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Aims: COVID-19 leaves diverse sequalae beyond the acute illness, referred to as 'long COVID'. However, the aetiology, characteristics and risk factors of Long-COVID is still lacking. COVID-19 patients experience various stressful events and suffer emotional distress which causes post-traumatic stress disorders. This study aimed to investigate association between of perceived distress to COVID-19 infection and long COVID. Method(s): Data from 56 patients who visited the psychiatric department of our post-COVID clinic between March and June 2022 were analysed. All patients completed a subjective symptom checklist [32 symptoms in eight categories], selected cognitive function tests [digit span test, trail making test (TMT), and Stroop word colour interference test], and validated neuropsychological scales [Hospital Anxiety and Depression Scale (HAS and HDS), Pittsburgh sleep quality index (PSQI) and Impact of event scale-revised (IES-R)]. We classified patients into two groups, 'High distress group'(N = 37) and 'Low distress group (N = 19) through IES-R score (cut-off = 25). The frequency and severity of long COVID-symptoms between the two groups were compared with Mann-whitney and chi-square test. Result(s): The average age of the patients was 53.34 years, and 70.53 days had passed from the SARS-CoV-2 confirmation using RTPCR. 'High distress group' showed higher HAS (284 vs. 455, p = .01), HDS (197 vs. 387, p = .032), and PSQI (238 vs. 428, p = .05) scores and suffered shortness of breath, palpitation, tingling, subjective memory deficit more frequently. Regarding neurocognitive functioning, there was no difference between two groups. Conclusion(s): Managing perceived distress due to COVID-19 could alleviate the long-covid sequalae especially in neuropsychiatric area.
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A plethora of evidence links SARS-CoV-2 infection with concomitant cognitive dysfunction, which often persists weeks to months after the acute stages of illness and affects executive function, attention, memory, orientation, and movement control. It remains largely unclear which conditions or factors exacerbate the recovery. In a cohort of N=37 Slovenian patients (5 females, aged M = 58, SD = 10.7 years) that were hospitalized because of COVID-19, the cognitive function and mood states were assessed immediately after discharge and 2-months later to investigate the early post-COVID recovery changes. We assessed the global Montreal Cognitive Assessment (MoCA), Simple and Choice Reaction Times, executive functions (Trail-Making Test - TMT-A and TMT-B), short-term memory (Auditory Verbal Learning Test - AVLT), and visuospatial memory. We monitored depressive and anxiety symptoms and applied general self-efficacy and cognitive complaints questionnaires. Our results showed a global cognitive impairment (MoCA, Z = 332.5; p = 0.012), poorer performance on executive functions (TMT-A, Z = 188; p = 0.014; and TMT-B, Z = 185; p = 0.012), verbal memory (AVLT, F = 33.4; p < 0.001), and delayed recall (AVLT7, F = 17.1; p < 0.001), and higher depressive (Z = 145; p = 0.015) and anxiety (Z = 141; p = 0.003) symptoms after hospital discharge compared to 2-month follow-up, indicating that SARS-CoV-2 may transiently impair cognitive function and adversely affect the mood. No improvement in MoCA was observed in 40.5% of the patients at follow-up, indicating possible long-term effects of COVID-19 on global cognitive performance. Medical comorbidities (p = 0.035) significantly predicted the change in MoCA score over time, while fat mass (FM, p = 0.518), Mediterranean diet index (p = .0.944), and Florida Cognitive Activities Score (p = 0.927) did not. These results suggest that the patients' medical comorbidities at the time of SARS-CoV-2 infection could importantly contribute to the acute impairment of cognitive function and stress the importance of systemic implementation of countermeasures to limit the negative consequences on public health.
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Background: Nervous system post-acute sequelae of COVID-19 (NS-PASC) include cognitive and mental health symptoms. To further define these, we applied a Research Domain Criteria (RDoC) approach to examine motor, positive valence (PV) and negative valence (NV) systems, and social processing data in The COVID Mind Study of NS-PASC. Method(s): NS-PASC participants (>3 months after COVID-19) referred from a NeuroCOVID Clinic and non-COVID controls from New Haven, CT and Baltimore, MD completed an RDoC test battery for cognition (language, declarative and working memory, cognitive control, perception), motor, PV, NV, and social processes. To date, 3T MRI with diffusion tensor imaging was performed in 11 NS-PASC to assess white matter integrity (global white matter fractional anisotropy [FA]) as a contributor to alterations identified on the RDoC tests. Analysis of Covariance examined group differences after adjusting for sex, race, ethnicity, age, and years of education. Result(s): 25 NS-PASC participants (age 43.4+/-11.3 yrs, 76% female, 402 days after COVID-19 symptom onset) and 29 controls (age 46.2.6+/-13.1 yrs, 66% female) completed the battery. Controls were more racially diverse and less educated than NS-PASC (43% vs. 12% Black, p=0.005;14.5 vs. 16.1 yrs of education, p< 0.05). Means and statistics for RDoC between NS-PASC and controls are shown in Table. NS-PASC performed worse in language, verbal working and declarative memory, and perception and reported greater cognitive control difficulties (e.g., behavioral inhibition, set shifting) without issues on performance-based metrics (Stroop, Trail Making Test-Part B), and had slower motor function. NS-PASC reported more NV issues including greater symptoms of depression, rumination in response to depressive mood, apathy, childhood trauma, anxiety, and perceived stress. There were no differences in PV and social processing. In a subset of NS-PASC participants who underwent MRI, there was a dynamic range of FA values with a mean of 0.509 (IQR 0.481 - 0.536). Conclusion(s): Our findings extend previous PASC studies characterizing cognitive and mental health alterations, indicating that additional RDoC assessments warrant focus, including alterations in motor and the negative valence system. In future analyses, we will examine white matter integrity as a pathophysiologic contributor to these RDoC systems.
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Background: Neurocognitive dysfunction is common in long COVID and in people living with HIV (PWH). It is unknown whether PWH experience different disturbances in neurocognitive function following COVID-19 compared to HIVseronegative people. Method(s): The amfAR-Johns Hopkins University COVID Recovery Study is a prospective observational cohort study consisting of four groups: participants who had SARS-CoV-2 infection for the first time within 30 days prior to enrollment with HIV (PWH, arm 1) and without HIV (arm 2);participants with no history of SARS-CoV-2 infection with HIV (arm 3) and without HIV (arm 4). 93.5% of the cohort had received a COVID-19 vaccine prior to enrollment. Cognitive tests were administered at 1-and 4-months post symptom onset (arms 1-2) or post-enrollment (arms 3-4) in seven domains. Age standardized scores (all tests) and age-sex-and education-standardized scores (verbal fluency) were obtained. Standardized scores were compared using the Mann-Whitney U Test and the Kruskal-Wallis test. Result(s): PWH scored lower than HIV-seronegative participants at 1 and 4 months post-COVID on three tests: the Hopkins Verbal Learning Test-Revised (HVLT-R) learning (M1, p=0.011, M4, p=0.015), HVLT-R memory (M1, p=0.029, M4, p=0.007), and category-cued verbal fluency (VF;M1&4, p< 0.001). For the majority of timepoints, PWH who were post-COVID produced equivalent scores as PWH who never had COVID (p-levels > 0.05). Comparing post-COVID HIV-seronegative people to those who never had COVID, post-COVID participants scored lower than never-COVID participants on the Oral Trail Making Test part A (OTMT) test of processing speed at month 1 (p=0.033). Between month 1 and 4, HIV-seronegative people who were post-COVID showed improvements in HVLT-R Recognition (p=0.039), OTMT A (p=0.003), and OTMT B test of executive function (p=0.032). Conclusion(s): Neurocognitive scores in PWH were independent of COVID status, suggesting that higher frequencies of post-COVID neurocognitive dysfunction in PWH compared to HIV-seronegative people are due to HIV-associated factors more so than COVID. HIV-seronegative, post-COVID people demonstrate diminished recognition memory, processing speed, and executive function at 1 month post-COVID that improves by 4 months. Post-COVID neurocognitive dysfunction is present, if temporary, even in a highly vaccinated cohort of people.
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The purpose of the study is to explore the current state of tourism development in natural protected areas Republic of Buryatia using the case of Dzherginsky Reserve and to identify favorable and negative factors influencing the development of tourism, to determine the main directions for the development of ecological tourism on its territory. Research methods. The main research method was the comparative geographical method. This method helped reveal the features of the development of tourism in Dzherginsky Reserve in comparison with Baikalsky and Barguzinsky Reserves. The statistical method using the dynamics of visitors in the reserves the Republic of Buryatia was determined. In article shown the number of visitors in Dzherginsky reserve is less than in other reserves. The main prerequisites analyzed for the development of tourism in the reserve and factors identified hindering its development. The cartographic method applied in the analysis of the economic-geographical and transport-geographical position of the reserve. On the method of analogies based, identified and substantiated promising directions for the development of ecological tourism in Dzherginsky Reserve. Research results. In the course of the work carried out, that the main factors revealed hindering the development of tourism in Dzherginsky Reserve are the transport inaccessibility of the territory, the lack of access roads with a hard surface, and the environmental and educational nature of the activity. The analysis showed that since 2008 observed the positive dynamics of the number of reserve visitors. Due to the coronavirus pandemic, there has been a decrease in the number of tourists, which is a temporary phenomenon. The reserve has developed five ecological tours designed for tourists with physical training. The reserve has an ethnotourist complex to accommodate tourists. Conclusions. The development of ecological tourism is a promising area of activity for Dzherginsky reserve, for which there are all prerequisites. However, in order for ecological tourism to be profitable, cooperation with government agencies, representatives of the tourist industry and the local population is necessary. In this regard, it is important to use the existing experience of Baikalsky reserve in training the local population and attracting tourists to serve. At the present stage, it is necessary to develop program documents in which it is necessary to provide for measures to mitigate adverse factors. © 2022 North Caucasian Institute of Mining and Metallurgy, State Technological University. All rights reserved.
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The purpose of the study is to explore the current state of tourism development in natural protected areas Republic of Buryatia using the case of Dzherginsky Reserve and to identify favorable and negative factors influencing the development of tourism, to determine the main directions for the development of ecological tourism on its territory. Research methods. The main research method was the comparative geographical method. This method helped reveal the features of the development of tourism in Dzherginsky Reserve in comparison with Baikalsky and Barguzinsky Reserves. The statistical method using the dynamics of visitors in the reserves the Republic of Buryatia was determined. In article shown the number of visitors in Dzherginsky reserve is less than in other reserves. The main prerequisites analyzed for the development of tourism in the reserve and factors identified hindering its development. The cartographic method applied in the analysis of the economic-geographical and transport-geographical position of the reserve. On the method of analogies based, identified and substantiated promising directions for the development of ecological tourism in Dzherginsky Reserve. Research results. In the course of the work carried out, that the main factors revealed hindering the development of tourism in Dzherginsky Reserve are the transport inaccessibility of the territory, the lack of access roads with a hard surface, and the environmental and educational nature of the activity. The analysis showed that since 2008 observed the positive dynamics of the number of reserve visitors. Due to the coronavirus pandemic, there has been a decrease in the number of tourists, which is a temporary phenomenon. The reserve has developed five ecological tours designed for tourists with physical training. The reserve has an ethnotourist complex to accommodate tourists. Conclusions. The development of ecological tourism is a promising area of activity for Dzherginsky reserve, for which there are all prerequisites. However, in order for ecological tourism to be profitable, cooperation with government agencies, representatives of the tourist industry and the local population is necessary. In this regard, it is important to use the existing experience of Baikalsky reserve in training the local population and attracting tourists to serve. At the present stage, it is necessary to develop program documents in which it is necessary to provide for measures to mitigate adverse factors. © 2022 North Caucasian Institute of Mining and Metallurgy, State Technological University. All rights reserved.
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PURPOSE: We evaluated the host-response marker score "BV" and its components TRAIL, IP-10, and CRP in SARS-CoV-2 positive children, and estimated the potential impact on clinical decision-making. METHODS: We prospectively analyzed levels of TRAIL, IP-10, CRP, and the BV score, in children with suspected COVID-19. Classification of infectious etiology was performed by an expert panel. We used a 5-point-questionnaire to evaluate the intention to treat with antibiotics before and after receiving test results. RESULTS: We screened 111 children, of whom 6 (5.4%) were positive for SARS-CoV-2. A total of 53 children were included for the exploratory analysis. Median age was 3.1 years (interquartile range [IQR] 1.3-4.3), and 54.7% (n = 29) were girls. A viral and a bacterial biomarker pattern was found in 27/53 (50.9%) and 15/53 (28.3%), respectively. BV scores differed between COVID-19, children with other viral infections, and children with bacterial infections (medians 29.5 vs. 9 vs. 66; p = 0.0006). Similarly, median TRAIL levels were different (65.5 vs. 110 vs. 78; p = 0.037). We found no differences in IP-10 levels (555 vs. 504 vs. 285; p = 0.22). We found a concordance between physicians' "unlikely intention to treat" children with a viral test result in most cases (n = 19/24, 79.2%). When physicians expressed a "likely intention to treat" (n = 15), BV test revealed 5 bacterial, viral, and equivocal scores each. Antibiotics were withheld in three cases (20%). Overall, 27/42 (64%) of pediatricians appraised the BV test positively, and considered it helpful in clinical practice. CONCLUSION: Host-response based categorization of infectious diseases might help to overcome diagnostic uncertainty, support clinical decision-making and reduce unnecessary antibiotic treatment.
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Overhydration is the primary cause of exercise-associated hyponatremia (EAH). If intended hydration practices are different than actual practices, this may lead to overhydration and will increase the risk of EAH. The purpose of this research was to assess and compare the self-reported hydration practices of long-distance trail runners during an intended long training run, an intended event, and during an actual event. The researchers hypothesized hydration volumes and strategies intended would be different than actual. In a cross-sectional pre and post-online survey design, the participants completed a pre-race survey (n = 26) and a post-race survey (n = 17) in two different Connecticut trail races. A moderate correlation (R = 0.52, P = 0.05) was found when comparing volumes during the actual event to the intended event. In addition, moderate agreement (64-85%) was found to be significant by the Kappa statistic when comparing the hydration strategies in the intended and the actual events. Finally, this study found that 50% of participants reported knowledge and awareness of EAH, while 62% felt they had a solid understanding of an effective hydration plan. These findings indicate the need for ongoing and further education in the trail running community. © 2022, Journal of Exercise Physiology Online. All Rights Reserved.
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Through a quantitative approach, this study aimed to clarify the changes in the number of visitors and visits to green spaces according to green space type before and after the COVID-19 pandemic. We explored the changes in the proportion of repeat visitors and the distance between green spaces and visitors' places of residence. We used KDDI Location Analyzer, which performs novel analysis using mobile phone GPS and census data. The study area included 10 target sites (urban parks and nature trails in the backcountry) located in the Sapporo metropolitan area in Japan. The survey period included snow-free seasons from 2019 to 2021, and 2019 was considered the period "before the pandemic." The results revealed that the number of visits during the pandemic increased compared with those before the pandemic, except for those of urban parks near the city center. In 2020, the proportion of repeat visitors increased for all 10 target sites. In addition, since the outbreak of the pandemic, distances between all urban parks and visitors' residences decreased. The same trend was observed for nature trails in the backcountry close to the city center. These findings indicate a generally decreasing trend in the number of visits to green spaces as many people have been refraining from visiting the site since the outbreak of the pandemic. Contrastingly, the number of visits by repeat visitors who reside close to the target sites has increased in some cases, which compensated for the general decreases.
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Cognitive acuity is important for academic success. The preliminary efficacy of early time-restricted eating (eTRE) on cognitive acuity was examined in a sample of university students attending a large southwestern university. It was hypothesized that adherence to eTRE would result in improved cognitive acuity as assessed by the Trail Making Tests (i.e., TMT-A and TMT-B) and the Stroop Color and Word Test. Participants were randomized to an intervention group (eTRE) with a daily 6-hour eating window or a control group (CON) with a daily 16-hour eating window; 24 participants initiated the study (13 eTRE and 11 CON). Blood ketones (i.e., ß-hydroxybutyrate [BHB]) and brain-derived neurotrophic factor were also assessed. The 8-week intervention was forestalled by COVID-19 laboratory closures beginning in March 2020, and only data obtained at week 0 (baseline) and week 4 were viable for statistical analyses. Study attrition was high (50% for eTRE and 23% for CON). At week 4, there was a 27% and 6% decrease in TMT-B response time for the eTRE and CON groups, respectively (P = .02). TMT-B response time was inversely correlated to plasma BHB among participants (r = -0.633; P = .008). Considering the inverse relationship between TMT-B response time and plasma BHB, these preliminary data suggest that eTRE may improve some aspects of cognitive acuity in this population. Future investigations are needed to confirm these findings and should accommodate individual preferences regarding the initiation time of the eating window while also considering the impact on social influences and exercise engagement.
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The recent covid-19 restrictions like social distancing has limited physical human interaction. There were days when people wish to visit the physical shopping outlets and try the best-suited outfits in the trial rooms. In the post-pandemic era, people are now preferring the E-shopping zone to select the outfits. This type of virtual shopping has its own disadvantages like the suitability of outfits to the customer’s preferences. Regardless of some applications that offer outfit suitability, there are some entrust issues with online stores. This research study analyzes many general customer related concerns like fit of the outfit;appearance;color suitability with the customer skin tone and proposes the possibility of implementing virtual trial rooms. The proposed model empowers the clients to evaluate their outfits based on their stature, shape, size, and wellness estimations by standing in front of the gadget.
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Approximately 43-70% of people living with multiple sclerosis (MS) experience cognitive impairment. This study-within-a-trial (SWAT) takes place within a host trial investigating the feasibility of the Cognitive-Occupation-Based programme for people with MS (COB-MS), a holistic therapy on the management of cognitive symptoms in MS. Reliable remote cognitive testing could provide safer and more convenient care for MS patients, during the COVID-19 pandemic and thereafter. The SWAT examines the reliability of delivering the Brief International Cognitive Assessment for MS (BICAMS) and the Trail-Making Test (TMT) remotely to people to 68 people with MS experiencing cognitive difficulties. Group 1 (N=34) were tested in-person pre-pandemic. Group 2 were tested remotely. No significant differences between virtual and in-person administrations of the CVLT-II and SDMT were detected. BVMT-R scores were significantly higher for virtual administrations, possibly indicating inter-rater differences. Strong positive correlations were found for in-person and virtual scores within Group 1 on the CVLT-II. The findings support the reliability of remote administration of BICAMS and the TMT in people living with MS. Future research with larger samples could investigate performance on BVMT-R with regards to screen size of device used.
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AIM: This study aimed to determine the correlation between inflammation with cognitive function in COVID-19 patients. METHODS: We recruited COVID-19 patients using consecutive sampling methods in Adam Malik General Hospital Medan, Indonesia. The neutrophil-to-lymphocyte ratio (NLR,) C-reactive protein (CRP), D-dimer, and ferritin serum levels were measured as inflammatory markers. Cognitive function was assessed in several cognitive domains using Forward Digit Span for attention, Bacward Digit Span for working memory, and Trail Making Test parts A and B for executive function. The correlation between inflammatory markers and cognitive function was analyzed using Spearman correlation test. RESULTS: This study involved 40 COVID-19 patients consisting of 13 (32.5%) males and 27 (67.5%) females;the median age of the patients was 39.5 (19–65) years. We found that higher D-dimer and ferritin levels were significantly correlated with worse BDS scores (r = −0.369 p = 0.019 and r = −0.408 p = 0.009, respectively) and higher ferritin level was also correlated with worse FDS score (r = −0.365 p = 0.020 and). Higher D-dimer and ferritin levels were also significantly correlated with a longer time of completion of TMT-B (r = 0.363 p = 0.022 and r = 0.433 p = 0.005) and higher ferritin level was also correlated with a longer time of completion of TMT-A (r = 0.438 P=0.005). There were no significant correlations between NLR and CRP levels with cognitive function. CONCLUSION: Higher inflammatory markers are correlated with worse attention, working memory, and executive function in COVID-19 patients.
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BACKGROUND: Early prognostication of COVID-19 severity will potentially improve patient care. Biomarkers, such as TNF-related apoptosis-inducing ligand (TRAIL), interferon gamma-induced protein 10 (IP-10), and C-reactive protein (CRP), might represent possible tools for point-of-care testing and severity prediction. METHODS: In this prospective cohort study, we analyzed serum levels of TRAIL, IP-10, and CRP in patients with COVID-19, compared them with control subjects, and investigated the association with disease severity. RESULTS: A total of 899 measurements were performed in 132 patients (mean age 64 years, 40.2% females). Among patients with COVID-19, TRAIL levels were lower (49.5 vs 87 pg/ml, P = 0.0142), whereas IP-10 and CRP showed higher levels (667.5 vs 127 pg/ml, P <0.001; 75.3 vs 1.6 mg/l, P <0.001) than healthy controls. TRAIL yielded an inverse correlation with length of hospital and intensive care unit (ICU) stay, Simplified Acute Physiology Score II, and National Early Warning Score, and IP-10 showed a positive correlation with disease severity. Multivariable regression revealed that obesity (adjusted odds ratio [aOR] 5.434, 95% confidence interval [CI] 1.005-29.38), CRP (aOR 1.014, 95% CI 1.002-1.027), and peak IP-10 (aOR 1.001, 95% CI 1.00-1.002) were independent predictors of in-ICU mortality. CONCLUSIONS: We demonstrated a correlation between COVID-19 severity and TRAIL, IP-10, and CRP. Multivariable regression showed a role for IP-10 in predicting unfavourable outcomes, such as in-ICU mortality. TRIAL REGISTRATION: Clinicaltrials.gov, NCT04655521.
Subject(s)
C-Reactive Protein , COVID-19 , C-Reactive Protein/metabolism , COVID-19/diagnosis , Chemokine CXCL10 , Female , Humans , Intensive Care Units , Interferon-gamma , Male , Middle Aged , Prospective Studies , SARS-CoV-2 , TNF-Related Apoptosis-Inducing LigandABSTRACT
Digital pen features model characteristics of sketches and user behavior, and can be used for various supervised machine learning (ML) applications, such as multi-stroke sketch recognition and user modeling. In this work, we use a state-of-the-art set of more than 170 digital pen features, which we implement and make publicly available. The feature set is evaluated in the use case of analyzing paper-pencil-based neurocognitive assessments in the medical domain. Most cognitive assessments, for dementia screening for example, are conducted with a pen on normal paper. We record these tests with a digital pen as part of a new interactive cognitive assessment tool with automatic analysis of pen input. The physician can, first, observe the sketching process in real-time on a mobile tablet, e.g., in telemedicine settings or to follow Covid-19 distancing regulations. Second, the results of an automatic test analysis are presented to the physician in real-time, thereby reducing manual scoring effort and producing objective reports. As part of our evaluation we examine how accurately different feature-based, supervised ML models can automatically score cognitive tests, with and without semantic content analysis. A series of ML-based sketch recognition experiments is conducted, evaluating 10 modern off-the-shelf ML classifiers (i.e., SVMs, Deep Learning, etc.) on a sketch data set which we recorded with 40 subjects from a geriatrics daycare clinic. In addition, an automated ML approach (AutoML) is explored for fine-tuning and optimizing classification performance on the data set, achieving superior recognition accuracies. Using standard ML techniques our feature set outperforms all previous approaches on the cognitive tests considered, i.e., the Clock Drawing Test, the Rey-Osterrieth Complex Figure Test, and the Trail Making Test, by automatically scoring cognitive tests with up to 87.5% accuracy in a binary classification task.
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Use of urban trails and other green space during the early stages of the COVID-19 pandemic reached record highs around the world. Although the use of these resource amenities has been documented to have several physical and mental health benefits, the density of their use during the pandemic required managers to issue guidance and/or use-requirements to mitigate the spread of the virus. Hence, this investigation sought to document adherence to commonly suggested physical distancing guidelines at 14 trails across six states in the United States. Trained research team members unobtrusively observed over 10,000 encounters between trail visitors. Results indicated that over half of visitor groups failed to allow for enough physical distancing between themselves and another party, suggesting a need for trail and green space managers to consider additional messaging and trail design changes to encourage greater adherence to future public health guidelines. Subscribe to JPRA
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Scout is one of the extracurricular activities in Indonesia. Currently, extra-curricular activities have decreased the number of members due to students' interest in other activities at their school. After COVID-19 pandemic, many students were no longer actively participating in Scout extracurriculars. Even though there are many benefits that can be taken in scouting activities, one of which is applying skill material such as learning codes, learning a form of cheating, general public knowledge, and even the ability to survive in protecting something. Scouting activities are the key to the practice of nation building in Indonesia. One way to increase student interest is by utilizing information technology. Scouting activities can be combined into a game with a scouting theme as is commonly played, which is like a educational puzzle to sharpen critical thinking. This research is more about the application of the SAHC algorithm for puzzle cases based on the scout trail game. The application of this method is to find a solution point from a predetermined character position. Interesting games can be used as promotions for students, so students can be interested in scouting activities. © 2021 IEEE.
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Physical activity (PA), associated with all-cause mortality, morbidity, and healthcare costs, improves vitamin D absorption, immune response, and stress when completed outdoors. Rural communities, which experience PA inequities, rely on trails to meet PA guidelines. However, current trail audit methods could be more efficient and accurate, which geospatial video may support. Therefore, the study purpose was (1) to identify and adopt validated instruments for trail audit evaluations using geospatial video and a composite score and (2) to determine if geospatial video and a composite score motivate (influence the decision to use) specific trail selection among current trail users. Phase 1 used a mixed-method exploratory sequential core design using qualitative data, then quantitative data for the development of the Spatial-temporal Trail Audit Tool (STAT). Geospatial videos of two Northeast Ohio trails were collected using a bicycle-mounted spatial video camera and video analysis software. The creation of STAT was integrated from Neighborhood Environment Walkability Scale (NEWS), Walk Score, and Path Environment Audit Tool (PEAT) audit tools based on four constructs: trail accessibility, conditions, amenities, and safety. Scoring was determined by three independent reviewers. Phase 2 included a mixed-method convergent core design to test the applicability of STAT for trail participant motivation. STAT has 20 items in 4 content areas computing a composite score and was found to increase trail quality and motivation for use. STAT can evaluate trails for PA using geospatial video and a composite score which may spur PA through increased motivation to select and use trails.
Subject(s)
Exercise , Walking , Humans , Ohio , Research Design , Residence CharacteristicsABSTRACT
It is becoming progressively more understandable that pharmaceutical targeting of drug-resistant cancers is challenging because of intra- and inter-tumor heterogeneity. Interestingly, naturally derived bioactive compounds have unique ability to modulate wide-ranging deregulated oncogenic cell signaling pathways. In this review, we have focused on the available evidence related to regulation of PI3K/AKT/mTOR, Wnt/ß-catenin, NF-κB and TRAIL/TRAIL-R by fisetin in different cancers. Fisetin has also been shown to inhibit the metastatic spread of cancer cells in tumor-bearing mice. We have also summarized how fisetin regulated autophagy in different cancers. In addition, this review also covers fisetin-mediated regulation of VEGF/VEGFR, EGFR, necroptosis and Hippo pathway. Fisetin has entered into clinical trials particularly in context of COVID19-associated inflammations. Furthermore, fisetin mediated effects are also being tested in clinical trials with reference to osteoarthritis and senescence. These developments will surely pave the way for full-fledge and well-designed clinical trials of fisetin in different cancers. However, we still have to comprehensively analyze and fully unlock pharmacological potential of fisetin against different oncogenic signaling cascades and non-coding RNAs. Fisetin has remarkable potential as chemopreventive agent and future studies must converge on the identification of additional regulatory roles of fisetin for inhibition and prevention of cancers.
Subject(s)
Antineoplastic Agents, Phytogenic/administration & dosage , Flavonols/administration & dosage , Nanostructures/administration & dosage , Neoplasms/drug therapy , Animals , Chemoprevention , Humans , Intercellular Signaling Peptides and Proteins/metabolism , NF-kappa B/metabolism , Neoplasms/metabolism , Neoplasms/prevention & control , Receptors, Vascular Endothelial Growth Factor/metabolism , Signal Transduction/drug effects , TOR Serine-Threonine Kinases/metabolism , beta Catenin/metabolismABSTRACT
Digital trails, data collections of individuals' traceable digital activities online or on digital devices, have been utilized by many industries to provide valuable insights to enhance customer experience, improve operation efficiency, and increase revenues. Despite the abundance of digital trails among health care data, health care has lagged behind other industries in extracting their values. Recently, telehealth's accelerated adoption due to the COVID-19 pandemic provides an unprecedented opportunity for health care providers to take advantage of digital trails. In this study, we describe digital trails generated from the telehealth workflow and discuss a few use cases to demonstrate how telehealth digital trails can be used to improve clinical service quality, streamline patient care workflow, and enhance the patient experience.