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Interactive Journal of Medical Research
A new general medical journal for the 21st century, focusing on innovation in health and medical research.
Background: Hypertension is a Non-Communicable Disease (NCD) where this disease cannot be transmitted through any form. The development of this disease takes a relatively long time. In this case, non-communicable diseases are one of the leading causes of death in the world. Hypertension is often referred to as a silent killer. Hypertension is also a major risk factor for sudden death due to heart disease, left ventricular hypertrophy, chronic kidney disease, diabetes mellitus, metabolic syndrome, vascular dementia, Alzheimer's disease, and eye disease. Efforts to prevent hypertension sufferers can be done by carrying out primordial prevention, namely, avoiding hypertension by doing physical activity and not smoking. Primary prevention by following counseling related to hypertension, secondary prevention in the form of routine treatment for hypertension sufferers who have been diagnosed with hypertension, and carrying out tertiary prevention by carrying out behaviors to prevent complications in hypertension sufferers Objective: This study aims to determine how the behavior of preventing hypertension in the elderly in the working area of the Cendana Putih Health Center, Mappedeceng District, North Luwu Regency Methods: This study uses a descriptive qualitative method with a content analysis approach. Data collection through observation, in-depth interviews, and documentation. Field observations or observations are carried out first with the aim of observing the habits carried out by informants. In-depth interviews are carried out with the aim of digging deeper information carried out by researchers to informants. And the last stage is to document the results of observations and interviews that have been conducted. Other supporting data is carried out by obtaining primary data and secondary data. Results: Overall, this study found that the behavior of preventing hypertension in the elderly is diverse, such as some informants doing physical activities such as gymnastics, other activities such as gardening, walking, routinely taking hypertension medication, having regular health checks, and also consuming herbal plants obtained around the informant's home environment. The role of the family in supporting or motivating the elderly to prevent hypertension is also needed, such as helping to remind the elderly to take medication or simply taking the elderly to have a check-up at the nearest health facility. Conclusions: Hypertension prevention behavior in the elderly can be done independently by the elderly by doing light activities such as walking and exercise at home, routinely taking hypertension medication, avoiding foods that can trigger high blood pressure, and carrying out traditional medicine by utilizing plants around the house that are already trusted to be one of the herbal plants for treating hypertension. Clinical Trial: Hypertension, Prevention, Physical Activity, Gymnastics, Examination, Hypertension Medication, Herbal Plants
(Toronto, June 27, 2024) JMIR Publications announced today that the Interactive Journal of Medical Research has received a Journal Impact Factor (JIF) of 1.9 as published in the 2024 Journal Citation Report (JCR) from Clarivate.
Here’s a selection of some of the highly cited articles from the Interactive Journal of Medical Research:
Overall, 8 JMIR Publications journals (more than half of our portfolio of journals with a JIF) secured positions in the top quartile of their respective categories.
A Complete List of JMIR Publications Titles With a JIF in 2024:
For 25 years, JMIR Publications has been advocating for open access in digital health. Discover our complete open access journal portfolio and explore the communities progressing digital health and health research in the internet age.
We are grateful to the scholars, researchers, institutions, funders, peer reviewers, editors, and editorial board members who have contributed to our mission of advancing scientific knowledge.
Interactive Journal of Medical Research (i-JMR, ISSN: 1929-073X, Journal Impact Factor™: 1.9 (Clarivate, 2024), 5-Year Journal Impact Factor™: 2.2) is a general medical journal with a focus on innovation in health, health care, and medicine - through new medical techniques and innovative ideas and/or research, including—but not limited to—technology, clinical informatics, sociotechnical and organizational health care innovations, or groundbreaking research.
i-JMR is indexed in PubMed, PubMed Central, Sherpa/Romeo, EBSCO, DOAJ, and Clarivate's Emerging Sources Citation Index (ESCI).
Background: Plagiocephaly is defined as an asymmetrical distortion of the skull, resulting in an oblique trapezoid or parallelogram head shape. Deformational plagiocephaly (DP) is caused by forces acting on one side of the back of the head, distorting normal skull symmetry.
Objective: The aims of this systematic review and meta-analysis were to critically assess the evidence for nonobstetric risk factors for DP and to make evidence-based recommendations for reducing the prevalence of DP.
Methods: The selection criterion was studies reporting risk factors for DP. Case reviews, case series, expert opinions, and systematic reviews were excluded. PubMed and Web of Science were searched from August 21, 2010, to August 21, 2022. Publication bias was assessed using funnel plots. Meta-analyses were presented using forest plots.
Results: A total of 19 studies (cohort studies: n=13, 68%; case-control studies: n=5, 26%; and cross-sectional studies: n=1, 5%) with a total of 14,808 participants were included. Of the 43 investigated potential nonobstetric factors, 16 (37%) were associated with DP. Of these 16 factors, 12 (75%) had odds ratios (ORs) with 95% CIs not crossing 1: insufficient vitamin D intake (OR 7.15, 95% CI 3.77-13.54), head position preference (OR 4.75, 95% CI 3.36-6.73), bottle-only feeding (OR 4.65, 95% CI 2.70-8.00), reduced tummy time (OR 3.51, 95% CI 1.71-7.21), sleeping position (OR 3.12, 95% CI 2.21-4.39), fewer motor milestones reached by the age of 6 months (OR 2.56, 95% CI 1.66-3.96), obesity (OR 2.45, 95% CI 1.02-5.90), maternal education level (OR 1.66, 95% CI 1.17-2.37), male sex (OR 1.51, 95% CI 1.07-2.12), formula feeding (OR 1.51, 95% CI 1.00-2.27), head circumference (OR 1.22, 95% CI 1.06-1.40), and mechanical ventilation (OR 1.10, 95% CI 1.00-1.14). No evidence of publication bias was detected.
Conclusions: This study provides a comprehensive assessment of the nonobstetric factors associated with DP and presents 11 evidence-based recommendations for reducing its prevalence. The primary limitation is that only publication bias was assessed.
Trial Registration: PROSPERO CRD42020204979; https://www.crd.york.ac.uk/prospero/display_record.php? ID=CRD42020204979
Background: Prehospital telemedicine triage systems combined with machine learning (ML) methods have the potential to improve triage accuracy and safely redirect low-acuity patients from attending the emergency department. However, research in prehospital settings is limited but needed; emergency department overcrowding and adverse patient outcomes are increasingly common.
Objective: In this scoping review, we sought to characterize the existing methods for ML-enhanced telemedicine emergency triage. In order to support future research, we aimed to delineate what data sources, predictors, labels, ML models, and performance metrics were used, and in which telemedicine triage systems these methods were applied.
Methods: A scoping review was conducted, querying multiple databases (MEDLINE, PubMed, Scopus, and IEEE Xplore) through February 24, 2023, to identify potential ML-enhanced methods, and for those eligible, relevant study characteristics were extracted, including prehospital triage setting, types of predictors, ground truth labeling method, ML models used, and performance metrics. Inclusion criteria were restricted to the triage of emergency telemedicine services using ML methods on an undifferentiated (disease nonspecific) population. Only primary research studies in English were considered. Furthermore, only those studies using data collected remotely (as opposed to derived from physical assessments) were included. In order to limit bias, we exclusively included articles identified through our predefined search criteria and had 3 researchers (DR, JS, and KS) independently screen the resulting studies. We conducted a narrative synthesis of findings to establish a knowledge base in this domain and identify potential gaps to be addressed in forthcoming ML-enhanced methods.
Results: A total of 165 unique records were screened for eligibility and 15 were included in the review. Most studies applied ML methods during emergency medical dispatch (7/15, 47%) or used chatbot applications (5/15, 33%). Patient demographics and health status variables were the most common predictors, with a notable absence of social variables. Frequently used ML models included support vector machines and tree-based methods. ML-enhanced models typically outperformed conventional triage algorithms, and we found a wide range of methods used to establish ground truth labels.
Conclusions: This scoping review observed heterogeneity in dataset size, predictors, clinical setting (triage process), and reported performance metrics. Standard structured predictors, including age, sex, and comorbidities, across articles suggest the importance of these inputs; however, there was a notable absence of other potentially useful data, including medications, social variables, and health system exposure. Ground truth labeling practices should be reported in a standard fashion as the true model performance hinges on these labels. This review calls for future work to form a standardized framework, thereby supporting consistent reporting and performance comparisons across ML-enhanced prehospital triage systems.
Background: Diet-related diseases, such as type 2 diabetes, require strict dietary management to slow down disease progression and call for innovative management strategies. Conventional diet monitoring places a significant memory burden on patients, who may not accurately remember details of their meals and thus frequently falls short in preventing disease progression. Recent advances in sensor and computational technologies have sparked interest in developing eating detection platforms.
Objective: This review investigates central hemodynamic and thermoregulatory responses as potential biomarkers for eating detection.
Methods: We searched peer-reviewed literature indexed in PubMed, Web of Science, and Scopus on June 20, 2022, with no date limits. We also conducted manual searches in the same databases until April 21, 2024. We included English-language papers demonstrating the impact of eating on central hemodynamics and thermoregulation in healthy individuals. To evaluate the overall study quality and assess the risk of bias, we designed a customized tool inspired by the Cochrane assessment framework. This tool has 4 categories: high, medium, low, and very low. A total of 2 independent reviewers conducted title and abstract screening, full-text review, and study quality and risk of bias analysis. In instances of disagreement between the 2 reviewers, a third reviewer served as an adjudicator.
Results: Our search retrieved 11,450 studies, and 25 met our inclusion criteria. Among the 25 included studies, 32% (8/25) were classified as high quality, 52% (13/25) as medium quality, and 16% (4/25) as low quality. Furthermore, we found no evidence of publication bias in any of the included studies. A consistent postprandial increase in heart rate, cardiac output, and stroke volume was observed in at least 95% (heart rate: 19/19, cardiac output: 18/19, stroke volume: 11/11) of the studies that investigated these variables’ responses to eating. Specifically, cardiac output increased by 9%-100%, stroke volume by 18%-41%, and heart rate by 6%-21% across these studies. These changes were statistically significant (P<.05). In contrast, the 8 studies that investigated postprandial thermoregulatory effects displayed grossly inconsistent results, showing wide variations in response with no clear patterns of change, indicating a high degree of variability among these studies.
Conclusions: Our findings demonstrate that central hemodynamic responses, particularly heart rate, hold promise for wearable-based eating detection, as cardiac output and stroke volume cannot be measured by any currently available noninvasive medical or consumer-grade wearables.
Trial Registration: PROSPERO CRD42022360600; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=360600
Background: Anterior chamber–associated immune deviation (ACAID) is an active immunotolerance mechanism, which is induced by placing antigen into the anterior eye chamber as long as a major surgical trauma is avoided. For this reason, ACAID may be a major contributor to the favorable immunologic outcomes in Descemet membrane endothelial keratoplasty (DMEK). Rodent models have demonstrated the importance of a functional spleen for the development of an ACAID.
Objective: This study aimed to investigate whether splenectomy leads to increased rejection rates after DMEK in humans.
Methods: A retrospective evaluation was conducted on the course following DMEK at the Eye Center, Medical Center, University of Freiburg, for patients with a self-reported history of splenectomy compared to patients without this condition. Potential study patients were contacted by mail. A questionnaire to self-report splenectomy and the time thereof was sent out. The medical records of all consenting patients at the Eye Center were reviewed for graft survival and immune reactions.
Results: We asked 1818 patients after DMEK to report their history of splenectomy. A total of 1340 patients responded and were included in the study. Of these 1340 patients, 16 (1.2%) reported a history of splenectomy (ie, 26 DMEKs, with 10 patients being transplanted in both eyes and 6 patients being transplanted in 1 eye; median age at surgery 73.7, range 66.7-76.1 y). The remaining patients (1324 patients, ie, 1941 eyes) served as controls, with 1941 DMEKs (median age at surgery 71.5, range 64.1-77.2 y). Five (19%) out of the 26 eyes from the splenectomy group required a second transplant due to dislocation (n=2.8%), failure (n=2.8%), and rejection (n=1.4%). Kaplan-Meier analysis revealed no relevant difference compared with controls.
Conclusions: Our results suggest that splenectomy has no major effect on the outcome following DMEK. Subsequent, ACAID may not be the main reason for the favorable immunological outcomes in DMEK, or the camero-splenic axis may be subordinate in humans. However, we only included 16 patients who underwent splenectomy, so it might be possible that we missed a minor effect.
Telehealth presents both the potential to improve access to care and to widen the digital divide contributing to health care disparities and obliging health care systems to standardize approaches to measure and display telehealth disparities. Based on a literature review and the operational experience of clinicians, informaticists, and researchers in the Supporting Pediatric Research on Outcomes and Utilization of Telehealth (SPROUT)–Clinical and Translational Science Awards (CTSA) Network, we outline a strategic framework for health systems to develop and optimally use a telehealth equity dashboard through a 3-phased approach of (1) defining data sources and key equity-related metrics of interest; (2) designing a dynamic and user-friendly dashboard; and (3) deploying the dashboard to maximize engagement among clinical staff, investigators, and administrators.
Background: Advancements in technology have overcome geographical barriers, making telemedicine, which offers remote emergency services, healthcare, and medication guidance, increasingly popular. COVID-19 restrictions amplified its global importance by bridging distances.
Objective: This study aimed to analyze Chinese and global literature data, present new global telemedicine research trends, and clarify the development potential, collaborations, and deficiencies in China's telemedicine research.
Methods: We conducted bibliometrics and network analyses on relevant documents from the Web of Science database from 2001 to 2022. Data collection was completed on October 30, 2023. Considering COVID-19’s impact, 2020 was used as a baseline, dividing the data into 2 periods: 2001-2019 and 2020-2022. The development potential was determined based on publication trends. An international coauthorship network analysis identified collaboration statuses and potential. Co-occurrence analysis was conducted for China and the world.
Results: We identified 25,333 telemedicine-related research papers published between 2001 and 2022, with a substantial increase during the COVID-19 period (2020-2022), particularly in China (1.93-fold increase), moving its global publication rank from tenth to sixth. The United States, the United Kingdom, and Australia contributed 62.96% of the literature, far ahead of China’s 3.90%. Globally, telemedicine research increased significantly post-2020. Between 2001 and 2019, the United States and Australia were central in coauthor networks; post-2020, the United States remained the largest node. Network hubs included the United States, the United Kingdom, Australia, and Canada. Keyword co-occurrence analysis revealed 5 global clusters from 2001 to 2019 (system technology, health care applications, mobile health, mental health, and electronic health) and 2020 to 2022 (COVID-19, children’s mental health, artificial intelligence, digital health, and rehabilitation of middle-aged and older adults). In China, the research trends aligned with global patterns, with rapid growth post-2020. From 2001 to 2019, China cooperated closely with Indonesia, India, Japan, Taiwan, and South Korea. From 2020 to 2022, cooperation expanded to Japan, Singapore, Malaysia, and South Korea, as well as Saudi Arabia, Egypt, South Africa, Ghana, Lebanon, and other African and Middle Eastern countries. Chinese keyword co-occurrence analysis showed focus areas in system technology, health care applications, mobile health, big data analysis, and electronic health (2001-2019) and COVID-19, artificial intelligence, digital health, and mental health (2020-2022). Although psychology research increased, studies on children’s mental health and middle-aged and older adults’ rehabilitation were limited.
Conclusions: We identified the latest trends in telemedicine research, demonstrating its significant potential in China and providing directions for future development and collaborations in telemedicine research.
Background: The declaration of the COVID-19 pandemic led to public health restrictions that impacted the lives of people across the globe. Parents were particularly burdened with balancing multiple responsibilities, such as working from home while caring for and educating their children. Alcohol use among parents is an area that warrants further exploration. Objective: This study aimed to investigate patterns of parental alcohol consumption during the COVID-19 pandemic, focusing on relative changes in the frequency and quantity of alcohol use compared to prepandemic use, nonparent adult samples, or both. Methods: A scoping review informed by the methodology of Arksey and O’Malley explored patterns of parental alcohol consumption during the COVID-19 pandemic. Searches were conducted in CINAHL, Ovid MEDLINE, PsycINFO, and Web of Science. Search terms were created using the Joanna Briggs Institute framework of Population, Concept, and Context, with the population being parents and the concept being alcohol consumption during the COVID-19 pandemic. Results: The database search yielded 3568 articles, which were screened for eligibility. Of the 3568 articles, 40 (1.12%) met the inclusion criteria and were included in the scoping review. Findings indicated the following: (1) having children at home was a factor associated with parental patterns of alcohol use; (2) mixed findings regarding gender-related patterns of alcohol consumption; and (3) linkages between parental patterns of alcohol use and mental health symptoms of stress, depression, and anxiety. Conclusions: This scoping review revealed heterogeneous patterns in parental alcohol use across sociocultural contexts during the COVID-19 pandemic. Given the known harms of alcohol use, it is worthwhile for clinicians to assess parental drinking patterns and initiate conversations regarding moderation in alcohol use.
Background: There is evidence that anxiety and stress increased among college students during the COVID-19 pandemic. However, less is known about daily experiences of affect, worry, substance use behaviors, experiences of pleasure, concern over food security, experiences of bias or discrimination, feelings of belongingness, and other indicators of well-being and how they vary across days in this population.
Objective: This study surveyed a wide range of indicators of health and well-being in daily life over 21 days with a sample of college students in a large university system in the United States during the pandemic. The overall variance in each daily measure was partitioned to reflect the proportion due to (1) between-person differences versus (2) within-person, day-to-day variability. This is important because measures that vary primarily due to between-person differences may be more amenable to interventions that target particular students, whereas measures that vary more due to day-to-day variability may be more amenable to interventions that target day-level contextual factors.
Methods: A sample of 2068 young adult college students (aged 18-24, mean 19.8, SD 1.3 years; 66.6% women) completed a baseline survey; 97.3% (n=2012) then completed up to 21 consecutive daily surveys that assessed a comprehensive set of daily markers of health, behavior, and well-being. The daily diary study produced a total of 33,722 person-days.
Results: Among all person-days, a minority were substance use days (eg, 14.5% of days involved alcohol use, 5.6% vaping, and 5.5% cannabis). Experiences of pleasure were reported on most (73.5%) days. Between-person differences explained more than 50% of the variance in numerous indicators of health and well-being, including daily vaping, cannabis use, other illicit substance use, experiences of bias or discrimination, positive affect, negative affect, worry, food insecurity, and feelings of belonging at the university. In contrast, within-person differences explained more than 50% of the variance in daily alcohol use, cigarette use, stress, experiences of pleasure, where the student slept last night, and physical activity.
Conclusions: College student health and well-being are multifaceted, with some aspects likely driven by person-level characteristics and experiences and other aspects by more dynamic, contextual risk factors that occur in daily life. These findings implicate services and interventions that should target individual students versus those that should target days on which students are at high risk for poor experiences or behaviors.
Background: Metabolically associated fatty liver disease (MAFLD) insidiously affects people's health, and many models have been proposed for the evaluation of liver fibrosis. However, there is still a lack of noninvasive and sensitive models to screen MAFLD in high-risk populations.
Objective: The purpose of this study was to explore a new method for early screening of the public and establish a home-based tool for regular self-assessment and monitoring of MAFLD.
Methods: In this cross-sectional study, there were 1758 eligible participants in the training set and 200 eligible participants in the testing set. Routine blood, blood biochemistry, and FibroScan tests were performed, and body composition was analyzed using a body composition instrument. Additionally, we recorded multiple factors including disease-related risk factors, the Forns index score, the hepatic steatosis index (HSI), the triglyceride glucose index, total body water (TBW), body fat mass (BFM), visceral fat area, waist-height ratio (WHtR), and basal metabolic rate. Binary logistic regression analysis was performed to explore the potential anthropometric indicators that have a predictive ability to screen for MAFLD. A new model, named the MAFLD Screening Index (MFSI), was established using binary logistic regression analysis, and BFM, WHtR, and TBW were included. A simple rating table, named the MAFLD Rating Table (MRT), was also established using these indicators.
Results: The performance of the HSI (area under the curve [AUC]=0.873, specificity=76.8%, sensitivity=81.4%), WHtR (AUC=0.866, specificity=79.8%, sensitivity=80.8%), and BFM (AUC=0.842, specificity=76.9%, sensitivity=76.2%) in discriminating between the MAFLD group and non-fatty liver group was evaluated (P<.001). The AUC of the combined model including WHtR, HSI, and BFM values was 0.900 (specificity=81.8%, sensitivity=85.6%; P<.001). The MFSI was established based on better performance at screening MAFLD patients in the training set (AUC=0.896, specificity=83.8%, sensitivity=82.1%) and was confirmed in the testing set (AUC=0.917, specificity=89.8%, sensitivity=84.4%; P<.001).
Conclusions: The novel MFSI model was built using WHtR, BFM, and TBW to screen for early MAFLD. These body parameters can be easily obtained using a body fat scale at home, and the mobile device software can record specific values and perform calculations. MFSI had better performance than other models for early MAFLD screening. The new model showed strong power and stability and shows promise in the area of MAFLD detection and self-assessment. The MRT was a practical tool to assess disease alterations in real time.
Background: Computational signal preprocessing is a prerequisite for developing data-driven predictive models for clinical decision support. Thus, identifying the best practices that adhere to clinical principles is critical to ensure transparency and reproducibility to drive clinical adoption. It further fosters reproducible, ethical, and reliable conduct of studies. This procedure is also crucial for setting up a software quality management system to ensure regulatory compliance in developing software as a medical device aimed at early preclinical detection of clinical deterioration.
Objective: This scoping review focuses on the neonatal intensive care unit setting and summarizes the state-of-the-art computational methods used for preprocessing neonatal clinical physiological signals; these signals are used for the development of machine learning models to predict the risk of adverse outcomes.
Methods: Five databases (PubMed, Web of Science, Scopus, IEEE, and ACM Digital Library) were searched using a combination of keywords and MeSH (Medical Subject Headings) terms. A total of 3585 papers from 2013 to January 2023 were identified based on the defined search terms and inclusion criteria. After removing duplicates, 2994 (83.51%) papers were screened by title and abstract, and 81 (0.03%) were selected for full-text review. Of these, 52 (64%) were eligible for inclusion in the detailed analysis.
Results: Of the 52 articles reviewed, 24 (46%) studies focused on diagnostic models, while the remainder (n=28, 54%) focused on prognostic models. The analysis conducted in these studies involved various physiological signals, with electrocardiograms being the most prevalent. Different programming languages were used, with MATLAB and Python being notable. The monitoring and capturing of physiological data used diverse systems, impacting data quality and introducing study heterogeneity. Outcomes of interest included sepsis, apnea, bradycardia, mortality, necrotizing enterocolitis, and hypoxic-ischemic encephalopathy, with some studies analyzing combinations of adverse outcomes. We found a partial or complete lack of transparency in reporting the setting and the methods used for signal preprocessing. This includes reporting methods to handle missing data, segment size for considered analysis, and details regarding the modification of the state-of-the-art methods for physiological signal processing to align with the clinical principles for neonates. Only 7 (13%) of the 52 reviewed studies reported all the recommended preprocessing steps, which could have impacts on the downstream analysis.
Conclusions: The review found heterogeneity in the techniques used and inconsistent reporting of parameters and procedures used for preprocessing neonatal physiological signals, which is necessary to confirm adherence to clinical and software quality management system practices, usefulness, and choice of best practices. Enhancing transparency in reporting and standardizing procedures will boost study interpretation and reproducibility and expedite clinical adoption, instilling confidence in the research findings and streamlining the translation of research outcomes into clinical practice, ultimately contributing to the advancement of neonatal care and patient outcomes.
Background: Hyperbaric oxygen (HBO2) treatment is used across a range of medical specialties for a variety of applications, particularly where hypoxia and inflammation are important contributors. Because of its hypoxia-relieving and anti-inflammatory effects HBO2 may be useful for new indications not currently approved by the Undersea and Hyperbaric Medical Society. Identifying these new applications for HBO2 is difficult because individual centers may only treat a few cases and not track the outcomes consistently. The web-based International Multicenter Registry for Hyperbaric Oxygen Therapy captures prospective outcome data for patients treated with HBO2 therapy. These data can then be used to identify new potential applications for HBO2, which has relevance for a range of medical specialties.
Objective: Although hyperbaric medicine has established indications, new ones continue to emerge. One objective of this registry study was to identify cases where HBO2 has been used for conditions falling outside of current Undersea and Hyperbaric Medical Society–approved indications and present outcome data for them.
Methods: This descriptive study used data from a web-based, multicenter, international registry of patients treated with HBO2. Participating centers agree to collect data on all patients treated using standard outcome measures, and individual centers send deidentified data to the central registry. HBO2 treatment programs in the United States, the United Kingdom, and Australia participate. Demographic, outcome, complication, and treatment data, including pre- and posttreatment quality of life questionnaires (EQ-5D-5L) were collected for individuals referred for HBO2 treatment.
Results: Out of 9726 patient entries, 378 (3.89%) individuals were treated for 45 emerging indications. Post–COVID-19 condition (PCC; also known as postacute sequelae of COVID-19; 149/378, 39.4%), ulcerative colitis (47/378, 12.4%), and Crohn disease (40/378, 10.6%) accounted for 62.4% (n=236) of the total cases. Calciphylaxis (20/378, 5.3%), frostbite (18/378, 4.8%), and peripheral vascular disease–related wounds (12/378, 3.2%) accounted for a further 13.2% (n=50). Patients with PCC reported significant improvement on the Neurobehavioral Symptom Inventory (NSI score: pretreatment=30.6; posttreatment=14.4; P<.001). Patients with Crohn disease reported significantly improved quality of life (EQ-5D score: pretreatment=53.8; posttreatment=68.8), and 5 (13%) reported closing a fistula. Patients with ulcerative colitis and complete pre- and post-HBO2 data reported improved quality of life and lower scores on a bowel questionnaire examining frequency, blood, pain, and urgency. A subset of patients with calciphylaxis and arterial ulcers also reported improvement.
Conclusions: HBO2 is being used for a wide range of possible applications across various medical specialties for its hypoxia-relieving and anti-inflammatory effects. Results show statistically significant improvements in patient-reported outcomes for inflammatory bowel disease and PCC. HBO2 is also being used for frostbite, pyoderma gangrenosum, pterygium, hypospadias repair, and facial filler procedures. Other indications show evidence for improvement, and the case series for all indications is growing in the registry.
Background: Home medication management has been insufficiently studied, including the factors that impact the development and effectiveness of adherence strategies under both routine and anomalous circumstances. Older adults are a particularly important population to study due to the greater likelihood of taking medication in combination with the desire to “age in place.”
Objective: This interview study aims to understand how older adults develop medication management strategies, identify when and why such strategies succeed or fail, learn more about how older adults think about their medication, and explore interventions that increase medication adherence.
Methods: This study used a qualitative, semistructured interview design to elicit older adults’ experiences with home medication management. Overall, 22 participants aged ≥50 years taking 1 to 3 prescription medications were recruited and interviewed. Interview responses were recorded, and thematic, qualitative analysis was performed by reviewing recordings and identifying recurring patterns and themes. Responses were systematically coded, which not only facilitated the identification of these themes but also allowed us to quantify the prevalence of behaviors and perceptions, providing a robust understanding of medication management and medication adherence.
Results: Participants reported developing home medication management strategies on their own, with none of the participants receiving guidance from health care providers and 59% (13/22) of the participants using trial and error. The strategies developed by study participants were all unique and generally encompassed prescription medication and vitamins or supplements, with no demarcation between what was prescribed or recommended by a physician and what they selected independently. Participants thought about their medications by their chemical name (10/22, 45%), by the appearance of the pill (8/22, 36%), by the medication’s purpose (2/22, 9%), or by the medication’s generic name (2/22, 9%). Pill cases (17/22, 77%) were more popular than prescription bottles (5/22, 23%) for storage of daily medication. Most participants (19/22, 86%) stored their pill cases or prescription bottles in visible locations in the home, and those using pill cases varied in their refill routines. Participants used ≥2 routines or objects as triggers to take their medication. Nonadherence was associated with a disruption to their routine. Finally, only 14% (3/22) of the participants used a time-based reminder or alarm, and none of the participants used a medication adherence device or app.
Conclusions: Participants in our study varied considerably in their home medication management strategies and developed unique routines to remember to take their medication as well as to refill their pill cases. To reduce trial and error in establishing a strategy, there are opportunities for physicians and pharmacists to provide adherence guidance to older adults. To minimize the impact of disruptions on adherence, there are opportunities to develop more durable strategies and to design aids to medication adherence that leverage established daily routines.
Background: Hypertension is a Non-Communicable Disease (NCD) where this disease cannot be transmitted through any form. The development of this disease takes a relatively long time. In this case, non-...
Background: Hypertension is a Non-Communicable Disease (NCD) where this disease cannot be transmitted through any form. The development of this disease takes a relatively long time. In this case, non-communicable diseases are one of the leading causes of death in the world. Hypertension is often referred to as a silent killer. Hypertension is also a major risk factor for sudden death due to heart disease, left ventricular hypertrophy, chronic kidney disease, diabetes mellitus, metabolic syndrome, vascular dementia, Alzheimer's disease, and eye disease. Efforts to prevent hypertension sufferers can be done by carrying out primordial prevention, namely, avoiding hypertension by doing physical activity and not smoking. Primary prevention by following counseling related to hypertension, secondary prevention in the form of routine treatment for hypertension sufferers who have been diagnosed with hypertension, and carrying out tertiary prevention by carrying out behaviors to prevent complications in hypertension sufferers Objective: This study aims to determine how the behavior of preventing hypertension in the elderly in the working area of the Cendana Putih Health Center, Mappedeceng District, North Luwu Regency Methods: This study uses a descriptive qualitative method with a content analysis approach. Data collection through observation, in-depth interviews, and documentation. Field observations or observations are carried out first with the aim of observing the habits carried out by informants. In-depth interviews are carried out with the aim of digging deeper information carried out by researchers to informants. And the last stage is to document the results of observations and interviews that have been conducted. Other supporting data is carried out by obtaining primary data and secondary data. Results: Overall, this study found that the behavior of preventing hypertension in the elderly is diverse, such as some informants doing physical activities such as gymnastics, other activities such as gardening, walking, routinely taking hypertension medication, having regular health checks, and also consuming herbal plants obtained around the informant's home environment. The role of the family in supporting or motivating the elderly to prevent hypertension is also needed, such as helping to remind the elderly to take medication or simply taking the elderly to have a check-up at the nearest health facility. Conclusions: Hypertension prevention behavior in the elderly can be done independently by the elderly by doing light activities such as walking and exercise at home, routinely taking hypertension medication, avoiding foods that can trigger high blood pressure, and carrying out traditional medicine by utilizing plants around the house that are already trusted to be one of the herbal plants for treating hypertension. Clinical Trial: Hypertension, Prevention, Physical Activity, Gymnastics, Examination, Hypertension Medication, Herbal Plants
Background: Cardiovascular diseases are one of the leading causes of mortality globally. Cardiac rehabilitation (CR) programs are crucial for patients recovering from cardiac events, as they help redu...
Background: Cardiovascular diseases are one of the leading causes of mortality globally. Cardiac rehabilitation (CR) programs are crucial for patients recovering from cardiac events, as they help reduce the risk of recurrent events and support patient recovery. The patient’s journey in CR spans the stages before, during, and after the program. Patients have to progress through each stage of CR programs successfully to complete the entire CR journey and get the full benefits of CR programs, but numerous barriers within this journey can hinder patient progression. Objective: To explore the barriers to progression at all stages of the CR patient journey from the perspectives of healthcare providers involved in CR care. Methods: This qualitative study involved semi-structured interviews with healthcare providers involved in CR care from July 2023 and January 2024. A purposive maximal variation sampling method was used to target providers with diverse demographics and specialties. Snowball sampling was used to recruit participants, leveraging the existing networks of participants. Each interview lasted between 30 and 45 minutes. Interviews were recorded, transcribed verbatim, and analyzed using an inductive thematic analysis approach. Data analysis was conducted from August 2023 to February 2024. Results: Ten healthcare providers, comprising seven females and three males, were interviewed. Their roles included physician, program director, nurse manager, clinical manager, nurse coordinator, nurse, physiotherapist, and kinesiologist. The analysis identified four overarching themes related to barriers to progression in the CR journey: (1) patients not being referred to CR programs, (2) patients not enrolling in CR programs, (3) patients dropping out of CR programs, and (4) patients’ lack of adherence to lifestyle changes post-CR programs. Conclusions: In light of the growing interest in technological interventions in CR programs, we proposed four potential technological solutions to address the barriers to progression identified in our analysis. These solutions aim to provide a foundation for future research and guide the development of effective technologies to enhance patient progression within the CR journey.
Background: Multiple Correspondence Analysis (MCA) is an unsupervised data science methodology that aims to identify and represent associations between categorical variables. Gliomas are an aggressive...
Background: Multiple Correspondence Analysis (MCA) is an unsupervised data science methodology that aims to identify and represent associations between categorical variables. Gliomas are an aggressive type of cancer characterized by diverse molecular and clinical features that serve as key prognostic factors. Thus, advanced computational approaches are essential to enhance analysis and interpretation of the associations between clinical and molecular features in gliomas. Objective: This study aims to apply MCA to identify associations between glioma prognostic factors and also explore their associations with stemness phenotype. Methods: Clinical and molecular data from 448 brain tumor patients were obtained from The Cancer Genome Atlas (TCGA). The mDNA stemness index, derived from DNA methylation patterns, was built using a one-class logistic regression (OCLR). Associations between variables were evaluated using the chi-square test with k degrees of freedom, followed by analysis of the adjusted standardized residuals. MCA was employed to uncover associations between glioma prognostic factors and stemness. Results: Our analysis revealed significant associations among molecular and clinical characteristics in gliomas. Additionally, we demonstrated the capability of MCA to identify associations between stemness and these prognostic factors. Our results exhibited a strong association between higher mDNA stemness index and features related to poorer prognosis, demonstrating the utility of MCA as an analytical tool for elucidating potential prognostic factors. Conclusions: MCA proves to be a valuable tool for understanding the complex interdependence of prognostic markers in gliomas. MCA facilitates the exploration of large-scale datasets and enhances the identification of significant associations.
Background: Individuals of childbearing age enter pregnancy less healthy than previous generations, placing them at increased risk for pregnancy complications. One approach to ensuring effective monit...
Background: Individuals of childbearing age enter pregnancy less healthy than previous generations, placing them at increased risk for pregnancy complications. One approach to ensuring effective monitoring and treatment of at-risk pregnant/birthing people is designing technology-based interventions that prevent maternal morbidities and treat perinatal conditions. Objective: This scoping review evaluates what informatics interventions have been designed and tested to prevent and treat maternal morbidity. Methods: MEDLINE, EMBASE, and Cochrane Library were searched to identify relevant studies. Inclusion criteria were: (a) tested a medical or clinical informatics intervention; (b) enrolled pregnant/birthing people; and (c) addressed preeclampsia, gestational diabetes mellitus (GDM), preterm birth, CDC-defined severe maternal morbidity, or perinatal mental health conditions. Demographic, population, and intervention data were extracted to characterize the technologies, conditions, and populations addressed. Results: 80 studies were identified that met inclusion criteria. Of these, 73% tested technologies for either GDM or perinatal mental health conditions, and 15% tested technologies for preeclampsia. For technology, 32% of the technologies tested were smartphone or tablet application, 26% were telehealth interventions, and 15% were remote monitoring technologies. Most (79%) studies assessed patient physical or mental health outcomes. Conclusions: Per this scoping review, most informatics interventions address three conditions: GDM, preeclampsia, and mental health. There may be opportunities to treat other potentially lethal conditions like postpartum hemorrhage using proven technologies such as mobile applications. Ample gaps in the literature exist concerning the use of informatics technologies aimed at maternal morbidity. There may therefore be opportunities to use informatics for lesser-targeted conditions and populations.
Background: Virtual reality (VR) has become a powerful tool for enhancing experiences of patients with critical illness; however, there is a lack of research on the comparison of VR intervention effec...
Background: Virtual reality (VR) has become a powerful tool for enhancing experiences of patients with critical illness; however, there is a lack of research on the comparison of VR intervention effects on healthy and hospitalized children’s psychological cognition of VR. Objective: The aim of this study was to evaluate the pleasurable experience of VR and the impact of VR on hospitalized children’s travel expectations and hope by adopting electrocardiography (ECG) and the questionnaire mixed methods to increase the objectivity of research. Methods: The subjects of this research were children between seven and 18 years of age. Eighteen hospitalized children with leukemia were placed in the experimental group, and thirty healthy children were placed in the control group. A questionnaire was designed to understand the differences in the children’s feeling of hope, and their physiological data was collected through ECG. Results: There was no significant difference in the sense of hope between the experimental group and the control group before using VR, but there was a significant difference (P=.049) after using VR to experience tourist attractions. In addition, heartbeats and indicators from ECG were found to be significant when the two groups were using VR: standard deviation of all normal to normal intervals (SDNN) (P=.035) was related to the parasympathetic nerves, and low frequency (LW) (P=.008) was related to the sympathetic nerves. The results indicated that the responses of the hospitalized children and the healthy children during the VR experience were different. Conclusions: Both the hospitalized children and the healthy children felt pleasure when using VR to experience new things and had expectations about traveling. However, it was more difficult to stimulate the sense of hope in the hospitalized children than in the healthy children. This study suggests increasing health care workers’ attention to hospitalized children’s needs and psychological feelings in practice, as well as helping hospitalized children make psychological adjustments to reduce the impact and pressure of long-term hospitalization. Future studies are recommended to examine the different contents of VR and the medical conditions of hospitalized children.
(Toronto, June 27, 2024) JMIR Publications announced today that the Interactive Journal of Medical Research has received a Journal Impact Factor (JIF) of 1.9 as published in the 2024 Journal Citation Report (JCR) from Clarivate. 
