Tag: pubmed

J Med Internet Res. 2024 Nov 18;26:e52435. doi: 10.2196/52435.

ABSTRACT

BACKGROUND: The wearable monitoring device (WMD) is emerging as a promising tool for community-dwelling older adults to monitor personal health, enhance awareness of their activities, and promote healthy behaviors. However, the sustained use of WMDs among this population remains a significant challenge.

OBJECTIVE: This study aims to implement an interventional program that promotes and motivates the continued use of WMDs among older adults through a peer and professional support approach. This program will facilitate the integration of WMDs into their daily lives.

METHODS: This feasibility trial examined the following: (1) the usability of the WMD from the users’ perspectives; (2) the feasibility of the Live With Wearable Monitoring Device program; and (3) the effectiveness of the Live With Wearable Monitoring Device program among community-dwelling older adults. The intervention, based on Self-Determination Theory, involved using the Live With Wearable Monitoring Device program over a 3-month period, with ongoing professional and peer support provided by community health workers, aided by a nurse and social workers. This support included 1 home visit and biweekly communication via WhatsApp. Data were collected at baseline and at 1, 3, and 6 months.

RESULTS: A total of 39 participants were enrolled in the intervention group, while 37 participants were in the control group. The recruitment rate was high (76/89, 85%), and the attrition rate was low (8/76, 11%), indicating that the program is feasible for older adults. Participants in the intervention group exhibited higher self-efficacy, lower anxiety levels, and used the smartwatch more frequently, in terms of both days and hours, compared with the control group. A between-group difference was observed in self-efficacy between the intervention and control groups (β=3.31, 95% CI 0.36-6.25, P=.03), with statistically significant higher mean values recorded at all 4 time points.

CONCLUSIONS: It is clear that merely providing a WMD to older adults does not guarantee its usage, particularly for those unfamiliar with how to utilize its health-related functions in their daily routines. This study implemented a theory-based program aimed at enhancing the ongoing use of WMDs among older adults, suggesting that continuous professional and peer support may significantly influence WMD usage.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05269303; https://clinicaltrials.gov/ct2/show/NCT05269303.

PMID:39556810 | DOI:10.2196/52435

JMIR Rehabil Assist Technol. 2024 Nov 18;11:e55776. doi: 10.2196/55776.

ABSTRACT

BACKGROUND: Visual disability is a growing problem for many middle-aged and older adults. Conventional mobility aids, such as white canes and guide dogs, have notable limitations that have led to increasing interest in electronic travel aids (ETAs). Despite remarkable progress, current ETAs lack empirical evidence and realistic testing environments and often focus on the substitution or augmentation of a single sense.

OBJECTIVE: This study aims to (1) establish a novel virtual reality (VR) environment to test the efficacy of ETAs in complex urban environments for a simulated visual impairment (VI) and (2) evaluate the impact of haptic and audio feedback, individually and combined, on navigation performance, movement behavior, and perception. Through this study, we aim to address gaps to advance the pragmatic development of assistive technologies (ATs) for persons with VI.

METHODS: The VR platform was designed to resemble a subway station environment with the most common challenges faced by persons with VI during navigation. This environment was used to test our multisensory, AT-integrated VR platform among 72 healthy participants performing an obstacle avoidance task while experiencing symptoms of VI. Each participant performed the task 4 times: once with haptic feedback, once with audio feedback, once with both feedback types, and once without any feedback. Data analysis encompassed metrics such as completion time, head and body orientation, and trajectory length and smoothness. To evaluate the effectiveness and interaction of the 2 feedback modalities, we conducted a 2-way repeated measures ANOVA on continuous metrics and a Scheirer-Ray-Hare test on discrete ones. We also conducted a descriptive statistical analysis of participants’ answers to a questionnaire, assessing their experience and preference for feedback modalities.

RESULTS: Results from our study showed that haptic feedback significantly reduced collisions (P=.05) and the variability of the pitch angle of the head (P=.02). Audio feedback improved trajectory smoothness (P=.006) and mitigated the increase in the trajectory length from haptic feedback alone (P=.04). Participants reported a high level of engagement during the experiment (52/72, 72%) and found it interesting (42/72, 58%). However, when it came to feedback preferences, less than half of the participants (29/72, 40%) favored combined feedback modalities. This indicates that a majority preferred dedicated single modalities over combined ones.

CONCLUSIONS: AT is crucial for individuals with VI; however, it often lacks user-centered design principles. Research should prioritize consumer-oriented methodologies, testing devices in a staged manner with progression toward more realistic, ecologically valid settings to ensure safety. Our multisensory, AT-integrated VR system takes a holistic approach, offering a first step toward enhancing users’ spatial awareness, promoting safer mobility, and holds potential for applications in medical treatment, training, and rehabilitation. Technological advancements can further refine such devices, significantly improving independence and quality of life for those with VI.

PMID:39556804 | DOI:10.2196/55776

J Med Internet Res. 2024 Nov 18;26:e57476. doi: 10.2196/57476.

ABSTRACT

BACKGROUND: The development of technology and information systems has led to important changes in public health surveillance.

OBJECTIVE: This scoping review aimed to assess the available evidence and gather information about the use of digital tools for arbovirus (dengue virus [DENV], zika virus [ZIKV], and chikungunya virus [CHIKV]) surveillance.

METHODS: The databases used were MEDLINE, SCIELO, LILACS, SCOPUS, Web of Science, and EMBASE. The inclusion criterion was defined as studies that described the use of digital tools in arbovirus surveillance. The exclusion criteria were defined as follows: letters, editorials, reviews, case reports, series of cases, descriptive epidemiological studies, laboratory and vaccine studies, economic evaluation studies, and studies that did not clearly describe the use of digital tools in surveillance. Results were evaluated in the following steps: monitoring of outbreaks or epidemics, tracking of cases, identification of rumors, decision-making by health agencies, communication (cases and bulletins), and dissemination of information to society).

RESULTS: Of the 2227 studies retrieved based on screening by title, abstract, and full-text reading, 68 (3%) studies were included. The most frequent digital tools used in arbovirus surveillance were apps (n=24, 35%) and Twitter, currently called X (n=22, 32%). These were mostly used to support the traditional surveillance system, strengthening aspects such as information timeliness, acceptability, flexibility, monitoring of outbreaks or epidemics, detection and tracking of cases, and simplicity. The use of apps to disseminate information to society (P=.02), communicate (cases and bulletins; P=.01), and simplicity (P=.03) and the use of Twitter to identify rumors (P=.008) were statistically relevant in evaluating scores. This scoping review had some limitations related to the choice of DENV, ZIKV, and CHIKV as arboviruses, due to their clinical and epidemiological importance.

CONCLUSIONS: In the contemporary scenario, it is no longer possible to ignore the use of web data or social media as a complementary strategy to health surveillance. However, it is important that efforts be combined to develop new methods that can ensure the quality of information and the adoption of systematic measures to maintain the integrity and reliability of digital tools’ data, considering ethical aspects.

PMID:39556803 | DOI:10.2196/57476

JMIR Hum Factors. 2024 Nov 18;11:e55562. doi: 10.2196/55562.

ABSTRACT

BACKGROUND: Frontline health care staff are frequently exposed to traumatic events as part of their work. Although this study commenced before the emergence of COVID-19, levels of exposure were heightened by the pandemic. Many health care staff members report intrusive memories of such events, which can elicit distress, affect functioning, and be associated with posttraumatic stress disorder symptoms in the long term. We need evidence-based interventions that are brief, preventative, nonstigmatizing, suitable for the working lives of frontline health care staff, and effective for repeated trauma exposure. A brief, guided imagery-competing task intervention involving a trauma reminder cue and Tetris gameplay may hold promise in this regard, given evidence that it can prevent and reduce the number of intrusive memories following trauma across various settings.

OBJECTIVE: This case series aims to investigate the impact of a brief imagery-competing task intervention on the number of intrusive memories, general functioning, and symptoms of posttraumatic stress, anxiety, and depression, and examine the feasibility and acceptability of the intervention for UK National Health Service frontline health care staff. The intervention was delivered with guidance from a clinical psychologist.

METHODS: We recruited 12 clinical staff from the UK National Health Service, specifically from emergency departments, the intensive care unit, and the ambulance service. We evaluated the intervention using an AB single-case experimental design, where the baseline (A) was the monitoring-only phase and the postintervention (B) period was the time after the intervention was first administered. Methods were adapted once the COVID-19 pandemic began.

RESULTS: There was a decrease (59%) in the mean number of intrusive memories per day from baseline (mean 1.29, SD 0.94) to postintervention (mean 0.54, SD 0.51). There was a statistically significant reduction in the number of intrusive memories from baseline to postintervention, as shown by an aggregated omnibus analysis with a small effect size (τ-U=-0.38; P<.001). Depression, anxiety, and posttraumatic stress symptoms all significantly reduced from preintervention to postintervention. Participants also reported improvements in functioning based on both quantitative and qualitative measures. The intervention was feasible to deliver and rated as acceptable by participants.

CONCLUSIONS: These preliminary findings suggest that this brief therapist-guided imagery-competing task intervention offers a potential approach to mitigating the impact of work-related traumatic events in frontline health care staff, both during a pandemic and beyond. Randomized controlled trials will be an important next step.

PMID:39556801 | DOI:10.2196/55562

Neurology. 2024 Dec 10;103(11):e209815. doi: 10.1212/WNL.0000000000209815. Epub 2024 Nov 18.

ABSTRACT

BACKGROUND AND OBJECTIVES: Stereo-EEG-guided radiofrequency thermocoagulation (RFTHC) has been proposed as relatively safe from a cognitive perspective; however, there is a lack of evidence based on neuropsychological assessments supporting this. This study is the first prospective evaluation of neuropsychological outcomes associated with stereo-EEG-guided RFTHC in patients with focal drug-resistant epilepsy.

METHODS: This cohort study involved prospective recruitment of consecutive patients undergoing stereo-EEG from 2 Australian centers. A comprehensive neuropsychological assessment was administered before implantation and 3 months after RFTHC (M = 104.51 days, SD = 29.25). Outcomes across cognitive domains were assessed at a group level with repeated measures t tests. Factorial repeated measures analyses of variance compared memory and language outcomes according to whether dominant mesial temporal lobe (mTL) structures were coagulated. Reliable change indices (RCIs) were computed to explore psychometrically reliable changes at an individual level.

RESULTS: The sample comprised 39 patients who underwent stereo-EEG (M = 37.08 ± 9.67 years, range = 17-56 years, 54% female). Nineteen (49%) had a language dominant epileptogenic zone (EZ), 16 (41%) a nondominant EZ, and 4 (10%) a bilateral EZ. All patients underwent RFTHC with a mean of 11.87 (SD = 6.82, range = 2-29) coagulation sites. Ten patients (26%) had RFTHC within the dominant mTL. At a group level, RFTHC was not associated with a significant decline on any neuropsychological measures (all comparisons p > 0.05). Subgroup analyses revealed a decline in delayed verbal recall after RFTHC of dominant mTL structures (F(1,37) = 4.46, p = 0.04, η_p² = 0.11, 95% CI [0-0.30]; medium to large effect), although it did not remain statistically significant after correction for false discovery rate. No statistically significant group differences were observed on visual memory or language measures post-RFTHC (all comparisons p > 0.05). RCI revealed that after RFTHC within the dominant mTL, 20% of patients experienced a decline in verbal memory and 10% in visual memory. By contrast, 7% declined in verbal memory and 10% in visual memory post-RFTHC outside the dominant mTL.

DISCUSSION: While these findings support the current view that RFTHC is cognitively benign for most cases, the results raise the question of a verbal memory decline after coagulation of the dominant mTL. Individualized neuropsychological counseling before stereo-EEG is essential to avoid unanticipated deficits.

PMID:39556777 | DOI:10.1212/WNL.0000000000209815

Proc Natl Acad Sci U S A. 2024 Nov 26;121(48):e2322888121. doi: 10.1073/pnas.2322888121. Epub 2024 Nov 18.

ABSTRACT

Cultural evolutionary processes can often lead to a statistical association between neutral and adaptive traits during episodes of population dispersal and the introduction of a beneficial technology in a geographic region. Here, we examine such cultural hitchhiking processes using an individual-based model that portrays the cultural interaction between a migrant and an incumbent population. Our model is loosely based on the interaction between farming and foraging populations during the initial stages of the adoption and diffusion of agricultural practices. The two populations are characterized by different variants for their neutral and adaptive cultural traits, with the latter set providing a reproductive advantage for the migrant communities over the incumbent ones. We explore how the neutral traits of the migrant population spread and how this process is conditioned by the following factors: 1) the possibility of transmission of the adaptive traits; 2) the extent of the increased reproductive advantage provided by the adaptive variants of the migrant population; 3) postmarital residence rules; and 4) how and when neutral traits are transmitted. Our results reveal a diverse range of outputs, highlighting the relevance of factors such as the nature of postmarital resocialization and the specific combination of postmarital residence rules and sex-biased transmission.

PMID:39556741 | DOI:10.1073/pnas.2322888121

Proc Natl Acad Sci U S A. 2024 Nov 26;121(48):e2412684121. doi: 10.1073/pnas.2412684121. Epub 2024 Nov 18.

ABSTRACT

Symmetry lies at the heart of two-dimensional (2D) bioelectronics, determining material properties at the fundamental level. Breaking the symmetry allows emergent functionalities and effects. However, symmetry modulation in 2D bioelectronics and the resultant applications have been largely overlooked. Here, we devise an oxidized architectural MXene, referred to as oxidized MXene (OXene), that couples orbit symmetric breaking with inverse symmetric breaking to entitle the optimized interfacial impedance and Schottky-induced piezoelectric effects. The resulting OXene validates applications ranging from microelectrode arrays, gait analysis, active transistor matrix, and wireless signaling transmission, which enables high-fidelity signal transmission and reconfigurable logic gates. Furthermore, OXene interfaces were investigated in both rodent and porcine myocardium, featuring high-quality and spatiotemporally resolved physiological recordings, while accurate differentiated predictions, enabled via various machine learning pipelines.

PMID:39556733 | DOI:10.1073/pnas.2412684121

Proc Natl Acad Sci U S A. 2024 Nov 26;121(48):e2322887121. doi: 10.1073/pnas.2322887121. Epub 2024 Nov 18.

ABSTRACT

Cultural evolution applies evolutionary concepts and tools to explain the change of culture over time. Despite advances in both theoretical and empirical methods, the connections between cultural evolutionary theory and evidence are often vague, limiting progress. Theoretical models influence empirical research but rarely guide data collection and analysis in logical and transparent ways. Theoretical models themselves are often too abstract to apply to specific empirical contexts and guide statistical inference. To help bridge this gap, we outline a quality-assurance computational workflow that starts from generative models of empirical phenomena and logically connects statistical estimates to both theory and real-world explanatory goals. We emphasize and demonstrate validation of the workflow using synthetic data. Using the interplay between conformity, migration, and cultural diversity as a case study, we present coded and repeatable examples of directed acyclic graphs, tailored agent-based simulations, a probabilistic transmission model for longitudinal data, and an approximate Bayesian computation model for cross-sectional data. We discuss the assumptions, opportunities, and pitfalls of different approaches to generative modeling and show how each can be used to improve data analysis depending on the structure of available data and the depth of theoretical understanding. Throughout, we highlight the significance of ethnography and of collecting basic cultural and demographic information about study populations and call for more emphasis on logical and theory-driven workflows as part of science reform.

PMID:39556723 | DOI:10.1073/pnas.2322887121

JMIR Pediatr Parent. 2024 Nov 18;7:e59283. doi: 10.2196/59283.

ABSTRACT

BACKGROUND: The Singapore integrated 24-hour activity guide for children and adolescents was introduced to promote healthy lifestyle behaviors, including physical activity, sedentary behavior, sleep, and diet, to enhance metabolic health and prevent noncommunicable diseases. To support the dissemination and implementation of these recommendations, a user-friendly online resource was created to help children and adolescents adopt these behaviors in Singapore.

OBJECTIVE: This study aimed to assess the acceptability of the online resource in the adoption of healthier lifestyle behaviors, and the change in the users’ behaviors with the use of this online resource.

METHODS: Participants aged 7-17 years were required to log their activity levels of the past 7 days at the beginning and at the end of a 3-month period using the browser-based online resource, including information on the duration and frequency of moderate- to vigorous-intensity physical activity (MVPA), length of sedentary behavior, duration and regularity of sleep, and food portions. User satisfaction, on the length, ease of use, and relevance of the online resource, was also recorded using a 10-point Likert scale. Descriptive statistics and statistical analyses, including the Wilcoxon signed rank test and McNemar test, were carried out at baseline and at the end of 3 months.

RESULTS: A total of 46 participants were included for analysis. For physical activity, the number of days of MVPA increased from a median of 3 (IQR 2-5) days to 4 (IQR 2-5) days (P=.01). For sedentary behavior, the median daily average screen time decreased from 106 (IQR 60-142.5) minutes to 90 (IQR 60-185) minutes. For sleep, 10% (5/46) more participants met the recommended duration, and the number of days with regular sleep increased from a median of 6 (IQR 5-7) days to 7 (IQR 5-7) days (P=.03). For diet, there was a decrease in the portion of carbohydrates consumed from a median of 42% (IQR 30-50) to 40% (IQR 30-48.5; P=.03), and the number of days of water and unsweetened beverage consumption remained stable at a median of 5 days but with a higher IQR of 4-7 days (P=.04). About 90% (39-41/46) of the participants reported that the online resource was relevant and easy to use, and the rating for user satisfaction remained favorable at a median of 8 with a higher IQR of 7-9 (P=.005).

CONCLUSIONS: The findings support the development of a dedicated online resource to assist the implementation of healthy lifestyle behaviors based on the Singapore integrated 24-hour activity guide for children and adolescents. This resource received favorable ratings and its use showed the adoption of healthier behaviors, including increased physical activity and sleep, as well as decreased sedentary time and carbohydrate consumption, at the end of a 3-month period.

PMID:39556715 | DOI:10.2196/59283

Circulation. 2024 Nov 19;150(21):1741-1744. doi: 10.1161/CIRCULATIONAHA.124.069792. Epub 2024 Nov 18.

NO ABSTRACT

PMID:39556651 | DOI:10.1161/CIRCULATIONAHA.124.069792