Feasibility of an Open Dialogue-Inspired Approach for Young Adults with Psychosis in a Public Hospital System.

The objective was to determine the feasibility of an Open Dialogue-inspired approach in a metropolitan, public hospital setting with predominately African American participants. Participants were ages 18-35, experienced psychosis within the past month, and involved at least one support person in their care. We evaluated domains of feasibility including implementation, adaptation, practicality, acceptability, and limited-efficacy. An organizational change model (Addressing Problems Through Organizational Change) facilitated implementation. Clinicians received three trainings and ongoing supervision. Network meetings were successfully implemented with good self-reported fidelity to principles of dialogic practice. Some adaptations (less frequent meetings and no home visits) were necessary. A subset of individuals completed research assessments over 12 months. Qualitative interviews with participants suggested the intervention was acceptable. Symptom and functional outcomes were preliminary but trended toward improvement. Implementation was feasible with relatively brief training, organizational change processes, and context-specific adaptations. Lessons learned can assist in planning a larger research study.

A cost-analysis study of using adult red cell packs and Pedi-Packs in newborn intensive care units in Southern Iran.

BACKGROUND AND OBJECTIVE: Saving blood products is an important public health issue especially in developing countries with limited financial resources. We aimed to suggest a new hypothetical model to make a change in the current blood transfusion policy in the newborn intensive care unit (NICU) to reduce wastage of blood supplies as well as the risk of exposure to multiple donors. METHODS: In this cross-sectional study, all transfused neonates (n = 70) who were admitted to NICU of Nemazee Hospital, a tertiary referral hospital in Southern Iran, were evaluated between March and June 2019. Based on the information of neonates' transfusion during this study period and determined transfusion indices, a specific pediatric pack was suggested and the related total costs per transfusion, as well as the donor-exposure rate of the hypothetical and the current transfusion method, were compared. RESULTS: Considering the mean number of transfusions per neonate: 4 and mean volume of transfused packed red cells: 20 ml per transfusion, the cost-analysis of pediatric and the adult pack was presented. Arithmetically, we proved a higher total cost per transfusion for using adult pack comparing to pediatric pack. Additionally, using a pediatric pack set leads to a 24% reduction in RBCs wastage per transfusion and a 68.13% reduction in donor-exposure rate. CONCLUSIONS: The assignment of a dedicated pediatric pack for neonates will be able to improve the cost-effectiveness by a substantial reduction in donor-exposure rate and blood wastage. This finding should be taken into consideration to generate economic growth and make improvements in child health status.

Evaluation of the University of California Diabetes Prevention Program (UC DPP) Initiative.

BACKGROUND: Type 2 diabetes can negatively impact long term health outcomes, healthcare costs and quality of life. However, intensive lifestyle interventions, including the Diabetes Prevention Program (DPP), can significantly lower risk of incident type 2 diabetes among overweight adults with prediabetes. Unfortunately, the majority of adults in the US who are at risk of developing diabetes do not engage in DPP-based lifestyle change programs. Increased adoption of evidence-based obesity and diabetes prevention interventions, such as the DPP, may help large employers reduce health risks and improve health outcomes among employees. In 2018, the University of California Office of thePresident (UCOP) implemented the UC DPP Initiative, a novel, multi-component program to address diabetes and obesity prevention across the UC system. METHODS: The goal of our study is to conduct a multifaceted evaluation of the UC DPP Initiative using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Our evaluation will integrate unique and diverse UC data sources, including electronic health record (EHR) data, administrative claims, campus-based DPP cohort data, qualitative interviews and site visits. Our primary outcome of interest is the mean percent weight change among three groups of overweight/obese UC beneficiaries at risk for diabetes at 12-month follow-up. Secondary outcomes include mean percent weight change at 24-month follow-up, barriers and facilitators associated with implementatio, as well as  the degree of program adoption and maintenance. DISCUSSION: Our study will help inform diabetes and obesity prevention efforts across the UC system. Findings from this evaluation will also be highly applicable to universities and large employers, as well as community organizers, healthcare organizations and insurers implementing the DPP and/or other health promotion interventions.

Own and partners' dyadic coping and depressive symptoms in individuals with early-stage dementia and their caregiving partners.

OBJECTIVES: In patients with early-stage dementia and their caregiving partners, reciprocal dyadic coping (DC) is crucial for preventing or reducing depressive symptoms in both partners. This study examines the relationships between 'own DC' and 'perceived partner DC' with depressive symptoms in couples coping with dementia on individual (actor effects) and cross-person (partner effects) levels. METHOD: 164 individuals (82 patients with early-stage dementia and their 82 caregiving partners; ND = 82 dyads) participated in this prospective study with measures (DC, depressive symptoms, and dementia severity) taken at baseline and at six months. Each partner evaluated their own and the perceived partner DC. Actor-partner interdependence models were applied to the resulting four independent evaluations. RESULTS: Results differed substantially between patients and caregivers. DC was significantly related to patients' but not to caregivers' depressive symptoms, when adjustments were made for individual coping. Perceived partner DC showed a negative association with depressive symptoms in patients, whereas own DC was adversely related for actor as well as for partner effects across individuals. CONCLUSION: The adverse association between the own DC of the caregiver and the patient on depressive symptoms of the patient might be due to inappropriate efforts or to the loss of autonomy as a care-receiver. DC is important in both patients and caregivers, as shown by the negative association between perceived partner DC and depressive symptoms in the patients, which might inform interventions that target the couple as a whole.

Who benefits from a dietary online intervention? Evidence from Italy, Spain and Greece.

OBJECTIVE: The traditional Mediterranean diet includes high consumption of fruits, vegetables, olive oil, legumes, cereals and nuts, moderate to high intake of fish and dairy products, and low consumption of meat products. Intervention effects to improve adoption of this diet may vary in terms of individuals' motivational or volitional prerequisites. In the context of a three-country research collaboration, intervention effects on these psychological constructs for increasing adoption of the Mediterranean diet were examined. DESIGN: An intervention was conducted to improve Mediterranean diet consumption with a two-month follow-up. Linear multiple-level models examined which psychological constructs (outcome expectancies, planning, action control and stage of change) were associated with changes in diet scores. SETTING: Web-based intervention in Italy, Spain and Greece. SUBJECTS: Adults (n 454; mean age 42·2 (sd 10·4) years, range 18-65 years; n 112 at follow-up). RESULTS: Analyses yielded an overall increase in the Mediterranean diet scores. Moreover, there were interactions between time and all four psychological constructs on these changes. Participants with lower levels of baseline outcome expectancies, planning, action control and stage of change were found to show steeper slopes, thus greater behavioural adoption, than those who started out with higher levels. CONCLUSIONS: The intervention produced overall improvements in Mediterranean diet consumption, with outcome expectancies, planning, action control and stage of change operating as moderators, indicating that those with lower motivational or volitional prerequisites gained more from the online intervention. Individual differences in participants' readiness for change need to be taken into account to gauge who would benefit most from the given treatment.

An application of the Health Action Process Approach model to oral hygiene behaviour and dental plaque in adolescents with fixed orthodontic appliances.

BACKGROUND: The Health Action Process Approach (HAPA) model addresses health behaviours, but it has never been applied to model adolescents' oral hygiene behaviour during fixed orthodontic treatment. AIM: This study aimed to apply the HAPA model to explain adolescents' oral hygiene behaviour and dental plaque during orthodontic treatment with fixed appliances. METHODS: In this cross-sectional study, 116 adolescents with fixed appliances from an orthodontic clinic situated in Almere (the Netherlands) completed a questionnaire assessing oral health behaviours and the psychosocial factors of the HAPA model. Linear regression analyses were performed to examine the factors associated with dental plaque, toothbrushing, and the use of a proxy brush. RESULTS: Stepwise regression analysis showed that lower amounts of plaque were significantly associated with higher frequency of the use of a proxy brush (R2 = 45%), higher intention of the use of a proxy brush (R2 = 5%), female gender (R2 = 2%), and older age (R2 = 2%). The multiple regression analyses revealed that higher action self-efficacy, intention, maintenance self-efficacy, and a higher education were significantly associated with the use of a proxy brush (R2 = 45%). CONCLUSION: Decreased levels of dental plaque are mainly associated with increased use of a proxy brush that is subsequently associated with a higher intention and self-efficacy to use the proxy brush.

The Effects of Two Planning Interventions on the Oral Health Behavior of Iranian Adolescents: A Cluster Randomized Controlled Trial.

PURPOSE: The aim of this study was to investigate the effectiveness of a planning intervention (specifying when, where, and how to act) and an implementation intention intervention (specifying the same in the format of an if-then plan) in increasing self-reported brushing in adolescents. METHODS: The study adopted a cluster randomized controlled trial design, and 1158 students in 48 schools were randomized to planning, implementation intention, or active control conditions. After baseline assessment, all participants received a leaflet containing information and recommendations on oral health and instructions on correct brushing behavior. After reading the leaflets, they were provided with a toothbrush and toothpaste plus a calendar in which to record their brushing. Participants in the planning condition and in the implementation intention condition also received instructions to form specific plans regarding brushing behavior. Self-reported brushing, perceived behavioral control, self-monitoring, intention, frequency of planning, oral health-related quality of life, and dental plaque and periodontal status were measured 1 and 6 months later. RESULTS: Both intervention conditions showed a significant improvement in the frequency of self-reported brushing, self-monitoring, frequency of planning, intention, perceived behavioral control, plaque index, periodontal health, and oral health-related quality of life compared to the control condition at both follow-ups. Comparing the two intervention conditions revealed that adolescents who received the implementation intention intervention had significantly greater improvement in the frequency of self-reported brushing, intention, frequency of planning, and periodontal health than those in planning condition. CONCLUSIONS: Taken together, the findings suggest that forming implementation intentions as well as planning has the potential to increase dental self-reported brushing rates in adolescents, but that forming implementation intentions has the strongest impact on dental hygiene behavior and is, therefore, recommended. TRIAL REGISTRATION NUMBER: The trial was registered with the ClinicalTrials.gov database (NCT02066987) https://www.clinicaltrials.gov/ct2/show/NCT02066987 .

A randomized controlled multimodal behavioral intervention trial for improving antiepileptic drug adherence.

PURPOSE: Medication nonadherence is one of the most important reasons for treatment failure in patients with epilepsy. The present study investigated the effectiveness of a multicomponent intervention to improve adherence to antiepileptic drug (AED) medication in patients with epilepsy. METHODS: In a prospective, randomized multicenter trial, three sessions of face-to-face motivational interviewing (MI) in combination with complementary behavior change techniques were compared with standard care. Motivational interviewing prompted change talk and self-motivated statements from the patients, planning their own medication intake regimen and also identifying and overcoming barriers that may prevent adherence. Participants were provided with calendars to self-monitor their medication taking behavior. A family member and the health-care team were invited to attend the last session of MI in order to improve the collaboration and communication between patients, their caregiver or family member, and their health-care provider. At baseline and 6-month follow-up, psychosocial variables and medical adherence were assessed. RESULTS: In total, 275 participants were included in the study. Compared with the active control group, patients in the intervention group reported significantly higher medication adherence, as well as stronger intention and perceptions of control for taking medication regularly. The intervention group also reported higher levels of action planning, coping planning, self-monitoring, and lower medication concerns. CONCLUSIONS: This study shows that MI can be effective in clinical practice to improve medication adherence in patients with epilepsy. It also provides evidence that combining volitional interventions, including action planning, coping planning, and self-monitoring with motivational interviewing can promote the effectiveness of the medical treatments for epilepsy by improving adherence.

A Brief Self-Regulatory Intervention Increases Dental Flossing in Adolescent Girls.

BACKGROUND: Oral diseases such as dental caries, periodontal disease, and tooth loss are a considerable public health problem. A review of the epidemiological data from many countries indicates that a global increase in dental caries prevalence affects children as well as adults. Despite the improvement in oral health of children in the last few decades, tooth decay remains one of the most common childhood diseases in both industrialized and developing countries. PURPOSE: The study evaluates the effects of a self-regulatory intervention to increase dental flossing among adolescents and examines the mediating mechanisms underlying behavioral changes. METHODS: A cluster randomized controlled trial compared a brief intervention arm with a control arm in 166 girls aged 11-15 years. Planning, self-efficacy, and behavioral intention were specified as mediators between treatment conditions and follow-up dental flossing frequency. At baseline, the intervention group received theory-guided materials on oral hygiene. Four weeks later, changes in behavior and social-cognitive variables were assessed. RESULTS: The brief self-regulatory intervention led to an increase in dental flossing and social-cognitive constructs. A sequential mediator model was identified in which first changes in intention and afterwards changes in self-efficacy mediated between treatment conditions and behavioral outcomes. CONCLUSION: Intention formation and self-efficacy seem to play an instrumental role in the mechanism that facilitates dental flossing among adolescent girls. Oral self-care interventions should consider the application of intention formation strategies combined with building confidence in one's ability to adhere to the regimen.

Mothers improve their daughters' vegetable intake: a randomized controlled trial.

The increasing prevalence of childhood overweight makes children an important target for health promotion programmes. An intervention was designed for mothers to provide more vegetables to their daughters' diet. A randomized controlled trial compared a self-regulation condition with a control condition in 155 mothers aged 25-50 years. Dependent variable was children's (aged 6-11 years) vegetable consumption which was reported by their mothers at three points in time. After baseline (Time 1), the intervention group received theory-based instructional leaflets to promote self-regulatory skills for providing a healthy nutrition for children. Changes were assessed after two weeks (Time 2) and at three-month follow-up (Time 3). The self-regulation intervention in mothers led to an increase in vegetable intake among their daughters at Time 2 but not at Time 3. However, maintenance of vegetable consumption at Time 3 was mediated by the amount of vegetable intake at Time 2. Engaging mothers in self-regulatory health promotion programmes may be a feasible strategy to facilitate more vegetable intake among their daughters.

Comparing a motivational and a self-regulatory intervention to adopt an oral self-care regimen: a two-sequential randomized crossover trial.

A sequential intervention to facilitate the adoption and maintenance of dental flossing was conducted among 205 students in India, aged 18-26 years. Two experimental groups received different treatment sequences and were observed at three assessment points, 34 days apart. One group received first a motivational intervention (intention, outcome expectancies, and risk perception, followed by a self-regulatory intervention (planning, self-efficacy, and action control). The second group received the same intervention in the opposite order. Both intervention sequences yielded gains in terms of flossing, planning, self-efficacy, and action control. However, at Time 2, those who had received the self-regulatory intervention first, were superior to their counterparts who had received the motivational intervention first. At Time 3, differences vanished as everyone had then received both interventions. Thus, findings highlight the benefits of a self-regulatory compared to a mere motivational intervention.

A Quality-of-life Study in Patients with Anaphylaxis to Hymenoptera Venom in Iran.

Little is known about the quality of life of patients with anaphylaxis to Hymenoptera venom. The Vespid Allergy Quality of Life Questionnaire (VQLQ) is commonly used to assess the psychological burden of this condition. This study aimed to evaluate the validity and reliability of the Persian version of VQLQ. In this cross-sectional study, VQLQ was translated into Persian according to expert recommendations.  The final translated version of VQLQ was then administered to 115 patients with Hymenoptera venom allergy at an asthma and allergy clinic in Iran. More than half of the participants were between 20 and 40 years of age, and 60% were male. Fear, anxiety, and outdoor activities had the most significant impact on the quality of life of patients with Hymenoptera venom allergy. Additionally, quality of life was more affected in women than in men, while no correlation was found with age. Furthermore, the quality of life was affected by a history of acute anaphylactic shock due to Hymenoptera venom. The Persian version of VQLQ enables the measurement of quality of life in patients with Hymenoptera venom allergy in the Iranian population. The inclusion of VQLQ in the initial evaluation of these patients may potentially guide allergist in providing support for venom-specific immunotherapy.

Dietary fiber intake and all-cause and cause-specific mortality: An updated systematic review and meta-analysis of prospective cohort studies.

BACKGROUND: Accumulating evidence supports the effects of dietary fiber on the risk of non-communicable diseases (NCDs). However, there is no updated systematic review and meta-analysis that compares and pools the effect of different types of fiber on mortality. METHODS: In this systematic review and meta-analysis, all prospective cohort studies that evaluated the relationship between dietary fiber intake and all-cause or cause-specific mortality were included. The PubMed, SCOPUS, and Web of Science databases were searched up to October 2022. Data extraction and quality assessment were performed by two researchers independently. Heterogeneity between studies was assessed using Chi-square based test. Random/fixed effect meta-analysis was used to pool the hazard ratios (HR) or relative risks (RR) and 95 % confidence intervals (CI) for the association between different types of fiber and mortality. RESULTS: This systematic review included 64 eligible studies, with a total sample size of 3512828 subjects, that investigated the association between dietary fiber intake and mortality from all-cause, cardiovascular disease (CVD), and cancer. Random-effect meta-analysis shows that higher consumption of total dietary fiber, significantly decreased the risk of all-cause mortality, CVD-related mortality, and cancer-related mortality by 23, 26 and 22 % (HR:0.77; 95%CI (0.73,0.82), HR:0.74; 95%CI (0.71,0.77) and HR:0.78; 95%CI (0.68,0.87)), respectively. The consumption of insoluble fiber tended to be more effective than soluble fiber intake in reducing the risk of total mortality and mortality due to CVD and cancer. Additionally, dietary fiber from whole grains, cereals, and vegetables was associated with a reduced risk of all-cause mortality, while dietary fiber from nuts and seeds reduced the risk of CVD-related death by 43 % (HR:0.57; 95 % CI (0.38,0.77)). CONCLUSION: This comprehensive meta-analysis provides additional evidence supporting the protective association between fiber intake and all-cause and cause-specific mortality rates.

Twelve-Month Reach and Effectiveness of a University-Based Diabetes Prevention Initiative.

INTRODUCTION: The University of California (UC) implemented the Diabetes Prevention Program (DPP) to address diabetes and obesity risk. This project examined the reach and effectiveness of this university-based DPP delivery approach. METHODS: This project compared 12-month weight change among three groups of UC beneficiaries with overweight/obesity: (1) those who received invitation letters and enrolled in UC DPP, (2) those mailed invitation letters but did not enroll, and (3) those who were not mailed letters and did not enroll (controls). Using 2012-2022 EHR, administrative and DPP cohort data, an interrupted time series was conducted in 2022-2023 to compare group differences in rate of weight change. RESULTS: Among 6,231 beneficiaries (132 UC DPP aware enrollees, 1,750 DPP aware non-enrollees, 4,349 controls), UC DPP enrollees were older (mean age 49), mostly women (76%), and more diverse (33% Asian, 8% Black, 20% Hispanic, 4% Multi/Other). Over 12 months of follow-up, UC DPP enrollee postenrollment rate of weight loss was -0.68 lbs./month. UC DPP enrollees had significantly greater weight change from pre- to post-enrollment than DPP aware non-enrollees (adjusted Δ-1.02 vs. Δ-0.07 lbs./month, difference= -0.95, p<0.001). Weight change among all participants who received letters with/without DPP enrollment was similar to controls. CONCLUSIONS: UC DPP reached a diverse group and was effective for weight loss at 12-month follow-up. However, UC DPP invitation letters to raise prediabetes and DPP awareness were not associated with significant weight change in the absence of DPP enrollment. University-based approaches to DPP delivery are effective and may enhance reach of DPP among at-risk adults.

Multilevel perceptions of the virtual delivery of the University of California Diabetes Prevention Program on RE-AIM domains due to COVID-19 mandates.

Background: The University of California's Diabetes Prevention Program (UC DPP) Initiative was implemented across all 10 UC campuses in 2018. The COVID-19 pandemic and accompanying mandates required swift changes to program delivery, including pivoting from in-person to virtual delivery (i.e., Zoom). Our goal was to assess multilevel constituent perceptions of the use of a virtual platform to deliver UC DPP due to COVID-19 mandates. Methods: We conducted qualitative interviews with 68 UC DPP participants, coordinators, and leaders to examine the use of virtual platform delivery on the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) of UC DPP. Transcripts were analyzed using rapid qualitative analysis and emergent themes were categorized using domains corresponding to RE-AIM framework. Results: Among UC DPP participants (n = 42), virtual delivery primarily impacted perceptions of UC DPP effectiveness and implementation. Some participants perceived program effectiveness to be negatively impacted, given their preference for in-person sessions, which they felt provided more engagement, peer support, and accountability. Implementation challenges included problems with virtual format (e.g., "Zoom fatigue"); however, several benefits were also noted (e.g., increased flexibility, maintenance of DPP connections during campus closures). UC DPP coordinators (n = 18) perceived virtual delivery as positively impacting UC DPP reach, since virtual platforms provided access for some who could not participate in-person, and negatively impacting effectiveness due to reduced engagement and lower peer support. UC leaders (n = 8) perceived that use of the virtual format had a positive impact on reach (e.g., increased availability, accessibility) and negatively impacted effectiveness (e.g., less intensive interactions on a virtual platform). Across constituent levels, the use of a virtual platform had little to no impact on perceptions of adoption and maintenance of UC DPP. Conclusion: Perceptions of the reach, effectiveness, and implementation of UC DPP using a virtual platform varied across constituents, although all groups noted a potential negative impact on overall program effectiveness. Unanticipated program adaptations, including virtual delivery, present potential benefits as well as perceived drawbacks, primarily across the effectiveness domain. Understanding differential constituent perceptions of the impact of virtual delivery can help maximize RE-AIM and inform future UC DPP delivery strategies.

A dietary planning intervention increases fruit consumption in Iranian women.

The study examined whether a dietary planning intervention would help increase fruit consumption among Iranian women focusing on self-regulatory mechanisms in behavior change. We conducted a randomized controlled trial to compare a planning intervention with a control condition in 165 Iranian women (aged 17-48years). Dependent variable was fruit intake, and dietary planning served as the mediator. After baseline assessment (T1) the intervention group received a leaflet on fruit consumption with a planning sheet. Changes were assessed at 3-weeks (T2) and at 3-months follow-ups (T3). Findings showed that the dietary planning intervention led to an increase in fruit intake. Age moderated this mediation. Changes in dietary planning mediated between intervention and fruit consumption in middle aged women. Dietary planning seems to play a role in the mechanism that facilitates fruit intake among Iranian women. This mediation by planning was found in middle aged women (30-48 years old), but not in young adult women (17-29 years old).

Evaluation of acute and sub-chronic oral toxicities of Neoneaster in rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Jaundice is a condition caused by the elevation of bilirubin level in the blood. Due to the neurological and neurodevelopmental sequalae of jaundice in newborns, the high cost of the treatment, and the side effects of the currently used therapies, novel therapeutically approaches are needed. Purgative manna (Shir-e-Khesht) has been used in Persian traditional medicine to reduce serum bilirubin levels of neonates. Neoneaster® is a natural health product formulated by a unique method from the manna of Cotoneaster nummularius Fisch. & C.A.Mey. for treating neonatal jaundice and managing constipation. The main component of Neoneaster®, mannitol, is an osmotic laxative which could increase intestinal transit and reduce the re-absorption of bilirubin in the enterohepatic cycle. AIM OF THE STUDY: We conducted this study to investigate acute and sub-chronic oral toxicities of Neoneaster in Wistar rats. MATERIALS AND METHODS: In the acute oral toxicity test, based on OECD 423 we administered Neoneaster to the Wistar rats at doses of 5, 50, 300, and 2000 mg/kg(OECD, 2002). Toxicological effects, including mortality and behavioral changes, were recorded for 14 days and compared to the control group. We also carried out histopathological assessments of the tissues of liver, heart, kidney, and spleen after this period. To evaluate sub-chronic toxicity, while administering 2000 mg/kg of Neoneaster daily to the Wistar rats, we recorded for changes in mortality and behavior for 45 days and compared these to the values of the control group. We also carried out biochemical, hematological, and histopathological assessments after this period. RESULTS: In both acute and sub-chronic oral toxicity tests, no mortalities, behavioral abnormalities, and histological signs of toxicity was observed in any of the administered doses in comparison to the control group. The percentage of weight gains in acute toxicity test and the weight gain in sub-chronic test were not significant (P>0/05). There were also no significant differences in hematological and biochemical markers (P>0/05). Based on our finding, Neoneaster can be classified as category 5 in the Globally Harmonized Chemical Classification and Labeling System (GHS) as its Lethal Dose 50 (LD50) is higher than 2000 mg/kg. CONCLUSIONS: This study suggests that Neoneaster is safe and can be classified as category 5 in the GHS system.

Enhancing review criteria for dissemination and implementation science grants.

BACKGROUND: The existing grant review criteria do not consider unique methods and priorities of Dissemination and Implementation Science (DIS). The ImplemeNtation and Improvement Science Proposals Evaluation CriTeria (INSPECT) scoring system includes 10 criteria based on Proctor et al.'s "ten key ingredients" and was developed to support the assessment of DIS research proposals. We describe how we adapted INSPECT and used it in combination with the NIH scoring system to evaluate pilot DIS study proposals through our DIS Center. METHODS: We adapted INSPECT to broaden considerations for diverse DIS settings and concepts (e.g., explicitly including dissemination and implementation methods). Five PhD-level researchers with intermediate to advanced DIS knowledge were trained to conduct reviews of seven grant applications using both the INSPECT and NIH criteria. The INSPECT overall scores range from 0 to 30 (higher scores are better), and the NIH overall scores range from 1 to 9 (lower scores are better). Each grant was independently reviewed by two reviewers, then discussed in a group meeting to compare the experiences using both criteria to evaluate the proposal and to finalize scoring decisions. A follow-up survey was sent to grant reviewers to solicit further reflections on each scoring criterion. RESULTS: Averaged across reviewers, the INSPECT overall scores ranged from 13 to 24, while the NIH overall scores ranged from 2 to 5. Reviewer reflections highlighted the unique value and utility for each scoring criterion. The NIH criteria had a broad scientific purview and were better suited to evaluate more effectiveness-focused and pre-implementation proposals not testing implementation strategies. The INSPECT criteria were easier to rate in terms of the quality of integrating DIS considerations into the proposal and to assess the potential for generalizability, real-world feasibility, and impact. Overall, reviewers noted that INSPECT was a helpful tool to guide DIS research proposal writing. CONCLUSIONS: We confirmed complementarity in using both scoring criteria in our pilot study grant proposal review and highlighted the utility of INSPECT as a potential DIS resource for training and capacity building. Possible refinements to INSPECT include more explicit reviewer guidance on assessing pre-implementation proposals, providing reviewers with the opportunity to submit written commentary with each numerical rating, and greater clarity on rating criteria with overlapping descriptions.

Computer-aided design of novel antibacterial 3-hydroxypyridine-4-ones: application of QSAR methods based on the MOLMAP approach.

3-Hydroxypyridine-4-one derivatives have shown good inhibitory activity against bacterial strains. In this work we report the application of MOLMAP descriptors based on empirical physicochemical properties with genetic algorithm partial least squares (GA-PLS) and counter propagation artificial neural networks (CP-ANN) methods to propose some novel 3-hydroxypyridine-4-one derivatives with improved antibacterial activity against Staphylococcus aureus. A large collection of 302 novel derivatives of this chemical scaffold was selected for this purpose. The activity classes of these compounds were determined using the two quantitative structure activity relationships models. To evaluate the predictability and accuracy of the obtained models, nineteen compounds belonging to all three activity classes were prepared and the activity of them was determined against S. aureus. Comparing the experimental results and the predicted activity classes revealed the accuracy of the obtained models. Seventeen of the nineteen synthesized molecules were correctly predicted by GA-PLS model according to the antimicrobial evaluation method. Molecules 5f and 5h proved to be moderately active and active experimentally, but were predicted as inactive and moderately active compounds, respectively by this model. The CP-ANN based prediction was correct for sixteen out of the nineteen synthesized molecules. 5a, 5h and 5q were moderately active and active based on the antimicrobial assays, but they were introduced as members of inactive, moderately active and inactive classes of compounds, respectively according to CP-ANN model.

Nonlinear model-based cardiac arrhythmia diagnosis using the optimization-based inverse problem solution.

This study investigates a nonlinear model-based feature extraction approach for the accurate classification of four types of heartbeats. The features are the morphological parameters of ECG signal derived from the nonlinear ECG model using an optimization-based inverse problem solution. In the model-based methods, high feature extraction time is a crucial issue. In order to reduce the feature extraction time, a new structure was employed in the optimization algorithms. Using the proposed structure has considerably increased the speed of feature extraction. In the following, the effectiveness of two types of optimization methods (genetic algorithm and particle swarm optimization) and the McSharry ECG model has been studied and compared in terms of speed and accuracy of diagnosis. In the classification section, the adaptive neuro-fuzzy inference system and fuzzy c-mean clustering methods, along with the principal component analysis data reduction method, have been utilized. The obtained results reveal that using an adaptive neuro-fuzzy inference system with data obtained from particle swarm optimization will have the shortest process time and the best diagnosis, with a mean accuracy of 99% and a mean sensitivity of 99.11%.