BackgroundChronic disease patients often face multiple challenges from difficult comorbidities. Smartphone health technology can be used to help them manage their conditions only if they accept and use the technology.ObjectiveThe aim of this study was to develop and test a theoretical model to predict and explain the factors influencing patients’ acceptance of smartphone health technology for chronic disease management.MethodsMultiple theories and factors that may influence patients’ acceptance of smartphone health technology have been reviewed. A hybrid theoretical model was built based on the technology acceptance model, dual-factor model, health belief model, and the factors identified from interviews that might influence patients’ acceptance of smartphone health technology for chronic disease management. Data were collected from patient questionnaire surveys and computer log records about 157 hypertensive patients’ actual use of a smartphone health app. The partial least square method was used to test the theoretical model.ResultsThe model accounted for .412 of the variance in patients’ intention to adopt the smartphone health technology. Intention to use accounted for .111 of the variance in actual use and had a significant weak relationship with the latter. Perceived ease of use was affected by patients’ smartphone usage experience, relationship with doctor, and self-efficacy. Although without a significant effect on intention to use, perceived ease of use had a significant positive influence on perceived usefulness. Relationship with doctor and perceived health threat had significant positive effects on perceived usefulness, countering the negative influence of resistance to change. Perceived usefulness, perceived health threat, and resistance to change significantly predicted patients’ intentions to use the technology. Age and gender had no significant influence on patients’ acceptance of smartphone technology. The study also confirmed the positive relationship between intention to use and actual use of smartphone health apps for chronic disease management.ConclusionsThis study developed a theoretical model to predict patients’ acceptance of smartphone health technology for chronic disease management. Although resistance to change is a significant barrier to technology acceptance, careful management of doctor-patient relationship, and raising patients’ awareness of the negative effect of chronic disease can negate the effect of resistance and encourage acceptance and use of smartphone health technology to support chronic disease management for patients in the community.

Mitochondrial functions are dynamically regulated in the heart. In particular, protein phosphorylation has been shown to be a key mechanism modulating mitochondrial function in diverse cardiovascular phenotypes. However, site-specific phosphorylation information remains scarce for this organ. Accordingly, we performed a comprehensive characterization of murine cardiac mitochondrial phosphoproteome in the context of mitochondrial functional pathways. A platform using the complementary fragmentation technologies of collision-induced dissociation (CID) and electron transfer dissociation (ETD) demonstrated successful identification of a total of 236 phosphorylation sites in the murine heart; 210 of these sites were novel. These 236 sites were mapped to 181 phosphoproteins and 203 phosphopeptides. Among those identified, 45 phosphorylation sites were captured only by CID, whereas 185 phosphorylation sites, including a novel modification on ubiquinol-cytochrome c reductase protein 1 (Ser-212), were identified only by ETD, underscoring the advantage of a combined CID and ETD approach. The biological significance of the cardiac mitochondrial phosphoproteome was evaluated. Our investigations illustrated key regulatory sites in murine cardiac mitochondrial pathways as targets of phosphorylation regulation, including components of the electron transport chain (ETC) complexes and enzymes involved in metabolic pathways (e.g. tricarboxylic acid cycle). Furthermore, calcium overload injured cardiac mitochondrial ETC function, whereas enhanced phosphorylation of ETC via application of phosphatase inhibitors restored calcium-attenuated ETC complex I and complex III activities, demonstrating positive regulation of ETC function by phosphorylation. Moreover, in silico analyses of the identified phosphopeptide motifs illuminated the molecular nature of participating kinases, which included several known mitochondrial kinases (e.g. pyruvate dehydrogenase kinase) as well as kinases whose mitochondrial location was not previously appreciated (e.g. Src). In conclusion, the phosphorylation events defined herein advance our understanding of cardiac mitochondrial biology, facilitating the integration of the still fragmentary knowledge about mitochondrial signaling networks, metabolic pathways, and intrinsic mechanisms of functional regulation in the heart. Molecular

The lower than expected rates of children affected by coronavirus disease-2019 does not mean that there was no impact on children's health. Using data on pediatric healthcare visits before and after the breakout of coronavirus disease-2019 and historical data, we identified pediatric conditions that were most affected by the pandemic and epidemic control measures during the pandemic.

No abstract

Discovery of clinical pathway (CP) patterns has experienced increased attention over the years due to its importance for revealing the structure, semantics and dynamics of CPs, and to its usefulness for providing clinicians with explicit knowledge which can be directly used to guide treatment activities of individual patients. Generally, discovery of CP patterns is a challenging task as treatment behaviors in CPs often have a large variability depending on factors such as time, location and patient individual. Based on the assumption that CP patterns can be derived from clinical event logs which usually record various treatment activities in CP executions, this study proposes a novel approach to CP pattern discovery by modeling CPs using mixtures of an extension to the Latent Dirichlet Allocation family that jointly models various treatment activities and their occurring time stamps in CPs. Clinical case studies are performed to evaluate the proposed approach via real-world data sets recording typical treatment behaviors in patient careflow. The obtained results demonstrate the suitability of the proposed approach for CP pattern discovery, and indicate the promise in research efforts related to CP analysis and optimization.