non-US Studies Research Articles

Barriers and facilitators to next-generation sequencing use in United States oncology settings: a systematic review.

Aim: Next-generation sequencing (NGS) of solid tumors can inform treatment decisions; however, uptake remains low. This objective of this systematic review was to identify barriers to and facilitators of NGS in US oncology settings.Materials & methods: Embase and MEDLINE were searched in March 2023 for articles published from 2012 to2023 on barriers and facilitators of NGS adoption for solid tumors. Surveys, interviews and observational studies were eligible. Studies on genetic testing for hereditary cancers and non-US studies were excluded. The Motheral scale, Joanna Briggs Institute critical appraisal checklist and McGill Mixed Methods Appraisal Tool were used to assess study quality. Data were synthesized narratively.Results: Twenty-one studies were included. Study participants were clinicians, payers and administrators. Key barriers included complex reimbursement processes and uncertainties around clinical utility. Including recommendations for NGS in clinical practice guidelines was a key facilitator, although insurance policies were often more restrictive than guideline recommendations.Conclusion: Uptake of NGS is increasing but barriers remain. Changes to the current reimbursement frameworks are needed to increase access to NGS. The impact of implementing the 2018 National Coverage Determination, which allows access to NGS for all Medicare beneficiaries with advanced cancer, is not yet evident in the published literature.

The Influence of Trust, Health Beliefs, and Technology Acceptance on The Intent to use an Mhealth in Indonesia: An Empirical Study of Users and Non-Users

The Influence of Trust, Health Beliefs, and Technology Acceptance on The Intent to use an Mhealth in Indonesia: An Empirical Study of Users and Non-Users

Ultra-Processed Food Consumption and Risk of Incident Hypertension in US Middle-Aged Adults.

Consumption of ultra-processed food, which is manufactured food that is high in additives and sparse in intact foods, is adversely associated with cardiovascular health, primarily in non-US study populations. We aimed to estimate the association between ultra-processed food consumption and incident hypertension in middle-aged adults in the United States. We included 8923 ARIC (Atherosclerosis Risk in Communities) study participants who were hypertension free at baseline and had complete dietary, covariate, and hypertension data from visit 1 (1987-1989). Over a median (25th, 75th percentile) follow-up of 13 (6-21) years, 79% of participants developed hypertension. Participants in the highest quartile of ultra-processed food consumption had 15% higher risk of incident hypertension than those in the lowest quartile (hazard ratio [HR], 1.15 [95% CI, 1.08-1.23]). Participants in the highest quartile of consumption of sugar-sweetened beverages, red and processed meat, and margarine had 16% (HR, 1.16 [95% CI, 1.08-1.24]; p-trend <0.001), 10% (HR, 1.10 [95% CI, 1.03-1.19]; P trend = 0.005), and 6% (HR, 1.06 [95% CI, 0.99, 1.45]; P trend = 0.045) higher risk of incident hypertension, respectively, when compared with the lowest quartiles of consumption. Each additional serving of minimally or unprocessed food was associated with a 2% lower risk of incident hypertension (HR, 0.98 [95% CI, 0.98, 0.99], P<0.001). High consumption of ultra-processed foods, specifically of sugar-sweetened beverages, red and processed meat, and margarine, was associated with a higher incidence of hypertension, whereas minimally or unprocessed food consumption was associated with lower hypertension risk.

Pornography use, demographic and sexual health characteristics among university students: a gender-based comparative study of non-users, non-problematic users, and problematic users

BackgroundLimited gender-based research has compared sexual health among pornography users (PUs) and non-users, including non-problematic pornography users (non-PPUs) and problematic pornography users (PPUs), particularly in non-Western cultures.MethodsA 2022 cross-sectional study involving 450 Iranian university students categorized participants as PUs or non-users based on 12 months of use. PUs were further classified as non-PPUs or PPUs using the 'Problematic Pornography Use Scale' cutoff point, with comparisons of demographic and sexual variables made between these groups.ResultsPornography use was reported among 39.6% of students, including 51.7% of men and 33.6% of women. In general, 9.5% of participants were PPUs, including 17.4% of men and 5.6% of women. PUs were mainly men, had fewer children, shorter marriages, lower religiosity, and lower levels of education. Compared with non-users, PUs reported earlier sexual relationships, lower satisfaction with sex frequency and communication, and greater rates of extramarital relationships, masturbation, sexual desire, and sexual distress. PPUs reported more sexual desire, pornography use, masturbation, and extramarital affairs than non-PPUs. Similar patterns in demographics, sexual history, and health were observed in pornography use across genders. The regression indicated being male (OR: 2.42, 95% CI: 1.44–4.06), having lower education (OR: 0.89, 95% CI: 0.81–0.97), fewer children (OR: 0.64, 95% CI: 0.48–0.86), higher masturbation (OR: 1.31, 95% CI: 1.14–1.49), more extramarital relationship (OR: 1.69, 95% CI: 1.07–2.67), less religiosity (OR: 0.87, 95% CI: 0.82–0.93), more sexual excitement (OR: 0.79, 95% CI:0.62–1), and more sexual distress (OR: 1.20, 95% CI: 1.02–1.32) were associated with pornography use.Two-way ANOVA found no significant effects of gender or pornography use on sexual satisfaction. Women had worse sexual function regardless of usage. Pornography users, regardless of gender, experienced higher sexual distress.

National Public Health Dashboards: Protocol for a Scoping Review.

The COVID-19 pandemic highlighted the importance of robust public health data systems and the potential utility of data dashboards for ensuring access to critical public health data for diverse groups of stakeholders and decision makers. As dashboards are becoming ubiquitous, it is imperative to consider how they may be best integrated with public health data systems and the decision-making routines of diverse audiences. However, additional progress on the continued development, improvement, and sustainability of these tools requires the integration and synthesis of a largely fragmented scholarship regarding the purpose, design principles and features, successful implementation, and decision-making supports provided by effective public health data dashboards across diverse users and applications. This scoping review aims to provide a descriptive and thematic overview of national public health data dashboards including their purpose, intended audiences, health topics, design elements, impact, and underlying mechanisms of use and usefulness of these tools in decision-making processes. It seeks to identify gaps in the current literature on the topic and provide the first-of-its-kind systematic treatment of actionability as a critical design element of public health data dashboards. The scoping review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. The review considers English-language, peer-reviewed journal papers, conference proceedings, book chapters, and reports that describe the design, implementation, and evaluation of a public health dashboard published between 2000 and 2023. The search strategy covers scholarly databases (CINAHL, PubMed, Medline, and Web of Science) and gray literature sources and uses snowballing techniques. An iterative process of testing for and improving intercoder reliability was implemented to ensure that coders are properly trained to screen documents according to the inclusion criteria prior to beginning the full review of relevant papers. The search process initially identified 2544 documents, including papers located via databases, gray literature searching, and snowballing. Following the removal of duplicate documents (n=1416), nonrelevant items (n=839), and items classified as literature reviews and background information (n=73), 216 documents met the inclusion criteria: US case studies (n=90) and non-US case studies (n=126). Data extraction will focus on key variables, including public health data characteristics; dashboard design elements and functionalities; intended users, usability, logistics, and operation; and indicators of usefulness and impact reported. The scoping review will analyze the goals, design, use, usefulness, and impact of public health data dashboards. The review will also inform the continued development and improvement of these tools by analyzing and synthesizing current practices and lessons emerging from the literature on the topic and proposing a theory-grounded and evidence-informed framework for designing, implementing, and evaluating public health data dashboards. DERR1-10.2196/52843.

Abstract WP85: Evaluating the Strengths and Limitations to Patient-Reported Modified Rankin Scale Studies: A Systematic Review

Background: Studies evaluating patient-reported modified Rankin scales (mRS) in patients with stroke in different cultural and language settings have not been aggregated to determine validity of these adapted assessments. Objectives: To systematically review all patient-reported mRS studies performed outside of the United States (US). Methods: We searched PubMed and Web of Science for non-US based studies that evaluated patient-reported mRS against in-person clinician mRS among patients with stroke. Studies were analyzed for country of investigation, mRS self-assessment modality, care setting (inpatient vs outpatient), study limitations, and concordance between patient-reported and in-person mRS scores. Results: We identified 13 patient-reported mRS evaluation studies across all continents except Africa. The most common self-reported mRS assessment was the telephone mRS questionnaire. Average time between in-person and self-reported mRS assessments was ~14 days. The weighted kappa agreement between patient-reported and in-person mRS scores ranged from moderate to very good (K w range: 0.56 to 0.90), though unweighted kappa scores were significantly lower (K range: 0.27 to 0.68). Discrepancies between patient-reported and clinician-evaluated mRS scores tended to result from patients at the scale extremes. Patients with good mRS outcomes (mRS &lt; 2) tended to rate themselves better than their clinicians while those with poor outcomes (mRS &gt; 3) tended to rate themselves worse than their clinicians did. Major limitations across studies included sampling bias in the in-patient setting, time delays between in-person and self-reported mRS assessments, and differences in the structure of the clinician-led vs patient-reported mRS assessments. Conclusion: While patient-reported mRS validation studies to date have generally displayed good agreement with clinician-reported outcomes, significant scoring discrepancies exist for patients with very poor and very good outcomes. Future studies should consider limiting time between mRS assessments and understanding reasons for differences in patient and clinician assessments. Further, data on validity of self-report mRS tools are lacking from much of the world, especially Africa.

Effectiveness of maternal immunisation with a three-component acellular pertussis vaccine at preventing pertussis in infants in the United States: Post-hoc analysis of a case-control study using Bayesian dynamic borrowing

BackgroundImmunisation during pregnancy with a tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine can protect infants against pertussis between birth and paediatric vaccination. We aimed to estimate the vaccine effectiveness (VE) of third-trimester pregnancy immunisation with the three-component acellular pertussis (Td3ap) vaccine at preventing pertussis in infants <2 months in the United States (US), to support a label update. MethodsWe performed a post-hoc sub-analysis of a case-control study conducted in six US Emerging Infections Program Network states between 2011 and 2014. Our analysis included only cases and controls whose mothers were either vaccinated with Td3ap or did not receive any Tdap vaccine. The association between Td3ap maternal immunisation and pertussis in infants was assessed for US data using a frequentist method with conditional logistic regression. A robustified analysis was conducted using Bayesian dynamic borrowing of non-US data, considering a mixing-weighted prior of 90% for historical non-US VE data, and of 10% for a vague prior. VE was estimated as (1-odds ratio) × 100%. Sensitivity analyses accounting for the impact of each non-US study, different mixing weights and missing/ambiguous data were performed. ResultsWe included 108 cases and 183 controls. Based on US data, the estimated VE of third-trimester maternal immunisation with Td3ap at preventing pertussis in infants <2 months was 78.0% (95% confidence interval: −38.0; 96.5). VE estimated by Bayesian dynamic borrowing of non-US data (with a 90% weight for historical data) was 83.4% (95% credible interval: 55.7; 92.5); sensitivity analyses produced similar VE estimates. ConclusionsEffectiveness of third-trimester pregnancy immunisation with Td3ap at preventing infant pertussis in the US is very likely to be ≥ 50% and is most likely ∼ 80%. Bayesian dynamic borrowing of non-US VE data allowed overcoming the limited power (due to small sample size) of a brand-specific sub-analysis by considering additional evidence.

Trend over time on knowledge of the health effects of cigarette smoking and smokeless tobacco use in Bangladesh: Findings from the International Tobacco Control Policy Evaluation Bangladesh Surveys.

Cigarette smoking and smokeless tobacco (ST) use are prevalent in Bangladesh. This longitudinal study examined how knowledge of the health effects of smoking and ST use in Bangladesh has changed overtime with the country's acceleration of tobacco control efforts. Data were analysed from the International Tobacco Control Survey, a nationally representative longitudinal study of users and non-users of tobacco (aged 15 and older) in Bangladesh, across four waves conducted in 2009 (n = 4378), 2010 (n = 4359), 2012 (n = 4223) and 2015 (n = 4242). Generalised estimating equations assessed the level of knowledge about harms of tobacco use across four waves. Multivariable logistic regressions assessed whether knowledge of health effects from cigarette smoking and ST use in 2015 differed by user group. In 2015 survey, most tobacco users were aware that cigarette smoking causes stroke (92%), lung cancer (97%), pulmonary tuberculosis (97%) and ST use causes mouth cancer (97%) and difficulty in opening mouth (80%). There were significant increases in the total knowledge score of smoking related health harm from 2010 to 2012 (mean difference = 0.640; 95% confidence interval [CI] 0.537, 0.742) and 2012 to 2015 (mean difference = 0.555; 95% CI 0.465, 0.645). Participants had greater odds of awareness for ST health effects from 2010 to 2015. The results suggest that increasing efforts of awareness policy interventions is having a positive effect on tobacco-related knowledge in Bangladesh. These policy initiatives should be continued to identify optimal methods to facilitate behaviour change and improve cessation of smoking and ST use.

Chronic pain trials often exclude people with comorbid depressive symptoms: A secondary analysis of 346 randomized controlled trials.

Chronic pain and depression are common comorbid conditions, but there is limited evidence-based guidance for management of the two conditions together. In recent years, there has been an increase in the number of chronic pain randomized controlled trials that collect depression outcomes, but it is unknown how often these trials include people with depression or significant depressive symptoms. If trials do not include participants representative of real-world populations, evidence and guidance generated from these trials risk being inapplicable for large proportions of the target population, or worse, risk harm. Thus, in order to identify pathways to improve the conduct of clinical trials, the aims of this study were to (1) estimate the proportion of randomized controlled trials evaluating chronic pain interventions and reporting depression outcomes that include participants with significant depressive symptoms; and (2) assess the variability of inclusion proportions by pain type, intervention type, gender, country of origin, and publication year. Studies were extracted from an umbrella review of interventions for chronic pain that reported depression outcomes. Screening and data extraction were completed in duplicate and conflicts were resolved by a third author. Randomized controlled trials with at least 50% adult participants and validated depression scales were included, and randomized controlled trials with populations whose mean scores were at or above depression thresholds at baseline were considered to have included participants with depression. Of the 346 randomized controlled trials analyzed, 142 (41%) included participants with depression. Eight pain-type groups and nine intervention types were identified. Randomized controlled trials investigating fibromyalgia and mixed chronic pain had the highest proportion of participants with depression, whereas studies of arthritis and axial pain had among the lowest. Randomized controlled trials from the United States had a significantly lower inclusion proportion compared with non-US studies, especially for studies on arthritis. The increase in inclusion proportion by publication year was driven by the increase in fibromyalgia studies. This study highlights opportunities to improve the conduct of chronic pain clinical trials. The majority of randomized controlled trials s analyzed evaluated participants without significant depressive symptoms at baseline, thus the findings synthesized in systematic reviews and subsequent guidelines are most applicable to the subset of real-world populations that do not have significant depressive symptoms. As well, systemic biases around psychological conditions and gender may be important contributors to differences in the study of depression in fibromyalgia compared with common conditions such as arthritis and axial pain. In order to better inform clinical practice, future research must intentionally include individuals with comorbid depression in trials of common chronic pain conditions, and consider methods to mitigate biases that may distort study design.

Abstract P419: Ultra-Processed Food Consumption and Risk of Hypertension in US Adults

Introduction: Ultra-processed food (UPF) consumption has an adverse impact on cardiovascular health. Current research is primarily based on non-US study populations. The purpose of our study was to estimate the association between UPF consumption and risk of incident hypertension in a population of middle-aged black and white men and women. Methods: Atherosclerosis Risk in Communities (ARIC) study participants who were hypertension free at baseline and had complete dietary, covariate, and hypertension data from visit 1 (1987 - 1989) were included (n = 8,866). Participants were followed through November 30, 2019 for the development of hypertension defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or recent patient-reported use of blood pressure lowering medication. Processing level was determined using the NOVA classification system. Data were analyzed using three progressively adjusted Cox proportional hazards regression models. Results: 6,960 participants developed hypertension during a median follow-up of 13 years. Participants in the highest quartile of UPF consumption were 9% more likely to develop incident hypertension than those in the lowest quartile (model 2 HR: 1.09; CI: 1.02-1.16; P for trend = 0.01) ( Table ). Participants who were in the highest quartile of sugar-sweetened beverages and red and processed meat consumption had a 20% higher risk of hypertension (model 2 HR, 1.20; CI, 1.12 - 1.28; P for trend &lt;0.001) and 9% higher risk of hypertension (model 2 HR, 1.09; CI, 1.02 - 1.17; P for trend &lt;0.001), respectively, when compared to the lowest quartile. Participants in the highest quartile of minimally or unprocessed food consumption had 9% lower incidence of hypertension (model 2 HR, 0.91; 95% CI, 0.85 - 0.97; P for trend 0.01). Conclusions: High UPF consumption, specifically sugar-sweetened beverages and red and processed meat, was associated with higher risk of hypertension, whereas minimally or unprocessed food consumption was associated with lower hypertension risk.

Peer pressure and social acceptability between hookah pipe users and non-users among a sample of South African adolescents

Background. Hookah pipe smoking is a high-risk phenomenon which is widely seen as an acceptable social practice, but the extent of its acceptability is not very clear among South African youth, nor is the influence of peers very clear.Objective. To establish a link between social acceptability and peer pressure and to compare this relationship among hookah pipe users and non-users in a sample of South African adolescents.Methods. A cross-sectional comparative correlation study was conducted among Grade 9 adolescents attending secondary schools in the Metro East Education District in Cape Town. The final sample comprised 270 participants. A questionnaire was used to collect data which were analysed using SPSS.Results. No relationship was found between peer pressure and social acceptability, but a relationship was found between parental rules and monitoring around tobacco use for hookah pipe users. A significant difference was also found in attitudes towards hookah use among users and non-users.Conclusion. This descriptive study of hookah pipe users and non-users among Grade 9 adolescents is a further study in the quantitative research approach and may be helpful in gaining more insight into understanding how parental rules and monitoring are put in place and why users’ and non-users’ attitudes towards tobacco use differ significantly. The implications and significance of this study are further explained.

Social stratification and social media disengagement. The effect of economic, cultural and social capital on reasons for non-use of social media platforms

Much of the current research on digital and social media practices uses a Bourdieusian framework to explain stratification processes in the digital realm. This approach typically focusses on social media platform users, neglecting the adequate study of non-users. In this paper, we analyse how cultural, economic and cultural capital are related to reasons non-users in Flanders give for not using social media. We find that access remains a significant obstacle for those with low levels of cultural, economic or social capital, while those with more capital tend to avoid social media over concerns about self-presentation. Education level (as a specific indicator of cultural capital) is also related to both technological skills and technophobia (fear of making mistakes), which are more important barriers for the lower educated. The higher educated also list privacy issues and a lack of time as impediments to social media participation. Implications for research on digital inequalities are discussed in the conclusion section.

Parental stress and life satisfaction: A comparative study of social services users and nonusers from a gender perspective.

The psychometric properties of the Spanish version of the Parental Stress Scale (PSS) scale have not been verified on the Spanish population. Similarly, the literature on gender differences and parental stress is inconclusive, and there is little evidence of their relationship with life satisfaction. To analyze the psychometric properties of the Spanish version of the PSS scale, (2) to examine possible gender differences, and (3) to study the relationship between parental stress (PS) and parental rewards (PR) and satisfaction with life (SWL) attending to the possible moderating effect of gender. These objectives were examined in samples comprising Social Services Users (SSU) (N = 525; 78.3% female; Mage = 38.3) and non-SSU users (N = 421; 41.1% male; Mage = 37.08). A CFA corroborated a two-factor structure: PS and PR. In the SSU sample, mothers showed higher PS and lower PR. However, PR was also higher in mothers from the non-SSU sample compared to fathers. PR and PS were directly related to SWL in the SSU sample. However, gender moderated the relationship between PR and SWL in the non-SSU sample in the case of mothers. The results are discussed considering gender roles and the characteristics of both samples.

Interventions to Mitigate Vaping Misinformation: A Meta-Analysis

The impact of misinformation about vapes’ relative harms compared with smoking may lead to increased tobacco-related burden of disease and youth vaping. Unfortunately, vaping misinformation has proliferated. Despite growing attempts to mitigate vaping misinformation, there is still considerable ambiguity regarding the ability to effectively curb the negative impact of misinformation. To address this gap, we use a meta-analysis to evaluate the relative impact of interventions designed to mitigate vaping-related misinformation. We searched (from January 2020 till August 2021) various databases and gray literature. Only English language, original studies that employed experimental designs where participants were randomly assigned either to receive mitigating information or to a no-mitigation condition (either misinformation-only or neutral control) were included. Meta-analysis was conducted for the four eligible studies. The mean effect size of attempts to mitigate vaping misinformation was positive but not statistically significant (d = 0.383, 95% CI [−0.029, 0.796], p = .061, k = 5) with lack of evidence for publication bias. Given limited studies included, we were unable to determine factors affecting the efficacy of interventions. The limited focus on non-US studies and youth populations is concerning given the popularity of vaping in low- to middle-income countries (LMICs) and among youth. The findings of this meta-analysis describe the current state of the literature and prescribe specific recommendations to better address the proliferation of vaping misinformation, providing insights helpful in limiting the tobacco mortality burden and curtailing youth vaping.

Efficacy and Safety of Vamorolone in Duchenne Muscular Dystrophy

Vamorolone is a synthetic steroidal drug with potent anti-inflammatory properties. Initial open-label, multiple ascending dose-finding studies of vamorolone among boys with Duchenne muscular dystrophy (DMD) found significant motor function improvement after 6 months treatment in higher-dose (ie, ≥2.0 mg/kg/d) groups. To investigate outcomes after 30 months of open-label vamorolone treatment. This nonrandomized controlled trial was conducted by the Cooperative International Neuromuscular Research Group at 11 US and non-US study sites. Participants were 46 boys ages 4.5 to 7.5 years with DMD who completed the 6-month dose-finding study. Data were analyzed from July 2020 through November 2021. Participants were enrolled in a 24-month, long-term extension (LTE) study with vamorolone dose escalated to 2.0 or 6.0 mg/kg/d. Change in time-to-stand (TTSTAND) velocity from dose-finding baseline to end of LTE study was the primary outcome. Efficacy assessments included timed function tests, 6-minute walk test, and NorthStar Ambulatory Assessment (NSAA). Participants with DMD treated with glucocorticoids from the Duchenne Natural History Study (DNHS) and NorthStar United Kingdom (NSUK) Network were matched and compared with participants in the LTE study receiving higher doses of vamorolone. Among 46 boys with DMD who completed the dose-finding study, 41 boys (mean [SD] age, 5.33 [0.96] years) completed the LTE study. Among 21 participants treated with higher-dose (ie, ≥2.0 mg/kg/d) vamorolone consistently throughout the 6-month dose-finding and 24-month LTE studies with data available at 30 months, there was a decrease in mean (SD) TTSTAND velocity from baseline to 30 months (0.206 [0.070] rises/s vs 0.189 (0.124) rises/s), which was not a statistically significant change (-0.011 rises/s; CI, -0.068 to 0.046 rises/s). There were no statistically significant differences between participants receiving higher-dose vamorolone and matched participants in the historical control groups receiving glucocorticoid treatment (75 patients in DNHS and 110 patients in NSUK) over a 2-year period in NSAA total score change (0.22 units vs NSUK; 95% CI, -4.48 to 4.04]; P = .92), body mass index z score change (0.002 vs DNHS SD/mo; 95% CI, -0.006 to 0.010; P = .58), or timed function test change. Vamorolone at doses up to 6.0 mg/kg/d was well tolerated, with 5 of 46 participants discontinuing prematurely and for reasons not associated with study drug. Participants in the DNHS treated with glucocorticoids had significant growth delay in comparison with participants treated with vamorolone who had stable height percentiles (0.37 percentile/mo; 95% CI, 0.23 to 0.52 percentile/mo) over time. This study found that vamorolone treatment was not associated with a change in TTSTAND velocity from baseline to 30 months among boys with DMD aged 4 to 7 years at enrollment. Vamorolone was associated with maintenance of muscle strength and function up to 30 months, similar to standard of care glucocorticoid therapy, and improved height velocity compared with growth deceleration associated with glucocorticoid treatment, suggesting that vamorolone may be an attractive candidate for treatment of DMD. ClinicalTrials.gov Identifier: NCT03038399.

A Comparative Study of Users versus Non-Users’ Behavioral Intention towards M-Banking Apps’ Adoption

The banking sector has been considered as one of the primary adopters of Information and Communications Technologies. Especially during the last years, they have invested a lot into the digital transformation of their business process. Concerning their retail customers, banks realized very early the great potential abilities to provide value added self-services functions via mobile devices, mainly smartphones to them; thus, they have invested a lot into m-banking apps’ functionality. Furthermore, the COVID-19 pandemic has brought out different ways for financial transactions and even more mobile users have taken advantage of m-banking app services. Thus, the purpose of this empirical paper is to investigate the determinants that impact individuals on adopting or not m-banking apps. Specifically, it examines two groups of individuals, users (adopters) and non-users (non-adopters) of m-banking apps, and aims to reveal if there are differences and similarities between the factors that impact them on adopting or not this type of m-banking services. To our knowledge, this is the second scientific attempt where these two groups of individuals have been compared on this topic. The paper proposes a comprehensive conceptual model by extending Venkatech’s et al. (2003) Unified Theory of Acceptance and Use of Technology (UTAUT) with ICT facilitators (i.e., reward and security) and ICT inhibitors (i.e., risk and anxiety), as well as the recommendation factor. However, this study intends to fill the research gap by investigating and proving for the first time the impact of social influence, reward and anxiety factors on behavioral intention, the relationship between risk and anxiety and the impact of behavioral intention on recommendation via the application of Confirmatory Factor Analysis and Structural Equation Modeling (SEM) statistical techniques. The results reveal a number of differences regarding the factors that impact or not these two groups towards m-banking app adoption; thus, it provides new insights regarding m-banking app adoption in a slightly examined scientific field. Thus, the study intends to assist the banking sector in better understanding their customers with the aim to formulate and apply customized m-business strategies and increase not only the adoption of m-banking apps but also the level of their further use.

Prevalence of Tuberculosis and Mental Disorders Comorbidity: A Systematic Review and Meta-analysis.

Persons with tuberculosis (TB) also often have a mental disorder (MD). We examined TB-MD comorbidity prevalence and its impact on TB treatment outcomes as reported in studies set in the United States or in the top five countries of origin (Mexico, the Philippines, India, Vietnam, and China) for non-US-born persons with TB. We searched MEDLINE, EMBASE, OVID, PsycINFO, CINAHL, and Scopus for articles published from database inception through September 2018. Of the 9 studies analyzed, one was set in the United States. The estimated pooled prevalence of comorbid TB-MD from eight non-US studies, with 2921 participants, was 34.0% [95% confidence interval (CI) 21.1%-49.5%]. Comorbid TB-MD prevalence varied by country in the studies evaluated. Additional research might elucidate the extent of TB-MD in the United States and the top five countries of origin.

Heritability×SES Interaction for IQ: Is it Present in US Adoption Studies?

An interaction between socioeconomic status (SES) and the heritability of IQ, such that the heritability of IQ increases with higher SES, has been reported in some US twin studies, although not in others, and has generally been absent in studies outside the US (England, Europe, Australia). Is such an interaction present in US adoption studies? Data from two such studies, the Texas and the Colorado Adoption Projects, were examined, involving 238-469 adopted children given IQ tests at various ages. A mini multi-level analysis was made of the prediction of the IQs by the SES of the rearing home (a composite of parental education and occupation), by the birth mother's intelligence, and by the interaction of the two. Neither study showed any substantial heritability×SES interaction: the effect size estimates in units comparable to twin moderation models were negative (-0.042 and -0.004), and the meta-analytic estimate for the combined analysis was -0.27 (SE = 0.042) with a 95% confidence interval of -0.109 to 0.054. Thus, while we cannot rule out positive moderation based on our two studies, the joint agreement across these studies, and with the non-US twin studies, warrants attention in further research. SES may not fully capture proximal familial-environmental aspects that moderate child IQ.

A study of non-users of digital libraries: the case of the Capes digital library in Brazil

PurposeThe purpose of this paper is to understand the reasons that hinder the use of digital libraries.Design/methodology/approachThis study analyzed data obtained through a web survey sent to 14,763 faculty members in Brazilian universities. Of the 6,689 respondents, 1,075 (16.1%) reported not using the Capes digital library and 1,017 answered the questionnaire for non-users.FindingsResults showed that the main reasons for non-use are lack of knowledge of the existence of the Capes digital library, use of other resources, preference for printed journals and difficulty of access. Eight factors of non-use were elicited: insufficient dissemination, inadequacies in contents, in infrastructure, in access policy, in training and in the interface, personal constraints and personal attitude. The reasons and factors for non-use were categorized as intrinsic and extrinsic to the digital library. Intrinsic reasons relate to characteristics of the Capes digital library. Extrinsic factors are influenced by user characteristics. The chi-square test demonstrated that the variables: area of knowledge, age, hours dedicated to research and computer skills influence non-use.Originality/valueThis study has contributed to research about non-users of digital libraries, differing from previous research by surveying a large-scale population and by investigating in a single work the reasons for non-use, other electronic sources used by non-users, advantages of using the digital library and intention of non-users to become users if barriers were removed. Qualitative data complemented the quantitative data collected which allowed a more complete picture of the respondent’s positions.

Race, Ethnicity and Geographical Variables in the Study of Polycystic Ovarian Syndrome

Introduction Polycystic Ovarian Syndrome (PCOS), the most common endocrine disorder in women, is diagnosed based on a pattern of signs/symptoms including obesity, infertility, androgen excess, hirsutism, oligomenorrhea/amenorrhea, metabolic syndrome, and polycystic ovaries on ultrasound. Yet, there is little information on the variation in its presentation or response to treatment based on race or ethnicity. Many metabolic and cardiovascular disease (CVD) factors vary depending on race and/or ethnicity; stratifying PCOS patients in this way allows for a more detailed, individualized treatment. Our aim was to evaluate published primary source studies and describe the PCOS participants based on their race, ethnicity or geographical region. We hypothesized that there is an underrepresentation of minority populations in PCOS studies related to race and/or ethnicity. Methods A PubMed search was done in May 2020 for keywords ‘PCOS’ or ‘Polycystic Ovarian Syndrome’ or ‘Polycystic Ovarian Disease’ combined with keywords ‘Race’ or ‘Ethnicity.’ The resultant studies were limited to randomized control trials (RCT) or clinical trials. Studies were reviewed for classification of race: US Census criteria (white, Black, Native American/Alaskan Native, Asian/ Pacific Islander) or other, and details of Hispanic or non-Hispanic ethnicity. For non-US studies, geographic region was used as a variable for race or ethnicity. Results Our search strategy with chosen keywords yielded 19,756 studies. Limiting to keywords Race or Ethnicity resulted in 804 studies from which 28 were RCT or clinical trials. Of these, 23 studies from years 1994 to 2019 were available for review. Total subjects reported were 8,658, of those 7,451 were patients with PCOS. Race information was available in 10 studies; 3,853 subjects classified as per US census. Hispanic ethnicity information was available in 7 studies; total of 3,484 subjects. Remaining studies were based on geographical region of origin. Most studies did not differentiate Black or white Hispanic groups. There were 10 studies from Southeast Asia, China, and the Middle East that did not report race or ethnicity information. Among those that reported racial data, black people were 15% of participants (579/3,853) in US based studies. Asians were a highly studied group (22%) because of the quantity of publications from that geographical region. Of the symptoms/signs associated with PCOS, the most frequently reported were menstrual disturbances (18/23) and androgen excess (21/23). Less frequently reported were polycystic ovaries on ultrasound (14/23). Only studies based outside the US used infertility or hirsutism as PCOS diagnostic criteria. Conclusions Published reports on PCOS show an under-representation of black women, both as a race and as an ethnic sub-group among Hispanics. Racial/ethnic data has been significant in the management of PCOS comorbidities such as CVD, yet there is a paucity in this information on PCOS. Our future plan is to perform a systematic review of the interaction of race and ethnicity on the presentation and management of PCOS.