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BackgroundMobile health (mHealth) interventions can improve health by improving cardiovascular risk factors, but their adoption in care by physicians and patients is untapped. Few mHealth apps have been evaluated in clinical trials, and due to the fast pace of technological development, those previously evaluated are often outdated by the time trial results are available. Given the rapid pace of change in this field, it is not feasible to rigorously evaluate mHealth apps with current methodologies. ObjectiveThe overall aim of this pilot study was to test the feasibility of using a web research platform called Trial My App to conduct efficient and rigorous web-based randomized controlled trials (RCTs) of mHealth apps relevant to patients with cardiovascular risk factors by evaluating an app that targets hypertension. MethodsFor this study, 200 participants with suboptimally controlled hypertension will be recruited through advertisements in newsletters, media, and the internet, as well as through referrals from their health care providers. Screening, consent, randomization, and collection of patient-important health confidence and self-management ability outcomes will be conducted online through the Trial My App research platform. Participants will be randomized into 2 groups: 100 that will use an mHealth app for tracking hypertension and 100 that will be considered as an educational control. All participants will complete questionnaires at 0, 1, 3 and 6 months after enrolment. A substudy to validate the method of blood pressure readings and the consistency of data entered through Trial My App will be conducted with 40 participants. ResultsThe development of the Trial My App web platform has been completed. The creation of survey instruments has been completed in collaboration with our patient partners and advisory board. Recruitment is expected to begin in the first quarter of 2021; data collection and analysis are expected to be completed approximately 1 year after study commencement. Results will be disseminated through conferences and publications. The primary outcomes of this study include the feasibility of conducting an RCT using the Trial My App platform by reporting recruitment, retention, and completion statistics. We will validate app-entered data with a standard 7-day home blood pressure measurement method. Lastly, the pilot, nonblinded RCT will assess the effectiveness of the mHealth app in improving the control of hypertension compared with the control of hypertension in the educational control group. ConclusionsThis study will determine if it is feasible to use the Trial My App web-based platform to evaluate the effectiveness of mHealth apps for patients with cardiovascular risk factors. As more mHealth apps are evaluated in RCTs, patients will be able to select apps that meet their needs and physicians will be able to make evidence-based recommendations to their patients for apps aimed at improving cardiovascular health. Trial RegistrationClinicalTrials.gov NCT04528654; https://clinicaltrials.gov/ct2/show/NCT04528654 International Registered Report Identifier (IRRID)PRR1-10.2196/26155

Purposes It aims to discuss how to effectively carry out the ecological governance of the coastline of Qionghai City, Hainan Province under the concept of One Health [1] to promote the sustainable development of residents’ income and provide practical cases and theoretical references for the ecological governance of the Hainan Coastline. Methods Use field research and random interview methods to obtain relevant data and conduct quantitative analysis. Results and shortcomings Residents’ income has stable growth, water pollution control effects are outstanding, and the governance of air pollution is obvious. However, there are still problems such as serious degradation of coral reef ecosystems and lack of effective funding for ecological compensation, mainly due to the threat of insufficient capital investment and human activities. Conclusions It is recommended to improve the sustainable development capacity of the township governments, build a reasonable ecological compensation mechanism, accelerate the transformation of the township governments to the ecological government, increase the implementation of green GDP, form a virtuous circle of compared to achieve ecological environmental protection and economic development. Department decision -making provides a scientific basis.

A crucial component of the urban ecology, waterfront space plays a key role in mitigating the urban heat island effect. However, waterfront spaces in mountain cities differ greatly from those in plain cities in terms of spatial form and environmental factors. Accordingly, it is urgent to study and improve the thermal environment of waterfront spaces in mountain cities. According to the spatial morphological characteristics and shading means of the waterfront space in Chongqing, a typical mountain city in China, the summer thermal environment of the waterfront space has been studied through field measurements. The outdoor thermal environment factors assessed include air temperature, relative humidity, wind speed, and mean radiation temperature. The results showed that the cooling effect was more significant at 1 m from the water's edge and decreased as the elevation increased. Air temperature and humidity showed a clear stratification characteristic with increasing elevation. At the same time, viaduct-shading was the most effective way of reducing heat stress, followed by the combined shading of sun sails with building-shading, while tree-shading was the least. This study offers basic data for further study and optimization of shading strategies for waterfront spaces in mountain communities.

Short‐ and long‐latency afferent inhibition (SAI and LAI respectively) are phenomenon whereby the motor evoked potential induced by transcranial magnetic stimulation (TMS) is inhibited by a sensory afferent volley consequent to nerve stimulation. It remains unclear whether dopamine participates in the genesis or modulation of SAI and LAI. The present study aimed to determine if SAI and LAI are modulated by levodopa (l‐DOPA). In this placebo‐controlled, double‐anonymized study Apo‐Levocarb (100 mg l‐DOPA in combination with 25 mg carbidopa) and a placebo were administered to 32 adult males (mean age 24 ± 3 years) in two separate sessions. SAI and LAI were evoked by stimulating the median nerve and delivering single‐pulse TMS over the motor hotspot corresponding to the first dorsal interosseous muscle of the right hand. SAI and LAI were quantified before and 1 h following ingestion of drug or placebo corresponding to the peak plasma concentration of Apo‐Levocarb. The results indicate that Apo‐Levocarb increases SAI and does not significantly alter LAI. These findings support literature demonstrating increased SAI following exogenous dopamine administration in neurodegenerative disorders. Key points: Short‐ and long‐latency afferent inhibition (SAI and LAI respectively) are measures of corticospinal excitability evoked using transcranial magnetic stimulation.SAI and LAI are reduced in conditions such as Parkinson's disease which suggests dopamine may be involved in the mechanism of afferent inhibition.125 mg of Apo‐Levocarb (100 mg dopamine) increases SAI but not LAI.This study increases our understanding of the pharmacological mechanism of SAI and LAI. [ABSTRACT FROM AUTHOR]

Introduction: Retention in HIV care is necessary to achieve adherence to antiretroviral therapy, viral load suppression, and optimal health outcomes. There is no standard definition for retention in HIV care, which compromises consistent and reliable reporting and comparison of retention across facilities, jurisdictions, and studies. Objective: The objective of this study is to explore how stakeholders involved in HIV care define retention in HIV care and their preferences on measuring retention. Methods: We will use an exploratory sequential mixed methods design involving HIV stakeholder groups such as people living with HIV, people involved in providing care for PLHIV, and people involved in decision-making about PLHIV. In the qualitative phase of the study, we will conduct 20–25 in-depth interviews to collect the perspectives of HIV stakeholders on using their preferred retention measures. The findings from the qualitative phase will inform the development of survey items for the quantitative phase. Survey participants (n = 385) will be invited to rate the importance of each approach to measuring retention on a seven-point Likert scale. We will merge the qualitative and quantitative findings phase findings to inform a consensus-building framework for a standard definition of retention in care. Ethical issues and dissemination: This study has received ethics approval from the Hamilton Integrated Research Ethics Board. The findings will be disseminated through peer-reviewed publications, conference presentations, and among stakeholder groups. Limitations: This study has limitations; we won't be able to arrive at a standard definition; a Delphi technique amongst the stakeholders will be utilized using the framework to reach a consensus globally accepted definition. [ABSTRACT FROM AUTHOR]

Purpose Prevention of fractures is an unmet need in glucocorticoid (GC)-treated Duchenne muscular dystrophy. This study explored factors associated with incident vertebral fractures (VFs) to inform future fracture prevention efforts. Methods VFs were evaluated prospectively at study baseline and 12 months on lateral spine radiographs in participants aged 4 to 25 years with Duchenne muscular dystrophy. Clinical factors were analyzed for their association with the change in Spinal Deformity Index (sum of the Genant-defined VF grades from T4 to L4) between baseline and 12 months. Results Thirty-eight males were evaluated (mean ± SD age at baseline 11.0 ± 3.6 years; mean ± SD GC duration at baseline 4.1 ± 3.1 years; 74% ambulatory). Nine of 38 participants (24%) had 17 incident VFs, of which 3/17 VFs (18%) were moderate/severe. Participants with 12-month incident VF had lower mean ± SD baseline lumbar spine areal bone mineral density Z -scores (−2.9 ± 1.0 vs −1.9 ± 1.1; P =.049) and lower total body less head areal bone mineral density Z -scores (−3.1 ± 1.2 vs −1.6 ± 1.7; P =.036). Multivariable linear regression showed that at least 1 VF at baseline (P <.001), a higher number of antecedent non-VF (P <.001), and greater bone age delay at baseline (P =.027) were significant predictors of an increase in the Spinal Deformity Index from baseline to 12 months. Conclusion The observation that ≥ 1 prevalent VF and/or non-VF were the strongest predictors of incident VFs at 12 months supports the need for prevention of first fractures in this high-risk setting. Bone age delay, a marker of GC exposure, may assist in the prioritization of patients in efforts to prevent first fractures. [ABSTRACT FROM AUTHOR]