bluuebunny/crossref_metadata_2025_split huggingface dataset:
PRObiotics and SYNbiotics to improve gut health and growth in infants in western Kenya (PROSYNK Trial): Study protocol for a 4-arm, open-label, randomised, controlled trial.
Authors: Otiti Mary Iwaret , Kariuki Simon , Wang Duolao , Hall Lindsay J. , Kuile Feiko O. Ter , Allen Stephen 
Published: February 2022

Abstract
BackgroundMalnutrition amongst under-fives remains common in resource-poor countries and is resistant to current interventions. New opportunities have emerged to target “environmental enteric dysfunction” (EED) that refers to the abnormal gut structure and function that results from colonisation of the gut with pathogenic microbes and compromises nutrition and growth in early life. Although the gut microbiome may provide a defence against ingested gut pathogens through colonisation resistance, its development is adversely affected by multiple environmental factors. Dietary supplements of pro- or synbiotics may build the resilience of the gut microbiome against these environmental factors and boost colonisation resistance. We aim to assess whether dietary supplementation of newborns in rural Kenya with pro/synbiotics prevents or ameliorates EED and improves growth.MethodsSix hundred newborns less than four days old will be recruited from Homa Bay County Teaching and Referral Hospital, western Kenya. Newborns will be randomly allocated, stratified by HIV exposure, in a 1:1:1:1 ratio to one of 4 study arms to receive either of two synbiotics, a probiotic or no supplement. Supplements will be given daily for ten days and then weekly until six months of age. Participants will be followed until the age of two years. The primary outcome is systemic inflammation at six months assessed by plasma alpha-1-acid glycoprotein. Secondary outcomes include biomarkers of gut health and growth, anthropometric indices, morbidity and mortality.DiscussionAs dietary supplements with pro- or synbiotics may improve gut health and can be administered in early life, our findings may inform the package of interventions to prevent malnutrition and improve growth in Africa and similar low-resource settings.Trial registrationPan African Clinical Trials Registry, Trial number: PACTR202003893276712. Date: 02/03/2020 https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=9798
COVID-19 case prediction via wastewater surveillance in a low-prevalence urban community: a modeling approach
Authors: Zhu Yifan , Oishi Wakana , Maruo Chikako , Bandara Sewwandi , Lin Mu , Saito Mayuko , Kitajima Masaaki , Sano Daisuke 
Published: February 2022

Abstract
Estimating and predicting the epidemic size from wastewater surveillance results remains challenging for the practical implementation of wastewater-based epidemiology (WBE). In this study, by employing a highly sensitive detection method, we documented the time series of SARS-CoV-2 RNA occurrence in the wastewater influent from an urban community with a 360,000 population in Japan, from August 2020 to February 2021. The detection frequency of the viral RNA increased during the outbreak events of COVID-19 and the highest viral RNA concentration was recorded at the beginning of January 2021, amid the most serious outbreak event during the study period. We found that: (1) direct back-calculation still suffers from great uncertainty dominated by inconsistent detection and the varying gap between the observed wastewater viral load and the estimated patient viral load, and (2) the detection frequency correlated well with reported cases and the prediction of the latter can be carried out via data-driven modeling methods. Our results indicate that wastewater virus occurrence can contribute to epidemic surveillance in ways more than back-calculation, which may spawn future wastewater surveillance implementations.
Establishment of local wastewater-based surveillance programmes in response to the spread and infection of COVID-19 – case studies from South Africa, the Netherlands, Turkey and England
Authors: Tlhagale M. , Liphadzi S. , Bhagwan J. , Naidoo V. , Jonas K. , van Vuuren L. , Medema G. , Andrews L. , Béen F. , Ferreira M. L. , Saatci A. M. , Alpaslan Kocamemi B. , Hassard F. , Singer A. C. , Bunce J. T. , Grimsley J. M. S. , Brown M. , Jones D. L. 
Published: February 2022

Abstract
The COVID-19 pandemic has resulted in over 340 million infection cases (as of 21 January 2022) and more than 5.57 million deaths globally. In reaction, science, technology and innovation communities across the globe have organised themselves to contribute to national responses to COVID-19 disease. A significant contribution has been from the establishment of wastewater-based epidemiological (WBE) surveillance interventions and programmes for monitoring the spread of COVID-19 in at least 55 countries. Here, we examine and share experiences and lessons learnt in establishing such surveillance programmes. We use case studies to highlight testing methods and logistics considerations associated in scaling the implementing of such programmes in South Africa, the Netherlands, Turkey and England. The four countries were selected to represent different regions of the world and the perspective based on the considerable progress made in establishing and implementing their national WBE programmes. The selected countries also represent different climatic zones, economies, and development stages, which influence the implementation of national programmes of this nature and magnitude. In addition, the four countries' programmes offer good experiences and lessons learnt since they are systematic, and cover extensive areas, disseminate knowledge locally and internationally and partnered with authorities (government). The programmes also strengthened working relations and partnerships between and among local and global organisations. This paper shares these experiences and lessons to encourage others in the water and public health sectors on the benefits and value of WBE in tackling SARS-CoV-2 and related future circumstances.
A Conceptual Framework to Design Connected Mental Health Solutions in the United Arab Emirates: Questionnaire Study
Authors: Drissi Nidal , Ouhbi Sofia , Amiri Leena , Al Mugaddam Fadwa , Jan Reem K , Isomursu Minna 
Published: February 2022

Background
Connected mental health (CMH) is a field presenting information and communications technology–based mental care interventions that could help overcome many mental care delivery barriers. Culture and background influence people’s attitudes, preferences, and acceptance of such solutions. Therefore, the suitability of CMH solutions to the targeted population is an important factor in their successful adoption.

Objective
The aim of this study is to develop a framework for the design and creation of CMH solutions suitable for the UAE context. The framework is based on investigating enablers and barriers of CMH adoption in the United Arab Emirates, from the mental health professional's (MHP) perspective and from related literature.

Methods
A survey of literature on relevant studies addressing the use of technology for mental care in Arab countries, and a web-based questionnaire-based survey with 17 MHPs practicing in the United Arab Emirates investigating their attitudes and views toward CMH was conducted. Results from the questionnaire and from related studies were analyzed to develop the design framework.

Results
On the basis of findings from the literature survey and analyzing MHP answers to the web-based survey, a framework for the design of CMH solutions for the UAE population was developed. The framework presents four types of recommendation categories: favorable criteria, which included blended care, anonymity, and ease of use; cultural factors including availability in multiple languages, mainly Arabic and English, in addition to religious and cultural considerations; technical considerations, including good-quality communication, availability in formats compatible with mobile phones, and providing technical support; and users’ health and data safety considerations, including users’ suitability testing, confidentiality, and ensuring MHP integrity.

Conclusions
CMH has the potential to help overcome many mental care barriers in the United Arab Emirates in particular and in the Arab world in general. CMH adoption in the United Arab Emirates has a potential for success. However, many factors should be taken into account, mainly cultural, religious, and linguistic aspects.
Medication Optimization Among People With Type 2 Diabetes Participating in a Continuous Glucose Monitoring–Driven Virtual Care Program: Prospective Study
Authors: Majithia Amit R , Erani David M , Kusiak Coco M , Layne Jennifer E , Lee Amy Armento , Colangelo Francis R , Romanelli Robert J , Robertson Scott , Brown Shayla M , Dixon Ronald F , Zisser Howard 
Published: February 2022

Background
The Onduo virtual care program for people with type 2 diabetes (T2D) includes a mobile app, remote lifestyle coaching, connected devices, and telemedicine consultations with endocrinologists for medication management and prescription of real-time continuous glucose monitoring (RT-CGM) devices. In a previously described 4-month prospective study of this program, adults with T2D and baseline glycated hemoglobin (HbA1c) ≥8.0% to ≤12.0% experienced a mean HbA1c decrease of 1.6% with no significant increase in hypoglycemia.

Objective
The objective of this analysis was to evaluate medication optimization and management in the 4-month prospective T2D study.

Methods
Study participants received at least 1 telemedicine consultation with an Onduo endocrinologist for diabetes medication management and used RT-CGM intermittently to guide therapy and dosing. Medication changes were analyzed.

Results
Of 55 participants, 48 (87%) had a medication change consisting of a dose change, addition, or discontinuation. Of these, 15 (31%) participants had a net increase in number of diabetes medication classes from baseline. Mean time to first medication change for these participants was 36 days. The percentage of participants taking a glucagon-like peptide-1 receptor agonist increased from 25% (12/48) to 56% (n=27), while the percentages of participants taking a sulfonylurea or dipeptidyl peptidase 4 inhibitor decreased from 56% (n=27) to 33% (n=16) and 17% (n=8) to 6% (n=3), respectively. Prescriptions of other antidiabetic medication classes including insulin did not change significantly.

Conclusions
The Onduo virtual care program can play an important role in providing timely access to guideline-based diabetes management medications and technologies for people with T2D.

Trial Registration
ClinicalTrials.gov NCT03865381; https://clinicaltrials.gov/ct2/show/NCT03865381
Participatory Methods for Systems Modeling of Youth Mental Health: Implementation Protocol
Authors: Freebairn Louise , Occhipinti Jo-An , Song Yun Ju C , Skinner Adam , Lawson Kenny , Lee Grace Yeeun , Hockey Samuel J , Huntley Samantha , Hickie Ian B 
Published: February 2022

Background
Despite significant investment, mental health issues remain a leading cause of death among young people globally. Sophisticated decision analysis methods are needed to better understand the dynamic and multisector drivers of youth mental health. System modeling can help explore complex issues such as youth mental health and inform strategies to effectively respond to local needs and achieve lasting improvements. The advantages of engaging stakeholders in model development processes have long been recognized; however, the methods for doing so are often not well-described.

Objective
This paper aims to describe the participatory procedures that will be used to support systems modeling for national multisite implementation. The Right Care, First Time, Where You Live research program will focus on regional youth mental health applications of systems modeling in 8 different sites across Australia.

Methods
The participatory model development approach involves an iterative process of engaging with a range of participants, including people with lived experience of mental health issues. Their knowledge of the local systems, pathways, and drivers is combined with the academic literature and data to populate the models and validate their structure. The process centers around 3 workshops where participants interact and actively engage in group model-building activities to define, refine, and validate the systems models. This paper provides a detailed blueprint for the implementation of this process for mental health applications.

Results
The participatory modeling methods described in this paper will be implemented at 2 sites per year from 2022 to 2025. The 8 selected sites have been chosen to capture variations in important factors, including determinants of mental health issues and access to services. Site engagement commenced in August 2021, and the first modeling workshops are scheduled to commence in February 2022.

Conclusions
Mental health system decision makers require tools to help navigate complex environments and leverage interdisciplinary problem-solving. Systems modeling can mobilize data from diverse sources to explore a range of scenarios, including the impact of interventions in different combinations and contexts. Involving stakeholders in the model development process ensures that the model findings are context-relevant and fit-for-purpose to inform decision-making.

International Registered Report Identifier (IRRID)
PRR1-10.2196/32988
Internet-Delivered Interventions for Depression and Anxiety Symptoms in Children and Young People: Systematic Review and Meta-analysis
Authors: Eilert Nora , Wogan Rebecca , Leen Aisling , Richards Derek 
Published: February 2022

Background
Mental health difficulties in children and adolescents are highly prevalent; however, only a minority receive adequate mental health care. Internet-delivered interventions offer a promising opportunity to increase access to mental health treatment. Research has demonstrated their effectiveness as a treatment for depression and anxiety in adults. This work provides an up-to-date examination of the available intervention options and their effectiveness for children and young people (CYP).

Objective
In this systematic review and meta-analysis, we aimed to determine the evidence available for the effectiveness of internet-delivered interventions for treating anxiety and depression in CYP.

Methods
Systematic literature searches were conducted throughout November 2020 using PubMed, PsycINFO, and EBSCO academic search complete electronic databases to find outcome trials of internet-delivered interventions treating symptoms of anxiety and/or depression in CYP by being either directly delivered to the CYP or delivered via their parents. Studies were eligible for meta-analysis if they were randomized controlled trials. Risk of bias and publication biases were evaluated, and Hedges g between group effect sizes evaluating intervention effects after treatment were calculated. Meta-analyses used random-effects models as per protocol.

Results
A total of 23 studies met the eligibility criteria for the systematic review, of which 16 were included in the meta-analyses, including 977 participants in internet-delivered treatment conditions and 1008 participants in control conditions across 21 comparisons. Random-effects models detected a significant small effect for anxiety symptoms (across 20 comparisons; Hedges g=−0.25, 95% CI −0.38 to −0.12; P<.001) and a small but not significant effect for depression (across 13 comparisons; Hedges g=−0.27, 95% CI −0.55 to 0.01; P=.06) in favor of internet-delivered interventions compared with control groups. Regarding secondary outcomes, there was a small effect of treatment across 9 comparisons for impaired functioning (Hedges g=0.52, 95% CI 0.24-0.80; P<.001), and 5 comparisons of quality of life showed no effect (Hedges g=−0.01, 95% CI −0.23 to 0.21; P=.94).

Conclusions
The results show that the potential of internet-delivered interventions for young people with symptoms of anxiety or depression has not been tapped into to date. This review highlights an opportunity for the development of population-specific interventions and their research to expand our current knowledge and build an empirical base for digital interventions for CYP.

Trial Registration
PROSPERO CRD42020220171; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=220171
A Smartwatch Step-Counting App for Older Adults: Development and Evaluation Study
Authors: Boateng George , Petersen Curtis L , Kotz David , Fortuna Karen L , Masutani Rebecca , Batsis John A 
Published: February 2022

Background
Older adults who engage in physical activity can reduce their risk of mobility impairment and disability. Short amounts of walking can improve quality of life, physical function, and cardiovascular health. Various programs have been implemented to encourage older adults to engage in physical activity, but sustaining their motivation continues to be a challenge. Ubiquitous devices, such as mobile phones and smartwatches, coupled with machine-learning algorithms, can potentially encourage older adults to be more physically active. Current algorithms that are deployed in consumer devices (eg, Fitbit) are proprietary, often are not tailored to the movements of older adults, and have been shown to be inaccurate in clinical settings. Step-counting algorithms have been developed for smartwatches, but only using data from younger adults and, often, were only validated in controlled laboratory settings.

Objective
We sought to develop and validate a smartwatch step-counting app for older adults and evaluate the algorithm in free-living settings over a long period of time.

Methods
We developed and evaluated a step-counting app for older adults on an open-source wrist-worn device (Amulet). The app includes algorithms to infer the level of physical activity and to count steps. We validated the step-counting algorithm in the lab (counting steps from a video recording, n=20) and in free-living conditions—one 2-day field study (n=6) and two 12-week field studies (using the Fitbit as ground truth, n=16). During app system development, we evaluated 4 walking patterns: normal, fast, up and down a staircase, and intermittent speed. For the field studies, we evaluated 5 different cut-off values for the algorithm, using correlation and error rate as the evaluation metrics.

Results
The step-counting algorithm performed well. In the lab study, for normal walking (R2=0.5), there was a stronger correlation between the Amulet steps and the video-validated steps; for all activities, the Amulet’s count was on average 3.2 (2.1%) steps lower (SD 25.9) than the video-validated count. For the 2-day field study, the best parameter settings led to an association between Amulet and Fitbit (R2=0.989) and 3.1% (SD 25.1) steps lower than Fitbit, respectively. For the 12-week field study, the best parameter setting led to an R2 value of 0.669.

Conclusions
Our findings demonstrate the importance of an iterative process in algorithm development before field-based deployment. This work highlights various challenges and insights involved in developing and validating monitoring systems in real-world settings. Nonetheless, our step-counting app for older adults had good performance relative to the ground truth (a commercial Fitbit step counter). Our app could potentially be used to help improve physical activity among older adults.
The Experiences of Patients With Adjuvant and Metastatic Melanoma Using Disease-Specific Social Media Communities in the Advent of Novel Therapies (Excite Project): Social Media Listening Study
Authors: Faust Guy , Booth Alison , Merinopoulou Evie , Halhol Sonia , Tosar Heena , Nawaz Amir , Szlachetka Magdalena , Chiu Gavin 
Published: February 2022

Background
Immunotherapy and targeted therapy treatments are novel treatments available for patients with metastatic and adjuvant melanoma. As recently approved treatments, information surrounding the patients’ and caregivers’ experience with these therapies, perceptions of treatments, and the effect the treatments have on their day-to-day life are lacking. Such insights would be valuable for any future decision-making with regard to treatment options.

Objective
This study aims to use health-related social media data to understand the experience of patients with adjuvant and metastatic melanoma who are receiving either immunotherapy or targeted therapies. This study also included caregivers’ perspectives.

Methods
Publicly available social media forum posts by patients with self-reported adjuvant or metastatic melanoma (and their caregivers) between January 2014 to October 2019 were programmatically extracted, deidentified, cleaned, and analyzed using a combination of natural language processing and qualitative data analyses. This study identified spontaneously reported symptoms and their impacts, symptom duration, and the impact of treatment for both treatment groups.

Results
Overall, 1037 users (9023 posts) and 114 users (442 posts) were included in the metastatic group and adjuvant group, respectively. The most identified symptoms in both groups were fatigue, pain, or exanthema (identified in 5%-43% of patients dependent on the treatment group). Symptom impacts reported by both groups were physical impacts, impacts on family, and impacts on work. Positive treatment impacts were reported in both groups and covered the areas of work, social and family life, and general health and quality of life.

Conclusions
This study explored health-related social media to better understand the experience and perspectives of patients with melanoma receiving immunotherapy or targeted therapy treatments as well as the experience of their caregivers. This exploratory work uncovered the most discussed concerns among patients and caregivers on the forums including symptoms and their impacts, thus contributing to a deeper understanding of the patient/caregiver experience.