Background In recent decades, advances in information technology have given new momentum to telemedicine research. These advances in telemedicine range from individual to population levels, allowing the exchange of patient information for diagnosis and management of health problems, primary care prevention, and education of physicians via distance learning. Objective This scientometric investigation aims to examine collaborative research networks, dominant research themes and disciplines, and seminal research studies that have contributed most to the field of telemedicine. This information is vital for scientists, institutions, and policy stakeholders to evaluate research areas where more infrastructural or scholarly contributions are required. Methods For analyses, we used CiteSpace (version 4.0 R5; Drexel University), which is a Java-based software that allows scientometric analysis, especially visualization of collaborative networks and research themes in a specific field. Results We found that scholarly activity has experienced a significant increase in the last decade. Most important works were conducted by institutions located in high-income countries. A discipline-specific shift from radiology to telestroke, teledermatology, telepsychiatry, and primary care was observed. The most important innovations that yielded a collaborative influence were reported in the following medical disciplines, in descending order: public environmental and occupational health, psychiatry, pediatrics, health policy and services, nursing, rehabilitation, radiology, pharmacology, surgery, respiratory medicine, neurosciences, obstetrics, and geriatrics. Conclusions Despite a continuous rise in scholarly activity in telemedicine, we noticed several gaps in the literature. For instance, all the primary and secondary research central to telemedicine was conducted in the context of high-income countries, including the evidence synthesis approaches that pertained to implementation aspects of telemedicine. Furthermore, the research landscape and implementation of telemedicine infrastructure are expected to see exponential progress during and after the COVID-19 era.

Although healthcare workers play a crucial role in helping curb the hazardous health impact of coronavirus disease 2019 (COVID-19), their lives and major functioning have been greatly affected by the pandemic. This study examined the effects of the COVID-19 pandemic on the quality of life (QoL) of Malaysian healthcare workers and its predictive factors. An online sample of 389 university-based healthcare workers completed questionnaires on demographics, clinical features, COVID-19-related stressors, psychological experiences, and perceived social support after the movement lockdown was lifted. All domains of QoL were within the norms of the general population except for social relationship QoL, which was lower than the norm. Multiple linear regression analysis indicated that COVID-19-related stressors (e.g., stress due to annual leave being frozen, loss of daily routine, and frequent exposure to COVID-19 patients) and psychological sequelae (e.g., greater severity of depression, anxiety, and stress) predicted lower QoL. Conversely, greater perceived social support from friends and significant others predicted higher QoL. Clinical and demographic characteristics predicted QoL to a lesser extent: A history of pre-existing medical illness was associated only with lower physical health QoL, whereas older age and being single, divorced, or widowed were only predictive of higher environmental QoL. Efforts to enhance QoL among healthcare workers in response to the pandemic should focus on mitigating COVID-19-related stressors and psychological sequelae and facilitating social support.

ObjectiveThis study aimed to evaluate the quality of life (QoL) and determine its association with various factors and social support among university students during the COVID-19 pandemic after the end of movement lockdown.Design, setting and participantsThis online cross-sectional study recruited 316 participants. The inclusion criteria were students 18 years and above who were registered with the faculties of medicine at Malaysian public universities located in Klang Valley and in the states of Penang and Kelantan in Peninsular Malaysia. The exclusion criteria were those who presented with psychotic disorders, bipolar mood disorder or a history of illicit drugs.Outcome measuresParticipants were administered a self-reported questionnaire to gather data on demographic, personal, clinical and psychological characteristics. The questionnaire comprised of the 21-item Depression, Anxiety and Stress Scale, the Multidimensional Scale of Perceived Social Support, and the WHO Quality of Life- Brief Version (WHOQoL-BREF).ResultsThe psychological and social QoL scores were lower than the non-pandemic norms of the general population, while the physical health and environmental QoL scores were comparable. After adjusting for relevant demographic, personal and clinical variables, religious coping, greater number of hours of online classes attended, and greater social support from family, friends and significant others were significantly associated with higher QoL among the participants. Frustration due to study disruption, living in areas with a high prevalence of COVID-19 cases, and a higher severity of depressive and stress symptoms were significantly associated with lower QoL.ConclusionCOVID-19 impaired the QoL of university students even after the movement lockdown was lifted.

Objective To determine the effectiveness of telemedicine in the delivery of diabetes care in low- and middle-income countries. Methods We searched seven databases up to July 2020 for randomized controlled trials investigating the effectiveness of telemedicine in the delivery of diabetes care in low- and middle-income countries. We extracted data on the study characteristics, primary end-points and effect sizes of outcomes. Using random effects analyses, we ran a series of meta-analyses for both biochemical outcomes and related patient properties. Findings We included 31 interventions in our meta-analysis. We observed significant standardized mean differences of −0.38 for glycated haemoglobin (95% confidence interval, CI: −0.52 to −0.23; I 2 = 86.70%), −0.20 for fasting blood sugar (95% CI: −0.32 to −0.08; I 2 = 64.28%), 0.81 for adherence to treatment (95% CI: 0.19 to 1.42; I 2 = 93.75%), 0.55 for diabetes knowledge (95% CI: −0.10 to 1.20; I 2 = 92.65%) and 1.68 for self-efficacy (95% CI: 1.06 to 2.30; I 2 = 97.15%). We observed no significant treatment effects for other outcomes, with standardized mean differences of −0.04 for body mass index (95% CI: −0.13 to 0.05; I 2 = 35.94%), −0.06 for total cholesterol (95% CI: −0.16 to 0.04; I 2 = 59.93%) and −0.02 for triglycerides (95% CI: −0.12 to 0.09; I 2 = 0%). Interventions via telephone and short message service yielded the highest treatment effects compared with services based on telemetry and smartphone applications. Conclusion Although we determined that telemedicine is effective in improving several diabetes-related outcomes, the certainty of evidence was very low due to substantial heterogeneity and risk of bias.

BPA is one of the most common endocrine disruptors that is widely being manufactured daily nationwide. Although scientific evidence supports claims of negative effects of BPA on humans, there is also evidence suggesting that a low level of BPA is safe. However, numerous in vivo trials contraindicate with this claim and there is a high possibility of BPA exposure could lead to obesity. It has been speculated that this does not stop with the exposed subjects only, but may also cause transgenerational effects. Direct disruption of endocrine regulation, neuroimmune and signaling pathways, as well as gut microbiata, has been identified to be interrupted by BPA exposure, leading to overweight or obesity. In these instances, cardiovascular complications are one of the primary notable clinical signs. In regard to this claim, this review paper discusses the role of BPA on obesity in the perspective of endocrine disruptions and possible cardiovascular complications that may arise due to BPA. Thus, the aim of this review is to outline the changes in gut microbiota and neuroimmune or signaling mechanisms involved in obesity in relation to BPA. To identify potentially relevant articles, a depth search was done on the databases Nature, PubMed, Wiley Online Library, and Medline & Ovid from the past 5 years. According to Boolean operator guideline, selected keywords such as (1) BPA OR environmental chemical AND fat OR LDL OR obese AND transgenerational effects or phenocopy (2) Endocrine disruptors OR chemical AND lipodystrophy AND phenocopy (3) Lipid profile OR weight changes AND cardiovascular effect (4) BPA AND neuroimmune OR gene signaling, were used as search terms. Upon screening, 11 articles were finalized to be further reviewed and data extraction tables containing information on (1) the type of animal model (2) duration and dosage of BPA exposure (3) changes in the lipid profile or weight (4) genes, signaling mechanism, or any neuroimmune signal involved, and (5) transgenerational effects were created. In toto, the study indicates there are high chances of BPA exposure affecting lipid profile and gene associated with lipolysis, leading to obesity. Therefore, this scoping review recapitulates the possible effects of BPA that may lead to obesity with the evidence of current in vivo trials. The biomarkers, safety concerns, recommended dosage, and the impact of COVID-19 on BPA are also briefly described.

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Purpose: Despite the significant impact of COVID-19 on mental health among university students, data on the related quality of life (QoL) are lacking in this group of the population. This study aimed to evaluate quality of life (QoL) and determine its association with various factors and social support among university students during the COVID-19 pandemic after the end of movement lockdown. Methods: This was an online, cross-sectional study recruited a total of 316 participants. Participants were administered a self-reported questionnaire to gather data on demographic, personal, clinical and psychological characteristics; the 21-item depression, anxiety and stress scale (DASS-21) to assess the severity of their depressive, anxiety and stress symptoms; the multidimensional scale of perceived social support (MSPSS) to assess the degree of social support; and the World Health Organization quality of life-BREF (WHOQoL-BREF) to assess QoL. Results: The psychological and social QoL scores were lower than the non-pandemic norms of the general population, while the physical health and environmental QoL scores were comparable. After adjusting for relevant demographic, personal, and clinical variables, religious coping; greater number of hours of online classes attended; and greater social support from family, friends and significant others were found to be significantly associated with higher QoL among the participants. Frustration because of study disruption, living in areas with a high prevalence of COVID-19 cases, and a higher severity of depressive and stress symptoms were significantly associated with lower QoL. Conclusion: COVID-19 impaired the QoL of university students even after the movement lockdown was lifted.

Diabetes mellitus (DM) and obesity account for the highest burden of non-communicable diseases. There is increasing evidence showing therapeutic patient education (TPE) as a clinically and cost-effective solution to improve biomedical and psychosocial outcomes among people with DM and obesity. The present systematic review and meta-analysis present a critical synthesis of the development of TPE interventions for DM and obesity and the efficacy of these interventions across a range of biomedical, psychosocial and psychological outcomes. A total of 54 of these RCTs were identified among patients with obesity and diabetes and were thus qualitatively synthesized. Out of these, 47 were included in the quantitative synthesis. There was substantial heterogeneity in the reporting of these outcomes (I2 = 88.35%, Q = 317.64), with a significant improvement noted in serum HbA1c levels (standardized mean difference (SMD) = 0.272, 95% CI: 0.118 to 0.525, n = 7360) and body weight (SMD = 0.526, 95% CI: 0.205 to 0.846, n = 1082) in the intervention group. The effect sizes were comparable across interventions delivered by different modes and delivery agents. These interventions can be delivered by allied health staff, doctors or electronically as self-help programs, with similar effectiveness (p < 0.001). These interventions should be implemented in healthcare and community settings to improve the health outcomes in patients suffering from obesity and DM.