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Oxidative Stress Markers and Prediction of Severity With a Machine Learning Approach in Hospitalized Patients With COVID-19 and Severe Lung Disease: Observational, Retrospective, Single-Center Feasibility Study. 用机器学习方法预测COVID-19合并严重肺部疾病住院患者的氧化应激标志物和严重程度:观察性、回顾性、单中心可行性研究
IF 2
JMIR Formative Research Pub Date : 2025-04-11 DOI: 10.2196/66509
Olivier Raspado, Michel Brack, Olivier Brack, Mélanie Vivancos, Aurélie Esparcieux, Emmanuelle Cart-Tanneur, Abdellah Aouifi
{"title":"Oxidative Stress Markers and Prediction of Severity With a Machine Learning Approach in Hospitalized Patients With COVID-19 and Severe Lung Disease: Observational, Retrospective, Single-Center Feasibility Study.","authors":"Olivier Raspado, Michel Brack, Olivier Brack, Mélanie Vivancos, Aurélie Esparcieux, Emmanuelle Cart-Tanneur, Abdellah Aouifi","doi":"10.2196/66509","DOIUrl":"https://doi.org/10.2196/66509","url":null,"abstract":"<p><strong>Background: </strong>Serious pulmonary pathologies of infectious, viral, or bacterial origin are accompanied by inflammation and an increase in oxidative stress (OS). In these situations, biological measurements of OS are technically difficult to obtain, and their results are difficult to interpret. OS assays that do not require complex preanalytical methods, as well as machine learning methods for improving interpretation of the results, would be very useful tools for medical and care teams.</p><p><strong>Objective: </strong>We aimed to identify relevant OS biomarkers associated with the severity of hospitalized patients' condition and identify possible correlations between OS biomarkers and the clinical status of hospitalized patients with COVID-19 and severe lung disease at the time of hospital admission.</p><p><strong>Methods: </strong>All adult patients hospitalized with COVID-19 at the Infirmerie Protestante (Lyon, France) from February 9, 2022, to May 18, 2022, were included, regardless of the care service they used, during the respiratory infectious COVID-19 epidemic. We collected serous biomarkers from the patients (zinc [Zn], copper [Cu], Cu/Zn ratio, selenium, uric acid, high-sensitivity C-reactive protein [hs-CRP], oxidized low-density lipoprotein, glutathione peroxidase, glutathione reductase, and thiols), as well as demographic variables and comorbidities. A support vector machine (SVM) model was used to predict the severity of the patients' condition based on the collected data as a training set.</p><p><strong>Results: </strong>A total of 28 patients were included: 8 were asymptomatic at admission (grade 0), 14 had mild to moderate symptoms (grade 1) and 6 had severe to critical symptoms (grade 3). As the first outcome, we found that 3 biomarkers of OS were associated with severity (Zn, Cu/Zn ratio, and thiols), especially between grades 0 and 1 and between grades 0 and 2. As a second outcome, we found that the SVM model could predict the level of severity based on a biological analysis of the level of OS, with only 7% misclassification on the training dataset. As an illustrative example, we simulated 3 different biological profiles (named A, B, and C) and submitted them to the SVM model. Profile B had significantly high Zn, low hs-CRP, a low Cu/Zn ratio, and high thiols, corresponding to grade 0. Profile C had low Zn, low selenium, high oxidized low-density lipoprotein, high glutathione peroxidase, a low Cu/Zn ratio, and low glutathione reductase, corresponding to grade 2.</p><p><strong>Conclusions: </strong>The level of severity of pulmonary damage in patients hospitalized with COVID-19 was predicted using an SVM model; moderate to severe symptoms in patients were associated with low Zn, low plasma thiol, increased hs-CRP, and an increased Cu/Zn ratio among a panel of 10 biomarkers of OS. Since this panel does not require a complex preanalytical method, it can be used and studied in other pathologies associated with OS","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e66509"},"PeriodicalIF":2.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating User Experience and Satisfaction in a Concussion Rehabilitation App: Usability Study. 评估脑震荡康复应用程序中的用户体验和满意度:可用性研究。
IF 2
JMIR Formative Research Pub Date : 2025-04-11 DOI: 10.2196/67275
Michael G Hutchison, Alex P Di Battista, Kyla L Pyndiura
{"title":"Evaluating User Experience and Satisfaction in a Concussion Rehabilitation App: Usability Study.","authors":"Michael G Hutchison, Alex P Di Battista, Kyla L Pyndiura","doi":"10.2196/67275","DOIUrl":"https://doi.org/10.2196/67275","url":null,"abstract":"<p><strong>Background: </strong>Evidence-based guidelines support the use of structured exercise to facilitate concussion recovery. Despite the growing number of mobile health (mHealth) apps aimed at managing concussions, few focus on delivering exercise rehabilitation protocols. Therefore, a mobile app was developed to provide personalized rehabilitation programs based on evidence-based exercise principles designed to cater to individuals recovering from concussions.</p><p><strong>Objective: </strong>This study aimed to evaluate the usability and user experience of a mobile app designed to deliver an evidence-based rehabilitation program to individuals recovering from concussions.</p><p><strong>Methods: </strong>A two-week prospective single-arm pilot study was conducted among adults with a physician-diagnosed concussion. Participants engaged in home-based rehabilitation exercises through a mobile app. Usability was assessed using a combination of the mHealth App Usability Questionnaire (MAUQ) and five custom questions evaluating confidence in recommendations, exercise flow, clarity of voice commands, and usability of the exercise report feature. Following the two-week period, participants rated each question on a 7-point Likert scale ranging from \"strongly agree\" to \"strongly disagree\".</p><p><strong>Results: </strong>Twenty-six participants consented and were enrolled in the study, with 23 participants (82%) completing all study components at the end of two weeks. The majority of participants were women, aged 26-38 years, and on average, approximately at three months postconcussion. Responses to both the MAUQ and custom questions were overwhelmingly positive. Overall, seven MAUQ questions received 100% positive responses, with no single question scoring below 83% positive responses. In the \"ease of use and satisfaction\" category, 100% of users responded positively to questions on ease of learning, usability, interface likeness, and comfort in social settings, while 83%-96% (19-22) of users responded positively to the remaining four questions. In the \"system information arrangement\" category, 100% (N=23) of users rated screen navigation, function usability, and health care service acceptability positively, with 87%-96% of users approving action acknowledgment, error recovery, and expected functions. Under the \"usefulness\" category, 96% (n=22) of users found the app beneficial for health and well-being, and 91% (n=21) users felt it effectively managed their health. For the five custom questions, 100% (N=23) users responded positively to voice command clarity, exercise awareness, ease of following exercises, and report understandability, with a single unfavorable response noted for confidence in app recommendations.</p><p><strong>Conclusions: </strong>The findings of this study indicate that the mobile app is a user-friendly platform for delivering evidence-based exercise rehabilitation to individuals recovering from concussions. Positive user fe","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e67275"},"PeriodicalIF":2.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development of an eHealth Mindfulness-Based Music Therapy Intervention for Adults Undergoing Allogeneic Hematopoietic Stem Cell Transplantation: Qualitative Study. 电子健康正念音乐治疗干预成人异体造血干细胞移植的发展:定性研究。
IF 2
JMIR Formative Research Pub Date : 2025-04-11 DOI: 10.2196/65188
Sara E Fleszar-Pavlovic, Blanca Noriega Esquives, Padideh Lovan, Arianna E Brito, Ann Marie Sia, Mary Adelyn Kauffman, Maria Lopes, Patricia I Moreno, Tulay Koru-Sengul, Rui Gong, Trent Wang, Eric D Wieder, Maria Rueda-Lara, Michael Antoni, Krishna Komanduri, Teresa Lesiuk, Frank J Penedo
{"title":"Development of an eHealth Mindfulness-Based Music Therapy Intervention for Adults Undergoing Allogeneic Hematopoietic Stem Cell Transplantation: Qualitative Study.","authors":"Sara E Fleszar-Pavlovic, Blanca Noriega Esquives, Padideh Lovan, Arianna E Brito, Ann Marie Sia, Mary Adelyn Kauffman, Maria Lopes, Patricia I Moreno, Tulay Koru-Sengul, Rui Gong, Trent Wang, Eric D Wieder, Maria Rueda-Lara, Michael Antoni, Krishna Komanduri, Teresa Lesiuk, Frank J Penedo","doi":"10.2196/65188","DOIUrl":"https://doi.org/10.2196/65188","url":null,"abstract":"<p><strong>Background: </strong>Allogeneic hematopoietic stem cell transplantation (allo-SCT) is an effective treatment for various hematologic cancers, though it often results in severe side effects and psychological distress, which can negatively impact health outcomes. Integrative therapies like mindfulness-based stress reduction (MBSR), mindfulness meditation (MM), and music therapy (MT) yield promising results in enhancing both psychosocial outcomes (eg, reducing anxiety and depression) and physiological adaptation (eg, decreasing inflammation) in cancer patients.</p><p><strong>Objective: </strong>We developed and refined, using focus groups and environmental and field testing, an eHealth-delivered mindfulness-based music therapy (eMBMT) intervention aimed at improving health-related quality of life, symptom burden (ie, pain, fatigue, and sleep), disease activity (ie, chronic graft-versus-host disease, cytomegalovirus activation, and infections) and psychosocial (ie, depression, anxiety, and cancer-specific distress) and physiological adaptation (ie, inflammation and immune reconstitution) tailored to adults receiving allo-SCT.</p><p><strong>Methods: </strong>eMBMT intervention content is grounded in MT, MM, and MBSR, developed by a multidisciplinary team, and adapted for adults undergoing allo-SCT. eMBMT content was refined through focus groups and usability and field testing. Focus groups used a semistructured interview guide, while field testing used the \"think aloud\" method. Usability was evaluated using the 30-item Usefulness, Satisfaction, and Ease of Use (USE) questionnaire. Descriptive statistics analyzed the USE questionnaire and participant characteristics, while rapid qualitative analysis was applied to focus groups and field-testing sessions. Survivors eligible to participate in the focus groups and usability and field testing were adults (>18 years old) who received an allo-SCT (<36 months) for myelodysplastic syndrome, acute myeloid leukemia, or chronic myeloid leukemia, and were in remission for greater than 3 months.</p><p><strong>Results: </strong>During the focus groups, participants (n=11; mean age 43.6, SD 17.8 years) provided qualitative feedback highlighting the shock of diagnosis, challenges during hospitalization, and coping strategies posttreatment. The eMBMT platform received positive evaluations for usefulness (mean 6.47, SD 0.29), ease of use (mean 6.92, SD 0.60), and satisfaction (mean 6.16, SD 0.82). Key themes from field testing highlighted the significance of social support, hope, and maintaining an active lifestyle. Suggestions for improvement included incorporating more representative content, reducing text, enhancing guidance, offering diverse music options, and streamlining blood sample collection.</p><p><strong>Conclusions: </strong>The eMBMT intervention is a comprehensive, user-friendly eHealth tool tailored to the unique needs of allo-SCT patients. The positive feedback and identified areas for improve","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e65188"},"PeriodicalIF":2.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Encouraging the Voluntary Mobilization of Mental Resources by Manipulating Task Design: Explorative Study. 通过操纵任务设计鼓励心理资源的自愿调动:探索性研究。
IF 2
JMIR Formative Research Pub Date : 2025-04-10 DOI: 10.2196/63491
Lina-Estelle Louis, Saïd Moussaoui, Sébastien Ravoux, Isabelle Milleville-Pennel
{"title":"Encouraging the Voluntary Mobilization of Mental Resources by Manipulating Task Design: Explorative Study.","authors":"Lina-Estelle Louis, Saïd Moussaoui, Sébastien Ravoux, Isabelle Milleville-Pennel","doi":"10.2196/63491","DOIUrl":"https://doi.org/10.2196/63491","url":null,"abstract":"<p><strong>Background: </strong>Cognitive training is increasingly being considered and proposed as a solution for several pathologies, particularly those associated with aging. However, trainees need to be willing to invest enough mental effort to succeed and make progress.</p><p><strong>Objective: </strong>In this study, we explore how gamification in a narrative context (ie, the addition of visual game-like elements [GLEs] embedded in real-world contexts) could contribute increase in perceived playfulness (PP) and voluntary mental effort allocated to a cognitive task. In such context, narrative elements and GLEs can be designed to align with a commonly relatable scenario (like simulating fishing or gardening activity) to ground the task in familiar, real-world contexts. We also consider if the supposed effect of GLEs on PP and voluntary mental effort could endure while manipulating an intrinsic variable of the task (ie, by increasing cognitive solicitation).</p><p><strong>Methods: </strong>In total, 20 participants (average age 33.6, SD 8.6 y) took part in 3 cognitive tasks proposed in a numerical format: a classic version of the Corsi test (Classic Corsi, a spatial memory task), a playful version of the Classic Corsi test (Playful Corsi), with added visual GLEs in a narrative context, and a playful version of the Classic Corsi test with added cognitive solicitation, that is, mental motor inhibition (Playful Corsi Multi). We assessed the impact of visual GLEs and cognitive solicitation on PP (1 question) and mental workload (MWL) using NASA-Task Load Index (NASA-TLX) and workload profile (WP) questionnaires.</p><p><strong>Results: </strong>Results showed that PP was not influenced by interface's playful characteristics (Classic Corsi [mean 62.4, SD 8.8] vs Playful Corsi [mean 66, SD 8.8]; W=77; P=.30) but decreased the time necessary to complete the task (Classic Corsi [mean 10.7, SD 2.1 s] vs Playful Corsi [mean 6.8, SD 1.6 s]; W=209; P<.001) as well as performance (Classic Corsi [mean 92.4, SD 9.1] vs Playful Corsi [mean 88.2, SD 11.3]; W=140.5; P=.02). So, possibly, visual GLEs could raise the stakes of the task slightly and implicitly encourage people to go a bit faster. Furthermore, visual GLEs increased MWL regarding attentional resources (assessed by WP: Classic Corsi [mean 52.4, SD 10.9] vs Playful Corsi [mean 65.8, SD 10.9]; W=27.5; P=.04), while manipulating cognitive solicitation impacted MWL when linked to task requirements (assessed by NASA-TLX: Playful Corsi [mean 54.2, SD 9.4] vs Playful Corsi Multi [mean 67.5, SD 9.4]; W=35.5; P=.01) without impacting the performance to the task (Playful Corsi [mean 83.8, SD 13.9] vs Playful Corsi Multi [mean 94, SD 5.5]; W=27; P=.007). Thus, working on the way cognitive functions are solicited would be wiser than adding visual GLEs to improve users' voluntary mental effort while preserving performance.</p><p><strong>Conclusions: </strong>These results offer valuable insights to improve users' ","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e63491"},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improving Health and Well-Being of People With Post-COVID-19 Consequences in South Africa: Situation Analysis and Pilot Intervention Design. 改善南非covid -19后人民的健康和福祉:情况分析和试点干预设计。
IF 2
JMIR Formative Research Pub Date : 2025-04-10 DOI: 10.2196/58436
Nicole Audrey Glover, Farzana Sathar, Pride Mokome, Nkululeko Mathabela, Sipokazi Taleni, Sarah Alexandra van Blydenstein, Anna-Maria Mekota, Salome Charalambous, Andrea Rachow, Olena Ivanova
{"title":"Improving Health and Well-Being of People With Post-COVID-19 Consequences in South Africa: Situation Analysis and Pilot Intervention Design.","authors":"Nicole Audrey Glover, Farzana Sathar, Pride Mokome, Nkululeko Mathabela, Sipokazi Taleni, Sarah Alexandra van Blydenstein, Anna-Maria Mekota, Salome Charalambous, Andrea Rachow, Olena Ivanova","doi":"10.2196/58436","DOIUrl":"https://doi.org/10.2196/58436","url":null,"abstract":"<p><strong>Background: </strong>Multisystemic complications post-COVID-19 infection are increasingly described in the literature, yet guidance on the management remains limited.</p><p><strong>Objectives: </strong>This study aimed to assess the needs, preferences, challenges, and existing interventions for individuals with post-COVID-19 symptoms. Based on this, we aimed to develop a context-adapted intervention to improve the overall health and well-being of individuals with post-COVID-19 complications.</p><p><strong>Methods: </strong>We conducted a cross-sectional mixed-methods situation analysis assessing the needs, preferences, challenges, and existing interventions for patients with post-COVID-19 symptoms. We collected data through questionnaires, semistructured in-depth interviews, and focus group discussions (FGDs) from individuals diagnosed with COVID-19 within the previous 18-month period and health care providers who managed patients with COVID-19 in both inpatient and outpatient settings. Quantitative data were summarized using descriptive statistics, qualitative data were transcribed, and deductive analysis focused on suggestions for future interventions. Findings guided the development of a group intervention.</p><p><strong>Results: </strong>We conducted 60 questionnaires, 13 interviews, and 3 FGDs. Questionnaires showed limited knowledge of post-COVID-19 complications at 26.7% (16/60). Of those who received any rehabilitation for COVID-19 (19/60, 31.7%), 94.7% (18/19) found it helpful for their recovery. Just over half (23/41, 56%) of those who did not receive rehabilitation reported that they would have liked to. The majority viewed rehabilitation as an important adjunct to post-COVID-19 care (56/60, 93.3%) and that support groups would be helpful (53/60, 88.3%). Qualitative results highlighted the need for mental health support, structured post-COVID-19 follow-up, and financial aid in post-COVID-19 care. Based on the insights from the situation analysis, the theory of change framework, and existing post-COVID-19 evidence, we designed and conducted a pilot support group and rehabilitation intervention for individuals with post-COVID-19 complications. Our main objective was to assess the change in physical and psychological well-being pre- and postintervention. The intervention included 8 weekly themed group sessions supplemented by home tasks. Effectiveness of the intervention was evaluated by questionnaires pre- and postintervention on post-COVID-19 symptoms, quality of life with the EuroQoL 5-Dimension 5-Level, short Warwick-Edinburgh Mental Wellbeing Scale, and physical function by spirometry and 1-minute sit-to-stand test. We also assessed the feasibility and acceptability of the intervention by questionnaires and semistructured in-depth interviews. The intervention outcome analysis is yet to be conducted.</p><p><strong>Conclusions: </strong>Insights from patients and health care providers on the characteristics of post-COVID-19 ","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e58436"},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Support of Home-Based Structured Walking Training and Prediction of the 6-Minute Walk Test Distance in Patients With Peripheral Arterial Disease Based on Telehealth Data: Prospective Cohort Study. 基于远程医疗数据的外周动脉疾病患者家庭结构化步行训练的支持和6分钟步行测试距离的预测:前瞻性队列研究
IF 2
JMIR Formative Research Pub Date : 2025-04-10 DOI: 10.2196/65721
Fabian Wiesmüller, Andreas Prenner, Andreas Ziegl, Gihan El-Moazen, Robert Modre-Osprian, Martin Baumgartner, Marianne Brodmann, Gerald Seinost, Günther Silbernagel, Günter Schreier, Dieter Hayn
{"title":"Support of Home-Based Structured Walking Training and Prediction of the 6-Minute Walk Test Distance in Patients With Peripheral Arterial Disease Based on Telehealth Data: Prospective Cohort Study.","authors":"Fabian Wiesmüller, Andreas Prenner, Andreas Ziegl, Gihan El-Moazen, Robert Modre-Osprian, Martin Baumgartner, Marianne Brodmann, Gerald Seinost, Günther Silbernagel, Günter Schreier, Dieter Hayn","doi":"10.2196/65721","DOIUrl":"https://doi.org/10.2196/65721","url":null,"abstract":"<p><strong>Background: </strong>Telehealth has been effective in managing cardiovascular diseases like stroke and heart failure and has shown promising results in managing patients with peripheral arterial disease. However, more work is needed to fully understand the effect of telehealth-based predictive modeling on the physical fitness of patients with peripheral arterial disease.</p><p><strong>Objective: </strong>For this work, data from the Keep Pace study were analyzed in depth to gain insights on temporal developments of patients' conditions and to develop models to predict the patients' total walking distance at the study end. This could help to determine patients who are likely to benefit from the telehealth program and to continuously provide estimations to the patients as a motivating factor.</p><p><strong>Methods: </strong>This work analyzes continuous patient-reported telehealth data, in combination with in-clinic data from 19 Fontaine stage II patients with peripheral arterial disease who underwent a 12-week telehealth-based walking program. This analysis granted insights into the increase of the total walking distance of the 6-minute walk tests (6MWT) as a measure for physical fitness, the steady decrease in the patients' pain, and the positive correlation between well-being and the total walking distance measured by the 6MWT.</p><p><strong>Results: </strong>This work analyzed trends of and correlations between continuous patient-generated data. Findings of this study include a significant decrease of the patients' pain sensation over time (P=.006), a low but highly significant correlation between pain sensation and steps taken on the same day (r=-0.11; P<.001) and the walking distance of the independently performed 6MWTs (r=-0.39; P<.001). Despite the reported pain, adherence to the 6MWT measurement protocol was high (85.53%). Additionally, patients significantly improved their timed-up-and-go test times during the study (P=.002). Predicting the total walking distance at the study end measured by the 6MWT worked well at study baseline (root mean squared error of 30 meters; 7.04% of the mean total walking distance at the study end of 425 meters) and continuously improved by adding further telehealth data. Future work should validate these findings in a larger cohort and in a prospective setting based on a clinical outcome.</p><p><strong>Conclusions: </strong>We conclude that the prototypical trend estimation has great potential for an integration in the telehealth system to be used in future work to provide tailored patient-specific advice based on these predictions. Continuous data from the telehealth system grant a deeper insight and a better understanding of the patients' status concerning well-being and level of pain as well as their current physical fitness level and the progress toward reaching set goals.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e65721"},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Web-Based Explainable Machine Learning-Based Drug Surveillance for Predicting Sunitinib- and Sorafenib-Associated Thyroid Dysfunction: Model Development and Validation Study. 基于网络的可解释机器学习的药物监测预测舒尼替尼和索拉非尼相关甲状腺功能障碍:模型开发和验证研究。
IF 2
JMIR Formative Research Pub Date : 2025-04-10 DOI: 10.2196/67767
Fan-Ying Chan, Yi-En Ku, Wen-Nung Lie, Hsiang-Yin Chen
{"title":"Web-Based Explainable Machine Learning-Based Drug Surveillance for Predicting Sunitinib- and Sorafenib-Associated Thyroid Dysfunction: Model Development and Validation Study.","authors":"Fan-Ying Chan, Yi-En Ku, Wen-Nung Lie, Hsiang-Yin Chen","doi":"10.2196/67767","DOIUrl":"https://doi.org/10.2196/67767","url":null,"abstract":"<p><strong>Background: </strong>Unlike one-snap data collection methods that only identify high-risk patients, machine learning models using time-series data can predict adverse events and aid in the timely management of cancer.</p><p><strong>Objective: </strong>This study aimed to develop and validate machine learning models for sunitinib- and sorafenib-associated thyroid dysfunction using a time-series data collection approach.</p><p><strong>Methods: </strong>Time series data of patients first prescribed sunitinib or sorafenib were collected from a deidentified clinical research database. Logistic regression, random forest, adaptive Boosting, Light Gradient-Boosting Machine, and Gradient Boosting Decision Tree were used to develop the models. Prediction performances were compared using the accuracy, precision, recall, F1-score, area under the receiver operating characteristic curve, and area under the precision-recall curve. The optimal threshold for the best-performing model was selected based on the maximum F1-score. SHapley Additive exPlanations analysis was conducted to assess feature importance and contributions at both the cohort and patient levels.</p><p><strong>Results: </strong>The training cohort included 609 patients, while the temporal validation cohort had 198 patients. The Gradient Boosting Decision Tree model without resampling outperformed other models, with area under the precision-recall curve of 0.600, area under the receiver operating characteristic curve of 0.876, and F1-score of 0.583 after adjusting the threshold. The SHapley Additive exPlanations analysis identified higher cholesterol levels, longer summed days of medication use, and clear cell adenocarcinoma histology as the most important features. The final model was further integrated into a web-based application.</p><p><strong>Conclusions: </strong>This model can serve as an explainable adverse drug reaction surveillance system for predicting sunitinib- and sorafenib-associated thyroid dysfunction.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e67767"},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of Gait Parameters Using Wearable Sensors and Their Association With Muscle Mass, Strength, and Physical Performance in Korean Older Adults: Cross-Sectional Study. 使用可穿戴传感器评估韩国老年人的步态参数及其与肌肉质量、力量和身体表现的关联:横断面研究。
IF 2
JMIR Formative Research Pub Date : 2025-04-10 DOI: 10.2196/63928
Jinyoung Shin, Hyuk Jung Kweon, Jaekyung Choi
{"title":"Assessment of Gait Parameters Using Wearable Sensors and Their Association With Muscle Mass, Strength, and Physical Performance in Korean Older Adults: Cross-Sectional Study.","authors":"Jinyoung Shin, Hyuk Jung Kweon, Jaekyung Choi","doi":"10.2196/63928","DOIUrl":"https://doi.org/10.2196/63928","url":null,"abstract":"<p><strong>Background: </strong>Gait speed indicates the onset or decline of physical performance in sarcopenia. However, real-time measurements of other gait parameters, such as step length, stride length, step width, and support time, are limited. The advent of wearable technology has facilitated the measurement of these parameters, necessitating further investigation into their potential applications.</p><p><strong>Objective: </strong>This study aimed to investigate the relationship between gait parameters measured using wearable sensors and muscle mass, strength, and physical performance in community-dwelling older adults.</p><p><strong>Methods: </strong>In a cross-sectional study of 91 participants aged ≥65 years, gait parameters, such as step count, step length, cadence, single and double support times, vertical oscillation, and instantaneous vertical loading rate (IVLR), measured using a wireless earbud device, were analyzed on the basis of the appendicular skeletal muscle mass index (SMI), calf circumference, handgrip strength, 5-time chair stand test, short physical performance battery (SPPB), and the SARC-F (strength, assistance with walking, rise from a chair, climb stairs and fall frequency) questionnaire. This study was conducted from July 10 to November 1, 2023, at an outpatient clinic of a university hospital in Seoul, Korea. Multiple regression analysis was performed to investigate independent associations after adjusting for age, sex, BMI, and comorbidities.</p><p><strong>Results: </strong>Among 91 participants (45 men and 46 women; mean age 74.1 years for men and 73.6 years for women), gait speed and vertical oscillation showed negative associations with their performance in the 5-time chair stand test (P<.001) and SARC-F and positive associations with their performance in the SPPB (P<.001). Vertical oscillations were also associated with grip strength (P=.003). Single and double support times were associated with performance in the 5-time chair stand test and SPPB (P<.001). In addition, double support time was associated with SARC-F scores (P<.001). Gait speed, support time, vertical oscillation, and IVLR showed independent associations with performance in the 5-time chair stand test and SPPB (P<.001), both related to muscle strength or physical performance. Gait speed, double support time, and vertical oscillation all had significant associations with SARC-F scores.</p><p><strong>Conclusions: </strong>This study demonstrated a significant association between gait monitoring using wearable sensors and quantitative assessments of muscle strength and physical performance in older people. Furthermore, this study substantiated the extensive applicability of diverse gait parameters in predicting sarcopenia.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e63928"},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of Social Media Recruitment and Depression Among Racially and Ethnically Diverse Metabolic and Bariatric Surgery Candidates: Prospective Cohort Study. 在不同种族和民族的代谢和减肥手术候选人中,社交媒体招聘与抑郁的关联:前瞻性队列研究。
IF 2
JMIR Formative Research Pub Date : 2025-04-10 DOI: 10.2196/58916
Jackson M Francis, Sitapriya S Neti, Dhatri Polavarapu, Folefac Atem, Luyu Xie, Olivia Kapera, Matthew S Mathew, Elisa Marroquin, Carrie McAdams, Jeffrey Schellinger, Sophia Ngenge, Sachin Kukreja, Benjamin E Schneider, Jaime P Almandoz, Sarah E Messiah
{"title":"Association of Social Media Recruitment and Depression Among Racially and Ethnically Diverse Metabolic and Bariatric Surgery Candidates: Prospective Cohort Study.","authors":"Jackson M Francis, Sitapriya S Neti, Dhatri Polavarapu, Folefac Atem, Luyu Xie, Olivia Kapera, Matthew S Mathew, Elisa Marroquin, Carrie McAdams, Jeffrey Schellinger, Sophia Ngenge, Sachin Kukreja, Benjamin E Schneider, Jaime P Almandoz, Sarah E Messiah","doi":"10.2196/58916","DOIUrl":"https://doi.org/10.2196/58916","url":null,"abstract":"<p><strong>Background: </strong>Due to the widespread use of social media and the internet in today's connected world, obesity and depression rates are increasing concurrently on a global scale. This study investigated the complex dynamics involving social media recruitment for scientific research, race, ethnicity, and depression among metabolic and bariatric surgery (MBS) candidates.</p><p><strong>Objective: </strong>This study aimed to determine (1) the association between social media recruitment and depression among MBS candidates and (2) racial and ethnic differences in social media recruitment engagement.</p><p><strong>Methods: </strong>The analysis included data from 380 adult MBS candidates enrolled in a prospective cohort study from July 2019 to December 2022. Race and ethnicity, recruitment method (social media: yes or no), and depression status were evaluated using χ2 tests and logistic regression models. Age, sex, and ethnicity were adjusted in multivariable logistic regression models.</p><p><strong>Results: </strong>The mean age of the candidates was 47.35 (SD 11.6) years, ranging from 18 to 78 years. Participants recruited through social media (n=41, 38.32%) were more likely to report past or current episodes of depression compared to nonsocial media-recruited participants (n=74, 27.11%; P=.03), with a 67% increased likelihood of depression (odds ratio [OR] 1.67, 95% CI 1.04-2.68, P=.03). Further analysis showed that participants with a history of depression who were below the mean sample age were 2.26 times more likely to be recruited via social media (adjusted OR [aOR] 2.26, 95% CI 1.03-4.95; P=.04) compared to those above the mean age. Hispanic (n=26, 38.81%) and non-Hispanic White (n=53, 35.10%) participants were significantly more likely to be recruited via social media than non-Hispanic Black (n=27, 18.37%) participants (P<.001). After adjusting for covariates, non-Hispanic Black participants were 60% less likely than non-Hispanic White participants to be recruited via social media (aOR 0.40, 95% CI 0.22-0.71; P=.002).</p><p><strong>Conclusions: </strong>We found that individuals recruited through social media channels, especially younger participants, were more likely to report past or current episodes of depression compared to those recruited through nonsocial media. The study also showed that non-Hispanic Black individuals are less likely to engage in social media recruitment for scientific research versus other racial and ethnic groups. Future mental health-related studies should consider strategies to mitigate potential biases introduced by recruitment methods to ensure the validity and generalizability of research findings.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e58916"},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Provider Perspectives on Implementing an Enhanced Digital Screening for Adolescent Depression and Suicidality: Qualitative Study. 提供者对实施青少年抑郁和自杀的强化数字筛查的观点:定性研究。
IF 2
JMIR Formative Research Pub Date : 2025-04-10 DOI: 10.2196/67624
Morgan A Coren, Oliver Lindhiem, Abby R Angus, Emma K Toevs, Ana Radovic
{"title":"Provider Perspectives on Implementing an Enhanced Digital Screening for Adolescent Depression and Suicidality: Qualitative Study.","authors":"Morgan A Coren, Oliver Lindhiem, Abby R Angus, Emma K Toevs, Ana Radovic","doi":"10.2196/67624","DOIUrl":"https://doi.org/10.2196/67624","url":null,"abstract":"<p><strong>Background: </strong>With a growing adolescent mental health crisis, pediatric societies are increasingly recommending that primary care providers (PCPs) engage in mental health screening. While symptom-level screens identify symptoms, novel technology interventions can assist PCPs with providing additional point-of-care guidance to increase uptake for behavioral health services.</p><p><strong>Objective: </strong>In this study, we sought community PCP feedback on a web-based, digitally enhanced mental health screening tool for adolescents in primary care previously only evaluated in research studies to inform implementation in community settings.</p><p><strong>Methods: </strong>A total of 10 adolescent providers were recruited to trial the new screening tool and participate in structured interviews based on the Consolidated Framework for Implementation Research domains. Interviews were audio recorded, transcribed, and coded according to a prespecified codebook using a template analysis approach.</p><p><strong>Results: </strong>Providers identified improving mental health screening and treatment in pediatric primary care as a priority and agreed that a web-based digitally enhanced screening tool could help facilitate identification of and management of adolescent depression. Salient barriers identified were lack of electronic health record integration, time to administer screening, implications on clinic workflow, accessibility, and lack of transparency within health care organizations about the process of approving new technologies for clinical use. Providers made multiple suggestions to enhance implementation in community settings, such as incorporating customization options.</p><p><strong>Conclusions: </strong>Technology interventions can help address the need for improved behavioral health support in primary care settings. However, numerous barriers exist, complicating implementation of new technologies in real-world settings.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e67624"},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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