A/B Testing of User Enrollment Forms to Enhance Diversity in the Biomedical Workforce via the National Research Mentoring Network: User-Centered Design Case Study.

Background: The National Research Mentoring Network (NRMN) is a National Institutes of Health-funded program for diversifying the science, technology, engineering, math, and medicine research workforce through the provision of mentoring, networking, and professional development resources. The NRMN provides mentoring resources to members through its online platform-MyNRMN. Objective: MyNRMN helps members build a network of mentors. Our goal was to expand enrollment and mentoring connections, especially among those who have been historically underrepresented in biomedical training and the biomedical workforce. Methods: To improve the ease of enrollment, we implemented the split testing of iterations of our user interface for platform registration. To increase mentoring connections, we developed multiple features that facilitate connecting via different pathways. Results: Our improved user interface yielded significantly higher rates of completed registrations (P<.001). Our analysis showed improvement in completed enrollments that used the version 1 form when compared to those that used the legacy form (odds ratio 1.52, 95% CI 1.30-1.78). The version 2 form, with its simplified, 1-step process and fewer required fields, outperformed the legacy form (odds ratio 2.18, 95% CI 1.90-2.50). By improving the enrollment form, the rate of MyNRMN enrollment completion increased from 57.3% (784/1368) with the legacy form to 74.5% (2016/2706) with the version 2 form. Our newly developed features delivered an increase in connections between members. Conclusions: Our technical efforts expanded MyNRMN's membership base and increased connections between members. Other platform development teams can learn from these efforts to increase enrollment among underrepresented groups and foster continuing, successful engagement.

Deep learning framework for comprehensive molecular and prognostic stratifications of triple-negative breast cancer.

Triple-negative breast cancer (TNBC) is the most challenging breast cancer subtype. Molecular stratification and target therapy bring clinical benefit for TNBC patients, but it is difficult to implement comprehensive molecular testing in clinical practice. Here, using our multi-omics TNBC cohort (N = 425), a deep learning-based framework was devised and validated for comprehensive predictions of molecular features, subtypes and prognosis from pathological whole slide images. The framework first incorporated a neural network to decompose the tissue on WSIs, followed by a second one which was trained based on certain tissue types for predicting different targets. Multi-omics molecular features were analyzed including somatic mutations, copy number alterations, germline mutations, biological pathway activities, metabolomics features and immunotherapy biomarkers. It was shown that the molecular features with therapeutic implications can be predicted including the somatic PIK3CA mutation, germline BRCA2 mutation and PD-L1 protein expression (area under the curve [AUC]: 0.78, 0.79 and 0.74 respectively). The molecular subtypes of TNBC can be identified (AUC: 0.84, 0.85, 0.93 and 0.73 for the basal-like immune-suppressed, immunomodulatory, luminal androgen receptor, and mesenchymal-like subtypes respectively) and their distinctive morphological patterns were revealed, which provided novel insights into the heterogeneity of TNBC. A neural network integrating image features and clinical covariates stratified patients into groups with different survival outcomes (log-rank P < 0.001). Our prediction framework and neural network models were externally validated on the TNBC cases from TCGA (N = 143) and appeared robust to the changes in patient population. For potential clinical translation, we built a novel online platform, where we modularized and deployed our framework along with the validated models. It can realize real-time one-stop prediction for new cases. In summary, using only pathological WSIs, our proposed framework can enable comprehensive stratifications of TNBC patients and provide valuable information for therapeutic decision-making. It had the potential to be clinically implemented and promote the personalized management of TNBC.

Surveying the welfare of farmed fish species on a global scale through the fair-fish database.

Fish welfare is a critical issue that needs to be addressed by the rapidly growing aquaculture industry. Scientific knowledge regarding the natural behaviors of species and the conditions in which they are kept in farms is essential for improving their welfare in aquaculture. To provide a consistent overview of the welfare of farmed fish, the organization fair-fish has created the online platform fair-fish database, which gathers ethological knowledge categorized into profiles of farmed aquatic species. The WelfareChecks on this platform are profiles based on criteria that are rated based on the likelihood and potential of the species to experience a high level of welfare in aquaculture systems, together with the certainty about the findings. A score (WelfareScore) is calculated from these ratings, serving as a reference to identify knowledge gaps, assess welfare, and suggest ways to improve it. Here, we performed an in-depth analysis of the species with WelfareChecks already published in the fair-fish database based on their respective WelfareScores. In general, although just a small percentage of farmed aquatic species (~5%) have at least a 20% chance of experiencing a good level of welfare under minimal aquaculture conditions, 60% of them have at least some potential to achieve good welfare under high-standard conditions, with more than a third of the species (~37%) having at least a 20% potential. Despite that, several species exhibit a very high frequency of low chances and potential for experiencing good welfare levels under aquaculture conditions, besides a low degree of certainty based on literature reviews. Furthermore, many others show a very frequent occurrence of unclear or nonexistent knowledge in their profiles. The current welfare state is therefore poor for the majority of farmed aquatic species; yet, there is considerable potential for improvement. However, many species are very unlikely to achieve good welfare, even under high-standard conditions. Importantly, large knowledge gaps remain for an accurate assessment of the welfare of several farmed species.

Diverse Mentoring Connections Across Institutional Boundaries in the Biomedical Sciences: Innovative Graph Database Analysis.

BACKGROUND: With an overarching goal of increasing diversity and inclusion in biomedical sciences, the National Research Mentoring Network (NRMN) developed a web-based national mentoring platform (MyNRMN) that seeks to connect mentors and mentees to support the persistence of underrepresented minorities in the biomedical sciences. As of May 15, 2024, the MyNRMN platform, which provides mentoring, networking, and professional development tools, has facilitated more than 12,100 unique mentoring connections between faculty, students, and researchers in the biomedical domain. OBJECTIVE: This study aimed to examine the large-scale mentoring connections facilitated by our web-based platform between students (mentees) and faculty (mentors) across institutional and geographic boundaries. Using an innovative graph database, we analyzed diverse mentoring connections between mentors and mentees across demographic characteristics in the biomedical sciences. METHODS: Through the MyNRMN platform, we observed profile data and analyzed mentoring connections made between students and faculty across institutional boundaries by race, ethnicity, gender, institution type, and educational attainment between July 1, 2016, and May 31, 2021. RESULTS: In total, there were 15,024 connections with 2222 mentees and 1652 mentors across 1625 institutions contributing data. Female mentees participated in the highest number of connections (3996/6108, 65%), whereas female mentors participated in 58% (5206/8916) of the connections. Black mentees made up 38% (2297/6108) of the connections, whereas White mentors participated in 56% (5036/8916) of the connections. Mentees were predominately from institutions classified as Research 1 (R1; doctoral universities-very high research activity) and historically Black colleges and universities (556/2222, 25% and 307/2222, 14%, respectively), whereas 31% (504/1652) of mentors were from R1 institutions. CONCLUSIONS: To date, the utility of mentoring connections across institutions throughout the United States and how mentors and mentees are connected is unknown. This study examined these connections and the diversity of these connections using an extensive web-based mentoring network.

Impact of National Lockdown Measures on the Association Between Social Media Use and Sleep Disturbance During COVID-19: A Meta-Analysis of 21 Nations.

During the COVID-19 pandemic, the extensive lockdown measures implemented for disease mitigation triggered a surge in round-the-clock social media use, giving rise to widespread concerns regarding its impact on sleep health. This meta-analysis examined the association between social media use and sleep disturbance during the pandemic, along with potential moderators. The dataset included 43 independent samples comprising 68,247 residents of 21 countries across 7 world regions. The three-level mixed-effects meta-analysis revealed a weak, positive overall effect size (r = 0.1296, 95% confidence interval: 0.0764-0.1828, k = 90). The magnitude of the effect size varied by the type of social media use: compulsive use exhibited a moderately strong effect size, whereas information-focused use showed marginal significance. The effect size was more pronounced in countries imposing stricter (vs. less strict) lockdown measures. Lockdown status also moderated this association, with a marginally significant effect size observed during lockdowns but a significant effect size after lockdowns. For demographics, samples involving emerging adults demonstrated moderately strong effect sizes, whereas those involving the general population had modest effect sizes. Notably, the interaction between the type of social media use and lockdown status was significant. Specifically, the positive association with information-focused use was significant only during lockdowns, whereas that with general use was significant after, but not during, lockdowns. However, compulsive use showed a moderately strong effect size both during and after lockdowns. These findings underscored the importance of considering multiple factors-such as the type of social media use, context, and demographics-when studying social media use and sleep health.

Spiders in Thailand (SIT) via spiderthailand.info: Thailand spider data retrieval system for geographical occurrence and photographic identification.

Background: High biodiversity in the tropics is good for ecosystem services; however, challenges in taxonomy and identification usually come from such high biodiversity. Spiders are no exception to the challenges. Identifying spiders in tropical places like Thailand is difficult and time consuming. To reduce the difficulty of identifying Thai spiders, a data retrieval system for geographical occurrence and photographic identification was conducted to deploy on an online platform, Spiders in Thailand (SIT) via the website "spiderthailand.info". This allows professional arachnologists and amateur spider lovers to visit and check the geographical distribution of Thai spiders and to quickly access pictures for comparative photographic identification. To facilitate Thai spider identification, there were two parts, the database and the website, which are connected to each other. Data of Thai spiders were extracted from the World Spider Catalog to build a database comprising geographical occurrence and pictures of spider species in Thailand. The database was then linked with the website to display data. New information: The dataset of pictures and illustrations extracted from taxonomic literature of the World Spider Catalog were included in the database for connecting with the online platform, Spiders in Thailand (SIT) via the website "spiderthailand.info" which facilitated access to pictures and illustrations, expediting the identification of Thai spider specimens. Geographical occurrences of Thai spiders consisted of 1419 records belonging to 670 species of 228 genera and 50 families. Amongst those, 461 species from 133 genera of 41 families were distributed only in Thailand. Around Thailand, 756 geographical localities were reported for spider occurrences. From 76 provinces and one additional special administrative area (Bangkok), 58 provinces showed occurrence records of spiders and 18 provinces showed non-occurrence records. Those provinces of non-occurrence records of spiders were Amnat Charoen, Ang Thong, Bueng Kan, Chai Nat, Maha Sarakham, Mukdahan, Nakhon Phanom, Nong Bua Lam Phu, Nonthaburi, Phayao, Phichit, Phra Nakhon Si Ayutthaya, Samut Prakan, Samut Sakhon, Si Sa Ket, Sing Buri, Uthai Thani and Yasothon. Most spiders were reported from Chiang Mai Province.

Analyzing bivariate cross-trait genetic architecture in GWAS summary statistics with the BIGA cloud computing platform.

As large-scale biobanks provide increasing access to deep phenotyping and genomic data, genome-wide association studies (GWAS) are rapidly uncovering the genetic architecture behind various complex traits and diseases. GWAS publications typically make their summary-level data (GWAS summary statistics) publicly available, enabling further exploration of genetic overlaps between phenotypes gathered from different studies and cohorts. However, systematically analyzing high-dimensional GWAS summary statistics for thousands of phenotypes can be both logistically challenging and computationally demanding. In this paper, we introduce BIGA (https://bigagwas.org/), a website that aims to offer unified data analysis pipelines and processed data resources for cross-trait genetic architecture analyses using GWAS summary statistics. We have developed a framework to implement statistical genetics tools on a cloud computing platform, combined with extensive curated GWAS data resources. Through BIGA, users can upload data, submit jobs, and share results, providing the research community with a convenient tool for consolidating GWAS data and generating new insights.

Drug-Online: an online platform for drug-target interaction, affinity, and binding sites identification using deep learning.

BACKGROUND: Accurately identifying drug-target interaction (DTI), affinity (DTA), and binding sites (DTS) is crucial for drug screening, repositioning, and design, as well as for understanding the functions of target. Although there are a few online platforms based on deep learning for drug-target interaction, affinity, and binding sites identification, there is currently no integrated online platforms for all three aspects. RESULTS: Our solution, the novel integrated online platform Drug-Online, has been developed to facilitate drug screening, target identification, and understanding the functions of target in a progressive manner of "interaction-affinity-binding sites". Drug-Online platform consists of three parts: the first part uses the drug-target interaction identification method MGraphDTA, based on graph neural networks (GNN) and convolutional neural networks (CNN), to identify whether there is a drug-target interaction. If an interaction is identified, the second part employs the drug-target affinity identification method MMDTA, also based on GNN and CNN, to calculate the strength of drug-target interaction, i.e., affinity. Finally, the third part identifies drug-target binding sites, i.e., pockets. The method pt-lm-gnn used in this part is also based on GNN. CONCLUSIONS: Drug-Online is a reliable online platform that integrates drug-target interaction, affinity, and binding sites identification. It is freely available via the Internet at http://39.106.7.26:8000/Drug-Online/ .

A survey on prevalence and parents' perceptions of food allergy in 3- to 16-year-old children in Wuhan, China.

Background: The prevalence of food allergy (FA) has risen in recent decades, yet there is limited data on the cognition and beliefs of FA among the parents of FA children. Objective: To investigate the prevalence of FA and assess the knowledge and perception of FA among parents of FA children in Wuhan, China. Methods: Online questionnaires were conducted for the parents of 3- to 16-year-old children. They reported symptoms of suspected FA in the screening questionnaire were interviewed for further diagnostic evaluation. All the parents of the suspected FA children completed the subsequent assessments of the knowledge and perception on FA as well as their attitude towards the current online platforms. Results: A total of 1963 children were recruited. The prevalence of self-reported FA was 10.2% (95% CI: 8.1-12.4%) and the physician-diagnosed FA was 6.2% (95% CI: 5.1-7.2%) in 3- to 16-year-olds in Wuhan. And the children with family history (57.9%) were predisposed to developing FA (P＜0.001). The total Brief Illness Perception Questionnaire (B-IPQ) score was 41.3 ± 10.0 among the parents. The B-IPQ scores correlated with symptom onset, but not with family history or other atopic comorbidities. The parents who never sought treatments obtained lower B-IPQ scores on most items compared to those who received treatments. The accuracy rate of the FA knowledge questionnaire was 56.7%. 11.6% of participants reported that children's FA had an impact on their lives. 67.2% of participants had searched information of FA online, among whom 80% expected to obtain professional suggestions on management and prevention strategies of FA from online platform. Conclusion: In 3- to 16-year-old children in Wuhan, the prevalence of self-reported and physician-diagnosed FA was 10.2% and 6.2% respectively. Parents' knowledge of FA was insufficient and only a small proportion of parents perceived that their lives and careers have been affected considerably by FA of their children. Patient education and current online platforms should be improved among parents of FA children.

CPhaMAS: An online platform for pharmacokinetic data analysis based on optimized parameter fitting algorithm.

BACKGROUND AND OBJECTIVE: Clinical pharmacological modeling and statistical analysis software is an essential basic tool for drug development and personalized drug therapy. The learning curve of current basic tools is steep and unfriendly to beginners. The curve is even more challenging in cases of significant individual differences or measurement errors in data, resulting in difficulties in accurately estimating pharmacokinetic parameters by existing fitting algorithms. Hence, this study aims to explore a new optimized parameter fitting algorithm that reduces the sensitivity of the model to initial values and integrate it into the CPhaMAS platform, a user-friendly online application for pharmacokinetic data analysis. METHODS: In this study, we proposed an optimized Nelder-Mead method that reinitializes simplex vertices when trapped in local solutions and integrated it into the CPhaMAS platform. The CPhaMAS, an online platform for pharmacokinetic data analysis, includes three modules: compartment model analysis, non-compartment analysis (NCA) and bioequivalence/bioavailability (BE/BA) analysis. Our proposed CPhaMAS platform was evaluated and compared with existing WinNonlin. RESULTS: The platform was easy to learn and did not require code programming. The accuracy investigation found that the optimized Nelder-Mead method of the CPhaMAS platform showed better accuracy (smaller mean relative error and higher R2) in two-compartment and extravascular administration models when the initial value was set to true and abnormal values (10 times larger or smaller than the true value) compared with the WinNonlin. The mean relative error of the NCA calculation parameters of CPhaMAS and WinNonlin was <0.0001 %. When calculating BE for conventional, high-variability and narrow-therapeutic drugs. The main statistical parameters of the parameters Cmax, AUCt, and AUCinf in CPhaMAS have a mean relative error of <0.01% compared to WinNonLin. CONCLUSIONS: In summary, CPhaMAS is a user-friendly platform with relatively accurate algorithms. It is a powerful tool for analysing pharmacokinetic data for new drug development and precision medicine.

Optimising listening skills: Analysing the effectiveness of a blended model with a top-down approach through cognitive load theory.

The ability to listen is critical in the task of language learning. Although listening has the least pedagogical attention, the growing emphasis on communication and language proficiency makes listening skills prominent in the language classroom. This paper aims to analyse the effectiveness of the Blended model to improve teaching listening skills, by instigating a top-down approach through Cognitive Load Theory. The top-down approach aids the students with the background knowledge of the audio with information like context, situation, phrases, etc. The blended model enables the teacher to facilitate students through the technological platform to process their listening input. A questionnaire was adopted for data collection and a semi-structured interview was performed from 60 samples from prefinal year Engineering students selected through purposive sampling techniques and grouped as experimental N = 30 and control N = 30 groups. The experimental group was trained with a top-down approach with the support of LMS. The control group was provided with the same listening material but taught in the conventional method. The purpose of this study is to show the statistically significant impact of employing technology inside the language classroom to teach listening skills. Findings showed that samples in the experimental group could identify the relevant and non-relevant information from the audio, conceptualise the audio content and predict the information beforehand. The difficulties that the students and teachers faced and the remedial measures to overcome them are also discussed. The following objectives were established for the study through mixed methods of enhancing listening skills through Cognitive Load Theory (CLT). •To explore the effect of intervention through a top-down approach with the support of technology (LMS) on enhancing the listening skills of the students.•How the blending of synchronous and asynchronous and a top-down approach develops the predicting skills of the students during the listening comprehension exercises.•To adapt procedures involved in enhancing the self-paced learning efficacy and reducing listening anxiety in ESL learners.

Evaluation of the Needs and Experiences of Patients with Hypertriglyceridemia: Social Media Listening Infosurveillance Study.

BACKGROUND: Hypertriglyceridemia is a risk factor for cardiovascular diseases. Internet usage in China is increasing, giving rise to large-scale data sources, especially to access, disseminate, and discuss medical information. Social media listening (SML) is a new approach to analyze and monitor online discussions related to various health-related topics in diverse diseases, which can generate insights into users' experiences and expectations. However, to date, no studies have evaluated the utility of SML to understand patients' cognizance and expectations pertaining to the management of hypertriglyceridemia. OBJECTIVE: The aim of this study was to utilize SML to explore the disease cognition level of patients with hypertriglyceridemia, choice of intervention measures, and the status quo of online consultations and question-and-answer (Q&A) search platforms. METHODS: An infosurveillance study was conducted wherein a disease-specific comprehensive search was performed between 2004 and 2020 in Q&A search and online consultation platforms. Predefined single and combined keywords related to hypertriglyceridemia were used in the search, including disease, symptoms, diagnosis, and treatment indicators; lifestyle interventions; and therapeutic agents. The search output was aggregated using an aggregator tool and evaluated. RESULTS: Disease-specific consultation data (n=69,845) and corresponding response data (n=111,763) were analyzed from 20 data sources (6 Q&A search platforms and 14 online consultation platforms). Doctors from inland areas had relatively high voice volumes and appear to exert a substantial influence on these platforms. Patients with hypertriglyceridemia engaging on the internet have an average level of cognition about the disease and its intervention measures. However, a strong demand for the concept of the disease and "how to treat it" was observed. More emphasis on the persistence of the disease and the safety of medications was observed. Young patients have a lower willingness for drug interventions, whereas patients with severe hypertriglyceridemia have a clearer intention to use drug intervention and few patients have a strong willingness for the use of traditional Chinese medicine. CONCLUSIONS: Findings from this disease-specific SML study revealed that patients with hypertriglyceridemia in China actively seek information from both online Q&A search and consultation platforms. However, the integrity of internet doctors' suggestions on lifestyle interventions and the accuracy of drug intervention recommendations still need to be improved. Further, a combined prospective qualitative study with SML is required for added rigor and confirmation of the relevance of the findings.

Preventive Conservation of a Short Theatre Skit (Valencian "Sainete") with Cloud Data Storage and Internet of Things.

Preventing the progressive deterioration of works of art over time is a topic of great interest to collectors and museums. With this aim, time capsules where environmental conditions remain unchanged are well known for preserving art. In this paper, a prototype of an IoT time capsule is presented with a focus on low cost in order to make it accessible to private collectors or small museums with tight budgets. Valencian 'sainetes' (small plays), which are considered materials of artistic interest, have been placed in a "time capsule", which is a manually made container with insulating materials for keeping small pieces for a long time. Environmental control has been performed with a low-cost microcontroller, sensors and actuators connected to a free online IoT platform. This platform recorded data and made decisions based on these data, sending cooling or heating orders to an environmental control system. The results obtained are very satisfactory and open interesting perspectives for future research. However, they also highlight some relevant technical and economic limitations that will have to be considered in the future.

Leveling the Research Playing Field: Decolonizing Global Health Research Through Web-Based Platforms.

Global health research has traditionally been rooted in colonialism, with some investigators in high-income countries leading and managing research and investigators in low- and middle-income countries serving as implementing partners. The Community Health Worker-Led Intervention for Vaccine Information and Confidence (CIVIC) Project, conducted in India and led jointly by India- and US-based investigators, leveraged web-based platforms to facilitate a more horizontal, inclusive, and balanced approach to partnerships between researchers and the community. Using web-based platforms to conduct research was found to be an effective strategy to engage researchers at all levels and combat systemic barriers associated with in-person activities such as power, economic, social, and gender dynamics. Connecting online for research meetings created a more equitable environment for community members to engage meaningfully with research. Further, by conducting research through web-based platforms, we found that we were able to strengthen the diversity of participants, provide a space for more marginalized groups to speak up, and minimize logistical barriers to attendance. Harnessing web-based approaches in research provides a pathway toward opportunities to promote equity and contribute to the decolonization of global health spaces.

Spinal Cord Stimulation and Related Health Information on Social Media: An Analysis of Instagram Posts.

INTRODUCTION: Spinal cord stimulation (SCS) has been a well-established, effective, minimally invasive procedure for the treatment of chronic medically refractory neuropathic pain involving the limbs and trunk. Social media platforms, including Instagram, are increasingly being used for medical education and sharing patient experiences. This study aimed to investigate posts related to SCS on Instagram. METHODS AND MATERIALS: This study presents a comprehensive analysis of Instagram posts utilizing the hashtags #spinalcordneuromodulation, #spinalcordstimulation, #spinalcordstimulationsurgery, #spinalcordstimulationtherapy, and #spinalcordstimulationimplant, all of which were collected on August 1, 2023. The outcomes were organized into four distinct source-based categories: posts generated by medical practitioners (both surgeons and non-surgeons); content shared by medical organizations; content created by patients; and content from indeterminate categories. The content was further classified based on its nature, encompassing educational material and reflections on patient or physician experiences. Moreover, the impact of users was evaluated in terms of their follower count and the count of posts. RESULTS: The search yielded a total of 4983 posts. The majority of posts were created by medical practitioners (38.53%, n = 1920). The distribution of remaining Instagram posts about SCS was as follows: medical organizations for 35% (n = 1744), patients for 24.12% (n = 1202), and indeterminate categories for 2.35% (n = 117). Among the collected posts, 348 (41.4%) originated from accounts associated with medical practitioners, 286 (34%) from medical organizations, 145 (17.2%) from patients, and 62 (7.4%) remained unspecified. The statistical analysis revealed a significant difference in follower distribution between medical practitioners and all other groups (p<0.001). Reported side effects included pain over the implant (n = 257; 88.92%), lead migration (n = 18; 6.22%), infection (n = 9; 3; 11%), and seroma (n = 5; 1.73%). CONCLUSIONS: When searching for posts about SCS on Instagram, one is more likely to encounter posts authored by medical practitioners that are mostly focused on educational content. Posts created by medical practitioners may be overshadowed and buried among numerous other posts created by patients. We suggest posting educational medical content with the hashtag #MedEd in an attempt to make educational content more easily accessible.

The ChIP-Hub Resource: Toward plantEncode.

Recent advances in sequencing technologies lead to the generation of an enormous amount of regulome and epigenome data in a variety of plant species. However, a comprehensive standardized resource is so far not available. In this chapter, we present ChIP-Hub, an integrative platform that has been developed based on the ENCODE standards by collecting and reanalyzing regulatory genomic datasets from 41 plant species. The ChIP-hub website is introduced in this chapter, including information on detailed steps of searching, data download, and online analyses, which facilitates users to explore ChIP-Hub. We also provide a cross-species comparison of chromatin accessibility information that gives a thorough view of evolutionary regulatory networks in plants.

Rapid Expansion of a Teledermatology Web Application for Digital Dermatology Assessment Necessitated by the COVID-19 Pandemic: Retrospective Evaluation.

BACKGROUND: The COVID-19 pandemic necessitated a change in the provision of outpatient care in dermatology. OBJECTIVE: A novel, asynchronous, digital consultation platform was codeveloped with 2 National Health Service dermatology teams to improve access and enhance choice in outpatient care. METHODS: The rollout of the platform was accelerated during the initial COVID-19 lockdown, and its wider use across 2 Scottish health boards was retrospectively evaluated. Integrated with the hospital booking system and electronic patient record, the platform provides an alternative to face-to-face consultations, using information and images submitted by the patients. RESULTS: In total, 297 new patient consultations and 108 return patient consultations were assessed, and 80% (324/405) of the images submitted were of satisfactory quality. The consultations were, on average, 3 minutes shorter than equivalent face-to-face interactions, and a total of 5758 km of patient travel was avoided. Outcomes included web-based reviews (66/405, 16.3%), face-to-face reviews (190/405, 46.9%), biopsies (46/405, 11.4%), discharge (89/405, 22%), and other treatments or investigations (14/405, 3.5%). High levels of patient satisfaction (92/112, 82.1%) were reported. CONCLUSIONS: Digital dermatology assessments are now included in the choices for consultation types that are available to patients, helping to augment service capacity during pandemic recovery.

Patient Portals as Facilitators of Engagement in Patients With Diabetes and Chronic Heart Disease: Scoping Review of Usage and Usability.

BACKGROUND: Patient portals have the potential to improve care for chronically ill patients by engaging them in their treatment. These platforms can work, for example, as a standalone self-management intervention or a tethered link to treatment providers in routine care. Many different types of portals are available for different patient groups, providing various features. OBJECTIVE: This scoping review aims to summarize the current literature on patient portals for patients with diabetes mellitus and chronic heart disease regarding usage behavior and usability. METHODS: We conducted this review according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement for scoping reviews. We performed database searches using PubMed, PsycInfo, and CINAHL, as well as additional searches in reviews and reference lists. We restricted our search to 2010. Qualitative and quantitative studies, and studies using both approaches that analyzed usage behavior or usability of patient portals were eligible. We mapped portal features according to broad thematic categories and summarized the results of the included studies separately according to outcome and research design. RESULTS: After screening, we finally included 85 studies. Most studies were about patients with diabetes, included patients younger than 65 years, and were conducted in the United States. Portal features were categorized into educational/general information, reminder, monitoring, interactivity, personal health information, electronic/personal health record, and communication. Portals mostly provided educational, monitoring, and communication-related features. Studies reported on usage behavior including associated variables, usability dimensions, and suggestions for improvement. Various ways of reporting usage frequency were identified. A noticeable decline in portal usage over time was reported frequently. Age was most frequently studied in association with portal use, followed by gender, education, and eHealth literacy. Younger age and higher education were often associated with higher portal use. In two-thirds of studies reporting on portal usability, the portals were rated as user friendly and comprehensible, although measurement and reporting were heterogeneous. Portals were considered helpful for self-management through positive influences on motivation, health awareness, and behavioral changes. Helpful features for self-management were educational/general information and monitoring. Barriers to portal use were general (eg, aspects of design or general usability), related to specific situations during portal use (eg, login procedure), or not portal specific (eg, user skills and preferences). Frequent themes were aspects of design, usability, and technology. Suggestions for improvement were mainly related to technical issues and need for support. CONCLUSIONS: The current state of research emphasizes the importance of involving patients in the development and evaluation of patient portals. The consideration of various research designs in a scoping review is helpful for a deeper understanding of usage behavior and usability. Future research should focus on the role of disease burden, and usage behavior and usability among older patients.

Characteristics of direct-to-consumer platforms offering erectile dysfunction treatment.

Background: Due to the sensitivity and potential embarrassment of discussing erectile dysfunction (ED) in person, men are seeking treatment online. Aims: We sought to compare offerings of direct-to-consumer (DTC) platforms for ED treatment with respect to consultation, pricing, services, and privacy policy. Methods: Google was queried to identify DTC platforms offering ED treatment with the keywords: "telehealth erectile dysfunction," "telemedicine erectile dysfunction," and "online erectile dysfunction." Inclusion criteria were as follows: serving a majority of U.S. states, existing online only, providing both the consultation and prescription for phosphodiesterase type 5 inhibitors, and delivering the prescription to the patient. Results: Fifteen DTC platforms met criteria. Ten provided free consultations; 4 bundled the consultation fee with the first month of the prescription, with 1 of these functioning as a subscription service. Fourteen (93%) relied on online intake forms and 10 (67%) advertised review by the prescriber within 2 business days. Only 4 (27%) platforms explicitly advertised physician-only consults. Direct contact with the prescriber would only occur if needed or if required by state law at 8 (53%) platforms. Purchasing sildenafil and tadalafil was advertised on all platforms. Minimum prices of sildenafil ranged from $0.50 to $35/pill (mean $5.16/pill, median $2.65/pill); tadalafil ranged from $0.50 to $9.80/pill (mean $4.70/pill, median $3.21/pill). In addition to ED therapy, 13 (86%) platforms offered treatment for other men's health issues. All platforms included a website privacy policy, but only 10 (67%) mentioned Health Insurance Portability and Accountability Act compliance, with 2 of these claiming to not be covered entities. Conclusion: Although DTC platforms are transparent with phosphodiesterase type 5 inhibitor medication and subscription pricing information, few offer direct contact with a physician to further discuss issues related to ED after completion of the online intake form. For comprehensive evaluation of ED in Health Insurance Portability and Accountability Act-compliant settings, in-person or telemedicine visits should be arranged with men's physicians.

Response Consistency of Crowdsourced Web-Based Surveys on Type 1 Diabetes.

Although Amazon Mechanical Turk facilitates the quick surveying of a large sample from various demographic and socioeconomic backgrounds, it may not be an optimal platform for obtaining reliable diabetes-related information from the online type 1 diabetes population.