BackgroundEmerging health technologies are increasingly being used in health care for communication, data collection, patient monitoring, education, and facilitating adherence to chronic disease management. However, there is a lack of studies on differences in the preference for using information exchange technologies between patients with chronic and nonchronic diseases and factors affecting these differences.ObjectiveThe purpose of this paper is to understand the preferences and use of information technology for information exchange among a nationally representative sample of adults with and without 3 chronic disease conditions (ie, cardiovascular disease [CVD], diabetes, and hypertension) and to assess whether these preferences differ according to varying demographic variables.MethodsWe utilized data from the 2012 and 2014 iteration of the Health Information National Trends Survey (N=7307). We used multiple logistic regressions, adjusting for relevant demographic covariates, to identify the independent factors associated with lower odds of using health information technology (HIT), thus, identifying targets for awareness. Analyses were weighted for the US population and adjusted for the sociodemographic variables of age, gender, race, and US census region.ResultsOf 7307 participants, 3529 reported CVD, diabetes, or hypertension. In the unadjusted models, individuals with diabetes, CVD, or hypertension were more likely to report using email to exchange medical information with their provider and less likely to not use any of the technology in health information exchange, as well as more likely to say it was not important for them to access personal medical information electronically. In the unadjusted model, additional significant odds ratio (OR) values were observed. However, after adjustment, most relationships regarding the use and interest in exchanging information with the provider were no longer significant. In the adjusted model, individuals with CVD, diabetes, or hypertension were more likely to access Web-based personal health information through a website or app. Furthermore, we assessed adjusted ORs for demographic variables. Those aged >65 years and Hispanic people were more likely to report no use of email to exchange medical information with their provider. Minorities (Hispanic, non-Hispanic black, and Asian people) were less likely to indicate they had no interest in exchanging general health tips with a provider electronically.ConclusionsThe analysis did not show any significant association among those with comorbidities and their proclivity toward health information, possibly implying that HIT-related interventions, particularly design of information technologies, should focus more on demographic factors, including race, age, and region, than on comorbidities or chronic disease status to increase the likelihood of use. Future research is needed to understand and explore more patient-friendly use and design of information technologies, which can be utilized by diverse age, race, and education or...

With reports of its emergence as far back as the early 1900s, human immunodeficiency virus (HIV) has become one of the deadliest and most difficult viruses to treat in the era of modern medicine. Although not always effective, HIV treatment has evolved and improved substantially over the past few decades. Despite the major advancements in the efficacy of HIV therapy, there are mounting concerns about the physiological, cardiovascular, and neurological sequelae of current treatments. The objective of this review is to (Blattner et al., Cancer Res., 1985, 45(9 Suppl), 4598s–601s) highlight the different forms of antiretroviral therapy, how they work, and any effects that they may have on the cardiovascular health of patients living with HIV, and to (Mann et al., J Infect Dis, 1992, 165(2), 245–50) explore the new, more common therapeutic combinations currently available and their effects on cardiovascular and neurological health. We executed a computer-based literature search using databases such as PubMed to look for relevant, original articles that were published after 1998 to current year. Articles that had relevance, in any capacity, to the field of HIV therapy and its intersection with cardiovascular and neurological health were included. Amongst currently used classes of HIV therapies, protease inhibitors (PIs) and combined anti-retroviral therapy (cART) were found to have an overall negative effect on the cardiovascular system related to increased cardiac apoptosis, reduced repair mechanisms, block hyperplasia/hypertrophy, decreased ATP production in the heart tissue, increased total cholesterol, low-density lipoproteins, triglycerides, and gross endothelial dysfunction. The review of Integrase Strand Transfer Inhibitors (INSTI), Nucleoside Reverse Transcriptase Inhibitors (NRTI), and Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI) revealed mixed results, in which both positive and negative effects on cardiovascular health were observed. In parallel, studies suggest that autonomic dysfunction caused by these drugs is a frequent and significant occurrence that needs to be closely monitored in all HIV + patients. While still a relatively nascent field, more research on the cardiovascular and neurological implications of HIV therapy is crucial to accurately evaluate patient risk.

Hereditary spastic paraplegias (HSPs) are a genetically heterogeneous collection of neurodegenerative disorders categorized by progressive lower-limb spasticity and frailty. The complex HSP forms are characterized by various neurological features including progressive spastic weakness, urinary sphincter dysfunction, extra pyramidal signs and intellectual disability (ID). The kinesin superfamily proteins (KIFs) are microtubule-dependent molecular motors involved in intracellular transport. Kinesins directionally transport membrane vesicles, protein complexes, and mRNAs along neurites, thus playing important roles in neuronal development and function. Recent genetic studies have identified kinesin mutations in patients with HSPs. In this study, we used the computational approaches to investigate the 40 missense mutations associated with HSP and ID in KIF1A and KIF5A. We performed homology modeling to construct the structures of kinesin–microtubule binding domain and kinesin–tubulin complex. We applied structure-based energy calculation methods to determine the effects of missense mutations on protein stability and protein–protein interaction. The results revealed that the most of disease-causing mutations could change the folding free energy of kinesin motor domain and the binding free energy of kinesin–tubulin complex. We found that E253K associated with ID in KIF1A decrease the protein stability of kinesin motor domains. We showed that the HSP mutations located in kinesin–tubulin complex interface, such as K253N and R280C in KIF5A, can destabilize the kinesin–tubulin complex. The computational analysis provides useful information for understanding the roles of kinesin mutations in the development of ID and HSPs.

Background: Emerging health technologies are increasingly being used in health care for communication, data collection, patient monitoring, education, and to facilitate adherence to chronic disease management. However, there is also lack of studies on differences in preference for using information exchange technologies between chronic and non-chronic disease patients and factors affecting these differences. Objective: The purpose of this paper is to understand preferences and interests in use of technology for information exchange among a nationally representative sample of adults with and without chronic disease conditions and to assess whether these preferences differ according to varying demographic variables. Methods: We utilized data from the 2021 and 2014 iteration of the Health Information National Trends Study (HINTS, N=7307). We modeled negative responses using multiple logistic regressions adjusting for relevant covariates to identify independent factors associated with lowers odds of using health information technology, and therefore identify targets for awareness. Analyses were weighted for the US population and adjusted for the sociodemographic variables of age, gender, race and US census region. Results: Analysis included 7,307 participants (weighted population 230,993,888) and 3,529 participants of this sample (weighted population of 90,748,995) reported CVD, diabetes, or hypertension. In the unadjusted models, individuals with Diabetes/CVD/Hypertension were more likely to report using email to exchange medical information with their provider (Odds Ratio [OR] 1.431; 95% Confidence Interval [95% CI] 1.113, 1.838) and less likely to not use any of the technology in health information exchange (OR 0.778; 95% CI 0.618, 0.979). In unadjusted model, additional significant odds ratio values are observed. However, after adjustment, all relationships regarding use and interest in exchanging information with the provider were no longer significant. As a next step, we looked at adjusted odds ratios for demographic variables. Individuals above 65 years old (OR 2.32; 95% CI 1.55, 3.49) and Hispanics (OR 1.95; 95% CI 1.26, 3.01) were less likely to report using email to exchange medical information with their provider. Minorities were less likely to indicate they had no interest in exchanging general health tips with a provider electronically ((Hispanics OR 0.55; 95% CI 0.34, 0.88), 95% CI 0.23, 0.56), (Asians OR 0.33; )).Conclusions: Health information technology related interventions; particularly design of m-health technologies should focus more on demographic factors including race, age and region than chronic disease status to increase likelihood of use. Future research is needed to understand and explore more patient friendly use and design of m-health applications which can be utilized by variety of age, race or education/ health literacy groups efficiently to further bridge the gap in communication between patients and their provider.