bluuebunny/crossref_metadata_2025 huggingface dataset:
OSMANLI KLASİK DÖNEMİNDE SİPAHİ, KÖYLÜ VE DEVLET
Authors: TÜRKMENOĞLU Mehmet Ali
Published: January 2022

Ülke ekonomisinin tarımsal üretime dayandığı tüm Orta çağ devletlerinde temel üretici olan köylü ile onun devlete karşı olan yükümlülüklerini tespit ve tahsil eden mahalli yöneticilerin ilişkileri her zaman dikkat çekici olmuştur. Osmanlı Devleti özelinde konuya yaklaşıldığında sipahi ve köylü bu yöneten ve yönetilen gurubun en önemli temsilcileridir. Osmanlı Devleti’nde sipahi; hem bir asker hem de vergi toplayıcısı olmasının yanında daha birçok memurun görevini icra eden konumuyla taşrada yönetimin temsilcisi, köylü ise; üreten, vergi ödeyen ve devlet tarafından idare edilen yani yönetilen kesimdir. Toplumun oluşmasında etkili olan bu iki grup birbirleriyle sıkı bir ilişki içindedir. Sipahi-köylü ilişkileri genellikle Osmanlı iktisat tarihçilerinin ele aldığı meselelerden biri haline gelmiştir. Fakat arşiv kayıtlarına dayanan yerli çalışmalar, bu alanda yabancıların yaptığı çalışmalarla kıyaslandığında sınırlı kalmış görünmektedir. Klasik sınıf çatışmaları teorisi savunucularının baktığı pencereden bu iki sınıfın ilişkilerine bakıldığında aralarında bir çatışma aranılır. Hatta belki de sipahi-köylü ilişkilerini izlediğimiz şer’iyye sicillerine bakıldığında bu çatışmanın görüntüsünün varlığı düşünülür. Gerçekten de kaynaklara bakıldığında devlet adına vergi toplama işini layıkıyla yapmaya çalışan sipahilerin yanında görevini kendi menfaati için kullanan şahısların varlığı da görülebilmektedir. Görevini layıkıyla yapmayan sipahilerin su-i istimalleri köylüyü mağdur ettiği gibi devlete karşı yükümlülüklerini yerine getirmesi gereken köylünün de zaman zaman bu yükümlülüklerden kaçınmasına da yol açmıştır. Şüphesiz her zaman üzerine düşeni yapmaktan imtina eden sipahi değildir. Köylünün de gerek devlete karşı gerekse sipahisine karşı yükümlülüklerinde ihmal olsun kötü niyetli hareket olsun mağduriyete sebebiyet vermesi durumu ile karşılaşmak mümkündür. Devlet anlayışının temeli adalet olan ve özellikle klasik döneminde bunu sağlama konusunda başarılı olduğu bilinen Osmanlı Devleti’nde bu çatışmalar, mahkeme kayıtlarından da anlaşılacağı üzere, meşru hukuk kanallarıyla giderilmeye çalışılmıştır. Zira bu sınıfların her biri devlet için ayrı bir anlam ifade eder ve vazgeçilmezdir. Devlet, ne en önemli askeri gücü olan bunun da ötesinde vergisini toplayan ülkede huzur ve güveni sağlayan sipahiden vazgeçebilir ne de temel üretici olan köylüden vazgeçebilir, yani birine karşı diğerini kollaması ve bir grubu ihmal etme pahasına diğerine arka çıkması imkânsızdır. Makalede bu amaçla arşiv kayıtlarından yararlanılarak devletin müdahalesi, tasarrufu ve bunların sonuçlarına da yer verilmiştir.
Non-Formal Education for MSMEs based on Business Financial Management Counseling
Authors: Santoso Aprih , Widowati Sri Yuni , Saefudin Saefudin
Published: January 2022

Micro small business in Tegalarum village is one of the micro small business groups in Mranggen District, Demak Regency. The majority of these micro small business entrepreneurs do not have skills in the field of finance, especially cash flow statements (cash flow statements). Therefore, non-formal education activities are needed in the form of counseling aimed at providing non-formal education through an outreach approach to the preparation of cash flow reports so that these reports can be accounted for and accountable. ) which has been prepared by the Indonesian Institute of Accountants (IAI) as a standard compiler for cash flow reports, so that this report can later be accounted for and can be read by parties with an interest in the report. The activity method in the form of a participatory training approach is carried out through several activity steps, namely: counseling, training and monitoring and evaluation. As for the results of non-formal education activities through counseling that has been carried out, it is known that micro small business entrepreneurs in Tegalarum Village, Mranggen District, Demak Regency have been able to increase their knowledge and skills in making financial reports, especially cash flow reports.Usaha mikro kecil  desa  Tegalarum merupakan salah satu kelompok Usaha mikro kecil Kecamatan Mranggen Kabupaten Demak. Mayoritas pengusaha Usaha mikro kecil tersebut belum mempunyai skill dibidang finance khususnya cash flow statement (laporan arus kas). Oleh karena itu, dibutuhkan kegiatan pendidikan non formal berupa penyuluhan yang  bertujuan memberikan pendidikan jon formal melalui pendekatan penyuluhan penyusunan laporan arus kas agar laporan tersebut  dapat dipertanggungjawabkan  dan akuntabel  Dalam  penyusunan  laporan    arus kas  tersebut telah  diatur dalam  Pedoman  Standar  Arus kas kuntansi  Keuangan  (PSAK-45)  yang  telah  disusun  oleh Ikatan Akuntan Indonesia (IAI) sebagai penyusun standar laporan arus kas, agar laporan ini nantinya bisa dipertanggungjawabkan dan dapat dibaca oleh pihak-pihak yang berkepentingan terhadap laporan tersebut. Metode kegiatan dalam bentuk pendekatan participatory training dilakukan melalui beberapa langkah kegiatan. yaitu : penyuluhan, pelatihan dan monitoring serta evaluasi.  Adapun hasil kegiatan pendidikan non formal mekalui penyuluhan yang telah dilaksanakan diketahui bahwa pengusaha Usaha mikro kecil desa Tegalarum Kecamatan Mranggen Kabupaten Demak sudah mampu meningkatkan pengetahuan dan ketrampilan dalam membuat laporan keuangan khususnya laporan arus kas.
Millennial customer response on social-media marketing effort, brand image, and brand awareness of a conventional bank in Indonesia
Authors: Dewindaru Deanda , Syukri Anneke , Maryono Rahajeng Angelita , Yunus Ulani
Published: January 2022

Due to the fierce competition in banking for raising funds, banks have been obliged to develop marketing strategies to attract new consumers, particularly millennials. The marketing communication strategy that is often applied by banks is the loyalty program that is informed through social media. One of the banks in Indonesia with a loyalty program is the Bank Tabungan Negara (Bank BTN) or State Savings Bank whose a more prominent brand image of credit products than savings. This study investigated the effect of Social-Media Marketing Efforts, Brand Awareness, and Brand Image on Millennial Customer Response. This study employed a qualitative method by distributing questionnaires to 400 respondents. The results revealed that Millennial Customer Response was influenced by Social-Media Marketing Effort, Brand Awareness, and Brand Image. To conclude, Social-Media Marketing Efforts, Brand Image, and Brand Awareness of Conventional Banks in Indonesia affect Millennial Customer Response.
Active blended learning management in music subject based on the hybrid learning framework for primary 4 students at Ban Nong Du School, Thawat Buri District, Roi Et Province
Authors: Kaewsrisai Kamonchanok
Published: January 2022

The objectives of this research were 1) to develop an active blended learning management plan in Music subject based on the hybrid learning framework to be effective according to 80/80 criteria, 2) to compare the students' academic achievement between pretest and posttest periods, and   3) to study the satisfaction of students towards the active blended learning management in music subject based on the hybrid learning framework. The target group of this research was the 14 primary 4 students of Ban Nong Du School. Thawat Buri District, Roi Et Province in semester 1, academic year 2021, which was selected from purposive sampling. The research instruments were: 1) the index of conformity (IOC) of the music learning management plan according to the hybrid learning framework was 0.87. This showed that experts are of the opinion that an effective learning management plan can be implemented.   2) The achievement test was a 30-item, four-choice test. The test had a difficulty and power value classified between 0.41-0.60, which was appropriate and could be tested.   3) A questionnaire on the satisfaction of students towards active blended learning management in music subject based on the hybrid learning framework consisted of 15 items.
Efficiency of emergency service for COVID-19 patients in Indonesia
Authors: Makmuriana Lestari , Sari Ade Risna , Nogueyan Moelisa
Published: January 2022

Since the implementation of physical distancing and Large-Scale Social Restrictions (PSBB) on March 20, 2020, there was a decrease in patients at Cicendo Eye Hospital as much as 67.9% from March to April 2020. Encouragement to the public to keep their distance, avoid crowds, and the advice to stay at home resulted in a flow the process of health care during the COVID-19 pandemic has changed, such as the implementation of standard precautions for all patients and ensure early identification and source control. The existence of COVID-19 policies in the form of screening, service procedures, and the changing flow of the service process is thought to also affect patient satisfaction and the quality of nursing services. To analyze the quality of nursing services during the COVID-19 pandemic at Cicendo Eye Hospital. Using the Importance Performance Analysis (IPA) method. Data collection is carried out in outpatient and inpatient settings. Cicendo Eye Hospital. Sources of data in the form of primary data through questionnaires Responsiveness, Assurance, Tangible, Empathy and Reliability (RATER) and secondary data in the form of patient satisfaction data and service quality in 2019.
O docente e sua influência na adaptação do estudante à Universidade: Um estudo qualitativo
Authors: Basso Fabíola de Cássia Reghelin , Souza Luciana Karine de , Dias Ana Cristina Garcia
Published: January 2022

O docente universitário participa direta e indiretamente da adaptação do estudante ao ensino superior. O presente estudo investigou como o professor compreende a sua influência sobre o processo de adaptação estudantil à universidade. Foram entrevistados 16 docentes de universidades públicas e privadas brasileiras. Realizou-se uma análise qualitativa sobre as transcrições das entrevistas mediante codificação descritiva e criação de categorias. As categorias foram organizadas em três grupos: relação professor-estudante, posturas e disposições do docente, e estilo e didática docente. Na discussão, são abordadas as questões da amizade entre estudantes e docentes, a empatia docente, e a prática reflexiva na docência. Essas questões são abordadas no contexto da influência do professor sobre a adaptação dos estudantes à universidade.
O ciclo de vida dos professores e a extensão da idade da reforma: Perspetivas de estudo a partir de uma revisão de literatura
Authors: Thomas Dotta Leanete Teresinha , Lopes Amélia
Published: January 2022

O objetivo deste artigo é contribuir para o enriquecimento do corpus de conhecimentos sobre o estudo dos professores em final de carreira, numa altura em que esse final se alterou substancialmente. Realizou-se uma revisão de literatura com o objetivo de mapear e relacionar terminologias, cronologias, geografias e metodologias. Nas bases de dados Scopus e Web of Science (WOS), consideraram-se as publicações do período de 2000 a 2019 que tinham por população em estudo os professores em fase avançada da sua carreira docente, ou seja, com mais de 50 anos e/ou mais de 20 anos de experiência. Identificaram-se artigos com ênfase no desenvolvimento profissional, nos conhecimentos profissionais, na satisfação profissional e na saúde, ênfases a que correspondem, por vezes, diferentes terminologias, geografias e cronologias. Verifica-se que, sendo o final de carreira cada vez mais variável, se torna necessário que a investigação vá para além dos critérios enunciados (idade e anos de experiência), de forma a discriminar situações que oscilam entre os 50 e os 70 anos de idade, ou entre os 20 e os 45 anos de serviço. Este alargamento exigirá alterações de terminologias e inversões de tendência nos estudos sobre o ciclo de vida dos professores.
The effect of network convergence on digital culture industry: Model construction of network industrial economics and empirical study on China
Authors: Niu Panqiang , Masduki Anang , Li Xigen , Sukmono Filosa Gita
Published: January 2022

This paper constructs the model of network economics to study the effect of different levels of network convergence on the digital culture industry. Then uses regression models and mediating effect models to test the effect mechanism of network convergence on the digital culture industry of China.  This paper used panel data to conduct an empirical study. The data in this paper were quarterly. The time range was from the first quarter of 2009 to the third quarter of 2013 for 19 quarters.The three data types in econometrics are time series data, cross-sectional data, and panel data.The main conclusions are as follows. Network convergence brings positive policy effects and adverse capital effects. The impact of network convergence on firm performance of the digital culture industry is not statistically significant, and this effect also has no indirect effects on the test of mediating effect. However, network convergence indirectly leads to the reduction of operating costs of the digital culture industry. The indirect effect is brought by the chain mediating effect of policy effect and capital effect. The study could provide a reference for other countries and regions. Meanwhile, it can be used to analyze the impact of different media convergence on digital industries.
Impact of Ubiquitination Signaling Pathway Modifications on Oral Carcinoma
Authors: KYRODIMOS EFTHIMIOS , CHRYSOVERGIS ARISTEIDIS , MASTRONIKOLIS NICHOLAS , TSIAMBAS EVANGELOS , MANAIOS LOUKAS , ROUKAS DIMITRIOS , PANTOS PAVLOS , RAGOS VASILEIOS , PESCHOS DIMITRIOS , PAPANIKOLAOU VASILEIOS
Published: January 2022

Among intra-cellular homeostasis mechanisms, ubiquitination plays a critical role in protein metabolism regulation by degrading proteins via activating a broad spectrum of ubiquitin chains. In fact, ubiquitination and sumoylation signaling pathways are characterized by increased complexity regarding the molecules and their interactions. The Ubiquitin-Proteasome System (Ub-PS) recognizes and targets a broad spectrum of protein substrates. Ubiquitin conjugation modifies each substrate protein determining its biochemical fate (degradation). A major functional activity of Ub-PS is autophagy mechanism regulation. Interestingly, Ub-PS promotesall stages of bulk autophagy (initiation, execution, and termination). Autophagy is a crucial catabolic process that provides protein degradation and for this reason the interaction with Ub-PS is crucial. Furthermore, ubiquitination controls and regulates specific types of protein targets. Ub-PS is also involved in oxidative cellular stress and DNA damage response. Additionally, the functional role of Ub-PS in ribosome machinery regulation seems to be crucial. Concerning carcinogenesis, Ub-PS is involved in malignant disease development and progression by negatively affecting the corresponding TGF-B-, MEEK/MAPK/ERK-JNK- dependent signaling pathways. In the current review article, we describe the role of Ub-PSbiochemicalmodifications and alterations in oral squamous cell carcinoma (OSCC).
Hyaluronic Acid May Be a Predictive Biomarker for Thrombocytopenia and Liver Dysfunction After Oxaliplatin-based Chemotherapy
Authors: MIYATA TAKASHI , TOMITA YASUTO , SAN-NOMIYA YUTA , NAGAYAMA TAIGO , KIN RYOSUKE , NISHIKI HISASHI , HASHIMOTO AKIFUMI , FUJII YORITAKA , MIURA SEIKO , KAIDA DAISUKE , NAKAMURA NAOHIKO , MIYASHITA TOMOHARU , FUJITA HIDETO , UEDA NOBUHIKO , TAKAMURA HIROYUKI
Published: January 2022

Background/Aim: Following oxaliplatin-based chemotherapy, approximately half of all colorectal cancer patients develop sinusoidal obstruction syndrome (SOS). SOS can be monitored by measuring splenic volume; however, obtaining this measurement is not a simple process. In this study, we evaluated changes in hyaluronic acid (HA) concentrations as a simpler marker of SOS. Patients and Methods: We measured splenic volume and laboratory data, including hyaluronic acid concentration, liver enzymes, and platelet counts, in 34 patients with colorectal cancer who underwent radical resection and who received capecitabine plus oxaliplatin (CapeOx) chemotherapy. Results: A strong correlation was identified between ≥30% increase in splenic volume and significantly elevated HA concentrations. Affected patients also had persistent thrombocytopenia and liver dysfunction compared to patients without elevated HA concentration. Conclusion: HA concentration may predict SOS in patients who receive CapeOx adjuvant chemotherapy.
Predictive Value of the Prognostic Nutritional Index in Neoadjuvant Chemoradiotherapy for Rectal Cancer
Authors: MIZUTANI CHIKA , MATSUHASHI NOBUHISA , TOMITA HIROYUKI , TAKAHASHI TAKAO , SUETSUGU TOMONARI , TAJIMA JESSE YU , KIYAMA SHIGERU , YASUFUKU ITARU , TANAKA YOSHIHIRO , OKUMURA NAOKI , MURASE KATSUTOSHI , FUTAMURA MANABU , KAWAGUCHI MASAYA , ISHIHARA TAKUMA , MATSUO MASAYUKI , MIYAZAKI TATSUHIKO , HARA AKIRA , YOSHIDA KAZUHIRO
Published: January 2022

Background/Aim: Prognostic nutritional index (PNI) and neutrophil-to-lymphocyte ratio (NLR) indicate nutritional status and host immunity. We used immunohistochemistry and apparent diffusion coefficient (ADC) values calculated using diffusion-weighted imaging (DWI) to investigate relationships of these factors with pathological and radiological characteristics in rectal cancer treated with neoadjuvant chemoradiotherapy (nCRT). Patients and Methods: We evaluated expression levels of VEGFA, CD8, CD33, and ADC values in tumors pre/post nCRT; and analyzed the relationships between those factors and PNI, NLR in 32 patients. Results: Pretreatment PNI negatively correlated with change in tumor stromal CD8+ T cells and positively correlated with ADC values. Pretreatment NLR and PNI change correlated with recurrence-free survival (RFS). Conclusion: Patients with higher pretreatment PNI had greater changes in ADC values and stromal CD8+ T-cell counts, and those with greater PNI reduction from nCRT had a worse prognosis. Proper nutritional management during nCRT benefits patients and may lead to better prognosis in rectal cancer.
Immune-related Thyroid Dysfunction (irTD) in Non-small Cell Lung Cancer (NSCLC) Correlates With Response and Survival
Authors: CHILELLI MARIO GIOVANNI , SIGNORELLI CARLO , GIRON BERRIOS JULIO RODRIGO , ONORATO ANGELO , NELLI FABRIZIO , FABBRI MARIA AGNESE , PRIMI FRANCESCA , MARRUCCI ELEONORA , VIRTUOSO ANTONELLA , SCHIRRIPA MARTA , MAZZOTTA MARCO , RUGGERI ENZO MARIA
Published: January 2022

Background: There is no clear information on the proportion of patients who need therapy for immune-related thyroid dysfunction (irTD) or who need to delay, omit, or discontinue immunotherapy. Furthermore, it is not well known whether irTD correlates with better outcomes or not. Patients and Methods: We conducted a retrospective study in patients with metastatic non-small cell lung cancer (NSCLC) treated with anti-PD1 or anti-PD-L1. Results: Our study enrolled 75 patients, 25.3% of them developed immune-related thyroid dysfunction. Three patients delayed a course of immunotherapy due to irTD, 2 patients omitted a course and 1 patient permanently discontinued. In patients with irTD compared with those without irTD the ORR was 42.1% vs. 7.1% (p<0.001), DCR was 78.9% vs. 32.1% (p<0.001); mPFS was 15.7 vs. 3.6 months (p<0.001) and mOS was 18.6 months vs. 5.1 months (p<0.001). Conclusion: Immune-related thyroid dysfunction has a mild impact on the immunotherapy treatment program. The occurrence of irTD correlates with more favorable response and survival.
Coaching to Support Mental Health Apps: Exploratory Narrative Review
Authors: Meyer Ashley , Wisniewski Hannah , Torous John
Published: January 2022

Background

The therapeutic alliance is crucial for the success of face-to-face therapies. Little is known about how coaching functions and fosters the therapeutic alliance in asynchronous treatment modalities such as smartphone apps.

Objective

The aim of this paper was to assess how coaching functions and fosters the therapeutic alliance in asynchronous treatment modalities.

Methods

We conducted a selected review to gather preliminary data about the role of coaching in mobile technology use for mental health care. We identified 26 trials using a 2019 review by Tønning et al and a 2021 scoping review by Tokgöz et al to assess how coaching is currently being used across different studies.

Results

Our results showed a high level of heterogeneity as studies used varying types of coaching methods but provided little information about coaching protocols and training. Coaching was feasible by clinicians and nonclinicians, scheduled and on demand, and across all technologies ranging from phone calls to social media.

Conclusions

Further research is required to better understand the effects of coaching in mobile mental health treatments, but examples offered from reviewed papers suggest several options to implement coaching today. Coaching based on replicable protocols that are verifiable for fidelity will enable the scaling of this model and a better exploration of the digital therapeutic alliance.
Telehealth Before and During the COVID-19 Pandemic: Analysis of Health Care Workers' Opinions
Authors: Nitiema Pascal
Published: January 2022

Background

The COVID-19 pandemic and the lockdowns for controlling the spread of infection have led to a surge in telehealth adoption by many health care organizations. It is unclear how this pandemic has impacted health professionals’ view about telehealth. The analysis of textual data, such as comments posted on a discussion forum, can uncover information that may not be captured by a structured survey.

Objective

This study aims to examine the opinions of health care workers about telehealth services during the time frame of March 2013-December 2020.

Methods

Comments about telehealth posted by health care workers from at least 46 countries were collected from an online discussion forum dedicated to health professionals. The analysis included the computation of sentiment scores from the textual data and the use of structural topic modeling to identify the topics of discussions as well as the factors that may be associated with the prevalence of these topics.

Results

The analysis of the comments revealed positive opinions about the perceived benefits of telehealth services before and during the pandemic, especially the ability to reach patients who cannot come to the health facility for diverse reasons. However, opinions about these benefits were less positive during the pandemic compared to the prepandemic period. Specific issues raised during the pandemic included technical difficulties encountered during telehealth sessions and the inability to perform certain care routines through telehealth platforms. Although comments on the quality of care provided through telehealth were associated with a negative sentiment score overall, the average score was less negative during the pandemic compared to the prepandemic period, signaling a shift in opinion about the quality of telehealth services. In addition, the analysis uncovered obstacles to the adoption of telehealth, including the absence of adequate legal dispositions for telehealth services and issues regarding the payment of these services by health insurance organizations.

Conclusions

Enhancing the adoption of telehealth services beyond the pandemic requires addressing issues related to the quality of care, payment of services, and legal dispositions for delivering these services.
Technology-Mediated Enrichment in Aged Care: Survey and Interview Study
Authors: Waycott Jenny , Zhao Wei , Kelly Ryan M , Robertson Elena
Published: January 2022

Background

Digital technologies such as virtual reality (VR), humanoid robots, and digital companion pets have the potential to provide social and emotional enrichment for people living in aged care. However, there is currently limited knowledge about how technologies are being used to provide enrichment, what benefits they provide, and what challenges arise when deploying these technologies in aged care settings.

Objective

This study aims to investigate how digital technologies are being used for social and emotional enrichment in the Australian aged care industry and identify the benefits and challenges of using technology for enrichment in aged care.

Methods

A web-based survey (N=20) was distributed among people working in the Australian aged care sector. The survey collected information about the types of technologies being deployed and their perceived value. The survey was followed by semistructured interviews (N=12) with aged care workers and technology developers to investigate their experiences of deploying technologies with older adults living in aged care. Survey data were analyzed using summary descriptive statistics and categorizing open-ended text responses. Interview data were analyzed using reflexive thematic analysis.

Results

The survey revealed that a range of commercial technologies, such as VR, tablet devices, and mobile phones, are being used in aged care to support social activities and provide entertainment. Respondents had differing views about the value of emerging technologies, such as VR, social robots, and robot pets, but were more united in their views about the value of videoconferencing. Interviews revealed 4 types of technology-mediated enrichment experiences: enhancing social engagement, virtually leaving the care home, reconnecting with personal interests, and providing entertainment and distraction. Our analysis identified 5 barriers: resource constraints, the need to select appropriate devices and apps, client challenges, limited staff and organizational support, and family resistance.

Conclusions

This study demonstrates that technologies can be used in aged care to create personally meaningful enrichment experiences for aged care clients. To maximize the effectiveness of technology-mediated enrichment, we argue that a person-centered care approach is crucial. Although enrichment experiences can be created using available technologies, they must be carefully selected and co-deployed with aged care clients. However, significant changes may be required within organizations to allow caregivers to facilitate individual technology-based activities for enrichment.
Predicting High Flow Nasal Cannula Failure in an Intensive Care Unit Using a Recurrent Neural Network With Transfer Learning and Input Data Perseveration: Retrospective Analysis
Authors: Pappy George , Aczon Melissa , Wetzel Randall , Ledbetter David
Published: January 2022

Background

High flow nasal cannula (HFNC) provides noninvasive respiratory support for children who are critically ill who may tolerate it more readily than other noninvasive ventilation (NIV) techniques such as bilevel positive airway pressure and continuous positive airway pressure. Moreover, HFNC may preclude the need for mechanical ventilation (intubation). Nevertheless, NIV or intubation may ultimately be necessary for certain patients. Timely prediction of HFNC failure can provide an indication for increasing respiratory support.

Objective

The aim of this study is to develop and compare machine learning (ML) models to predict HFNC failure.

Methods

A retrospective study was conducted using the Virtual Pediatric Intensive Care Unit database of electronic medical records of patients admitted to a tertiary pediatric intensive care unit between January 2010 and February 2020. Patients aged <19 years, without apnea, and receiving HFNC treatment were included. A long short-term memory (LSTM) model using 517 variables (vital signs, laboratory data, and other clinical parameters) was trained to generate a continuous prediction of HFNC failure, defined as escalation to NIV or intubation within 24 hours of HFNC initiation. For comparison, 7 other models were trained: a logistic regression (LR) using the same 517 variables, another LR using only 14 variables, and 5 additional LSTM-based models using the same 517 variables as the first LSTM model and incorporating additional ML techniques (transfer learning, input perseveration, and ensembling). Performance was assessed using the area under the receiver operating characteristic (AUROC) curve at various times following HFNC initiation. The sensitivity, specificity, and positive and negative predictive values of predictions at 2 hours after HFNC initiation were also evaluated. These metrics were also computed for a cohort with primarily respiratory diagnoses.

Results

A total of 834 HFNC trials (455 [54.6%] training, 173 [20.7%] validation, and 206 [24.7%] test) met the inclusion criteria, of which 175 (21%; training: 103/455, 22.6%; validation: 30/173, 17.3%; test: 42/206, 20.4%) escalated to NIV or intubation. The LSTM models trained with transfer learning generally performed better than the LR models, with the best LSTM model achieving an AUROC of 0.78 versus 0.66 for the 14-variable LR and 0.71 for the 517-variable LR 2 hours after initiation. All models except for the 14-variable LR achieved higher AUROCs in the respiratory cohort than in the general intensive care unit population.

Conclusions

ML models trained using electronic medical record data were able to identify children at risk of HFNC failure within 24 hours of initiation. LSTM models that incorporated transfer learning, input data perseveration, and ensembling showed improved performance compared with the LR and standard LSTM models.
Researching the Links Between Smartphone Behavior and Adolescent Well-being With the FUTURE-WP4 (Modeling the Future: Understanding the Impact of Technology on Adolescent’s Well-being Work Package 4) Project: Protocol for an Ecological Momentary Assessment Study
Authors: Elavsky Steriani , Blahošová Jana , Lebedíková Michaela , Tkaczyk Michał , Tancos Martin , Plhák Jaromír , Sotolář Ondřej , Smahel David
Published: January 2022

Background

Smartphone ownership has increased among teens within the last decade, with up to 89% of adolescents owning a smartphone and engaging daily with the online world through it. Although the results of recent meta-analyses suggest that engaging digital technology plays only a small role in adolescent well-being, parents, professionals, and policymakers remain concerned about the impact that the instant connectivity of smartphones has on adolescent well-being.

Objective

Herein, we introduce the protocol of a research study investigating the associations between adolescent smartphone use and different facets of well-being (social, physical, and psychological), with the aim to apply innovative methods to address the limitations of existing empirical studies.

Methods

This 12-month prospective study of adolescents uses a repeated measurement-burst design with the ecological momentary assessment methodology. Adolescents (N=203; age range 13-17 years) complete baseline assessments through online questionnaires, four 14-day intensive data collection bursts, and an online questionnaire at the end of the study. As part of the 4 measurement bursts, adolescent smartphone behavior is assessed objectively by passive data collection of smartphone data logs and through self-reports in short questionnaires administered via a custom-built Android app.

Results

The protocol describes the study objectives, research tools (including the development of the Android app and specialized software), and process (including pilot studies, the main study, and targets for machine learning approaches). Two of the 203 enrolled participants provided no data during the first data collection burst of the main study. Preliminary analyses of the data from the first data collection burst indicated an acceptable level of compliance (72.25%) with the daily questionnaires. The design of the study will allow for the assessment of both within- and between-person variabilities in smartphone behavior, as well as short-term variation and long-term change in smartphone behavior and how it impacts the indicators of social, physical, and psychological well-being.

Conclusions

The innovative methods applied in this study (objective smartphone logs, ecological momentary assessment, and machine learning) will allow for a more nuanced assessment of the links between smartphone use and well-being, informing strategies to help adolescents navigate the online world more constructively in terms of the development of their physical, social, and psychological well-being.

International Registered Report Identifier (IRRID)

DERR1-10.2196/35984
A Smartphone App for Attentional Bias Retraining in Smokers: Mixed Methods Pilot Study (Preprint)
Authors: Choo Carol C , Tan Yi Zhuang , Zhang Melvyn W B
Published: January 2022

BACKGROUND

Smoking is a global health threat. Attentional bias influences smoking behaviors. Although attentional bias retraining has shown benefits and recent advances in technology suggest that attentional bias retraining can be delivered via smartphone apps, there is a paucity of research on this topic.

OBJECTIVE

This study aims to address this gap by exploring the use of attentional bias retraining via a novel smartphone app using a mixed methods pilot study. In the quantitative phase, it is hypothesized that participants in the training group who undertake attentional bias retraining via the app should have decreased levels of attentional bias, subjective craving, and smoking frequency, compared with those in the control group who do not undertake attentional bias retraining. The qualitative phase explores how the participants perceive and experience the novel app.

METHODS

In all, 10 adult smokers (3 females and 7 males) between the ages of 26 and 56 years (mean 34.4 years, SD 9.97 years) were recruited. The participants were randomly allocated to the training and control groups. In weeks 1 and 3, participants from both groups attempted the standard visual probe task and rated their smoking frequency and subjective craving. In week 2, the participants in the training group attempted the modified visual probe task. After week 3, participants from both groups were interviewed about their views and experiences of the novel app.

RESULTS

The results of the quantitative analysis did not support this study’s hypothesis. The qualitative data were analyzed using thematic analysis. The results yielded 5 themes: ease, helpfulness, unhelpful aspects, barriers, and refinement.

CONCLUSIONS

Findings from the qualitative study were consistent with those from previous studies on health-related smartphone apps. The qualitative results were helpful in understanding the user perspectives and experiences of the novel app, indicating that future research in this innovative area is necessary.

CLINICALTRIAL
Patients, Caregivers, and Healthcare Professionals’ Needs When Designing the Content of a Mobile Application for the Clinical Monitoring of Patients with Chronic Obstructive Pulmonary Disease and Home Oxygen Therapy: A User-Centered Design (Preprint)
Authors: Naranjo Rojas Anisbed , Molina-Recio Guillermo , Perula-de-torres Luis Angel
Published: January 2022

BACKGROUND

Patients with chronic respiratory diseases require oxygen supply in a considerable amount to reduce their symptoms and increase their survival. The development of abilities for the self-management of chronic diseases has been shown to be essential to decrease exacerbation of symptoms. Therefore, the design and development of health mobile applications (apps) that aid in educating and training for disease self-management are cost-effective strategies.

OBJECTIVE

The purpose of this research was to describe the main characteristics that, according to final users, should be included in a mobile application for monitoring patients prescribed home oxygen therapy.

METHODS

A participative-qualitative design was used, involving direct participation of patients, caregivers, and healthcare professionals. Focus groups were conducted to identify the needs and perspectives related to the app. A card sorting method was used to determine the contents and basic architecture of the app.

RESULTS

By means of the focus groups, we could identify nine basic functions of the app for the clinical monitoring of patients under home oxygen therapy. For both profiles, the app structure was determined by identifying the most frequent contents among participants.

CONCLUSIONS

The implementation of a user-centered design allowed for the detection of the functions, contents, and basic architecture of the app by identifying healthcare professionals and patients’ needs and preferences regarding the self-management and monitoring of home oxygen prescriptions.

CLINICALTRIAL

Trial Registration: The study is registered in ClinicalTrials.gov: NCT04820790
Authors' Responses to Peer Review of “Telerehabilitation for People With Physical Disabilities and Movement Impairment: A Survey of United Kingdom Practitioners” (Preprint)
Authors: Buckingham Sarah A , Anil Krithika , Demain Sara , Gunn Hilary , Jones Ray B , Kent Bridie , Logan Angela , Marsden Jonathan , Playford E Diane , Freeman Jennifer
Published: January 2022

UNSTRUCTURED

These are authors' responses to peer review of ms#30516.
Peer Review of “Telerehabilitation for People With Physical Disabilities and Movement Impairment: A Survey of United Kingdom Practitioners” (Preprint)
Authors: Brehon Katelyn
Published: January 2022

UNSTRUCTURED

This is peer review of ms#30516.
Providing care beyond the therapy session — a natural language processing–based recommender system that identifies cancer patients who experience psychosocial challenges and provides self-care support (Preprint)
Authors: Leung Yvonne W , Park Bomi , Heo Rachel , Adikari Achini , Chackochan Suja , Wong Jiahui , Alie Elyse , Gancarz Matthew , Kacala Martyna , Hirst Greame , de Silva Daswin , French Leon , Bender Jackie , Mishna Faye , Gratzer David , Alahakoon Damminda , Esplen Mary Jane
Published: January 2022

BACKGROUND

The negative psychosocial impacts of cancer diagnoses and treatments are well documented. Virtual care has become an essential mode of care delivery during the COVID-19 pandemic and online support groups (OSGs) are shown to improve accessibility to psychosocial and supportive care. The de Souza Institute offers CancerChatCanada, a therapist-led OSG service where sessions are monitored by an artificial intelligence-based co-facilitator (AICF). AICF is equipped with a recommender system that uses natural language processing to tailor online resources to patients according to their psychosocial needs.

OBJECTIVE

To outline the development protocol and to evaluate AICF on its precision and recall in recommending resources to cancer OSG members.

METHODS

Human input informed the design and evaluation on its ability to 1) appropriately identify key words indicating a psychosocial concern and 2) recommend the most appropriate online resource to the OSG member expressing each concern. Three rounds of human evaluation and algorithm improvement were performed iteratively.

RESULTS

We evaluated 7,190 outputs and achieved .797 precision, .981 recall, and an F1 score of .880 by the third round of evaluation. Resources were recommended to 48 patients and 25 (52.1%) accessed at least one resource. Of those who accessed the resources, 75.4% found them useful.

CONCLUSIONS

The preliminary findings suggest that AICF can help provide tailored support for cancer OSG members with high precision, recall, and satisfaction. AICF has undergone rigorous human evaluation and the results provide much-needed evidence, while outlining potential strengths and weaknesses for future applications in supportive care.
An mHealth Platform for Augmenting Behavioral Health in Primary Care: Longitudinal Feasibility Study (Preprint)
Authors: Moon Khatiya Chelidze , Sobolev Michael , Grella Megan , Alvarado George , Sapra Manish , Ball Trever
Published: January 2022

BACKGROUND

The collaborative care model is a well-established system of behavioral health care within primary care settings. There is potential for mobile health (mHealth) technology to augment collaborative behavioral health care in primary care settings, thereby improving scalability, efficiency, and clinical outcomes.

OBJECTIVE

We aimed to assess the feasibility of engaging with and the preliminary clinical outcomes of an mHealth platform that was used to augment an existing collaborative care program in primary care settings.

METHODS

We performed a longitudinal, single-arm feasibility study of an mHealth platform that was used to augment collaborative care. A total of 3 behavioral health care managers, who were responsible for coordinating disease management in 6 primary care practices, encouraged participants to use a mobile app to augment the collaborative model of behavioral health care. The mHealth platform’s functions included asynchronous chats with the behavioral health care managers, depression self-report assessments, and psychoeducational content. The primary outcome was the feasibility of engagement, which was based on the number and type of participant-generated actions that were completed in the app. The primary clinical end point was a comparison of the baseline and final assessments of the Patient Health Questionnaire-9.

RESULTS

Of the 245 individuals who were referred by their primary care provider for behavioral health services, 89 (36.3%) consented to app-augmented behavioral health care. Only 12% (11/89) never engaged with the app during the study period. Across all participants, we observed a median engagement of 7 (IQR 12; mean 10.4; range 0-130) actions in the app (participants: n=78). The chat function was the most popular, followed by psychoeducational content and assessments. The subgroup analysis revealed no significant differences in app usage by age (P=.42) or sex (P=.84). The clinical improvement rate in our sample was 73% (32/44), although follow-up assessments were only available for 49% (44/89) of participants.

CONCLUSIONS

Our preliminary findings indicate the moderate feasibility of using mHealth technology to augment behavioral health care in primary care settings. The results of this study are applicable to improving the design and implementation of mobile apps in collaborative care.
Using a Convolutional Neural Network and Convolutional Long Short-term Memory to Automatically Detect Aneurysms on 2D-DSA Images (Preprint)
Authors: Liao JunHua , Liu LunXin , Duan HaiHan , Huang YunZhi , Zhou LiangXue , Chen Liangyin , Wang Chaohua
Published: January 2022

BACKGROUND

It is hard to distinguish cerebral aneurysms from overlapping vessels based on 2D DSA images due to their lack of spatial information.

OBJECTIVE

The aim of this study was to construct a deep learning diagnostic system to improve the ability to detect posterior communicating artery (PCoA) aneurysms on 2D-DSA images and validate the efficiency of the deep learning diagnostic system in 2D-DSA aneurysm detection.

METHODS

We proposed a two-stage detecting system. First, we established the regional localization stage (RLS) to automatically locate specific detection regions of raw 2D-DSA sequences. Then, in the intracranial aneurysm detection stage (IADS), we constructed the Bi-input+RetinaNet+C-LSTM framework to compare the performance of aneurysm detection with the existing three frameworks. Each of the frameworks had a fivefold cross-validation scheme. The area under the curve (AUC), the receiver operating characteristic (ROC) curve, and mean average precision (mAP) were used to validate the efficiency of different frameworks. The sensitivity, specificity and accuracy were used to identify the abilities of different frameworks.

RESULTS

A total of 255 patients with PCoA aneurysms and 20 patients without aneurysms were included in this study. The best AUC results of RetinaNet, RetinaNet+C-LSTM, Bi-input+RetinaNet and Bi-input+RetinaNet+C-LSTM were 0.95, 0.96, 0.92 and 0.97, respectively. The sensitivities of RetinaNet, RetinaNet+C-LSTM, Bi-input+RetinaNet, Bi-input+RetinaNet+C-LSTM, and human experts were 89.00% (67.02% to 98.43%), 88.00% (65.76% to 98.06%), 87.00% (64.53% to 97.66%), 89.00% (67.02% to 98.43%), and 90% (68.30% to 98.77%), respectively. The specificity of RetinaNet, RetinaNet+C-LSTM, Bi-input+RetinaNet, Bi-input+RetinaNet+C-LSTM, and human expert were 80.00% (56.34% to 94.27%), 89.00% (67.02% to 98.43%), 86.00% (63.31% to 97.24%), 93.00% (72.30% to 99.56%), and 90% (68.30% to 98.77%), respectively. The accuracies of RetinaNet, RetinaNet+C-LSTM, Bi-input+RetinaNet, Bi-input+RetinaNet+C-LSTM, and human experts were 84.50% (69.57% to 93.97%), 88.50% (74.44% to 96.39%), 86.50% (71.97% to 95.22%), 91.00% (77.63% to 97.72%), and 90.00% (76.34% to 97.21%), respectively.

CONCLUSIONS

A two-stage aneurysm detection system can reduce the time cost and the computational load. According to our results, more spatial and temporal information can help improve the performances of the frameworks so that Bi-input+RetinaNet+C-LSTM has the best performance compared to the other frameworks. Our study demonstrates that our system can assist doctors in detecting intracranial aneurysms on 2D-DSA images.
Assessing Global Kidney Nutrition Care
Authors: Wang Angela Yee-Moon , Okpechi Ikechi G. , Ye Feng , Kovesdy Csaba P. , Brunori Giuliano , Burrowes Jerrilynn D. , Campbell Katrina , Damster Sandrine , Fouque Denis , Friedman Allon N. , Garibotto Giacomo , Guebre-Egziabher Fitsum , Harris David , Iseki Kunitoshi , Jha Vivekanand , Jindal Kailash , Kalantar-Zadeh Kamyar , Kistler Brandon , Kopple Joel D. , Kuhlmann Martin , Lunney Meaghan , Mafra Denise , Malik Charu , Moore Linda W. , Price S. Russ , Steiber Alison , Wanner Christoph , ter Wee Pieter , Levin Adeera , Johnson David W. , Bello Aminu K.
Published: January 2022

Background and objectives

Nutrition intervention is an essential component of kidney disease management. This study aimed to understand current global availability and capacity of kidney nutrition care services, interdisciplinary communication, and availability of oral nutrition supplements.

Design, setting, participants, & measurements

The International Society of Renal Nutrition and Metabolism (ISRNM), working in partnership with the International Society of Nephrology (ISN) Global Kidney Health Atlas Committee, developed this Global Kidney Nutrition Care Atlas. An electronic survey was administered among key kidney care stakeholders through 182 ISN-affiliated countries between July and September 2018.

Results

Overall, 160 of 182 countries (88%) responded, of which 155 countries (97%) answered the survey items related to kidney nutrition care. Only 48% of the 155 countries have dietitians/renal dietitians to provide this specialized service. Dietary counseling, provided by a person trained in nutrition, was generally not available in 65% of low-/lower middle–income countries and “never” available in 23% of low-income countries. Forty-one percent of the countries did not provide formal assessment of nutrition status for kidney nutrition care. The availability of oral nutrition supplements varied globally and, mostly, were not freely available in low-/lower middle–income countries for both inpatient and outpatient settings. Dietitians and nephrologists only communicated “sometimes” on kidney nutrition care in ≥60% of countries globally.

Conclusions

This survey reveals significant gaps in global kidney nutrition care service capacity, availability, cost coverage, and deficiencies in interdisciplinary communication on kidney nutrition care delivery, especially in lower-income countries.