Gender-Specific Impact of Self-Monitoring and Social Norm Information on Walking Behavior Among Chinese College Students Assessed Using WeChat: Longitudinal Tracking Study

Background Walking is a simple but beneficial form of physical activity (PA). Self-monitoring and providing information about social norms are the 2 most widely used “mobile health (mHealth)” strategies to promote walking behavior. However, previous studies have failed to discriminate the effect of self-monitoring from the combination of the 2 strategies, and provide practical evidence within Chinese culture. Some essential moderators, such as gender and group identity, were also overlooked. Objective We aimed to investigate the effectiveness of social norm and self-monitoring interventions for walking behavior and assess the moderating effects of gender and group identity, which could guide optimal mHealth intervention projects in China. Methods In 2 longitudinal tracking studies (study 1, 22 days; study 2, 31 days), Chinese college students wore trackers for at least 8 hours per day (MASAI 3D Pedometer and Xiaomi Wristband 2) to record their daily step counts in baseline, intervention, and follow-up stages. In each study, participants (study 1: n=117, 54% female, mean age 25.60 years; study 2: n=180, 51% female, mean age 22.60 years) were randomly allocated to 1 of the following 3 groups: a self-monitoring group and 2 social norm intervention groups. In the 2 intervention groups and during the intervention stage, participants received different social norm information regarding group member step rankings corresponding to their grouping type of social norm information. In study 1, participants were grouped by within-group member PA levels (PA consistent vs PA inconsistent), and in study 2, participants were grouped by their received gender-specific social norm information (gender consistent vs gender inconsistent). Piece-wise linear mixed models were used to compare the difference in walking steps between groups. Results In study 1, for males in the self-monitoring group, walking steps significantly decreased from the baseline stage to the intervention stage (change in slope=−1422.16; P=.02). However, additional social norm information regardless of group consistency kept their walking unchanged. For females, social norm information did not provide any extra benefit beyond self-monitoring. Females exposed to PA-inconsistent social norm information even walked less (slope during the intervention=−122.18; P=.03). In study 2, for males, a similar pattern was observed, with a decrease in walking steps in the self-monitoring group (change in slope=−151.33; P=.08), but there was no decrease in the 2 social norm intervention groups. However, for females, gender-consistent social norm information decreased walking steps (slope during the intervention=−143.68; P=.03). Conclusions Both gender and group identity moderated the effect of social norm information on walking. Among females, social norm information showed no benefit for walking behavior and may have exerted a backfire effect. Among males, while walking behavior decreased with self-monitoring only, the inclusion of social norm information held the level of walking behavior steady.

Effect of Robot-Assisted Neuroendoscopic Hematoma Evacuation Combined Intracranial Pressure Monitoring for the Treatment of Hypertensive Intracerebral Hemorrhage

Objective: This study aimed to investigate the clinical efficacy of robot-assisted neuroendoscopic hematoma evacuation combined intracranial pressure (ICP) monitoring for the treatment of hypertensive intracerebral hemorrhage (HICH).Patients and Methods: A retrospective analysis of 53 patients with HICH undergoing neuroendoscopic hematoma evacuation in our department from January 2016 to December 2020 was performed. We divided the patients into two groups: the neuroendoscopic group (n = 32) and the robot-assisted neuroendoscopic combined ICP monitoring group (n = 21). Data on clinical characteristics, treatment effects, and outcomes were retrospectively reviewed and analyzed between these two groups.Results: The operation time of the procedure of the neuroendoscopic group was significantly longer than that of the robot-assisted neuroendoscopic combined ICP-monitoring group (mean time 153.8 ± 16.8 vs. 132.8 ± 15.7 min, P < 0.001). The intraoperative blood loss was significantly less in the robot-assisted neuroendoscopic combined ICP-monitoring group than in the neuroendoscopic group (215.4 ± 28.3 vs. 190.1 ± 25.6 ml, P = 0.001). However, the patients undergoing neuroendoscopic had a comparable hematoma clearance rate with those undergoing robot-assisted neuroendoscopic combined ICP monitoring (85.2 ± 4.8 vs. 89.2 ± 5.4%, P = 0.997). The complications rate was greater in the endoscopic group (25%) than in the robot-assisted neuroendoscopic combined ICP-monitoring group (9.5%) but without significant difference (P = 0.159). We also found that the dose of used mannitol was significantly less in the ICP monitoring group (615.2 ± 63.8 vs. 547.8 ± 65.3 ml, P < 0.001) and there was a significant difference in modified Rankin scale (mRS) score at discharge, patients with less mRS score in the robot-assisted neuroendoscopic combined ICP monitoring group than in the neuroendoscopic group (3.0 ± 1.0 vs. 3.8 ± 0.8, p = 0.011). Patients undergoing robot-assisted neuroendoscopic combined ICP monitoring had better 6-month functional outcomes, and there was a significant difference between the two groups (p = 0.004). Besides, multivariable analysis shows younger age, no complication, and robot-assisted neuroendoscopic combined ICP monitoring were predictors of 6-month favorable outcomes for the patients with HICH.Conclusion: Robot-assisted neuroendoscopic hematoma evacuation combined with ICP monitoring appears to be safer and more effective as compared to the neuroendoscopic hematoma evacuation in the treatment of HICH. Robot-assisted neuroendoscopic hematoma evacuation combined with ICP monitoring might improve the clinical effect and treatment outcomes of the patients with HICH.

Treasury Single Account And Financial Discipline: A Causality Analysis

Government revenue is the most critical variable that determines the level of expenditure, investment and growth of the economy. This study assessed the pre government revenue and the post government revenue generation outcomes using Treasury Single Account’s effective year of implementation as the baseline in Nigeria. The study sought to assess whether or not government revenue had changed significantly on the adoption of TSA. To drive this objective, government revenues were collated for 2010 – 2014 (pre TSA) and 2015-2019 (post TSA) from the Statistical Bulletin of the Central Bank of Nigeria. The study applied the paired sampled t-test to determine whether or not government revenue had increased significantly in the post TSA years of adoption. Findings showed that there is a significant increase in government revenue after the adoption of TSA in Nigeria. Following this finding, the study recommended that internal control system should be strengthened in government Ministries and Parastatals to forestall revenue leakages, and that public servants should be properly trained on the efficient application of TAS software. Also, the federal government should put in place Budget Monitoring Group to constantly monitor revenue targets and control expenditure limits.

Effectiveness of a Real-Time X-ray Dosimetry Monitor in Reducing Radiation Exposure in Coronary Procedures: The ESPRESSO-Raysafe Randomized Trial

Background—Several methods to reduce radiation exposure in the setting of coronary procedures are available on the market, and we previously showed that additional radiation shields reduce operator exposure during radial interventions. We set out to examine the efficacy of real-time personal dosimetry monitoring in a real-world setting of radial artery catheterization. Methods and Results—In an all-comer prospective, parallel study, consecutive coronary diagnostic and intervention procedures were performed with the use of standard radiation shield alone (control group) or with the addition of a real-time dosimetry monitoring system (Raysafe, Billdal, Sweden, monitoring group). The primary outcome was the difference in exposure of the primary operator among groups. Additional endpoints included patient, nurse, second operator exposure and fluoroscopy time. A total of 700 procedures were included in the analysis (n = 369 in the monitoring group). There were no differences among groups in patients’ body mass index (p = 0.232), type of procedure (intervention vs. diagnostic, p = 0.172), and patient sex (p = 0.784). Fluoroscopy time was shorter in the monitoring group (5.6 (5.1–6.2) min vs. 7.0 (6.1–7.7) min, p = 0.023). Radiation exposure was significantly lower in the monitoring group for the patient (135 (115–151) µSv vs. 208 (176–245) µSv, p < 0.0001) but not for the first operator (9 (7–11) µSv vs. 10 (8–11), p = 0.70) and the assistant (2 (1–2) µSv vs. 2 (1–2) µSv, p = 0.121). Conclusions—In clinical daily practice, the use of a real-time dosimetry monitoring device reduces patient radiation exposure and fluoroscopy time without an effect on operator radiation exposure.

Monitoring Group Activity of Hamsters and Mice as a Novel Tool to Evaluate COVID-19 Progression, Convalescence, and rVSV-ΔG-Spike Vaccination Efficacy

The COVID-19 pandemic initiated a worldwide race toward the development of treatments and vaccines. Small animal models included the Syrian golden hamster and the K18-hACE2 mice infected with SARS-CoV-2 to display a disease state with some aspects of human COVID-19. A group activity of animals in their home cage continuously monitored by the HCMS100 (Home cage Monitoring System 100) was used as a sensitive marker of disease, successfully detecting morbidity symptoms of SARS-CoV-2 infection in hamsters and in K18-hACE2 mice. COVID-19 convalescent hamsters rechallenged with SARS-CoV-2 exhibited minor reduction in group activity compared to naive hamsters. To evaluate the rVSV-ΔG-spike vaccination efficacy against SARS-CoV-2, we used the HCMS100 to monitor the group activity of hamsters in their home cage. A single-dose rVSV-ΔG-spike vaccination of the immunized group showed a faster recovery than the nonimmunized infected hamsters, substantiating the efficacy of rVSV-ΔG-spike vaccine. HCMS100 offers nonintrusive, hands-free monitoring of a number of home cages of hamsters or mice modeling COVID-19.

Effect of Adjusted Antiplatelet Therapy on Preventing Ischemic Events After Stenting for Intracranial Aneurysms

Background and Purpose: This study tests whether patients with unruptured intracranial aneurysm who underwent stent placement benefitted from platelet function monitoring–guided adjustment of antiplatelet therapy. Methods: We conducted a randomized, open-label, parallel group, assessor-blinded trial. Patients with unruptured intracranial aneurysm who underwent stent placement were assigned in a 1:1 ratio to receive either drug adjustment (patients who had high on-treatment platelet reactivity to antiplatelet therapy on the basis of platelet function monitoring [monitoring group]) or conventional therapy (without monitoring and drug adjustment [conventional group]). The second monitoring was performed 14 days after randomization in patients with drug adjustment. The primary outcome was the composite frequency of ischemic stroke, transient ischemic attack, stent thrombosis, urgent revascularization, and cerebrovascular death within 7 days after stent implantation. The safety outcome was the composite frequency of major, minor, or minimal bleeding within 1 month after stent implantation. Results: In total, 314 patients were included (n=157 per group). The primary combined outcome occurred in 19 patients (12.1%) in the conventional group and 8 patients (5.1%) in the monitoring group (hazard ratio, 0.39 [95% CI, 0.17–0.92]; P =0.03). Ischemic stroke occurred at a lower frequency in the monitoring group compared with that in the conventional group (4.5% versus 12.1%; hazard ratio, 0.34 [95% CI, 0.14–0.83]; P =0.01), which drove the overall primary combined outcome. The safety outcome occurred in the monitoring group (7.0%) and in the conventional group (1.9%; hazard ratio, 3.87 [95% CI, 1.06–14.14]; P =0.03). A significant difference was observed in the frequency of minor or minimal bleeding events between the two groups (monitoring group versus conventional group, 6.4% versus 1.3%; P =0.02) but not in the frequency of major bleeding events between the two groups. Conclusions: Platelet function monitoring–guided antiplatelet therapy reduces thromboembolic events in patients with unruptured intracranial aneurysm after stent placement, significantly enhancing minor or minimal bleeding events but not major bleeding events. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03989557.

Remote monitoring of patients with chronic heart failure using blood pressure telemonitoring and ECG

Introduction. Remote monitoring of patients with chronic heart failure seems to be very promising in connection with a possible decrease in mortality as a result of the use of telemedicine technologies in the treatment of chronic heart failure (CHF). Materials and methods. Remote monitoring of the health of 997 patients with confirmed diagnoses of circulatory diseases complicated by CHF, aged 18 to 74, inclusive, living in rural areas, mainly in remote and hard-to-reach settlements of Uvatsky, Vagaysky, Nizhnetavdinsky, Tobolsky and Yarkovsky, was carried out. districts of the Tyumen region. Results. We studied the results of remote monitoring of blood pressure and ECG in 997 patients with chronic heart failure in rural areas for 24 months using various models of telemedicine support. In the «home» monitoring group (n = 316), patients independently recorded and broadcast blood pressure and ECG data; in the «office» monitoring group (n = 681), the same studies were performed by medical workers. Additionally, the presence or absence of patient complaints about the state of health at the time of the research was recorded. Conclusions. The organization and conduct of remote monitoring of the health status of patients with CHF using teleAP and teleECG in the «home» self-registration mode has an advantage over the implementation of such monitoring in a medical organization, which is reflected in a statistically significant decrease in the need for hospitalizations.

Monitoring group activity of hamsters and mice as a novel tool to evaluate COVID-19 progression, convalescence and rVSV-ΔG-spike vaccination efficacy

COVID-19 pandemic initiated a worldwide race toward the development of treatments and vaccines. Small animal models were the Syrian golden hamster and the K18-hACE2 mice infected with SARS-CoV-2 to display a disease state with some aspects of the human COVID-19. Group activity of animals in their home cage continuously monitored by the HCMS100 was used as a sensitive marker of disease, successfully detecting morbidity symptoms of SARS-CoV-2 infection in hamsters and in K18-hACE2 mice. COVID-19 convalescent hamsters re-challenged with SARS-CoV-2, exhibited minor reduction in group activity compared to naive hamsters. To evaluate rVSV-ΔG-spike vaccination efficacy against SARS-CoV-2, we used the HCMS100 to monitor group activity of hamsters in their home cage. Single-dose rVSV-ΔG-spike vaccination of immunized group showed a faster recovery compared to the non-immunized infected hamsters, substantiating the efficacy of rVSV-ΔG-spike vaccine. HCMS100 offers non-intrusive, hands-free monitoring of a number of home cages of hamsters or mice modeling COVID-19.

Gender-Specific Impact of Self-Monitoring and Social Norm Information on Walking Behavior Among Chinese College Students Assessed Using WeChat: Longitudinal Tracking Study (Preprint)

BACKGROUND Walking is a simple but beneficial form of physical activity (PA). Self-monitoring and providing information about social norms are the 2 most widely used “mobile health (mHealth)” strategies to promote walking behavior. However, previous studies have failed to discriminate the effect of self-monitoring from the combination of the 2 strategies, and provide practical evidence within Chinese culture. Some essential moderators, such as gender and group identity, were also overlooked. OBJECTIVE We aimed to investigate the effectiveness of social norm and self-monitoring interventions for walking behavior and assess the moderating effects of gender and group identity, which could guide optimal mHealth intervention projects in China. METHODS In 2 longitudinal tracking studies (study 1, 22 days; study 2, 31 days), Chinese college students wore trackers for at least 8 hours per day (MASAI 3D Pedometer and Xiaomi Wristband 2) to record their daily step counts in baseline, intervention, and follow-up stages. In each study, participants (study 1: n=117, 54% female, mean age 25.60 years; study 2: n=180, 51% female, mean age 22.60 years) were randomly allocated to 1 of the following 3 groups: a self-monitoring group and 2 social norm intervention groups. In the 2 intervention groups and during the intervention stage, participants received different social norm information regarding group member step rankings corresponding to their grouping type of social norm information. In study 1, participants were grouped by within-group member PA levels (PA consistent vs PA inconsistent), and in study 2, participants were grouped by their received gender-specific social norm information (gender consistent vs gender inconsistent). Piece-wise linear mixed models were used to compare the difference in walking steps between groups. RESULTS In study 1, for males in the self-monitoring group, walking steps significantly decreased from the baseline stage to the intervention stage (change in slope=−1422.16; <i>P</i>=.02). However, additional social norm information regardless of group consistency kept their walking unchanged. For females, social norm information did not provide any extra benefit beyond self-monitoring. Females exposed to PA-inconsistent social norm information even walked less (slope during the intervention=−122.18; <i>P</i>=.03). In study 2, for males, a similar pattern was observed, with a decrease in walking steps in the self-monitoring group (change in slope=−151.33; <i>P</i>=.08), but there was no decrease in the 2 social norm intervention groups. However, for females, gender-consistent social norm information decreased walking steps (slope during the intervention=−143.68; <i>P</i>=.03). CONCLUSIONS Both gender and group identity moderated the effect of social norm information on walking. Among females, social norm information showed no benefit for walking behavior and may have exerted a backfire effect. Among males, while walking behavior decreased with self-monitoring only, the inclusion of social norm information held the level of walking behavior steady.

Prospective Study on Effectiveness of Facial Nerve Monitoring in Improving the Surgical Outcomes for Parotidectomy of Benign Parotid Tumours in a Tertiary Hospital in South India

BACKGROUND Salivary gland diseases are rare but an important group of disorders. Following surgeries involving the parotid gland, facial nerve paresis is a common postoperative complication. The reported worldwide incidence of facial nerve paresis following parotidectomy is approximately 20 - 60 %. We need to determine the incidence of facial nerve paresis in the post-operative period following superficial, adequate, or extra-capsular parotidectomy of benign parotid tumours with the use of intraoperative facial nerve monitoring. METHODS A non-randomised interventional trial was initiated once cleared by the institutional review board. With the calculated sample size of 44, the patients underwent nervemonitoring for the identification of the branches of the facial nerve. Clinical grading of the nerve function was done using the House-Brackmann score on the postoperative days 2, 7, and 60. The findings were compared with the historical controls (HC) of 53 patients who underwent similar procedures but with no intraoperative facial nerve monitoring. All patients were recruited in continuity for over two years. RESULTS The incidence of facial nerve paresis was 30 - 40 % and 10 - 20 % in the historical control and nerve monitoring group, respectively (P = 0.07). The duration of surgery in the nerve monitoring group was 83 ± 30 minutes and 95 ± 15 minutes in the HC group. The incidence of nerve paresis was similar among the trainees and consultants suggestive of adequate training. CONCLUSIONS Intraoperative facial nerve monitoring is a useful adjunct to reduce the incidence of early postoperative facial nerve paresis. The technique would not prolong the duration of the procedure. The technique may be utilized safely on a routine basis even during surgical training. KEYWORDS Facial Nerve Monitoring, Parotidectomy, Benign Parotid Tumour, HouseBrackmann Score