bluuebunny/crossref_metadata_2025 huggingface dataset:
O Marketplace como estratégia de vendas em uma microempresa do setor de selaria e moda country
Authors: Molica de Mendonça Fabrício , José David Erasmo , De Lima Siqueira Paulo Henrique , De Barros Diláscio Mirella , Martins Diniz Daniela
Published: January 2022

O presente trabalho teve como objetivo analisar o papel do marketplace como estratégia comercial para a criação e expansão de uma microempresa varejista do setor de selaria e de moda country da cidade de Dores de Campos (MG). A relevância desse trabalho se traduz na apresentação de uma opção aos novos empreendedores que não dispõe de volume de recursos suficientes para comercializar, através de loja física, seus bens e serviços no mercado. Em termos metodológicos, foi realizado um estudo de caso de natureza qualitativa aplicada em uma microempresa varejista do setor de selaria e de moda country a partir de visitas in loco, aplicação de entrevistas e análise de documentos. Os resultados empíricos apontam que a adoção do marketplace possibilitou o crescimento significativo das vendas da empresa, sendo essa a única estratégia utilizada nos dois primeiros anos de atuação. Além disso, constatou-se que o e-commerce não é somente uma opção viável, mas também essencial para a consolidação de micro e pequenos negócios recém-criados no mercado.
As Empresas Simples de Crédito como alternativa na concessão de Crédito às Micro e Pequenas Empresas - MPE
Authors: Do Nascimento Felizardo Ana Carolina , Pinheiro Casanova Vargas Kelvin , Da Silva Bortoli Lorrainy Kelly , Vieira Eloir Trindade Vasques , Bennett Fortunato
Published: January 2022

O presente artigo reportou a concessão de crédito mediante a Lei Complementar 167/2019, a qual sancionou a criação da Empresa Simples Crédito (ESC) que, por sua vez, trouxe à premissa de facilitação a obtenção de empréstimos e financiamentos para micro e pequenas empresas. Tendo em vista que as MPE possuem vasta relevância no cenário econômico e carecem de empréstimos e financiamentos para se estabelecerem economicamente, na prática, a relação entre as instituições financeiras e MPE se mostra limitante em função (em parte) à burocratização e onerosidade do Sistema Financeiro Nacional (SFN) quanto à concessão de crédito aos pequenos empresários (SEBRAE, 2018). O objetivo geral foi apresentar às Empresas Simples de Crédito como possível alternativa no cenário de crédito para micro e pequenas empresas; especificamente, o enfoque do trabalho foi analisar a evolução histórica do crédito para as MPE no Brasil; evidenciar a importância da análise de crédito; e, demonstrar se as ESC terão a capacidade de facilitar a concessão de crédito.
Implementation of a Metacognitive Learning Strategies Session in an Online Asynchronous Human Anatomy and Physiology Course
Authors: O'Malley Chasity , Ross Kyla , Hull Kerry , Hood Suzanne , Page Olivia , Jensen Murray
Published: January 2022

A unique approach to improving student success in Human Anatomy and Physiology can be centered around teaching the students about metacognitive learning strategies. This perspective discusses the implementation of a metacognitive learning strategies session and highlights some of the outcomes that resulted from the session through exam wrapper responses. A one-hour session discussing metacognitive learning strategies was presented for the students through a pre-recorded video with embedded participation questions. Topics included methods for changing student studying habits to be more efficient and to retain a deeper level of understanding of the material. The session was also accompanied by exam wrappers to help the students to apply the concepts from the session.
The Role of Educational Technology in Face-to-Face and online Anatomy and Physiology Classrooms in Higher Education: A Review of Some Recent Literature
Authors: Edwards Anthony
Published: January 2022

Many anatomy and physiology instructors use some form of technology in both face-to-face and online classes. This article reviews recent literature and surveys strategies for implementing educational technology in both face-to-face and online classrooms. The article concludes with implications for anatomy and physiology instructors and educational technology leaders to help support anatomy physiology instructors.
Investigating the Impacts of a Semester Long Growth Mindset Intervention on Students' Academic Success in a Human Anatomy Course
Authors: Stuart Peter , Wolcott Daniel
Published: January 2022

Human anatomy and physiology are challenging courses for many undergraduate students often leading to low rates of academic success and persistence. Implementation of growth mindset strategies has shown promise in improving academic success in challenging courses; however, few studies have focused specifically on anatomy and physiology courses. To investigate the impact of growth mindset interventions on academic success, lab sections of a human anatomy course were randomly assigned to an intervention or control group. Five growth mindset interventions were integrated into course material for the intervention group at multiple points over the course of the semester. Performance on quizzes and exams, and overall academic success were compared between the groups. The intervention group increased scores in their growth mindsets and performance on low-stake assessments. There was no difference between performance on high-stake assessments and overall academic success. Potential future studies should focus on understanding the impacts this intervention has on specific participant demographics.
Venación foliar de tres especies de Cedrela (Meliaceae) de los andes del Perú
Authors: Wong Sato Akira A. , Reynel Carlos
Published: January 2022

Información sobre la venación foliar del género Cedrela, y de la familia Meliaceae en general, es escasa. En este estudio usamos la técnica de diafanización para facilitar la caracterización de la venación foliar de tres especies de Cedrela: C. angustifolia, C. montana y C. nebulosa. Además, usamos análisis de correspondencia múltiple para determinar si existe alguna relación entre las especies estudiadas y ciertas características de sus venaciones. Las tres especies estudiadas presentan características similares de venación laminar, venaciones inferiores y superiores, areolas y vénulas. Asimismo, los análisis de correspondencia múltiple sugieren que la venación foliar es muy similar entre las tres especies. Sin embargo, C. nebulosa puede ser diferenciada de las otras dos especies estudiadas por su angosta vena primaria en relación con el ancho de la lámina.
A Telecare System for Use in Traditional Persian Medicine
Authors: Nafisi Vahid R. , Ghods Roshanak
Published: January 2022

Background:

In Persian Medicine (PM), measuring the wrist temperature/humidity and pulse is one of the main methods for determining a person's health status and temperament. An important problem is the dependence of the diagnosis on the physician's interpretation of the above-mentioned criteria. Perhaps this is one reason why this method has yet to be combined with modern medical methods. Also, sometimes there is a need to use PM to diagnose patients remotely, especially during a pandemic. This brings up the question of how to implement PM into a telecare system. This study addresses these concerns and outlines a system for measuring pulse signals and temperament detection based on PM.

Methods:

A system was designed and clinically implemented based on PM that uses data from recorded thermal distribution, a temperament questionnaire, and a customized device that logs the pulse waves on the wrist. This system was used for patient careviatelecare.

Results:

The temperaments of 34 participants were assessed by a PM specialist using the standardized Mojahedi Mizaj Questionnaire (MMQ). Thermal images of the wrist in the supine position (namedMalmasin PM), the back of the hand, and the entire face were also recorded under the supervision of the physician. Also, the wrist pulse waves were evaluated by a customized pulse measurement device. Finally, the collected data could be sent to a physician via a telecare system for further interpretation and prescription of medications.

Conclusion:

This preliminary study focused on the implementation of a combinational hardware-software system for patient assessment based on PM. It appears that the design and construction of a customized device that can measure the pulse waves, and some other criteria, according to PM, is possible and can decrease the dependency of the diagnostic to PM specialists. Thus, it can be incorporated into a telemedicine system.
Um programa religioso num contexto secular os professores de Educação Moral e Religiosa Católica no concelho do Porto
Authors: Pinto Tiago
Published: January 2022

This article explores the programmatic representations of Catholic Moral and Religious Education(EMRC) teachers, regarding the disciplineprogram, in public schools in the municipality of Porto (Portugal). Through a diachronic approach to the socio-religious panorama and Catholic religious teaching in Portuguese public schools, it is possible to identify, nowadays, new challenges for the Roman Catholic Church andforits school educators. The interviews carried out showed that teachers tend to consider the study planas limited, unmotivating and with excessive religious contents, so they proposed a subjectof moral and religious education not confined to the Catholic universe.
DECREMENTAL RESPONSE ON PROLONGED EXERCISE TEST IN A PATIENT WITH THYROTOXIC PERIODIC PARALYSIS
Authors: Ostwal Piyush , Alshaheen Maher
Published: January 2022

Paralysis of acute onset often presents a diagnostic challenge for the assessing physician because of a large number of differential diagnosis and overlap of clinical features among them. Thyrotoxic periodic paralysis is an uncommon cause of acute weakness. In addition to serological tests, electromyography findings during prolonged exercise test are very helpful in confirming the diagnosis. Only a few case reports of thyrotoxic periodic paralysis have been published from Middle East and none of them have described this specific electrophysiological data. A man in his 20s presented to us with acute onset weakness in both legs which was evaluated further and found to have hypokalemia. The work up for the etiology revealed thyrotoxic status and a final diagnosis of thyrotoxic periodic paralysis was established. The prolonged exercise test performed in this patient showed typical progressive decremental respsonse with nadir at 40 minutes after the exercise.
STUDY OF SIGNIFICANCE OF PHASE MASK IMAGE IN ACUTE STROKE PATIENTS
Authors: Teja Nerella Krishna , Reddy Ayapaneni Dileep , Srikonda Surekha
Published: January 2022

Background: Phase images contains information regarding local susceptibility changes between the tissues, which can help measure the iron and other content which changes the local field. Typically, this information is ignored before looking at console. Susceptibility weighted imaging (SWI) is a magnetic resonance (MR) technique detects an early hemorrhagic transformation within the infarct to provide insight into cerebral hemodynamics following the stroke. Objective: Significance of “phase mask imaging in differentiation of hemorrhage and calcifications” in acute stroke patients. Methods: An observational non-interventional study carried out on 100 patients with stroke and headache symptoms. MRI Brain Stroke Profile with FLAIR, DWI, ADC, SWAN, and Phase mask sequences, done on 3T GE MRI scanner. Results: All patients underwent MRI study with SWI sequence. Of 183 cases, 33%(n=60) patients had microbleeds, 5%(n=10) patients had granulomas, 32%(n=58) patients had arterial thrombus with infarct, 11%(n=20) patients had falx calcifications, 11%(n=20) patients had intraparenchymal haemorrhage, and 8%(n=15) patients had infarcts with haemorrhagic transformation. The sensitivity of phase imaging in the detection of calcification was 90%. Conclusion: Phase mask imaging plays an important role to detect intracranial calcifications and chronic microbleeds. Phase mask imaging acts as a supplement tool in acute stroke patients, which guides further management.
PROFILE OF HISTORY OF FEBRILE SEIZURE IN PATIENTS WITH EPILEPSY
Authors: Muhammad Basyarahil Rayhan , Rahmatul Islamiyah Wardah , Indra Gunawan Prastiya
Published: January 2022

Background: Febrile seizure is convulsions with fever (temperature ³38°C) with no central nervous system infection that commonly found in children (6-60 months). Febrile seizures do not always mean the child has epilepsy. However, febrile seizures can be a possible long-term risk factor for epilepsy. Objective: The objective of this study is to know the profile of febrile seizure in patients with epilepsy. Methods: A retrospective descriptive study on 23 patients with epilepsy in the EEG Department of Neurology, Dr. Soetomo General Hospital, Surabaya, Indonesia in the period 2018-2019 based on inclusion and exclusion criteria. The total number of epilepsy patients is 849 patients, 216 of whom had a history of febrile seizure. Among 216 epilepsy patients who had a history of febrile seizures, 23 of them were qualified as the sample. The sampling technique used was total population sampling. The instrument of this research is the patients’ medical record. Data analysis is carried out descriptively. Results: The characteristics of the history of febrile seizures that found in patients with epilepsy are more patients are male, have the age of onset on less than 2 years old, have the body temperature more than 38.3°C, have the seizure duration less than 15 minutes, have focal seizures, have recurrent seizures in 24 hours, have a history of more than one febrile seizure, have accompanying neurological disorders, and have no family history of epilepsy. Conclusion: Febrile seizure is still becoming a concern because there is a possibility that it may develop into epilepsy. Even though, not all children who experience febrile seizure will generate epilepsy.
EFFECT OF DATE FRUIT (PHOENIX DACTYLIFERA L.) EXTRACT ON TNFα LEVELS AND BRAIN WEIGHT OF ALZHEIMER’S MODEL RATS
Authors: Marintan Elita , Wasita Brian , Magna Adi
Published: January 2022

Background: Alzheimer's disease (AD) is a neurodegenerative disorder marked by brain inflammation resulted in structural damage and brain dysfunction. Tumor necrosis factor α (TNFα) is a cytokine that plays an important role in inflammation. Dates fruit may help to fight oxidative stress and inflammation in the brain. Objective: To determine the effect of date fruit extracts on blood TNFα levels and brain weight of alzheimer’s model rats. Methods: This research is a laboratory experimental study by post-test only with control group design using alzheimer model rats. This study used 6 treatment groups with simple randomization. Each treatment group was represented by 8 Sprague Dawley rats. The normal control group (KN) was not induced by Hcy and was not given date palm extract, the negative control group (K-) was the Alzheimer's experimental rats which was not given the date palm extract, the positive group was the Alzheimer's experimental rats which was given the Donepezil (K+). Groups P1, P2, P3 were Alzheimer's experimental rats that were given date palm extract at a dose of 200, 400,800 mg / kgBW / day. The effect of date palm extract dosage on TNFα levels and brain weight were analyzed using the One Way Anova test followed by Tukey's post hoc test. Results: The difference in TNFα levels between groups showed a significant difference (p = 0.00). Meanwhile there was no significant difference in brain weight among all groups (p > 0,05). Conclusion: Date palm extract at doses of 200, 400, 800 mg / kgBW can decrease blood TNFα levels of Alzheimer’s model rats.
MANAGEMENT DYSPHAGIA IN POST-STROKE PATIENTS RECOMMENDATIONS FOR INDONESIAN NURSING INTERVENTION STANDARDS: A LITERATURE REVIEW
Authors: Syahrun Syahrun , Hany Alfrina , Rahayu Masruroh
Published: January 2022

Background: Dysphagia often occurs in post-stroke patients, causing aspiration that can result in disability or death. Nurses have an essential role to play in preventing these complications as they 24/7 care for patients. However, there is no written standard of nursing care regarding specific interventions of post-stroke dysphagia in reality. Objective: The purpose of this article is to conduct a literature review of interventions that can be made in patients with post-stroke dysphagia so that it can be a recommendation for Indonesian nursing standards. Design: Electronic literature searches PubMed, EBSCO (Medline), ProQuest, and ScienceDirect databases from January 2011 to October 2020. There was sixteen studies reviewed included in this systematic study were experimental, randomized controlled trials, or systematic reviews (which are also experimental designs, randomized controlled trials). The study focused on non-invasive interventions performed on post-stroke dysphagia patients. Results: Interventions in dysphagia found, namely: The use of food thickeners against the risk of aspiration resulted in the patient's swallowing ability significantly increased by 71.9% (p <0.01); Chin down intervention combined with thickening fluid provides a solution to improve the nutritional needs of patients dysphagia post-stroke; Tongue training interventions, swallowing training and speech therapy; Tongue stretching exercises that have a positive effect on tongue motility and oromotor function in post-stroke dysphagia patients; Intervention of Tongue resistance training that increases the strength of the tongue and reduces fluid residue in the vallecular; and early screening of dysphagia by nurses using formal guidelines to manage dysphagia patients thereby reducing chest infections and mortality. Conclusion: Nurses should not diagnose dysphagia, but can identify post-stroke dysphagia to determine the interventions necessary for nutrition management, hydration, and aspiration prevention. Interventions include early dysphagia screening within 24 hours after stroke, thickening nutrition according to nutritionist recommendations, laryngeal elevation exercises, peripheral stimulation, posture regulation, and education on eating and drinking.
An overview of the remaining challenges of the RILEM TC 274-TCE, testing and characterisation of earth-based building materials and elements
Authors: Fabbri Antonin , Morel Jean Claude , Aubert Jean-Emmanuel , Bui Quoc-Bao , Gallipoli Domenico , Ventura Anne , Reddy Venkatarama B. V. , Hamard Erwan , Pelé-Peltier Antoine , Abhilash Holur Narayanaswamy
Published: January 2022

Based on the RILEM Technical Committee 274-TCE work, this paper is a discussion of the remaining engineering challenges faced by earthen architecture. The assessment of earth material performances requires the development of appropriate procedures and standards. This is discussed in particular for the characterisation, hygrothermal behaviour, mechanical behaviour, and durability of earth materials. One other important challenge, since one of the main advantages classically put forward, is its ecological performance, is a proper assessment of life cycle assessment of earth materials, elements and buildings. Moreover, the paper develops why the approach to earthen construction must be different compared to the dominant construction materials, to preserve its ability to contribute to the ecological transition in the construction sector. In particular, the needs of using local soils, with an architectural approach coping with the limits of the materials, and developing an architectural optimisation to preserve the earthen materials multifunctionality rather than selecting a sole property to be maximised. Lastly, the findings of the paper can be used to develop a holistic approach to earthen construction to foster the development of new earthen architecture projects.
Analysis of the difficulty index of item bank according to cognitive aspects during the Covid-19 pandemic
Authors: Fauzie Maizura , Pada Andi Ulfa Tenri , Supriatno Supriatno
Published: January 2022

The Covid-19 pandemic is a major challenge for the education system. The face-to-face learning process shifted to online learning, including the school exams. In Aceh province, the school exams have changed from paper-based and computer-based. This research aims to analyze the difficulty index of an item bank based on cognitive aspects of Bloom’s Taxonomy. The study samples included 850 students. The data were the item bank of a final semester exam consisting of 200 multiple-choice items, answer keys, and students’ answer sheets. The empirical analysis of the item bank using classical test theory (CTT) found that 141 out of 200 items are valid based on content validity and computing data set using the Aiken’s V formula. Item tests have reliability of 0.983. The reliability is calculated using the Kuder-Richardson 21 formula. If the reliability coefficient is r11 ≥ 0.70, then the item is declared reliable. In addition, 62 out of 141 (43.97%) items from the item bank are classified with a moderate difficulty index, and 79 items (56.03%) are categorized with a high difficulty index. The cognitive aspects found in the items are remembering, understanding, applying, and analyzing. Students mostly found items with the cognitive aspects of remembering and understanding are difficult to solve.
Evaluating the learning goal attainment in Nihongo Noryoku Shiken N5 course
Authors: Setiawati Ai Sumirah , Wagiran Wagiran , Subyantoro Subyantoro
Published: January 2022

The objective of the study is to evaluate the learning implementation of the Nihongo Noryoku Shiken N5 course as a new course offered in the 2020 curriculum at the Japanese Language Education Study Program in UNNES. A goal-oriented evaluation model by Tyler was employed in the evaluation process to measure how far the learning goals that have been determined at the beginning of the lecture are achieved. This evaluative research relied on a quantitative descriptive approach; its steps comprised (1) data collection, (2) data processing and analysis, and (3) recommendation formulation. According to the evaluation results, the learning goals of Nihongo Noryoku Shiken N5 had been met, although it was not that significant. Several conditions cause such issues. (1) In the class, some students had good Japanese language skills; they claimed that the lesson was too easy, so their progress was not significant. (2) The evaluation instruments were not valid. (3) Other conditions, e.g., the implementation of online learning and tests, hindered classroom activities and monitoring. Improving the teaching and learning materials and evaluation instruments is recommended. Furthermore, some additions to the curriculum need to be considered, such as adding the credits for the grammar or Bunpo course.
Self-evaluation in perspective of Surah Al-Isrā verse 14th
Authors: Usman Kasmah , Abubakar Achmad , Mahfudz Muhsin
Published: January 2022

This paper describes, knows, understands, and analyzes self-evaluation from the perspective of surah Al-Isrā verse 14. Self-evaluation in psychology is called self-introspection, which means self-correction, while in Islam, it is called muḥāsabah or muḥāsabah al-nafṣ. Muḥāsabah, in the person of a Muslim in particular, is an attempt to count and evaluate himself, how many sins he has committed and what good he has not done. This study is qualitative research under the literature study method, which focuses on the question of self-evolution from the perspective of surah Al-Isra verse 14. The data source comes from the ministry of religious affairs' translation of the Qur'an, and books related to self-evaluation contain self-evaluation from surah Al-Isra' verse 14. Data were analyzed using the qualitative data analysis method. Self-evaluation in QS Al-Isra': 14refers to the word al-ḥisāb, if an evaluation may be done by oneself on all the deeds that have been done. Explaining this, in surah Al-Isrā'a verse 14, Allah evaluates His creatures on the day of reckoning (the trial of the Hereafter). Therefore it is a man who is commanded to judge his own deeds. Suppose it is associated with the point of evaluation of education. In that case, the meaning of al-ḥisāb indicates that the assessment results depend on the intensity of the subject in completing the exam question. Therefore, the task of educators is to motivate the subject of the learner to learn and maximum when completing the exam question seriously.
Factors affecting asset investment of public companies in plastic and packaging industry in Vietnam
Authors:   Faculty of Banking and Finance, Thuongmai University, Hanoi, Vietnam, et al. Vu
Published: January 2022

The purpose of this research is to identify and analyze the influence of internal factors on asset investment of public companies in the plastic and packaging industry in Vietnam. The research has built a regression model to determine the relationship of internal factors affecting asset investment of public companies in the plastic and packaging industry in Vietnam. The strength of this research is to use the E-view software in quantitative analysis to build a panel data regression model. At the same time, the researchers used the Hausman test to select the appropriate model compared to other research. The data of the research are collected and calculated from the financial statements of 27 companies in the plastic and packaging industry in Vietnam from 2013 to 2020. The research results show that such factors as sale, equity, and debt ratio have a positive impact on asset investment, the return on assets has a negative impact on asset investment, while the average loan interest rate does not affect the asset investment of enterprises. Therefore, the author has made recommendations to help public companies in the plastic and packaging industry in Vietnam to improve the efficiency of asset investment. The results of this research are very useful for corporate financial managers in helping them make appropriate financial decisions for their companies.
Acceptance of artificial intelligence (AI) and machine learning (ML) among radiologists in Saudi Arabia
Authors:   Department of Radiological Science and Medical Imaging, College of Applied Medical Sciences, Majmaah University, Al Majma'ah, Saudi Arabia, Alamoudi Abdullah
Published: January 2022

Artificial intelligence (AI) and machine learning (ML), in the new age of technological progress, provide huge benefits to every area of employment, ranging from IT to health care. To assess the knowledge of, attitude towards, and in-practice use of artificial intelligence and machine learning among radiology residents and faculty radiologists. A web-based questionnaire was distributed via Google Drive to 55 radiologists in the central region of the Kingdom of Saudi Arabia. The questionnaire comprised two sections: three questions regarding demographics and three questions regarding the knowledge, attitudes, and practices (KAP) of AI and ML in radiology. A total of 55 respondents (100%) completed the survey. The majority of respondents claimed familiarity with AI and ML (61.8%). Most radiologists (54.5%) expressed mixed feelings regarding the benefits of AI and ML applications in radiology. Regarding usability, a mixed response was received: 49.1% supported its usability and 45.5% were uncertain of the usability of AI and ML in radiology. Several studies have been conducted which have suggested the usability of AI and ML and their incorporation into the radiology department. The majority of radiologists in Saudi Arabia support the use of AI and ML. Further investigation into the usability of these tools is needed.
The Mental Health Impact of the COVID-19 Pandemic Among Physicians, Nurses, and Other Health Care Providers in Alberta: Cross-sectional Survey
Authors: El Gindi Hany , Shalaby Reham , Gusnowski April , Vuong Wesley , Surood Shireen , Hrabok Marianne , Greenshaw Andrew J , Agyapong Vincent
Published: January 2022

Background

During the COVID-19 pandemic, threats to mental health, psychological safety, and well-being are evident, particularly among the first responders and the health care staff.

Objective

This study aims to examine the prevalence and potential predictors of the likely stress, generalized anxiety disorder, and major depressive disorder among health care workers (HCWs).

Methods

A cross-sectional survey was used through a survey link sent to gather demographic information and responses on several self-report scales, including the Perceived Stress Scale, the Generalized Anxiety Disorder 7-item scale, and the Patient Health Questionnaire-9 among HCWs enrolled in the Text4Hope program.

Results

The result from this study suggests that during the COVID-19 pandemic, HCWs reported a high likelihood of moderate-to-high perceived stress (n=840, 81.2%), moderate-to-severe anxiety (n=369, 38.6%), and depression (n=317, 32.7%) symptoms. Nurses and other HCWs were significantly more likely to report depressive symptoms compared to physicians (F(2, 159.47)=15.89, 95% CI –5.05 to –2.04). Younger age groups of HCWs (≤30 years) were more prone to report likely stress, anxiety, and depressive symptoms compared to HCWs 41-50 and >50 years old (odds ratio [OR] 1.82-3.03). Similarly, females and those who reported a lack of social support (separated/divorced and single) among HCWs had a higher likelihood to report likely stress and depressive symptoms, respectively (OR 1.8 and 1.6, respectively).

Conclusions

This cross-sectional study explored a high level of mental health burdens during the COVID-19 pandemic among HCWs in Alberta. Levels of psychological symptoms were more noticeable in the female gender and the nursing profession.
Feasibility of Monitoring Health and Well-being in Emerging Adults: Pilot Longitudinal Cohort Study
Authors: Lystad Reidar P , Fajardo Pulido Diana , Peters Lorna , Johnstone Melissa , Ellis Louise A , Braithwaite Jeffrey , Wuthrich Viviana , Amin Janaki , Cameron Cate M , Mitchell Rebecca J
Published: January 2022

Background

Emerging adulthood is a distinct segment of an individual’s life course. The defining features of this transitional period include identity exploration, instability, future possibilities, self-focus, and feeling in-between, all of which are thought to affect quality of life, health, and well-being. A longitudinal cohort study with a comprehensive set of measures would be a valuable resource for improving the understanding of the multifaceted elements and unique challenges that contribute to the health and well-being of emerging adults.

Objective

The main aim of this pilot study was to evaluate the feasibility and acceptability of recruiting university graduates to establish a longitudinal cohort study to inform the understanding of emerging adulthood.

Methods

This pilot study was conducted among graduates at a large university. It involved collecting web-based survey data at baseline (ie, graduation) and 12 months post baseline, and linking survey responses to health records from administrative data collections. The feasibility outcome measures of interest included the recruitment rate, response rate, retention rate, data linkage opt-out rate, and availability of linked health records. Descriptive statistics were used to evaluate the representativeness of the sample, completeness of the survey responses, and data linkage characteristics.

Results

Only 2.8% of invited graduates (238/8532) agreed to participate in this pilot cohort study, of whom 59.7% (142/238) responded to the baseline survey. The retention rate between the baseline and follow-up surveys was 69.7% (99/142). The completeness of the surveys was excellent, with the proportion of answered questions in each survey domain ranging from 87.3% to 100% in both the baseline and follow-up surveys. The data linkage opt-out rate was 32.4% (77/238).

Conclusions

The overall recruitment rate was poor, while the completeness of survey responses among respondents ranged from good to excellent. There was reasonable acceptability for conducting data linkage of health records from administrative data collections and survey responses. This pilot study offers insights and recommendations for future research aiming to establish a longitudinal cohort study to investigate health and well-being in emerging adults.

Trial Registration

Australian New Zealand Clinical Trials Registry number ACTRN12618001364268; https://tinyurl.com/teec8wh

International Registered Report Identifier (IRRID)

RR2-10.2196/16108
Effectiveness of Digital Counseling Environments on Anxiety, Depression, and Adherence to Treatment Among Patients Who Are Chronically Ill: Systematic Review
Authors: Paalimäki-Paakki Karoliina , Virtanen Mari , Henner Anja , Nieminen Miika T , Kääriäinen Maria
Published: January 2022

Background

Patients who are chronically ill need novel patient counseling methods to support their self-care at different stages of the disease. At present, knowledge of how effective digital counseling is at managing patients’ anxiety, depression, and adherence to treatment seems to be fragmented, and the development of digital counseling will require a more comprehensive view of this subset of interventions.

Objective

This study aims to identify and synthesize the best available evidence on the effectiveness of digital counseling environments at improving anxiety, depression, and adherence to treatment among patients who are chronically ill.

Methods

Systematic searches of the EBSCO (CINAHL), PubMed, Scopus, and Web of Science databases were conducted in May 2019 and complemented in October 2020. The review considered studies that included adult patients aged ≥18 years with chronic diseases; interventions evaluating digital (mobile, web-based, and ubiquitous) counseling interventions; and anxiety, depression, and adherence to treatment, including clinical indicators related to adherence to treatment, as outcomes. Methodological quality was assessed using the standardized Joanna Briggs Institute critical appraisal tool for randomized controlled trials or quasi-experimental studies. As a meta-analysis could not be conducted because of considerable heterogeneity in the reported outcomes, narrative synthesis was used to synthesize the results.

Results

Of the 2056 records screened, 20 (0.97%) randomized controlled trials, 4 (0.19%) pilot randomized controlled trials, and 2 (0.09%) quasi-experimental studies were included. Among the 26 included studies, 10 (38%) digital, web-based interventions yielded significantly positive effects on anxiety, depression, adherence to treatment, and the clinical indicators related to adherence to treatment, and another 18 (69%) studies reported positive, albeit statistically nonsignificant, changes among patients who were chronically ill. The results indicate that an effective digital counseling environment comprises high-quality educational materials that are enriched with multimedia elements and activities that engage the participant in self-care. Because of the methodological heterogeneity of the included studies, it is impossible to determine which type of digital intervention is the most effective for managing anxiety, depression, and adherence to treatment.

Conclusions

This study provides compelling evidence that digital, web-based counseling environments for patients who are chronically ill are more effective than, or at least comparable to, standard counseling methods; this suggests that digital environments could complement standard counseling.
Developing a Smartphone-Based Adjunct Intervention to Reduce Cannabis Use Among Juvenile Justice-Involved Adolescents: Protocol for a Multiphase Study
Authors: Helseth Sarah A , Guigayoma John , Price Dayna , Spirito Anthony , Clark Melissa A , Barnett Nancy P , Becker Sara J
Published: January 2022

Background

Adolescents involved in the juvenile justice system who use cannabis are at an increased risk of future substance use disorders and rearrest. Many court-involved, nonincarcerated (CINI) youth are referred for services in the community and often encounter multiple barriers to care, highlighting the need for minimally burdensome services that can be delivered in justice settings. Digital health interventions are accessible, easy to implement, and can provide ongoing support but have not been developed to address the unique needs of CINI youth who use cannabis.

Objective

This multiphase study will aim to develop, implement, and pilot test a novel smartphone app, Teen Empowerment through Computerized Health (TECH), to reduce cannabis and other substance use among CINI youth. TECH is conceptualized as a digital adjunct to a brief computerized intervention delivered by our family court partner.

Methods

Following the principles of user-centered design, phase I interviews with CINI youth aged 14-18 years (n=14-18), their caregivers (n=6-8), and behavioral health app developers (n=6-8) will guide the TECH design decisions. Next, in phase II, CINI youth (n=10) will beta test the TECH app prototype for 1 month; their feedback regarding feasibility and acceptability will directly inform the app refinement process. Finally, in phase III, CINI youth (n=60) will participate in a pilot randomized controlled trial for 6 months, comparing the preliminary effectiveness of the adjunctive TECH app on cannabis use outcomes.

Results

Phase I data collection began in September 2020 and was completed in December 2021; 14 CINI youth, 8 caregivers, and 11 behavioral health app developers participated in the study. Phases II and III will occur in 2022 and 2023 and 2023 and 2025, respectively.

Conclusions

This body of work will provide insight into the feasibility and acceptability of a smartphone-based adjunctive intervention designed for CINI youth. Phase III results will offer a preliminary indication of the effectiveness of the TECH app in reducing cannabis use among CINI youth.

International Registered Report Identifier (IRRID)

DERR1-10.2196/35402
Individuals With SARS-CoV-2 Infection During the First and Second Waves in Catalonia, Spain: Retrospective Observational Study Using Daily Updated Data (Preprint)
Authors: Alves-Cabratosa Lia , Comas-Cufí Marc , Blanch Jordi , Martí-Lluch Ruth , Ponjoan Anna , Castro-Guardiola Antoni , Hurtado-Ganoza Abelardo , Pérez-Jaén Ana , Rexach-Fumaña Maria , Faixedas-Brunsoms Delfi , Gispert-Ametller Maria Angels , Guell-Cargol Anna , Rodriguez-Batista Maria , Santaularia-Font Ferran , Orriols Ramon , Bonnin-Vilaplana Marc , Calderón López Juan Carlos , Sabater-Talaverano Gladis , Queralt Moles Francesc Xavier , Rodriguez-Requejo Sara , Avellana-Revuelta Esteve , Balló Elisabet , Fages-Masmiquel Ester , Sirvent Josep-Maria , Lorencio Carol , Morales-Pedrosa Josep Miquel , Ortiz-Ballujera Patricia , Ramos Rafel
Published: January 2022

BACKGROUND

A description of individuals with SARS-CoV-2 infection comparing the first and second waves could help adapt health services to manage this highly transmissible infection.

OBJECTIVE

We aimed to describe the epidemiology of individuals with suspected SARS-CoV-2 infection, and the characteristics of patients with a positive test comparing the first and second waves in Catalonia, Spain.

METHODS

This study had 2 stages. First, we analyzed daily updated data on SARS-CoV-2 infection in individuals from Girona (Catalonia). Second, we compared 2 retrospective cohorts of patients with a positive reverse-transcription polymerase chain reaction or rapid antigen test for SARS-CoV-2. The severity of patients with a positive test was defined by their admission to hospital, admission to intermediate respiratory care, admission to the intensive care unit, or death. The first wave was from March 1, 2020, to June 24, 2020, and the second wave was from June 25, 2020, to December 8, 2020.

RESULTS

The numbers of tests and cases were lower in the first wave than in the second wave (26,096 tests and 3140 cases in the first wave versus 140,332 tests and 11,800 cases in the second wave), but the percentage of positive results was higher in the first wave than in the second wave (12.0% versus 8.4%). Among individuals with a positive diagnostic test, 818 needed hospitalization in the first wave and 680 in the second; however, the percentage of hospitalized individuals was higher in the first wave than in the second wave (26.1% versus 5.8%). The group that was not admitted to hospital included older people and those with a higher percentage of comorbidities in the first wave, whereas the characteristics of the groups admitted to hospital were more alike.

CONCLUSIONS

Screening systems for SARS-CoV-2 infection were scarce during the first wave, but were more adequate during the second wave, reflecting the usefulness of surveillance systems to detect a high number of asymptomatic infected individuals and their contacts, to help control this pandemic. The characteristics of individuals with SARS-CoV-2 infection in the first and second waves differed substantially; individuals in the first wave were older and had a worse health condition.
Mobile Apps for Dietary and Food Timing Assessment: Evaluation for Use in Clinical Research (Preprint)
Authors: Gioia Siena , Vlasac Irma M , Babazadeh Demsina , Fryou Noah L , Do Elizabeth , Love Jessica , Robbins Rebecca , Dashti Hassan S , Lane Jacqueline M
Published: January 2022

BACKGROUND

Over the last decade, health mobile apps have become an increasingly popular tool used by clinicians and researchers to track food consumption and exercise. However, many consumer apps lack the technological features for facilitating the capture of critical food timing details.

OBJECTIVE

This study aimed to introduce users to 11 apps from US app stores that recorded both dietary intake and food timing to establish which one would be the most appropriate for clinical research.

METHODS

To determine a viable app that recorded both dietary intake and food timing for use in a food timing–related clinical study, we evaluated the time stamp data, usability, privacy policies, the accuracy of nutrient estimates, and general features of 11 mobile apps for dietary assessment that were available on US app stores. The following apps were selected using a keyword search of related terms and reviewed: text entry apps—Cronometer, DiaryNutrition, DietDiary, FoodDiary, Macros, and MyPlate; image entry apps—FoodView and MealLogger; and text plus image entry apps—Bitesnap, myCircadianClock, and MyFitnessPal.

RESULTS

Our primary goal was to identify apps that recorded food time stamps, which 8 (73%) of the 11 reviewed apps did. Of the 11 apps, only 4 (36%) allowed users to edit the time stamps. Next, we sought to evaluate the usability of the apps using the System Usability Scale across 2 days, and 82% (9/11) of the apps received favorable scores for usability. To enable use in research and clinical settings, the privacy policies of each app were systematically reviewed using common criteria, with 1 (9%) Health Insurance Portability and Accountability Act–compliant app (Cronometer). Furthermore, protected health information was collected by 9 (82%) of the 11 apps. Finally, to assess the accuracy of the nutrient estimates generated by these apps, we selected 4 sample food items and a 3-day dietary record to input into each app. The caloric and macronutrient estimates of the apps were compared with the nutrient estimates provided by a registered dietitian using the Nutrition Data System for Research database. In terms of the 3-day food record, the apps were found to consistently underestimate daily calories and macronutrients compared with the Nutrition Data System for Research output.

CONCLUSIONS

Overall, we found that the Bitesnap app provided flexible dietary and food timing functionality capable of being used in research and clinical settings, whereas most other apps lacked in the necessary food timing functionality or user privacy.
Identifying COVID-19 Outbreaks From Contact-Tracing Interview Forms for Public Health Departments: Development of a Natural Language Processing Pipeline (Preprint)
Authors: Caskey John , McConnell Iain L , Oguss Madeline , Dligach Dmitriy , Kulikoff Rachel , Grogan Brittany , Gibson Crystal , Wimmer Elizabeth , DeSalvo Traci E , Nyakoe-Nyasani Edwin E , Churpek Matthew M , Afshar Majid
Published: January 2022

BACKGROUND

In Wisconsin, COVID-19 case interview forms contain free-text fields that need to be mined to identify potential outbreaks for targeted policy making. We developed an automated pipeline to ingest the free text into a pretrained neural language model to identify businesses and facilities as outbreaks.

OBJECTIVE

We aimed to examine the precision and recall of our natural language processing pipeline against existing outbreaks and potentially new clusters.

METHODS

Data on cases of COVID-19 were extracted from the Wisconsin Electronic Disease Surveillance System (WEDSS) for Dane County between July 1, 2020, and June 30, 2021. Features from the case interview forms were fed into a Bidirectional Encoder Representations from Transformers (BERT) model that was fine-tuned for named entity recognition (NER). We also developed a novel location-mapping tool to provide addresses for relevant NER. Precision and recall were measured against manually verified outbreaks and valid addresses in WEDSS.

RESULTS

There were 46,798 cases of COVID-19, with 4,183,273 total BERT tokens and 15,051 unique tokens. The recall and precision of the NER tool were 0.67 (95% CI 0.66-0.68) and 0.55 (95% CI 0.54-0.57), respectively. For the location-mapping tool, the recall and precision were 0.93 (95% CI 0.92-0.95) and 0.93 (95% CI 0.92-0.95), respectively. Across monthly intervals, the NER tool identified more potential clusters than were verified in WEDSS.

CONCLUSIONS

We developed a novel pipeline of tools that identified existing outbreaks and novel clusters with associated addresses. Our pipeline ingests data from a statewide database and may be deployed to assist local health departments for targeted interventions.
Physician Burnout and the Electronic Health Record Leading Up to and During the First Year of COVID-19: Systematic Review (Preprint)
Authors: Kruse Clemens Scott , Mileski Michael , Dray Gevin , Johnson Zakia , Shaw Cameron , Shirodkar Harsha
Published: January 2022

BACKGROUND

Physician burnout was first documented in 1974, and the electronic health record (EHR) has been known to contribute to the symptoms of physician burnout. Authors pondered the extent of this effect, recognizing the increased use of telemedicine during the first year of COVID-19.

OBJECTIVE

The aim of this review was to objectively analyze the literature over the last 5 years for empirical evidence of burnout incident to the EHR and to identify barriers to, facilitators to, and associated patient satisfaction with using the EHR to improve symptoms of burnout.

METHODS

No human participants were involved in this review; however, 100% of participants in studies analyzed were adult physicians. We queried 4 research databases and 1 targeted journal for studies commensurate with the objective statement from January 1, 2016 through January 31, 2021 (n=25).

RESULTS

The hours spent in documentation and workflow are responsible for the sense of loss of autonomy, lack of work-life balance, lack of control of one’s schedule, cognitive fatigue, a general loss of autonomy, and poor relationships with colleagues. Researchers have identified training, local customization of templates and workflow, and the use of scribes as strategies to alleviate the administrative burden of the EHR and decrease symptoms of burnout.

CONCLUSIONS

The solutions provided in the literature only addressed 2 of the 3 factors (workflow and documentation time) but not the third factor (usability). Practitioners and administrators should focus on the former 2 factors because they are within their sphere of control. EHR vendors should focus on empirical evidence to identify and improve the usability features with the greatest impact. Researchers should design experiments to explore solutions that address all 3 factors of the EHR that contribute to burnout.

CLINICALTRIAL

PROSPERO International Prospective Register of Systematic Reviews CRD42020201820; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=201820

INTERNATIONAL REGISTERED REPORT

RR2-10.2196/15490