Mobile applications (apps) for tobacco cessation: Behaviour change potential and heuristic analysis using the Mobile Application Rating Scale (MARS) [version 2; peer review: 2 approved, 1 approved with reservations]

Background Given the high prevalence of tobacco use, India presents a significant challenge in tobacco control. Yet, the support received for tobacco cessation is suboptimal. Hence, the aim of this narrative review was to identify and heuristically evaluate ‘high-quality’ and ‘engaging’ tobacco cessation mobile apps using the Mobile Application Rating Scale (MARS). Also, to categorize and analyse their features with respect to engagement, functionality, aesthetics, and information quality. Methods A systematic search of tobacco cessation apps was done within app stores of prominent smartphone platforms developed by Apple and Android. The following search terms: ‘quit smoking,’ ‘smoking cessation, ‘stop smoking,’ ‘smoking therapy,’ ‘quit tobacco,’ ‘cigarette cessation,’ ‘cold turkey,’ and ‘quit cigarette.’ Pearson’s correlations were used to analyse correlations between app scores (Total score app-quality/mean score) and downloads/ratings and number of downloads with the overall MARS score. A Chi-square test was performed to analyse any association between app focus and app release dates. Results Total MARS scores ranged from 3.1 to 4.9. Quitsure app (4.9), Craving to Quit! app (4.8) and Stop Tobacco Mobile Trainer: Quit Smoking App (4.74) were ranked the highest according to the MARS overall mean score. Older apps focussed more on mere goal setting or substance use, as compared to behaviour change; whereas, recently developed apps are now focussing more on behaviour change. Conclusions The content and functionality of behaviour change-focused apps were of higher quality than those of other app categories. These recently developed mHealth apps can effectively supersede the traditional smoking cessation methods

Complement in the homeostatic and ischemic brain

The complement system is a component of the immune system involved in both recognition and response to pathogens, and it is implicated in an increasing number of homeostatic and disease processes. It is well documented that reperfusion of ischemic tissue results in complement activation and an inflammatory response that causes post-reperfusion injury. This occurs following cerebral ischemia and reperfusion and triggers secondary damage that extends beyond the initial infarcted area, an outcome that has rationalized the use of complement inhibitors as candidate therapeutics after stroke. In the central nervous system, however, recent studies have revealed that complement also has essential roles in synaptic pruning, neurogenesis, and neuronal migration. In the context of recovery after stroke, these apparent divergent functions of complement may account for findings that the protective effect of complement inhibition in the acute phase after stroke is not always maintained in the subacute and chronic phases. The development of effective stroke therapies based on modulation of the complement system will require a detailed understanding of complement-dependent processes in both early neurodegenerative events and delayed neuro-reparatory processes. Here, we review the role of complement in normal brain physiology, the events initiating complement activation after cerebral ischemia-reperfusion injury, and the contribution of complement to both injury and recovery. We also discuss how the design of future experiments may better characterize the dual role of complement in recovery after ischemic stroke

Community social responsibility of continued and appropriate use of silver amalgam as dental restorative material in southern India: A cross-sectional study [version 5; peer review: 1 approved, 2 approved with reservations]

Background For more than 150 years, dental amalgam (DA) has been popular as a dental restorative material. Many organizations oppose its use due to perceived toxicity and environmental concerns. Hence, this study aimed to explore the continued use of DA from a South Indian dental practitioners’ perspective. Methods This cross-sectional study was conducted among fifty-two private and public dental practitioners of Udupi district in Southern India. A self‑administered questionnaire was distributed, that involved assessment of their preferences, continuation of use and concerns of using DA as a restorative material. The percentage contribution of each variable was calculated. Preferences for continuation of use of silver amalgam based upon the age, experience and mercury toxicity as a risk factor were analyzed using Students-t test and Fisher’s Exact Test test. Results Most dentists were satisfied (87%) with the results of the DA, found minimal failures (96%) and found DA more economical (89%). More than half (54%) of the participants reported that they would not continue the use of DA owing to mercury toxicity and environmental concerns. Dentists with higher age and longer clinical experience preferred continuation of DA. Conclusions Despite satisfaction with DA for its minimal failure, longevity and affordability, the authors found that most practitioners did not prefer its continued usage. This highlights their concerns over mercury toxicity and soft tissue lesions and accentuates their community social responsibility. There is also an urgent need to educate dentists on mercury hygiene, mercury waste management and disposal

Serious games: a game changer in cancer education

The enormous global burden of cancer has created the need to develop cutting-edge strategies for enhancing public education on cancer. Over the years, conventional educational strategies, such as the use of posters and leaflets, have been preferentially employed as public education strategies on oral cancer; however, the use of digital education-based strategies has been largely underutilized. Notably, the use of digital education-based strategies, particularly serious games, has proven to be a superior cancer education strategy, when compared to conventional strategies, due to their rigorous design and features. This commentary discusses serious games as a game changer in cancer education, itemizing their diverse roles in cancer prevention, advocacy, and management. Also, this commentary also detailed those factors that might limit the use and availability of serious games in resource-limited settings

Reperfusion injury following cerebral ischemia: pathophysiology, MR imaging, and potential therapies

INTRODUCTION: Restoration of blood flow following ischemic stroke can be achieved by means of thrombolysis or mechanical recanalization. However, for some patients, reperfusion may exacerbate the injury initially caused by ischemia, producing a so-called “cerebral reperfusion injury”. Multiple pathological processes are involved in this injury, including leukocyte infiltration, platelet and complement activation, postischemic hyperperfusion, and breakdown of the blood–brain barrier. METHODS/RESULTS AND CONCLUSIONS: Magnetic resonance imaging (MRI) can provide extensive information on this process of injury, and may have a role in the future in stratifying patients’ risk for reperfusion injury following recanalization. Moreover, different MRI modalities can be used to investigate the various mechanisms of reperfusion injury. Antileukocyte antibodies, brain cooling and conditioned blood reperfusion are potential therapeutic strategies for lessening or eliminating reperfusion injury, and interventionalists may play a role in the future in using some of these therapies in combination with thrombolysis or embolectomy. The present review summarizes the mechanisms of reperfusion injury and focuses on the way each of those mechanisms can be evaluated by different MRI modalities. The potential therapeutic strategies are also discussed

A Computational Model of Vortex Ring Formation in Hydrogels

Duo An, a PhD student at Cornell University, is developing a method that uses electrospray technique to expel clay hydrogel droplets into an ion solution. Upon contact, the droplets crosslink and form various solid geometries, including spheres and toroids. Depending on a few factors, including composition of the hydrogel, volume, viscosity, and speed of falling, the hydrogel will form a variety shapes. Toroidal shapes have many applications because they have a greater surface area to volume ratio than spheres. Therefore, clay hydrogels in the shape of a torus have a greater diffusive capacity than spherically shaped hydrogel formations. This allows for greater mass transfer and thus more efficient drug treatment therapies. The current problem is that the specific conditions that cause micro-toroid formation are not well understood. The majority of An’s data has used a larger scale droplet size diameter. This project aimed to elucidate the formation of a toroid shape by creating a COMSOL® simulation that can model the fluid flow and physics on a smaller scale. A pseudo three-phase model was designed to represent the three parts: the droplet of hydrogel, the air, and the ion solution. However, the model had to be implemented as a two-phase problem, due to the three-phase restraints in COMSOL. This was accomplished by implementing the solution and hydrogel as a single phase by defining an initial ion concentration for both the hydrogel and water bath. Additionally, the particle-tracing feature was used in COMSOL to help track the hydrogel species during the simulation. A larger scale model with a diameter of 3.0 mm was first developed to demonstrate toroid formation on a larger scale. Performing a sensitivity analysis on particle number, density, diameter and initial velocity showed that initial velocity had the largest impact on formation of the final product. This reflects An’s findings that varying initial velocities of the hydrogel droplet leads to different spreading and shape formation. In order to further evaluate the model, simulations with different initial velocities were run and their shape formations were qualitatively compared to images and descriptions from An's data. Success in obtaining vortex formation at the large scale indicated that a smaller scale model could be useful in predicting and understanding micro-toroid formation of these hydrogels. Next, the model was scaled down to a 500 μm diameter droplet and the results were compared to the larger droplet. When compared, the small model had similar vorticity trends to the large model at a faster rate. In order to compare the model’s results to An’s, the Reynolds and Weber numbers were calculated and final shape formation images were compared with experimental images for models that matched these numbers. Two of the models showed a similar mushroom shape formation to experimental data. The use of COMSOL to create a scaled down model of An's work helps to provide a better understanding of the underlying physics behind toroid formation of these clay hydrogels. This understanding will lead to better control of the process, in order to produce hydrogels of desired geometries and dimensions, which could give promise for production in future biomedical applications

Oral Health for all Schools: A Call to Integrate Oral Health in School Systems

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