship between physical activity habit strength and depressive symptoms was fully mediated by perceived social support.

Conclusions

We suggest that physical activity treatment in people interested in reducing their cardiovascular risk should also embed social support to target depressive symptoms. Internet-based interventions and electronic health may provide a good option for doing so.

Trial Registration

ClinicalTrials.gov NCT01909349; https://clinicaltrials.gov/ct2/show/NCT01909349 (Archived by WebCite at http://www.webcitation.org/73Y9RfdiY)
A Web-Based Intervention for Relatives of People Experiencing Psychosis or Bipolar Disorder: Design Study Using a User-Centered Approach
Authors: Honary Mahsa , Fisher Naomi Ruth , McNaney Roisin , Lobban Fiona
Published: October 2018

Background

Relatives of people experiencing bipolar mood episodes or psychosis face a multitude of challenges (eg, social isolation, limited coping strategies, and issues with maintaining relationships). Despite this, there is limited informational and emotional support for people who find themselves in supporting or caring roles. Digital technologies provide us with an opportunity to offer accessible tools, which can be used flexibly to provide evidence-based information and support, allowing relatives to build their understanding of mental health problems and learn from others who have similar experiences. However, to design tools that are useful to relatives, we first need to understand their needs.

Objective

The aim of this study was to use a user-centered design approach to develop an accessible Web-based intervention, based on the Relatives Education And Coping Toolkit (REACT) booklet, to support the informational and emotional needs of relatives of people experiencing psychosis or bipolar disorder.

Methods

We engaged relatives of people with experiences of bipolar disorder or psychosis in workshops to identify their needs and design requirements for developing a Web-based version of a paper-based toolkit. We used a 2-phase qualitative approach to explore relatives’ views on content, design, and functionalities, which are considered to be engaging and useful in a Web-based intervention. In phase 1, we consulted 24 relatives in 2 workshops to better understand their existing support infrastructure, their barriers for accessing support, unmet needs, and relatives’ views on online support. On the basis of the results of these workshops, we developed a set of design considerations to be explored in a smaller workshop. Workshop 3 then involved working with 2 digitally literate relatives to design a usable and acceptable interface for our Web-based toolkit. Finally, in phase 2, we conducted a heuristic evaluation to assess the usability of the toolkit.

Results

Our findings indicated that relatives require technologies that (1) they can place their trust in, particularly when discussing a highly sensitive topic, (2) enable learning from the lived experiences of others while retaining confidentiality, and (3) they can work through at their own pace in a personalized manner.

Conclusions

Our study highlights the need for providing a trustworthy, supportive tool where relatives can engage with people who have similar experiences to their own. Our heuristic evaluation showed promise in terms of perceived usability of the REACT Web-based intervention. Through this work, we emphasize the need to involve stakeholders with various characteristics, including users with limited computer literacy or experience in online support.
Fall Risk Classification in Community-Dwelling Older Adults Using a Smart Wrist-Worn Device and the Resident Assessment Instrument-Home Care: Prospective Observational Study (Preprint)
Authors: Yang Yang , Hirdes John P , Dubin Joel A , Lee Joon
Published: October 2018

BACKGROUND

 Little is known about whether off-the-shelf wearable sensor data can contribute to fall risk classification or complement clinical assessment tools such as the Resident Assessment Instrument-Home Care (RAI-HC).

OBJECTIVE

 This study aimed to (1) investigate the similarities and differences in physical activity (PA), heart rate, and night sleep in a sample of community-dwelling older adults with varying fall histories using a smart wrist-worn device and (2) create and evaluate fall risk classification models based on (i) wearable data, (ii) the RAI-HC, and (iii) the combination of wearable and RAI-HC data.

METHODS

 A prospective, observational study was conducted among 3 faller groups (G0, G1, G2+) based on the number of previous falls (0, 1, ≥2 falls) in a sample of older community-dwelling adults. Each participant was requested to wear a smart wristband for 7 consecutive days while carrying out day-to-day activities in their normal lives. The wearable and RAI-HC assessment data were analyzed and utilized to create fall risk classification models, with 3 supervised machine learning algorithms: logistic regression, decision tree, and random forest (RF).

RESULTS

 Of 40 participants aged 65 to 93 years, 16 (40%) had no previous falls, whereas 8 (20%) and 16 (40%) had experienced 1 and multiple (≥2) falls, respectively. Level of PA as measured by average daily steps was significantly different between groups (P=.04). In the 3 faller group classification, RF achieved the best accuracy of 83.8% using both wearable and RAI-HC data, which is 13.5% higher than that of using the RAI-HC data only and 18.9% higher than that of using wearable data exclusively. In discriminating between {G0+G1} and G2+, RF achieved the best area under the receiver operating characteristic curve of 0.894 (overall accuracy of 89.2%) based on wearable and RAI-HC data. Discrimination between G0 and {G1+G2+} did not result in better classification performance than that between {G0+G1} and G2+.

CONCLUSIONS

 Both wearable data and the RAI-HC assessment can contribute to fall risk classification. All the classification models revealed that RAI-HC outperforms wearable data, and the best performance was achieved with the combination of 2 datasets. Future studies in fall risk assessment should consider using wearable technologies to supplement resident assessment instruments.
Young People’s Satisfaction With the Online Mental Health Service eheadspace: Development and Implementation of a Service Satisfaction Measure (Preprint)
Authors: Rickwood Debra , Wallace Alison , Kennedy Vanessa , O’Sullivan Shaunagh , Telford Nic , Leicester Steven
Published: October 2018

BACKGROUND

Online youth mental health services are an expanding approach to meeting service need and can be used as the first step in a stepped-care approach. However, limited evidence exists regarding satisfaction with online services, and there is no standardized service satisfaction measure.

OBJECTIVE

This study implemented an online youth mental health service satisfaction questionnaire within eheadspace, an online youth mental health service. The aims were to test the questionnaire’s psychometric properties and identify current levels of satisfaction among service users, as well as to identify client and service contact characteristics that affect satisfaction.

METHODS

Data were collected from 2280 eheadspace clients via an online questionnaire advertised and accessed through the eheadspace service platform between September 2016 and February 2018. Client and service contact characteristics, potential outcomes, and session and service feedback data were collected.

RESULTS

The service satisfaction questionnaire demonstrated high internal consistency for the overall satisfaction scale (alpha=.95) and its three subscales: session satisfaction, potential outcomes, and service satisfaction. A three-factor model was the best fit to the data, although including a higher order unidimensional construct of overall satisfaction was also a reasonable fit. Overall, young people were very satisfied with eheadspace (mean 3.60, SD 0.83). Service characteristics, but not client characteristics, were significantly associated with satisfaction. Young people were more satisfied with eheadspace when they had greater engagement as evident through receiving esupport rather than briefer service provision, having a longer session and greater interaction with the clinician, and not previously attending a face-to-face headspace center.

CONCLUSIONS

The online youth mental health service satisfaction questionnaire developed for and implemented in eheadspace showed good psychometric properties. The measure is brief, has good internal consistency, and has a clear factor structure. The measure could be adapted for use in other online youth mental health services. The young people using eheadspace and completing the feedback survey were highly satisfied. Greater engagement with the online service was shown to be associated with greater satisfaction. No specific client demographic groups were shown to be more or less satisfied.
A Digital Behavioral Weight Gain Prevention Intervention in Primary Care Practice: Cost and Cost-Effectiveness Analysis (Preprint)
Authors: Krishnan Anirudh , Finkelstein Eric Andrew , Levine Erica , Foley Perry , Askew Sandy , Steinberg Dori , Bennett Gary G
Published: October 2018

BACKGROUND

Obesity is one of the largest drivers of health care spending but nearly half of the population with obesity demonstrate suboptimal readiness for weight loss treatment. Black women are disproportionately likely to have both obesity and limited weight loss readiness. However, they have been shown to be receptive to strategies that prevent weight gain.

OBJECTIVE

The aim of this study was to evaluate the costs and cost-effectiveness of a digital weight gain prevention intervention (Shape) for black women. Shape consisted of adaptive telephone-based coaching by health system personnel, a tailored skills training curriculum, and patient self-monitoring delivered via a fully automated interactive voice response system.

METHODS

A cost and cost-effectiveness analysis based on a randomized clinical trial of the Shape intervention was conducted from the payer perspective. Costs included those of delivering the program to 91 intervention participants in the trial and were summarized by program elements: self-monitoring, skills training, coaching, and administration. Effectiveness was measured in quality-adjusted life years (QALYs). The primary outcome was the incremental cost per QALY of Shape relative to usual care.

RESULTS

Shape cost an average of US $758 per participant. The base-case model in which quality of life benefits decay linearly to zero 5 years post intervention cessation, generated an incremental cost-effectiveness ratio (ICER) of US $55,264 per QALY. Probabilistic sensitivity analyses suggest an ICER below US $50,000 per QALY and US $100,000 per QALY in 39% and 98% of simulations, respectively. Results are highly sensitive to durability of benefits, rising to US $165,730 if benefits end 6 months post intervention.

CONCLUSIONS

Results suggest that the Shape intervention is cost-effective based on established benchmarks, indicating that it can be a part of a successful strategy to address the nation’s growing obesity epidemic in low-income at-risk communities.
Improved Real-Time Influenza Surveillance: Using Internet Search Data in Eight Latin American Countries (Preprint)
Authors: Clemente Leonardo , Lu Fred , Santillana Mauricio
Published: October 2018

BACKGROUND

Novel influenza surveillance systems that leverage Internet-based real-time data sources including Internet search frequencies, social-network information, and crowd-sourced flu surveillance tools have shown improved accuracy over the past few years in data-rich countries like the United States. These systems not only track flu activity accurately, but they also report flu estimates a week or more ahead of the publication of reports produced by healthcare-based systems, such as those implemented and managed by the Centers for Disease Control and Prevention. Previous work has shown that the predictive capabilities of novel flu surveillance systems, like Google Flu Trends (GFT), in developing countries in Latin America have not yet delivered acceptable flu estimates.

OBJECTIVE

The aim of this study was to show that recent methodological improvements on the use of Internet search engine information to track diseases can lead to improved retrospective flu estimates in multiple countries in Latin America.

METHODS

A machine learning-based methodology that uses flu-related Internet search activity and historical information to monitor flu activity, named ARGO (AutoRegression with Google search), was extended to generate flu predictions for 8 Latin American countries (Argentina, Bolivia, Brazil, Chile, Mexico, Paraguay, Peru, and Uruguay) for the time period: January 2012 to December of 2016. These retrospective (out-of-sample) Influenza activity predictions were compared with historically observed flu suspected cases in each country, as reported by Flunet, an influenza surveillance database maintained by the World Health Organization. For a baseline comparison, retrospective (out-of-sample) flu estimates were produced for the same time period using autoregressive models that only leverage historical flu activity information.

RESULTS

Our results show that ARGO-like models’ predictive power outperform autoregressive models in 6 out of 8 countries in the 2012-2016 time period. Moreover, ARGO significantly improves on historical flu estimates produced by the now discontinued GFT for the time period of 2012-2015, where GFT information is publicly available.

CONCLUSIONS

We demonstrate here that a self-correcting machine learning method, leveraging Internet-based disease-related search activity and historical flu trends, has the potential to produce reliable and timely flu estimates in multiple Latin American countries. This methodology may prove helpful to local public health officials who design and implement interventions aimed at mitigating the effects of influenza outbreaks. Our methodology generally outperforms both the now-discontinued tool GFT, and autoregressive methodologies that exploit only historical flu activity to produce future disease estimates.
Effectiveness of Text Message Reminders on Adherence to Inhaled Therapy in Patients With Asthma: Prospective Multicenter Randomized Clinical Trial (Preprint)
Authors: Almonacid Carlos , Melero Carlos , López Viña Antolín , Cisneros Carolina , Pérez de Llano Luis , Plaza Vicente , García-Rivero Juan Luis , Romero Falcón Auxiliadora , Ramos Jacinto , Bazús González Teresa , Andrés Prado María , Muriel Alfonso
Published: October 2018

BACKGROUND

Poor adherence to inhaled medication in asthma patients is of great concern. It is one of the main reasons for inadequate asthma control.

OBJECTIVE

The goal of the research was to determine if motivational messages using short message service (SMS, or text) improved adherence to inhaled medication in patients with asthma.

METHODS

A prospective multicenter randomized parallel-group clinical trial was conducted in 10 asthma clinics in Spain. Adherence was assessed with electronic monitors (Smartinhaler, Adherium Ltd) connected to inhalers. Patients in the SMS group received psychologist-developed motivational messages every 3 days for 6 months.

RESULTS

There were 53 patients in the SMS group and 88 patients in the control group. After 6 months, mean electronic adherence was 70% (SD 17%) in the intervention group and 69% (SD 17%) in the control group (P=.82). Significant differences between the study groups in morning and evening adherence to inhaled therapy, asthma control, exhaled nitric oxide levels, or improvement of lung functions were not observed.

CONCLUSIONS

Motivational messages were not useful to improve adherence to inhaled asthma medication compared with usual care.
Usability Testing of a Mobile App to Report Medication Errors Anonymously: Mixed-Methods Approach (Preprint)
Authors: George Doris , Hassali Mohamed Azmi , HSS Amar-Singh
Published: October 2018

BACKGROUND

Reporting of medication errors is one of the essential mechanisms to identify risky health care systems and practices that lead to medication errors. Unreported medication errors are a real issue; one of the identified causes is a burdensome medication error reporting system. An anonymous and user-friendly mobile app for reporting medication errors could be an alternative method of reporting medication error in busy health care settings.

OBJECTIVE

The objective of this paper is to report usability testing of the Medication Error Reporting App (MERA), a mobile app for reporting medication errors anonymously.

METHODS

Quantitative and qualitative methods were employed involving 45 different testers (pharmacists, doctors, and nurses) from a large tertiary hospital in Malaysia. Quantitative data was retrieved using task performance and rating of MERA and qualitative data were retrieved through focus group discussions. Three sessions, with 15 testers each session, were conducted from January to March 2018.

RESULTS

The majority of testers were pharmacists (23/45, 51%), female (35/45, 78%), and the mean age was 36 (SD 9) years. A total of 135 complete reports were successfully submitted by the testers (three reports per tester) and 79.2% (107/135) of the reports were correct. There was significant improvement in mean System Usability Scale scores in each session of the development process (P<.001) and mean time to report medication errors using the app was not significantly different between each session (P=.70) with an overall mean time of 6.7 (SD 2.4) minutes. Testers found the app easy to use, but doctors and nurses were unfamiliar with terms used especially medication process at which error occurred and type of error. Although, testers agreed the app can be used in the future for reporting, they were apprehensive about security, validation, and abuse of feedback featured in the app.

CONCLUSIONS

MERA can be used to report medication errors easily by various health care personnel and it has the capacity to provide feedback on reporting. However, education on medication error reporting should be provided to doctors and nurses in Malaysia and the security of the app needs to be established to boost reporting by this method.
Do Search Engine Helpline Notices Aid in Preventing Suicide? Analysis of Archival Data (Preprint)
Authors: Cheng Qijin , Yom-Tov Elad
Published: October 2018

BACKGROUND

Search engines display helpline notices when people query for suicide-related information.

OBJECTIVE

In this study, we aimed to examine if these notices and other information displayed in response to suicide-related queries are correlated with subsequent searches for suicide prevention rather than harmful information.

METHODS

Anonymous suicide-related searches made on Bing and Google in the United States, the United Kingdom, Hong Kong, and Taiwan in a span of 10 months were extracted. Descriptive analyses and regression models were fit to the data to assess the correlation with observed behaviors.

RESULTS

Display of helpline notices was not associated with an observed change in the likelihood of or future suicide searches (P=.42). No statistically significant differences were observed in the likelihood of people making future suicide queries (both generally and specific types of suicide queries) when comparing search engines in locations that display helpline notices versus ones that do not. Pages with higher rank, being neutral to suicide, and those shown among more antisuicide pages were more likely to be clicked on. Having more antisuicide Web pages displayed was the only factor associated with further searches for suicide prevention information (hazard=1.18, P=.002).

CONCLUSIONS

Helpline notices are not associated with harm. If they cause positive change in search behavior, it is small. This is possibly because of the variability in intent of users seeking suicide-related information. Nonetheless, helpline notice should be displayed, but more efforts should be made to improve the visibility and ranking of suicide prevention Web pages.
Factors Influencing User Engagement of Health Information Disseminated by Chinese Provincial Centers for Disease Control and Prevention on WeChat: Observational Study (Preprint)
Authors: Zhang Yan , Xia Tingsong , Huang Lingfeng , Yin Mingjuan , Sun Mingwei , Huang Jingxiao , Ni Yu , Ni Jindong
Published: October 2018

BACKGROUND

Social media is currently becoming a new channel for information acquisition and exchange. In China, with the growing popularity of WeChat and WeChat official accounts (WOAs), health promotion agencies have an opportunity to use them for successful information distribution and diffusion online.

OBJECTIVE

We aimed to identify features of articles pushed by WOAs of Chinese provincial Centers for Disease Control and Prevention (CDC) that are associated with user engagement.

METHODS

We searched and subscribed to 28 WOAs of provincial CDCs. Data for this study consisted of WeChat articles on these WOAs between January 1, 2017 and December 31, 2017. We developed a features frame containing title type, article content, article type, communication skills, number of marketing elements, and article length for each article and coded the data quantitatively using a coding scheme that assigned numeric values to article features. We examined the descriptive characteristics of articles for every WOA and generated descriptive statistics for six article features. The amount of reading and liking was converted into the level of reading and liking by the 75% position. Two-category univariate logistic regression and multivariable logistic regression were conducted to explore associations between the features of the articles and user engagement, operationalized as reading level and liking level.

RESULTS

All provincial CDC WOAs provided a total of 5976 articles in 2017. Shanghai CDC articles attracted the most user engagement, and Ningxia CDC articles attracted the least. For all articles, the median reading was 551.5 and the median liking was 10. Multivariable logistic regression analysis revealed that article content, article type, communication skills, number of marketing elements, and article length were associated with reading level and liking level. However, title type was only associated with liking level.

CONCLUSIONS

How social media can be used to best achieve health information dissemination and public health outcomes is a topic of much discussion and study in the public health community. Given the lack of related studies based on WeChat or official accounts, we conducted this study and found that article content, article type, communication skills, number of marketing elements, article length, and title type were associated with user engagement. Our study may provide public health and community leaders with insight into the diffusion of important health topics of concern.
Use of Mobile and Computer Devices to Support Recovery in People With Serious Mental Illness: Survey Study (Preprint)
Authors: Noel Valerie A , Acquilano Stephanie C , Carpenter-Song Elizabeth , Drake Robert E
Published: October 2018

BACKGROUND

Mental health recovery refers to an individual’s experience of gaining a sense of personal control, striving towards one’s life goals, and meeting one’s needs. Although people with serious mental illness own and use electronic devices for general purposes, knowledge of their current use and interest in future use for supporting mental health recovery remains limited.

OBJECTIVE

This study aimed to identify smartphone, tablet, and computer apps that mental health service recipients use and want to use to support their recovery.

METHODS

In this pilot study, we surveyed a convenience sample of 63 mental health service recipients with serious mental illness. The survey assessed current use and interest in mobile and computer devices to support recovery.

RESULTS

Listening to music (60%), accessing the internet (59%), calling (59%), and texting (54%) people were the top functions currently used by participants on their device to support their recovery. Participants expressed interest in learning how to use apps for anxiety/stress management (45%), mood management (45%), monitoring mental health symptoms (43%), cognitive behavioral therapy (40%), sleep (38%), and dialectical behavior therapy (38%) to support their recovery.

CONCLUSIONS

Mental health service recipients currently use general functions such as listening to music and calling friends to support recovery. Nevertheless, they reported interest in trying more specific illness-management apps.
Using Twitter to Detect Psychological Characteristics of Self-Identified Persons With Autism Spectrum Disorder: A Feasibility Study (Preprint)
Authors: Hswen Yulin , Gopaluni Anuraag , Brownstein John S , Hawkins Jared B
Published: October 2018

BACKGROUND

More than 3.5 million Americans live with autism spectrum disorder (ASD). Major challenges persist in diagnosing ASD as no medical test exists to diagnose this disorder. Digital phenotyping holds promise to guide in the clinical diagnoses and screening of ASD.

OBJECTIVE

This study aims to explore the feasibility of using the Web-based social media platform Twitter to detect psychological and behavioral characteristics of self-identified persons with ASD.

METHODS

Data from Twitter were retrieved from 152 self-identified users with ASD and 182 randomly selected control users from March 22, 2012 to July 20, 2017. We conducted a between-group comparative textual analysis of tweets about repetitive and obsessive-compulsive behavioral characteristics typically associated with ASD. In addition, common emotional characteristics of persons with ASD, such as fear, paranoia, and anxiety, were examined between groups through textual analysis. Furthermore, we compared the timing of tweets between users with ASD and control users to identify patterns in communication.

RESULTS

Users with ASD posted a significantly higher frequency of tweets related to the specific repetitive behavior of counting compared with control users (P<.001). The textual analysis of obsessive-compulsive behavioral characteristics, such as fixate, excessive, and concern, were significantly higher among users with ASD compared with the control group (P<.001). In addition, emotional terms related to fear, paranoia, and anxiety were tweeted at a significantly higher rate among users with ASD compared with control users (P<.001). Users with ASD posted a smaller proportion of tweets during time intervals of 00:00-05:59 (P<.001), 06:00-11:59 (P<.001), and 18:00-23.59 (P<.001), as well as a greater proportion of tweets from 12:00 to 17:59 (P<.001) compared with control users.

CONCLUSIONS

Social media may be a valuable resource for observing unique psychological characteristics of self-identified persons with ASD. Collecting and analyzing data from these digital platforms may afford opportunities to identify the characteristics of ASD and assist in the diagnosis or verification of ASD. This study highlights the feasibility of leveraging digital data for gaining new insights into various health conditions.
A Qualitative Evaluation of the Acceptability of a Tailored Smartphone Alcohol Intervention for a Military Population: Information About Drinking for Ex-Serving Personnel (InDEx) App (Preprint)
Authors: Puddephatt Jo-Anne , Leightley Daniel , Palmer Laura , Jones Norman , Mahmoodi Toktam , Drummond Colin , Rona Roberto J , Fear Nicola T , Field Matt , Goodwin Laura
Published: October 2018

BACKGROUND

Alcohol consumption in the UK Armed Forces is higher than in the general population, and this pattern continues after leaving the service. Smartphone apps may be useful to increase ex-serving personnel’s awareness of their alcohol consumption, support self-monitoring, and prompt a change in behavior.

OBJECTIVE

The study aimed to explore the acceptability of Information about Drinking in Ex-serving personnel (InDEx), a tailored smartphone app, combined with personalized short message service (SMS) text messaging designed to target ex-serving personnel who meet the criteria for hazardous alcohol use.

METHODS

The InDEx intervention included 4 key modules: (1) assessment and normative feedback, (2) self-monitoring and feedback, (3) goal setting and review, and (4) personalized SMS text messaging. A semistructured telephone interview study was conducted with ex-serving personnel after using the app for a 28-day period. Interviews were used to explore the acceptability of app modules and its functionality and the perceived changes in participant’s drinking. Interview transcripts were analyzed using inductive thematic analysis.

RESULTS

Overall, 94% (29/31) participants who used InDEx agreed to take part in a telephone interview. Overall, 4 themes were identified: Credibility, Meeting their needs, Simplicity, and Helpful for ex-serving personnel. The importance of credibility, functionality, and meeting the individual needs of ex-serving personnel was emphasized. Acceptability and engagement with specific modules of the app and text messages were influenced by the following: (1) if they felt it provided credible information, (2) whether the content was appropriately personalized to them, (3) the ease of use, and (4) beliefs about their own drinking behaviors. Participants recommended that the app would be most suitable for personnel about to leave the Armed Forces.

CONCLUSIONS

InDEx was an acceptable smartphone app for ex-serving personnel for monitoring alcohol consumption and in providing meaningful feedback to the individual. Pages that met the participant’s interests and provided real time personalized, credible feedback on their drinking and text messages tailored to participant’s interactions with the app were particularly favored.
Association Between Residual Inhibition and Neural Activity in Patients with Tinnitus: Protocol for a Controlled Within- and Between-Subject Comparison Study (Preprint)
Authors: Hu Suyi , Anschuetz Lukas , Huth Markus E , Sznitman Raphael , Blaser Daniela , Kompis Martin , Hall Deborah A , Caversaccio Marco , Wimmer Wilhelm
Published: October 2018

BACKGROUND

Electroencephalography (EEG) studies indicate possible associations between tinnitus and changes in the neural activity. However, inconsistent results require further investigation to better understand such heterogeneity and inform the interpretation of previous findings.

OBJECTIVE

This study aims to investigate the feasibility of EEG measurements as an objective indicator for the identification of tinnitus-associated neural activities.

METHODS

To reduce heterogeneity, participants served as their own control using residual inhibition (RI) to modulate the tinnitus perception in a within-subject EEG study design with a tinnitus group. In addition, comparison with a nontinnitus control group allowed for a between-subjects comparison. We will apply RI stimulation to generate tinnitus and nontinnitus conditions in the same subject. Furthermore, high-frequency audiometry (up to 13 kHz) and tinnitometry will be performed.

RESULTS

This work was funded by the Infrastructure Grant of the University of Bern, Bern, Switzerland and Bernafon AG, Bern, Switzerland. Enrollment for the study described in this protocol commenced in February 2018. Data analysis is currently under way and the first results are expected to be submitted for publication in 2019.

CONCLUSIONS

This study design helps in comparing the neural activity between conditions in the same individual, thereby addressing a notable limitation of previous EEG tinnitus studies. In addition, the high-frequency assessment will help to analyze and classify tinnitus symptoms beyond the conventional clinical standard.

INTERNATIONAL REGISTERED REPOR

PRR1-10.2196/12270
Technology-Supported Self-Guided Nutrition and Physical Activity Interventions for Adults With Cancer: Systematic Review (Preprint)
Authors: Kiss Nicole , Baguley Brenton James , Ball Kylie , Daly Robin M , Fraser Steve F , Granger Catherine L , Ugalde Anna
Published: October 2018

BACKGROUND

Nutrition and physical activity interventions are important components of cancer care. With an increasing demand for services, there is a need to consider flexible, easily accessible, and tailored models of care while maintaining optimal outcomes.

OBJECTIVE

This systematic review describes and appraises the efficacy of technology-supported self-guided nutrition and physical activity interventions for people with cancer.

METHODS

A systematic search of multiple databases from 1973 to July 2018 was conducted for randomized and nonrandomized trials investigating technology-supported self-guided nutrition and physical activity interventions. Risk of bias was assessed using the Cochrane Risk of Bias tool. Outcomes included behavioural, health-related, clinical, health service, or financial measures.

RESULTS

Sixteen randomized controlled trials representing 2684 participants were included. Most studies were web-based interventions (n=9) and had a 12-week follow-up duration (n=8). Seven studies assessed dietary behaviour, of which two reported a significant benefit on diet quality or fruit and vegetable intake. Fifteen studies measured physical activity behaviour, of which eight studies reported a significant improvement in muscle strength and moderate-to-vigorous physical activity. Four of the nine studies assessing the health-related quality of life (HRQoL) reported a significant improvement in global HRQoL or a domain subscale. A significant improvement in fatigue was found in four of six studies. Interpretation of findings was influenced by inadequate reporting of intervention description and compliance.

CONCLUSIONS

This review identified short-term benefits of technology-supported self-guided interventions on the physical activity level and fatigue and some benefit on dietary behaviour and HRQoL in people with cancer. However, current literature demonstrates a lack of evidence for long-term benefit.

CLINICALTRIAL

PROSPERO CRD42017080346; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=80346