bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of Secondary Hip Arthritis from Shell Fragment and Gunshot Injury in the Syrian Civil War
Authors: Özden Raif , Davut Serkan , Doğramacı Yunus , Kalacı Aydıner , Duman İbrahim Gökhan , Uruç Vedat
Published: June 2020

Background: In gunshot and shell fragment injuries to the hip joint, orthopaedic intervention includes wound assessment and care, osteosynthesis of fractures, and avoiding of infection and osteoarthritis. The aim of this study was to evaluate the outcomes of the patients with secondary hip arthritis due to prior gunshot and shell fragment (shrapnel) injuries who underwent primary total hip arthroplasty. Methods: This retrospective study reviewed 26 patients (24 males, 2 females) who underwent hip arthroplasty due to prior gunshot and shell fragment injuries from November 2013 to January 2019. For all patients Harris Hip Score (HHS) were evaluated preoperatively and after surgery. Results: Mean age was 31,5 (range, 19-48) years. The mean preoperative HHS was 52.95 points and the mean postoperative HHS was 79.92 points at the final follow-up after surgery. Patients with shell fragment injuries to the hip joint, had higher infection rates but it is not statistically significant.Conclusions: An anatomic reduction of the fracture may not be possible in these cases as a result of significant bone and/or cartilage loss. Total hip arthroplasty can be done after gunshot and shell fragment related posttraumatic arthritis. It is efective treatment choice to reduce pain and improve function but the surgeon must be very carefull because of high rate of infection.
The Impact of Switching from Short-Term Teriparatide Treatment to Denosumab Therapy Compared with Denosumab Alone for Patients with Osteoporotic Hip Fracture: A 1-Year Follow-up Study
Authors: Park Chan Ho , Yoo Jun-Il , Choi Chang Hyun , Suh You-Sung
Published: June 2020

Background: Switching the prescription from bone-forming medication to resorptive agents is reportedly effective for patients with severe osteoporosis. The objective of this study is to determine the impact of implementing short-term teriparatide (TPTD) intervention before denosumab (DMab) therapy compared with DMab therapy alone for 1 year after hip fracture.Methods: TPTD was administered to 24 patients for an average of 12.1 weeks after which the intervention was switched to DMab therapy for 12 months (group 1). DMab alone was administered to 16 patients for 12 months (group 2). Bone mineral density (BMD) was evaluated before and after treatment at the 1-year follow-up. The improvement of BMD and T-score in hip and spine was compared with the levels of bone turnover marker.Results: The difference of hip BMD after osteoporosis treatment was -0.0081±0.03 in group 1 and 0.0074±0.04 in group 2 (p=0.180). The difference of spine BMD was 0.0819±0.04 in group 1 and 0.0145±0.03 in group 2 (p<0.001). BMD and T-score of the spine improved significantly in groups 1 and 2 (p < 0.001). There was no statistical difference in C-terminal telopeptide and osteocalcin level. Conclusion: Short-term TPTD administration followed by DMab alone was effective only in improving spine BMD. Short-term treatment with TPTD caused mild improvement in femur neck BMD compared with DMab alone. However, further research with a longer duration of TPTD treatment is warranted, as our findings lack statistical significance.
Analysis on Risk Factors for Neck Shortening After Internal Fixation for Pauwels II Femoral Neck Fracture in Young Patients
Authors: Zhao Fulong , Guo Lijuan , wang xuefei , Zhang Yakui
Published: June 2020

Background:Femoral neck shortening can occur in in young patients receiving internal fixation for Pauwels type II femoral neck fracture. The risk factors for neck shortening, which can affect hip function, are not clear. This study aimed to retrospectively identify risk factors for neck shortening after internal fixation with parallel partially threaded cannulated cancellous screws for Pauwels type II femoral neck fracture in relatively young patients. Methods: Clinical data from 122 cases with Pauwels type II femoral neck fracture from February 2014 to February 2019 were reviewed and analyzed, and causes of neck shortening were statistically analyzed. And the chi-squared test or Fisher’s exact test was used to compare indicators. Multivariate analysis was conducted with non-conditional logistic regression analysis. Results: Statistically significant differences were found in age, sex, BMD, BMI, fracture type, posterior medial cortex comminution, and reduction quality between patients with femoral neck shortening and those without femoral neck shortening. Logistic regression analysis showed that fracture type, posterior medial cortex comminution, and reduction quality were the main risk factors for neck shortening. Conclusion：Fracture type, posterior medial cortex comminution, and reduction quality can be used as important reference indexes to predict the possibility of neck shortening after internal fixation with parallel, partially threaded, cannulated cancellous screws for Pauwels type II femoral neck fracture in young patients.BMD and BMI may be also risk factors.
Factors Affecting Family Business Succession in the Food Hawking Business in Malaysia
Authors: Ng Jonathan Cho Kin
Published: June 2020

Food hawking businesses around the world largely contribute to the economy of countries and provides much needed jobs that feed employment, even though earnings are low. The food hawking business in Malaysia is under threat of extinction due to the reluctance of the next generation in taking over the food hawking businesses from the elderships. As research in the area of family business succession is scarce, this study serves to add to the theoretical aspect of the area. The purpose of this study was to analyse the effects of vending environment, operating hours, successor willingness, relationship among family members and preparation level of heir on the intention of family succession in the food hawking business in Malaysia. Leader’s approval was also studied as a potential moderator. The methodology used was a questionnaire survey study design with a sample size of 208, respondents were obtained via convenience sampling from Kuala Lumpur and Penang as hawkers are abundant in these two locations. Findings show that vending environment, successor willingness, relationship among family members and preparation level of heir have a significant effect on the intention of family succession in the food hawking business in Malaysia. Leader’s approval was found to be insignificant as a moderator. Operating hours was not significant, possibly due to the difference in importance placed by Malaysian hawkers in succession.
Eye Movement Biomarkers Allow for the Definition of Phenotypes in Gaucher Disease
Authors: Donald Aimee , Tan Chong Yew , Chakrapani Anupam , Hughes Derralyn , Sharma Reena , Cole Duncan , Bardins Stanislav , Gorges Martin , Jones Simon Allan , Schneider Erich
Published: June 2020

Background Neurological forms of Gaucher disease, the inherited disorder of b-Glucosylceramidase caused by bi-allelic variants in GBA1, is a progressive disorder which lacks a disease-modifying therapy. Systemic manifestations of disease are effectively treated with Enzyme Replacement Therapy (ERT), however, molecules which cross the blood-brain barrier are still under investigation. Clinical trials of such therapeutics require robust, reproducible clinical endpoints to demonstrate efficacy and clear phenotypic definitions to identify suitable patients for inclusion in trials. The single consistent clinical feature in all patients with neuronopathic disease is the presence of a supranuclear saccadic gaze palsy, in the presence of Gaucher disease this finding serves as diagnostic of ‘type 3’ Gaucher disease. MethodsWe undertook a study to evaluate saccadic eye movements in Gaucher patients and to assess the role of the EyeSeeCam in measuring saccades. The EyeSeeCam is a video oculography device which was used to run a protocol of saccade measures. We studied 39 patients with non-neurological Gaucher disease (type 1), 21 patients with type 3 (neurological) disease and a series of 35 healthy controls. Mean saccade parameters were compared across disease subgroups. ResultsWe confirmed the saccadic abnormality in patients with type 3 Gaucher disease andidentified an unexpected subgroup of patients with type 1 Gaucher disease who demonstrated significant saccade parameter abnormalities. These patients also showed subtle neurological findings and shared aGBA1 variant. ConclusionsThis striking novel finding of a potentially attenuated type 3 Gaucher phenotype associated with a specific GBA1 variant and detectable saccadic abnormality prompts review of current disease classification. Further, this finding highlights the broad spectrum of neuronopathic Gaucher phenotypes relevant when designing inclusion criteria for clinical trials.
Transjugular Intrahepatic Portosystemic Shunt In COVID-19 Patient: A Case Report
Authors: Oliveira Daniel Simões de , Rímoli José Ragide Jamal , Valle Leonardo Guedes Moreira , Benini Bárbara Burza , Siqueira Luiz Tenório de Brito
Published: June 2020

Transjugular intrahepatic portosystemic shunt (TIPS) should be considered in all liver transplant candidates, besides being a life-saving procedure in bleeding from esophageal or gastric varices. In this case, we describe the management of a patient with diagnosis of coronavirus (COVID-19) with variceal bleeding in an emergency situation with worsening of pulmonary function.
COVID-19 pandemic fear and anxiety among healthcare professionals in Pakistan
Authors: Saleem Zohra , Majeed Muhammad Mansoor , Rafique Sara , Siqqiqui Zarah , Ghandhi Dinaz , Tariq Hira
Published: June 2020

During the current pandemic, Pakistan is badly affected. It has exerted great pressure on vigor as well as the psychology of the healthcare professionals. Limited resources, illiteracy, myths, and not following the proper protocol by the general population may have increased the risk for everyone, and anxiety and fear among the frontline healthcare professionals. Anxiety is a common response to any stressful situation and its the fear of the unknown and it may have multiple consequences.In the current study, we attempted to analyze the fear and anxiety among the healthcare professionals of Pakistan.Methodology: An online questionnaire-based survey was performed using a non-probability snowball sampling technique. The questionnaire was validated and comprised of demographics and 10 questions regarding fear and anxiety as per fear of coronavirus-19 scale (FCV-19S). SPSS 21 was used for data analysis.Data of 404 participants analyzed. A significant difference between gender, age group, and the profession was found (p<0.05). Out of 404 participants, 322 (79.70%) were considered to have high and severe anxiety (p=0.020). Based on the results anxiety was reported higher among the nurses and in females. A significant relationship was observed between fear and anxiety score and the different healthcare professionals with p value< 0.001 (Multilinear regression).Concerning the high occurrence of anxiety and fear among healthcare professionals appropriate psychological/psychiatric intervention necessitates and emphasizes the need to implement urgent measures.
Withaferin A: a potential therapeutic agent against COVID-19 infection
Authors: Straughn Alex R. , Kakar Sham S.
Published: June 2020

The outbreak and continued spread of the novel coronavirus disease 2019 (COVID-19) is a preeminent global health threat that has resulted in the infection of over 6 million people worldwide. In addition, the pandemic has claimed the lives of over 350,000 people worldwide. Age and the presence of underlying comorbid conditions have been found to be key determinants of patient mortality. One such comorbidity is the presence of an oncological malignancy, with cancer patients exhibiting an approximate two-fold increase in mortality rate. Due to a lack of data, no consensus has been reached about the best practices for the diagnosis and treatment of cancer patients. Interestingly, two independent research groups have discovered that Withaferin A (WFA), a steroidal lactone with anti-inflammatory and anti-tumorigenic properties, may bind to the viral spike (S-) protein of SARS-CoV-2. Further, preliminary data from our research group has demonstrated that WFA does not alter expression of ACE2 in the lungs of tumor-bearing female mice. Downregulation of ACE2 has recently been demonstrated to increase the severity of COVID-19. Therefore, WFA demonstrates real potential as a therapeutic agent to treat or prevent the spread of COVID-19 due to the reported interference in viral S-protein to host receptor binding and its lack of effect on ACE2 expression in the lungs.
Fairway Renovation with Fraise Mowing Cultivation and Dazomet Fumigation
Authors: Bearss Ryan C. , Rogers John N. , Crum James R. , Silcox Charles A.
Published: June 2020

Renovation is an opportune time for golf courses to address annual bluegrass (Poa annua L.) weed populations. Dazomet (tetrahydro-3,5-dimethyl-2H-1,3,5-thiadiazine-2-thione) is an effective fumigant, but without a tarp cover, it is only effective at the highest labeled rates. Fraise mowing cultivation could be used to help remove surface material and allow practitioners to effectively fumigate at lower rates. In Summer 2018 and Summer 2019, two cool-season fairway renovation experiments were conducted in East Lansing, MI. The objective of these experiments was to assess annual bluegrass control and creeping bentgrass establishment following dazomet applications to fraise mowed surfaces. In the first experiment (fraise mowing surface disturbance experiment), dazomet was applied at a fixed rate (294 kg·ha−1) to fraise mowed plots at varying levels of surface disturbance (0%, 15%, 50%, and 100%) to a depth of 1.9 cm. In the second experiment (dazomet rate experiment), fraise mowing removed 100% of surface material at a depth of 1.9 cm and dazomet was applied at five rates (0, 294, 588, 147 + 147, and 294 + 294 kg·ha−1). Both experiments were conducted on two soils (sand topdressed vs. native) and evaluated two methods of fumigant incorporation (solid-tine cultivation vs. tillage). Five days after treatments were applied, plots were seeded with ‘Pure Select’ creeping bentgrass (Agrostis stolonifera L.). The level of fraise mowing surface disturbance had no effect on annual bluegrass emergence, and creeping bentgrass cover was poorest in native soils at the highest levels of surface disturbance. In the dazomet rate experiment, dazomet applied twice at 294 kg·ha−1 provided the most consistent control of annual bluegrass. With the exception to single applications of 294 in 2018, all dazomet treatments allowed for greater creeping bentgrass establishment than the nontreated control. Fraise mowing cultivation may simplify the removal of surface material from large areas; however, even when combined with dazomet applied at the highest rates, it fails to provide complete annual bluegrass control.
Genetic Diversity and Population Structure of Chinese Corylus heterophylla and Corylus kweichowensis Using Simple Sequence Repeat Markers
Authors: Zhao Tiantian , Ma Wenxu , Ma Qinghua , Yang Zhen , Liang Lisong , Wang Guixi , Wang Lujun
Published: June 2020

Corylus heterophylla and Corylus kweichowensis are economically and ecologically important nut-producing woody shrubs that are distributed across northern and southern regions of China. However, few studies have examined the genetic diversity and genetic relationships between C. heterophylla and C. kweichowensis, and their taxonomic relationships have been questioned. In this study, 796 individuals collected from 34 natural populations (21 C. heterophylla and 13 C. kweichowensis populations) were investigated to assess the genetic diversity and population structure using 11 microsatellite loci. Analysis of molecular variance revealed that genetic differentiation of C. heterophylla and C. kweichowensis within populations accounted for 93.57% and 88.91% of total variation, respectively. The C. heterophylla and C. kweichowensis populations as a whole group were analyzed by multiple programs, which showed that the 34 populations were divided into two genetic clusters. One cluster included 21 C. heterophylla populations, and the second cluster contained 13 C. kweichowensis populations. We conclude from these results that C. heterophylla and C. kweichowensis are distinct species. The Mantel test showed that the genetic distance was significantly correlated with the geographic distance (r = 0.580, P < 0.001). The populations of C. heterophylla [e.g., populations WC (Weichang), MS (Mishan), and WA (Wu’an)] and C. kweichowensis [e.g., populations YX (Yuexi), ZP (Zhenping), LA (Lin’an), and TB (Taibai)] with high allelic richness are considered suitable for in situ conservation. Our study provides valuable information for breeding and conservation of genetic resources of C. heterophylla, C. kweichowensis, and related species.
Determinação de metanol em bebidas alcoólicas utilizando colorimetria por imagens digitais
Authors: Reis Josiane Amorim , Martins Valdomiro Lacerda , Lyra Wellington da Silva , Gomes Paulo Roberto Barros
Published: June 2020

Este trabalho propõe um método colorimétrico por imagens digitais para determinação de metanol em bebidas alcoólicas. O método é baseado na oxidação do metanol a formaldeído, seguido da reação com ácido cromotrópico produzindo um composto púrpura. Imagens digitais do produto de reação são capturadas usando um scanner e as estas são tratadas usando o programa ImageJ. As condições experimentais foram otimizadas e uma curva analítica, usando o índice colorimétrico de imagens digitais como resposta analítica, foi construída na faixa de 0,0100%-0,1000% v/v de metanol. Os limites de detecção e quantificação foram 1,95 x 10-³% e 6,50 x 10-³% v/v, respectivamente. A viabilidade do método é ilustrada na aplicação em amostras de cachaça e licor. Em comparação com a espectrometria ultravioleta-visível, os resultados não mostraram diferenças estatisticamente significativas mediante aplicação do teste-t emparelhado ao nível de confiança de 95%. Em comparação com outros métodos semelhantes, o proposto apresentou uma sensibilidade superior. Tal característica vantajosa é atribuída à natureza trivariada da detecção do scanner.
Participação social na coleta seletiva solidária: estudo de caso de uma instituição federal de ensino superior no Brasil
Authors: Freitas Tiago Guterres de , Kocourek Sheila , Oliveira Jairo da Luz , Campos Angelica Oliveira de
Published: June 2020

Considerando a necessidade de um destino ambientalmente adequado aos resíduos gerados pela própria atividade da administração pública e na busca da promoção da inclusão social dos catadores de materiais recicláveis, o Governo Federal publicou o Decreto n. 5.940, de 25 de outubro de 2006, instituindo a separação dos resíduos recicláveis descartados pelos órgãos e entidades da administração pública federal direta e indireta, na fonte geradora, e a sua destinação às associações e cooperativas de catadores de materiais recicláveis. Com isso, estabeleceu-se a coleta seletiva solidária na Administração Púbica Federal, criando a necessidade dos seus órgãos e entidades adequarem-se a essa realidade. Assim, as instituições federais de ensino superior (IFES) têm a responsabilidade de implementar esse modelo de coleta seletiva. Um dos aspectos fundamentais para garantir a sua consolidação da coleta seletiva solidária é a efetiva participação das fontes geradoras. Diante disso, este estudo trata da participação social na coleta seletiva solidária da Universidade Federal de Santa Maria (UFSM), norteando-se pelo seguinte problema "como contribuir com proposições para efetiva participação social na coleta seletiva solidária da UFSM?" A partir disso, objetivou-se analisar a participação social na coleta seletiva solidária da UFSM, tendo em vista contribuir com ações de gestão socioambiental na busca do efetivo envolvimento da comunidade acadêmica, por meio de ações de educação ambiental. Para tanto, foi realizada uma pesquisa survey, a partir de um estudo de caso, com caráter exploratório e uma abordagem quantitativa. O instrumento utilizado para obter os dados foi um questionário on line semiestruturado. Como resultados, foi percebido que a comunidade acadêmica compreende que suas ações são importantes para efetivação da coleta seletiva solidária e recomece o valor dessa ação para a gestão de resíduos recicláveis na UFSM. Além disso, manifesta preocupação em relação ao quantitativo de resíduos gerados, buscando reduzir o volume desses materiais. Foi possível também observar que a sustentabilidade ambiental com vistas à preservação do meio ambiente, a manutenção do campus limpo e a geração de emprego e renda para os recicladores são os aspectos mais relevantes para motivação da participação social na coleta seletiva solidária. Em contrapartida, identificou-se que o conhecimento insuficiente acerca da coleta seletiva solidária pela comunidade acadêmica e a presença de lacunas nas ações de divulgação e sensibilização são obstáculos para maior e mais efetiva participação social. Baseado nesses achados percebeu-se a necessidade e a relevância da promoção permanente de ações de educação ambiental fortalecendo a informação, sensibilização e mobilização objetivando contribuir para uma maior e mais efetiva participação social na coleta seletiva solidária da UFSM.
«YAMAL LNG» PROJECT IN THE СONTEXT ОF THE NORTHERN SEA ROUTE DEVELOPMENT
Authors: Popova E. A. , Sizova Yu. S. , Filatova A. A.
Published: June 2020

The research paper focuses on identifying the conditions in which Yamal LNG can effectively finance construction work through private investment. The Case study of the Yamal LNG liquefied natural gas production complex, the ratio of the shares of public and private investment in the project for the construction of the Utrenniy terminal is considered. The authors analyze possible ways of financing construction works: using Yamal LNG's own funds, Bank lending, and a loan from NOVATEK PJSC, as the main shareholder of the project. Calculations are made and the expediency of issuing and receiving a loan from PJSC «NOVATEK» for the construction of the terminal «Untrenniy» in the port of Sabetta is proved. Regression analysis confirms the possibility of repayment of the loan from the main Yamal LNG activities is proved. As a result of the study, methods of analysis of solvency, liquidity, autonomy, cash flow analysis, forecasting and generalization methods are used. This analysis allows to take into account the scale of activity of one of the largest operators for the supply of liquefied natural gas in Russia.
INTERNATIONAL STANDARDS IMPACT ON THE REGULATION OF NATIONAL TAXI AGGREGATOR MARKETS
Authors: Girich M. G. , Saule A.
Published: June 2020

The development of the sharing economy has affected the change in the passenger transportation market, as online platforms for taxi services have appeared. For example, Uber Technologies plays a significant role in the market, which in 2017 won first place in the top 10 startups of the sharing economy. Currently, there are many problems that arise with the regulation of online taxi platforms. The Organization for Economic Co-operation and Development, together with the International Transport Forum, is conducting a study of the law enforcement practices of countries regarding the regulation of online taxi platforms (or taxi aggregators), in particular, the problems of deploying the online platform for the transport of passengers and baggage by passenger taxi as a regular online platform or as a transport provider, and licensing problems for such online platforms, problems of control over obtaining permission directly by the driver, problems of vehicle safety of control over the drivers, ensure quality of service, traffic security problems and etc.
La etnografía en los conflictos ambientales y las fronteras de la antropología
Authors: Casillas Báez Miguel Ángel , Peña de Paz Francisco Javier
Published: June 2020

Nuestro objetivo es reflexionar acerca de las fronteras epistemológicas de la antropología en el contexto ético de los etnógrafos cuando estudian un conflicto medioambiental. Revisamos las posiciones en Temacapulín, Jalisco (México), comunidad en resistencia por la construcción de la presa El Zapotillo, mediante un trabajo etnográfico longitudinal (desde 2005 hasta 2018) que descubre detalles de una “megaobra” culmen del neoliberalismo, puntilla de la política hidráulica de Estado mexicano y sostén de un modelo de gestión que transfiere inversión pública al utilitarismo privado. La comunidad en conflicto ambiental es escenario múltiple para los etnógrafos según sean las implicaciones académicas, institucionales y personales, porque suscita posturas críticas de la dirección económica de las políticas públicas. Dadas las características de los conflictos medioambientales, esta reflexión versa sobre las fronteras de la antropología según la posición ética de los etnógrafos que estudian resistencias frente a proyectos hidráulicos, que unos denuncian, otros interrogan, pero otros más sostienen jurídicamente.
A Cardiovascular Health and Wellness Mobile Health Intervention Among Church-Going African Americans: Formative Evaluation of the FAITH! App (Preprint)
Authors: Brewer LaPrincess C , Kumbamu Ashok , Smith Christina , Jenkins Sarah , Jones Clarence , Hayes Sharonne N , Burke Lora , Cooper Lisa A , Patten Christi A
Published: June 2020

BACKGROUND

In light of the scarcity of culturally tailored mobile health (mHealth) lifestyle interventions for African Americans, we designed and pilot tested the Fostering African-American Improvement in Total Health (FAITH!) App in a community-based participatory research partnership with African American churches to promote cardiovascular health and wellness in this population.

OBJECTIVE

This report presents the results of a formative evaluation of the FAITH! App from participants in an intervention pilot study.

METHODS

We included 2 semistructured focus groups (n=4 and n=5) to explore participants’ views on app functionality, utility, and satisfaction as well as its impact on healthy lifestyle change. Sessions were audio-recorded and transcribed verbatim, and qualitative data were analyzed by using general inductive analysis to generate themes.

RESULTS

In total, 6 overarching themes emerged among the 9 participants: overall impression, content usefulness, formatting, implementation, impact, and suggestions for improvement. Underpinning the themes was a high level of agreement that the intervention facilitated healthy behavioral change through cultural tailoring, multimedia education modules, and social networking. Suggestions for improvement were streamlining the app self-monitoring features, prompts to encourage app use, and personalization based on individuals’ cardiovascular risk.

CONCLUSIONS

This formative evaluation found that the FAITH! App had high reported satisfaction and impact on the health-promoting behaviors of African Americans, thereby improving their overall cardiovascular health. Further development and testing of the app among African Americans is warranted.

CLINICALTRIAL

ClinicalTrials.gov NCT03084822; https://clinicaltrials.gov/ct2/show/NCT03084822.
Patient Factors Associated with Interest in Teledermatology: Cross-sectional Survey (Preprint)
Authors: Ghani Maham , Adler Colin , Yeung Howa
Published: June 2020

BACKGROUND

Teledermatology is a conduit for patients communicating with dermatologists on the internet, which bypasses in-person visits. It holds promise to address access needs for dermatologic care; however, the interest in using teledermatology is unknown in underserved populations with potential barriers to the use of health care technology.

OBJECTIVE

This study aimed to characterize the association between demographic characteristics with interest in exchanging digital images or videos of skin lesions with health care providers electronically.

METHODS

We examined data from the Health Information National Trends Survey (HINTS) 4 cycle 4 (2014) of the National Cancer Institute. HINTS is a cross-sectional, nationally representative household survey conducted annually, which collects information on demographics, perceptions and use of health information, and provides information on how cancer risks are perceived. HINTS 4 cycle 4 had a sample of 3677 participants. We examined the outcome to the question, “how interested are you in exchanging digital images or videos (eg, photos of skin lesions) with a health care provider electronically?” We dichotomized the outcome by a high level of interest (responding with “very”) and those who did not have a high level of interest (responding with “somewhat,” “a little,” or “not at all”) in exchanging images or videos. We used a multivariable logistic regression model developed through backwards selection, with all final covariates associated with varying levels of teledermatology use at P<.05. Sensitivity analysis was performed by changing the outcome dichotomy to model those who were “not at all” interested. Two-sided tests were performed with P<.05 considered significant.

RESULTS

Among 3447 respondents, 888 (weighted prevalence=26.2%) were “very” interested in participating in teledermatology. A higher interest in using teledermatology was associated with a younger age, higher educational attainment, higher household income, internet usage, type of mobile device ownership, history of electronic medical information exchange with a clinician within the past 12 months, and high level of trust in web-based information on cancer (for all, P<.01), but not with the female gender, race or ethnicity, health insurance status, or having a regular medical provider.

CONCLUSIONS

Modifiable access barriers to teledermatology adoption include trust, experience with teledermatology, and use of health apps. Teledermatology program implementation should address these specific factors within the digital divide to promote equitable access to care across diverse patient populations.
Effectiveness of Mobile Apps to Promote Health and Manage Disease: Systematic Review and Meta-analysis of Randomized Controlled Trials (Preprint)
Authors: Iribarren Sarah J , Akande Tokunbo O , Kamp Kendra J , Barry Dwight , Kader Yazan G , Suelzer Elizabeth
Published: June 2020

BACKGROUND

Interventions aimed at modifying behavior for promoting health and disease management are traditionally resource intensive and difficult to scale. Mobile health apps are being used for these purposes; however, their effects on health outcomes have been mixed.

OBJECTIVE

This study aims to summarize the evidence of rigorously evaluated health-related apps on health outcomes and explore the effects of features present in studies that reported a statistically significant difference in health outcomes.

METHODS

A literature search was conducted in 7 databases (MEDLINE, Scopus, PsycINFO, CINAHL, Global Index Medicus, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews). A total of 5 reviewers independently screened and extracted the study characteristics. We used a random-effects model to calculate the pooled effect size estimates for meta-analysis. Sensitivity analysis was conducted based on follow-up time, stand-alone app interventions, level of personalization, and pilot studies. Logistic regression was used to examine the structure of app features.

RESULTS

From the database searches, 8230 records were initially identified. Of these, 172 met the inclusion criteria. Studies were predominantly conducted in high-income countries (164/172, 94.3%). The majority had follow-up periods of 6 months or less (143/172, 83.1%). Over half of the interventions were delivered by a stand-alone app (106/172, 61.6%). Static/one-size-fits-all (97/172, 56.4%) was the most common level of personalization. Intervention frequency was daily or more frequent for the majority of the studies (123/172, 71.5%). A total of 156 studies involving 21,422 participants reported continuous health outcome data. The use of an app to modify behavior (either as a stand-alone or as part of a larger intervention) confers a slight/weak advantage over standard care in health interventions (standardized mean difference=0.38 [95% CI 0.31-0.45]; I2=80%), although heterogeneity was high.

CONCLUSIONS

The evidence in the literature demonstrates a steady increase in the rigorous evaluation of apps aimed at modifying behavior to promote health and manage disease. Although the literature is growing, the evidence that apps can improve health outcomes is weak. This finding may reflect the need for improved methodological and evaluative approaches to the development and assessment of health care improvement apps.

CLINICALTRIAL

PROSPERO International Prospective Register of Systematic Reviews CRD42018106868; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=106868
Health Care Professionals’ Experiences of Patient-Professional Communication Over Patient Portals: Systematic Review of Qualitative Studies (Preprint)
Authors: Laukka Elina , Huhtakangas Moona , Heponiemi Tarja , Kujala Sari , Kaihlanen Anu-Marja , Gluschkoff Kia , Kanste Outi
Published: June 2020

BACKGROUND

The popularity of web-based patient-professional communication over patient portals is constantly increasing. Good patient-professional communication is a prerequisite for high-quality care and patient centeredness. Understanding health care professionals’ experiences of web-based patient-professional communication is important as they play a key role in engaging patients to use portals. More information is needed on how patient-professional communication could be supported by patient portals in health care.

OBJECTIVE

This systematic review of qualitative studies aims to identify how health care professionals experience web-based patient-professional communication over the patient portals.

METHODS

Abstract and full-text reviews were conducted by 2 reviewers independently. A total of 4 databases were used for the study: CINAHL (EBSCO), ProQuest (ABI/INFORM), Scopus, and PubMed. The inclusion criteria for the reviewed studies were as follows: the examination of health care professionals’ experiences, reciprocal communication between patients and health care professionals, peer-reviewed scientific articles, and studies published between 2010 and 2019. The Joanna Briggs Institute’s quality assessment criteria were used in the review process. A total of 13 included studies were analyzed using a thematic synthesis, which was conducted by 3 reviewers.

RESULTS

A total of 6 analytical themes concerning health care professionals’ experiences of web-based patient-professional communication were identified. The themes were related to health care professionals’ work, change in communication over patient portals, patients’ use of patient portals, the suitability of patient portals for communication, the convenience of patient portals for communication, and change in roles.

CONCLUSIONS

Health care professionals’ experiences contain both positive and negative insights into web-based patient-professional communication over patient portals. Most commonly, the positive experiences seem to be related to the patients and patient outcomes, such as having better patient engagement. Health care professionals also have negative experiences, for example, web-based patient-professional communication sometimes has deficiencies and has a negative impact on their workload. These negative experiences may be explained by the poor functionality of the patient portals and insufficient training and resources. To reduce health care professionals’ negative experiences of web-based patient-professional communication, their experiences should be taken into account by policy makers, health care organizations, and information technology enterprises when developing patient portals. In addition, more training regarding web-based patient-professional communication and patient portals should be provided to health care professionals.
The Role of Enjoyment in a Serious Game for Binge Drinking Prevention: Pretest-Posttest Quasi-Experimental Study (Preprint)
Authors: Hong Traci , Cabrera Joshua , Beaudoin Christopher E
Published: June 2020

BACKGROUND

Although binge drinking peaks at age 21 to 25 years, there is limited research on the effects of serious games in this population, as well as on the process by which playing serious games impacts alcohol-related outcomes. Designed with both health behavioral theory and game theory, One Shot is an online serious game that aims to prevent binge drinking.

OBJECTIVE

This study utilized a conceptual model for serious video game processes. Using One Shot, the model assessed the following process stages: (1) Alcohol Use Disorders Identification Test-Concise (AUDIT-C); (2) in-game factors of game time and risky alcohol decisions; (3) game enjoyment; and (4) postgame outcomes of intention to drink less and drinking refusal self-efficacy.

METHODS

In a one-group pretest-posttest quasi-experimental design, a sample (N=550) of young adults (age 21-25 years) who reported recent binge drinking played the One Shot game. Intention to drink less and drinking refusal self-efficacy were measured at pregame and postgame, with their effects lagged in statistical analysis. Participants were presented with various scenarios in the game that pertained to risky alcohol decisions, which, along with game time, were unobtrusively recorded by the server. A structural equation model (SEM) was used to test the conceptual model, with assessments made to determine if enjoyment mediated the effects of game time and risky alcohol decisions on the 2 postgame alcohol-related outcomes.

RESULTS

A well-fitting SEM demonstrated support for the multistep model, with AUDIT-C predicting risky alcohol decisions (β=.30). Risky alcohol decisions (β=−.22) and game time (β=.18) predicted enjoyment, which, in turn, predicted intention to drink less (β=.21) and drinking refusal self-efficacy (β=.16). Enjoyment significantly (P<.001) mediated the effects of game time and risky alcohol decision on intention to drink less and drinking refusal self-efficacy.

CONCLUSIONS

The results support a conceptual model in which staggered individual and in-game factors influence alcohol-related outcomes. Enjoyment is important for participants’ intentions to drink less and beliefs that they can refuse alcohol.
An Integrated Blueprint for Digital Mental Health Services Amidst COVID-19 (Preprint)
Authors: Balcombe Luke , De Leo Diego
Published: June 2020

UNSTRUCTURED

In-person traditional approaches to mental health care services are facing difficulties amidst the coronavirus disease (COVID-19) crisis. The recent implementation of social distancing has redirected attention to nontraditional mental health care delivery to overcome hindrances to essential services. Telehealth has been established for several decades but has only been able to play a small role in health service delivery. Mobile and teledigital health solutions for mental health are well poised to respond to the upsurge in COVID-19 cases. Screening and tracking with real-time automation and machine learning are useful for both assisting psychological first-aid resources and targeting interventions. However, rigorous evaluation of these new opportunities is needed in terms of quality of interventions, effectiveness, and confidentiality. Service delivery could be broadened to include trained, unlicensed professionals, who may help health care services in delivering evidence-based strategies. Digital mental health services emerged during the pandemic as complementary ways of assisting community members with stress and transitioning to new ways of living and working. As part of a hybrid model of care, technologies (mobile and online platforms) require consolidated and consistent guidelines as well as consensus, expert, and position statements on the screening and tracking (with real-time automation and machine learning) of mental health in general populations as well as considerations and initiatives for underserved and vulnerable subpopulations.
Breast Engorgement among Women with Caesarean Section: Impact of Nursing Intervention
Authors: Hassan Hanan Elzeblawy , EL-Kholy Galal Ahmed , Ateya Aziza Ahmed , Hassan Amal Ahmed
Published: June 2020

Background: Breast engorgement is defined as enlarged & filling of breast with milk. It is one of the most significant problems confronting nursing women, especially primiparous, in the first week of motherhood. The aim of the study was to investigate the impact of nursing intervention on relieve of breast engorgement among women with caesarean section. Design and setting an interventional study was conducted in postnatal unit of Beni-Suef University hospital. Sample was simple random sample comprised a total of 90 Primiparae’s cesarean section mothers; 45 in the interventional group & 45 in the control group. Tools of Data Collection were interview questionnaire sheet, knowledge assessment sheet and observational & Engorgement assessment scale. The study revealed that, the nursing intervention was more effective and contributed rapid recovery from breast engorgement especially among the older, educated, housewives, high social class's women and those who were rural dwellers. The study recommended that Prevention is a key element in reducing breast engorgement potentially among nursing mothers. So, primiparous mothers should learn about preventive measures for breast engorgement. Teaching mother how to express both breasts simultaneously to yield the most volume and to decrease time spend pumping each consecutively is the responsibility of health care providers.
Educational Environment and Mental Health of Moroccan Medical Students: A Study in the Faculty of Medicine of Marrakech
Authors: Benali Abdeslam , Chichou Hajar
Published: June 2020

Introduction: Studies concur that an optimal learning environment is a vital aspect for effective learning and for enhancing students’ well-being. Conversely, medical training is reported to be a suboptimal environment, thereby compromising students’ learning and well-being.Purpose: To evaluate the relationship between students’ perceptions of the educational environment and their mental health.Methods: This was a cross-sectional descriptive and analytical study, using the GHQ-12 and the DREEM questionnaires, with 380 students from the Faculty of Medicine and Pharmacy of Marrakech (3rd, 4th, 5th, 6th, 7th and 8th year), during the academic year 2017-2018. Results: We recruited 358 students in a period of 2 weeks, achieving a response rate of 94.2%. There was a predominance of females (66.48%). The mean age was 22.20 ± 2.149 years. The average GHQ score was 6.37 ± 3.484, with a psychological distress rate of 66.76%. The mean total score of DREEM was 86.5 ± 29.194 which indicates the existence of several significant problems. There was a statistically significant association between the poor perception of the educational environment and psychological distress.Conclusion: Improving the educational environment and promoting deep learning approaches for medical students will improve their psychological health during medical training.
Effects of Enhancement and Modified Atmosphere Packaging on Flavor and Tenderness of Dark-Cutting Beef
Authors: Denzer Morgan L. , Cassens Andrew M. , Wills Kendra M. , Pfeiffer Morgan M. , Mafi Gretchen G. , VanOverbeke Deborah L. , Ramanathan Ranjith
Published: June 2020

The objective of this study was to evaluate the effects of rosemary/beef flavor enhancement and modified atmosphere packaging (MAP) on retail display color and palatability of beef longissimus lumborum muscle. Dark-cutting beef strip loins (n = 8; pH > 6.0) and USDA Low Choice beef strip loins (n = 5) were selected from a commercial packing plant within 72 h of harvest. Dark-cutting strip loins were divided into 2 equal sections and randomly assigned to either nonenhanced or rosemary/beef flavor–enhanced treatments. Dark-cutting enhanced loins were injected to 110% of their green weight with a rosemary/beef flavor enhancement to attain 0.1% rosemary, 0.5% salt, and 0.55% beef flavor in the final product. Six 2.54-cm-thick steaks were cut from nonenhanced USDA Choice, nonenhanced dark-cutting, and enhanced dark-cutting strip loins and randomly assigned to one of 3 packaging treatments: vacuum packaging, carbon monoxide MAP (0.4% CO, 69.6% N, and 30% CO2), and high-oxygen MAP (80% O2 and 20% CO2). Following 3-d retail display, instrumental color measurements were recorded, and one steak from each packaging type was evaluated by a trained sensory taste panel and another used to measure Warner-Bratzler shear force. Enhanced dark-cutting steaks packaged in high-oxygen MAP and carbon monoxide MAP had greater a* values (P < 0.0001) than dark-cutting steaks in vacuum packaging. Enhanced dark-cutting steaks were lighter (P < 0.0001, greater L* values) than nonenhanced dark-cutting steaks. Nonenhanced dark-cutting steaks exhibited a lower (P = 0.03) overall juiciness compared to enhanced dark-cutting steaks. Enhanced and nonenhanced dark-cutting steaks were more tender (P = 0.002) than the USDA Choice steaks. Enhanced dark-cutting steaks had higher (P = 0.006) sour flavor in vacuum packaging than other packaging types. The results suggest that rosemary/beef flavor enhancement has the potential to improve the surface color of dark-cutting beef while improving or maintaining palatability.
El modelo “clase invertida” en química analítica
Authors: Balverdi Cecilia Viviana , Balverdi María del Pilar , Marchisio Patricia Fátima , Sales Adriana María
Published: June 2020

En la actualidad se trata de trasladar el eje central del acto pedagógico del docente hacia el alumno, transformándolo así en responsable activo de la adquisición del conocimiento. Es por ello que se implementó el modelo de clase invertida en la enseñanza de un tema fundamental en el área de la química analítica instrumental con el fin de mejorar el proceso de enseñanza - aprendizaje del mismo. Se trabajó con un grupo de 15 alumnos de la Licenciatura en Química de la Universidad Nacional de Tucumán, Argentina. Se escogió el tema de espectrometría de absorción atómica para la aplicación del modelo aula invertida. La experiencia se evaluó  mediante dos herramientas. La primera fue la elaboración de un informe final global del tema que los estudiantes presentaron en forma individual y en el que se abarcaron contenidos teóricos y prácticos. La otra fue la realización de una encuesta de opinión a los alumnos en la que se indagó sobre su percepción respecto a la metodología de trabajo y los resultados alcanzados por ellos. Desde el punto de vista de los docentes involucrados, la experiencia fue muy positiva en cuanto a la adquisición de los conocimientos y sobre todo en el desarrollo de la práctica.
Rethinking Gender and Health
Authors: Hasan Md Kamrul , Aggleton Peter
Published: June 2020

Help-seeking and health-seeking are social practices influenced by ethnicity, class, race, age, and gender, among other factors. Globally, research suggests that ideas about masculinity influence men’s health-seeking practices. However, only a modest body of literature has considered masculinity in relation to men’s health problems in South Asia. To address this research gap, a qualitative study was conducted to gather the narratives of three distinct social generations of men in Bangladesh concerning the understandings of gender and masculinity, and men’s help-seeking and health-seeking practices. Drawing on evidence from men’s accounts, we suggest some of the ways in which specific forms of social generational masculinity influence men’s help-seeking and sexual health-seeking practices. Findings carry implications for future health policy and health promotion practices. Generational masculinities and generation-specific health-seeking practices need to be taken into account in health policy and practice.