bluuebunny/crossref_metadata_2025 huggingface dataset:
Reverse Migration Determinant Factor: A systematic literature review
Authors: Anuar Azreen , Mohd Hussain Nur Huzeima , Mohd Thuraiya , Masrom Suraya , Hugh Byrd
Published: March 2021

Reverse migration in Malaysia is a relatively new emerging phenomenon where the migrants have intentionally chosen to return to their hometown for better living. Thus, there is a demand to investigate the determinants that lead to these changing population mobility trends in Malaysia. This study adopts the systematic literature review to identify the determinant factors of reverse migration. The aim is to analyse empirical studies to determine factors in reverse migration. Consequently, the findings have revealed several determinants: following family, career, environment, economic reason, quality of life, and social aspect as the driving factors towards achieving subsistence living.
Keywords: reverse migration, systematic literature review, determinant, Malaysia
eISSN: 2398-4287© 2021. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v6i16.2731
Алмазные фотокатоды как полевые катоды для вакуумной микроэлектроники
Authors: Ильичев Э.А. , Кулешов А.Е. , Петрухин Г.Н. , Минаков П.В. , Рычков Г.С. , Сень В.В. , Теверовская Е.Г.
Published: March 2021

The use of diamond photocathodes and electron flow amplifiers in high-frequency vacuum micro and nanoelectronics is analyzed. The main devices are a vacuum microtriode and an electron gun for an integral traveling wave tube.
Возможность управления динамикой и структурой магнитного солитона в трехслойной ферромагнитной структуре
Authors: Екомасов Е.Г. , Назаров В.Н. , Самсонов К.Ю. , Муртазин Р.Р.
Published: March 2021

The generation and excitation of a magnetic soliton in a three-layer ferromagnet by constant magnetic fields and fields of variable frequency and small amplitude in the presence of dissipation in the system are considered. The analysis of the solutions of the equation of motion in an alternating field shows the possibility of increasing the amplitude of the magnetic soliton over time under certain conditions. The resonant effect is also affected by the geometric parameters of the thin layer: at a large layer width, the translational mode of the soliton oscillations is also excited.
Радиоактивационный контроль плотности износостойких покрытий AlN и CrN на кремнии
Authors: Рыжков В.А. , Тарбоков В.А. , Смолянский Е.А. , Ремнев Г.Е.
Published: March 2021

In this work, the mass and linear thicknesses of AlN and CrN coatings deposited onto silicon substrates by magnetron sputtering were measured, respectively, by a combination of the methods of nondestructive radioactivation analysis on proton beams of the U-120M cyclotron and optical micro-interferometry. It is shown that, at linear thicknesses in the range of 2.2-5.7 μm, the coating density is close to the values for bulk materials AlN (3.26 g / cm3) and CrN (5.9 g / cm3), and the stoichiometry of nitrides is controlled by the parameters of magnetron deposition. The technique can also be used to determine the density of wear-resistant coatings from carbides and metal oxides.
Изменение характеристик поверхности стали 12Х18Н10Т при лазерном модифицировании в слое графитовой пасты, содержащей наночастицы диоксида титана
Authors: Проскуряков В.И. , Родионов И.В.
Published: March 2021

Experimental studies of laser modification of the surface of 12Cr18Ni10T stainless steel in a layer of graphite paste and nanodispersed titanium dioxide powder (anatase) were carried out. It was established that as a result of laser pulsed processing, a microheterogeneous modifying layer is formed on the surface of the samples. The surface is characterized by increased microhardness and microroughness parameters, which depend to a greater extent on the pulse voltage. In the diffusion layer of the experimental samples, the formation of fine particles with sizes ranging from 100 to 300 nm was revealed
Applying Clinical Decision Support Design Best Practices With the Practical Robust Implementation and Sustainability Model Versus Reliance on Commercially Available Clinical Decision Support Tools: Randomized Controlled Trial (Preprint)
Authors: Trinkley Katy E , Kroehl Miranda E , Kahn Michael G , Allen Larry A , Bennett Tellen D , Hale Gary , Haugen Heather , Heckman Simeon , Kao David P , Kim Janet , Matlock Daniel M , Malone Daniel C , Page 2nd Robert L , Stine Jessica , Suresh Krithika , Wells Lauren , Lin Chen-Tan
Published: March 2021

BACKGROUND

Limited consideration of clinical decision support (CDS) design best practices, such as a user-centered design, is often cited as a key barrier to CDS adoption and effectiveness. The application of CDS best practices is resource intensive; thus, institutions often rely on commercially available CDS tools that are created to meet the generalized needs of many institutions and are not user centered. Beyond resource availability, insufficient guidance on how to address key aspects of implementation, such as contextual factors, may also limit the application of CDS best practices. An implementation science (IS) framework could provide needed guidance and increase the reproducibility of CDS implementations.

OBJECTIVE

This study aims to compare the effectiveness of an enhanced CDS tool informed by CDS best practices and an IS framework with a generic, commercially available CDS tool.

METHODS

We conducted an explanatory sequential mixed methods study. An IS-enhanced and commercial CDS alert were compared in a cluster randomized trial across 28 primary care clinics. Both alerts aimed to improve beta-blocker prescribing for heart failure. The enhanced alert was informed by CDS best practices and the Practical, Robust, Implementation, and Sustainability Model (PRISM) IS framework, whereas the commercial alert followed vendor-supplied specifications. Following PRISM, the enhanced alert was informed by iterative, multilevel stakeholder input and the dynamic interactions of the internal and external environment. Outcomes aligned with PRISM’s evaluation measures, including patient reach, clinician adoption, and changes in prescribing behavior. Clinicians exposed to each alert were interviewed to identify design features that might influence adoption. The interviews were analyzed using a thematic approach.

RESULTS

Between March 15 and August 23, 2019, the enhanced alert fired for 61 patients (106 alerts, 87 clinicians) and the commercial alert fired for 26 patients (59 alerts, 31 clinicians). The adoption and effectiveness of the enhanced alert were significantly higher than those of the commercial alert (62% vs 29% alerts adopted, P<.001; 14% vs 0% changed prescribing, P=.006). Of the 21 clinicians interviewed, most stated that they preferred the enhanced alert.

CONCLUSIONS

The results of this study suggest that applying CDS best practices with an IS framework to create CDS tools improves implementation success compared with a commercially available tool.

CLINICALTRIAL

ClinicalTrials.gov NCT04028557; http://clinicaltrials.gov/ct2/show/NCT04028557
Arabic Version of the Electronic Health Literacy Scale in Arabic-Speaking Individuals in Sweden: Prospective Psychometric Evaluation Study (Preprint)
Authors: Wångdahl Josefin , Dahlberg Karuna , Jaensson Maria , Nilsson Ulrica
Published: March 2021

BACKGROUND

Health information is often communicated through the internet. It is vital for the end user to have a range of digital skills as well as understand the information to promote their health. There is a valid and reliable 8-item instrument, the Electronic Health Literacy Scale (eHEALS), that evaluates these skills. The number of Arabic-speaking people migrating to Sweden and to other parts of the world is increasing due to unstable military and political situations in their countries of origin. Poor health and limited health literacy have been described in this population in Sweden. Still, to our knowledge, an Arabic version of eHEALS has not been tested for validity or reliability. Thus, Arabic-speaking populations in Sweden cannot be included in studies measuring eHealth literacy, which does not support equal treatment in health care.

OBJECTIVE

The aim of this study was to translate and adapt the original English eHEALS version into Arabic and to evaluate its psychometric properties.

METHODS

The eHEALS was rigorously translated, adapted, and evaluated for content validity. We conducted prospective psychometric evaluation with natively Arabic-speaking participants living in Sweden. Construct validity, factor structure, internal consistency, and test-retest reliability were evaluated using Spearman correlation, principal component analysis, Cronbach α, and weighted quadratic Cohen κ, respectively.

RESULTS

The study population consisted of Arabic-speaking participants (n=298; age: mean 41.8 years, SD 10.5). Construct validity was supported with weak and moderate correlations. Principal component factor analysis revealed a one-factor structure. Internal consistency was high (Cronbach α=0.92); test-retest reliability was acceptable (weighted quadratic Cohen κ=0.76). Evaluation indicated that eHealth literacy threshold values should be dichotomized (limited and sufficient) rather than trichotomized (inadequate, problematic, and sufficient).

CONCLUSIONS

The Arabic version of eHEALS, a unidimensional scale that is valid and reliable for measuring eHealth literacy among natively Arabic-speaking people in Sweden, was found to be acceptable and feasible in a general population.
Diagnostic Classification and Prognostic Prediction Using Common Genetic Variants in Autism Spectrum Disorder: Genotype-Based Deep Learning (Preprint)
Authors: Wang Haishuai , Avillach Paul
Published: March 2021

BACKGROUND

In the United States, about 3 million people have autism spectrum disorder (ASD), and around 1 out of 59 children are diagnosed with ASD. People with ASD have characteristic social communication deficits and repetitive behaviors. The causes of this disorder remain unknown; however, in up to 25% of cases, a genetic cause can be identified. Detecting ASD as early as possible is desirable because early detection of ASD enables timely interventions in children with ASD. Identification of ASD based on objective pathogenic mutation screening is the major first step toward early intervention and effective treatment of affected children.

OBJECTIVE

Recent investigation interrogated genomics data for detecting and treating autism disorders, in addition to the conventional clinical interview as a diagnostic test. Since deep neural networks perform better than shallow machine learning models on complex and high-dimensional data, in this study, we sought to apply deep learning to genetic data obtained across thousands of simplex families at risk for ASD to identify contributory mutations and to create an advanced diagnostic classifier for autism screening.

METHODS

After preprocessing the genomics data from the Simons Simplex Collection, we extracted top ranking common variants that may be protective or pathogenic for autism based on a chi-square test. A convolutional neural network–based diagnostic classifier was then designed using the identified significant common variants to predict autism. The performance was then compared with shallow machine learning–based classifiers and randomly selected common variants.

RESULTS

The selected contributory common variants were significantly enriched in chromosome X while chromosome Y was also discriminatory in determining the identification of autistic individuals from nonautistic individuals. The ARSD, MAGEB16, and MXRA5 genes had the largest effect in the contributory variants. Thus, screening algorithms were adapted to include these common variants. The deep learning model yielded an area under the receiver operating characteristic curve of 0.955 and an accuracy of 88% for identifying autistic individuals from nonautistic individuals. Our classifier demonstrated a considerable improvement of ~13% in terms of classification accuracy compared to standard autism screening tools.

CONCLUSIONS

Common variants are informative for autism identification. Our findings also suggest that the deep learning process is a reliable method for distinguishing the diseased group from the control group based on the common variants of autism.
COVID-19 and health information seeking behavior: Digital health literacy survey amongst university students in Pakistan (Preprint)
Authors: Zakar Rubeena , Iqbal Sarosh , Zakar Muhammad Zakria , Fischer Florian
Published: March 2021

BACKGROUND

Amid to the COVID-19 pandemic, digital health literacy (DHL) has become a significant public health concern.

OBJECTIVE

This research aims to assess information seeking behavior, as well as the ability to find relevant information and deal with DHL among university students in Pakistan.

METHODS

An online-based cross-sectional survey, using a web-based interviewing technique, was conducted to collect data on DHL. Simple bivariate and multivariate linear regression was performed to assess the association of key characteristics with DHL.

RESULTS

The results show a high DHL related to COVID-19 in 54.3% of students. Most of the Pakistani students demonstrated ~50% DHL in all dimensions, except of reliability. Multivariate findings showed that gender, sense of coherence and importance of information were found to be significantly associated with DHL. However, a negative association was observed with students’ satisfaction with information.

CONCLUSIONS

This led to the conclusion that critical operational and navigations skills are essential to achieve COVID-19 DHL and cope with stress, particularly to promote both personal and community health. Focused interventions and strategies should be designed to enhance DHL amongst university students to combat the pandemic.
Brazilian people general knowledge about COVID-19 disease and safety measures: an online survey (Preprint)
Authors: Knechtle Beat
Published: March 2021

BACKGROUND

COVID-19 presents itself as a clinical condition ranging from an asymptomatic infection to a severe respiratory condition. Due to its high transmissibility, the SARS-CoV-2 coronavirus has spread rapidly around the world and preventive measures are necessary. People adherence to these measures can be affected by their knowledge and attitudes.

OBJECTIVE

Our aim was to assess the knowledge of a Brazilian sample (n=2,673) about COVID-19 and their knowledge and attitudes regarding the disease.

METHODS

We have prepared an online survey (“Google Forms”), disseminated through social networks and carried out in May 2020, with Brazilian’s adults who volunteered to answer a multiple-choice questionnaire about prevention, symptoms, transmission, and treatment of COVID-19. Average age of our sample was 40.0 (±13.8) years and the majority were women (76.3%), married (47.2%), Catholic (46.4%), with graduate degree (44.2%), family income of 4 to 7 minimum wages in R$ (30.4%), and from the Southeast region (87.2%).

RESULTS

The knowledge level about COVID-19 of Brazilian people was considered “very good”, with an average percentage of correct answers of 83.8% (±6.6). Significant associations were found between the level of knowledge with age, sex, religion, education, and income. The level of knowledge was “very good” in relation to COVID-19, with younger people, women, and agnostics/atheists. Health professionals having greater knowledge while people with low family income and less education had a lower level of knowledge.

CONCLUSIONS

Although our results are positive regarding the level of knowledge and attitudes towards COVID-19 in Brazil, it is necessary to consider that our sample is predominantly from the region with the highest socio-economic and educational level, that is, the Southeast region.

CLINICALTRIAL

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Effectiveness of Unguided Internet-Based Cognitive Behavioral Therapy and the Three Good Things Exercise for Insomnia: 3-Arm Randomized Controlled Trial (Preprint)
Authors: Sato Daisuke , Sekizawa Yoichi , Sutoh Chihiro , Hirano Yoshiyuki , Okawa Sho , Hirose Motohisa , Takemura Ryo , Shimizu Eiji
Published: March 2021

BACKGROUND

The treatment of insomnia with sleep medication causes problems such as long-term use, dependence, and significant economic losses, including medical expenses. Evidence-based lifestyle guidance is required to improve insomnia symptoms not only in person but also in easy-to-use web-based formats.

OBJECTIVE

This study aims to clarify whether unguided internet-based cognitive behavioral therapy (ICBT) or the Three Good Things (TGT) exercise, both administered as self-help internet interventions without email support, could improve insomnia symptoms compared with a waiting list control (WLC) group.

METHODS

A 4-week program was implemented, and participants were randomly allocated to 1 of the 3 groups. The primary outcome measure was the Pittsburgh Sleep Questionnaire (PSQI) score at 4 weeks compared with baseline.

RESULTS

Of the 21,394 individuals invited to participate, 312 (1.46%) met the eligibility criteria and were randomly assigned to 1 of the 3 groups. Of these 312 individuals, 270 (86.5%; ICBT 79/270, 29.3%; TGT 88/270, 32.6%; and WLC 103/270, 38.1%) completed a postintervention survey at 4 and 8 weeks. The adjusted mean changes of the primary outcome measure (PSQI) in the ICBT (−1.56, 95% CI −2.52 to −0.59; P<.001) and TGT (−1.15, 95% CI −2.08 to −0.23; P=.002) groups at 4 weeks from baseline showed a significant improvement compared with the WLC group. The adjusted mean changes in the secondary outcome measures of sleep onset latency, total sleep time, Athens Insomnia Scale score, and Patient Health Questionnaire-9 score at 4 weeks from baseline, as well as in the PSQI at 8 weeks from baseline, showed significant improvement for ICBT. Moreover, total sleep time, Athens Insomnia Scale, and Patient Health Questionnaire-9 scores at 4 weeks from baseline showed a significant improvement in the TGT group compared with the WLC group.

CONCLUSIONS

A total of 4 weeks of unguided ICBT and TGT exercises improved insomnia.

CLINICALTRIAL

University Hospital Medical Information Network Clinical Trial Registry UMIN000034927; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000039814
Redesigning a Web-Based Stakeholder Consensus Meeting About Core Outcomes for Clinical Trials: Formative Feedback Study (Preprint)
Authors: Katiri Roulla , Hall Deborah A , Hoare Derek J , Fackrell Kathryn , Horobin Adele , Buggy Nóra , Hogan Nicholas , Kitterick Pádraig T ,   Core Rehabilitation Outcome Set For Single-Sided Deafness (CROSSSD) Initiative
Published: March 2021

BACKGROUND

Clinical trials that assess the benefits and harms of an intervention do so by measuring and reporting outcomes. Inconsistent selection and diversity in the choice of outcomes make it challenging to directly compare interventions. To achieve an agreed core set of outcomes, a consensus methodology is recommended, comprising a web-based Delphi survey and a face-to-face consensus meeting. However, UK government regulations to control the pandemic prohibited plans for a face-to-face consensus meeting as part of the Core Rehabilitation Outcome Set for Single-Sided Deafness (CROSSSD) study.

OBJECTIVE

This study aims to evaluate the modifications made by the CROSSSD study team to achieve consensus using web-based methods, but with minimal deviation from the original study protocol.

METHODS

The study team worked with health care users and professionals to translate the planned face-to-face consensus meeting in a web-based format, preserving the key elements of the nominal group technique. A follow-up survey gathered evaluation feedback on the experiences of the 22 participating members. Feedback covered premeeting preparation, the process of facilitated discussions and voting, ability to contribute, and perceived fairness of the outcome.

RESULTS

Overall, 98% (53/54) of feedback responses agreed or strongly agreed with the statements given, indicating that the web-based meeting achieved its original goals of open discussion, debate, and voting to agree with a core outcome set for single-sided deafness. Hearing-impaired participants were fully engaged, but there were some methodological challenges. For the participants, challenges included building rapport, understanding, and delivering the tasks in hand. For the study team, challenges included the need for thorough preparation and management of the unpredictability of tasks on the day.

CONCLUSIONS

Sharing our experiences and lessons learned can benefit future core outcome set developers. Overcoming the challenges of delivering a web-based consensus exercise in the face of the pandemic can be applied more generally to maximize inclusiveness, enhance geographical access, and reduce research costs.

CLINICALTRIAL
An mHealth App to Support Patients With Psoriasis in Relation to Follow-up Consultations: Qualitative Study (Preprint)
Authors: Trettin Bettina , Danbjørg Dorthe Boe , Andersen Flemming , Feldman Steven , Agerskov Hanne
Published: March 2021

BACKGROUND

Teledermatology has the potential to help deliver health care by transforming the relationship between patients and health care professionals (HCPs), shifting the power of consultation so that patients can become more informed, assertive, and involved in their care. Mobile health (mHealth) is a promising and reliable tool for the long-term management of patients with psoriasis on systemic treatment. In an attempt to facilitate a more patient-centered approach in clinical practice, we designed and developed an mHealth solution to support patients with self-management and empowerment.

OBJECTIVE

The aim of this study is to explore the experiences and perceptions of patients and health care professionals of using an mHealth solution that was developed using a participatory design approach.

METHODS

This was an exploratory qualitative study. Data were collected through semistructured interviews with patients and focus group interviews with HCPs.

RESULTS

All participants found it easy to use the mHealth solution, and the patients found it convenient. Patients’ reflexivity was improved because they could prepare ahead of consultations. Video consultations provided patients with a degree of freedom in their everyday lives, with not having to attend in-person visits. Among the HCPs, there were concerns regarding their medical responsibilities, as they could not assess the patients’ skin as they used to. The mHealth solution required new workflows and procedures that were not part of the existing consultation routines.

CONCLUSIONS

The mHealth solution can strengthen the relationship between HCPs and patients and facilitate patients to become more active in their care. Alignment and structure in relation to the selection of eligible patient candidates for being offered the mHealth solution could reduce social health inequalities. In addition, video consultations changed HCPs’ work practice, necessitating new types of skills to communicate with patients.
Reddit Users’ Experiences of Suicidal Thoughts During the COVID-19 Pandemic: A Qualitative Analysis of r/Covid19_support Posts (Preprint)
Authors: Slemon Allie , McAuliffe Corey , Goodyear Trevor , McGuinness Liza , Shaffer Elizabeth , Jenkins Emily
Published: March 2021

BACKGROUND

The COVID-19 pandemic is having considerable impacts on population-level mental health, with research illustrating an increased prevalence in suicidal thoughts due to pandemic stressors. While the drivers of suicidal thoughts amid the pandemic are poorly understood, qualitative research holds great potential for expanding upon projections from pre-pandemic work and contextualizing emerging epidemiological data. Despite calls for qualitative inquiry, there is a paucity of qualitative research examining experiences of suicidality related to COVID-19. The use of publicly available data from social media offers timely and pertinent information into ongoing pandemic-related mental health, including individual experiences of suicidal thoughts.

OBJECTIVE

The objective of this paper is to examine online posts that discuss suicidal thoughts within one Reddit community r/COVID19_support with the aim to identify contributing stressors and coping strategies related to the COVID-19 pandemic.

METHODS

This study draws on online posts from within the Reddit community r/COVID19_support that describe users’ suicidal thoughts during and related to the COVID-19 pandemic. Data were collected from creation of this subreddit on February 12, 2020 until December 31, 2020. Using the search term “suicide”, we used the NCapture add-on tool, hosted by NVivo, to conduct our investigation. A qualitative thematic analysis, as described by Braun and Clarke, was conducted to generate themes reflecting users’ experiences of suicidal thoughts.

RESULTS

A total of 83 posts from 57 users were included in the analysis. Reddit posts described a range of users’ lived experiences of suicidal thoughts related to the pandemic, including deterioration in mental health, complex emotions associated with suicidal thinking, and concern that suicidal thoughts may progress to action. Seven prominent and compounding stressors were identified as contributing to Reddit users’ suicidal thoughts, including social isolation, employment and finances, virus exposure and COVID-19 illness, uncertain timeline of the pandemic, news and social media, pre-existing mental health conditions, and lack of access to mental health resources. Some users described individual coping strategies used in attempt to manage suicidal thoughts, however these were recognized as insufficient for addressing the multilevel stressors of the pandemic.

CONCLUSIONS

Multiple and intersecting stressors have contributed to individuals’ experiences of suicidal thoughts in the context of the COVID-19 pandemic, requiring thoughtful and complex public health and policy responses. While ongoing challenges exist with self-disclosure of mental health challenges on social media, Reddit and other online platforms may a supportive space for users to share suicidal thoughts and discuss potential coping strategies.
Exploring the Experiences of Family Caregivers of Children With Special Health Care Needs to Inform the Design of Digital Health Systems: Formative Qualitative Study (Preprint)
Authors: Tennant Ryan , Allana Sana , Mercer Kate , Burns Catherine M
Published: March 2021

BACKGROUND

Family caregivers of children with special health care needs (CSHCN) are responsible for managing and communicating information regarding their child’s health in their homes. Although family caregivers currently capture information through nondigital methods, digital health care applications are a promising solution for supporting the standardization of information management in complex home care across their child’s health care team. However, family caregivers continue to use paper-based methods where the adoption of digital health care tools is low. With the rise in home care for children with complex health care needs, it is important to understand the caregiving work domain to inform the design of technologies that support child safety in the home.

OBJECTIVE

The aim of this study is to explore how family caregivers navigate information management and communication in complex home care for CSHCN.

METHODS

This research is part of a broader study to explore caregivers’ perspectives on integrating and designing digital health care tools for complex home care. The broader study included interviews and surveys about designing a voice user interface to support home care. This formative study explored semistructured interview data with family caregivers of CSHCN about their home care situations. Inductive thematic analysis was used to analyze the information management and communication processes.

RESULTS

We collected data from 7 family caregivers in North America and identified 5 themes. First, family caregivers were continuously learning to provide care. They were also updating the caregiver team on their child’s status and teaching caregivers about their care situation. As caregiving teams grew, they found themselves working on communicating with their children’s educators. Beyond the scope of managing their child’s health information, family caregivers also navigated bureaucratic processes for their child’s home care.

CONCLUSIONS

Family caregivers’ experiences of caring for CSHCN differ contextually and evolve as their child’s condition changes and they grow toward adulthood. Family caregivers recorded information using paper-based tools, which did not sufficiently support information management. They also experienced significant pressure in summarizing information and coordinating 2-way communication about the details of their child’s health with caregivers. The design of digital health care systems and tools for complex home care may improve care coordination if they provide an intuitive method for information interaction and significant utility by delivering situation-specific insights and adapting to unique and dynamic home care environments. Although these findings provide a foundational understanding, there is an opportunity for further research to generalize the findings.
A Transcranial Magnetic Stimulation Trigger System for Suppressing Motor-Evoked Potential Fluctuation Using Electroencephalogram Coherence Analysis: Algorithm Development and Validation Study (Preprint)
Authors: Sasaki Keisuke , Fujishige Yuki , Kikuchi Yutaka , Odagaki Masato
Published: March 2021

BACKGROUND

Transcranial magnetic stimulation (TMS), when applied over the primary motor cortex, elicits a motor-evoked potential (MEP) in electromyograms measured from peripheral muscles. MEP amplitude has often been observed to fluctuate trial to trial, even with a constant stimulus. Many factors cause MEP fluctuations in TMS. One of the primary factors is the weak stationarity and instability of cortical activity in the brain, from which we assumed MEP fluctuations originate. We hypothesized that MEP fluctuations are suppressed when TMS is delivered to the primary motor cortex at a time when several electroencephalogram (EEG) channels measured on the scalp are highly similar in the frequency domain.

OBJECTIVE

We developed a TMS triggering system to suppress MEP fluctuations using EEG coherence analysis, which was performed to detect the EEG signal similarity between the 2 channels in the frequency domain.

METHODS

Seven healthy adults participated in the experiment to confirm whether the TMS trigger system works adequately, and the mean amplitude and coefficient of the MEP variation were recorded and compared with the values obtained during the control task. We also determined the experimental time under each condition and verified whether it was within the predicted time.

RESULTS

The coefficient of variation of MEP amplitude decreased in 5 of the 7 participants, and significant differences (P=.02) were confirmed in 2 of the participants according to an F test. The coefficient of variation of the experimental time required for each stimulus after threshold modification was less than that without threshold modification, and a significant difference (P<.001) was confirmed by performing an F test.

CONCLUSIONS

We found that MEP could be suppressed using the system developed in this study and that the TMS trigger system could also stabilize the experimental time by changing the triggering threshold automatically.
Physician resilience to computer decision support system-generated alerts (Preprint)
Authors: Piscitelli Antonio , Auxilia Francesco , Capobussi Matteo , Moja Lorenzo
Published: March 2021

UNSTRUCTURED

Can computerized clinical decision support system (CDSS) generated alerts increase professional distress in clinical practice? We review published studies exploring potential negative implications associated with the wide implementation of CDSSs linked to electronic health records. CDSSs have been developed to optimize standards of care and warn physicians of potential medication errors. In routine practice, however, clinicians are beset by a barrage of disruptive, often clinically irrelevant alerts, resulting in information overload, alert fatigue and, in worst case scenarios, they might represent a hazard to patient safety. Overriding alerts has become a defense tactic against tedious and time-consuming notifications. This tactic exposes physicians to potential drawbacks and represents a system failure. A critical rethinking of the design and implementation of alerts implies a greater focus on practice-related needs and the contexts in which end-users operate, as well as a hospital-wide re-evaluation of alarm notification systems. Shared responsibility between key stakeholders is essential to minimize alert fatigue and restore physician resilience.
Development of Tough Talks™ App: a theory-based virtual simulation intervention for HIV disclosure for young men having sex with men (Preprint)
Authors: Hightow-Weidman Lisa , Muessig Kate , Knudston Kelly , Soberano Zachary , Vecchio Alyssa , Currie Andrew , Adams Larson Margo
Published: March 2021

BACKGROUND

HIV status disclosure is an important decision with barriers specific to young men who have sex with men (YMSM), who have the highest rates of new HIV infections in the US. Behavioral and social determinants of the difficulty to disclose can include fear of rejection, stigma, loss of financial stability, and a lack of communication skills. Once able to disclose, a person may have increased access to social support, improved medication adherence, and informed risk reduction conversations. Despite the known challenges and advantages of disclosure, there are few effective tools supporting this behavior.

OBJECTIVE

To address this gap in disclosure interventions, Tough Talks™ App, an mHealth intervention using artificially intelligent (AI)-facilitated role-playing scenarios, was developed for YMSM. Here we report stages of developing the integrated app and the results of the usability testing.

METHODS

Building on the results of a successful phase 1, we subsequently developed an enhanced interactive dialogue feature for YMSM to practice disclosing their HIV status and placed this feature within the context of an integrated app. We assessed the new iteration for acceptability and relevance in a usability study with 8 YMSM with HIV in North Carolina. Participants completed a pre-survey, app modules, and a semi-structured qualitative interview.

RESULTS

Tough Talks™ App content and activities were based on Social Cognitive Theory and Disclosure Process Model framework and expanded into a 4-module curriculum. The AI-facilitated scenarios and associated utterance database were refined from a crowdsourced comic book contest. In usability testing, YMSM reported high satisfaction with Tough Talks™ App, with 93% of activities receiving positive ratings. Participants found the AI-facilitated scenarios and activities to be representative and relevant to their lived experiences, though, they noted difficulty having nuanced disclosure conversations with the AI.

CONCLUSIONS

Tough Talks™ App was an engaging and practical intervention for self-disclosure among YMSM living with HIV. Facilitating informed disclosure decisions has the potential to impact engagement in sexual risk behaviors and HIV care. More information is needed about the ideal environment, technical support, and clinical connection for an mHealth disclosure intervention. Tough Talks™ App is being tested as a scalable intervention in a multi-site, randomized control trial to address outstanding questions on accessibility and effect on viral suppression.

CLINICALTRIAL

NCT03414372
Data Quality of Longitudinally Collected Patient-Reported Outcomes After Thoracic Surgery: Comparison of Paper- and Web-Based Assessments (Preprint)
Authors: Yu Hongfan , Yu Qingsong , Nie Yuxian , Xu Wei , Pu Yang , Dai Wei , Wei Xing , Shi Qiuling
Published: March 2021

BACKGROUND

High-frequency patient-reported outcome (PRO) assessments are used to measure patients' symptoms after surgery for surgical research; however, the quality of those longitudinal PRO data has seldom been discussed.

OBJECTIVE

The aim of this study was to determine data quality-influencing factors and to profile error trajectories of data longitudinally collected via paper-and-pencil (P&P) or web-based assessment (electronic PRO [ePRO]) after thoracic surgery.

METHODS

We extracted longitudinal PRO data with 678 patients scheduled for lung surgery from an observational study (n=512) and a randomized clinical trial (n=166) on the evaluation of different perioperative care strategies. PROs were assessed by the MD Anderson Symptom Inventory Lung Cancer Module and single-item Quality of Life Scale before surgery and then daily after surgery until discharge or up to 14 days of hospitalization. Patient compliance and data error were identified and compared between P&P and ePRO. Generalized estimating equations model and 2-piecewise model were used to describe trajectories of error incidence over time and to identify the risk factors.

RESULTS

Among 678 patients, 629 with at least 2 PRO assessments, 440 completed 3347 P&P assessments and 189 completed 1291 ePRO assessments. In total, 49.4% of patients had at least one error, including (1) missing items (64.69%, 1070/1654), (2) modifications without signatures (27.99%, 463/1654), (3) selection of multiple options (3.02%, 50/1654), (4) missing patient signatures (2.54%, 42/1654), (5) missing researcher signatures (1.45%, 24/1654), and (6) missing completion dates (0.30%, 5/1654). Patients who completed ePRO had fewer errors than those who completed P&P assessments (ePRO: 30.2% [57/189] vs. P&P: 57.7% [254/440]; P<.001). Compared with ePRO patients, those using P&P were older, less educated, and sicker. Common risk factors of having errors were a lower education level (P&P: odds ratio [OR] 1.39, 95% CI 1.20-1.62; P<.001; ePRO: OR 1.82, 95% CI 1.22-2.72; P=.003), treated in a provincial hospital (P&P: OR 3.34, 95% CI 2.10-5.33; P<.001; ePRO: OR 4.73, 95% CI 2.18-10.25; P<.001), and with severe disease (P&P: OR 1.63, 95% CI 1.33-1.99; P<.001; ePRO: OR 2.70, 95% CI 1.53-4.75; P<.001). Errors peaked on postoperative day (POD) 1 for P&P, and on POD 2 for ePRO.

CONCLUSIONS

It is possible to improve data quality of longitudinally collected PRO through ePRO, compared with P&P. However, ePRO-related sampling bias needs to be considered when designing clinical research using longitudinal PROs as major outcomes.
RECRUITMENT AND SELECTION PRACTICE ON INDONESIA STATE-OWNED ENTERPRISE: A LITERATURE REVIEW
Authors: Basalamah Jafar , Syahnur Muhammad Herdiansyah , Basalamah Abdurrahman
Published: March 2021

In modern days recruitment and selection practices has become a challenge within the developing countries. Various companies struggling with personnel challenges due to increasing competent applicants. The labor market focuses on factors affecting recruitment and selection practices on organizational performance and it becomes a challenge for corporate owners. Because of the fact, attracting qualified, skilled and experienced candidates is important and urgent. In this note, relative HR strategy practices bring changes to organizational growth and impact organizational and corporate performance. The purpose of research was to explore factors affecting the recruitment and practice of selection on the company's performance. However, this research provides useful insight into critical literature, evidence and contributes to finding gaps in recruitment and practice selection at the company's performance in particular state-owned enterprises. Therefore, these studies review past literature and secondary data gathered from different sources such as official publications from each authority, website, journal, and books. This critical review emphasized that the recruitment and selection practices were manipulated in the recruitment sector of state-owned enterprise. Therefore, the company faced great difficulties to provide a professional public service.
STRENGTHENING DIGITAL START-UP DYNAMIC CAPABILITIES IN MALANG CITY THROUGH DESIGN THINKING AND ENTREPRENEURSHIP ORIENTATION.
Authors: Ruspitasari Widi Dewi , Anjaningrum Widiya Dewi , Cahyanti Mega Mirasaputri
Published: March 2021

Digital start-up is one part of the creative economy that is currently growing rapidly in Malang town. Looking at this rapidly changing environment in the era of the industrial revolution 4.0, it is important for digital start-ups to improve dynamic capabilities. The purpose of this study was to determine the effect of design thinking and entrepreneurial orientation on dynamic digital start-up capabilities. A total of 100 start-up actors have been selected as research samples. Quantitative data collected through questionnaires were analyzed using PLS analysis. The results showed that both design thinking and market orientation had a great influence on dynamic digital start-up capabilities. The strongest factor in the design thinking is the emphatize process so that the ability of start-ups to feel the environment and understand customer needs and market dynamics better than competitors. While the strongest factor in entrepreneurship is the courage to act to achieve goals so that start-ups are able to face market competition. Suggestions for further research is need to focus on two weaknesses factors, there are, the process of ideas in conducting design thinking and the lack of initiative in initiating innovative actions, because the innovation today is urgently needed to win the market competition.
THE EFFECT OF ATTITUDE, SUBJECTIVE NORMS AND CONTROL OF BEHAVIOR TOWARDS INTENTION IN SHARE INVESTMENT
Authors: Rahadjeng Erna Retna , Fiandari Yulist Rima
Published: March 2021

The development of the stock market has been dominated by individual. The decision-making process in investment actions is influenced by various individual characteristics and systematic factors are important elements that have an important influence on investors' financial decision making. Stock purchases can be influenced by attitudes, subjective norms and biases from past experiences. Stock investment is starting to be of interest to scholars. This study aims to determine and analyze the effect of attitudes, subjective norms and behavioral control on investment intentions in the capital market. The population that will be used as the research object is scholars in Malang, who have already been familiar with finance courses. The sampling method used was purposive sampling, namely determining the sample according to the research objectives. Data analysis is used to determine the effect of independent variables on the dependent variable, which is analyzed using path analysis with PLS. The result show that attitudes, subjective norms and behavioral control have an influence on the intention to invest in shares investment.
Review on Medicinal Importance of Moringa Olifera Leaf for Treating Anemic Conditions
Authors: S Gejalakshmi , .N Harikrishnan , .A Divyasri , .G.E, Thillai Govindarajan
Published: March 2021

Moringa olifera is a traditional medicinal plant that belongs to family moringaceae. It is also called as “Miracle tree”. It is rich in alkaloids, flavonoids, essential amino acids and considered as one of the highly nutritious plants. Moringa olifera a multiuse plant is used as a food and medicinal uses. It has various pharmacological activities such as analgesic, antiinflammatory, antipyretic, anticancer, antioxidant, nootropic, hepatoprotective, gastroprotective, antiulcer, anticancer, antioxidant, hepatoprotective, gastroprotective, cardiovascular, antiobesity, antiasthamatic and antidiarrheal properties. This review is a collective summary of phytochemical, pharmacological activity and therapeutic importance of this medicinal herb. Moringa olifera has numerous medicinal uses and it is used to treat many diseases conditions. The review has focused on various properties of Moringa Olifera and therapeutic importance of moringa olifera and its chemical constituents Moringa oleifera is considered to be one of the beneficial plant which has higher medicinal values. Its various nutritional properties made the people across the world to use for its health benefits. The leaf of moringa is considered to have more effective property in curing many diseases though other parts of Moringa oleifera possess less effective properties. The chemical compound of Moringa leaf has high content when compared to other parts and some chemical compounds are present only in leaf of Moringa. Moringa leaf can be used for various health conditions such as Anaemia, Diabetes, Asthma, Inflammation, and Ulcer, Tumor growth, Microbial growth and Plasmodia (Malaria). Anaemia is one of the threatening disorder which is spread all over the world, anaemia occur due to various conditions in which majority is iron deficiency anaemia due to low iron content in plasma. The decrease in haemoglobin will give rise to anaemic condition. From traditional medicine literature study, IDA can be treated by daily consumption of Moringa leaf syrup. The review w
RUUKKU VOICES: Joa Hug – Opening Lecture of the Defense of my Doctoral Research
Authors: Joa Hug
Published: March 2021

About this RUUKKU VOICES exposition

Opening lecture of the defense of my doctoral research 'Propositions for Unfinished Thinking: The Research Score as a Medium of Artistic Research'. Berlin/Helsinki, 19 September 2020. Recording of the livestream.
THE QUIET REVOLUTION: STATE SOCIETY AND THE CANADIAN HORROR FILM
Authors: Xavier Mendik
Published: March 2021

This two-part UK/Canadian produced documentary provides an extensive analysis of horror cinema trends from the 1960s to the present day. It critically evaluates Canadian traditions of the genre through a range of pertinent methodologies in order to explore wider tensions surrounding national identity (part one, 70 minutes), as well as the struggles for representation as advanced by female and indigenous filmmakers (part two, 52 minutes).
Trophic downgrading decreases species asynchrony and community stability regardless of climate warming
Authors: Rezende Felipe , Antiqueira Pablo , Petchey Owen , Velho Luiz , Rodrigues Luzia , Romero Gustavo
Published: March 2021

Theory and some evidence suggest that biodiversity promotes stability.
However, evidence of how trophic interactions and environmental changes
modulate this relationship in multitrophic communities is lacking. Given
the current scenario of biodiversity loss and climate changes, where top
predators are disproportionately more affected, filling these knowledge
gaps is crucial. We simulated climate warming and top predator loss in
natural microcosms to investigate their direct and indirect effects on
temporal stability of microbial communites. We also investigated the
role of underlying stabilizing mechanisms on community stability.
Community stability was insensitive to warming, but indirectly decreased
due to top predator loss via increased mesopredator abundance and
consequent reduction of species asynchrony and stability. The magnitude
of destabilizing effects differed among trophic levels, being
disproportionally higher at lower trophic levels (e.g. producers). Our
study unravels major patterns and causal mechanisms by which trophic
downgrading destabilizes large food webs, regardless of climate warming
scenarios.