Assessing carbon tax using a CGE model with firm heterogeneity: An application to Vietnam.

Vietnam's government is considering introducing a carbon market as part of its decarbonization strategy. The carbon tax is an option for the government to regulate greenhouse gas emissions. We evaluate the potential macroeconomic and climate impacts of carbon tax policy in Vietnam using a unique data set and simulation analysis with a multi-sector dynamic computable general equilibrium model. The model allows for firm heterogeneity: domestic firms and foreign-invested enterprises. The results show that with plausible tax rates, emissions can be reduced to levels 1.3-2.8 percent below the target value of emissions in 2030. The cost is a loss in GDP by 1.2-2.7 percent in 2030. The results also show that foreign-invested enterprises tend to increase emissions in the medium run even with a carbon tax while a carbon tax is more effective when applied to domestic firms. In addition, a substantial reduction in emissions from the energy sector and improvement in energy efficiency are keys to success in carbon abatement.

Adverse outcomes for chronic myeloid leukemia patients with splenomegaly and low in vivo kinase inhibition on imatinib.

Variability in the molecular response to frontline tyrosine kinase inhibitor (TKI) therapy in chronic myeloid leukemia may be partially driven by differences in the level of kinase inhibition induced. We measured in vivo BCR::ABL1 kinase inhibition (IVKI) in circulating mononuclear cells after 7 days of therapy. In 173 patients on imatinib 600 mg/day, 23% had low IVKI (<11% reduction in kinase activity from baseline); this was associated with higher rates of early molecular response (EMR) failure; lower rates of major molecular response (MMR), and MR4.5 by 36 months, compared to high IVKI patients. Low IVKI was more common (39%) in patients with large spleens (≥10 cm by palpation). Notably 55% of patients with large spleens and low IVKI experienced EMR failure whereas the EMR failure rate in patients with large spleens and high IVKI was only 12% (p = 0.014). Furthermore, patients with large spleen and low IVKI had a higher incidence of blast crisis, inferior MMR, MR4.5, and event-free survival compared to patients with large spleen and high IVKI and remaining patients. In nilotinib-treated patients (n = 73), only 4% had low IVKI. The combination of low IVKI and large spleen is associated with markedly inferior outcomes and interventions in this setting warrant further studies.

Cost-Effectiveness of Glucosamine in Osteoarthritis Treatment: A Systematic Review.

Osteoarthritis (OA) is a chronic condition that most frequently affects older adults. It is currently the most common disability. The cost of treating an aging population places pressure on the healthcare budget. As a result, it is imperative to evaluate medicines' cost-effectiveness and, accordingly, their influence on health resource allocation. Our study aims to summarize the cost and outcome of utilizing glucosamine in OA treatment. Databases like Medline, Cochrane, and Scopus were searched as part of the identification process up until April 2023. Our primary inclusion criteria centered on the economic evaluation of glucosamine in OA treatments, providing an incremental cost-effectiveness ratio (ICER). The Quality of Health Economic Studies (QHES) instrument was applied to grade the quality of the studies. Seven qualified studies that discussed the cost-effectiveness of glucosamine with or without other formulations were selected. All of them demonstrated that glucosamine was cost-effective. There was an increase in quality-adjusted life years (QALYs) when incorporating glucosamine in conventional care. Moreover, patented crystalline glucosamine sulfate (pCGS) was more cost-effective than the other formulations of glucosamine (OFG). Overall, utilizing pCGS was more beneficial than using OFG in terms both of cost and quality of life.

Lineage-specific detection of residual disease predicts relapse in patients with chronic myeloid leukemia stopping therapy.

ABSTRACT: Patients with chronic myeloid leukemia who are eligible for treatment-free remission (TFR) may still relapse after tyrosine kinase inhibitor (TKI) cessation. There is a need for accurate predictors of outcome to enable patients with a favorable profile to proceed while avoiding futile attempts. Sensitive detection of residual disease in total leukocytes at treatment cessation is associated with relapse but is not highly discriminatory, likely because it is a composite measure of residual leukemia derived from different cell lineages, whereas only some lineages are relevant for relapse. We prospectively measured BCR::ABL1 DNA as a predictive yes/no binary test in 5 cellular fractions from 48 patients meeting conventional criteria for TKI discontinuation. The median BCR::ABL1 DNA level was higher in granulocytes and T cells, but not in other lineages, in patients who relapsed. Among the 40 patients undergoing their first TFR attempt, we defined 3 groups with differing relapse risk: granulocyte-positive group (100%), granulocyte-negative/T-cell-positive group (67%), and granulocyte-negative /T-cell-negative group (25%). These data show the critical importance of lineage-specific assessment of residual disease in the selection of patients who can attempt to achieve TFR with a high expectation of success and, concurrently, defer patients who have a high probability of relapse.

Effectiveness and Safety of Glucosamine in Osteoarthritis: A Systematic Review.

Knee osteoarthritis is the most popular type of osteoarthritis that causes extreme pain in the elderly. Currently, there is no cure for osteoarthritis. To lessen clinical symptoms, glucosamine was suggested. The primary goal of our systematic review study is to evaluate the effectiveness and safety of glucosamine based on recent studies. Electronic databases such as PubMed, Scopus, and Cochrane were used to assess the randomized controlled trial (RCT). From the beginning through March 2023, the papers were checked, and if they fulfilled the inclusion criteria, they were then examined. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and Visual Analog Scale (VAS) scales were considered the main outcome measures. A total of 15 studies were selected. Global pain was significantly decreased in comparison to placebo, as measured by the VAS index, with an overall effect size of standardized mean difference (SMD) of -7.41 ([95% CI] 14.31, 0.51). The WOMAC scale confirmed that pain, stiffness, and physical function had improved, however the effects were insufficient. A statistical update also revealed that there were no reports of serious medication interactions or significant adverse events. To summarize, glucosamine is more effective than a placebo at reducing pain in knee osteoarthritis patients. In long-term treatment, oral glucosamine sulfate 1500 mg/day is believed to be well tolerated.

Clinical Epidemiology Features and Risk Factors for Acute Diarrhea Caused by Rotavirus A in Vietnamese Children.

Introduction: Acute diarrhea caused by group A rotavirus (RVA) is a leading cause of morbidity and mortality globally in children less than 5 years old. Acute diarrhea caused by RVA is often manifested by loose/watery stool leading to different degrees of dehydration. The detection of risk factors, diagnosis, and prompt treatment of acute diarrhea caused by RVA is critical. We aimed to describe clinical epidemiological features of acute diarrhea caused by RVA and its associated risk factors. Subjects and Method. We conducted a cross-sectional study that included 321 children under 5 years old with acute diarrhea at Haiphong Children's Hospital, Vietnam, from 1 August 2019 to 31 July 2020. Results: Among the 321 children included in our analysis, 221 (68.8%) children were positive for RVA. Males represented 61.1% of cases, 41.2% of children were in the 12-<24-month age group, and the majority of cases were among children in suburban areas (71.5%). Clinical manifestations included loose and watery stool (100%), vomiting-fever-loose/watery stool (57.9%), vomiting-loose/watery stool (83.2%), fever-loose/watery stool (58.8%), dehydration (30%), hyponatremia (22.1%), hypernatremia (1.4%), and hypokalemia (15%). Risk factors for acute diarrhea caused by RVA included history of diarrhea, not exclusive breastfeeding in the first 6 months, living area, maternal education, and income. Conclusions: Acute diarrhea due to RVA was very prevalent in children under 5 years old. Clinical manifestations included a high prevalence of loose/watery stools/day and dehydration with electrolyte disorder. Mothers should exclusively breastfeed their children for the first 6 months to avoid the risk of acute diarrhea caused by RVA.

Longitudinal characterization of circulating extracellular vesicles and small RNA during simian immunodeficiency virus infection and antiretroviral therapy.

OBJECTIVES: Latent infection by HIV hinders viral eradication despite effective antiretroviral treatment (ART). Among proposed contributors to viral latency are cellular small RNAs that have also been proposed to shuttle between cells in extracellular vesicles. Thus, we profiled extracellular vesicle small RNAs during different infection phases to understand the potential relationship between these extracellular vesicle associated small RNAs and viral infection. DESIGN: A well characterized simian immunodeficiency virus (SIV)/macaque model of HIV was used to profile extracellular vesicle enriched blood plasma fractions harvested during preinfection, acute infection, latent infection/ART treatment, and rebound after ART interruption. METHODS: Measurement of extracellular vesicle concentration, size distribution, and morphology was complemented with qPCR array for small RNA expression, followed by individual qPCR validations. Iodixanol density gradients were used to separate extracellular vesicle subtypes and virions. RESULTS: Plasma extracellular vesicle particle counts correlated with viral load and peaked during acute infection. However, SIV gag RNA detection showed that virions did not fully explain this peak. Extracellular vesicle microRNAs miR-181a, miR-342-3p, and miR-29a decreased with SIV infection and remained downregulated in latency. Interestingly, small nuclear RNA U6 had a tight association with viral load peak. CONCLUSION: This study is the first to monitor how extracellular vesicle concentration and extracellular vesicle small RNA expression change dynamically in acute viral infection, latency, and rebound in a carefully controlled animal model. These changes may also reveal regulatory roles in retroviral infection and latency.

Clinically relevant variation in FLT3-ITD quantitation as a result of PCR cycle number and ITD insertion size.

FLT3 internal tandem duplication (ITD) quantitation is key to prognostication in acute myeloid leukaemia (AML). One potential source of variability in the allelic ratio (AR) is the number of polymerase chain reaction (PCR) cycles used. Using 30 archived samples of varying ITD lengths and AR, we compared two FLT3-ITD assays (Huang and RATIFY), evaluated the effect of PCR cycle number on each assay, and examined the potential clinical consequences. Huang and RATIFY assays at 35 and 27 PCR cycles, respectively, were highly concordant. A progressive decrease in AR (median 47%) was observed with the RATIFY assay when the PCR cycles were increased from 27 to 35 cycles, potentially impacting risk categorisation in 29% of patients. In contrast, minimal change in AR was observed with the Huang assay. Hence, both FLT3-ITD assays were almost identical using respective standard conditions, but the effect of PCR cycle number is assay-dependent, which may impact risk stratification in AML.

COVID-19 impacts, opportunities and challenges for wildlife farms in Binh Duong and Ba Ria Vung Tau, Vietnam.

The wildlife trade is a major cause of species loss and can trigger disease transmission. While the COVID-19 pandemic sparked public interest in eliminating the wildlife trade, a better understanding is needed of the economic repercussions of COVID-19 on those who rely on wildlife farming for their livelihoods. Using the case studies of Ba Ria Vung Tau and Binh Duong provinces in Vietnam - a country seen as Asia's wildlife trade hotspot - this paper explores COVID-19's impacts on wildlife farms and their owners. Understanding these impacts is important, both in order to design appropriate interventions to support local people in mitigating COVID-19's impacts as well as to inform effective policymaking around wildlife conservation in Vietnam. In this study, we adopted mixed research methods (including a literature and policy review, stakeholder consultation with government agencies and NGOs engaged in designing and monitoring wildlife conservation policies, a wildlife farming household survey, and research validation workshop) to understand the status of Vietnamese wildlife farms, as well as the impacts of COVID-19, and any opportunities and challenges for wildlife conservation and management in Vietnam. Our paper shows that, across the two studied provinces, numbers of wildlife farms and farmed wildlife animals have both declined since the pandemic, with declining market demand and wildlife farm owners experiencing difficulties accessing markets due to travel restrictions. Although this affected wildlife-related income, this represented less than 30 % of families' overall income on average, and thus households were able to maintain their livelihoods through other sources. Most wildlife is raised as an additional food source for farming families and plays an important role in the diets of surveyed households. Findings also highlighted that most surveyed households' post-pandemic recovery strategies involved expanding their wildlife farms in scope and scale; these households perceived a stable domestic market and high prices for wildlife products in future. Our study found several opportunities for sustainable wildlife farming practices, including greater political commitment, an increasing number of wildlife conservation policies, and stronger law enforcement mechanisms. Challenges remain, however; including an unclear and inconsistent policy framework, the presence of an illegal market, and wildlife farm owners' limited knowledge and understanding of wildlife policies. Our paper also shows a lack of comprehensive data and understanding around actual wildlife transactions during the pandemic, leading to challenges in confirming whether COVID-19 had any real impact on wildlife trade. Further research is required to address this knowledge gap.

Preoperative planning using virtual reality for percutaneous transseptal valve-in-valve transcatheter mitral valve replacement: a case report.

Background: Virtual reality (VR) technology has been implemented as a pre-procedural planning tool for cardiovascular interventions to enable detailed evaluation of patient anatomy from different vantage points. Here, we employed a VR platform to preoperatively plan for percutaneous valve-in-valve transcatheter mitral replacement (ViV-TMVR) in a prohibitive surgical candidate. Case summary: An 85-year-old male with a history of two prior sternotomies for bioprosthetic aortic valve (AV) and mitral valve (MV) 31 mm Medtronic Mosaic bioprosthesis presented with severe mitral regurgitation from a degenerative bioprosthetic MV. The patient was deemed a prohibitive surgical candidate for a third sternotomy and instead was recommended a percutaneous transseptal ViV-TMVR. An electrocardiogram-gated chest computed tomography (CT) provided a neo-left-ventricular outflow tract (neo-LVOT) of 1.89 cm2. This CT was reconstructed to create a 360° VR (360VR) model. A 29 mm SAPIEN three bioprosthetic valve, selected based on the already implanted MV, was placed inside the bioprosthetic MV and analysed in VR at different angles to ensure it would not obstruct the LVOT. The neo-LVOT measured in VR was 3.02 cm2, which would allow for sufficient blood flow without significant obstruction from the new SAPIEN three bioprosthetic valve. The patient tolerated the procedure well. Discussion: This case demonstrates the utility of VR as a pre-procedural planning tool for interventional cardiology procedures. Preoperative planning in VR alleviated concerns regarding obstruction of the neo-LVOT and helped confirm safe implantation by clearly showing the three-dimensional spatial relationship between the implants and surrounding patient anatomy.

Synthesis of a UiO-66/g-C3N4 composite using terephthalic acid obtained from waste plastic for the photocatalytic degradation of the chemical warfare agent simulant, methyl paraoxon.

In our study, Zr-based UiO-66 (Zr) was synthesized using terephthalic acid obtained from waste plastic. Thereafter, UiO-66/g-C3N4 composites were prepared by the solvothermal method, and their photocatalytic activity in the photodegradation of the chemical warfare agent simulant, dimethyl 4-nitrophenyl phosphate (DMNP), was evaluated. The as-synthesized UiO-66/g-C3N4 exhibited a high surface area (1440 m2 g-1) and a high capillary volume (1.49 cm3 g-1). The UiO-66/g-C3N4 samples absorbed a visible light band with bandgap energies of 2.13-2.88 eV. The as-synthesized UiO-66/g-C3N4 composites exhibited highly efficient degradation of DMNP with a short half-life (t 1/2 of 2.17 min) at pH 7 under visible light irradiation. The trapping experiments confirmed that the h+ and ˙O2 - radicals played an important role in the photocatalytic degradation of DMNP. The UiO-66/g-C3N4 catalyst simultaneously performed two processes: the hydrolysis and photocatalytic oxidation of DMNP in water. During irradiation, a p-n heterojunction between UiO-66 and g-C3N4 restricted the recombination of photogenerated electrons and holes, resulting in the enhancement in the degradation rate of DMNP.

Augmented Reality Neuronavigation for En Bloc Resection of Spinal Column Lesions.

BACKGROUND: Primary tumors involving the spine are relatively rare but represent surgically challenging procedures with high patient morbidity. En bloc resection of these tumors necessitates large exposures, wide tumor margins, and poses risks to functionally relevant anatomical structures. Augmented reality neuronavigation (ARNV) represents a paradigm shift in neuronavigation, allowing on-demand visualization of 3D navigation data in real-time directly in line with the operative field. METHODS: Here, we describe the first application of ARNV to perform distal sacrococcygectomies for the en bloc removal of sacral and retrorectal lesions involving the coccyx in 2 patients, as well as a thoracic 9-11 laminectomy with costotransversectomy for en bloc removal of a schwannoma in a third patient. RESULTS: In our experience, ARNV allowed our teams to minimize the length of the incision, reduce the extent of bony resection, and enhanced visualization of critical adjacent anatomy. All tumors were resected en bloc, and the patients recovered well postoperatively, with no known complications. Pathologic analysis confirmed the en bloc removal of these lesions with negative margins. CONCLUSIONS: We conclude that ARNV is an effective strategy for the precise, en bloc removal of spinal lesions including both sacrococcygeal tumors involving the retrorectal space and thoracic schwannomas.

Single-stage cranioplasty with customized polyetheretherketone implant after tumor resection using virtual reality and augmented reality for precise implant customization and placement: illustrative case.

BACKGROUND: Cranioplasties are routinely performed to restore cosmesis and to protect intracranial contents after trauma, resection of tumors, or other pathologies. Traditionally done as a second-stage procedure, new single-stage cranioplasty protocols have been developed to minimize recovery periods, decrease complications, and improve patient satisfaction. These protocols, however, still require the use of larger than planned implants or use larger than ideal incisions to accommodate three-dimensional (3D) templates, which may not be optimal in regions with complex bony anatomy. OBSERVATIONS: A 50-year-old woman with a painful and progressively enlarging hemangioma of the left frontal bone underwent a single-stage resection followed by custom cranioplasty using a new extended reality (XR)-based workflow. Excellent cosmetic results, decreased operative time, and a feasible workflow were achieved. LESSONS: The use of an XR-based visualization platform allows the surgeon to treat lesions and perform custom cranioplasties in one session while avoiding common pitfalls of current single-stage workflows, such as increased operative times for tailoring implants, as well as minimizing the use of 3D overlay models, which may not appropriately conform to complex regional bony anatomy intraoperatively.

The First Pilot Study of an Interactive, 360° Augmented Reality Visualization Platform for Neurosurgical Patient Education: A Case Series.

BACKGROUND: Interactive technologies are increasingly being used for patient education. Augmented reality (AR) is the technology of superimposing digital content on the reality that the user observes. OBJECTIVE: To evaluate a brand new, commercial prototype of a 360° AR visualization platform (360 ARVP) to enhance patient education for neurosurgical patients. METHODS: This pilot study was a single-center, single-provider study that took place in the clinic setting of the senior author. Patients were given the opportunity to use the 360 ARVP (Surgical Theater) concurrently with the neurosurgeon. All patients completed a survey on their experience with the 360 ARVP immediately after use. RESULTS: A total of 24 patients participated in the study. All patients (19 [79.2%] strongly agreed and 5 [20.8%] agreed) reported that using the 360 ARVP system helped improve understanding of their medical condition. The total percentage of patients who either agreed or strongly agreed that experiencing the 360 ARVP helped improve their comfort levels and that they felt included in decisions about their treatment was 95.8%. When asked to rate their level of understanding of their treatment plans on a 0 to 10 scale, the difference in means for the patients' ratings before and after the use of 360 ARVP was statistically significant (P < .0017). CONCLUSION: This pilot study demonstrates that AR can be used as an adjunctive tool for patient education. Patients found that the 360 ARVP increased their understanding of their medical conditions and improved their comfort level with the proposed treatments.

Rational formulation design of injectable thermosensitive chitosan-based hydrogels for cell encapsulation and delivery.

This work reports a rational design of injectable thermosensitive chitosan systems for cell encapsulation and delivery. Using mixtures of two phosphate salts, beta-glycerophosphate and ammonium hydrogen phosphate, we demonstrate that the pH and the osmolarity can be adjusted separately by varying the molar ratios between the salts and the d-glucosamine monomers. We found the existence of a critical temperature above which gelation time decays following a power-law. This gelation kinetics can be finely tuned through the pH and salt-glucosamine ratios. Formulations having physiological pH and osmolarity were produced for chitosan concentrations ranging from 0.4 to 0.9 wt%. They remain liquid for more than 2 h at 20 °C and form a macroporous gel within 2 min at 37 °C. In vitro encapsulation of pre-osteoblastic cells and gingival fibroblasts showed homogeneous cell distribution and good cell viability up to 24 h. Such an approach provides a valuable platform to design thermosensitive cell-laden systems.

Real-time navigation guidance with intraoperative CT imaging for pedicle screw placement using an augmented reality head-mounted display: a proof-of-concept study.

OBJECTIVE: Augmented reality (AR) has the potential to improve the accuracy and efficiency of instrumentation placement in spinal fusion surgery, increasing patient safety and outcomes, optimizing ergonomics in the surgical suite, and ultimately lowering procedural costs. The authors sought to describe the use of a commercial prototype Spine AR platform (SpineAR) that provides a commercial AR head-mounted display (ARHMD) user interface for navigation-guided spine surgery incorporating real-time navigation images from intraoperative imaging with a 3D-reconstructed model in the surgeon's field of view, and to assess screw placement accuracy via this method. METHODS: Pedicle screw placement accuracy was assessed and compared with literature-reported data of the freehand (FH) technique. Accuracy with SpineAR was also compared between participants of varying spine surgical experience. Eleven operators without prior experience with AR-assisted pedicle screw placement took part in the study: 5 attending neurosurgeons and 6 trainees (1 neurosurgical fellow, 1 senior orthopedic resident, 3 neurosurgical residents, and 1 medical student). Commercially available 3D-printed lumbar spine models were utilized as surrogates of human anatomy. Among the operators, a total of 192 screws were instrumented bilaterally from L2-5 using SpineAR in 24 lumbar spine models. All but one trainee also inserted 8 screws using the FH method. In addition to accuracy scoring using the Gertzbein-Robbins grading scale, axial trajectory was assessed, and user feedback on experience with SpineAR was collected. RESULTS: Based on the Gertzbein-Robbins grading scale, the overall screw placement accuracy using SpineAR among all users was 98.4% (192 screws). Accuracy for attendings and trainees was 99.1% (112 screws) and 97.5% (80 screws), respectively. Accuracy rates were higher compared with literature-reported lumbar screw placement accuracy using FH for attendings (99.1% vs 94.32%; p = 0.0212) and all users (98.4% vs 94.32%; p = 0.0099). The percentage of total inserted screws with a minimum of 5° medial angulation was 100%. No differences were observed between attendings and trainees or between the two methods. User feedback on SpineAR was generally positive. CONCLUSIONS: Screw placement was feasible and accurate using SpineAR, an ARHMD platform with real-time navigation guidance that provided a favorable surgeon-user experience.

Scaffold-free human mesenchymal stem cell construct geometry regulates long bone regeneration.

Biomimetic bone tissue engineering strategies partially recapitulate development. We recently showed functional restoration of femoral defects using scaffold-free human mesenchymal stem cell (hMSC) condensates featuring localized morphogen presentation with delayed in vivo mechanical loading. Possible effects of construct geometry on healing outcome remain unclear. Here, we hypothesized that localized presentation of transforming growth factor (TGF)-ß1 and bone morphogenetic protein (BMP)-2 to engineered hMSC tubes mimicking femoral diaphyses induces endochondral ossification, and that TGF-ß1 + BMP-2-presenting hMSC tubes enhance defect healing with delayed in vivo loading vs. loosely packed hMSC sheets. Localized morphogen presentation stimulated chondrogenic priming/endochondral differentiation in vitro. Subcutaneously, hMSC tubes formed cartilage templates that underwent bony remodeling. Orthotopically, hMSC tubes stimulated more robust endochondral defect healing vs. hMSC sheets. Tissue resembling normal growth plate was observed with negligible ectopic bone. This study demonstrates interactions between hMSC condensation geometry, morphogen bioavailability, and mechanical cues to recapitulate development for biomimetic bone tissue engineering.

A Community and Technology-Based Approach for Hypertension Self-Management (COACHMAN) to Improve Blood Pressure Control in African Americans: Results from a Pilot Study.

PURPOSE: Adoption of technology has increased to support self-managing chronic diseases. However, behavioral interventions evaluating such technology have been understudied in African Americans with hypertension. The aim of this study was to explore a community and technology-based intervention for hypertension self-management (COACHMAN) intervention on blood pressure (BP) control and health-related quality of life (HRQoL) in African Americans with hypertension. METHODS: Sixty African Americans (mean age 60; 75% females) who were prescribed antihypertensive medications and owning a smartphone were randomized to the COACHMAN (n = 30) or enhanced usual care (n = 30) group for 12 weeks. COACHMAN is comprised of four components: web-based education, home BP monitoring, medication management application, and nurse counseling. Hypertension knowledge, self-efficacy, technology adoption/use, medication adherence, BP, and HRQoL scores were assessed. RESULTS: Mean systolic and diastolic BP at baseline was 150.49 (SD = 13.89) and 86.80 (SD = 13.39), respectively. After completing the 3-month intervention to improve hypertension self-management, the groups did not significantly differ in BP control and HRQoL. Clinically relevant BP reduction was observed in the intervention group. Paired t-test showed that mean medication-taking adherence scores significantly improved in the intervention group (P = 0.023) compared to the control group (P = 0.075). CONCLUSION: Using technology may have a positive impact on supporting hypertension self-management, particularly in medication-taking adherence. Further research is warranted in a larger sample and should include standardization of medication management to isolate the effects of behavioral interventions on changes in BP. CLINICALTRIALSGOV IDENTIFIER: NCT03722667.

The Design and Rationale of a Pilot Study: A COmmunity and Tech-Based ApproaCh for Hypertension Self-MANagement (COACHMAN).

African-Americans with hypertension continue to demonstrate poor blood pressure (BP) control and have markedly lower rates of hypertension self-management compared to non-African-Americans. Innovative and practical solutions such as mHealth technology are promising and can be leveraged to promote self-management of hypertension. Substantial evidence has demonstrated the importance of community support in improving patients' management of chronic illnesses. Unfortunately, such programs do not offer technology-based interventions (TBI) as a delivery method. Thus, this paper describes the design and rationale of an ongoing pilot study that incorporates TBI using a community-based participatory approach.