Web-based Program Research Articles

Mobile Health App as an Auxiliary Tool in Management of Atopic Dermatitis in Children: Randomized Controlled Trial.

Mobile health apps can boost treatment adherence and support disease management at home. The Atopic App and web-based Atopic School patient education program offer a chance to enhance adherence to atopic dermatitis (AD) management. We aim to evaluate the feasibility, acceptability, and preliminary efficacy of the Atopic App mobile health intervention in the managing of AD in children. A randomized controlled study in children with AD divided participants into 3 groups: a control group (no app), an observational group with the app, and an interventional group with investigator supervision. Patients were examined at screening and follow-up visits 1 and 2 at 3-month intervals. Outcome measures included SCORAD (Scoring Atopic Dermatitis) for objective severity and Patient-Oriented Eczema Measure (POEM) for subjective effectiveness. Statistical analysis used paired t tests (2-tailed), the Mann-Whitney U test, and multiple regression. Fifty-eight participants entered this study (38 boys and 20 girls): group 1 (control) comprised 17 patients, while experimental groups 2 and 3 consisted of 20 and 21 patients, respectively. The rates of missed appointments were similar and statistically insignificant across the groups. All groups showed a significant decrease in SCORAD and POEM scores (P<.05). Usage of the app for ≥8 days showed a more significant decrease in severity scores compared to those who used it for ≤7 days, or did not use it at all. Participants who used the app for ≥8 days had a median SCORAD of 6.25 (95% CI 4.6-14.1; IQR 4-16.3) at visit 1, significantly lower than nonusers (17.9, 95% CI 13.9-24.0; IQR 13.9-24; P=.03) and those using it ≤7 days (13, 95% CI 9.35-27; IQR 7.2-27; P=.04). Their median POEM of 2 (95% CI 1.0-4.5; IQR 1-5.3) was also significantly lower than those using the app ≤7 days (9, 95% CI 2-12; IQR 2-12; P=.04) and lower, though not significantly, than nonusers (7, 95% CI 1-9; IQR 1-9; P=.14). Additionally, using the Atopic App for ≥8 days after the screening visit strongly predicted a decrease in both SCORAD and POEM scores (P=.01 and P=.04, respectively). The time since the screening visit significantly predicted increased outcome scores, while prescriptions of topical calcineurin inhibitors, oral antihistamines, and oral antibiotics were weak and insignificant predictors of score changes. Our findings indicate that the Atopic App is helpful tool in managing AD in children, and they underscore the potential of mobile health interventions in the disease management.

Technology ownership, use, and perceptions of web-based program design features for older adults prescribed oral anticancer medication.

Older adults are often prescribed oral anticancer agents (OAAs). Technology-based interventions may offer medication and symptom support. We aimed to evaluate technology ownership, use, and preferred design features of a supportive web-based program using a multimethod design utilizing surveys and semi-structured interviews. Patients were recruited from a National Cancer Institute-designated Comprehensive Cancer Center. Eligibility included those: (1) ≥65years of age; (2) prescribed a Food and Drug Administration-approved OAA; (3) English speaking; (4) able/willing to complete telephone interviews. Interviews were audio-recorded and transcribed verbatim. Cohen's Kappa was used to evaluate inter-rater reliability and calculated at 0.87. Participants (N=30) were predominantly female (70%), White (83.3%), with metastatic disease (90%). The mean age was 74.9years. Ninety percent owned a smartphone, 66.7% owned a tablet, and 90% owned a computer. Nearly 57% reported using smartphones frequently for cancer-related purposes. Four themes with corresponding subthemes were identified: (1) comfort with technology; (2) reasons for technology use for health-related purposes (research of cancer, cancer treatment, and related symptoms/side effects; using the portal to manage health; and appointment and medication reminders); (3) recommended design features for a web-based program (OAA medication-specific information; calendars & medication alarms/reminders; symptom management & symptom trackers; and tutorials and testimonials); and (4) adaptations for older adults (simple navigation; larger font; use of layperson's terms; use of pictures, graphics, and color coding; and voice activation). Older adults use technology for health-related purposes. Specific web-design features and adaptations are needed to enhance usability among older adults.

Computerized cognitive training for problem gambling: A randomized controlled trial (TRAIN-online).

Non-face-to-face interventions offer promise, with cognitive training showing potential butinconsistent efficacy in problem gambling. We conducted a non-face-to-face, parallel, randomized, controlled, single-blinded trial to evaluate training programs in adults with problem gambling (CPGI ≥5). Participants were randomized 1:1 to a web-based cognitive training program targeting inhibition unrelated to addiction cues or a control program on visuo-spatial functioning. Both programs benefited from weekly phone calls to support engagement and transferability to daily life. Amixed community and out-patient sample was recruited at the national-level. The primary outcome was change in CPGI at week 6. Secondary outcomes were change in impulsivity, gambling behavior andquality of lifeat 6 and 14 weeks. 187 participants were screened, with 185 randomized: 93tointervention and 92 to control. No significant differences were found between groups for any outcome. Mean PGSI change at 6 weeks was -2.75, 95% CI [-12.95; 7.44] in the experimental arm versus -2.44, 95% CI [-13.52; 8.64] in controls, p = 0.76. 34% of participants were classed as no longer problem gamblers at week 14. Intervention acceptability was moderate, with 21 participants (22.58%) in the experimental group, and 32 (34.78%) controls never accessing the platform (p = 0.07). Further research is needed to optimize cognitive interventions in problem gambling, to improve engagement and to demonstrate their added value beyond minimal intervention. For a number of problem gamblers, minimal telephone interventions appeared to be sufficient to reduce gambling. Objective account-based gambling data will provide valuable insights into long-term and objective effects.

The outcome of diabetic retinopathy health education program in patients with type 2 diabetes mellitus: a quasi-experimental study.

Diabetic retinopathy (DR) may develop into sight-threatening DR and vision loss if early intervention is not carried out. This study was aimed to assess the effectiveness of DR health education program for patients with type 2 diabetes mellitus (T2DM). The quasi-experimental research design was applied. The intervention group underwent a web-based DR health education program while the control group was followed up the usual way at an ophthalmology clinic for 1 year. Data were analysed using descriptive statistics, repeated measures ANOVA and general linear model to evaluate the mean difference between groups. A total of 180 patients with T2DM were enrolled in the study, with equal number in the control and intervention groups, respectively, with 28% of dropout rate. There was a significant mean difference in knowledge score [F (1178) = 116.57, P = 0.001], diabetes self-care [F (1178) = 116.57, P = 0.001] and visual-related quality of life [F (1178) = 12.70), P = 0.001] between the control and the intervention groups. The intervention group scored the highest in all three categories. Educational interventions positively affected adherence to self-care and visual-related quality of life in type 2 diabetic patients as shown in this study. DRHEP should be considered an added benefit in T2DM management, starting with comprehensive care enrollment.

A Brief Web-Based Person-Centered Care Group Training Program for the Management of Generalized Anxiety Disorder: Feasibility Randomized Controlled Trial in Spain.

Shared decision-making (SDM) is a crucial aspect of patient-centered care. While several SDM training programs for health care professionals have been developed, evaluation of their effectiveness is scarce, especially in mental health disorders such as generalized anxiety disorder. This study aims to assess the feasibility and impact of a brief training program on the attitudes toward SDM among primary care professionals who attend to patients with generalized anxiety disorder. A feasibility randomized controlled trial was conducted. Health care professionals recruited in primary care centers were randomized to an intervention group (training program) or a control group (waiting list). The intervention consisted of 2 web-based sessions applied by 2 psychologists (VR and YA), based on the integrated elements of the patient-centered care model and including group dynamics and video viewing. The outcome variable was the Leeds Attitudes Towards Concordance scale, second version (LATCon II), assessed at baseline and after the second session (3 months). After the randomized controlled trial phase, the control group also received the intervention and was assessed again. Among 28 randomized participants, 5 withdrew before the baseline assessment. The intervention significantly increased their scores compared with the control group in the total scale (b=0.57; P=.018) and 2 subscales: communication or empathy (b=0.74; P=.036) and shared control (ie, patient participation in decisions: b=0.68; P=.040). The control group also showed significant pre-post changes after receiving the intervention. For a future effectiveness trial, it is necessary to improve the recruitment and retention strategies. The program produced a significant improvement in participants' attitude toward the SDM model, but due to this study's limitations, mainly the small sample size, more research is warranted.

Procalcitonin-guided duration of antibiotic treatment in children hospitalised with confirmed or suspected bacterial infection in the UK (BATCH): a pragmatic, multicentre, open-label, two-arm, individually randomised, controlled trial.

Procalcitonin is a rapid response biomarker specific for bacterial infection, which is not routinely used in the UK National Health Service. We aimed to assess whether using a procalcitonin-guided algorithm would safely reduce the duration of antibiotic therapy compared with usual care, in which C-reactive protein is the commonly used biomarker. The BATCH trial was a pragmatic, multicentre, open-label, parallel, two-arm, individually randomised, controlled trial conducted in 15 hospitals in England and Wales. Children aged 72 h to 18 years who were admitted to hospital and were being treated with intravenous antibiotics for suspected or confirmed bacterial infection and who were expected to remain on intravenous antibiotics for more than 48 h were enrolled. Participants were randomly assigned (1:1) to receive either current clinical management alone (usual care group) or clinical management with the addition of a procalcitonin test guided algorithm (procalcitonin group). Participants were randomly assigned by minimisation, with site and age group (0-6 months, 6 months to 2 years, 2-5 years, and older than 5 years) as minimisation factors and a random element to reduce predictability. Participants were randomly assigned remotely using a secure 24 h web-based randomisation programme. The coprimary outcomes were duration of intravenous antibiotic use, assessed for superiority, and a composite safety measure, assessed for non-inferiority (non-inferiority margin 5%). The primary analysis sample for each coprimary endpoint included all randomly assigned participants with available outcome data. This trial is registered with the International Standard Randomised Controlled Trial Number registry, ISRCTN11369832. Between June 11, 2018, and Oct 12, 2022, 15 282 children were screened for eligibility, 1949 of whom were randomly assigned to receive procalcitonin-guided antibiotic therapy (n=977) or usual care (n=972). The median intravenous antibiotic duration was 96·0 h (IQR 59·5-155·5) in the procalcitonin group and 99·7 h (61·2-153·8) in the usual care group (hazard ratio 0·96 [95% CI 0·87-1·05]). 78 (9%) of 917 participants in the procalcitonin group and 85 (9%) of 904 participants in the usual care group had at least one event covered by the composite safety outcome measure (estimated adjusted risk difference -0·81% [95% CI upper bound 1·11]). In children with suspected or confirmed bacterial infection admitted to hospitals in England and Wales for intravenous antibiotic treatment of at least 48 h, the introduction of a procalcitonin-guided algorithm did not reduce duration of intravenous antibiotics treatment and is non-inferior to usual care for safety outcomes. Therefore, evidence does not support the use of procalcitonin-guided algorithms where robust effective paediatric antibiotic stewardship programmes are established. National Institute for Health and Care Research.

The MyGuide Web-Based Self-Management Tool for Concussion Rehabilitation: Mixed Methods Cross-Sectional Study.

Web-based concussion self-management education programs for adolescents can improve functional outcomes, reduce concussion symptoms, and increase self-efficacy. However, there are a limited number of studies examining the perceptions and acceptance of these programs and the use of these tools in the adult concussion population. This study aimed to investigate the perceptions and acceptance of clinicians and adults with concussions using MyGuide Concussion (Vancouver Coastal Health), a web-based concussion self-management tool. Using a mixed methods sequential explanatory design, a convenience sample of 8 adults with concussions and 8 clinicians who used MyGuide Concussion over a 2-year period were interviewed, and their responses were analyzed. Participants reported two key benefits of using the web-based self-management tool: (1) the tool's emphasis on the interconnectedness of physical and psychological symptoms, and (2) the ability to provide reassurance that symptom being experienced were a normal part of the concussion experience. Clinicians described the tool as being useful as a supplementary source of information for clients in addition to clinical sessions and believed the content was useful for increasing clients' independence in managing their own recovery. Overall, the evaluation of the MyGuide tool is an acceptable and well-perceived tool for adults with concussions who require a basic understanding of concussion recovery, particularly in the early stages of recovery. Future research may include optimizing MyGuide by targeting promotional strategies and addressing other barriers to use.

The Effects of a Web-Based Need-Supportive Intervention for Physical Education Teachers on Students' Physical Activity and Related Outcomes: A Randomized Controlled Trial.

Globally, adolescents are insufficiently active, highlighting the need for effective strategies to enhance their activity levels. This study evaluated a web-based intervention program designed for physical education (PE) teachers, aimed at fostering students' basic psychological needs-autonomy, competence, and relatedness-in PE settings. Secondary school PE teachers and their students were randomly assigned into either an experimental (teachers n = 36; students n = 463, Mage = 13.94, SD = 0.88) or a control group (teachers n = 49; students n = 820, Mage = 13.93, SD = 0.87). Teachers in the experimental group underwent a 4-week web-based intervention program focused on autonomy-, competence-, and relatedness-supportive motivational techniques. Students completed questionnaires assessing psychological measures and self-reported physical activity (PA) before and after the teachers' training. Results indicated that students in the experimental group perceived significantly higher autonomy, competence, and relatedness support compared to their control group counterparts at post-test. Consequently, the web-based need-supportive intervention was effective in promoting need-supportive teacher behavior. As the developed training for PE teachers increased students' perceptions of need support from their PE teachers, it holds promise for future PE teacher education. Furthermore, the web-based format offers scalability for broader implementation.

Ig or Not Ig? That Is the Question: The Nucleating Supersecondary Structure of the Ig-Fold and the Extended Ig Universe.

Observing the omnipresence of the Ig-fold in all domains of life, one may wonder why this fold among all is such a wunderkind of evolution. Culminating in vertebrates, it enables a myriad of functions at the heart of the immune, nervous, vascular, and muscular systems. We suggest the Ig-fold resilience lies in the robust folding of a core supersecondary structure (SSS) that can accommodate a myriad of topological variations. In this chapter, we focus on the core supersecondary structure common to all topostructural variants of the Ig-fold and will see that this pattern can also be found in other β-sandwich folds. It represents a highly resilient central SSS that accommodates a very high plasticity observed among β-sandwiches. We have recently developed a universal numbering system to identify and annotate Ig-domains, Ig-like domains, and what we now call Ig-extended domains, i.e., β-sandwiches that contain and extend the Ig-fold topology (to be published). A universal numbering scheme, common to all topological and structural variants of any domain sharing the Ig-fold, allows a direct comparison of any Ig, Ig-like, and Ig-extended domain in sequence, topology, and structure. This can therefore help understand the robust patterns in Ig-folding and interactions with other Ig or non-Ig proteins, as well as help trace evolutionary patterns of immunoglobulin domains. The universal numbering scheme, called IgStrand, is now at the heart of an algorithm that can label secondary structure elements of the Ig-fold for any topological variant. It is implemented in the open-source web-based iCn3D program from NCBI (Wang, Youkharibache, Zhang, Lanczycki, Geer, Madej, Phan, Ward, Lu, Marchler, Bioinformatics 36:131-135, 2020). Interestingly, that algorithm captures SSS homologies across a very large spectrum of β-sandwiches, and one can envision classifying numerous such sandwiches as "Ig-extended" domains and their variable topological arrangements. In this chapter, we go through examples of Ig, Ig-like, and Ig-extended domains as in a journey through cells: in the cell nucleus, in the cytoplasm, or on extracellular regions of cell surface receptors, and in viruses.

The impact of web-based education provided to parents on the nutritional risk of preschoolers: A quasi-experimental study.

The purpose of this study was to evaluate the effectiveness of web-based nutrition education for parents of preschool children in reducing nutritional risk. The study was conducted in a one-group pretest-posttest quasi-experimental design. Parents of 3-5-year-old children from 11 preschools in Istanbul participated. They underwent a web-based nutrition education program. The NutriSTEP assessment tool was used to evaluate the nutritional risk score as a pretest assessment, followed by the training program. Posttests were conducted at 1- and 3-month intervals. Before the intervention, 55.8% of the children exhibited high nutritional risk. After the intervention, this percentage decreased significantly at the 1-month and 3-month follow-ups, with 94.2% and 93.6% of the children classified as low risk, respectively. The analysis also revealed significant associations between children's eating behaviours and factors such as maternal education, family income and family structure. As a result, web-based nutrition education was effective in reducing nutritional risk among preschool children. The findings underscore the importance of using technology for nutrition interventions, especially in diverse populations. The training program's simple, short and understandable video increased participants' interest in the training and encouraged regular follow-up.

Comparing the OurRelationship Program and Bibliotherapy for Parents Experiencing Couple Distress: A Randomized Pilot.

The OurRelationship Program is an 8-h web-based program for distressed couples adapted from Integrative Behavioral Couple Therapy. In this pilot randomized controlled trial, we aimed to replicate results from the founders and test feasibility criteria for program implementation across cultures. We randomized 39 Danish, opposite-sex, distressed, parenting couples to either the OurRelationship program or self-guided bibliotherapy (a self-help book with a reading guide). Results showed significant within-group changes in couple and individual functioning; for the OurRelationship, small-to-large effect sizes (d = 0.46-1.35 for relationship functioning, d = 0.29-0.80 for individual functioning), and for Bibliotherapy, small-to-moderate changes (d = 0.49-0.75 for relationship functioning, d = 0.28-0.45 for individual functioning). Differences between conditions were insignificant, except for moderate differences in reductions of communication conflict (d = 0.79) and relationship negatives (d = 0.43) in favor of OurRelationship. While feasibility results were positive, a sustainable implementation requires a resourceful organization and large-scale delivery.

Trauma web-based psychoeducational programme: systematic cultural adaptation and protocol for a feasibility-acceptability study

ABSTRACT Background: Trauma exposure in Indonesia is high despite the fact that there is limited accessibility to mental healthcare. Pulihkan Luka (PL) is a web-based trauma psychoeducation intervention that aims to provide a practical solution to overcome barriers to accessing mental healthcare. Objectives: This article aimed to (1) describe the cultural adaptation process of PL for Indonesian students and (2) describe the design of the pilot randomised controlled trial (RCT) that examines the feasibility and acceptability of PL. Methods: First, we describe the cultural adaptation process of PL following the 5-phase Formative Method for Adapting Psychotherapy (FMAP) approach: (1) knowledge generation, (2) information integration, (3) review and revision, (4) mini-testing, and (5) finalisation. Focus Group Discussion (FGD) was conducted to gather the views of 15 stakeholders on psychoeducation material and trauma-related mental health problems. Based on the outcomes, we decided to utilise the informal Indonesian language, incorporate practical worksheets and infographics, which include illustrations that reflect Indonesia’s cultural diversity, and provide guidance on seeking help that aligns with the mental health system in Indonesia. Second, we describe the design of a pilot RCT. Undergraduate students (N = 130) will be randomised to (1) four to seven sessions of PL + Enhanced Usual Care (PL + EUC; n = 65) or (2) Enhanced Usual Care only (EUC only; n = 65). Assessments will be conducted at baseline, post-intervention, and three and six-month follow-up. Additionally, 20 participants will be invited for an FGD to explore their experiences with the intervention. Quantitative data will be analysed using linear mixed-effect models, and qualitative data will be analysed using thematic analysis. Discussion: Cultural adaptation is crucial for optimally developing and assessing the feasibility and acceptability of a web-based trauma psychoeducation intervention in Indonesia. The outcomes of the RCT will inform the feasibility and acceptability of web-based trauma psychoeducation in the Indonesian undergraduate student population.

Positive dementia caregiving in 30 days (PDC30): Study protocol of a randomized controlled trial of a self-guided automated online training program.

The Benefit-Finding Intervention, a face-to-face psychoeducation program with a focus on the positive meanings of caregiving, has been found to reduce depressive symptoms and burden in dementia caregivers. The program was revamped into a computer-delivered web-based program to enable 24/7 access without location restriction. This study evaluates the efficacy of this new online program called Positive Dementia Caregiving in 30 Days (PDC30). A 2-arm (PDC30 vs. waitlist control) parallel-group randomized controlled trial will be conducted. Target sample is 200 mildly depressed dementia family caregivers with internet access and fluency in English, who will be recruited globally through a YouTube video promoted on social media and through service agencies. The primary outcome is depressive symptoms whereas secondary outcomes are anxiety symptoms, burden, and positive gains, all collected at baseline and 1, 2, and 3months. The treatment x time (both linear and quadratic) interaction effects will be examined using mixed-effect regression. Additionally, possible therapeutic mechanisms via strengthened self-efficacy in controlling upsetting thoughts and positive reappraisal coping will be examined in a mediation path model. If positive treatment effects are found, the potential public health benefits, given the ease of access, universal availability, and flexible approach, of this online intervention are considerable.

Design of Al-Husna canteen inventory and Sales System Uses User Centered Design

The Al-Husna School canteen provides food and other supplies that are ready to assist and serve students and teachers according to their needs. The school canteen members consist of seven people who provide food and other items to ensure that the needs of students and teachers are met. Sometimes, there are members who are not registered as official canteen members, and this can be considered illegal as they provide food without the knowledge of the canteen manager. Each canteen member is only allowed to supply their food once in the canteen for sale. If their stock runs out, they are not allowed to restock their food so that the remaining food from other members' supplies can also be sold out. The issue with this situation is that not only are there members who are not registered as canteen members and are unfair in providing food stock in the school canteen, but also errors in the canteen's records, such as input mistakes, forgetting to record canteen activities, and errors in the canteen's financial reports. Therefore, there is a need to develop a web-based program using PHP and MySQL programming languages. The method used for evaluating this website is the User-Centered Design method, which includes several indicators for providing feedback. Using this method, there is one sample or user, the canteen manager, who evaluates the website based on the User-Centered Design indicators. The results from data processing with a direct calculation show a score of 370, indicating that the system is feasible.

Effects of a Comprehensive Program on Reducing Cancer-Related Fatigue: A Randomized Controlled Trial.

Cancer-related fatigue (CRF) can affect patients undergoing chemotherapy severely. A comprehensive intervention targeted for reducing CRF is lacking. To evaluate the effectiveness of an innovative multifaceted web-based patient-empowered CRF management program for improving CRF, perceived self-efficacy for fatigue self-management (PSEFSM), physical activity, quality of sleep, anxiety, depression, pain and quality of life (QoL) among gastric cancer patients undergoing chemotherapy in China. A total of 92 eligible gastric cancer patients undergoing chemotherapy were recruited and randomly assigned to two groups. Participants in the intervention group received a 12-week CRF intervention including eight online sessions, patient diary for self-management practice; telephone follow-up and online support via WeChat. The control group received routine care. Primary outcome was CRF. Secondary outcomes included PSEFSM, physical activity, quality of sleep, anxiety, depression, pain, and QoL. Outcome variables were measured three times: at admission(T0), post-intervention(T1) and one-month post-intervention(T2). Repeated measures ANOVA or generalized estimating equations were used to evaluate the intervention effect. Significant group by time interaction was found in the scores of total CRF and its three dimensions, PSEFSM, total physical activities, quality of sleep, anxiety, depression, and QoL of the two groups (P <0.05). No significant difference was found in pain scores (P >0.05). This study provides evidence that an innovative multifaceted web-based patient-empowered CRF management program is effective in reducing CRF and improving related symptoms (depression, anxiety, quality of sleep), physical activity, PSEFSM and QoL for gastric cancer patients undergoing chemotherapy.

Effect of Proximal Blood Flow Arrest During Endovascular Thrombectomy (ProFATE): A Multicenter, Blinded-End Point, Randomized Clinical Trial.

The effect of temporary blood flow arrest during endovascular thrombectomy for acute ischemic stroke is uncertain due to the lack of evidence from randomized controlled trials. We aimed to investigate whether temporary blood flow arrest during endovascular thrombectomy using a balloon guide catheter improves intracranial vessel recanalization compared with nonflow arrest. The ProFATE trial (Proximal Blood Flow Arrest During Endovascular Thrombectomy) was a multicenter, randomized, participant- and outcome-blinded trial at 4 thrombectomy centers in the United Kingdom. Adults with acute ischemic stroke due to anterior circulation large vessel occlusion were randomly assigned (1:1) by a central, Web-based program with a minimization algorithm to undergo thrombectomy with temporary proximal blood flow arrest or nonflow arrest during each attempt. The primary outcome was the proportion of participants achieving near-complete/complete vessel recanalization (expanded Thrombolysis in Cerebral Infarction score of 2c or 3) at the end of the thrombectomy procedure, adjudicated by a blinded independent imaging core laboratory. Analyses were performed on the intention-to-treat population, adjusted for age, IV thrombolysis, onset-to-randomization time, Alberta Stroke Program Early CT Score, occlusion site, randomization site, and National Institutes of Health Stroke Scale. Between October 10, 2021, and June 27, 2023, we recruited 134 participants, of whom 131 participants (mean age, 75 years; 62 [47%] women and 69 [53%] men) were included in the final analysis. Sixty-six participants were allocated to the temporary blood flow arrest group and 65 to the nonflow arrest group. The proportion of participants with an expanded Thrombolysis in Cerebral Infarction 2c/3 score at the end of the endovascular procedure was 74.4% (49/66) in the flow arrest group and 70.8% (46/65) in the nonflow arrest group (adjusted odds ratio, 1.07 [95% CI, 0.45-2.55]; P=0.88). Among the prespecified secondary efficacy outcomes, a lower rate of emboli to a new vascular territory occurred in the blood flow arrest group compared with the nonflow arrest group (1.5% versus 12.3%; adjusted odds ratio, =0.04 [95% CI, 0.01-0.53]; P=0.014) and a higher rate of complete recanalization (expanded Thrombolysis in Cerebral Infarction score, 3) after the first attempt in the flow arrest group versus the nonflow arrest group (33.0% versus 15.3%; adjusted odds ratio, =3.80 [95% CI, 1.40-10.01]; P=0.007). No between-group differences were identified for the remaining procedural or clinical efficacy (modified Rankin Scale at 90 days) or safety outcomes (worsening of the stroke severity at 24 hours, adverse events, symptomatic intracranial hemorrhage, or mortality). Among patients presenting with anterior circulation large vessel occlusion acute ischemic stroke, temporary proximal blood flow arrest during endovascular thrombectomy, compared with nonflow arrest, did not significantly improve the near-complete/complete vessel recanalization (expanded Thrombolysis in Cerebral Infarction score, 2c-3) at the end of the procedure. Larger randomized controlled trials are warranted to confirm or refute a clinically significant treatment effect of temporary flow arrest on the functional outcome following endovascular thrombectomy. URL: https://www.clinicaltrials.gov; Unique identifier: NCT05020795.

Bioinformatic Comparisons of Some Web-based PCR Primer Design Programs

Bioinformatics has become an indispensable tool for both basic and applied research in biotechnology in the life sciences. The polymerase chain reaction (PCR) is a laboratory method that can be used to quickly amplify a large number of identical copies of a specific DNA segment. In PCR, short synthetic DNA fragments known as primers are used to selectively amplify a specific section of the genome. For PCR to be as efficient and specific as possible, it is important to choose an effective primer sequence and use the correct concentration of primers. If the primer is not designed carefully, non-specific amplification and/or primer dimer formation may occur, which may prevent product formation. Currently, a number of different design tools are available on the internet to assist molecular geneticists in designing PCR primers under optimal conditions. In this study, out of 39 web-based PCR primer design programs, 7 accessible, freely available and widely used web-based PCR primer design programs (NCBI, Primer3, Biserach, Genscript and Primer3plus; Stitcher 2.0; and PrimerQest Tool) were compared using bioinformatics applications for genomic sequences. The advantages and disadvantages of the web-based PCR programs are discussed on the basis of the comparison results.

Web-Based Parent Training With Telephone Coaching Aimed at Treating Child Disruptive Behaviors in a Clinical Setting During the COVID-19 Pandemic: Single-Group Study With 2-Year Follow-Up.

There is a lack of studies examining the long-term outcomes of web-based parent training programs implemented in clinical settings during the COVID-19 pandemic. The aim is to study 2-year outcomes of families with 3- to 8-year-old children referred from family counseling centers to the Finnish Strongest Families Smart Website (SFSW), which provides digital parent training with telephone coaching aimed at treating child disruptive behaviors. Counseling centers in Helsinki identified fifty 3- to 8-year-old children with high levels of disruptive behavioral problems. Child psychopathology and functioning as well as parenting styles and parental mental health were collected from parents at baseline; posttreatment; and at 6-, 12-, and 24-month follow-ups. The SFSW program had positive long-term changes in child psychopathology and parenting skills. Improvements in child psychopathology, including Strengths and Difficulties Questionnaire total score (Cohen d=0.47; P<.001), Strengths and Difficulties Questionnaire conduct scores (Cohen d=0.65; P<.001), and Affective Reactivity Index irritability scores (Cohen d=0.52; P<.001), were maintained until the 24-month follow-up. Similarly, changes in parenting skills measured with the Parenting Scale, including overreactivity (Cohen d=0.41; P=.001) and laxness (Cohen d=0.26; P=.02), were maintained until the 24-month follow-up. However, parental hostility changes were not maintained at long-term follow-up (Cohen d=-0.04; P=.70). The study shows that the SFSW parent training program can yield significant long-term benefits. Findings indicate that the benefits of the treatment may vary between different parenting styles, which is important to consider when developing more personalized parenting interventions.

The Impact of Assistive Technologies in Enhancing English Learning Outcomes for Students with Disabilities: A Meta-Narrative Analysis

Integrating assistive technologies in education is crucial for enhancing English learning outcomes among students with disabilities. This meta-narrative analysis aims to synthesize existing research on the impact of assistive technologies in improving English language skills in this population. We conducted a comprehensive search across databases, including Taylor and Francis and Scopus, identifying relevant studies published from 2020 to 2023. Eleven peer-reviewed articles met the inclusion criteria, focusing on empirical studies that evaluated tools such as EducaPlay, Rosetta Stone, PECS, AR applications, inclusive videos, LEA tools, VAS and multimedia tools, web-based drill programs, the AMALL application, and various assistive technologies like JAWS, MELDICT, OCR scanners, and Braille devices. Data collection involved extracting critical information on the effectiveness of the learning tools, types of disabilities, and educational outcomes related to language skills in using technology learning tools to study the English language for disabled students. The analysis revealed significant improvements in vocabulary, reading comprehension, and writing skills, demonstrating the positive impact of assistive technologies on English learning. The findings suggest that these technologies enhance engagement and motivation, offering personalized support that addresses individual needs. The discussion highlights the variability in effectiveness across different technologies and the importance of proper implementation and training for educators.

Overview of Computational Toxicology Methods Applied in Drug and Green Chemical Discovery.

In the field of computational chemistry, computer models are quickly and cheaply constructed to predict toxicology hazards and results, with no need for test material or animals as these computational predictions are often based on physicochemical properties of chemical structures. Multiple methodologies are employed to support in silico assessments based on machine learning (ML) and deep learning (DL). This review introduces the development of computational toxicology, focusing on ML and DL and emphasizing their importance in the field of toxicology. A fine balance between target potency, selectivity, absorption, distribution, metabolism, excretion, toxicity (ADMET) and clinical safety properties should be achieved to discover a potential new drug. It is advantageous to perform virtual predictions as early as possible in drug development processes, even before a molecule is synthesized. Currently, there are numerous commercially available and free web-based programs for toxicity prediction, which can be used to construct various predictive models. The key features of the QSAR method are also outlined, and the selection of appropriate physicochemical descriptors is a prerequisite for robust predictions. In addition, examples of open-source tools applied to toxicity prediction are included, as well as examples of the application of different computational methods for the prediction of toxicity in drug design and environmental toxicology.